In The News
New mechanisms have been uncovered in the development of an aggressive form of dementia called frontotemporal dementia. This is the third most common form of early-onset dementia, often beginning in the patient’s 50s.
“Frontotemporal” refers to the two lobes of the brain that become damaged in this type of dementia. The frontal lobes of the brain, behind the forehead, control behavior, emotions, and language. The temporal lobes, on either side of the brain, control our understanding of words.
Frontotemporal dementia is caused when nerve cells in one or any of these lobes of the brain die, and changes occur in their connecting pathways. Brain tissue in the frontal and temporal lobes shrinks over time.
This causes language abilities to be affected, and personality and behavior change, so the patient may be become excessively uninhibited in social situations.
In contrast with Alzheimer’s disease, individuals with early-stage frontotemporal dementia tend not to have problems with day-to-day memory or with visual skills such as judging distances between objects.
A team led by Dr. Sean Sweeney of York University, U.K., collaborated with researchers at the University of Massachusetts Medical School and University of Puerto Rico. Together, they looked at how the connections between synapses can be affected by changes in a protein named CHMP2B, a subunit of cell machinery called endosomal sorting complexes required for transport (ESCRT).
In lab tests on the effects of CHMP2B on Drosophila, a species of fruit fly, they discovered mechanisms that caused synapses to overgrow.
The signals involved were previously known to affect immune reactions, but have not before been seen to impact synapse growth. Altered endosome function was also seen. This means that material within cells is not broken down correctly.
“These findings shed light on the events occurring in neurons as dementia takes hold,” said Dr. Sweeney. “The more we know about the steps that occur in disease progression, the more opportunities we have to intervene with potential therapies.”
The research was published in The Journal of Cell Biology. This data points to defective endosome function as creating defective “synaptic growth regulation during neurodegenerative processes,” they report.
Co-author Dr. Ryan West said, “We hope that this work helps to tease apart complex molecular processes occurring in neurons and identify how these can go wrong in neurodegenerative diseases, such as frontotemporal dementia.”
The team hopes the novel steps in disease progression identified here could be targeted by drugs to halt cognitive decline.
Commenting on the work, Dr. Clare Walton of the Alzheimer’s Society said, “We know less about the underlying causes of frontotemporal dementia than some other kinds of dementia so research like this is a vital step towards developing treatments for the condition. Further research will be needed to determine whether this mechanism plays a similar role in humans.”
In an editorial about the study, Dr. Ben Short of Rockefeller University, New York, N.Y., states that synaptic growth is stimulated by defects in endosomal function, resulting in neurodegeneration.
“Mutations in the gene encoding the ESCRT-III subunit CHMP2B have been linked to frontotemporal dementia,” he writes. “Additionally, a protein called POSH accumulates on endosomes. Removing POSH from Drosophila flies restored synaptic growth to normal levels.”
The findings were confirmed in studies on mammals, where POSH accumulation in neurons led to synaptic overgrowth. “The same pathways could also promote neurodegeneration,” he concludes.
A further protein which may influence the development of frontotemporal dementia was also identified. Called RAB8, it plays a role in regulating the movement of material along cell membranes.
Fruit flies lacking the RAB8 protein were used to explore the role of RAB8 deficiency. As predicted, it led to an overgrowth of the connections between neurons. Hence, it is now thought that RAB8 is involved in regulating the growth of neurons which are damaged in frontotemporal dementia, and that treatment to increase RAB8 may slow this type of neurodegeneration.
Sweeney now aims to identify additional genes involved in the process, again using their fruit fly models of frontotemporal dementia.
Genes are believed to be very important in frontotemporal dementia as it runs in families more often than other forms of dementia.
About one-third of patients have some family history of dementia, and about 10 percent to 15 percent have a strong family history of it, with several close relatives in different generations affected.
The children or siblings of someone with one of the mutations known to cause frontotemporal dementia have a 50 percent risk of carrying the same defective gene and may benefit from a specialist gene testing service.
Ryan, J.H. et al. Rab8, POSH, and TAK1 regulate synaptic growth in a Drosophila model of frontotemporal dementia. Journal of Cell Biology, 23 March 2015 doi: 10.1083/jcb.201404066
A new multi-year study of detained youth finds that most psychiatric disorders, including depression, do not predict future violent behavior.
Northwestern Medicine researchers believe the findings are especially timely given recent current events.
“Our findings are relevant to the recent tragic plane crash in the French Alps. Our findings show that no one could have predicted that the pilot, who apparently suffered from depression, would perpetrate this violent act,” said corresponding author Linda Teplin, Ph.D.
“It is not merely a suicide, but an act of mass homicide.”
An exception to the findings are that a history of substance abuse and dependence may be linked to increased incidence of violent behavior. Also, some delinquent youth with current psychiatric illness may be violent.
In this case, investigators describe a situation in which males with mania were more than twice as likely to report current violence than those without. However, the association did not necessarily suggest a cause and effect relationship.
Researchers discovered delinquent youth with psychiatric illness often have multiple risk factors such as living in violent and impoverished neighborhoods. These environments may increase their risk for violent behavior as well as worsen their psychiatric illness.
“Providing comprehensive treatment to persons with some psychiatric disorders could reduce violence,” said Katherine Elkington, Ph.D., study first author and an assistant professor of clinical psychology in psychiatry at Columbia University Medical School.
“We must improve how we address multiple problems, including violent behavior, as part of psychiatric treatment.”
The article was recently published in the Journal of the American Academy of Child & Adolescent Psychiatry.
The study used data from the Northwestern Juvenile Project, a longitudinal study of youth who were detained at the Cook County Juvenile Temporary Detention Center in Chicago between 1995 and 1998.
Violence and psychiatric disorders were assessed via self-report in 1,659 youth aged 13 to 25 years interviewed up to four times between three and five years after detention.
Emerging research suggests about one in 14 toddlers diagnosed with autism spectrum disorder (ASD) will improve and no longer meet the diagnostic criteria in elementary school.
However, investigators determined most will continue to have emotional/behavior symptoms and required special education supports.
The study was presented at the Pediatric Academic Societies (PAS) annual meeting in San Diego.
Previous studies have also shown that ASD symptoms resolve in some children over time. It is not clear, however, if these children continue to have cognitive, behavioral or learning deficits.
Researchers, led by developmental pediatrician Lisa Shulman, M.D., reviewed data on 38 children diagnosed with ASD in 2003-2013 whose symptoms had resolved when they were re-evaluated about four years later.
The children were among 569 children living in the Bronx who had been diagnosed with ASD by a multidisciplinary team at a university-affiliated early intervention program.
The children came from racially, ethnically and socioeconomically diverse backgrounds, a population generally underrepresented in autism studies. Forty-four percent were Hispanic, 36 percent were Caucasian, 10 percent were African-American, and 46 percent were on Medicaid.
Clinicians who made the original diagnosis also provided interventions and monitored response to treatment. Over time, they noted that ASD symptoms in some children resolved, but most continued to have other learning and emotional/behavioral symptoms needing attention.
“Autism generally has been considered a lifelong condition, but seven percent of children in this study who received an early diagnosis experienced a resolution of autistic symptoms over time,” said Shulman, director of Infant and Toddler Services at the Albert Einstein College of Medicine/Children’s Hospital in New York.
“The majority of the children at original diagnosis displayed intellectual disability but at the point of resolution of autistic symptomatology displayed normal cognition,” Shulman added.
Although the social impairment of autism resolved and cognitive functioning (IQ) improved, researchers found that 92 percent of the children had residual learning and/or emotional/behavioral impairment. Only three of the 38 children had no diagnosis.
Language/learning disability was found in 68 percent, and nearly half had externalizing problems such as attention-deficit hyperactivity disorder or disruptive behaviors.
In addition, 24 percent had internalizing problems such anxiety, obsessive-compulsive disorder or selective mutism. Finally, nearly three-quarters of the children continued to require academic supports, such as a small class setting or a resource room.
“When an early ASD diagnosis resolves, there are often other learning and emotional/behavioral diagnoses that remain,” said Shulman.
“Understanding the full range of possible positive outcomes in this scenario is important information for parents, clinicians and the educational system.”
Source: American Academy of Pediatrics
A new study finds that text messaging that connects teens with sexual health educators is effective for delivering sexual health information.
Investigators from Washington State University discovered the format is especially beneficial for teens at high risk.
“What we found is that teens identified as ‘at-risk’ use this text messaging service at a higher rate that other teens,” said Jessica Willoughby, Ph.D., lead investigator on the project.
“This is a critical first step in helping prevent negative sexual outcomes such as sexually transmitted disease and unwanted pregnancy.”
The study is currently found online and will be published in print in a forthcoming issue of the journal Health Education and Behavior.
Investigators looked at more than 2,000 students in six public schools where a statewide text message service that connects teens to sexual health educators was promoted.
Teens identified as “at-risk” — more likely to have had sex, to have been in a relationship and to have come from a lower socioeconomic background — were more likely to use the service.
Thus, the sexual health text message services were reaching the teens who may be most likely to benefit.
“With these new tools being provided as a possible option for sexual health information, we felt it was critical to examine how well they are working and for whom they are useful,” Willoughby said.
“What we can now say is that text messaging services that allow teens to reach out to a health educator can be an effective option to get critical information into the hands of teens that may need it most,” she said.
Source: Washington State University
Kindergartners who watch just one hour of TV a day are at greater risk for becoming overweight or obese compared to those who watch TV for less than 60 minutes a day, according to new research at the Pediatric Academic Societies (PAS) annual meeting in San Diego.
Earlier studies have shown that children who watch a lot of TV are more likely to be overweight. This study, however, is one of the first to look specifically at the link between TV watching and obesity among kindergartners.
For the study, researchers observed data from the Early Childhood Longitudinal Survey, which consisted of 11,113 kindergartners during the 2011-2012 school year.
Parents reported on particular lifestyle factors that could affect a child’s educational performance, including the number of hours of television children watched on weekdays and weekends, and how often they used computers. The children’s weight and height were measured as well.
One year later, 10,853 of the children’s height and weight were re-measured, and parents were asked again about their child’s TV habits.
The findings revealed that U.S. kindergartners watched an average of 3.3 hours of TV a day. Both kindergartners and first-graders who watched one to two hours or more than two hours daily had much higher body mass indexes than those who watched less than 30 minutes or 30-60 minutes a day, even after adjusting for socioeconomic status, race/ethnicity, and computer use.
Children who watched as little as one hour of TV daily were 50-60 percent more likely to be overweight and 58 percent to 73 percent more likely to be obese compared to those who watched TV for less than an hour. Computer use, however, was not associated with higher weight.
Even more so, children who watched one hour or more of TV daily were 39 percent more likely to become overweight and 86 percent more likely to become obese between kindergarten and first grade.
“Given overwhelming evidence connecting the amount of time TV viewing and unhealthy weight, pediatricians and parents should attempt to restrict childhood TV viewing,” said study author Mark D. DeBoer, M.D., M.Sc., M.C.R., associate professor of pediatrics, Division of Pediatric Endocrinology, University of Virginia.
The American Academy of Pediatrics (AAP) recommends limiting children and teens to less than two hours of screen time each day. DeBoer, however, suggests even less TV time.
“Given the data presented in this study, the AAP may wish to lower its recommended TV viewing allowances,” he said.
Source: American Academy of Pediatrics
Technological advances have led to the unprecedented use of mobile devices, even among young children.
Although smartphones and tablets have become part of everyday life, many parents worry that this may not be best thing for their children.
Even experts are uncertain as to the effect of early mobile use as the rapid advancement in use of technology has surpassed scientific inquiry on the benefits or dangers of mobile device use on family life.
In a study presented at the Pediatric Academic Societies’ (PAS) annual meeting, researchers conducted in-depth interviews with 35 parents/guardians to learn their views regarding mobile device use by themselves and their children.
Parents/guardians were asked to comment on what they believe are the benefits and drawbacks of mobile devices and how they believe their use affects family interactions.
Researchers interviewed caregivers of children younger than nine years old individually or in groups of two to five. Participants included mothers (63 percent), fathers (26 percent), and grandmothers (11 percent) with a mean age of 38 years.
One-third were single parents, 43 percent were nonwhite and 40 percent had a high school education or less.
Interviewers first asked standard questions about technology and parenting (e.g., what media-use rules parents had set, how mobile device use impacts child learning and behavior, and perceived risks and benefits). Follow-up questions further explored caregivers’ statements, and discussion was encouraged among participants.
Interviews were audiotaped and transcribed, and three researchers reviewed transcripts for major themes.
“One of the striking things about these interviews was that parents thanked us for letting them take part … for letting them vent their strong feelings and uncertainties about parenting and technology, and for letting them speak with other parents who were going through similar experiences,” said lead author Jenny Radesky, M.D., F.A.A.P., assistant professor of pediatrics, Boston University School of Medicine.
Results showed that caregivers had a high degree of tension regarding technology. Many reported feeling that they needed to buy their children tablets to keep up with educational system and workforce demands.
Parents also worried about how strongly their children were drawn to mobile devices and gaming, with some saying their kids were “hooked” or “addicted.” They also were concerned that time spent on screens would hurt their child’s social skills.
Other parents worried that reliance on technology would make their child less creative or less of an independent thinker.
Many lower-income caregivers said it was difficult to stay on top of what apps or social media their children were using, and they did not feel confident in their ability to set limits on mobile device use.
Parents did see some benefits of mobile media use, including the ability to teach things their child would not have tried in “real life” (e.g., putting together a puzzle). They also noted that apps are less expensive than toys, devices help keep children calm when parents are stressed, and video chat apps can be used to connect with distant family members.
“Tech for young children is evolving faster than scientific research can study its effects, and this study helps pediatric providers understand the experience and concerns of a diverse group of parents, so that we can give them the most relevant, and hopefully helpful, guidance possible,” Radesky said.
Source: American Academy of Pediatrics
Orphans living in low- and middle-income countries face a high risk of trauma, with physical and sexual abuse being by far the most prevalent of traumatic events, according to a new study by researchers at Duke University and the University of North Carolina at Chapel Hill.
The findings also show that orphaned boys in these settings are just as likely to experience abuse as girls. Study authors suggest the development of more support services and prevention programs aimed at protecting vulnerable boys.
For the study, researchers examined self-reported prevalence and incidence of several potentially traumatic event types, including physical and sexual abuse, among 2,235 children. The study was supported by the National Institute of Child Health and Development.
The findings show that physical and sexual abuse affect 12 percent of girls and 14 percent of boys in institution-based care, and 19 percent of girls and 20 percent of boys in family-based care annually. By age 13, approximately half of orphans experience abuse, regardless of gender or setting.
Most international funding programs — such as the U.S. President’s Emergency Plan for AIDS Relief and the United Nations task force on protection from sexual exploitation and abuse — often place a special emphasis on protecting girls while failing to to address the need to protect orphaned boys from abuse.
“So much of our funding for children in adversity focuses on girls,” said Kathryn Whetten, Ph.D., M.P.H., director of the Center for Health Policy and Inequalities Research at the Duke Global Health Institute.
“This study demonstrates the critical need to invest in support services for boys, too — not only for their own protection, but to help prevent them from becoming abusers themselves,” said Whetten, also a professor in Duke’s Sanford School of Public Policy. “And this, in turn, helps further protect girls in the long run.”
Previous research has found that exposure to a traumatic event such as abuse often leads to a significant long-term burden, negatively affecting one’s health, quality of life and economic productivity in adulthood. These findings reinforce the need for programs to protect both orphaned girls and boys in these countries, who are particularly susceptible to abuse.
The research was conducted as part of the Positive Outcomes for Orphans longitudinal study led by Whetten, in Cambodia, Ethiopia, India, Kenya and Tanzania .
The findings are published in the journal Global Mental Health.
Source: Duke University
Inclusive classrooms that use disability awareness curricula do not necessarily help children with disabilities make new friendships, according to a new study published in the journal Topics in Early Childhood Special Education.
The findings also showed that having at least one best friend helps children with numerous problem behaviors and low social skills gain peer acceptance.
Inclusive classrooms are defined as those that integrate children with special needs into a mainstream classroom.
“The fact that about 40 percent of young children with disabilities will enter kindergarten without age-appropriate social relationship skills is striking, because these skills help them form friendships, which in turn supports smoother transitions in kindergarten and may prevent later peer victimization,” said lead researcher Lori Erbrederis Meyer, Ph.D., assistant professor of early childhood and early childhood special education at the University of Vermont.
“We found that inclusion in and of itself does not equate to increased acceptance, classroom membership, or peer relationships. This research emphasizes the importance of individualizing class-wide programs based on children’s support needs.”
In the study, entitled “Impact of an Affective Intervention on the Friendships of Kindergarteners with Disabilities,” Meyer investigated the impact of a disability awareness curriculum on the development of close friendships among 26 kindergarteners with disabilities enrolled in six inclusive classrooms.
She also observed whether the presence of at least one best friend could help mediate the relationship between children’s social skills/problem behaviors and peer acceptance.
Myers compared the results of two study groups, each containing students with and without disabilities. In one group, teachers taught from a “Special Friends” program, a curriculum designed to increase children’s positive attitudes about disabilities. In the other group, teachers implemented a curriculum with a focus on science.
Each program included class-wide shared book reading, mixed-ability cooperative learning groups where students could participate in play-based activities with each other, and a lending library, in which students could bring books home to read with their families.
Children in the Special Friends program read books with a focus on disability-related themes, with teachers discussing the book’s plot, connections between the children and the characters in the books, understanding of disabilities and disability-specific vocabulary. Teachers using the science program led book reading in a very similar way.
“Contrary to our hypothesis that the number of best friendships would increase in the Special Friends program, we found a significant increase in the number of best friendships for children with disabilities participating in the science program,” Meyer says.
There was one important difference between the cooperative learning groups’ activities in Special Friends versus the science curriculum.
In the Special Friends group, the curriculum encouraged open-ended, dramatic play — like pretending to run a restaurant — while the science group worked on project-based activities that had clearly defined outcomes — such as working together to build a bird’s nest.
“Evidence shows that children in the Special Friends program may not have had the play skills necessary to engage in extended, independent play interactions during the cooperative learning group activities,” Meyer says.
“Some of the children weren’t sure how to initiate interactions. This may account for the group’s decline in the mean number of best friendships.”
Furthermore, the results showed that self-regulation and social skills are directly related to having at least one best friend and acceptance among peers.
“Children who had higher rates of problem behavior and lower social skills also had lower rates of peer acceptance,” Meyer says. “However, when children with these social-behavioral characteristics had a best friendship, it did not result in lower peer acceptance scores.”
Meyer suggests that to increase the chances of children with disabilities making friends, high-quality inclusion models must be structured in a way that creates an environment that supports young children’s acceptance, membership, and the development of friendships.
“Our research shows that at the same time we’re focusing on improving children’s social skills and decreasing their challenging behaviors, we also have to be helping them make friends in the classroom because of the protective factors that it has and its effect on producing better social and academic outcomes.” she says.
Source: University of Vermont
Children who are exposed to an adverse childhood experience (ACE) are 28 percent more likely to develop asthma, according to a new study published in the journal Annals of Allergy, Asthma & Immunology. The asthma risk increases even more with each additional ACE exposure.
“Asthma is one of the most common chronic childhood conditions, currently affecting seven million, or 9.5 percent, of children in the U.S.,” said researcher Robyn Wing, M.D., an emergency medicine physician at Hasbro Children’s Hospital in Providence, R.I.
“The biological risk factors for asthma onset and severity, such as genetics, allergens, tobacco smoke, air pollution, and respiratory infections, have been well established by previous studies. But, psychosocial factors, such as stress, which we know can be physically harmful, are now being examined as a risk factor for asthma in children.”
The researchers analyzed data from nearly 100,000 children and teens in the 2011-2012 National Survey of Children’s Health and compared parent or guardian reports of a child having asthma to whether a child had experienced an ACE at home.
An ACE is considered to have happened if the child has ever lived with a parent or guardian who experienced one of the following: got divorced, died, or served time in jail or prison.
An ACE could also include living with anyone who was mentally ill or suicidal, or severely depressed for more than a couple of weeks; living with anyone who had a problem with alcohol or drugs; or witnessing parents, guardians or any other adults in the home slap, hit, kick, punch, or beat each other up.
The findings showed that children exposed to one ACE had a 28 percent greater risk of developing asthma compared to those with no ACEs. These rates increase with each additional ACE, with children exposed to four ACEs having a 73 percent increase in reported asthma.
Earlier asthma studies have focused mostly on neighborhood and urban-related issues, such as family poverty, poor quality housing and access to community resources. But, disruptive family relationships within the home can be a significant source of psychosocial stress for children.
“Psychosocial stressors activate the sympathetic nervous system, which controls our ‘fight or flight’ responses when we experience stressful situations,” said Wing.
“Increased activity of this system releases cortisol, a stress hormone, which has been shown to affect the activity of immune cells. Occasional increases in these hormones are protective, but excessively high or prolonged exposures, such as those experienced by children exposed to ACEs, can be harmful.”
Wing hopes this study, and others like it, will highlight the complex causes of asthma, enabling clinicians to better target preventative medications and other interventions.
“Physicians taking care of children with asthma should take the time to ask about the child’s home situation,” said Wing.
“For children experiencing stressors at home, encouraging efforts to increase the child’s capability of handling stressors, using methods such as individual or family therapy, may help target pediatric asthma.”
“Stress should be viewed as a risk factor for asthma development and asthma exacerbations, much like tobacco smoke and dust mites. At the very least, clinicians can share with parents the impacts of ACEs on their child’s asthma, perhaps acting as a motivating factor for parents to remove or shield a child from a stressful home situation.”
While negative feedback is often painful, people are more likely to accept criticism and take steps toward changing their behavior when they take a broad “forest instead of the trees” view. They also need to believe that change is indeed possible, according to a new study published by the Society for Personality and Social Psychology.
“People are defensive when they are told about something they did wrong,” said lead researcher Jennifer Belding, Ph.D., from Ohio State University. “Listening to negative feedback requires self-control because you have to get past the fact that hearing it hurts and instead use the information to improve over time.”
In the first of three experiments, 85 undergraduate students at Ohio State University (47 female, 38 male) were randomly divided into two groups. The first group was encouraged to think in a broad view, which is known as high-level construal; while the second group was encouraged to think in a narrow view, or low-level construal.
The big-picture group was asked to name a category for 20 different objects. For example, these participants would say that a soda is a type of drink.The narrow-view group was asked to pick a specific example for each object. These participants might have said that an example of a soda is a Coke.
After reading about the dangers of skin cancer and tanning, participants were asked if they now wanted to reduce their risk by using sunblock and other means. Participants who enjoyed tanning were more motivated to change their behavior if they had been encouraged to think in a broad perspective.
According to the findings of a second experiment, people also need to believe change is possible to motivate them to alter their behavior. This study involved 133 undergraduate students (58 female, 72 male, three unrecorded).
In this case, one group read a message suggesting that skin cancer could be prevented through applying sunblock and avoiding tanning, while the other group was told that skin cancer was caused by predefined characteristics, such as genetics and ethnicity.
Then when participants were given the option to read about skin cancer prevention tips, those with a family history of skin cancer spent more time reading the materials if they had been told that skin cancer was preventable.
Two more experiments conducted online with more than 600 participants had similar results. People who liked to tan were more motivated to seek information about skin cancer prevention tips if they had been encouraged to think in a broad view and if they believed skin cancer could be prevented.
“Thinking about the big picture is going to make people more open to negative feedback when it’s something you can and should improve,” Belding said.
The research findings have important implications for a variety of scenarios. While delivering negative feedback to an employee, for example, a manager should speak broadly about why these improvements are needed and how they are possible before addressing specific steps, Belding said.
Screaming and blaming never helps because it makes employees more defensive and less likely to change their behavior, she added.
Furthermore, it would be helpful if health education campaigns focused on the big picture and assured people that change is possible — this would help motivate people to take action, Belding said.
The study was published online in the Personality and Social Psychology Bulletin.
In people who develop the disease frontotemporal dementia, those with more demanding jobs may live about three years longer than those with less skilled jobs, according to a new study published in the journal Neurology.
Frontotemporal dementia, which often develops in people still under the age of 65, causes changes in personality or behavior and problems with language, but does not affect the memory.
“This study suggests that having a higher occupational level protects the brain from some of the effects of this disease, allowing people to live longer after developing the disease,” said study author Lauren Massimo, Ph.D., CRNP, of the University of Pennsylvania in Philadelphia, Pennsylvania State University in State College, and a member of the American Academy of Neurology.
The study findings support the theory of “cognitive reserve,” which asserts that factors such as longer education, challenging occupations, and mental activity build up connections in the brain that create a buffer against disease.
“People with frontotemporal dementia typically live six to 10 years after the symptoms emerge, but little has been known about what factors contribute to this range,” Massimo said.
For the study, researchers looked at the medical charts of 83 people who had an autopsy after death to confirm the diagnosis of frontotemporal dementia or Alzheimer’s disease. They compared this information to people’s primary occupation.
Jobs were ranked by U.S. Census categories, with careers such as factory workers and service workers in the lowest level; jobs such as tradesworkers and sales people in the next level; and professional and technical workers, such as lawyers and engineers, at the highest level.
Researchers looked at when the dementia symptoms began based on the earliest report from family members telling of persistently abnormal behavior. Survival was defined as from the time symptoms began until death.
According to the findings, the 34 people who had developed frontotemporal dementia had an average survival time of about seven years. Those with more challenging jobs were more likely to have longer survival times than those with less challenging jobs.
Frontotemporal dementia patients in the highest occupation level survived an average of 116 months, while people in the lower occupation group survived an average of 72 months, suggesting that people with more challenging jobs may live up to three years longer.
The findings showed that occupational level was not linked to a longer lifespan in those with Alzheimer’s disease dementia. The number of years of education a person had was not linked to a longer life in either type of dementia.
Source: American Academy of Neurology
The risks associated with smoking cigars are very similar to the risks of smoking cigarettes, according to a new study published in open access journal BMC Public Health. The findings suggest that cigar smoking is not a safe alternative to cigarette smoking.
“The results reinforce the fact that cigar smoking carries many of the same health risks as cigarette smoking. Cigar smoking is linked to fatal oral, esophageal, pancreatic, laryngeal, and lung cancers, as well as heart disease and aortic aneurysm,” said lead researcher Cindy Chang, Ph.D., M.P.H., from the U.S. Food and Drug Administration (FDA).
While there was a 33 percent reduction in U.S. cigarette smoking between 2000 and 2011, cigar smoking doubled from 6.2 billion cigars to more than 13.7 billion during the same time period.
There is particular concern about cigar use in youth and young adults. Among young adults aged 18-24, 16 percent reported smoking cigars at least one day in the past 30 days during 2009-2010. Another recent study suggests during 2012, 12.6 percent of high school students smoked cigars, cigarillos or little cigars, at least one day in the past 30 days.
For the analysis, a research team from FDA carried out a systematic review of studies on cigar smoking and all-cause and smoking-related mortality to gain a better understanding of the long-term public health implications of cigar use.
The researchers wanted to know the health risks to current cigar smokers compared to those who had never smoked cigarettes or used any tobacco, so they excluded any study that involved current cigarette smokers.
Separate findings were reported for current cigar smokers with no prior history of cigarette smoking vs. those who had previously smoked cigarettes. As such, 22 studies were analyzed that were primarily conducted in the U.S., the U.K., Canada, Denmark, Sweden, and Finland.
The findings showed that people who exclusively smoked cigars and had never smoked other tobacco products had an increased risk of all-cause mortality.
The risk of death from oral, esophageal and lung cancers was found to increase with inhalation of cigar smoke. Even among cigar users who reported not inhaling the smoke, there was an increased risk of death by oral, laryngeal, and esophageal cancer.
People who smoked cigars and had previously smoked cigarettes had a much greater risk of lung cancer and chronic obstructive pulmonary disease compared to cigar smokers who had not previously smoked cigarettes. This could be due in part to the inhalation patterns of these different types of cigar smokers.
Source: Biomed Central
While moderate alcohol consumption has been linked to a lower mortality risk among whites, it does not appear to have the same protective effect among blacks, according to a new study by researchers at Harvard T.H. Chan School of Public Health.
Its potential benefits also may vary by gender.
“Current dietary guidelines recommend moderate consumption for adult Americans who consume alcoholic beverages. Our study suggests that additional refinements based on race/ethnicity may be necessary,” said lead author Chandra Jackson, Ph.D., research associate in the Chan school and Harvard Medical School.
Earlier studies have found a link between moderate drinking and lowered risk of type II diabetes, heart disease, and premature death, but those studies were conducted among mostly white populations, and some studies have suggested that blacks may not experience similar risk reduction.
For the new study, researchers observed data of 152,180 adults (25,811 blacks and 126,369 whites) from the National Health Interview Survey from 1997-2002, with follow-up through 2006 to account for deaths.
Study participants reported on how much alcohol they drank and how often; on sociodemographic factors such as education, employment and income; on other health issues such as smoking status; and on their health.
Researchers also took into account the absence of “social integration” into society, such as living in poverty or being unemployed.
Consistent with previous studies, the findings showed that 13 percent of white men and 24 percent of black men said they never drank. Among women, 23 percent of white women and 42 percent of black women reported never drinking.
When the researchers observed the connection between drinking alcohol and mortality, they found that it varied by both race and gender. For men, the lowest risk of mortality was among white men who consumed one or two drinks three to seven days per week and among black men who didn’t drink at all.
For women, the lowest risk of mortality was among white women consuming one drink per day three to seven days per week, and among black women who had one drink on two or fewer days per week.
The researchers believe that more studies may be needed to observe other factors that might be involved in the link between alcohol and mortality risk, such as…
- lifestyle related to diet, physical activity, sleep, youthful experimentation vs. coping with hardships;
- socioeconomic status and other markers of social integration;
- differences in physical, chemical, and social exposures in both occupational and residential environments;
- genetic differences;
- and gender differences.
The findings are published in the American Journal of Public Health.
Source: Harvard School of Public Health
Heavy drinking and binge drinking is becoming far more prevalent in the U.S. due in large part to rising rates of drinking among women, according to a new analysis published in the American Journal of Public Health.
By contrast, the percentage of people who drink any alcohol has remained relatively unchanged over time, according to the latest research by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington.
“We are seeing some very alarming trends in alcohol overconsumption, especially among women,” said Dr. Ali Mokdad, a lead author of the study and professor at IHME. “We also can’t ignore the fact that in many U.S. counties a quarter of the people, or more, are binge drinkers.”
The study is the first to track trends in alcohol use at the county level. The findings, focused on people aged 21 and older, showed that heavy drinking among Americans has increased sharply, up 17.2 percent since 2005.
The Centers for Disease Control and Prevention (CDC) defines heavy drinking as exceeding an average of one drink per day for women and two drinks per day for men over the past month.
Nationally, 18.3 people of people were binge drinkers in 2012, which the CDC defines as consuming four drinks or more for women and five drinks or more for men on a single occasion at least once during the past month. Since 2005, binge drinking has increased by 8.9 percent.
Overall, women showed a much faster escalation in binge drinking than men, with rates rising 17.5 percent between 2005 and 2012; men, on the other hand, saw rates of binge drinking increase 4.9 percent.
These rising rates of heavy and binge drinking starkly contrast with America’s trends for drinking any alcohol, which have remained largely unchanged over time (56 percent of people in the U.S. consumed any alcohol in 2005 and 2012).
Some regional drinking patterns emerged as well, with several areas in the West, Midwest, and New England showing higher levels of alcohol consumption, particularly in comparison with a number of counties in the southern United States and Utah.
However, the most startling disparities in alcohol use were found within state lines.
“In the U.S., state-level results often mask the full range of what people are experiencing health-wise,” said IHME’s Director Dr. Christopher Murray.
“When you can map out what’s happening county by county, over time, and for men and women separately, that’s also when you can really pinpoint specific health needs and challenges, and then tailor health policies and programs accordingly.”
Binge drinking is often linked to a higher risk for serious bodily harm, such as injuries, alcohol poisoning, and acute organ damage. Heavy drinking is considered a risk factor for longer-term conditions, such as liver cirrhosis and cardiovascular disease.
While most of the nation views California as an open-minded state, residents with mental health issues perceive a significantly different environment.
This belief was uncovered in a new RAND Corporation study that found a large proportion of individuals with mental illness reporting discrimination in both private and public settings.
Investigators found that just 41 percent of those surveyed believe that people are caring and sympathetic to those with mental illnesses. Moreover, 81 percent of those surveyed believed that people with mental illness experience high levels of prejudice and discrimination.
Consistent with their perceptions of public stigma, more than two-thirds of those polled said they definitely or probably would hide a mental health problem from co-workers or classmates, and more than one-third said they would do so from family or friends as well.
“These high levels of perceived stigma may discourage individuals facing a mental health challenge from getting needed support from friends and family, the workplace, school and mental health professionals,” said Eunice Wong, lead author of the report and a behavioral scientist at RAND.
The results come from the California Well-Being Survey, which assessed the impact of mental health prevention and early intervention programs on individuals who are experiencing psychological distress.
The survey was conducted by RAND as part of efforts by the California Mental Health Services Administration (CalMHSA) to create prevention and early intervention programs designed to improve the mental health of California residents.
“This new report from RAND researchers highlights both the need to confront stigma, and the opportunity to promote mental health in our state with the statewide stigma reduction efforts offered by CalMHSA,” said Wayne Clark, executive director of CalMHSA.
Researchers surveyed 1,066 people who had previously reported mild to serious psychological distress when they took part in the California Health Interview Survey, a statewide survey about a broad array of health issues.
The California Well-Being Survey is the first population-based survey of individuals who are at risk for or are experiencing mental health problems, but may or may not have obtained treatment.
The group is a key target for prevention and early intervention efforts and largely has been unstudied.
Among survey participants who acknowledged experiencing a mental health problem, nearly nine in 10 reported discrimination based on it. Most often discrimination occurred in the sphere of intimate social relationships, although they also reported high levels of discrimination at school, in the workplace, and from health care providers and law enforcement officials.
Although perceived discrimination appears rampant, Californians who are experiencing psychological distress are showing signs of resiliency. More than 80 percent of those surveyed said they have a plan for how to stay or become well and believe they can meet their personal goals.
In addition, about 70 percent of those surveyed said that they are satisfied with life. The large majority of respondents believe that recovery from mental illness is possible and say they would seek treatment for a mental health problem if needed.
“While California residents facing mental health challenges are finding ways to cope and maintain important aspects of well-being, they are substantially burdened by self-stigma and discrimination, which may significantly undermine recovery,” Wong said.
“Our overall findings show a clear need for stigma and discrimination reduction efforts in California.”
Source: RAND Corporation/EurekAlert!
People with borderline personality disorder (BPD) tend to suffer similar deterioration of their psychiatric and physical health as those with bipolar disorder, according to new research published in the British Journal of Psychiatry.
“Despite the clinical and public health significance of both of these disorders, it sometimes seems as if BPD lives in the shadow of bipolar disorder,” said researcher Mark Zimmerman, M.D., director of outpatient psychiatry at Rhode Island Hospital.
“Bipolar disorder is a widely researched, well-publicized, well-funded topic. By contrast, BPD is seldom discussed and it is not included in the Global Burden of Disease study, a comprehensive registry that quantifies diseases by cost, mortality, geography, risk, and other factors.”
About 1.6 percent of the U.S. population has been diagnosed with BPD, compared with 2.6 percent of those with bipolar disorder, according to the National Institute of Mental Health. The study is the largest comparison of patients who have been diagnosed with BPD or bipolar disorder.
“The level of psychosocial morbidity and suicidality associated with BPD is as great, or greater, than that experienced by patients with bipolar disorder,” said Zimmerman. “From a public health perspective, improving the detection and treatment of BPD is as imperative as diagnosing and treating bipolar disorders.”
People suffering from BPD have difficulty regulating emotions and thoughts, often tipping toward extremes. They engage in impulsive and reckless behavior, and their relationships with other people are typically unstable.
People with bipolar disorder often experience the same mood for weeks, while those with BPD deal with intense bouts of anger, depression and anxiety that are short in duration. According to the study, clinical experience suggests that BPD is just as debilitating as bipolar disorder. In fact, in psychiatric patient samples, BPD is as frequent as bipolar disorder.
Similar to patients with bipolar, those with BPD are more likely to suffer from depression, anxiety disorders, substance abuse, eating disorders, and suicidal behaviors. These other mental illnesses may have symptoms that overlap with BPD, making it difficult to recognize BPD in patients with these other mental illnesses.
This research was part of the MIDAS (Methods to Improve Diagnostic Assessment and Services) project, an ongoing clinical research study at Rhode Island Hospital. Their aim is to integrate research assessment methods into routine clinical practice.
Emerging research suggests a therapy technique that blocks the consolidation of traumatic memories could protect against the long-term psychological and physiological effects of trauma.
In a new study, UK researchers examined whether “updating” — a verbal therapy currently only used for patients with chronic post-traumatic stress disorder (PTSD) — could be applied more widely to victims of trauma before PTSD develops, during a period known as the ‘consolidation window’.
As published in the journal PLOS ONE, the study is the first to investigate the expanded use of ‘updating’ therapy as a preventative agent.
The consolidation window is thought to last around six hours after a traumatic event, and is when fear memories are established and strengthened.
The study is relevant because the experience of significant trauma is a relatively common event. Indeed, many millions of people experience a traumatic event in their lifetime, as well as the thousands of people regularly exposed to trauma in their line of work — including those in the emergency services, the military and journalists in conflict zones.
In the study, the researchers looked at two cognitive behavioral techniques used to treat PTSD.
The first was ‘updating’, where traumatic memories are re-written with factual information, bringing the meaning of trauma in line with what actually happened and the consequences for those involved.
The second strategy evaluated was ‘exposure therapy’ — a technique used for anxiety which involves presenting the original object of fear for long enough to decrease the intensity of an emotional reaction.
In the study, 115 participants watched a series of six film clips containing real-life footage of humans and animals in distress, a procedure regularly used to investigate causal factors in the development of PTSD.
Researchers found that verbally updating the trauma memory with information about the fate of the films’ protagonists reduced the frequency of intrusive memories by half (5.6 intrusive memories on average) compared to those in the exposure group (11.2, where the films were viewed again); and control group (10.6, where participants viewed non-traumatic films).
In addition, a self-reported measure of distress caused by these intrusions was found to be much lower in the updating group (19.7 rating) compared to the exposure (27.2) and control groups (25.5).
Updating also led to the greatest decrease in distress and the greatest changes in physical arousal (as measured by skin conductance) when participants were faced with reminders of the trauma.
The study also provided insights on susceptibility to PTSD.
Researchers discovered that a strong initial response to the films significantly predicted the development of PTSD symptoms. This suggests marked individual differences in how people initially respond to traumatic experiences, which could open up the possibility of tailored support for those identified as being at higher risk of developing PTSD symptoms.
Dr. Victoria Pile, lead author from the King’s College London, said, “Although most people will experience a traumatic event in their lifetime, almost all will recover over time from the post-traumatic stress symptoms that initially develop.
“However, nine percent will go on to develop PTSD. Our findings have important implications for identifying those at risk as well as for designing novel early interventions to prevent the development of PTSD.
“This research implies that finding out what actually happened as soon as possible after the trauma might change the way the memory is stored and so limit the devastating effects of PTSD.
“It could be particularly relevant for groups regularly exposed to trauma, such as emergency service workers, military personnel and journalists in conflict zones, who have higher rates of PTSD and for whom there are currently no established interventions to prevent the development of PTSD.”
Dr. Jennifer Wild, a co-author from the University of Oxford, said, “The updating approach is painless and carries no harmful side effects. With this approach the brain appears to re-encode the traumatic memory with new information, making the memory less frightening and less likely to be triggered in the future.”
Source: Kings College London
Emerging evidence suggests expanded insights into the nature of depression may be forthcoming. The optimism accompanies the discovery that the illness is associated with metabolic or cellular changes.
As reported in the journal Current Biology, the finding of a cellular signature may provide scientists an opportunity to measure and monitor mental health at the cellular level.
In some form, cellular changes may be a response to perceived stress — with depression a result of the cellular modifications.
“Our most notable finding is that the amount of mitochondrial DNA changes in response to stress,” says Professor Jonathan Flint of the University of Oxford.
Mitochondria are compartments in cells responsible for generating energy. An increase in mitochondrial DNA suggests a change in mitochondria and cellular energetics, Flint explains.
“We see an unexpected link between cellular energetics and major depression, which has always been seen as a mood disorder.”
Flint and his colleagues discovered this association serendipitously as they searched for genes that increase depression risk among thousands of women with recurrent major depression. Many of the women with depression also had experienced adversity in childhood, including sexual abuse.
Flint said the researchers noticed something rather unusual in the DNA. The samples taken from women with a history of stress-related depression contained more mitochondrial DNA than other samples.
“We were surprised at the observation that there was a difference in mitochondrial DNA — so surprised it took us a long time to convince ourselves it was real, and not an artifact,” Flint says.
The new discovery prompted Flint and his team to evaluate another molecular level phenomenon associated with depression in earlier studies.
Telomeres, repeated DNA sequences that physically cap the ends of chromosomes, shorten with each cell division (and therefore with one’s age). Changes in metabolism have been shown to alter the rate of aging, so the researchers wondered whether they might see a change in telomeres’ erosion too. And indeed they did.
To test these hypotheses further, Flint’s team looked to laboratory mice that were put through four weeks of stress. The studies in mice showed not only that stress caused both molecular changes, but also that the changes were partly reversible and elicited by administration of the stress hormone corticosterone.
Flint says the molecular changes they observed might reflect the body’s way of coping with major environmental stressors. As our brains perceive a threat — lack of food or a history of abuse, for example — it may initiate a series of protective metabolic changes.
“Depression might in some sense be considered a metabolic reaction to perceived stress,” Flint says.
The researchers also hope that the molecular changes can serve as biomarkers of stress and its consequences. It is possible, for example, that a decline in mitochondrial DNA levels post-treatment could be used as an indicator of success.
More work is still needed. “We have only a snapshot of the relationship between the molecular markers and depression,” Flint says.
“We want to know how they change over time — before, during, and after a depressive illness. That information will tell us much about their clinical utility.”
Source: Cell Press/EurekAlert!
New research suggest efforts to prevent teens from using the Internet — as a means of protecting them from online risk — is a futile, and in fact misguided battle.
A better approach to keeping teens safe is to teach the adolescent coping strategies that improve resiliency, say Pennsylvania State researchers.
In a study, more resilient teens were less likely to suffer negative effects even if they were frequently online, said Haiyan Jia, post-doctoral scholar in information sciences and technology.
“Internet exposure does not necessarily lead to negative effects, which means it’s okay to go online, but the key seems to be learning how to cope with the stress of the experience and knowing how to reduce the chances of being exposed to online risk,” said Jia.
While previous research suggested limiting online use as a way to minimize risks of privacy violations and traumatic online experiences — such as cyberbullying or exposure to sexually inappropriate pictures — the present ubiquity of online technologies makes staying offline an untenable option.
In fact, researchers now confirm that an online presence is a large part of teens’ social and educational lives and that abstinence may actually be less reliable and more harmful.
“Let’s assume that teens are going to deal with some online risk,” said Pamela Wisniewski, a post-doctoral scholar in information sciences and technology. “If risk is going to be present, we want to make sure to minimize the negative outcomes and make sure the teens are equipped to handle these experiences.”
Not allowing teens to use the Internet has its own risks, she added.
“As much as there are negatives associated with online use, there are also a lot of benefits to using online technologies,” said Wisniewski. “Parents should be aware that restricting online use completely could hurt their children educationally and socially.”
Both parents and technology companies may be able to help teens become more resilient, according to the researchers, who release their findings at the International Conference on the Computer Human Interaction conference in Seoul, South Korea.
Teens who are exposed to minimal risks can, over time, develop coping strategies and be more resilient as new, more risky situations arise.
“For example, let’s say a teen girl is surfing online and one of her online friends asks for a nude photo,” said Jia.
“If a teen doesn’t know how to deal with this, she might just succumb to the pressure and send the photo, and then suffer all kinds of stress and anxiety as a result, but if she builds up her resilience, she knows how to deal with the situation, she knows how to say no and prevent exposing herself to this risk.”
The researchers suggest that technology companies that create cyber-security software could design software solutions that alert teens to risky behavior in order to avoid relying solely on parental monitoring software that restricts certain websites and social media sites.
“You don’t want to parent strictly based on fear, you want to parent based on empowerment,” said Wisniewski.
The researchers examined the responses of 75 teens, including 46 girls and 29 boys between 13 and 17 years old, to questions about how they used the Internet and what problems, if any, they encountered. To determine how excessive exposure to the Internet influenced negative outcomes, they analyzed teens who were at risk of Internet addiction.
While there was a significant correlation between Internet addiction and negative effects, more resilient teens were less likely to be suffer negative consequences from extreme online exposure, according to the researchers.
Source: Pennsylvania State/EurekAlert!
Newborn babies experience pain much like adults and may even have a much lower pain threshold, according to a new Oxford study. The findings have important implications as many procedures are still performed on babies without painkillers.
As recently as the 1980s it was common practice for babies to be given neuromuscular blocks but no pain relief medication during surgery. In 2014, a review of neonatal pain management practice in intensive care highlighted that although such infants experience an average of 11 painful procedures per day 60 percent of babies do not receive any kind of pain medication.
“Thousands of babies across the UK undergo painful procedures every day but there are often no local pain management guidelines to help clinicians. Our study suggests that not only do babies experience pain but they may be more sensitive to it than adults,” said lead author Dr. Rebeccah Slater of Oxford University’s Department of Paediatrics.
“We have to think that if we would provide pain relief for an older child undergoing a procedure then we should look at giving pain relief to an infant undergoing a similar procedure.”
The research involved 10 healthy infants between one and six days old and 10 healthy adults aged 23-36 years. Infants were recruited from the John Radcliffe Hospital, Oxford (UK) and adult volunteers were Oxford University staff or students.
For the study, the babies, who were accompanied by parents and clinical staff, were placed in a Magnetic Resonance Imaging (MRI) scanner where most fell asleep. MRI scans were then taken of the babies’ brains as they were ‘poked’ on the bottom of their feet with a special retracting rod creating a sensation ‘like being poked with a pencil.’
The poking was mild enough to not wake them up. These scans were then compared with brain scans of adults exposed to the same pain stimulus.
“Up until recently people didn’t think it was possible to study pain in babies using MRI because, unlike adults, they don’t keep still in the scanner!” said Slater.
“However, as babies that are less than a week old are more docile than older babies, we found that their parents were able to get them to fall asleep inside a scanner so that, for the first time, we could study pain in the infant brain using MRI.”
The findings showed that 18 of the 20 brain regions active in adults experiencing pain were also active in babies. In fact, scans revealed that babies’ brains had the same response to a weak ‘poke’ as adults did to a stimulus four times as strong. This suggests that not only do babies experience pain much like adults but that they also have a much lower pain threshold.
“This is particularly important when it comes to pain: obviously babies can’t tell us about their experience of pain and it is difficult to infer pain from visual observations.
“In fact some people have argued that babies’ brains are not developed enough for them to really ‘feel’ pain, any reaction being just a reflex — our study provides the first really strong evidence that this is not the case,” said Slater.
Source: University of Oxford