Mental health preparation before major surgery could improve recovery for older patients, according to a new study published in JAMA Network Open.

Researchers found that addressing anxiety, depression and medication use before surgery led to greater improvements in mental health three months after an operation than providing patients with educational materials alone.

“The stress of surgery can worsen anxiety and depression symptoms and affect patients’ recovery and overall health,” said Joanna Abraham, the study’s first author.

The researchers argue that preparation for major surgery should address both physical and psychological health. They said mental health support from trained professionals is often absent from standard care provided before and around surgery.

“We recognize the importance of getting the body into shape before surgery, but preparing the mind and the brain is just as important,” said senior author Eric J. Lenze.

The study involved 306 adults aged 60 and older who were scheduled to undergo cardiac, cancer-related or orthopaedic surgery. Participants were divided into two groups to assess whether additional mental health and medication support could improve outcomes.

One group received self-help educational materials that they could review independently. The other group took part in between eight and 12 telephone sessions with trained mental health professionals, including social workers and mental health counsellors.

Patients in the second group also received personalised medication reviews from pharmacists and doctors. The reviews focused on safely adjusting or reducing the use of high-risk medicines where appropriate.

Three months after surgery, patients who received the additional support experienced a reduction in depression and anxiety symptoms that was 2.2 to 2.5 points greater than the control group on a 48-point scale.

The strongest improvement was recorded among older adults undergoing cancer surgery. Their scores were nearly five points lower than those of patients who received educational materials alone.

Participants also reported positive experiences with the programme. Researchers said patients and healthcare providers found the additional support manageable and straightforward to fit into existing surgical care.

Michael S. Avidan, one of the study’s authors, said healthcare should take a broader approach by bringing anesthesiology and psychiatry together to treat patients as a whole.

Abraham said the findings suggest proactive mental health support does not necessarily require major changes to hospital systems.

“What makes this care model so promising is that it’s practical to deliver,” she said. “Patients and healthcare providers found the program manageable and easy to integrate into existing surgical workflows.”

The researchers said the findings support greater attention to psychological wellbeing as part of preparation for major operations, particularly among older adults facing complex procedures.

DNA recovered from medieval manuscripts has given scientists new clues about the long history of sheep pox, a highly contagious disease that has threatened livestock for thousands of years.

An international team led by researchers at University College Dublin discovered traces of sheep pox virus in parchment used for some of Europe’s historic manuscripts. The findings suggest that animal diseases may have left genetic records in old documents, providing scientists with another way to study how pathogens developed over time.

During the Middle Ages, parchment was commonly made from the treated skin of sheep, goats and cattle. Researchers extracted DNA from the animal skins used to produce centuries-old manuscripts and identified genetic material linked to the sheep pox virus.

The study involved geneticists, historians, virologists, protein chemists and conservation specialists. Louis L’Hôte, the study’s lead author, said the research showed that parchment could preserve DNA from animal pathogens and provide valuable evidence about infectious diseases in the past.

Among the manuscripts examined was the approximately 1,000-year-old York Gospels, considered one of the finest surviving illuminated manuscripts from the late Anglo-Saxon period. Researchers also examined the Corpus Glossary at Corpus Christi College in Cambridge, an early English dictionary, along with other medieval texts from Britain and continental Europe.

In some manuscripts, several pages contained sheep pox virus DNA. Researchers said this could indicate that animals infected with the disease were used to produce the parchment.

The team compared the genetic material recovered from the manuscripts with older DNA samples obtained from Bronze Age sheep teeth. Their analysis indicated that sheep pox has affected livestock for more than 3,700 years.

Sheep pox spreads quickly among animals and can infect a large proportion of a flock. The disease causes fever and skin lesions and can result in death. Outbreaks can also cause major financial losses through reduced milk production, damage to wool and hides, and restrictions on livestock trade.

There is no evidence that sheep pox infects humans.

The research, published in Science Advances, also provided insight into how the virus changed over time. Scientists found that the sheep pox virus genome remained relatively stable during the past several thousand years.

L’Hôte said the finding contrasts with the evolutionary history of some other pathogens, including smallpox. The stability of the sheep pox genome may indicate that important genetic changes occurred much earlier in the virus’s history and helped it adapt to sheep.

Researchers said the work could encourage scientists to examine other archives and libraries for genetic traces of historic animal diseases. Ancient DNA preserved in manuscripts could offer a new source of information about outbreaks that affected livestock and societies long before modern disease surveillance existed.