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Updated: 17 min 22 sec ago

Older Moms More Likely to Live Longer

Thu, 06/26/2014 - 7:45am

According to a new study, women who had their children at an older age have a better chance to live to an unusually old age.

The case-control study has been published online in the journal Menopause.

Researchers evaluated data from the Long Life Family Study, an international collaboration to review the genetics and familial components of exceptional survival, longevity, and healthy aging.

Three hundred eleven women who survived past the oldest fifth percentile of survival (according to birth cohort-matched life tables) were identified as cases, while 151 women who died at ages younger than the top fifth percentile of survival served as controls.

Looking at the cases of all 462 women, the study found a significant association for older maternal age — in which women had their last child beyond age 33 years — had twice the odds for survival to the top fifth percentile of survival for their birth cohorts compared with women who had their last child by age 29 years.

Several previous studies had observed a similar association. For example, an analysis of New England Centenarian Study cohort data revealed that women who gave birth to a child after age 40 years had four times greater odds for being a centenarian compared with women from the same birth cohort who had their last child at a younger age.

In this latest study, it was observed that having more children (identified as three or more) moderated the association between increased maternal age and later survival. Mortality was not assessed for women who had no children.

Study authors believe it is significant that numerous studies have documented the same relationship between older maternal age at birth and exceptional survival.

They believe these findings provide evidence for sustained reproductive fitness, with age as a selective force for genetic variants conducive to longer life.

“While this documented relationship is noteworthy, what is more meaningful is that these findings support the need to conduct additional studies that identify the various genetic influences on reproductive fitness, as these could also influence the rate of aging and a woman’s susceptibility to age-related diseases,” said Margery Gass, M.D.

The study will be published in the January 2015 print edition of Menopause.

Source: The North American Menopause Society (NAMS)

More Benefits Found In Deep Brain Stimulation for Parkinson’s

Thu, 06/26/2014 - 7:00am

While it is well-recognized that deep brain stimulation (DBS) improves motor symptoms of patients with early and advanced Parkinson’s disease (PD), new research finds that DBS also reduces the number and severity of non motor symptoms.

“Non-motor features are common in PD patients, occur across all disease stages, and while well-described, are still under-recognized when considering their huge impact on patients’ quality of life,” said Lisa Klingelhoefer, M.D.

For example, DBS of the subthalamic nucleus (STN) is effective for alleviating sleep problems and fatigue associated with PD, producing noticeable long-term improvements in sleep efficiency and the quality and duration of continuous sleep.

DBS also decreases nighttime and early morning dystonia and improves nighttime mobility.

“DBS can contribute to better sleep, less daytime somnolence, improved mobility, and less need for dopamine replacement therapy,” said Klingelhoefer.

Emerging evidence now indicates that DBS can decrease the number and severity of non motor symptoms of patients with Parkinson’s disease (PD) as well, according to a review published in the Journal of Parkinson’s Disease.

However, the effects of DBS on some other non-motor symptoms of PD are less clear-cut, and transient worsening of neuropsychological and psychiatric symptoms have been reported.

For instance, behavioral disorders such as impulsivity (e.g. hypersexuality, pathological gambling, and excessive eating) can occur or worsen in PD patients after STN DBS.

While pre-existing drug-induced psychotic symptoms like hallucinations often disappear after STN DBS, transient psychotic symptoms such as delirium may emerge in the immediate post-operative period.

Similarly, conflicting reports have found that STN DBS improves, worsens, or does not change mood disorders such as depression, mania, or anxiety.

“Further work is required in order to fully understand the mechanisms and impact of DBS of the STN or other brain structures on the non-motor symptoms of PD,” concluded Klingelhoefer.

She suggests that in the future, non-motor symptoms of PD may become an additional primary indication for DBS.

Source: IOS Press

Premature Births Linked to Obesity Before Pregnancy

Thu, 06/26/2014 - 6:15am

A new Stanford Medical school study finds that women who were obese before they became pregnant have an increased risk of delivering a very premature baby.

The study of nearly one million California births provides important clues as to what triggers extremely preterm births, specifically those that occur prior to 28 weeks of pregnancy.

As published in the journal Paediatric and Perinatal Epidemiology, researchers found no link between maternal obesity and premature births that happen between 28 and 37 weeks of the normal 40-week gestation period.

The disparity suggests that premature birth may have different causes at different stages of pregnancy.

“Until now, people have been thinking about preterm birth as one condition, simply by defining it as any birth that happens at least three weeks early,” said Gary Shaw, Dr.P.H., professor of pediatrics and lead author of the new study.

“But it’s not as simple as that. Preterm birth is not one construct; gestational age matters.”

Preterm births affect one in nine pregnancies, or more than a half-million U.S. babies per year. Prematurity can lead to lifelong health problems, such as cerebral palsy, developmental delays, and impaired vision or hearing. Babies born before 28 weeks of pregnancy are at especially high risk.

High U.S. prematurity rates prompted the 2011 launch of the March of Dimes Prematurity Research Center at Stanford University School of Medicine, the first of five such centers the March of Dimes has planned across the country. The new findings are a product of the center’s work.

The study, which examined nearly all California births between January 2007 and December 2009, was the largest ever to look for population-based links between maternal obesity and prematurity.

To focus on spontaneous preterm births, the researchers excluded from analysis women who were pregnant with twins or other multiples, as well as women with illnesses previously linked to prematurity, such as diabetes, high blood pressure, or preeclampsia.

After these exclusions, the team had 989,697 births to analyze. Births were classified by gestational age, and many factors about the mothers were considered in the analysis, including body mass index, race/ethnicity, whether they were first-time mothers, educational attainment, when prenatal care began, source of health insurance, maternal age, and maternal height.

For first-time mothers, obesity was linked with a substantial increase in risk of delivery before 28 weeks of pregnancy. The risk was highest at the earliest gestational ages and also at the highest levels of obesity.

For instance, non-Hispanic, white first-time mothers in the most obese category were six times more likely than normal-weight women to deliver a baby between 20 and 23 weeks.

Obese women having their second or later child were also more likely to deliver very early than normal-weight women, though the risk was less pronounced than for first-time mothers.

“Ideally, as the American College of Obstetricians and Gynecologists has already recommended, women should embark upon a healthy diet and exercise program before becoming pregnant,” said study co-author Deirdre Lyell, M.D.

“Women who are obese should also consider meeting their obstetrician to discuss and understand the risks beyond those identified in this research,” Lyell added, noting that obesity has previously been shown to raise women’s risk of such pregnancy and delivery complications as gestational diabetes, preeclampsia, and cesarean section.

In general, African-American women face a greater risk of preterm delivery than other populations, so the researchers were surprised to find that the effect of obesity on early preterm delivery was not explained by women’s racial/ethnic background.

The finding indicates that there is something about obesity itself that can trigger early birth, which may or may not be associated with other factors, such as socioeconomic patterns, that put African-American women at greater risk.

“This is a clue that informs what sort of research we should try next,” Shaw said. For example, the researchers plan to investigate the role of increased inflammation from obesity because this factor cuts across racial backgrounds.

“We believe the inflammatory process is contributing to preterm birth, particularly at earlier gestational ages,” he said. “We’re at the edge of trying to solve this puzzle.”

Source: Stanford University Medical Center

 
Mother watching her newborn photo by shutterstock.

More Fruits and Veggies May Not Be Best Way to Lose Weight

Thu, 06/26/2014 - 5:30am

A new study suggests simply eating more fruits and vegetables will not aid in losing weight.

University of Alabama-Birmingham researchers say that while it is a commonly recommended weight-loss tactic to increase the feeling of being full by consuming more fruits and vegetables, increased fruit and vegetable consumption per se does not reduce body weight.

Or put another way, increasing consumption — even of healthy substances — will not help to reduce weight if caloric intake rises.

The recommended daily serving amount for adults is 1.5-2 cups of fruit and 2-3 cups of vegetables, according to the U.S. Department of Agriculture.

In the study, researchers performed a systematic review and meta-analysis of data of more than 1,200 participants in seven randomized controlled trials that focused on increasing fruit and vegetable intake to see effects on weight loss.

“Across the board, all studies we reviewed showed a near-zero effect on weight loss,” says Kathryn Kaiser, Ph.D., an instructor in the University of Alabama at Birmingham (UAB) School of Public Health.

“So I don’t think eating more alone is necessarily an effective approach for weight loss because just adding them on top of whatever foods a person may be eating is not likely to cause weight change.”

Despite the belief of some that increased intake of fruit may increase the risk for weight gain, Kaiser says that was not the case at the doses studied.

“It appears that an increase in servings does not increase weight, which is a good thing for getting more vitamins and fiber in one’s diet,” Kaiser said.

While Kaiser recognizes the importance of eating fruits and vegetables for their many other health benefits, expectations for weight loss should be kept in check.

“In the overall context of a healthy diet, energy reduction is the way to help lose weight, so to reduce weight you have to reduce caloric intake,” Kaiser said.

“People make the assumption that higher-fiber foods like fruits and vegetables will displace the less healthy foods, and that’s a mechanism to lose weight; but our findings from the best available evidence show that effect doesn’t seem to be present among people simply instructed to increase fruit and vegetable intake.”

“In public health, we want to send positive and encouraging messages and telling people to eat more fruits and vegetables seems far more positive and encouraging than just saying ‘eat less.’

Unfortunately, it seems that if we just get people to eat more fruits and vegetables without also taking explicit steps to reduce total food intake, lower weights are not achieved,” said senior author, David B. Allison, Ph.D., associate dean for science in the UAB School of Public Health.

Because this recommendation is so widely shared, Kaiser believes these results should bring change to public health messaging.

“There are many studies where people are spending a lot of money figuring out how to increase fruit and vegetable intake, and there are a lot of healthy things that this helps; but weight loss isn’t one of them,” Kaiser said.

“I think working on more multimodal healthy lifestyle interventions would be a better use of time and money.”

Kaiser says it is important that more quality research be performed to investigate how multiple foods may interact to create healthy weight loss that can be maintained.

“We need to design mechanistic studies to understand these things better so we can help the public be best informed and know what to do when it comes to weight-loss efforts,” Kaiser said.

“Overly simplified messages don’t seem to be very effective.”

Source: University of Alabama at Birmingham

 
Fruits and vegetables photo by shutterstock.

Digital Outreach May Slow Incidence of HIV

Wed, 06/25/2014 - 8:30am

Traditionally, communication of HIV prevention strategies has been delivered to young men in a face-to-face format.

New research suggests digital outreach efforts delivered via text messages, interactive games, chat rooms, and social networks may be a more effective way to reach at-risk younger men.

The research review, published in the Journal of Medical Internet Research, found that eHealth interventions are associated with reductions in risky sexual behaviors and increases in HIV testing among men who have sex with men.

Despite decades of outreach and education efforts that have stabilized human immunodeficiency (HIV) infection rates in the U.S., the pace of new infections among men who have sex with men has been steadily increasing, particularly among young adults and racial and ethnic minorities.

“This is a population that is very used to technology, and there is built-in privacy and immediacy with digital communication that may be especially appealing to men who aren’t comfortable disclosing their sexual orientation or their HIV status in a face-to-face encounter,” says lead study author Rebecca Schnall, PhD, RN.

“If we want to reduce HIV infection rates, particularly among younger men, we need to explore the use of technology to meet them where they live — online and on their phones.”

A team of researchers led by Schnall conducted a systematic literature review to determine the effectiveness of eHealth interventions for HIV prevention among men who have sex with men.

Included studies had to be focused exclusively on eHealth, limited to HIV prevention and testing rather than treatment, targeted only to adult men who have sex with men, written in English, designed as experimental or randomized controlled trials, and published between January 2000 and April.

One interactive website, Sexpulse, designed by health professionals and computer scientists to target men who seek sexual partners online, successfully reduced high-risk sexual behaviors.

Another site, Keep It Up! (KIU), used video games to help reduce rates of unprotected anal sex.

A third initiative, a downloadable video game, helped mitigate shame felt by some young men who have sex with men, though the reduction in risky sexual behavior wasn’t statistically significant.

Chat rooms may also help prevent HIV, the study found. When a sexual health expert entered a popular chat room to regularly post information about HIV testing and respond to instant messages seeking information on HIV, self-reported HIV testing among participants in the chat room significantly increased.

On social networks such as Facebook and Twitter, popular individuals can spread HIV-prevention messages to their friends and followers.

The sharing of information about HIV testing via trusted sources on a social network appeared to increase requests for HIV testing kits, one study found.

Another study found that using opinion leaders to disseminate HIV-prevention information via social networks may increase testing rates and bolster condom use during anal sex with partners found online.

“Taken together, the findings from all of these relatively small studies demonstrate the enormous potential of eHealth as a tool to prevent HIV,” says Schnall.

“The task is urgent,” she adds. “Although men who have sex with men represent about seven percent of the male population in the U.S., they account for about 78 percent of new HIV infections among males, reinforcing the need for new approaches to prevention.”

“What we now have is a road map to follow for larger, longer trials that may definitely confirm the effectiveness of eHealth in fighting the spread of HIV.”

Source: University of Columbia

 

Man using cell phone photo by shutterstock.

For Safe and Secure Passwords, Facing the Familiar

Wed, 06/25/2014 - 7:45am

Forgotten passwords are a big problem for both IT managers and users. Effective passwords must blend memorability and security: Simple passwords are easy to remember but easy to crack, while complex passwords are hard to crack but hard to remember.

While biometric solutions including finger-print readers and retina scanners have been used for more than a decade in certain industries, the technology is expensive and has had accuracy problems slowing diffusion.

Now, a newly proposed alternative hopes to build upon lessons learned. The technology, called “Facelock” is based on the psychology of face recognition.

Decades of psychological research has revealed a fundamental difference in the recognition of familiar and unfamiliar faces. Humans can recognize familiar faces across a wide range of images, even when their image quality is poor.

In contrast, recognition of unfamiliar faces is tied to a specific image, so much so that different photos of the same unfamiliar face are often thought to be different people.

Facelock exploits this psychological effect to create a new type of authentication system whose details were published in the journal PeerJ.

Familiarity with a particular face determines a person’s ability to identify it across different photographs and as a result a set of faces that are known only to a single individual can be used to create a personalized “lock.” Access is then granted to anyone who demonstrates recognition of the faces across images, and denied to anyone who does not.

To register with the system, users nominate a set of faces that are well known to them, but are not well-known to other people.

The researchers found that it was surprisingly easy to generate faces that have this property.

For example, a favorite jazz trombonist, or a revered poker player are more than suitable — effectively one person’s idol is another person’s stranger.

By combining faces from across a user’s domains of familiarity — say, music and sports — the researchers were able to create a set of faces that were known to that user only. To know all of those faces is then the key to Facelock.

The lock consists of a series of face grids and each grid is constructed so that one face is familiar to the user, whilst all other faces are unfamiliar. Authentication is a matter of simply touching the familiar face in each grid.

For the legitimate user, this is a trivial task, as the familiar face stands out from the others. However, a fraudster looking at the same grid hits a problem — none of the faces stand out.

Building authentication around familiarity has several advantages.

Unlike password or PIN-based systems, a familiarity-based approach never requires users to commit anything to memory. Nor does it require them to name the faces in order to authenticate. The only requirement is to indicate which face looks familiar.

Psychological research has shown that familiarity with a face is virtually impossible to lose and so this system is naturally robust. In the current study, users authenticated easily even after a one-year interval. In contrast, disused passwords can be forgotten within days.

As well as being extremely durable, familiarity is very hard to fake. This makes the system difficult for fraudsters to crack.

In the current study, the researchers asked volunteer attackers to watch a successful authentication sequence based on four target faces, so that they could pick out the same four faces from similar test grids. These attacks could be defeated simply by using different photos of the same faces in the test grids.

For the user, who is familiar with the target faces, it is easy to recognize the faces across a range of images. For the attacker, who is unfamiliar with the target faces, generalizing across images is difficult.

Lead author Rob Jenkins, Ph.D., of the University of York in the UK, said that “pretending to know a face that you don’t know is like pretending to know a language that you don’t know –it just doesn’t work. The only system that can reliably recognize faces is a human who is familiar with the faces concerned.”

The initial study elegantly combines the cognitive science of face perception and the computer science of secure authentication to work in sympathy with the strengths and limitations of human memory.

Researchers hope that software developers will now take this framework and create a powerful application with optimal usability.

Source: Peerj

 

Set of people photo by shutterstock.

Prayer Can Aid Organizational Bonding

Wed, 06/25/2014 - 7:00am

As diversity in America grows, organizations from Fortune 500 companies to political parties are challenged to create unity and consensus.

A new sociological study suggest an ancient solution — prayer — may help unite people from very different backgrounds.

Specifically, the study finds that interfaith group prayer serves as a “bridging cultural practice” in multi-faith community organizations.

“The prayer practices we observed appear to play a crucial role in binding participants together across significant racial and socioeconomic differences,” says sociology professor Dr. Ruth Braunstein of the University of Connecticut.

“They do this by being inclusive of multiple faith traditions, celebrating the diversity of the group, and encouraging individuals to interact with each other.”

The study, published online this month and scheduled to appear in the print edition of the American Sociological Review, consists of data from a national study of multi-faith community organizing groups.

These groups organize primarily through religious congregations in an effort to build civic coalitions that address a variety of issues, from health care access to crime. Such groups tend to be both racially and socioeconomically diverse.

Nationally, more than 50 percent of board members of these organizations are non-white, compared to 19 percent of all nonprofit board members and 13 percent of Fortune 500 board members.

Additionally, more than half the board members of the faith-based groups earn less than $50,000 a year.

What Braunstein and her fellow researchers discovered is that, far from being a source of division, religious practices play a unifying role in such groups, even in those — like the one where Braunstein did her fieldwork — that include members from Christian, Jewish, and Muslim faith traditions.

Interfaith group prayers took place in about 75 percent of the diverse gatherings Braunstein observed over two years.

Such prayers are defined by the authors of the study as a “bridging cultural practice,” meaning an activity that’s used to build shared identities across differences.

By analyzing data from the National Study of Faith-Based Community Organizing Coalitions, the researchers found that the greater a group’s diversity, the more likely they were to incorporate “bridging prayer practices” like prayer vigils into their regular activities.

“American society can learn a lot from organizations that are struggling honestly to embrace diversity — especially as we become a majority-minority society in the coming decades, with high levels of income inequality,” said Wood.

Obviously, group prayer is not going to work for every organization. The authors note that conservative religious groups uncomfortable with interfaith prayer, as well as secular organizations, are unlikely to embrace the types of practices observed in the study.

However, the kinds of “bridging” practices identified by Braunstein and her fellow researchers don’t have to be faith-based to be valuable. The researchers suggest that sharing meals, playing sports, or reading literature together could be similarly valuable to different types of organizations seeking to realize the benefits of member diversity.

“Organizations tend to be more effective when they engage, rather than avoid, the varied backgrounds represented among their members,” Fulton said.

The key seems to be organizational flexibility and a willingness to embrace activities that emphasize shared identities through meaningful collective practices, according to Braunstein.

“We aren’t talking about superficial team-building exercises,” she said.

“These are practices that are central to groups’ cultures, and emerge over time as participants reflect on the qualities that unite everyone in the group and develop shared rituals that are meaningful to everyone.”

Source: American Sociological Association

 
Multi-ethnic group praying photo by shutterstock.

Those With Low Self-Esteem May Not Want To Be Cheered Up

Wed, 06/25/2014 - 6:15am

New research suggests that cheering up a friend because they have low self-esteem may not be the best strategy.

Investigators found that people with low self-esteem may have a negative view of themselves and do not want to receive positive validations. Indeed, they often construe critical feedback, romantic rejections, or unsuccessful job applications as evidence of their general unworthiness.

And they likely don’t want you to try to boost their spirits.

“People with low self-esteem want their loved ones to see them as they see themselves. As such, they are often resistant to their friends’ reminders of how positively they see them and reject what we call positive reframing: expressions of optimism and encouragement for bettering their situation,” said Denise Marigold, Ph.D., lead author of the study.

These individuals usually prefer negative validation, which conveys that the feelings, actions, or responses of the recipient are normal, reasonable, and appropriate to the situation.

So a friend could express understanding about the predicament or for the difficulty of a situation, and suggest that expressing negative emotions is appropriate and understandable.

As published in the Journal of Personality and Social Psychology, researchers found no evidence that positive reframing helps participants with low self-esteem.

And in fact, the people providing support to friends with low self-esteem often felt worse about themselves when they attempted to cheer up their friend. Some study participants indicated that supporting friends with low self-esteem could be frustrating and tiring.

The researchers found that when these support providers used positive reframing instead of negative validation in these situations, they often believed the interaction went poorly, perhaps because the friends with low self-esteem were not receptive and the efforts didn’t work.

“If your attempt to point out the silver lining is met with a sullen reminder of the prevailing dark cloud, you might do best to just acknowledge the dark cloud and sympathize,” said Marigold.

Source: University of Waterloo

 
Giving support photo by shutterstock.

Puzzle Video Games Can Improve Aspects of Cognition

Wed, 06/25/2014 - 5:30am

The ability of video games to improve mental fitness has been the subject of considerable debate. A new study suggests playing a specific puzzle-oriented game can improve mental flexibility.

Scientists from Nanyang Technological University (NTU) in Singapore discovered that adults who played the physics-based puzzle video game Cut the Rope regularly, for as little as an hour a day, had improved executive functions.

Executive brain functions are important for making decisions in everyday life when you have to deal with sudden changes in your environment — better known as thinking on your feet. An example would be when the traffic light turns amber and a driver has to decide in an instant if he will be able to brake in time or if it is safer to travel across the junction/intersection.

Researchers tested four different games for the mobile platform, as their previous research had shown that different games trained different skills.

The games varied in their genres, which included a first person shooter (Modern Combat); arcade (Fruit Ninja); real-time strategy (StarFront Collision); and a complex puzzle (Cut the Rope).

Undergraduate students, who were non-gamers, were then selected to play an hour a day, fives days a week on their iPhone or iPod Touch. This video game training lasted for four weeks, a total of 20 hours.

Assistant professor Michael D. Patterson, Ph.D., said students who played Cut the Rope showed significant improvement on executive function tasks while no significant improvements were observed in those playing the other three games.

“This finding is important because previously, no video games have demonstrated this type of broad improvement to executive functions, which are important for general intelligence, dealing with new situations and managing multitasking,” said Patterson, an expert in the psychology of video games.

“This indicates that while some games may help to improve mental abilities, not all games give you the same effect. To improve the specific ability you are looking for, you need to play the right game,” said researcher and Ph.D. student Adam Oei.

Researchers analyzed how fast a player can switch tasks (an indicator of mental flexibility); how fast can a player adapt to a new situation instead of relying on the same strategy (the ability to inhibit prepotent or predominant responses); and how well a person can focus on information while blocking out distractors or inappropriate responses — also known as the Flanker task in cognitive psychology.

Patterson believes the reason Cut the Rope improved executive function in their players was probably due to the game’s unique puzzle design. Strategies which worked for earlier levels would not work in later levels, and regularly forced the players to think creatively and try alternate solutions.

This is unlike most other video games which keep the same general mechanics and goals, and just speed up or increase the number of items to keep track of.

After 20 hours of game play, players of Cut the Rope could switch between tasks 33 percent faster, were 30 percent faster in adapting to new situations, and 60 percent better in blocking out distractions and focusing on the tasks at hand than before training.

All three tests were done one week after the 52 students had finished playing their assigned game, to ensure that these were not temporary gains due to motivation or arousal effects.

The study is currently available online in the academic journal Computers in Human Behavior and will soon follow in hard copy.

Researchers say this is the first study that showed broad transfer to several different executive functions, further providing evidence video games can be effective in training human cognition.

“This result could have implications in many areas such as educational, occupational, and rehabilitative settings,” believe Patterson.

“In future, with more studies, we will be able to know what type of games improves specific abilities, and prescribe games that will benefit people aside from just being entertainment.”

In their previous study published last year in the journal PloS One, Patterson and Oei studied the effects mobile gaming had on 75 NTU undergraduates.

The non-gamers were instructed to play one of the following games: “match three” game Bejeweled, virtual life simulation game The Sims, and action shooter Modern Combat.

The study findings showed that adults who play action games improved their ability to track multiple objects in a short span of time, useful when driving during a busy rush hour; while other games improved the participants’ ability for visual search tasks, useful when picking out an item from a large supermarket.

Future research will evaluate if is any improvement from playing such games in experienced adult gamers and how much improvement one can make through playing games.

Source: Nanyang Technological University

Health Challenges Make Bisexual Men More Prone to Sexual Disease

Tue, 06/24/2014 - 9:15am

A new study from the Centers for Disease Control and Prevention (CDC) suggests bisexual men have many unmet public health needs, which leave them vulnerable to sexually transmitted infections (STIs) and other health problems.

The study, as published in the American Journal of Preventive Medicine, examines the behavioral, interpersonal, and social realities of men who have sex with men and women (MSMW) and reviews possible interventions to improve their health.

According to researchers, MSMW represent a small portion of the population, with about two percent of sexually active males reporting sex with both men and women.

Although low in numbers, the bisexual male population is disproportionally affected by HIV and STIs.

According to study author William L. Jeffries IV, Ph.D., M.P.H., M.A., factors that may affect the sexual health of MSMW include sex without condoms, early sexual debut, forced sexual encounters, increased numbers of sexual partners, substance use, exchange sex, risk behaviors of their male and female partners, and attitudes toward pregnancy.

These factors shape MSMW’s vulnerability to HIV and STIs in ways that distinguish bisexual men from gay and heterosexual men.

Negative attitudes toward bisexual individuals, economic barriers, masculinity norms, and the meanings associated with their sexual identities are among the social factors that may negatively influence their sexual partnerships and risks for HIV/STIs.

While HIV prevalence among MSMW is lower than among gay men, MSMW are more likely than heterosexual men to become infected with HIV.

Also, MSMW are less likely than gay men to be tested for HIV, which can lead to undiagnosed HIV and transmission to partners.

Along with HIV, other STIs are common among MSMW, with 21 percent of these men reporting STI treatment in the past year, compared to 12 percent for gay men and 2.3 percent of heterosexual men.

“MSMW’s increased likelihood of insertive sex without a condom, as well as commonly occurring oral sex with men and women, likely increase MSMW’s vulnerability to STIs readily acquired via penile-insertive and oral sex,” writes Jeffries.

“Moreover, receptive and insertive sex without a condom with men (no matter how common) makes MSMW more vulnerable to HIV than men who only have sex with women because HIV is more prevalent among men than women in the United States.”

Jeffries also identifies other behavioral factors that may increase chances of acquiring HIV and STIs among MSMW, including early sexual experiences, multiple partners, illicit drug use, and attitudes towards pregnancy.

“MSMW’s attitudes toward pregnancy influence their sexual health. Qualitative data from black men suggest that desires to prevent pregnancy may prompt some MSMW to consistently use condoms with women,”  Jeffries said.

“Yet, MSMW may avoid condom use when their female partners use other contraceptives or when female partners perceive condom use as a sign of relationship infidelity.

“Further, MSMW’s desires to produce offspring biologically may prompt sex without a condom with female partners. In this regard, desires for fatherhood may indirectly increase these men’s vulnerability to HIV/STIs and transmission of these infections within their sexual networks.”

In the current social climate, MSMW face several sociocultural obstacles including biphobia, or negative attitudes towards bisexuals.

“Biphobia can manifest in erroneous beliefs that MSMW are gay men who have not disclosed their sexual orientation and, particularly for black men, responsible for HIV transmission to women,” Jeffries said.

“Experiencing these sentiments can contribute to MSMW’s social isolation and psychological distress, which in turn may promote HIV/STI risk through substance use, sexual risk behaviors, and the avoidance of prevention services.”

This new research not only describes an understudied population, but also recommends interventions to better serve bisexual men.

Jeffries suggested that some strategies for comprehensively promoting MSMW’s sexual health may be to:

  • launch social marketing campaigns that use affirmative images of sexual minority men to counteract the biphobia and homophobia that MSMW experience;
  • develop comprehensive sexuality education programs that provide invaluable HIV/STI prevention education to MSMW, including promoting school safety for MSMW;
  • encourage social spaces that cultivate a sense of community to provide opportunities for social support and candid discussion of sexual health concerns;
  • engage medical and health professionals in sensitivity trainings to lessen any hostility encountered by MSMW when they seek information about sexual health or HIV/STI testing.

While more research and outreach is needed to better understand the particular health and other needs of bisexual men, this study sheds new light on the current situation.

“Sexual health promotion for MSMW should not be limited to HIV/STI prevention alone,” said Jeffries. “Recognition of MSMW’s unique sexual and social experiences can lay the foundation necessary for ensuring that these men have healthy and fulfilling sexual experiences.

“Purposefully designed and tailored efforts for MSMW are indispensable for improving the sexual health of this vulnerable population.”

Source: Elsevier

 
Doctor talking with male patient photo by shutterstock.

Study Looks at Gestures As Part of Language

Tue, 06/24/2014 - 8:30am

A new study seeks answers to a simple question: Why can’t we stay still when talking to others? Or, why do we use gestures?

“Because gestures and words very probably form a single communication system, which ultimately serves to enhance expression intended as the ability to make oneself understood,” said researcher and neuroscientist Marina Nespor, Ph.D., of International School for Advanced Studies (SISSA) of Trieste, Italy.

As published in the journal Frontiers in Psychology, Nespor together with Alan Langus and Bahia Guellai, explain the role of gestures in speech “prosody.”

Linguists define prosody as the intonation and rhythm of spoken language, features that help to highlight sentence structure and therefore make the message easier to understand.

For example, without prosody, nothing would distinguish the declarative statement “this is an apple” from the surprise question “this is an apple?” (in this case the difference lies in the intonation).

According to Nespor and colleagues, even hand gestures are part of prosody; “the prosody that accompanies speech is not ‘modality specific’” explains Langus. “Prosodic information, for the person receiving the message, is a combination of auditory and visual cues.”

“The ‘superior’ aspects (at the cognitive processing level) of spoken language are mapped to the motor-programs responsible for the production of both speech sounds and accompanying hand gestures.”

Nespor, Langus, and Guellai had 20 Italian speakers listen to a series of “ambiguous” utterances, which could be said with different prosodies corresponding to two different meanings.

Examples of utterances were “come sicuramente hai visto la vecchia sbarra la porta” where, depending on meaning, “vecchia” can be the subject of the main verb (sbarrare, to block) or an adjective qualifying the subject (sbarra, bar) (“As you for sure have seen the old lady blocks the door” versus “As you for sure have seen the old bar carries it”).

The utterances could be simply listened to (“audio only” modality) or be presented in a video, where the participants could both listen to the sentences and see the accompanying gestures. In the “video” stimuli, the condition could be “matched” (gestures corresponding to the meaning conveyed by speech prosody) or “mismatched” (gestures matching the alternative meaning).

“In the matched conditions there was no improvement ascribable to gestures: the participants’ performance was very good both in the video and in the “audio only” sessions.

“It’s in the mismatched condition that the effect of hand gestures became apparent”, explains Langus.

“With these stimuli the subjects were much more likely to make the wrong choice (that is, they would choose the meaning indicated in the gestures rather than in the speech) compared to matched or audio-only conditions.

This means that gestures affect how meaning is interpreted, and we believe this points to the existence of a common cognitive system for gestures, intonation, and rhythm of spoken language”.

“In human communication, voice is not sufficient: even the torso and in particular hand movements are involved, as are facial expressions,” Nespor said.

Source: International School of Advanced Studies (SISSA)

 
Man using hand gestures while speaking photo by shutterstock.

Growth Hormone May Lead to Depression in Kids

Tue, 06/24/2014 - 7:45am

New research discovers that children treated with growth hormone (GH) may become depressed and withdrawn over time.

Thus, although hormonal treatments may work to help a child become taller, the unintended consequences of psychosocial issues must be considered.

Study results were presented at the joint meeting of the International Society of Endocrinology and the Endocrine Society in Chicago.

“Daily injections, frequent clinic visits, and repeated discussions about height might exacerbate instead of improve psychosocial concerns in children with idiopathic short stature (ISS) who are otherwise healthy, and give them no cognitive improvements,” said lead author Emily C. Walvoord, M.D.

While the link between using GH to increase height and improved psychological adaptation is being debated, early data suggest that the subtle cognitive problems seen in adults with growth hormone deficiency (GHD) might also occur in children with GHD and might improve with treatment.

Walvoord and her colleagues evaluated the cognitive and behavioral status of children with GHD and ISS after they received either GH therapy or observation alone, and their preliminary results presented here challenge the idea that improvements in height also result in improvements in psychological functioning.

Their findings also raise the concern that GH treatment of these otherwise healthy children might even worsen their emotional symptoms.

In their study, 41 children with GHD and ISS between the ages of six and 16 years of age, 11 on average, took a series of tests that examined their cognitive functioning, and their parents completed questionnaires that assessed their child’s emotional and behavioral functioning.

The children were then assigned to either the group that was treated with growth hormone or the untreated control group, and after nine to 12 months, the children in both groups were retested.

So far, 41 children have had initial testing and 28 have had follow-up testing. Among these children, the researchers have found no differences in cognitive functioning between GHD and the ISS children from their first test to their retest.

However, compared with the untreated ISS children, whose depression and withdrawal according to their parents’ questionnaire responses have lessened over that period, the depression and withdrawal symptoms in the treated GHD and ISS children have worsened.

“This novel study of the cognitive and emotional effects of GH therapy in children with GHD and ISS compared to untreated short children raises concerns that, despite improvements in height, these children may not achieve psychosocial benefits,” Walvoord said.

Source: Endocrine Society/Newswise

 
Child receiving an injection photo by shutterstock.

Repetitive Learning Has Shortcomings

Tue, 06/24/2014 - 7:00am

A new study suggests learning from repetition alone may limit the amount of detail stored with the memory.

University of California, Irvine, researchers discovered that while repetition enhances the factual content of memories, when memory is repeatedly recalled, nuances may slip away.

In the study, student participants were asked to look at pictures either once or three times. They were then tested on their memories of those images.

The researchers found that multiple views increased factual recall but actually hindered subjects’ ability to reject similar “imposter” pictures. This suggests that the details of those memories may have been shaken loose by repetition.

This discovery supports neurobiologists Zachariah Reagh and Michael Yassa ‘s competitive trace theory, published last year in Frontiers in Behavioral Neuroscience.

The theory posits that the details of a memory become more subjective the more they are recalled and can compete with bits of other similar memories. The scientists hypothesize that this may even lead to false memories, akin to a brain version of the telephone game.

Yassa said that these findings do not discredit the practice of repetitive learning. However, he noted, pure repetition alone has limitations.

That is, for a better and longer-lasting learning experience, a variety of learning techniques such as learning over time and not cramming, and use of flash cards, should complement rote repetition.

Source: University of California, Irvine

 
Abstract of brain photo by shutterstock.

Best Learning Approach Uncovered

Tue, 06/24/2014 - 6:15am

New research indicates that practicing the right way is crucial to learning new skills.

To investigate how learning can be optimized, Tom Stafford, Ph.D., of Sheffield University in England gathered figures from 854,064 players of an online game called Axon which tests rapid perception, decision-making, and response times.

In the game, players must guide a neuron from connection to connection by clicking on potential targets. This tests participants’ ability to perceive, make decisions, and move quickly. The researchers used a tracking code to record each player’s identity, and kept track of the score, date and time, each time the game was played.

Some players improved more than others, even with the same duration of practice. This appeared to be because they either spaced out their practice sessions, or had registered more variable early performances, suggesting they were exploring how the game works.

Findings are published in the journal Psychological Science, a journal of the Association for Psychological Science. The authors write, “Use of game data allowed us to connect, for the first time, rich details of training history with measures of performance from participants engaged for a sustained amount of time in effortful practice.

“We showed that relations exist between practice spacing and subsequent performance. Additionally, we showed that greater initial variation in performance is linked to higher subsequent performance.”

“The study suggests that learning can be improved,” said Stafford. “You can learn more efficiently or use the same practice time to learn to a higher level. As we live longer, and more of our lives become based around acquiring complex skills, optimal learning becomes increasingly relevant to everyone.

“There is no reason to say that you can’t go on learning into later life. It isn’t clear that older people are any worse at learning than younger people. I would expect these results to apply equally to people of all ages.”

He also cautioned against being too perfectionist. “If you try too hard never to fail, you don’t explore the parameters of the activity. You have to do some exploration, and it is my theory that if you do this exploration, you will perform better in the long run.”

In terms of the ideal spacing between practice sessions, Stafford believes it depends on how long you want to remember the subject or skill. If you want to remember something for a year’s time, for example, he says you will need bigger spaces between practice sessions than if you want to remember something for just a week.

Stafford said that this study, with such a big sample of online game players, provides a useful template for looking at other types of learning. “This kind of data affords us to look in an unprecedented way at the shape of the learning curve,” he said.

He added that using data collected from people playing games has strong advantages over studying learning in a lab. He plans to work with game designers on further studies into optimal learning.

A further study that shows spaces between training sessions improves performance was carried out in April 2014 by researchers at Beijing Normal University, China. As Renlai Zhou, Ph.D., and colleagues pointed out, “Cognitive training studies yield wildly inconsistent results.”

But such studies vary enormously in the scheduling of training sessions, so the team addressed the issue by randomly assigning 115 fifth-grade children to four training groups. Each had 20 sessions training that used their working memory, spread across two, five, ten, or 20 days. Working memory is what we use when we hold several pieces of information in our mind, to use immediately.

All groups improved significantly on the training task, but the group with the greatest amount of spacing (20 days) had the best results on a separate test of fluid intelligence. This is our ability to think logically and solve new problems, regardless of “background” intelligence.

The experts add that boosting our working memory via training “is beneficial to various subject populations, varying from young children to old adults, including healthy subjects as well as those with special needs.”

In tests, it had aided the recovery of cognitive function after a stroke, improved memory among adults over 80 years old, and improved fluid intelligence in college students and younger pupils.

They summarize that the spacing effect seen here in memory may shed light on similar effects in other areas of brain training.

References

Stafford, T. and Dewar, M. Tracing the Trajectory of Skill Learning With a Very Large Sample of Online Game Players. Psychological Science, 30 December 2013, doi: 10.1177/0956797613511466 Axon

Wang, Z. et al. Spaced cognitive training promotes training transfer. Frontiers in Human Neuroscience, 10 April 2014, doi: 10.3389/fnhum.2014.00217
Abstract of brain photo by shutterstock.

Working With The Human Bent to Fear Approaching Things

Tue, 06/24/2014 - 5:30am

New research cites an evolutionary characteristic to explain the general tendency in humans to fear things that are approaching, even if the element is non-threatening.

Researchers believe that as our ancestors struggled for survival, humans learned that something approaching us is far more of a threat than something that is moving away. This makes sense, since a tiger bounding toward a person is certainly more of a threat than one that is walking away.

Though modern humans don’t really consider such fear, it turns out it still plays a big part in our day-to-day lives.

According to University of Chicago professor Christopher K. Hsee, Ph.D., we still have negative feelings about things that approach us — even if they objectively are not threatening.

“In order to survive, humans have developed a tendency to guard against animals, people, and objects that come near them,” Hsee explains. “This is true for things that are physically coming closer, but also for events that are approaching in time or increasing in likelihood.”

Hsee and his research team termed the trait, “approach avoidance,” and discuss the concept in a paper recently published in the Journal of Personality and Social Psychology.

The team conducted a battery of eight tests in support of their thesis and found that even nonthreatening objects and beings evoked negative feelings in participants as they came closer.

Even seemingly docile entities, such as deer, had a fear factor attached to them since participants could still attach some uncertainty to a wild animal’s behavior.

These initial investigations into approach avoidance are of practical use in a number of areas. Marketers, for example, can use this information to determine if they should gradually move a product closer to viewers in a television commercial, or whether that will actually harm the image of the product.

Similarly, speakers who tend to move closer and closer toward their audiences during their speeches should think twice, as doing so may cast an unfavorable impression on listeners.

“Approach avoidance is a general tendency – humans don’t seem to adequately distinguish between times they should use it and when they should not,” Hsee said. “They tend to fear approaching things and looming events even if objectively they need not fear.”

Source: University of Chicago-Booth

 
Approaching event photo by shutterstock.

Waking Up During Surgery Not Tied to PTSD

Mon, 06/23/2014 - 7:45am

Finnish researchers confirm in a study in the journal Anesthesia & Analgesia that patients who remain aware during anesthesia and surgery do not seem to be at increased risk of posttraumatic stress disorder (PTSD) or other problems with psychosocial well-being.

“We found no indication that intraoperative awareness with recall had any long-term effects on patients’ psychosocial outcome,” said researcher Dr. Tanja Laukkala of the Centre for Military Medicine in Helsinki, Finland.

Anesthesiologists “should respond to the findings… with a mixture of cautious optimism coupled with a renewed commitment to the prevention and treatment of PTSD” after intraoperative awareness, according to an accompanying editorial in the journal by Drs. George A. Mashour and Michael S. Avidan.

The new study included nine patients with a documented episode of intraoperative awareness during general anesthesia. All patients had “definite awareness with recall;” they accurately described events that occurred during their surgery.

A median of 17.2 years after their episode of intraoperative awareness, the patients were evaluated on a battery of tests of psychosocial well-being. Assessment included formal diagnostic interviews for PTSD, along with anxiety, depression, and other psychiatric disorders.

Nine patients with similar characteristics who had undergone surgery without intraoperative awareness were studied for comparison.

The results showed no significant difference in psychosocial outcomes for the patients with versus without intraoperative awareness. In particular, none of the patients with intraoperative awareness were diagnosed with PTSD.

In fact, in no patient did the episode of intraoperative awareness meet criteria for being a “potentially traumatic event” of the type leading to PTSD.

Other measures of psychosocial well-being, including quality of life ratings, were also similar between groups. A few patients in each group had depression or other psychiatric disorders.

Intraoperative awareness with recall is an uncommon but documented complication in patients undergoing general anesthesia. Previous studies have suggested it may place patients at risk for PTSD and other mental health conditions, such as depression or alcohol abuse. But because intraoperative awareness is rare, it is difficult to study the possible psychological after-effects.

Previous studies have reported high rates of PTSD after intraoperative awareness, but have had important limitations. For example, some studies have recruited patients through advertising, introducing a potential source of bias.

The new report is the longest follow-up study of patients with documented episodes of intraoperative awareness with recall.

Laukkala and co-authors noted that the patients in their study received “appropriate psychosocial support and services” and explanations of their memories and symptoms, which may have lessened the long-term impact of the event.

The results suggest that intraoperative awareness doesn’t necessarily increase the risk of PTSD and other mental health problems.

The researchers write, “We emphasize that it is of utmost importance to try to prevent intraoperative awareness, and when recognized, potentially traumatized individuals should be offered support according to evidence-based guidelines.”

While the findings are reassuring, they do not mean there’s no risk of PTSD after an episode of intraoperative awareness, according to Mashour and Avidan.

In their editorial, they call for further studies to understand which procedures or patients are associated with a higher risk of intraoperative awareness and PTSD, to facilitate early recognition and prompt treatment.

Source: Wolters Kluwer Health

 
Surgeons looking at patient photo by shutterstock.

Putting Faith to Work Linked to Job Satisfaction

Mon, 06/23/2014 - 7:00am

Regular attendance in a church that stresses faith as a component of work is associated with high job satisfaction and employment commitment.

Baylor University sociologists discovered the influence depends in part on how involved that person is in the congregation, not merely on occasional attendance.

“We already knew that about 60 percent of American adults are affiliated with congregations, but we wanted to delve into whether that carries over from weekend worship services to the work day,” said Jerry Z. Park, Ph.D.

“It turns out it does make some difference in their attitudes at work. That means it has a potential ‘payoff’ not only for employers, but for employees themselves.”

Researchers asked a random sample of full-time employees if they attended a place of worship, and if so, they were then asked whether their congregation emphasized integrating their faith in the workplace through “sacrificial love” to their co-workers, sensing God’s presence at work among others.

What seemed to make the difference, researchers found, was frequent attendance at a church that stressed a merging of faith and work. Simply being at such a congregation — or just attending any church — did not result in greater work satisfaction or dedication.

The study is published in the journal Sociology of Religion.

Researchers’ analysis was based on the National Survey of Work, Entrepreneurship, and Religion, a 2010 Web-based survey of 1,022 fulltime workers. Their findings concentrated on three areas:

  • Job satisfaction: Full-time workers who regularly attend a congregation that emphasizes integrating their faith at work report higher job satisfaction;
  • Job commitment: Full-time workers who regularly attend a congregation that emphasizes integrating their faith at work report higher commitment to their place of employment;
  • Entrepreneurship: People who are actively involved in in congregations that promote integration of faith with work are more likely to describe themselves as entrepreneurial, Park said.

However, attendance seems to impede entrepreneurship — perhaps because time and energy spent in entrepreneurial endeavors leaves less time for church attendance.

“How religion affects job satisfaction, commitment to one’s job and entrepreneurship was measured by researchers using a 15-item Congregational Faith at Work Scale,” Park said.

That scale includes such items as whether respondents

  • sense God’s presence while they work;
  • view their work as having eternal significance;
  • view co-workers as being made in the image of God;
  • believe they should demonstrate “sacrificial love” toward co-workers, and;
  • believe God wants them to develop their abilities and talents at work.

Workplace attitudes such as job commitment also were evaluated by a variety of items that asked how much participants felt like “part of the family” at their organization, how efficiently they get proposed actions through “bureaucratic red tape” and whether they “went to bat” for good ideas of co-workers.

Max Weber, an early social theorist, argued that Protestants who lived strict, simple lives — such as the Calvinists of the 16th and 17th centuries — viewed their worldly employment as service to God, so religion added significance to labor. Success in business was viewed as confirmation of salvation.

“Religious participation is an active part of life for millions of Americans, and it is relevant in other domains,” the study concluded.

Source: Baylor University

 
Church congregation photo by shutterstock.

Physical Fitness Tied to Kids’ Academic Performance

Mon, 06/23/2014 - 6:15am

A growing body of evidence suggests physical fitness may play a key role in brain health and academic performance.

In a new study scheduled for publication in the Journal of Pediatrics, researchers studied the independent and combined influence of components of physical fitness on academic performance.

Cardiorespiratory capacity, muscular strength, and motor ability are components of physical fitness that have documented potential to improve health. Each fitness component is believed to affect the brain differently and thus contribute academic performance.

According to Irene Esteban-Cornejo, MSc, Autonomous University of Madrid, “Because these physical fitness components are highly associated with each other, it is important to differentiate which physical fitness components are important in relation to academic performance.”

The study sample included 2,038 Spanish children and adolescents (six to 18 years of age) with complete data on physical fitness, body composition, and academic performance.

Esteban-Cornejo and the UP & DOWN Study Group members found that cardiorespiratory capacity and motor ability, both independently and combined, were related to academic performance.

However, the association of academic performance and physical fitness was stronger for motor ability than cardiorespiratory capacity, meaning that motor ability may be more important for academic performance. In contrast, children and adolescents who had both lower levels of cardiorespiratory capacity and motor ability had lower grades.

Muscular strength was not independently associated with academic performance.

Although the combined components of physical fitness can influence academic performance, this study suggests that cardiorespiratory capacity and, to a greater extent, motor ability, may be greater influences.

Said Esteban-Cornejo, “Having high levels of cardiorespiratory and motor fitness may, to some extent, reduce the risk of school failure.”

“Efforts should be made to promote physical activities for children and adolescents that involve aerobic exercises and motor tasks to enhance cardiorespiratory capacity and motor ability,” researchers said, “thereby improving academic development.”

Source: Elsevier

 
Student soccer player photo by shutterstock.

Report: Defense, VA Fail to Track If PTSD Treatment Works

Mon, 06/23/2014 - 5:30am

A new report from the independent, nonprofit Institute of Medicine (IOM) finds that the federal government is not measuring the effectiveness of treatment for post-traumatic stress disorder (PTSD) — calling into question the millions of dollars spent on mental health of service members.

Moreover, researchers discovered the neither the U.S. Department of Defense (DOD) nor U.S. Department of Veterans Affairs (VA) have kept pace with growing demand for PTSD treatment.

The health arm of the National Academy of Sciences, the IOM provides unbiased and authoritative advice to decision-makers and the public.

“Both departments lack a coordinated, consistent, and well-developed evidence-based system of treatment for PTSD and need to do a better job tracking outcomes,” said Sandro Galea, M.D., Dr.P.H., chair of the IOM committee, and chair of the Department of Epidemiology at Columbia University’s Mailman School of Public Health.

“Mental health is among the most important factors behind successful re-entry after military service, and we don’t know if treatments are working.”

The IOM issued this report on the heels of a scandal at the Department of Veterans Affairs that led to the resignation of VA Secretary Eric Shinseki on May 30. Federal investigators determined that service members were systematically denied timely care in a network of more than 1,700 healthcare facilities that suffers from inefficiency and bureaucracy.

PTSD is diagnosed by combination of symptoms, including hypervigilence and sleeplessness, and can be treated both pharmacologically and psychologically with cognitive-behavioral and other therapies involving multiple sessions with trained counselors.

An estimated five percent of service members have been diagnosed with PTSD; for veterans who served in Iraq and Afghanistan conflicts, the number rises to eight percent.

In 2012, more than a half-million sought care for PTSD in the VA — 9.2 percent of all VA users. In 2012 the DOD and VA spent $294 million for PTSD care.

If treatment demands continue to climb, the total cost for PTSD could exceed $500 million by 2017.

The report also recommends that the DOD and VA enlist a workforce of mental health care providers to meet the growing need for PTSD treatment.

While the departments have substantially increased mental health staffing, these increases do not appear to have kept pace with the demand.

The most surprising outcome over four years of deliberation, according to Galea, is the dissonance between the intention of senior leadership and how a PTSD management system is implemented.

“There is generally good will and spikes of excellence in both departments. Substantial effort has been made toward providing service members excellent PTSD care.

“However, there is tremendous variability in how care is implemented and an absence of data that tell us if programs are working or not,” Galea said.

“In many respects our findings that neither the DOD nor the VA has a system that documents patients’ progress and uses standardized instruments to chart long-term treatment are not surprising,” he added.

“We are hopeful that the report will provide a blueprint for where we need to get to.”

The report is the second of a two-phase assessment of PTSD services for the military. The first report of the committee, also chaired by Galea, was issued in July 2012.

Source: Columbia University’s Mailman School of Public Health

Antidepressants While Pregnant Tied to Child’s Obesity, Diabetes

Sun, 06/22/2014 - 8:45am

A new study has found a correlation between the use of a popular antidepressant during pregnancy and an increased risk of obesity and Type II diabetes in children.

“Obesity and Type II diabetes in children is on the rise and there is the argument that it is related to lifestyle and availability of high calorie foods and reduced physical activity, but our study has found that maternal antidepressant use may also be a contributing factor to the obesity and diabetes epidemic,” said the study’s senior investigator Alison Holloway, Ph.D., an associate professor of obstetrics and gynecology at McMaster University in Hamilton, Ontario, Canada.

Researchers note that up to 20 percent of women in the United States and about seven percent of Canadian women are prescribed an antidepressant during pregnancy. Previous studies have found that pregnant women are particularly vulnerable to depression, with estimates that one in five pregnant women have symptoms of depression during pregnancy.

“While it is known that these drugs can increase the risk of obesity in adults, it is unknown whether a woman’s antidepressant use during pregnancy increases the risk of metabolic disturbances in her children,” Holloway said.

The goal of the researchers’ project was to determine whether maternal exposure to fluoxetine, the commonly prescribed antidepressant also known as Prozac, is related to the development of fatty liver — an outcome commonly seen with obesity — in the offspring.

“We have demonstrated for the first time in an animal model that maternal use of a class of antidepressants called selective serotonin reuptake inhibitors, or SSRIs, resulted in increased fat accumulation and inflammation in the liver of the adult offspring, raising new concerns about the long-term metabolic complications in children born to women who take SSRI antidepressants during pregnancy,” said PhD student Nicole De Long, who presented the research at the joint meeting of the International Society of Endocrinology and The Endocrine Society.

The researchers note their study does not suggest women should not take antidepressants during pregnancy, only that there may be risks associated with antidepressants that haven’t been previously identified.

“The benefit of the study is it may help in the identification of a high-risk group of children who may require specific interventions to prevent obesity and Type II diabetes later in life,” Holloway said.

The next stage of the research will be to understand why these drugs pose a risk, according to the researchers.

“If we can understand how the antidepressant causes adverse metabolic outcomes in the offspring, then we can design therapeutic strategies to prevent the damage while allowing women who require these drugs to be treated but reduce the potential harm to the offspring,” she said.

Source: McMaster University