In The News
Although radiologists are highly trained to detect cases of potential child abuse, very few have received either formal or informal instruction in detecting elder abuse.
And while spotting abuse in older people tends to be a much more complicated task, many radiologists express a desire for more training in this area, according to a new study.
“Radiologists are a core part of the medical team in child abuse cases, so why shouldn’t they be a core part of the team in elder abuse?” said Dr. Tony Rosen, study coauthor and emergency physician at Weill Cornell Medical College, New York.
Rosen notes that one important obstacle to this training, however, is the lack of research examining injury patterns in elder abuse. And making the situation even more complicated is that it is much more difficult overall to detect abuse in elderly people than it is in children.
He said that, “for various reasons including age-related osteopenia, use of anticoagulant medications, and the frequency of accidental injuries from falls, elder abuse is often not easy to spot.”
“Also, while patient age is often very helpful to radiologists assessing images for potential child abuse, it is not as useful in older adults because one 81-year-old may be running marathons while another is bed-bound in a nursing home.”
Of the 19 diagnostic radiologists interviewed as part of this research, only two reported receiving formal or informal training in elder abuse detection, and all of the participants believed they had most likely missed cases of elder abuse. Despite this, all diagnostic radiologists interviewed expressed a desire for additional training in the area.
“Geriatric patients, particularly those with acute injuries, commonly undergo radiographic imaging as part of their medical evaluation, so radiologists may be well-positioned to raise suspicion for mistreatment, said Dr. Kieran Murphy, study coauthor and radiology professor at the University of Toronto, Ontario.
On the basis of these findings, the research team plans to conduct future studies to define pathognomonic injury patterns and to explore how to empower radiologists to incorporate detection into their practice.
As many as 10 percent of older U.S. adults experience elder mistreatment each year, and evidence suggests that victims have dramatically increased mortality and morbidity.
The study is published in the American Journal of Roentgenology (AJR) and was supported by the National Institute on Aging.
Source: American Roentgen Ray Society
An enzyme found in the fluid around the brain and spine is giving researchers a snapshot of what happens inside the minds of Alzheimer’s patients and how that relates to cognitive decline.
Iowa State University researchers say higher levels of the enzyme autotaxin “significantly” predict memory impairment and type II diabetes.
Just a one-point difference in autotaxin levels — for example, going from a level of two to a three — is equal to a 3.5 to five times increase in the odds of being diagnosed with some form of memory loss, said Dr. Auriel Willette, an assistant professor of food science and human nutrition at Iowa State.
Autotaxin, often studied in cancer research, is an even stronger indicator of type II diabetes, he noted. A single point increase reflects a 300 percent greater likelihood of having the disease or pre-diabetes.
Willette and Kelsey McLimans, a graduate research assistant, say the discovery is important because of autotaxin’s proximity to the brain.
“We’ve been looking for metabolic biomarkers which are closer to the brain,” Willette said. “We’re also looking for markers that reliably scale up with the disease and have consistently higher levels across the Alzheimer’s spectrum. This is as directly inside of the brain as we can get without taking a tissue biopsy.”
Willette’s previous research found a strong association between insulin resistance and memory decline and detrimental brain outcomes, increasing the risk for Alzheimer’s disease.
Insulin resistance is a good indicator, but Willette said it has limitations because what happens in the body does not consistently translate to what happens in the brain. That is why the correlation with this new enzyme found in the cerebrospinal fluid is so important, he said.
“It has a higher predictive rate for having Alzheimer’s disease,” McLimans said. “We also found correlations with worse memory function, brain volume loss and the brain using less blood sugar, which have also been shown with insulin resistance, but autotaxin has a higher predictive value.”
For the study, researchers analyzed data from 287 adults collected through the Alzheimer’s Disease Neuroimaging Initiative, a public-private partnership working to determine whether MRI and PET scans, as well as biological markers, can measure the progression of cognitive impairment and Alzheimer’s disease.
The data came from adults ranging in age from 56 to 89. The study participants completed various tests to measure cognitive function. This included repeating a list of words over various time increments, researchers said.
The fact that autotaxin is a strong predictor of type II diabetes and memory decline emphasizes the importance of good physical health, the researchers point out. They add people with higher levels of autotaxin are more likely to be obese, which often causes an increase in insulin resistance.
According to Willette, autotaxin levels can determine the amount of energy the brain is using in areas affected by Alzheimer’s disease.
People with higher autotaxin levels had fewer and smaller brain cells in the frontal and temporal lobes, areas of the brain associated with memory and executive function, he noted. As a result, they had lower scores for memory and tests related to reasoning and multitasking.
“Autotaxin is related to less real estate in the brain, and smaller brain regions in Alzheimer’s disease mean they are less able to carry out their functions,” Willette said.
“It’s the same thing with blood sugar. If the brain is using less blood sugar, neurons have less fuel and start making mistakes and in general do not process information as quickly.”
The study was published in the Journal of Alzheimer’s Disease.
Source: Iowa State University
Patterns of white matter microstructure present in babies’ brains at birth and that develop soon after birth have been found to predict the cognitive function of children at ages one and two, according to a new study led by researchers at the University of North Carolina (UNC) School of Medicine.
“To our knowledge, this study is the first to measure and describe the development of white matter microstructure in children and its relationship to cognitive development from the time they are born until the age of two years,” said John H. Gilmore, M.D., senior author of the study and director of the Early Brain Development Program in the UNC Department of Psychiatry.
White matter — tissue in the brain that contains axon fibers, which connect neurons in one brain region to another — is critical for normal brain function. Little is known about how white matter develops in humans or how it is related to growth of cognitive skills in early childhood, including language development.
For the study, 685 children (including 429 twins) received diffusion tensor imaging (DTI) scans of their brains. DTI is a magnetic resonance imaging (MRI) technique that provides a description of the diffusion of water through tissue. This image can be used to identify white matter tracts in the brain and describe the organization and maturation of the tracts.
The researchers used these brain scans to analyze the microstructure of 12 white matter fiber tracts important for cognitive function, their relationship to developing cognitive function and their heritability.
They found all 12 of the fiber tracts in the newborns were highly related to each other. By age one, these fiber tracts had begun to differentiate themselves from each other, and by age two this differentiation was further advanced.
The most interesting finding from the study was that the relationship between white matter tracts at birth predicted overall cognitive development at age one and language development at age two, suggesting that it may be possible to use brain imaging at birth to better understand how a child’s cognitive development will proceed in the first years after birth.
Because the study involved twins, the researchers were also able to calculate that this predictive trait was moderately heritable, suggesting that genetics may be a factor in its development.
“There is rapid growth of brain structure, cognition and behavior in early childhood, and we are just starting to understand how they are related,” said Gilmore.
“With a better understanding of these relationships, we ultimately hope to be able to identify children at risk for cognitive problems or psychiatric disorders very early and come up with interventions that can help the brain develop in a way to improve function and reduce risk.”
The study was published in the journal Proceedings of the National Academy of Sciences.
The increased public use of e-cigarettes has not re-normalized the use of conventional cigarettes, as some have argued, according to a new study conducted by the Centre for Substance Use Research (CSUR) in Scotland.
The findings are published in the journal International Archives of Addiction Research and Medicine.
Based on interviews with 100 non-smokers between the ages of 16 and 29, the vast majority (96 percent) of responses showed that young people are clearly able to differentiate between smoking traditional cigarettes and e-cigarettes. In fact, most expressed a disinterest in vaping, further confirming the notion that the e-cigs are primarily used for attempting to quit or reduce tobacco consumption.
Importantly, there was no reported change in the respondents’ desire to smoke after seeing the devices used in public, with some suggesting the products make cigarettes appear even less appealing.
While 61 percent of the young people suggested the sight of an e-cigarette made them curious about the devices and what the experience of using them was like, only a third of that group said they had tried one since first seeing the devices used in public, and none had gone on to use e-cigarettes more frequently. About 38 percent of the respondents said that seeing an e-cigarette used in public did not make them curious about vaping at all.
“These results cast doubt on claims of a link between the increased popularity of e-cigarettes, their ensuing visibility when used in public, and any resulting increase in the desire to smoke tobacco among young people,” said Dr. Neil McKeganey, director of CSUR and lead author of the study.
“While the study suggests more people now consider vaping to be a ‘normal’ activity, it also shows that there is no basis for regulating e-cigarettes based on a fear they are making smoking more attractive, because this fear is clearly unfounded. Any restrictions on their use, for example in public places, should reflect the reality that people do not think smoking is any more socially acceptable just because more people are seen to be vaping,” McKeganey added.
“If anything, the results of this study show the opposite is true. Vaping is making smoking less interesting for non-smokers. While there is still a need to pursue further research into e-cigarettes, on the basis of our results the devices in their current form can be clearly distinguished from traditional cigarettes. ”
E-cigarettes have been deemed 95 percent safer than traditional tobacco by Public Health England, a view that is supported by numerous other public health and tobacco-control groups.
University of Virginia researchers have found a rare and powerful type of immune cell in the meninges, the protective tissue around the brain, and its action in the brains of mice suggest it could play a critical role in some neurological diseases such as Alzheimer’s.
By harnessing the cells’ power, doctors may be able to develop new treatments for neurological diseases, traumatic brain injury, and spinal cord injuries — even migraines, according to researcher Jonathan Kipnis, Ph.D.
The researchers additionally suspect that the cells may be the missing link connecting the brain and the microbiota in our guts, a relationship already shown important in the development of Parkinson’s disease.
The cells, known as “type 2 innate lymphocytes,” previously have been found in the gut, lung, and skin — the body’s barriers to disease. Their discovery in the meninges, the membranes surrounding the brain, comes as a surprise, according to the researchers.
Kipnis’s lab found last year that the brain and immune system are directly connected via vessels long thought not to exist.
“This all comes down to immune system and brain interaction,” said Kipnis, chairman of University of Virginia’s Department of Neuroscience. “The two were believed to be completely not communicating, but now we’re slowly, slowly filling in this puzzle.
“Not only are these cells present in the areas near the brain, they are integral to its function. When the brain is injured, when the spinal cord is injured, without them, the recovery is much, much worse.”
Curiously, the immune cells were found along the vessels discovered by the research team.
“They’re right on the lymphatics, which is really weird,” noted researcher and doctoral student Sachin Gadani. “You have the lymphatics and they’re stacked right on top. They’re not inside of them — they’re around them.”
The immune cells play several important roles within the body, including guarding against pathogens and triggering allergic reactions.
In exploring their role in protecting the brain, the researchers determined they are vital in the body’s response to spinal cord injuries.
But it’s their role in the gut that makes Kipnis suspect they may be serving as a communicator between the brain’s immune response and our microbiomes. That could be of great importance, because our intestinal flora is critical for maintaining our health and wellbeing, he noted.
“These cells are potentially the mediator between the gut and the brain,” he said. “They are the main responder to microbiota changes in the gut. They may go from the gut to the brain, or they may just produce something that will impact those cells. But you see them in the gut and now you see them also in the brain.”
“We know the brain responds to things happening in the gut,” he said. “Is it logical that these will be the cells that connect the two? Potentially. We don’t know that, but it very well could be.”
While more research needs to be done to understand the role of these cells in the meninges, Gadani noted that it’s almost certain that the cells are important in a variety of neurological conditions.
“It would be inconceivable they’re not playing a role in migraines and certain conditions like that,” he said. “The long-term goal of this would be developing drugs for targeting these cells. I think it could be highly efficacious in migraine, multiple sclerosis and possibly other conditions.”
The study was published in the Journal of Experimental Medicine.
Source: University of Virginia Health System
Photo: The immune cells play a vital role in response to injuries to the spinal cord, University of Virginia School of Medicine researchers have determined. Credit: Sachin Gadani | University of Virginia School of Medicine.
Young adults who use seven to 11 social media platforms are three times more likely to suffer from depression and anxiety than those who use zero to two platforms, according to a new study by researchers at the University of Pittsburgh Center for Research on Media, Technology and Health (CRMTH).
The link remained strong even after adjusting for the amount of time spent on social media overall.
For the study, the researchers sampled 1,787 U.S. adults ages 19 through 32, using an established depression assessment tool and questionnaires to determine social media use.
The questionnaires asked about 11 popular social media platforms: Facebook, YouTube, Twitter, Google Plus, Instagram, Snapchat, Reddit, Tumblr, Pinterest, Vine, and LinkedIn.
Participants who used seven to 11 platforms had 3.1 times the odds of reporting higher levels of depressive symptoms than their counterparts who used zero to two platforms. Those who used the most platforms had 3.3 times the odds of high levels of anxiety symptoms than their peers who used the least number of platforms.
The researchers controlled for other factors that may contribute to depression and anxiety, including race, gender, relationship status, household income, education, and total time spent on social media.
“This association is strong enough that clinicians could consider asking their patients with depression and anxiety about multiple platform use and counseling them that this use may be related to their symptoms,” said lead author and physician Brian A. Primack, M.D., Ph.D., director of CRMTH and assistant vice chancellor for health and society in Pitt’s Schools of the Health Sciences.
“While we can’t tell from this study whether depressed and anxious people seek out multiple platforms or whether something about using multiple platforms can lead to depression and anxiety, in either case the results are potentially valuable.”
Primack, who also is a professor of medicine at Pitt, emphasized that the directionality of the association is unclear.
“It may be that people who suffer from symptoms of depression or anxiety, or both, tend to subsequently use a broader range of social media outlets. For example, they may be searching out multiple avenues for a setting that feels comfortable and accepting,” said Primack.
“However, it could also be that trying to maintain a presence on multiple platforms may actually lead to depression and anxiety. More research will be needed to tease that apart.”
Primack and his team propose several hypotheses as to why multi-platform social media use may drive depression and anxiety.
One suggestion is that users of multiple platforms would be constantly multitasking — as would happen when switching between platforms — which is strongly linked to poor cognitive and mental health outcomes. Also, they note that there is greater opportunity to commit a social media faux pas when using multiple platforms, which can lead to repeated embarrassments.
“Understanding the way people are using multiple social media platforms and their experiences within those platforms — as well as the specific type of depression and anxiety that social media users experience — are critical next steps,” said co-author and psychiatrist César G. Escobar-Viera, M.D., Ph.D., a postdoctoral research associate at Pitt’s Health Policy Institute and at CRMTH.
“Ultimately, we want this research to help in designing and implementing educational public health interventions that are as personalized as possible.”
The findings are published in the journal Computers in Human Behavior.
People who suffer neglect and abuse in childhood are much more likely to have time off work due to long-term sickness and are less likely to own their own homes when they reach middle age, according to a new study.
Published in the journal Pediatrics and undertaken as part of the Public Health Research Consortium, the study showed that the potential socioeconomic impact of child neglect and abuse may persist for decades.
Researchers at University College London found that neglected children often had worse reading and mathematics skills in adolescence than their peers, which could hamper their ability to find work and progress in the job market. These factors did not explain the poorer standard of living for those reporting child abuse, the researchers noted.
For the study, the research team followed 8,076 people from birth in 1958 until the age of 50, examining key socioeconomic indicators.
A person’s economic circumstances at the age of 50 are important because this is close to peak earning capacity in the U.K., the researchers explained. Poor living standards at this age can signal hardship and associated ill health during old age.
The research found adults who had been neglected in childhood were approximately 70 percent more likely to have time off work due to long-term sickness and not own their home at 50 years, compared to their peers who had not suffered from child abuse and neglect.
Also, the risk of a poor outcome was greatest for people experiencing multiple types of child maltreatment. For example those experiencing two or more types of child maltreatment, such as child neglect and physical abuse, had more than double the risk of long-term sickness absence from work, compared to those experiencing no maltreatment.
“Our findings suggest that maltreated children grow up to face socioeconomic disadvantage. This is important because such disadvantage could, in turn, influence the health of individuals affected and also that of their children,” said Dr. Snehal Pinto Pereira of the UCL Great Ormond Street Institute of Child Health, who led the research.
“As well as highlighting the importance of prevention of maltreatment in childhood, our research identified poor reading and mathematics skills as a likely connecting factor from child neglect to poor adult outcomes. This suggests that action is needed to improve and support these abilities in neglected children.”
Source: University College London
A new study explores, for the first time, the impact of pregnancy on the structure of the mother’s brain.
Researchers at the Universitat Autonoma de Barcelona (UAB) discovered that pregnancy involves long-lasting changes — at least for two years post-partum — in the morphology of a woman’s brain.
Using magnetic resonance imaging, the scientists found that after a first pregnancy, the brains of women show significant reductions in grey matter in regions associated with social cognition.
The researchers believe that such changes correspond to an adaptive process of functional specialization towards motherhood.
“These changes may reflect, at least in part, a mechanism of synaptic pruning, which also takes place in adolescence, where weak synapses are eliminated, giving way to more efficient and specialized neural networks,” said Elseline Hoekzema, co-lead author of the study.
According to Erika Barba, the other co-lead author, “these changes concern brain areas associated with functions necessary to manage the challenges of motherhood.”
In fact, researchers found that the areas with grey matter reductions overlapped with brain regions activated during a functional neuroimaging session in which the mothers of the study watched images of their own babies.
For the study, researchers compared magnetic resonance images of 25 first-time mothers before and after their pregnancy, of 19 male partners, and a control group of 20 women who had never been pregnant and 17 male partners. They gathered information about the participants over five years and four months.
The results of the research, directed by Òscar Vilarroya and Susanna Carmona, demonstrated a symmetrical reduction in the volume of grey matter in the medial frontal and posterior cortex line, as well as in specific sections of, mainly, prefrontal and temporal cortex in pregnant women.
“These areas correspond to a great extent with a network associated with processes involved in social cognition and self-focused processing,” said Carmona.
The researchers’ analyses of the scans determined with great reliability whether a woman in the study had been pregnant depending on the changes in the brain structure. The researchers note they were even able to predict the mother’s attachment to her baby in the postpartum period based on these brain changes.
The study took into account variations in both women who had undergone fertility treatments and women who had become pregnant naturally, and the reductions in grey matter were practically identical in both groups.
Researchers added they did not observe any changes in memory or other cognitive functions during the pregnancies and therefore believe that the loss of grey matter does not imply any cognitive deficits.
“The findings point to an adaptive process related to the benefits of better detecting the needs of the child, such as identifying the newborn’s emotional state,” Vilarroya explained. “Moreover, they provide primary clues regarding the neural basis of motherhood, perinatal mental health, and brain plasticity in general.”
The study was published in Nature Neuroscience.
Women are less likely than men to be bothered by the idea of women sharing a bathroom with male-to-female transgender persons, according to a new study published in the journal Gender Issues. Men are much more likely to take an offensive stance and worry about the safety and privacy of the women in their lives.
Such male transphobia seems to have its roots in how men see themselves as the protectors of women, said Dr. Rebecca Stones of Nankai University in China and Monash University in Australia.
The study has practical implications, as transgenderism has become controversial lately. In the U.S., for example, so-called “bathroom bills” are being considered that will determine whether transgender people can use restrooms that are in line with their current gender identity, or if they will have to go to those designated for their birth gender only.
Some people feel that allowing the former will cross a societal boundary, and legislators cite concerns about the safety and privacy of the women and children with whom transgender females would be sharing a bathroom.
For the study, Stones analyzed 1,035 comments posted by readers of 190 related online news articles in order to gauge public opinion regarding the presence of transgender females in women’s only bathrooms.
Men were found to be around 1.55 times more likely to express safety and privacy concerns than the very women who would be sharing facilities with transgender females. Women were much less likely to comment on news articles related to the topic, and when they did they used muted, less intense phrases. Women were much more concerned about the possibility of so-called “perverts” posing as transgender females and entering restrooms.
Stones says that male transphobia appears to be tied to the male gender role of protector. It is reflected in comments such as, “‘I don’t want some guy-turned-girl in a restroom while my wife is in there” and, “I have a teenage daughter and I demand that her privacy be protected from a gender-confused pervert that may walk in on her while she’s in the restroom!”
She theorizes that the concerns expressed by men in their online comments are also rooted in how they view transgender females. They see them not as women, but still as men who are just lying or are merely mistaken about their gender identity.
“Consequently they view themselves as protecting females from these males intruding into private, female-only spaces,” said Stones. “This may be further exacerbated by a fear of deception and a belief that transgender people are mentally ill or ‘sick’.”
An international team of scientists has discovered a new advance in the fight against Alzheimer’s disease by identifying a new drug target for not only improving symptoms of brain degeneration, but also extending the lifespan of terminally ill mice.
The four-year study by Medical Research Council (MRC) scientists based at the MRC Toxicology Unit at the University of Leicester was published in the Journal of Clinical Investigation.
“The paper describes drug-like molecules that can restore memory loss and slow progression of prion neurodegenerative disease in a manner that relates to the potential of these drugs in human Alzheimer’s disease,” explained Professor Andrew Tobin, corresponding author.
“We have been using mice whose brain cells are progressively dying, similar to what happens in Alzheimer’s disease. This project focuses on a particular protein in the brain, which is proposed to be involved in Alzheimer’s disease, and as such could be a potential target for new drugs.
“We have treated mice with a new class of drug, and found that these drugs cannot only improve symptoms of brain degeneration, such as cognitive decline, but can also extend the life-span of these terminally-sick mice,” he continued.
The researchers note the drugs that activate this protein receptor in the brain have previously been tested in clinical trials for Alzheimer’s disease, and showed positive results with respect to improving cognition, but the patients experienced a large number of adverse side effects.
This new class of drug is more selective and does not cause any side effects when administered to mice in the study, according to the scientists.
“This work may provide important information as to whether this protein is a viable drug target in the treatment of diseases associated with the progressive death of brain cells,” said Tobin, who moved from the University of Leicester to the University of Glasgow, alongside lead researcher Dr. Sophie Bradley.
“This is of great importance to society, based on the fact that the treatment options for Alzheimer’s disease are very limited. There are no cures for Alzheimer’s disease and current treatments are focused on relieving some of the symptoms.
“What we have found is a novel class of drugs, called allosteric ligands, that target a protein called the M1 muscarinic receptor, which is present in the brain,” he explained. “Activating this receptor protein cannot only improve cognitive function in mice with progressive brain degeneration, but when administered daily, can extend life span.”
The scientists say the work is important because it focuses on identifying a treatment that not only improves symptoms associated with neurodegeneration, like current treatments, but also identifies a new strategy for slowing disease progression and extending life span.
“Alzheimer’s disease is the most common form of dementia, and it affects an estimated 850,000 people in the U.K. alone,” Tobin said.
Source: University of Leicester
N-acetylcysteine (NAC) is a powerful antioxidant used in both conventional and alternative medicine and is particularly known for its role in treating patients with acetaminophen overdose.
Now a new study shows that when combined with group cognitive-behavioral therapy (CBT), NAC is able to reduce symptoms of post-traumatic stress disorder (PTSD), cravings, and depression significantly more than CBT alone in veterans with co-occurring PTSD and substance use disorder (SUD).
The study, conducted by researchers at the Medical University of South Carolina (MUSC) and the Ralph H. Johnson VA Medical Center, is the first to use NAC as a pharmacotherapy for PTSD and a broad range of SUDs.
The results are published in the Journal of Clinical Psychiatry.
It is estimated that 30 percent of Vietnam veterans will have experienced PTSD at some point in their life, and about 40 to 50 percent of veterans with PTSD also have a substance use disorder (SUD).
“Addiction goes along with virtually every psychiatric disorder at a higher percentage than it does in the general population” said Peter W. Kalivas, Ph.D. the senior author on the article and chair of the Department of Neuroscience at MUSC. “People who are prone to psychiatric disorders are also prone to addiction.”
“This is a tough patient population with SUD to work with. We have Vietnam vets that have had PTSD for 15 to 20 years. This is not an easy-to-turn-around population.”
Currently, there are no well-explored pharmacological treatments for patients with co-occurring PTSD/SUD. Although selective serotonin reuptake inhibitors (SSRIs) have been approved by the FDA for treatment of PTSD, they have demonstrated suboptimal results for patients with a combination of PTSD/SUD.
Previous research by Kalivas has shown that levels of glutamate transporters are decreased in SUDs and that administration of the antioxidant NAC can help restore those levels and guard against relapse in animal models of SUD.
Because evidence suggests that SUDs and PTSD share overlapping neurobiological pathways, that NAC treatment with CBT would be a novel approach to treat co-occurring PTSD and SUD, said Sudie E. Back, Ph.D., lead author on the article. Back is a professor in the Department of Psychiatry and Behavioral Sciences at MUSC and a staff psychologist at the Ralph H. Johnson VA Medical Center.
For the study, 35 veterans with PTSD and SUD, all of whom were receiving CBT for their SUD, were randomized to either 2400 mg/day of NAC or placebo. The average age of the veterans was 49 years. To be included, veterans had to have abstained from substance use for at least seven days. Of the veterans enrolled in the trial, 83 percent completed it, a very high rate for this difficult-to-treat population.
The NAC-treated group showed a 46 percent reduction in PTSD symptoms, compared with a 25 percent reduction in the placebo group.
“As a group, the NAC-treated veterans were below diagnostic level for PTSD at the end of treatment,” said Back. “For PTSD, these are some of the best outcomes we have seen in the literature for a medication.”
Craving and depression were also significantly reduced in the NAC-treated group. The amount of craving was reduced by 81 percent and the frequency of craving by 71 percent in the NAC group, compared with 32 percent and 29 percent in the placebo group.
“Craving is a key component of substance use in relapse,” said Back. “If you have a medication that can really reduce craving, that will go a long way to helping people stay clean and sober.”
Depression was also reduced 48 percent in the NAC group vs. 15 percent in the placebo group.
Although these early, promising findings show that NAC reduced PTSD symptoms, craving, and depression, NAC should not be used as a monotherapy or substitute for evidence-based behavioral treatment, but instead be seen as an adjunct therapy that enhances it.
“We would not advocate using it instead of therapy,” said Back. “But this could be something to help prevent relapse when used alongside a behavioral treatment.”
NAC is available over the counter and does not cause side effects at the doses used in the study, but it degrades quickly when stored, is contraindicated in patients with asthma, and can cause nausea at higher doses; it should always be obtained and administered under a physician’s supervision.
Frequent sauna bathing may significantly reduce the risk of Alzheimer’s disease and other forms of dementia, according to a recent study by researchers at the University of Eastern Finland. A sauna is a small room designed to induce sweating through the use of dry or wet heat.
After a 20-year follow-up, researchers found that men who went sauna bathing four to seven times a week were 66 percent less likely to be diagnosed with dementia compared to those who went to the sauna only once a week. The study is the first to investigate the link between sauna bathing and dementia risk.
The effects of sauna bathing on the risk of Alzheimer’s disease and other forms of dementia were based on data from the Kuopio Ischaemic Heart Disease Risk Factor Study (KIHD), involving more than 2,000 middle-aged men living in the eastern part of Finland (sauna bathing is an extremely popular practice in Northern Europe).
The study participants were divided into three groups based on their sauna-bathing habits: those who went sauna bathing once a week, those who went sauna bathing two to three times a week, and those who went sauna bathing four to seven times a week.
The findings show that the more frequently the participants went sauna bathing, the lower their risk of dementia. Among those who went sauna bathing four to seven times a week, the risk of any form of dementia was 66 percent lower and the risk of Alzheimer’s disease 65 percent lower than among those who went just once a week.
Currently, over five million Americans have Alzheimer’s disease and more than one in three seniors will die with Alzheimer’s disease or another form of dementia, according to the Alzheimer’s Association.
Previous results from the KIHD study have shown that frequent sauna bathing also significantly reduces the risk of sudden cardiac death, the risk of death due to coronary artery disease, and other cardiac events, as well as overall mortality.
According to Professor Jari Laukkanen, the study leader, sauna bathing may protect both the heart and memory to some extent via similar, still poorly known mechanisms.
“However, it is known that cardiovascular health affects the brain as well. The sense of well-being and relaxation experienced during sauna bathing may also play a role,” said Laukkanen.
Some of the other frequently claimed benefits of sauna bathing include muscle relaxation, stress reduction, weight loss, immune system strengthening, and blood flow improvement.
The findings were published recently in the Age and Ageing journal.
Source: University of Eastern Finland
A brain-boosting protein plays an important role in how well people respond to chemotherapy, according to new research.
A study presented at the European Society for Medical Oncology (ESMO) Asia 2016 Congress in Singapore found that cancer patients suffering depression have decreased amounts of brain-derived neurotophic factor (BDNF) in their blood. Low levels make people less responsive to cancer drugs and less tolerant of their side effects, according to researchers.
“It’s crucial doctors pay more attention to the mood and emotional state of patients,” said lead author Yufeng Wu, head of oncology at Henan Cancer Hospital, which is affiliated with Zhengzhou University in China. “Depression can reduce the effects of chemotherapy and BDNF plays an important role in this process.”
Low mood is common among cancer patients, especially the terminally ill. BDNF is essential for healthy brain function and low levels have already been linked with mental illness, the researcher noted.
This study aimed to discover how depression influenced outcomes for people with advanced lung cancer.
Researchers recruited 186 newly diagnosed patients receiving chemotherapy. To assess their state of mind, they were asked to rate their depression levels the day before treatment began. Quality of life details, overall survival, and other data were also collected. This allowed researchers to compare this information with the patients’ mood scores.
Results showed that those whose cancer had spread to other organs were the most depressed and this severely decreased their tolerance to chemotherapy. It was associated with vomiting, a reduction in white blood cells, and prolonged hospital stays.
The impact of severe depression was even greater. It reduced the length of time that patients lived with the disease without it getting worse.
Researchers found that BDNF clearly boosted the number of tumor cells killed by chemotherapy. Patients with severe depression had lower levels of the protein in the blood, so their bodies were not as effective at fighting cancer. This reduced their chance of surviving the disease, the researchers noted.
“Our aim now is to prescribe drugs such as fluoxetine to depressed patients and study their sensitivity to chemotherapy,” Wu said.
Results from a new study show that more than four in five cancer survivors suffer from anxiety and a similar number had depression a year after diagnosis.
“We urgently need new ways of supporting cancer survivors and addressing wider aspects of wellbeing,” said lead author Shridevi Subramaniam, a research officer at the National Clinical Research Center, Ministry of Health Malaysia, Kuala Lumpur, Malaysia. “Instead of just focusing on clinical outcome, doctors must focus equally on quality of life for cancer patients, especially psychologically, financially, and socially.”
Researchers included 1,362 Malaysian patients from the ACTION study (ASEAN Cost in Oncology Study). Nearly a third — 33 percent — had breast cancer, researchers noted.
All the patients filled in questionnaires to assess health-related quality of life (HRQoL). Anxiety and depression levels were also included in the survey.
A patient’s satisfaction with their physical health and mental wellbeing — or health-related quality of life — is an important end result in cancer care. But the study’s findings showed that patients’ mental and physical wellbeing was low overall 12 months after diagnosis. The more advanced the cancer, the lower the HRQoL, according to the findings.
The type of cancer was also a factor, because disease severity differs, the researchers noted.
Women with reproductive system cancers, for example, had higher wellbeing scores than lymphoma patients. This could be explained by the fact that lymphoma is often aggressive and progresses quickly, while reproductive system cancers, such as cervical, can spread slowly over a number of years, the researchers hypothesized.
“The key message is to focus more on supporting patients throughout their whole cancer ‘journey,’ especially in their lives after treatment,” added Subramanian, who presented the research at the European Society for Medical Oncology (ESMO) Asia 2016 Congress.
Cancer also has a significant impact on the lives and wellbeing of adolescents and young adults, as reported in a separate ongoing study at the ESMO Asia 2016 Congress.
Researchers set out to identify the extent of wellbeing issues and other problems among patients in this age group, who not only are at major milestones in their lives, but do not expect to develop the disease.
The study included patients who were newly diagnosed with cancer and with an average age of 28. They completed a survey that included questions on occupation and lifestyle, and were also asked about problems around physical symptoms, mental wellbeing, and financial issues.
Results showed that more than a third (37 percent) were suffering distress at the diagnosis of cancer. Nearly half identified the top cause as treatment decisions, followed by family health issues, sleep, and worry.
“The young differ from older people because they don’t expect to be ill, and certainly not with cancer,” said senior author Associate Professor Alexandre Chan of the Department of Pharmacy at the National University of Singapore and a Specialist Pharmacist at the National Cancer Center in Singapore.
“They’re also at a stage when they’re facing many social responsibilities and family burdens. That’s why they need effective supportive care and help in managing the physical, psychological, and emotional side-effects that come with both cancer diagnosis and treatment.”
Commenting on the studies, Ravindran Kanesvaran, an assistant professor at Duke-NUS Medical School, and a Consultant Medical Oncologist at the National Cancer Center in Singapore, said: “There is a critical need to find ways of addressing the high levels of distress among cancer survivors in general, as highlighted by the Malaysian study.
“The psycho-social impact of cancer on adolescents and young adults also clearly needs further evaluation. What’s required are specific interventions to meet the needs of this age group, as well as specially tailored survivorship programs and supportive care.
“While it’s not surprising that the young adult cancer population has a higher risk of suicide, conducting studies like this help us find new ways to address this issue effectively,” he concluded.
There’s a science to gift giving, with new research suggesting that giving an experience rather than a material item can strengthen a relationship.
The new study from Cindy Chan, an assistant professor at the University of Toronto Scarborough’s Department of Management and the Rotman School of Management, finds experiential gifts are more effective at improving relationships from the recipient’s perspective.
“The reason experiential gifts are more socially connecting is that they tend to be more emotionally evocative,” said Chan. “An experiential gift elicits a strong emotional response when a recipient consumes it — like the fear and awe of a safari adventure, the excitement of a rock concert or the calmness of a spa — and is more intensely emotional than a material possession.”
The research, co-authored with Cassie Mogilner, an associate professor at the University of California, Los Angeles Anderson School of Management, looks at how relationships between a gift giver and recipient were affected across four separate studies.
While past research focused mostly on how much recipients enjoy certain gifts, the new study explored the “pro-social consequences” of gifts — or how effective gifts are in building relationships, the researchers explained.
“Often the focus is only on whether someone likes a gift, rather than focusing on a fundamental objective of gift giving, and that is fostering relationships between giver and recipient,” Chan said.
She notes it is important to explore the “effectiveness” of gift-giving because the typical household spend about two percent of its annual income on buying gifts. Gifts are also important opportunities to nurture relationships, she added.
Yet, according to the new research, 78 percent of respondents reported most recently buying material gifts rather than an experience.
Those considering material gifts can also highlight the experience it provides, Chan said. Giving a friend a CD of music that reminds them of a concert enjoyed together can mimic the same effect as the experience of the concert itself.
In one of the studies, Chan found that emotionally evocative gifts can also strengthen relationships. Emotional material gifts like a joke-of-the-day calendar, a framed photo, or jewelry engraved with a loving message can be very effective gifts in that regard.
So what advice does she have for gift buyers ahead of the holiday season?
“Consider someone’s favorite hobby or something new they’ve always wanted to do,” she said. “Marketers should also package experiential gifts in a way that makes it easier for recipients to consume them so they don’t have to be tied to using the gifts by a particular day or time.”
The research fits into a broader body of research that suggests using discretionary spending for experiences rather than more material possessions. Chan points to honeymoon registries that allow people to buy a dinner, scuba lessons or chipping in on airfare as examples.
“People often struggle with the challenge of choosing what to give someone,” she said. “If you want to give them something that will make them feel closer to you, give an experience.”
The study was published in the Journal of Consumer Research.
While it is well-documented that morning people tend to work less efficiently at night than do night owls, the exact reasons for this have remained unclear. Now a new study by researchers at the National Research University Higher School of Economics in Russia and Oxford University in England reveals distinct differences between the thought processes of both morning people and night owls as they work on tasks at night.
The findings show that morning people who work at night appear to finish tasks more quickly than night owls, but they also tend to make more mistakes overall. On the other hand, night owls tend to work more slowly at night but demonstrate greater overall accuracy.
For the study, researchers Nicola Barclay and Andriy Myachykov investigated the influence of sleep deprivation on people with different chronotypes (behavioral differences due to circadian rhythms). Specifically, the researchers wanted to determine how an increase in time spent awake affects the attention system of early risers and night owls.
The study involved 26 participants (13 male, 13 female) with an average age of 25. The subjects were required to stay awake for 18 hours, from 8:00 a.m. to 2:00 a.m., and adhere to their normal routine. At the beginning and end of their time spent awake, the participants completed an Attention Network Test (ANT) as well as a questionnaire to help assess their chronotype.
The researchers did not find any significant differences between the scores of early birds and night owls on the ANT test completed in the morning, but the evening test showed a more pronounced contrast.
The early birds completed tests more quickly than did the night owls, which was a rather surprising and seemingly contradictory outcome, although the researchers did find an explanation for this.
They suggest that this can be explained by the way each group approaches the task. For example, night owls tended to take a more serious approach when it came to tasks requiring more time and attention during their favorite hours, i.e., in the late evening or at night.
“To deal with the most difficult test — resolving a conflict of attention — it was necessary not only to concentrate on the main visual stimulus, but at the same time to ignore accompanying stimulus that distract from the core task,” said Myachykov.
Completion of this task requires increased concentration. “An interesting fact is that although night owls spent more time finishing than early birds, their accuracy in completing the task was higher,” he said.
Overall, the evening people turned out to be slower but more efficient compared to the morning people, according to the second ANT taken at 2:00 a.m. after 18 hours of being awake.
“On the one hand, it’s known that night owls are more efficient in the late hours, but how this influences the speed and accuracy with which attention-related tasks are completed remains unclear. Our study demonstrated how night owls working late at night “sacrifice” speed for accuracy,” said Myachykov.
The new findings could be very useful for people who work the night shift, particularly those who depend on large doses of attention, concentration, and reaction time, such as pilots, air traffic controllers, and drivers.
The study is published in the journal Experimental Brain Research.
Brain connections that play a key role in complex thinking skills show the poorest health with advancing age, according to new research.
The new study, from researchers at the University of Edinburgh, also found that connections supporting functions such as movement and hearing are relatively well preserved in later life.
For the study, published in Nature Communications journal, researchers analyzed brain scans from more than 3,500 people between the ages of 45 and 75 taking part in the UK Biobank study.
The scientists say they were able to chart the brain’s connections and show the subtle ways in which those connections weaken with age.
Knowing how and where connections between brain cells — so-called white matter — decline as we age is important in understanding why some people’s brains and thinking skills age better than others, the researchers noted.
“By precisely mapping which connections of the brain are most sensitive to age, and comparing different ways of measuring them, we hope to provide a reference point for future brain research in health and disease,” said Dr. Simon Cox of the university’s Centre for Cognitive Ageing and Cognitive Epidemiology (CCACE), who led the study.
“This is only one of the first of many exciting brain imaging results still to come from this important national health resource.”
“Until recently, studies of brain scans with this number of people were not possible,” added Professor Ian Deary, CCACE Director. “Day by day the UK Biobank sample grows, and this will make it possible to look carefully at the environmental and genetic factors that are associated with more or less healthy brains in older age.”
Source: University of Edinburgh
Low-income minority adults account for the greater portion of asthma-related deaths and hospitalizations. However, most asthma studies do not focus on these particular patients or where they live — often in complicated, difficult circumstances — and instead tend to lean toward the greater convenience of recruiting patients to clinics.
And while many adult asthma patients have multiple diseases and are exposed to tobacco smoke, most asthma research tends to focus on patients who do not have comorbid diseases such as hypertension, diabetes, and obesity.
Researchers from the Community Asthma Prevention Program (CAPP) at Children’s Hospital of Philadelphia (CHOP) and the Perelman School of Medicine at the University of Pennsylvania describe those challenges in a study published in the Journal of Allergy and Clinical Immunology.
They argue that home visits offer a fuller understanding of how the social environment of asthma patients impacts their overall health.
“Medical personnel no longer make house calls, so this research gives us a view of how poverty, unfavorable home conditions, and lack of social resources limit patients’ ability to access healthcare,” says Andrea J. Apter, M.D., MSc, MA, principal investigator of the study and Chief of the Section of Allergy & Immunology at the Perelman School of Medicine at the University of Pennsylvania.
“Without the knowledge of these barriers, health providers do not have the information needed to create a tailored and empathetic approach to asthma management.”
The new study analyzes patients at ground level, drawing on reports from community health workers who visit asthma patients at home, where extreme living conditions such as poor housing, neighborhood violence, and lack of social support create steep barriers to public health care, as well as to high-quality research.
The study involved 301 adults living in low-income Philadelphia neighborhoods who were prescribed an inhaled corticosteroid for asthma and required oral steroids for an exacerbation and/or had an emergency or inpatient visit within the last six months.
Community health workers visited patients in their homes and found that 71 percent rented, with many living in one-room apartments or overcrowded spaces with multiple family members. Many patients also live in typical Philadelphia rowhomes, which were built in the late 19th century and are difficult to maintain on a limited income.
These patients are routinely exposed to common indoor asthma triggers, such as rodents, roaches, and mold. Only 25 percent of people who participated in the study were currently employed either part or full-time.
“Many of these patients start to feel a sense of hopelessness, especially the very sick,” says Tyra Bryant-Stephens, M.D., corresponding author and medical director of CAPP at CHOP.
“They feel there is very little possibility of changing their current living situation, which includes poor housing, exposure to violent crime, and limited access to transportation. Some of these living conditions make it difficult or impossible for patients to get to their medical visits, which results in a further decline of their health.”
“As long as there is poor housing, health disparities will continue to exist, despite medical advancements being made in the fight against asthma. The issue is not limited to Philadelphia and needs to be addressed on a national scale. Without addressing poor housing, we will never be able to truly eliminate disparities in outcomes among adult asthma patients.”
Living in a high-stress environment encourages many patients to continue smoking, despite knowing it contributes to their asthma symptoms. In fact, 28 percent of those surveyed admitted they currently smoke. Other issues community health workers encountered were low education rates, limited access to healthy foods, and poor general health; 58 percent of patients had hypertension and 32 percent had diabetes.
Cognitive behavioral therapy (CBT) by itself is a more effective long-term treatment for social anxiety disorder than medication alone or a combination of the two, according to a new study by researchers at the Norwegian University of Science and Technology (NTNU) and the University of Manchester in England.
Until now, a combination of cognitive therapy and medication was thought to be the most effective treatment for patients with social anxiety disorder. However, nearly 85 percent of the study participants significantly improved or became completely healthy using cognitive therapy alone.
“We’ve set a new world record in effectively treating social anxiety disorders,” says Hans M. Nordahl, a professor of behavioral medicine at NTNU. “This is one of the best studies on social anxiety disorders ever. It’s taken ten years to carry out and has been challenging both academically and in terms of logistics, but the result is really encouraging.”
Social anxiety disorder — or social phobia — is much more serious than social anxiety, which many people deal with to some extent, especially when put in the spotlight. Social anxiety disorder is a diagnosis for individuals who find it hard to function in social situations at all.
Many patients with social anxiety disorder are treated with a combination of talk therapy and medication, such as selective serotonin reuptake inhibitors (SSRIs), said Nordahl. However, these drugs may do more harm than good for these particular patients. He says that while SSRIs often work well in patients with depressive disorders, they actually have the opposite effect in people with social anxiety disorders.
SSRIs often have strong physical side effects as well. When patients have been on medications for some time and want to reduce them, the bodily feelings associated with social phobia, like shivering, flushing, and dizziness in social situations tend to return. Patients often end up in a state of severe social anxiety again.
“Patients often rely more on the medication and don’t place as much importance on therapy. They think it’s the drugs that will make them healthier, and they become dependent on something external rather than learning to regulate themselves. So the medication camouflages a very important patient discovery: that by learning effective techniques, they have the ability to handle their anxiety themselves,” says Nordahl.
For the study, the researchers set out to analyze and compare the most recognized methods for treating social anxiety disorders. Well over 100 patients participated in the study and were divided into four groups.
The first group received only medication, the second group received only therapy, the third group received a combination of the two, and the fourth received a placebo pill. The four groups were compared along the way, and researchers conducted a follow-up assessment with them a year after treatment ended.
During treatment and right afterwards, the patients in groups two and three were managing equally well. But after a year, it was clear that the patients in group two — those who had only received cognitive therapy — were faring the best.
With cognitive therapy alone, the researchers managed to increase the recovery rate in patients with social anxiety disorders by 20 to 25 percent, as compared with the norm for this group.
“This is the most effective treatment ever for this patient group. Treatment of mental illness often isn’t as effective as treating a bone fracture, but here we’ve shown that treatment of psychiatric disorders can be equally effective,” says Nordahl.
Nordahl and the rest of the research team have also worked to improve standard cognitive therapy. They have added new processing elements, which have shown greater effectiveness.
“We’re using what’s called metacognitive therapy, meaning that we work with patients’ thoughts and their reactions and beliefs about those thoughts. We address their rumination and worry about how they function in social situations. Learning to regulate their attention processes and training with mental tasks are new therapeutic elements with enormous potential for this group of patients,” says Nordahl.
The findings are published in the journal Psychotherapy and Psychosomatics.
Scientific facts are far more well-received when delivered in a narrative style — that is, when the writer tells a story, according to a new study published in the journal PLOS ONE. The findings show that the most highly cited scientific papers tend to include sensory language and a direct appeal to the reader to take action.
For the study, researchers at the University of Washington (UW) evaluated the abstracts of more than 700 scientific papers on climate change in order to determine what makes a paper influential in its field. But instead of focusing on scientific content, they tried a new approach that many would say is more in the realm of humanities professors than scientists — they looked at writing style.
Psychology and literary theory have long held that if you want someone to remember something, you should communicate it in the form of a story. So the researchers wondered whether scientific papers written in a more narrative style — those that tell a story and appeal to the senses and emotions — might be more influential than those with a drier, more fact-oriented style.
So study leader Annie Hillier, a recent graduate from the School of Marine and Environmental Affairs at UW and professors Ryan Kelly and Terrie Klinger set out to determine whether this theory would hold up in the realm of peer-reviewed scientific literature.
They discovered that it overwhelmingly did. They found that the most highly cited scientific papers tended to include elements like sensory language, a greater degree of language indicating cause-and-effect, and a direct appeal to the reader for a particular follow-up action.
“The results were especially surprising given that we often think of scientific influence as being driven by science itself, rather than the form in which it is presented,” said Hillier.
Perhaps even more surprising, the researchers noted, was the finding that the highest-rated journals tended to feature articles that had more narrative content.
“We don’t know if the really top journals pick the most readable articles, and that’s why those articles are more influential, or if the more narrative papers would be influential no matter what journal they are in,” said Kelly.
The researchers utilized a crowdsourcing website to evaluate the narrative content of the journal articles. Online contributors were asked a series of questions about each abstract to measure whether papers had a narrative style, including elements like language that appeals to one’s senses and emotions.
The researchers hope these new findings might lead to advances in scientific communication, improving the odds that science might lead the way to better decisions in the policy realm.
Source: University of Washington