Volition and low back pain

Ann Phys Rehabil Med. 2015 Nov 13. pii: S1877-0657(15)00556-4. doi: 10.1016/j.rehab.2015.10.005. [Epub ahead of print]

Volition and low back pain: When patients talk.

Mathy C1, Cedraschi C2, Broonen JP3, Azzi A4, Henrotin Y5.

Author information

1Unité de psychologie sociale, faculté de psychologie et des sciences de l’éducation, université libre de Bruxelles, CP 122, 50, avenue F.D.-Roosevelt, 1050 Bruxelles, Belgium; Service de kinésithérapie et de réadaptation fonctionnelle, hôpital Princesse-Paola, rue du Vivier, 21, 6900 Marche-en-Famenne, Belgium; Section rachis de la Société française de rhumatologie, Paris, France. Electronic address: celine.mathy@ulg.ac.be.

2Section rachis de la Société française de rhumatologie, Paris, France; Centre multidisciplinaire de la douleur, service de pharmacologie et toxicologie cliniques, service de médecine interne de réhabilitation, hôpitaux universitaires de Genève, faculté de médecine, université de Genève, Genève, Switzerland.

3Centre de recherche en psychologie du travail et de la consommation, faculté des sciences psychologiques et de l’éducation, université libre de Bruxelles, Bruxelles, Belgium.

4Unité de psychologie sociale, faculté de psychologie et des sciences de l’éducation, université libre de Bruxelles, CP 122, 50, avenue F.D.-Roosevelt, 1050 Bruxelles, Belgium.

5Service de kinésithérapie et de réadaptation fonctionnelle, hôpital Princesse-Paola, rue du Vivier, 21, 6900 Marche-en-Famenne, Belgium; Section rachis de la Société française de rhumatologie, Paris, France.



Our objective was to explore, describe and understand volition of chronic low back pain (LBP) patients, highlighting barriers and facilitators to practicing regular physical activity in order to develop a questionnaire assessing those volitional competencies.


A content analysis of semi-structured interviews with 30 chronic LBP patients was performed. Participants were asked about their pain, motivation, physical abilities, barriers and facilitators to regular exercises and finally strategies implemented to achieve the exercise program.


Patients often reported that they were motivated and that exercises had no negative effects on LBP. Many patients recognized having difficulties performing all their exercises regularly. The main barriers were: lack of time, fatigue, lack of visible results, pain and other daily priorities. The main facilitators were: group exercise, help from the therapist, strategic planning, favorable environment, pleasure associated with exercises, fear of pain recurrence and pain itself.


Content analysis showed that sharing stories allowed patients to express their experience of LBP in their own words. It provides a solid ground to develop a questionnaire assessing volitional competencies in chronic LBP patients in order to identify patients who will not realize their exercises and help them be (more) active and avoid chronicity.


Posted in Back Pain, Human Behavior: Willpower | Leave a comment

Ibuprofen intake increases exercise time to exhaustion: A possible role for preventing exercise-induced fatigue.

Scand J Med Sci Sports. 2015 Nov 21. doi: 10.1111/sms.12549. [Epub ahead of print]

Ibuprofen intake increases exercise time to exhaustion: A possible role for preventing exercise-induced fatigue.

Lima FD1, Stamm DN1, Della Pace ID2, Ribeiro LR3, Rambo LM2, Bresciani G4, Ferreira J5, Rossato MF6, Silva MA7, Pereira ME6, Ineu RP8, Santos AR3, Bobinski F3, Fighera MR9, Royes LF1.

Author information

1Department of Methods and Sports Techniques, Universidade Federal de Santa Maria, Santa Maria, Brazil.

2Department of Pharmacology, Universidade Federal de Santa Maria, Santa Maria, Brazil.

3Department of Physiological Sciences, Universidade Federal de Santa Catarina, Florianópolis, Brazil.

4Institut of Physical Activity and Health, Universidad Autonoma de Chile, Temuco, Chile.

5Department of Pharmacology, Universidade Federal de Santa Catarina, Florianópolis, Brazil.

6Department of Biochemistry and Molecular Biology, Universidade Federal de Santa Maria, Santa Maria, Brazil.

7College of Education and Culture of Vilhena, Vilhena, Brazil.

8Itapiranga College, Itapiranga, Brazil.

9Department of Neuropsychiatry, Universidade Federal de Santa Maria, Santa Maria, Brazil.


Although the intake of nonsteroidal anti-inflammatory drugs (NSAIDs) intake by athletes prevents soreness, little is known concerning their role in exercise performance. This study assessed the effects of ibuprofen intake on an exhaustive protocol test after 6 weeks of swimming training in rats. Animals were divided into sedentary and training groups. After training, animals were subdivided into two subsets: saline or ibuprofen. Afterwards, three repeated swimming bouts were performed by the groups. Ibuprofen (15 mg/kg) was administered once a day. Pain measurements were performed and inflammatory and oxidative stress parameters were assayed in cerebral cortex and gastrocnemius muscle. Training, ibuprofen administration, or both combined (P < 0.05; 211 ± 18s, 200 ± 31s, and 279 ± 23s) increased exercise time to exhaustion. Training decreased the acetylcholinesterase (AChE) activity (P < 0.05; 149 ± 11) in cerebral cortex. Ibuprofen intake decreased the AChE activity after exhaustive protocol test in trained and sedentary rats (P < 0.05; 270 ± 60; 171 ± 38; and 273 ± 29). It also prevented neuronal tumor necrosis factor-α (TNF-α) and interleukin (IL 1β) increase. Fatigue elicited by this exhaustive protocol may involve disturbances of the central nervous system. Additive anti-inflammatory effects of exercise and ibuprofen intake support the hypothesis that this combination may constitute a more effective approach. In addition, ergogenic aids may be a useful means to prevent exercise-induced fatigue.


Posted in Exercise: Capacity, Ibuprofen, Sports Medicine | Leave a comment

The Kenyan Runners

Scand J Med Sci Sports. 2015 Dec;25 Suppl 4:110-118. doi: 10.1111/sms.12573.

The Kenyan runners.

Larsen HB1, Sheel AW2.

Author information

1The Copenhagen Muscle Research Centre, Rigshospitalet, Copenhagen, Denmark.

2School of Kinesiology, University of British Columbia, Vancouver, BC, Canada.


Today the Kenyan dominance in middle- and long-distance running is so profound that it has no equivalence to any other sport in the world.

Critical physiological factors for performance in running include maximal oxygen consumption (VO2max ), fractional VO2max utilization and running economy (energetic cost of running).

Kenyan and non-Kenyan elite runners seem to be able to reach very high, but similar maximal oxygen uptake levels just as there is some indication that untrained Kenyans and non-Kenyans have a similar VO2max .

In addition, the fractional utilization of VO2max seems to be very high but similar in Kenyan and European runners.

Similarly, no differences in the proportion of slow muscle fibers have been observed when comparing Kenyan elite runners with their Caucasian counterparts.

In contrast, the oxygen cost of running at a given running velocity has been found to be lower in Kenyan elite runners relative to other elite runners and there is some indication that this is due to differences in body dimensions.

Pulmonary system limitations have been observed in Kenyan runners in the form of exercise-induced arterial hypoxemia, expiratory flow limitation, and high levels of respiratory muscle work.

It appears that Kenyan runners do not possess a pulmonary system that confers a physiological advantage.

Additional studies on truly elite Kenyan runners are necessary to understand the underlying physiology which permits extraordinary running performances.


Posted in Exercise: Capacity, Exercise: High Intensity, Exercise: Marathons, Fitness: Elite Athletes, Fitness: Running | Leave a comment

‘Life’s Simple 7’ and Long-Term Mortality After Stroke

J Am Heart Assoc. 2015 Nov 20;4(11). pii: e001470.

“Life’s Simple 7” and Long-Term Mortality After Stroke.

Lin MP1, Ovbiagele B2, Markovic D3, Towfighi A1.

Author information

1Department of Neurology, University of Southern California, Los Angeles, CA (M.P.L., A.T.) Department of Neurology, Rancho Los Amigos National Rehabilitation Center, Downey, CA (M.P.L., A.T.).

2Department of Neurology, Medical University of South Carolina, Charleston, SC (B.O.).

3Department of Biomathematics, University of California at Los Angeles, CA (D.M.).



The American Heart Association developed criteria dubbed “Life’s Simple 7” defining ideal cardiovascular health: not smoking, regular physical activity, healthy diet, maintaining normal weight, and controlling cholesterol, blood pressure, and blood glucose levels. The impact of achieving these metrics on survival after stroke is unknown. We aimed to determine cardiovascular health scores among stroke survivors in the United States and to assess the link between cardiovascular health score and all-cause mortality after stroke.


We assessed cardiovascular health metrics among a nationally representative sample of US adults with stroke (n=420) who participated in the National Health and Nutrition Examination Surveys in 1988-1994 (with mortality assessment through 2006). We determined cumulative all-cause mortality by cardiovascular health score under the Cox proportional hazards model after adjusting for sociodemographic characteristics and comorbidities. No stroke survivors met all 7 ideal health metrics. Over a median duration of 98 months (range, 53-159), there was an inverse dose-dependent relationship between number of ideal lifestyle metrics met and 10-year adjusted mortality: 0 to 1: 57%; 2: 48%; 3: 43%; 4: 36%; and ≥5: 30%. Those who met ≥4 health metrics had lower all-cause mortality than those who met 0 to 1 (hazard ratio, 0.51; 95% confidence interval, 0.28-0.92). After adjusting for sociodemographics, higher health score was associated with lower all-cause mortality (trend P-value, 0.022).


Achieving a greater number of ideal cardiovascular health metrics is associated with lower long-term risk of dying after stroke. Specifically targeting “Life’s Simple 7” goals might have a profound impact, extending survival after stroke.


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8 ways to be more thankful

I have fallen into the ‘I’ll be happy when” trap many times. I’ll be happy when I have my degree. I’ll be happy when I get married. I’ll be happy when I have children. I’ll be happy when everything works out exactly the way I want it to every day. If we don’t feel grateful with what we already have, what makes us think we’ll be happy with more? If we can’t appreciate the present moment then we’ll always be searching for the elusive, perfect tomorrow that never comes.

We can get out of the trap by seeing the blessings in our lives. Starting this Thanksgiving start the gratitude challenge by writing down or articulating out loud three new reasons to be grateful each day for the next 30 days. Here are eight ways to help begin the gratitude challenge.

  1. Focus on what is there instead of what isn’t. Seeing only the gaps in our lives block us from gratitude. Too often we think about all the things that we don’t have instead of noticing the abundance of gifts in our lives. Or we look at everything that we have as “not enough” instead of recognizing that God is constantly giving us exactly what we need.
  2. See the glass in your hands. It doesn’t matter if the glass is half empty or half full. Be grateful that you have a glass and that there is something in it.


Posted in Human Behavior: Gratitude | Leave a comment

5 ways to gamble with travel luggage roulette. P.S. The house always wins.

With Thanksgiving around the corner and Christmas-New Year’s not far behind, baggage is a hot topic for travelers. Thanks to fees and lost luggage, anyone toting a bag on a trip (most of us) is taking a bit of a gamble but there are ways to increase the odds of a good outcome and maybe save some money.

All you need to know are the five baggage-related things to never bet on.

What would you rather spend your money on during the holidays, a soul mate or a Samsonite?

1. Don’t bet on knowing the correct baggage fees.

Fees keep changing but airlines don’t go out of their way to publicize this. Example: Frontier’s homepage makes no mention of recently hiked bag fees; instead, the carrier talks about its new “value season pricing” when bag fees drop. The fees drop, all right, but only during a few slow travel periods and they drop down to the old prices; the rest of the time (including Thanksgiving, Christmas and New Year’s), fees are higher.

Hedge your bet: Learn your airline’s bag fees, either online or on the phone with an airline representative, and pay them at the first opportunity. Some airlines such as Spirit raise fees to $100 if paid at the airport.


Posted in Air Travel, Travel | Leave a comment

Two Words to Help You Gut Check Your Career

I love my career in competitive strategy, research, and teaching. It engages my mind. I feel an ongoing sense of discovery. I like helping people make decisions that will get them more of what they want.

Still, when I think back to my childhood, I don’t remember ever thinking that when I grow up I want to help large corporations get larger. As a child I felt no particular interest in pharmaceuticals, telecommunications, computers, oil and gas, health and beauty aids, medical devices, airlines, or shipbuilding, all of which I’ve simulated or war-gamed. I didn’t ponder whether shareholder wealth should be the sole fiduciary duty of top management. I wasn’t eager to change planes in Atlanta.

Somehow, incrementally, such things — corporations, industries, shareholders, Atlanta — came to occupy my life. I got an MBA, learned double-entry bookkeeping (at least one entry more than I’d previously wanted), and studied those things at the West Point of Capitalism that would valuqualify me to lead armies of economic units. I love my career; it’s just not what I’d expected, partly because I hadn’t known or chosen what to expect.

These days I wonder about some of the practices we see in business, probably done by people who didn’t expect or aspire as children to engage in such practices. I wonder what makes people create car software that masks deliberate pollution. I wonder what makes people market products that they know cause addiction and death.


Posted in Business, Human Behavior: Values | Tagged | Leave a comment

For pericarditis, a potential new treatment

Newswise — SAN FRANCISCO —A new study, presented this week at the American College of Rheumatology Annual Meeting in San Francisco, shows anakinra (Kineret®) to be a safe and effective treatment for pericarditis – the swelling and irritation of the thin membrane that surrounds the heart, which can be found in 30 percent of people with rheumatic diseases.

Pericarditis can be very disabling, causing pain in the chest and accumulation of fluid in the pericardium. This condition can eventually lead to, severe chest pain, coughing, difficulty breathing, and life-threatening pressure on the heart (called cardiac tamponade).

People with recurring pericarditis often don’t respond – or are intolerant — to Nonsteroidal anti-inflammatory drugs (called NSAIDS), corticosteroids and colchicine, or must be treated chronically with high dosages of corticosteroids. Additionally, the use of corticosteroids can cause a difficult-to-break cycle where the person does well while taking them, but has a flare as soon as they try to stop. Because of these challenges, and because recurring pericarditis shares many clinical features with rheumatic diseases, these patients are often seen by rheumatologists.

Researchers from Italy recently showed that low dose of corticosteroids or colchicine halved the recurrences of pericarditis in several well-conducted trials. The same researchers recently tested the safety and effectiveness of anakinra as an alternative treatment option for people with recurrent pericarditis.

“We first used anakinra in pediatric patients who were very ill with high fever, strikingly elevated c-reactive protein, large pericardial effusions, several recurrences,” recalls lead investigator in the study, Antonio Brucato, MD; chief, Internal Medicine; Ospeadale Papa Giovanni XXIII; Bergamo, Italy.“In this study, we observed spectacular results, so we asked ourselves whether patients of any age, with a severe disease and a long-lasting necessity of steroids, might benefit from this therapy.”
Dr. Brucato’s team recruited 21 patients (20 adults and one child) who were taking steroids and colchicine to treat ongoing idiopathic recurring pericarditis and followed them between June 2014 and June 2015. The adult patients were predominately women with an average age of just over 45 years. To be included in the study, these patients had a history of recurring pericarditis with at least two recurrences with an elevation of c-reactive protein, which was considered a sign of more acute inflammation that may respond better to anakinra.

The adult participants were given 100 mg of anakinra via subcutaneous injection each day for two months, and the child participant was given 2mg/kg each day for the same time period. Dosages of NSAIDs and colchicine were tapered over period of two weeks, and corticosteroids over maximum six weeks. All patients completed the first two months of the study and responded well with their c-reactive protein levels returning to normal within one week and disappearance of pain and of pericardial effusion.

After two months the group was divided and 11 participants were randomly assigned to continue their treatment while the other 10 participants received placebo for six additional months. Neither the patients nor the researchers knew who was assigned to each group. During this part of the study, the researchers documented the recurrence rates and how long it took each patient to experience a pericarditis flare (called “time to flare”).

They noted flares occurred in 90 percent of the patients in the placebo group (with the median time to flare of 12 days) and in only in 18 percent of the patients who were taking anakinra. Because there were so few flares in the anakinra group, the researchers couldn’t assess a median time to flare.

In addition to being effective, anakinra was shown to be acceptably safe. “The most common side effect of the treatment was a skin reaction at the site of the injection. While this occurred in 95 percent of the participants, it disappeared after one month, and no patient discontinued the study due to this side effect,” explains Dr. Brucato who goes on to note, “Two serious side effects occurred in patients who continued taking anakinra. One patient developed shingles, and the other developed an ischemic optic neuropathy in one eye side effects which cannot absolutely be attributed to anakinra.”

Overall, this study in a small series of patients shows that anakinra is very effective and safe for treatment of steroid dependent and colchicine resistant severe recurring pericarditis. While this study is hopeful, Dr. Brucato believes more studies are needed, saying, “Anakinra is quite effective, and generally well tolerated, particularly if compared to chronic therapy with corticosteroids at medium dosages, but recurrences may occur after its discontinuation. We need more studies to define a better way to taper anakinra, and to test it in combination with other effective therapies, such as colchicine.”

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Diet, rheumatoid arthritis linked

Newswise — SAN FRANCISCO— Two studies, presented this week at the American College of Rheumatology Annual Meeting in San Francisco, show a person’s diet can significantly affect his or her chance of developing rheumatoid arthritis.

Rheumatoid arthritis is the most common chronic autoimmune disease that affects the joints. RA has the potential for joint damage and deformity, with loss of function. The cause of RA is unknown. It affects people of all ages, and women more commonly than men. RA causes pain, stiffness and swelling, generally in multiple joints. RA may affect any joint, but the small joints in the hands and feet are most frequently involved. Rheumatoid inflammation may also develop in other organs such as the lungs.

The first study found that typical Western diets high in red meat, processed meat, refined grains, fried food, high-fat dairy, and sweets can increase a person’s risk of developing RA in comparison to Prudent diets made mostly of fruit, vegetables, legumes, whole grains, poultry and fish.

“The evidence for diet having a role in the etiology of RA is inconsistent, sometimes conflicting. The prior studies based on individual nutrients and food groups may not have enough power to detect small effects,” explains lead investigator in the study, Bing Lu, MD, DrPH; assistant professor of medicine; Brigham and Women’s Hospital and Harvard Medical School. “Instead, overall dietary pattern analysis examines the cumulative effects of multiple nutrients and foods, and may be more predictive of disease risk than individual foods or nutrients. The single-nutrient approach may be inadequate for taking into account complicated interactions among nutrients, and high levels of inter-correlation makes it difficult to examine their separate effects. Therefore, we proposed a prospective study examining the overall effect of dietary patterns to furnish novel information about diet and etiology of RA.”

Through the Nurses’ Health Study II, — a study of 116,460 female registered nurses ranging in age from 25 to 42 — Dr. Lu’s team followed 93,859 women without RA who filled out dietary questionnaires every four years between 1991 and 2011. From these questionnaires, the researchers discovered two dietary patterns among the women: Western and Prudent.

Throughout the course of the study, 347 women developed RA at an average age of 49. After taking into consideration their age, smoking status, body mass index, total calories consumed each day, alcohol consumption, level of physical activity, and socioeconomic factors, the women on Prudent diets had less of a chance of developing RA, while those on the Western diet were at increased risk, but BMI weakened these findings. “This indicates that the effects of the two dietary patterns on RA risk may be partially through BMI, and the clear mechanism is still unknown. Therefore, adherence to a healthy diet may be a way to prevent this debilitating disease, especially for high risk population,” explains Dr. Lu of the findings.

The second study, showed that following the Dietary Guidelines for Americans can also lower one’s chances of developing the disease. According to the United States Department of Agriculture, “the Dietary Guidelines for Americans … provide authoritative advice about consuming fewer calories, making informed food choices, and being physically active to attain and maintain a healthy weight, reduce risk of chronic disease, and promote overall health.”

Little has been reported on how following these guidelines can impact one’s risk of developing RA, so Dr. Lu’s team again utilized the Nurses’ Health Study II and food frequency questionnaires to determine if following these guidelines could lessen one’s chance of developing RA.

In this study — based on dietary intakes of various foods provided in the food frequency questionnaires, — the Alternate Healthy Eating Index 2010 was created to measure how well the participants followed the Dietary Guidelines for Americans (2010), and the researchers observed associations of the diets of study participants and the likelihood of developing RA.

Looking at data from 1991 to 2011, 347 study participants self-reported a diagnosis of RA, which was later confirmed through their medical records. The researchers noted those who best adhered to the Dietary Guidelines for Americans (based on the Alternate Healthy Eating Index 2010) had a 33 percent reduced risk of developing RA when compared to those who did not follow the guidelines as closely. And, just as in the first study, the researchers noted that body mass index may be a modest intermediate factor linking diet and risk of RA.

Of those who developed RA, 215 had seropositive RA (diagnosed due to the presence of anti-cyclic citrullinated peptides or rheumatoid factor in blood work) and 132 had seronegative RA (an RA diagnosis, but one that is lacking definitive bloodwork). This led the researchers to further look into the difference between these two groups, and they found the association between following the dietary guidelines and the risk of developing RA was stronger among those with seronegative RA than those with seropositive.

“As we found with the first study, it is clear that a healthy diet may prevent RA development, and our team is interested in conducting further studies to look at why diet is associated with this risk,” Dr. Lu concludes.

Posted in Arthritis: Rheumatoid, Nutrition is Medicine | Leave a comment

Prostate cancer, yoga, and side effects: new info

PHILADELPHIA — Men with prostate cancer who are undergoing radiation therapy can benefit from yoga, researchers at the Perelman School of Medicine at the University of Pennsylvania reported at the Society of Integrative Oncology’s 12th International Conference.

The new, first-of-its-kind study, led by Neha Vapiwala, MD, an associate professor in the department of Radiation Oncology at PSOM and Penn’s Abramson Cancer Center, found that general quality of life and measurements of side effects often experienced by prostate cancer patients–including fatigue, sexual health, and urinary incontinence–were stable throughout a course of outpatient radiation therapy among the men participating in an intensive yoga program.

“Data have consistently shown declines in these important measures among prostate cancer patients undergoing cancer therapy without any structured fitness interventions, so the stable scores seen with our yoga program are really good news,” Vapiwala said.

Cancer-related fatigue differs from everyday-life fatigue, which is usually temporary and can be relieved by rest or sleep. Fatigue that stems from cancer or cancer treatments has been found to lower patients’ quality of life even more than pain, and studies have shown that anywhere from 60 to 90 percent of patients receiving radiation therapy report this symptom. Furthermore, erectile dysfunction is reported in 21 to 85 percent of all prostate cancer patients, while urinary incontinence is reported in 24 percent of men with this disease.

The possible explanation for the benefits of yoga seen in the study stems from physiologic data demonstrating its ability to help reduce cancer- as well as treatment- related fatigue and to strengthen pelvic floor muscles and increase blood flow. These latter aspects may in turn improve erectile dysfunction and urinary incontinence, said Vapiwala.

“There may also be a psychosocial benefit that derives from participation in a group fitness activity that incorporates meditation and promotes overall healthiness. And all of this ultimately improves general quality of life,” she added.

Other studies have demonstrated beneficial health and quality of life effects from yoga interventions in cancer patients. However, yoga has been predominantly evaluated for breast cancer, and research on its role in alleviating prostate cancer patients’ side effects has been lacking, largely due to the perception that men would not be willing to participate in this form of holistic exercise.

National statistics indicate that 72 percent of those who practice yoga are female, and only 18 percent of practitioners are over the age of 55. The median age at diagnosis for cancer of the prostate is 66.

“Despite these figures, we found that a structured yoga intervention in the form of twice-weekly classes is feasible for patients during a six- to nine-week course of outpatient radiotherapy for prostate cancer,” said Vapiwala. “Our participation-rate finding alone is important because it is a caution against making assumptions about patients without proper evidence.”

Specifically, between May 2013 and June 2014, 68 eligible prostate cancer patients were identified and offered study participation, of which 45 consented (66 percent) to attend twice-weekly yoga classes of 75 minutes each, taught by trained Eischens yoga instructors within the Abramson Cancer Center.

Although 18 (40 percent) of these participants were voluntarily withdrawn early due to unavoidable and unanticipated conflicts between radiation treatment times and the yoga class schedule, the remainder were able to participate and the study’s feasibility endpoint was met.

“Eischens yoga incorporates ideas from movement theory and kinesiology and is accessible to all body types and experience levels,” said Tali Mazar Ben-Josef, DMD, a certified Eischens yoga instructor and researcher in the Abramson Cancer Center, who will present the results at the SOI meeting.

Most yoga participants reported a sense of well-being at the end of each class, and upon finishing the yoga program and concluding their study involvement, many patients requested and received an at-home practice routine to fit their needs, Ben-Josef said.

The effect of yoga was measured by participants’ responses to a series of questions that assess overall quality-of-life, cancer-related fatigue, and prevalence of sexual and erectile dysfunction and urinary incontinence. The researchers chose these variables because they affect so many prostate cancer patients.

Severity of fatigue scores demonstrated significant variability over the time of treatment, with increases by week four as expected, but then improving over the course of treatment. Erectile dysfunction, urinary incontinence, and general quality of life scores demonstrated steady trends.

Currently, the team is randomizing prostate cancer patients to participation vs. no participation in this structured yoga program in order to further characterize the potential benefits of yoga in this population.

This trial represents an expansion of the Abramson Cancer Center’s integrative medicine and wellness services that are available to patients and survivors. In addition to yoga, patients can receive training in stress-reduction techniques, meditation, reiki therapy, acupuncture, and massage.

“We offer several ways to enhance quality of life, minimize or reduce side effects of cancer and cancer treatment, and promote healing and recovery,” Vapiwala said. “This study represents one of many research projects we are conducting in an effort to pinpoint the best, most effective practices to help patients with these needs.”

Nearly 240,000 men are diagnosed with prostate cancer each year in the United States, according to the American Cancer Society, which funded the new study.

The full results from the feasibility study are expected to be published early 2016.


Posted in Cancer: Prostate, Exercise: Benefits, Fitness: Yoga | Tagged , , , | Leave a comment

Dementia and the holidays and family

Newswise — BIRMINGHAM, Ala. – On just about any Sunday morning, you will find Sydie Allen seated in her regular pew at Briarwood Presbyterian Church in Birmingham enjoying the music and singing songs of praise while her husband, Tommy, sits nearby and joyfully quacks along.

“He’ll be loud enough that people can hear him quacking, but it doesn’t bother the people in our church,” said Sydie, who has been married to Tommy for 53 years. “They just kind of laugh that he is so in tune and enjoying himself so much.”

To the uninformed, Tommy’s behavior might seem strange or out of place; but to those who sit around him regularly and know he suffers from Alzheimer’s disease, it is not unusual. They understand it is simply his way of worshipping right along with them.

When the holidays roll around, however, it is a completely different story. Though Tommy has always loved attending holiday concerts and special services, the Allens no longer do because it throws Tommy too far out of his regular routine.

“If I were to take him to a special music event at night like that, he loves music so much he would get so excited that, when everybody else is just listening, he might be laughing or quacking really loud, so I just don’t do it,” Sydie said. “I think it would not only throw him off, but it would throw me off because I would be so concerned. You want to keep them active, but at the same time you want them to keep their dignity, too.”

It is a wise choice by a family caregiver who understands that such changes in routine can have an adverse effect on someone suffering from any form of dementia, says University of Alabama at Birmingham School of Nursing associate professor Rita Jablonski-Jaudon, Ph.D., an internationally renowned authority on approaches to reduce behavioral and psychiatric symptoms associated with dementia.

While the family caregiver may be trying to make the holidays more festive or joyful for everyone, especially the dementia patient, making elaborate plans or scheduling special events may trigger behaviors that can at the least be unpleasant for all involved, and at the most dangerous for their loved one.

“Caregivers have really good, altruistic and wonderful ideas that collide with the reality of dementia like a bug on a windshield,” Jablonski-Jaudon said.

She relates a personal experience from last spring when she settled into her seat on a crowded plane for a flight from Birmingham to Seattle and immediately sensed there was a problem with the older man seated next to her.

The man was very upset and becoming more so as he related that he and his wife had made last-minute flight arrangements to attend a funeral and had been unable to get seats together. His wife was 10 rows up the aisle in a middle seat yelling back to him that she couldn’t do anything about the seating arrangement and telling him to calm down.

“I could tell by the repetitiveness of his speech that he had some type of dementia,” Jablonski-Jaudon said. “He kept saying, ‘I’ve got to sit with my wife. I’ve got to sit with my wife.’ He was not attending to the nonverbal cues he was receiving from the flight attendants or the pleas from his wife to sit quietly. He was becoming more and more physically agitated. His behavior progressed to the point that he began trying to grab at the flight attendants to get their attention, and I realized that they were becoming impatient with his behavior. I truly thought he was going to be removed from the plane.”

She quickly volunteered to trade seats with the man’s wife, and a situation that could have gone bad very quickly was averted. Still, it is a prime example of the kinds of things family caregivers of dementia patients need to keep in mind as they plan for the upcoming holiday season, Jablonski-Jaudon says.

Jablonski-Jaudon also cautions caregivers against feeling compelled to “pull out all the stops” because it could be the last holiday their loved one will ever remember.

“That, ironically, will usually make it the worst holiday anybody will remember,” Jablonski-Jaudon said. “In spite of the best intentions, many caregivers’ own behavior sometimes triggers negative emotions in the person with dementia: anger, aggression and sadness. The stress associated with the holidays may amplify those triggers.”

They just don’t understand
Sydie says she and Tommy do not do as much to commemorate the holidays as they used to because he simply does not understand the significance anymore.

“We’ve always had a Christmas tree, and I’ve always said that, as long as he’s alive I am going to put one up because I felt like that would bring back the memories he has of Christmas,” Sydie said. “But honestly, I probably do that more for me now than for him.

“I think just loving them every day is the key now. Loving them and doing the best for them you can every single day is truly the key.”

Holiday planning tips
Here’s a checklist of a few more items Jablonski-Jaudon suggests family caregivers use in their holiday planning to make things happier for everyone:

• Keep travel plans realistic – Taking public transportation with a person with dementia can have dramatic consequences; but if you are going to travel with them, allow plenty of time to navigate the airport, train station, etc., and be prepared for delayed departures, layovers and cancellations. Know where family restrooms are available at all your stops if possible. Some family caregivers have business cards printed that read “Please be patient with my loved one because she (or he) has dementia” to hand out as needed. It is best to limit travel and reduce periods of time in unfamiliar surroundings for the person with dementia as much as possible.

• Keep on a schedule – Staying on a schedule gives the person with dementia some type of predictability. If you are going to involve the person in a family event or activity, try to hold it at a time during the day that is a good one for him or her. Plan rest periods for your loved one, especially at times when he or she may be irritable or uneasy, and be sure to keep his or her bedtime the same.

• Avoid clutter – Ensure that holiday decorations, even those family heirlooms that have been displayed for generations, do not endanger your loved one. Make sure that holiday throw rugs and electrical cords do not become trip hazards. Do not place large displays in areas that would confuse the person with dementia. If the loved one helps with the decorating, be sure that he or she does not hide things where they cannot be found.

• Avoid alcohol – As a general rule, avoid alcohol consumption by persons with dementia; but if they are allowed to drink, remember that it may affect the quality of their sleep. Be prepared for them to awaken at odd times. With alcohol often prevalent at holiday parties, be attuned to how many beverages the person with dementia may have had, as he or she may easily lose count. One way to prevent accidental over-indulgence is to substitute nonalcoholic beverages for alcoholic ones. One enterprising family member of a wine drinker put a special mark on an empty bottle of her favorite wine, filled it with grape juice and poured from it throughout the festivities.

• Take a trip down memory lane – Break out the family scrapbooks or photo albums and ask the person with dementia, “Who is it in these pictures?” Let them start reminiscing about stories and things they do remember from the past, and let the grandkids film it on their smartphone for everyone to share later. Make it pleasant, and do not make the person with dementia feel as though you are quizzing them.

• Seek understanding – If possible, talk to family members beforehand, especially teenagers and younger children, and explain the situation. Alert them to any usual behaviors or conditions the person with dementia may exhibit, and ask them not to chastise or try to correct the person for these behaviors. Ask them to read about dementia on the Internet in advance. Ask everyone not to speak to the person with dementia in a condescending tone or talk “baby” talk to them. Ask them for their patience.

About UAB
Known for its innovative and interdisciplinary approach to education at both the graduate and undergraduate levels, the University of Alabama at Birmingham is the state of Alabama’s largest employer and an internationally renowned research university and academic medical center; its professional schools and specialty patient-care programs are consistently ranked among the nation’s top 50. UAB’s Center for Clinical and Translational Science is advancing innovative discoveries for better health as a two-time recipient of the prestigious Center for Translational Science Award. Find more information at www.uab.edu and www.uabmedicine.org.

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New drowsy driving position statement calls for greater public awareness, education

DARIEN, IL – A new position statement from the American Academy of Sleep Medicine warns that drowsy driving is a serious public health concern requiring greater public awareness and increased efforts to improve preventive education.

The AASM reports that drowsy driving, which is defined as the operation of a motor vehicle while impaired by a lack of adequate sleep, can have the same consequences as driving while under the influence of drugs and alcohol. Drowsiness compromises driving ability by reducing alertness and attentiveness, delaying reaction times, and hindering decision-making skills. Drowsy driving also tends to occur at high speeds, and the driver is often unable to attempt to avoid a crash, resulting in serious accidents.

“Every year thousands of people die in preventable motor vehicle accidents caused by drowsy driving,” said AASM President Dr. Nathaniel Watson. “The American Academy of Sleep Medicine believes that an awake and alert driver makes the roadways safer.”

The position statement is published in the Nov. 15 issue of the Journal of Clinical Sleep Medicine.

The AAA Foundation for Traffic Safety estimates that drowsy driving causes an average of 328,000 crashes annually in the U.S., including 6,400 fatal crashes. Young drivers between the ages of 16 and 24 years are most at risk of getting into an accident while driving drowsy, and males have a higher risk than females.

Through its Sleep and Transportation Safety Task Force, the AASM has developed model drowsy driving language for states to include in driver’s manuals, educational curricula and licensing examinations. The AASM also encourages the automobile insurance industry to implement drowsy driving educational discount programs.

According to the AASM, drowsiness while driving can be a symptom of a chronic sleep disease such as obstructive sleep apnea. Anyone who struggles to stay awake behind the wheel, despite getting adequate sleep, should discuss the problem with a doctor. Help for an ongoing sleep problem is available from board-certified sleep medicine physicians at more than 2,500 AASM accredited sleep centers across the U.S.

The AASM, together with its partners in the National Healthy Sleep Awareness Project, encourages every driver to take responsibility for staying ‘Awake at the Wheel’ by making it a daily priority to get sufficient sleep, refusing to drive when sleep-deprived, recognizing the signs of drowsiness, and pulling off the road to a safe location when sleepy. Learn more at http://www.projecthealthysleep.org.


To request a copy of the position statement, ‘Confronting Drowsy Driving: The American Academy of Sleep Medicine Perspective,’ or to arrange an interview with an AASM spokesperson, please contact:

Communications Coordinator
Lynn Celmer
630-737-9700, ext. 9364

About the American Academy of Sleep Medicine

Established in 1975, the American Academy of Sleep Medicine (AASM) improves sleep health and promotes high quality patient centered care through advocacy, education, strategic research, and practice standards. The AASM has a combined membership of 11,000 accredited member sleep centers and individual members, including physicians, scientists and other health care professionals. For more information about sleep and sleep disorders, including a directory of AASM accredited member sleep centers, visit http://www.sleepeducation.org.


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Where marijuana is legal, complaints aired about the smell

America’s growing experiment with legalized recreational pot has literally changed the atmosphere around a drug. And some don’t like it. 

That tinge of strange smoke once smelled mostly in the high seats at rock shows has become commonplace in parts of America where voters have legalized marijuana.

A Washington Post survey found that in some city wards nearly 70 percent of people smell marijuana smoke at least once a month during their perambulations and 1 in 3 people smell it every day, just a year after the city legalized it for recreational use and personal possession, though not sales. “People aren’t as discreet as they were before it was legal,” a 21-year-old D.C. resident named Wuan Smith told the Post.

Indeed, America’s growing experiment with legalized recreational pot has literally changed the atmosphere around a drug that has for decades been one of the top reasons for arrests in the US.

With pot out of the shadows in some states, the direct exposure to smoke has led to conflicts. Colorado, which in 2012 was the first state to legalize recreational marijuana, has seen odor complaints rise, with 30 percent of such complaints now regarding pot in Denver.


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When to replace these 8 household items

Unlike food, household items like pillows, mascara, and toothbrushes don’t typically come with an expiration date. Here’s a guide to how often you should replace some of the most commonly overused items, and some of them may surprise you.

I think it’s time for an intervention. Put down the fancy mascara your aunt got you for Christmas 2007. Take your head off the pillow you’ve been sleeping with since childhood. I know you love these things, but your relationship with them is no longer healthy. It’s time to let go.

We’re all guilty of holding onto stuff like this for way longer than we should. And it’s easy to understand why! Unlike food, household items don’t typically come with an expiration date, so it can be difficult to know just how often to replace these things. We put together a guide for how often you should replace some of the most commonly overused items, and some of them may surprise you.

Toothbrushes: every 3-4 months.

You might think this recommendation is based on the fact that old toothbrushes are germy, but according to the American Dental Association, this is more about the state of your bristles than anything else.



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Seniors, falls, and hospital readmissions

Newswise — DETROIT – A comprehensive care program that involves a team of specialists from multiple medical disciplines for treating injuries sustained from falls in older adults could help reduce hospital readmissions, according to researchers at Henry Ford Hospital in Detroit.

Under the program, the 30-day readmission rate for falls declined 10 percent from 2012-13 and remained unchanged in 2014. The 30-90 day readmission rate from 2012-13 also declined, before rising slightly in 2014.

“With the multidisciplinary approach we’ve put into place, we’ve made a significant impact on patients returning to a safer home environment and reducing their risk of subsequent falls and complications that could lead to readmission,” says Jennifer Peltzer-Jones, R.N., Psy.D., a clinical psychologist at Henry Ford’s Department of Emergency Medicine and the study’s lead author.

The collaborative approach that emphasizes early intervention was also reflective in the quality indicator of length of stay – no hospitalizations were extended. Additionally, 56 percent of patients were found to have suspected delirium with possible dementia.

The findings were presented Monday at the Trauma Quality and Improvement Program’s annual meeting in Tennessee.

An estimated one in three seniors ages 65 and older falls each year, according to the Centers for Disease Control and Prevention, and more than 700,000 are hospitalized for their injuries.

For its study, researchers sought to evaluate the quality of care for patients admitted to Henry Ford’s Trauma Services. Researchers analyzed data of 558 patients, half of whom were 80 years of age and older from 2012-14.

Henry Ford’s care program includes specialists in trauma, geriatrics, behavioral health, pharmacy and physical and occupational therapy, whom all meet collectively to manage and develop a care plan personalized for each patient. The program is unique in that patients are admitted to Trauma Services for repairing the injury. The specialists then collaborate on the care plan. Families also are engaged in the care planning, which has led to safer discharge plans for the home environment.

“Through this model we’ve been able to better understand the needs of this patient population,” says Peltzer-Jones. “At the same time, our program continues to evolve. We’re looking at ways in which we can involve the primary care team with the goal of preventing falls before they happen.”

Posted in Elder Care, Elder Care: Falls, Health Care: Medical Errors: Hospital Readmissions | Tagged | Leave a comment

Fear of failure paralyzes innovation

Thanks to disruptive technologies – and the notion that 40% of today’s Fortune 500 won’t be around in a decade – companies are scrambling to make innovation happen. So how do you get started? Is there a proven recipe for creating a successful culture of innovation? How can organizations move beyond the fear of failure that paralyzes innovation?

Bonnie D. Graham, host of Coffee Break with Game Changers Radio, discussed these innovation pain points with a panel of experts and students during a recent broadcast, “How Do We Live with Innovation?”

“Number one, you need a passionate team committed to working together to reach common goals,” said Graham. “You also need an environment where your team feels safe about trying new ideas; that means you take away the fear of failure.”

Strong leadership can also spark a culture of innovation but Graham reminded the audience that there’s no replacement for hard work, citing a famous quote from Thomas Edison, “Genius is 1% inspiration and 99% perspiration,” said Graham. “It may take a lot of work but it’s worth the effort because your company needs to have a culture of innovation.”

Fear of failure and thinking outside the box

As head of Service Innovation for Global Services at SAP, Michel Sérié knows a thing or two about managing organizations and believes innovation involves much more than simply thinking outside the box.


Posted in Business, Human Behavior: Conformity, Human Behavior: Failure, Human Behavior: Fear, Nutrition: Innovation | Tagged , , | Leave a comment

Rich kids seem to be thriving. But many are not. Why?

With financial success ought to come some measure of relief—a chance to take in a deep breath, exhale, and survey the world from the top.

But, as Hanna Rosin’s recent Atlantic cover story on the high rate of suicide among high-school students in Palo Alto, California, captures, that’s not how things work. To the contrary, kids living in one of the wealthiest zip codes in the country are stressed and miserable. As Rosin writes:

On the surface, the rich kids seem to be thriving. They have cars, nice clothes, good grades, easy access to health care, and, on paper, excellent prospects. But many of them are not navigating adolescence successfully.

The rich middle- and high-school kids [Yale professor Suniya] Luthar and her collaborators have studied show higher rates of alcohol and drug abuse on average than poor kids, and much higher rates than the national norm. They report clinically significant depression or anxiety or delinquent behaviors at a rate two to three times the national average. Starting in seventh grade, the rich cohort includes just as many kids who display troubling levels of delinquency as the poor cohort, although the rule-breaking takes different forms. The poor kids, for example, fight and carry weapons more frequently, which Luthar explains as possibly self-protective. The rich kids, meanwhile, report higher levels of lying, cheating, and theft.

Why is this?


Posted in Human Behavior: Stress, Parenting | Tagged , , | Leave a comment

10 ways to give up emotional eating

After a long day, you may find yourself feeling stressed, bored or anxious. The urge to reach out to a tub of ice-cream or a bag of chips kicks in, in hopes of drowning all those negative emotions. Although emotional eating might make you feel good in the moment, it often leads to feelings of regret, guilt or shame.

But it is common practice to many. As a child, we are nurtured and rewarded with food so having emotional connections to food is normal. But if we keep using food as a coping mechanism, it’s a surefire way to gain weight. It can be even more problematic if you already have existing health conditions such as diabetes and heart disease.

Fortunately, like any habit, emotional eating can be broken. Here are ten tips to get you back in control of healthy eating habits without letting your emotions get in control of them.

Keep your home healthy

The best way to reduce binge eating is to cut down on your go-to temptations. Keep your pantry free from processed food such as chips and chocolate. Instead have some handy healthy snacks at home such as vegetable sticks with a hummus dip, corn for popping, or home-made fruit yogurt.

Think about your triggers

If you’re having the urge to binge, pause for a moment and then write all the emotions you’re feeling in a diary. Ask yourself if you’re hungry, upset, anxious, lonely, or just plain bored. With time you may see patterns emerge that can give you insight on the connection between your moods and emotional eating.


Posted in Emotional Eating, Human Behavior: Impulse, Nutrition: Habits, Stress Eating | Tagged | Leave a comment

5 things on a to-do list is plenty; more is just plain folly

I love lists. I’ve sung their praises tirelessly. Lists help you feel in control, because you’re no longer relying on your brain to keep track of your to-dos; lists help you see your work more objectively, so you know when you’ve taken on too much. “What you need to do,” I’ve often found myself saying to stressed-out people, with all the zeal of an overcaffeinated Scientologist, “is make a list!” (“Thanks,” they reply, “but I didn’t actually say anything. Also, this is the quiet carriage.”) So naturally I responded with alarm to the advice of the time management expert Mark Forster, whose new book, Secrets Of Productive People, argues that to-do lists are bad, and that you should throw yours away.

Forster’s claim – which applies equally to back-of-the-envelope to-do lists, complex productivity systems, or “bucket lists” of life ambitions – is that lists are flights of fancy. Maybe they give you a feeling of control, but it’s a fake one. It’s far too easy to add to a list: an idea pops into your head, or a request into your inbox, and on to the list it goes, without your being forced to ask if it truly matters, or whether you’ve the bandwidth to do it. The ever-expanding list “refer[s] to a never-never land where you magically get time to do all this work”, Forster writes. Worse, it’s out of date the moment you create it – a record “of what you might have done or could have done at a point of time which is already receding into the past”, regardless of what’s possible, or important, to do now.


Posted in Human Behavior: Decision Making, Human Behavior: Goal Setting, Human Behavior: Stress, Workaholism, Workplace Issues | Leave a comment

Parents Aiming Too High Can Harm Child’s Academic Performance

WASHINGTON — When parents have high hopes for their children’s academic achievement, the children tend to do better in school, unless those hopes are unrealistic, in which case the children may not perform well in school, according to research published by the American Psychological Association.

“Our research revealed both positive and negative aspects of parents’ aspiration for their children’s academic performance. Although parental aspiration can help improve children’s academic performance, excessive parental aspiration can be poisonous,” said lead author Kou Murayama, PhD, of the University of Reading. The study was published in the Journal of Personality and Social Psychology®.

Murayama and his colleagues analyzed data from a longitudinal study from 2002-07 of 3,530 secondary school students (49.7 percent female) and their parents in Bavaria, Germany. The study assessed student math achievement as well as parental aspiration (how much they want their child to earn a particular grade) and expectation (how much they believe their child can achieve a certain grade) on an annual basis.

They found that high parental aspiration led to increased academic achievement, but only when it did not overly exceed realistic expectation. When aspiration exceeded expectation, the children’s achievement decreased proportionately.

To reinforce the results, the researchers attempted to replicate the main findings of the study using data from a two-year study of over 12,000 U.S. students and their parents. The results were similar to the German study and provided further evidence that parents’ overly high aspirations are associated with worse academic performance by their kids.

Previous psychological research has found the association between aspiration and academic achievement, but this study highlights a caveat, said Murayama.

“Much of the previous literature conveyed a simple, straightforward message to parents — aim high for your children and they will achieve more,” said Murayama. In fact, getting parents to have higher hopes for their children has often been a goal of programs designed to improve academic performance in schools. This study suggests that the focus of such educational programs should not be on blindly increasing parental aspiration but on giving parents the information they need to develop realistic expectations.

“Unrealistically high aspiration may hinder academic performance. Simply raising aspiration cannot be an effective solution to improve success in education,” he said.

Article: “Don’t Aim Too High for Your Kids: Parental Overaspiration Undermines Students’ Learning in Mathematics,” by Kou Murayama, PhD, University of Reading; Masayuki Suzuki, PhD, National Institute of Informatics, Japan; Reinhard Pekrun, PhD, and Stephanie Lichtenfeld, PhD, University of Munich; and Herbert Marsh, PhD, Australian Catholic University, Journal of Personality and Social Psychology, published online Nov. 16, 2015.


Posted in Human Behavior: Learning, Parenting | Leave a comment

How to leave work at work

(Reuters Health) – It can be difficult for employees to detach from incomplete work tasks, but having a plan for dealing with those tasks may help, a new study suggests.

Writing down how, when, and where they will complete the tasks may help workers enjoy their evenings, the author of the study says.

“When goals are left incomplete, even beyond the work setting, they tend to linger on our minds,” said Brandon Smit of Ball State University in Indiana, the author of the new study.

“We know that getting a break from work demands reduces fatigue and increases positive mood among employees,” Smit told Reuters Health by email. “It even predicts better job performance the following day, and that’s saying nothing to the obvious benefits to individuals who are present and engaged with their loved ones during family time.”

Through Amazon’s crowdsourcing website Mechanical Turk, Smit surveyed 103 people using two online questionnaires per day for five workdays. Participants submitted one survey immediately after work, including information on daily complete and incomplete goals, and another right before going to sleep, assessing how much they had thought about work since returning home.


Posted in Human Behavior: Work Ethic, Workaholism, Workplace Issues | Leave a comment

7 Things You Can Never Unsay In A Relationship

This morning, my best friend and I got into a discussion about things you should never say in a relationship. We came to the conclusion that there are quite a few things that really should never be said to your partner, and that we could all stand to learn how to pause more often, before we say something potentially damaging. “There are many things that are hard to forget,” she said, shaking her head. Even if someone says something seemingly benign — “I don’t like those pants”; “Your hair looks weird like that” — it can get stuck in your head like an earworm.

We realized that are countless things you can’t take back in a relationship, and we weren’t even talking intentionally mean comments said in anger in the midst of a bad argument. These are the thoughtless, offhand remarks that might not seem like a big deal to the speaker in the moment, but that stick around and haunt the recipient for months or years to come. Whether you’re in a relationship or just have ever been in a relationship, it’s likely that you can think of a few such ghosts — the comments that lie around and resurface from time to time. Here are seven things that men have actually said to my friend or me that we’ve never forgotten — comments that can never be taken back — and why they’re so hard to shake.


Posted in Human Behavior: Relationships | Leave a comment

Depression and inflammation linked: more evidence

About one third of people with depression have high levels of inflammation markers in their blood. New research indicates that persistent inflammation affects the brain in ways that are connected with stubborn symptoms of depression, such as anhedonia, the inability to experience pleasure.

The results were published online on Nov. 10 in Molecular Psychiatry.

More articles about the links between inflammation and depression

The findings bolster the case that the high-inflammation form of depression is distinct, and are guiding researchers’ plans to test treatments tailored for it.

Anhedonia is a core symptom of depression that is particularly difficult to treat, says lead author Jennifer Felger, PhD, assistant professor of psychiatry and behavioral sciences at Emory University School of Medicine and Winship Cancer Institute.

“Some patients taking antidepressants continue to suffer from anhedonia,” Felger says. “Our data suggest that by blocking inflammation or its effects on the brain, we may be able to reverse anhedonia and help depressed individuals who fail to respond to antidepressants.”

In a study of 48 patients with depression, high levels of the inflammatory marker CRP (C-reactive protein) were linked with a “failure to communicate”, seen through brain imaging, between regions of the brain important for motivation and reward.

Neuroscientists can infer that two regions of the brain talk to each other by watching whether they light up in magnetic resonance imaging at the same times or in the same patterns, even when someone is not doing anything in particular. They describe this as “functional connectivity.”

In patients with high CRP, Felger and her colleagues observed a lack of connectivity between the ventromedial prefrontal cortex and the ventral striatum. In contrast, patients with low CRP had robust connectivity, they write.

“We were interested in these regions of the brain because of their known importance for response to reward,” she says. “In addition, we had seen reduced activation of these areas in people receiving immuno-stimulatory treatments for hepatitis C virus or cancer, which suggested that they may be sensitive to inflammation.”

High CRP levels were also correlated with patients’ reports of anhedonia: an inability to derive enjoyment from everyday activities, such as food or time with family and friends. Low connectivity between another region of the striatum and the ventromedial prefrontal cortex was linked to a different symptom: slow motor function, as measured by finger tapping speed.

During the brain imaging portion of the study, participants were not taking antidepressants, anti-inflammatory drugs or other medications for at least four weeks, and CRP was measured on repeat visits to make sure its levels were stable. High CRP was also correlated with BMI (body mass index), but the statistical relationship was strong even after correcting for BMI and other variables such as age.

A previous study of people with difficult-to-treat depression found that those with high inflammation (as measured with CRP), but not other participants in the study, improved in response to the anti-inflammatory antibody infliximab.

As a next step, Felger is planning to test whether L-DOPA, a medicine that targets the brain chemical dopamine, can increase connectivity in reward-related brain regions in patients with high-inflammation depression. This upcoming study is being supported by the Dana Foundation.

Felger’s previous research in non-human primates suggests that inflammation leads to reduced dopamine release. L-DOPA is a precursor for dopamine and often given to people with Parkinson’s disease.

“We hope our investigations may lead to new therapies to treat anhedonia in high-inflammation depression,” she says.


Co-first author, research associate Zhihao Li, PhD is now at Shenzhen University. Other Emory co-authors include Andrew H. Miller, MD, professor of psychiatry and behavioral sciences at Emory University School of Medicine and Winship Cancer Institute, Ebrahim Haroon, MD, assistant professor of psychiatry and behavioral sciences at Emory University School of Medicine, and Xiaoping Hu, PhD, professor in the Wallace H. Coulter Department of Biomedical Engineering at Georgia Tech and Emory.


Posted in Inflammation, Mental Health: Depression | Leave a comment

New Chipotle E. coli outbreaks in Midwest, East

What’s New?

  • 3 additional states have reported people infected with the outbreak strain of Shiga toxin-producing Escherichia coli O26 (STEC O26) since the last update.
  • 45 people infected with the outbreak strain of STEC O26 have now been reported from a total of 6 states: California (2), Minnesota (2), New York (1), Ohio (1), Oregon (13), and Washington (26).
  • The epidemiologic evidence available at this time suggests that a common meal item or ingredient served at Chipotle Mexican Grill restaurants in several states is a likely source of this outbreak.
  • The investigation is still ongoing to determine what specific food is linked to illness.
  • CDC will advise the public if specific steps are identified that consumers can take to protect themselves.


  • Read the Advice to Consumers »
  • CDC, the U.S. Food and Drug Administration, and public health officials in several states are investigating an outbreak of Shiga toxin-producing Escherichia coli O26 (STEC O26) infections.
  • As of November 19, 2015, 45 people infected with the outbreak strain of STEC O26 have been reported from 6 states.
    • 16 ill people have been hospitalized. There have been no reports of hemolytic uremic syndrome and no deaths.
  • The epidemiologic evidence available at this time suggests that a common meal item or ingredient served at Chipotle Mexican Grill restaurants in several states is a likely source of this outbreak.
    • 43 (96%) of 45 ill people interviewed reported eating at a Chipotle Mexican Grill restaurant in the week before their illness started.
    • The investigation has not identified what specific food is linked to illness.
    • Chipotle Mexican Grill is assisting public health officials with understanding the distribution of food items served at locations where ill people ate and this work is ongoing.
  • Investigators are using whole genome sequencing, an advanced laboratory technique, to get more information about the DNA fingerprint of the STEC O26 bacteria causing illness.
    • To date, 10 STEC O26 isolates from ill people in Washington (9) and Minnesota (1) were found to be highly related genetically to one another.
  • CDC and state and local public health partners are continuing laboratory surveillance through PulseNet to identify additional ill persons and to interview them.
  • Consumers should contact a health care provider if they recently became ill with diarrheal symptoms after eating at a Chipotle Mexican Grill restaurant.
  • CDC will advise the public if specific steps are identified that consumers can take to protect themselves.

November 20, 2015

Case Count Update

CDC is only reporting ill people that have been confirmed by PulseNet as being infected with the outbreak strain of Shiga toxin-producing Escherichia coli O26 (STEC O26). Forty-five people infected with the outbreak strain of STEC O26 have been reported from 6 states. The majority of illnesses have been reported from Washington and Oregon. The number of ill people reported from each state is as follows: California (2), Minnesota (2), New York (1), Ohio (1), Oregon (13), and Washington (26).

Among people for whom information is available, illnesses started on dates ranging from October 19, 2015 to November 8, 2015. Ill people range in age from 2 years to 94, with a median age of 22. Fifty-eight percent of ill people are female. Sixteen (36%) people reported being hospitalized. There have been no reports of hemolytic uremic syndrome and no deaths.

This outbreak can be illustrated with a chart showing the number of people who became ill each day. This chart is called an epidemic curve or epi curve. Illnesses that occurred after October 31, 2015 might not be reported yet due to the time it takes between when a person becomes ill and when the illness is reported. This takes an average of 2 to 3 weeks. Please see the Timeline for Reporting Cases of E. coli Infection for more details.

CDC and state and local public health partners are continuing laboratory surveillance through PulseNet to identify additional ill persons and to interview them.

Investigation Update

CDC, the U.S. Food and Drug Administration, and public health officials in several states are investigating an outbreak of Shiga toxin-producing Escherichia coli O26 (STEC O26) infections.

The epidemiologic evidence available to investigators at this time suggests that a meal item or ingredient served at Chipotle Mexican Grill restaurants at several states is a likely source of this outbreak. The investigation has not identified what specific food is linked to illness. Chipotle Mexican Grill is assisting public health officials with understanding the distribution of food items served at locations where ill people ate and this work is ongoing.

State and local public health officials are interviewing ill people to obtain information about foods they might have eaten and other exposures in the week before their illness started. Forty-three (96%) of 45 people interviewed reported eating at a Chipotle Mexican Grill restaurant. The investigation is ongoing to identify common meal items or ingredients causing illness.

Investigators are also using whole genome sequencing, an advanced laboratory technique, to get more information about the DNA fingerprint of the STEC O26 bacteria causing illness. To date, whole genome sequencing has been performed on STEC O26 isolates from 9 ill people in Washington and 1 ill person in Minnesota. All 10 isolates were highly related genetically to one another. This provides additional evidence that illnesses outside the Pacific Northwest are related to the illnesses in Oregon and Washington.

Updates will be provided when more information is available.


Posted in Bacteria: E.coli | Leave a comment

‘Uber For Breakups’ Will Dump Your Boyfriend Over Snapchat For $5

Is it just not working out? Soon that busted old relationship could be gone in a Snap .

The Breakup Shop, a company that’s been likened to Uber for breakups, already offers a variety relationship-terminating services. But the new feature, which is expected to launch this weekend or Monday, will allow users to dump their soon-to-be exes with either a video or picture message. The $5 fee for the service is payable via Snapcash.

A spokesman for The Breakup Shop said the new option is an effort to reach high school-aged customers who use the popular vanishing message app.

“Breakups can be supported by technology just as getting into relationships can be,” spokesman Mackenzie told Forbes. “I think we are part of the realization that the attention has been focused on the beginning stages of relationships. No one is paying attention to the fact that more relationships are going to fail than succeed.”

He declined to give his last name, saying that the company has received harsh criticism since its Nov. 8 launch.

But whether you dump your partner via Snapchat or a text, there’s a good chance you’ll see them on your Facebook FB +1.19% feed.

A new tool announced by the social media behemoth Nov. 20 seeks to alleviate that awkward, potentially painful recurrence by effectively censoring your former lover without having to block them or unfriend them. 


Posted in Human Behavior: Conflict, Human Behavior: Cynicism, Human Behavior: Dignity, Human Behavior: Emotional Maturity, Human Behavior: Personal Responsibility, Human Behavior: Relationships, Human Behavior: Social Media | Leave a comment

Food waste: 5 high-tech ways to deal with it

In 2013, Americans threw away 204 million pounds of turkey, according to the NRDC. That’s $277 million worth. Or put another way: the resources it took to grow those turkeys is the equivalent to the amount of water needed to supply New York City for 100 days. The US Department of Agriculture reports that 35 percent of turkey is not consumed during the holiday season.

But food waste isn’t just a water problem or a waste problem. It is an environmental problem as well. In 2007, 1.4 billion hectares of land were used to produce food that was thrown away, according to the Food and Agricultural Organization of the United Nations. The carbon footprint of food waste was estimated at 3.3 Gigatonnes of carbon dioxide, which is more than twice the emissions of the USA road transportation in 2010. If food waste were ranked as a country, it would come behind the US and China as the top greenhouse gas emitter.

Annually, Americans throw away 40 percent of our food, so it’s not just about the holiday season. Food waste is such a massive, overwhelming problem, we need to keep the conversation going to raise awareness and effect change. There are many startups and organizations trying to tackle the problem, and policies are slowly staring to take place.

1. EcoSafe Digester

The EcoSafe Digester is a machine made by BioHitech America. It’s an aerobic, on-site digester for food waste disposal. The company claims it diverts more than 70 million pounds of food waste from landfills every year, and prevents more than 25 million metric tons of carbon per year.


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Large-scale warming events 10,000+ years ago triggered loss of oxygen: National Science Foundation

A new study has found a link between abrupt ocean warming at the end of the last ice age and the sudden onset of low-oxygen, or hypoxic, conditions that led to vast marine dead zones.

Results of the research, which was funded by the National Science Foundation (NSF), are published today in the journal Nature.

“This works tackles a long-standing debate about what causes expansion of Oxygen Minimum Zones, also known as dead zones, in the oceans,” said Candace Major, a program director in NSF’s Division of Ocean Sciences. “The results demonstrate a link between warming surface temperatures and dead zones at great depths. The findings also show that the response time between warming and dead zone expansion is quite fast.”

Large-scale warming events at about 14,700, and again 11,500, years ago occurred rapidly and triggered loss of oxygen in the North Pacific, raising concern that low-oxygen areas will expand again as the oceans warm in the future.

Anomalous warmth that occurred recently in the Northeastern Pacific Ocean and the Bering Sea–dubbed “The Blob”–is of a scale similar to events documented in the geologic record. If such warming is sustained, oxygen loss becomes more likely.

Although many scientists believe that a series of low-oxygen “dead zones” in the Pacific Ocean off Oregon and Washington during the last decade may be caused by ocean warming, evidence confirming that link has been sparse.

Clear connection: Past ocean warming and dead zones

The new study, however, found a clear connection between two historic intervals of abrupt ocean warming that ended the last ice age with an increase in the flux of marine plankton sinking to the seafloor, ultimately leading to a sudden onset of low-oxygen conditions, or hypoxia.

“Our study reveals a strong link between ocean warming, loss of oxygen and an ecological shift to favor diatom production,” said paper lead author Summer Praetorius of the Carnegie Institution for Science. “During each warming event, the transition to hypoxia occurred abruptly and persisted for about 1,000 years, suggesting a feedback that sustained or amplified hypoxia.”

Warmer water, by itself, is not sufficient to cause diatom blooms, nor hypoxia, the researchers note.

Just as warming soda loses its fizzy gas, warmer seawater contains less dissolved oxygen, and this can start the oxygen decline. But it isn’t until accelerated blooming of microscopic diatoms–which have large shells and tend to sink more rapidly than other smaller types of plankton–that de-oxygenation is increased.

Diatoms are known to thrive in warm, stratified water, but they also require sources of nutrients and iron, according to Alan Mix of Oregon State University, a co-author of the paper.

There are some competing effects, and the final story depends on which one wins. Warming may, for a time, decrease mixing from below, but if the major nutrients are there, as they are in the high North Pacific, then warming favors plankton growth.

“The high-latitude North Pacific is rich in common nutrients such as nitrate and phosphate, but it is poor in iron and that seems to be the key,” Mix said. “A partial loss of oxygen causes a chemical reaction that releases iron previously trapped in continental margin sediments. That iron then fuels diatoms, which bloom, die and sink to the seafloor, consuming oxygen along the way.”

Ocean response times a concern

The concern is how rapidly the ocean may respond, the researchers said.

“Many people have assumed that climate change effects will be gradual and predictable,” Mix said, “but this study shows that the ecological consequences of climate change can be massive and can occur pretty fast with little warning.”

Because the competing effects of mixing and iron may happen on different timescales, the exact sequence of events may be confusing.

On the scale of a few years, mixing may win, but on the scale of decades to centuries, the bigger effects kick into gear. The geologic record studied by the scientists emphasized these longer scales.

The new discovery was the result of a decades-long effort by numerous researchers at Oregon State University to collect marine sediment cores from the North Pacific, creating comprehensive, high-resolution records of climate change in the region.

The temperature records came from trace quantities of organic molecules, called biomarkers, produced by plankton.

In addition to “The Blob” of unusually warm ocean temperatures seen across the North Pacific, this year has had a record-breaking algae bloom dominated by a certain species of diatom.

“While it’s too soon to know how this event ties into the long-term climate patterns that will emerge in the future,” Praetorius said, “current conditions seem eerily reminiscent of past conditions that gave way to extended periods of hypoxia.”


Posted in Environmental Health: Climate, Environmental Health: Oceans | Leave a comment

Cystic fibrosis: New treatment for underlying cause has received EU approval

Researchers at Queen’s University, as part of an international research team which trialled a combination of two drugs – Lumafactor and Ivacaftor, which can improve lung function and reduce hospital treatments for cystic fibrosis sufferers, has received EU approval.

ORKAMBI® (lumacaftor/ivacaftor), is the first medicine to treat the underlying cause of cystic fibrosis (CF) in people ages 12 and older who have two copies of the F508del mutation.

Professor Stuart Elborn, M.D., Dean, School of Medicine, Dentistry and Biomedical Sciences at Queen’s University Belfast, and a lead Principal Investigator for the Phase 3 TRAFFIC study said: “The combination of lumacaftor and ivacaftor represents a step-change in the management of cystic fibrosis for these patients because it addresses the underlying cause of the disease. By doing so, it has shown meaningful and sustained benefits.

“For people with cystic fibrosis, the disease is a lifelong battle that becomes progressively more serious with repeated hospitalization due to lung infections. Until now, people with two copies of the F508del mutation have only had treatments for the symptoms and complications of the disease.

“The combination of lumacaftor and ivacaftor represents a step-change in the management of cystic fibrosis for these patients because it addresses the underlying cause of the disease. By doing so, it has shown meaningful and sustained benefits.”

Today’s approval is based on previously announced data from two 24-week global Phase 3 studies, TRAFFIC and TRANSPORT, and additional interim 24-week data from the subsequent extension study, PROGRESS, in people ages 12 and older who have two copies of the F508del mutation and were already being treated with standard-of-care medicines.

In the TRAFFIC and TRANSPORT studies, which enrolled more than 1,100 patients, those treated with the combination of lumacaftor and ivacaftor experienced significant improvements in lung function. Patients also experienced improvements in body mass index (BMI) and reductions in pulmonary exacerbations (acute lung infections) including those requiring hospitalizations and intravenous antibiotic use. Interim data from PROGRESS showed that these improvements were sustained through 48 total weeks of treatment (24 weeks in TRAFFIC/TRANSPORT + 24 weeks in PROGRESS).

In addition, the pattern and magnitude of response observed after the initiation of combination treatment across all patients who received placebo in TRAFFIC and TRANSPORT and subsequently received a combination regimen in PROGRESS were similar to those seen among patients who received a combination regimen in TRAFFIC and TRANSPORT.

The combination of lumacaftor and ivacaftor was generally well tolerated in all three studies. In TRAFFIC and TRANSPORT, the most common adverse events included shortness of breath and/or chest tightness, upper respiratory tract infection (common cold) and gastrointestinal symptoms (including nausea, diarrhea, or gas). In the extension study, the safety and tolerability results, including the type and frequency of adverse events and serious adverse events, were consistent with those observed in TRAFFIC and TRANSPORT, and no new safety concerns were identified. Over 48 weeks, the most common adverse events were infective pulmonary exacerbation, cough and increased sputum. The incidence of serious adverse events during PROGRESS was generally similar to TRAFFIC and TRANSPORT.


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Infant crib-bumper deaths up: WUSTL

A new study shows that the number of infant deaths and injuries attributed to crib bumpers has spiked significantly in recent years, prompting the researchers to call for a nationwide ban on the bedding accessory.

The findings stem from an analysis by longtime experts on the topic – a professor emeritus of pediatrics at Washington University School of Medicine in St. Louis and two former researchers with the U.S. Consumer Product Safety Commission (CPSC). The findings indicate that in the majority of incidents studied, crib bumpers were the sole cause of harm, rebutting beliefs that other items also in the cribs — such as blankets, pillows and stuffed animals — caused the deaths and injuries.

Further, the research shows that the 23 crib-bumper deaths reported to the CPSC over a seven-year span — from 2006 through 2012 — were three times higher than the average of eight deaths reported in each of the three previous seven-year time spans.

And alarmingly, the researchers report, the lack of data gathered on crib-bumper deaths and injuries over the decades suggests that the actual number of related deaths and injuries is likely much larger than what is now known.

“Crib bumpers are killing kids,” said senior author Bradley T. Thach, MD, a professor emeritus of pediatrics at the School of Medicine and the author of a landmark study published in 2007 that first documented crib-bumper deaths. “Bumpers are more dangerous than we originally thought. The infant deaths we studied could have been prevented if the cribs were empty.”

The findings are reported Nov. 24 in The Journal of Pediatrics.

There are no federal regulations regarding crib bumpers. In 2012, a voluntary industry standard was revised to improve crib-bumper safety by limiting the items’ thickness. And in 2013, the CPSC directed its staff to explore rule-making options, suggesting change, but it has not resulted in any federal action.

According to the new research, a review of CPSC data showed that 48 infant deaths from 1985-2012 were specifically attributed to crib bumpers. An additional 146 infants were involved in crib-bumper incidents in which the babies nearly suffocated, choked or were strangled. The mean age of death was 4.6 months, with an age range of one to 22 months. Documents reviewed included death certificates and autopsy, death scene and other investigative records.


Thach and his fellow researchers — lead author N.J. Scheers, PhD, former manager of CPSC’s Infant Suffocation Project, and Dean W. Woodard, former CPSC corrective actions director — determined that 32 of the 48 deaths they examined could have been prevented if crib bumpers had not been used in the cribs. Most of those infants died due to suffocation because their noses and mouths were covered by a bumper or were between a bumper and a crib mattress. No other objects were between the infants’ faces and the bumpers.

“When a baby’s nose and mouth is covered by a bumper, the infant can suffocate when his or her airway becomes blocked, or from breathing oxygen-depleted air,” Scheers explained. “So if bumpers had not been in the cribs, these babies would not have died.”

Regarding the other 16 infant deaths, the researchers found that the babies were wedged between a bumper and a pillow, a bumper and a recliner used to elevate an infant’s head or, in one instance, a bumper and a twin sleeping in the same crib. Had the bumpers not been in the cribs, the researchers maintain, the babies would not have been wedged into such positions and would have survived.

However, the researchers linked more deaths to crib bumpers than the 48 indicated in the CPSC data. A review of data from the National Center for the Review and Prevention of Child Deaths revealed reports of 32 additional bumper-related deaths from 37 states from 2008-2011. That puts the number of fatalities tied to crib bumpers at 77 — and suggests the actual number is much higher.


“This highlights the most important limitation of the study,” said Scheers, who has served as a consultant on sleep safety to the American Academy of Pediatrics. “CPSC relies on death certificates to identify deaths caused by specific products. Bumper involvement is often not specified on death certificates, so it is highly likely many deaths caused by crib bumpers are missed.”

Of the 146 bumper-related incidents, researchers said most were caused by poor bumper design or construction. For example, near-suffocations resulted from a lack of bottom ties or not enough ties, which allowed infants’ faces to get trapped in the bumpers. Incidents involving choking and strangulation occurred because of detached bumper ties and decorations, frayed ribbons and loose stuffing.

Infant deaths and injuries occurred with thick pillow-like bumpers and thin bumpers, the latter of which some manufacturers have touted as being safer than plush ones. Newer mesh bumpers and vertical bumpers that wrap crib slats were not included in the study because there is little information about such items yet. “They should still be watched,” said Thach. “Crib bumpers serve no purpose.”

Originally designed to protect infants from slipping through crib slats, entangling their limbs in the gaps or bumping their heads, many parents consider bumpers as necessary safety precautions. However, since 1973, federal regulations have required that crib slats be narrow enough to prevent a baby’s head from going through the slats.

“Ours is the first study to document that slat entrapments and infants hitting their heads also occurred with bumpers in the crib,” said Scheers, adding that sleep sacks prevent a baby’s limbs from getting tangled in the slats. “It’s also unlikely that a baby hitting her head on the crib sides would result in serious injury.”

Despite the data, crib bumpers remain popular among expecting parents who see bumpers in store displays, magazines and catalogues featuring high-end celebrity nurseries.

The study recommends the CPSC follow the lead of Maryland and Chicago by banning the sale of crib bumpers. The state of Maryland banned their sale in 2013; the city of Chicago did so in 2011.

The American Academy of Pediatrics, Canadian Pediatric Society, the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention have recommended against the use of crib bumpers. Ultimately, though, the CPSC is the only agency with the power to institute a U.S. ban; however, the researchers said the commission is a small, underfunded division with limited resources and looming priorities.

“A ban on crib bumpers would reinforce the message that no soft bedding of any kind should be placed inside a baby’s crib,” Thach said. “There is one sure-fire way to prevent infant deaths from crib bumpers: Don’t use them, ever.”

Scheers NJ, Woodard DW, Thach BT. Crib Bumpers Continue to Cause Infant Deaths: A Need for a New Preventive Approach. The Journal of Pediatrics. Published online Nov. 24, 2015.

Washington University School of Medicine’s 2,100 employed and volunteer faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children’s hospitals. The School of Medicine is one of the leading medical research, teaching and patient-care institutions in the nation, currently ranked sixth in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children’s hospitals, the School of Medicine is linked to BJC HealthCare.

Posted in Pediatric Health, Pediatric Health: Abuse and Neglect, Pediatric Health: Day Care, Pediatric Health: Infants, Pediatric Health: Injuries, Pediatric Health: Sleep, Pediatric Health: Swaddling, SIDS | Leave a comment

Boutique chocolates to match everyone’s favorite flavor, similar to wines, tea, and coffee

Washington, DC – November 20, 2015 – A team of Belgian researchers has shown that the yeasts used to ferment cocoa during chocolate production can modify the aroma of the resulting chocolate. “This makes it possible to create a whole range of boutique chocolates to match everyone’s favorite flavor, similar to wines, tea, and coffee,” says Jan Steensels, a postdoctoral researcher at the University of Leuven, and the Flanders Institute for Biotechnology, Belgium. The research is published November 20 in Applied and Environmental Microbiology, a publication of the American Society for Microbiology.

Initially, the researchers sought robust yeast strains that could outcompete the many invading yeast strains that flood the cocoa beans during fermentation. “After harvesting, the cocoa beans are collected in large plastic boxes, or even piled in large heaps on the soil, right in the farms where they are grown,” explained Esther Meersman, a postdoctoral researcher with Steensels at the two institutions. The beans are surrounded by a gooey pulp, which is fermented by yeasts and bacteria. Any species in the environment can get into the mix, leaving little control over the ultimate flavor. But by outcompeting other microbes, robust yeast strains could prevent such infelicitous variability in taste, she said.

But the investigators noted striking differences in aroma among the chocolates made from fermentations using different robust yeasts, said Steensels. That was remarkable, he said, since only the yeast strains were different: the fermentations were performed identically, and the same recipe was used each time.

The team set out to breed novel yeast hybrids that would combine robustness with strong flavor production. “We were initially surprised that the volatile flavor compounds are retained in the beans during drying and roasting,” said Meersman. The researchers hypothesize that the volatiles are protected from evaporation since they are dissolved in the fat fraction.

The investigators, who collaborated in this research with Barry Callebaut, the world’s largest chocolate producer, have combined two critical characteristics of yeast in single hybrid variants: the ability to dominate cocoa fermentations, and to produce a specific flavor. “This means that for the first time, chocolate makers have a broad portfolio of different yeast strains that are all producing different flavors,” says Steensels. “This is similar to the current situation in beer brewing and wine making.” A new era of chocolate may be dawning.


The American Society for Microbiology is the largest single life science society, composed of over 39,000 scientists and health professionals. ASM’s mission is to promote and advance the microbial sciences.

ASM advances the microbial sciences through conferences, publications, certifications and educational opportunities. It enhances laboratory capacity around the globe through training and resources. It provides a network for scientists in academia, industry and clinical settings. Additionally, ASM promotes a deeper understanding of the microbial sciences to diverse audiences.


Posted in Nutrition: Food: Chocolate | Leave a comment

That great-smelling sea air? Not so good for you after all.

New data presented by researchers at Lund University and others in the journal Oceanologia show that the air along the coasts is full of hazardous nanoparticles from sea traffic. Almost half of the measured particles stem from sea traffic emissions, while the rest is deemed to be mainly from cars but also biomass combustion, industries and natural particles from the sea.

“This is the first time an attempt has been made to estimate the proportion of nanoparticles stemming from sea traffic. The different types of nanoparticles have previously not been distinguished, but this new method makes it possible”, says Adam Kristensson, researcher in Aerosol Technology at the Lund University Faculty of Engineering in Sweden.

“Previously, we thought that land-based pollution from northern European countries and emissions of natural particles from the surface of the sea accounted for a much larger proportion”, he says.

Nanoparticles can be hazardous to our health as they, because of their small size, can penetrate deeper into the lungs than larger particles contributing to both cardiovascular and pulmonary diseases. A cubic centimetre can contain several thousand nanoparticles.

To arrive at these results, he and his colleagues have studied the air flow from their measuring station in southern Sweden as it passes over the Baltic Sea, all the way to the measuring station on the Lithuanian coast. The wind often travels towards the east, and the particles can travel long distances before they are trapped in our lungs or washed away by the rain. They have also studied the air flow from a station in the Finnish archipelago towards the Lithuanian station.

By comparing levels of nanoparticles, the researchers can draw conclusions about the respective proportions that stem from cars and other emissions, and sea traffic.

Particles from sea traffic in the North Sea and the Baltic Sea are expected to contribute to 10 000 premature deaths every year, but Adam Kristensson stresses that this estimate is very uncertain, and believes that it is important to continue to conduct these types of measurements.

He also advocates stricter legislation. “It is especially important to continue to set stricter caps on nitrogen oxides and sulphate content from ship fuel.”

“It is especially important to continue to raise the caps on emissions of nitrogen oxides and sulphate content from ship fuel.

Future regulations will hopefully reduce the emissions of harmful nanoparticles, especially soot particles, which are considered the most hazardous.

“This year a new regulation was introduced for the North Sea and the Baltic Sea that limits the sulphate content in fuel to 0.1%. As researchers, we still have to look at what positive effects this has had so far with regard to the particle levels.”


Watch research video: Sea traffic pollutes more than previously thought – https://www.youtube.com/watch?v=fmksLarO6Fc


Posted in Environmental Health: Air Quality, Environmental Health: Oceans, Environmental Health: Sustainability | Leave a comment

How fast you move may predict how healthy you’ll be

As humans have begun to live longer it has become clear that the quality of our lives is equally as important as the duration. In the lab, a dramatic extension of lifespan isn’t difficult to achieve. In previous experiments using several types of mutated Caenorhabditis elegans roundworms (C. elegans), researchers were able to significantly extend the worm’s lifespan. The lengthened life that the worms experienced was not necessarily a good one, as many of the mutated varieties were less healthy than wild-type worms, especially during the segment of life that was extended beyond normal. Instead of focusing on drawing out the length of life, South Korea’s IBS Center for Plant Aging Research and the research group led by Coleen Murphy, a professor at Princeton University have created a tool that can be used for accurately predicting lifespan as well as assessing the current health state, and discovered the regulatory mechanism that extends “healthspan”, the time in which an organism is at its optimal health.

The scientists created their own health assessment for C. elegans, modeled after the Short Physical Performance Battery (SPPB), one of the most widely used tests of physical performance in elderly humans, which can accurately predict their future health. Among other things, the SPPB measures walking speed which was the inspiration for the C. elegans version of the test. The scientists recorded the maximum velocity (MV) of wild-type C. elegans worms during timed 30 second sessions for a life time. In the experiment, the worms all showed a decrease in MV from day 6 and onwards just as the movement ability of humans starts to decline at some point of our later life and onwards. Additionally, they found that at day 9 (midlife), the median lifespan of worms in the high MV group (23 ± 3.2 days) was 35.3% longer than that of the worms in the low MV group (17 ± 3.6 days) (Fig. 1). They concluded that MV of wild-type worms at day 9 of adulthood is a reliable predictor of longevity. Another factor they observed was the state of C. elegans mitochondria. Elderly humans have weaker muscles and less strength resulted from mitochondrial defects which occur later in life. C. elegans with lower MV exhibit similar defects by midlife but there are far fewer defects in worms with higher MV at the same age. These observations indicate that MV correlates with mitochondrial health expression, suggesting that MV can be a reliable indicator of the actual physical state. The findings show that MV of C. elegans is a reliable indicator of age-related physical decline, accurately reports movement ability and if measured in mid-adulthood, is predictive of future longevity.

What sets this research apart from previous studies is that they discovered a genetic regulator that can lengthen good quality life, which was not properly appreciated by others. The research groups found overwhelming evidence which contradicts a previous study by Bansal, et al [1] which concluded that daf-2(e1370) insulin/IGF-1 signaling (IIS) mutants are less healthy than wild-type animals, disproportionately extending their “unhealthy” lifetime. The daf-2 mutation affects the insulin/IGF-1 signaling (IIS) pathway which in turn has a direct effect on longevity through its control of the metabolism of nutrients and enhances many physiological functions with age. Tests with daf-2 mutants showed that they had a higher MV than wild-type worms with age, especially at day 10 and after. Even after all the wild-type worms had died at day 26 of adulthood, the daf-2 mutants still maintained on average 36% of MV (Fig. 2). Fig. 3 shows the area under the MV curve which serves as an indicator of overall physical performance., daf-2 mutants showed a 2.4-fold increase over wild type in overall physical performance (Fig. 3). The researchers showed that daf-2(e1370) mutation extends both lifespan and healthspan, without proportionally extending the unhealthy part of life, in contrast to Bansal, et al.’s conclusions.

As part of their efforts to explain the discrepancies with the previous research, the research groups recorded movement of daf-2 mutants across an unseeded surface, contrary to the previous research that used the seeded plates full of food, assuming that the food source actually may get in the way of the worm’s desire to explore. They found that daf-2 mutants have an inherently higher preference for food than exploration, presumably because its high levels of the odr-10 odor receptor cause daf-2 mutants to prefer food over exploration, slowing its movement on bacteria. Corresponding author and IBS director of the Center for Plant Aging Research Hong Gil Nam explains that “because this type of movement is not limited by ability, but rather by preference, it may be difficult to draw conclusions regarding healthspan from on-food motility assays.” From these results the researchers concluded that the only way to accurately measure worm motility is to conduct the trials on a bacteria-free surface, so the worms didn’t get preoccupied by their ingrained food-seeking behavior.

The IBS Center for Plant Aging Research, which was originally designed to gain insight into cell-death processes of plants, has recently expanded its focus to animal longevity and senescence. Despite the challenge of embarking on a new area of research, the group has made some important breakthroughs. According to Hong Gil Nam, “our analysis takes into account the length of time an individual can expect to live, and how healthy that individual can expect to be with age.” Many parts of the insulin/IGF-1 signaling (IIS) pathway that enable these functions have been identified, and many of these genes and the underlying mechanisms are conserved in mammals, which mean that the extended abilities that insulin/IGF-1 signaling (IIS) exhibits could offer therapeutic target possibilities for humans in the future. The IBS Center isn’t just looking at push the limits for long life; instead they are unraveling the mechanisms in our cells to maximize our health as we age.


– Daniel Kopperud

1Bansal A, Zhu LHJ, Yen K, Tissenbaum HA. Uncoupling lifespan and healthspan in Caenorhabditis elegans longevity mutants. Proc Natl Acad Sci U S A 112, E277-E286 (2015).


Posted in Exercise: Benefits, Healthspan | Tagged | Leave a comment

Machines Beat Humans At Hiring Best Employees

Machines make better hiring recommendations than people, at least when it comes to employing low-skilled workers, according to a National Bureau of Economic Research study released this week.

The study, “Discretion in Hiring,” conducted by Mitchell Hoffman from the University of Toronto, Lisa B. Kahn from Yale University, and Danielle Li from Harvard Business School, examined the hiring of almost 300,000 low-skilled service-sector workers, such as call center operators, standardized test graders, and data entry clerks at 15 companies.

By evaluating algorithmic hiring recommendations from a job test alongside human hiring decisions that deviated from the recommendations, the researchers found that hiring managers who exercise discretion produce worse results.

Specifically, employees hired based on algorithmic recommendations had job tenures that lasted 15% longer than people hired without testing. Managers who overruled machine-based recommendations hired workers less well-matched to the job, as measured by job tenure.

The researchers conclude, “[M]anagers systematically make hiring decisions that are not in the interest of the firm.”

In other words, hiring managers have biases, something seen in other studies. The study cites a 2012 paper, “Hiring as Cultural Matching: The Case of Elite Professional Service Firms,” that found one of the most important factors in hiring was shared leisure activities.


Posted in Business, Human Behavior: Decision Making, Human Behavior: Intuition, Human Behavior: Perception | Leave a comment

For multiple myeloma, FDA approves Ninlaro, new oral medication

Today the U.S. Food and Drug Administration granted approval for Ninlaro (ixazomib) in combination with two other therapies to treat people with multiple myeloma who have received at least one prior therapy.

Multiple myeloma is a form of blood cancer that occurs in infection-fighting plasma cells (a type of white blood cell) found in the bone marrow. These cancerous cells multiply, produce an abnormal protein and push out other healthy blood cells from the bone marrow. The disease may result in a weakened immune system and cause other bone or kidney problems. The National Cancer Institute estimates there will be 26,850 new cases of multiple myeloma and 11,240 related deaths in the United States this year.

“As we learn more about the underlying biology of multiple myeloma, we are encouraged to see the development of new ways to treat this disease,” said Richard Pazdur, M.D., director of the Office of Hematology and Oncology Products in FDA’s Center for Drug Evaluation and Research. “Today’s approval is the third drug for multiple myeloma approved this year and provides patients with a new oral treatment that slows disease progression when other therapy has failed.” The FDA approved Farydak (panobinostat)in February and Darzalex (daratumumab) earlier this month.

Ninlaro is a type of cancer drug called a proteasome inhibitor and works by blocking enzymes from multiple myeloma cells, hindering their ability to grow and survive. Ninlaro is the first oral proteasome inhibitor and is approved in combination with another FDA-approved treatment for multiple myeloma called Revlimid (lenalidomide) and dexamethasone (a type of corticosteroid).

The safety and efficacy of Ninlaro were demonstrated in an international, randomized, double-blind clinical trial of 722 patients whose multiple myeloma came back after, or did not respond to, previous treatment. Study participants received either Ninlaro in combination with lenalidomide and dexamethasone or placebo plus lenalidomide and dexamethasone. Those taking Ninlaro lived longer without their disease worsening (average 20.6 months) compared to participants taking the other regimen (14.7 months).

The most common side effects of Ninlaro are diarrhea, constipation, low blood platelet count (thrombocytopenia), peripheral neuropathy (numbness and pain from nerve damage, usually in the hands and feet), nausea, peripheral edema (fluid under the skin causing swelling), vomiting and back pain.

The FDA granted priority review and orphan drug designations for Ninlaro. Priority review status is granted to applications for drugs that, if approved, would be a significant improvement in safety or effectiveness in the treatment of a serious condition. Orphan drug designation provides incentives such as tax credits, user fee waivers, and eligibility for orphan drug exclusivity to assist and encourage the development of drugs for rare diseases.

Ninlaro is marketed by Takeda Pharmaceuticals based in Osaka, Japan. Farydak is marketed by East Hanover, New Jersey-based Novartis Pharmaceuticals. Darzalex is marketed by Janssen Biotech of Horsham, Pennsylvania. Revlimid is marketed by Celgene Corporation, based in Summit, New Jersey.

The FDA, an agency within the U.S. Department of Health and Human Services, protects the public health by assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices. The agency also is responsible for the safety and security of our nation’s food supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products.


Posted in Cancer: Multiple Myeloma | Leave a comment

ADHD Meds May Be a Prescription for Bullying: U of Michigan

Newswise — ANN ARBOR—Kids and teens who take medications like Ritalin to treat attention-deficit hyperactivity disorder are twice as likely to be physically or emotionally bullied by peers than those who don’t have ADHD, a new University of Michigan study found.

At even higher risk were middle and high school students who sold or shared their medications—those kids were four-and-a-half times likelier to be victimized by peers than kids without ADHD.

The main findings are the same for both sexes, said the study’s first author, Quyen Epstein-Ngo, research assistant professor at the U-M Institute for Research on Women and Gender and a fellow at the U-M Injury Center. Carol Boyd, professor of nursing, is the principal investigator.

It’s long been known that kids with ADHD have a harder time making and keeping friends and are bullied and victimized more. This study is believed to be the first known to look at how stimulant medications affect their relationships with peers.

“Many youth with ADHD are prescribed stimulant medications to treat their ADHD and we know that these medications are the most frequently shared or sold among adolescents,” said Epstein-Ngo, a licensed clinical psychologist.

The U-M researchers surveyed nearly 5,000 middle and high school students over four years. About 15 percent were diagnosed with ADHD and roughly 4 percent were prescribed stimulants within the past 12 months.

Of those who took ADHD meds, 20 percent reported being approached to sell or share them, and about half of them did.

When looking at the overall figures, relatively few students were asked to divert their medications or did. However, Epstein-Ngo said the numbers don’t tell the entire story.

“Having a diagnosis of ADHD has lifelong consequences,” she said. “These youth aren’t living in isolation. As they transition into adulthood, the social effects of their ADHD diagnosis will impact a broad range of people with whom they come into contact.”

From 2003 to 2011, there was a 42 percent increase in ADHD cases diagnosed in the U.S., and between 2007 and 2011, there was a 27 percent increase in stimulant-treated ADHD.

Epstein-Ngo said the findings shouldn’t scare parents away from considering a stimulant medication. Rather, the study reinforces why parents must talk to kids about never sharing their medications.

“For some children stimulant medications are immensely helpful in getting through school,” Epstein-Ngo said. “This study doesn’t say ‘don’t give your child medication.’ It suggests that it’s really important to talk to your children about who they tell.”

It’s unclear why kids with prescriptions for stimulant medications are more at risk for bullying and victimization, but Epstein-Ngo said it’s probably several factors.

“Is it a function of the fact that they are in riskier situations, or are they being coerced and forced to give up their medications? Probably a little bit of both,” she said.

Epstein-Ngo believes the biggest takeaway is to have compassion for kids with ADHD.

“I think the biggest misconception about ADHD is that these kids aren’t trying hard enough, and that’s just not the case,” she said. “If these kids could do better they would. With the proper support and treatment they can overcome this.”

The study, “Diversion of ADHD stimulants and peer victimization among adolescents,” is scheduled to appear in the Journal of Pediatric Psychology. It was funded by the National Institute on Drug Abuse.

Quyen Epstein-Ngo
Carol Boyd

Posted in ADHD, Human Behavior: Bullying | Tagged | Leave a comment

Preeclampsia detectable six weeks into pregnancy with new biomarker

Newswise — Annapolis, Md. (November 20, 2015)—Preeclampsia is generally diagnosed later in pregnancy, but new research could lead to diagnosis in the first trimester, improving care and potentially leading to the development of preventative measures.

Preeclampsia is characterized by high blood pressure and high levels of protein in the urine. It can lead to serious complications for the mother and baby, including reduced growth of the baby; seizures, stroke and multi-organ failure in the mother; or death of the mother or child. Often, the only cure is preterm delivery. New research to be presented at Cardiovascular, Renal and Metabolic Diseases: Physiology and Gender reports that the protein copeptin can predict the development of preeclampsia as early as six weeks of gestation.

This development is significant, says lead investigator Mark Santillan, MD, because early identification of women at high risk of developing preeclampsia will enable health care providers to quickly respond and provide the appropriate level of care. “Clinically, this timeframe is the earliest a woman can find out if she is pregnant by an over-the-counter pregnancy test. A similar simple test could be developed to predict preeclampsia via copeptin,” Santillan says.

Copeptin is a byproduct of the protein arginine vasopressin (AVP). The research, conducted at the University of Iowa, also found that pregnant mice given AVP throughout pregnancy showed all the cardiovascular, kidney, obstetrics and immune components of human preeclampsia. Together, the mouse and human data suggest that AVP is involved in initiating preeclampsia. Targeting its pathway could potentially treat, prevent and even cure preeclampsia, says Santillan.

Santillan will present “Vasopressin: A New Beginning for the End of Preeclampsia?” as part of the symposium “Pregnancy and Pre-eclampsia” on Friday, Nov. 20, at 8:40 AM in Wye Room of the Crowne Plaza Annapolis Hotel.

About the American Physiological Society
Physiology is the study of how molecules, cells, tissues and organs function in health and disease. Established in 1887, the American Physiological Society (APS) was the first U.S. society in the biomedical sciences field. The Society represents more than 10,000 members and publishes 15 peer-reviewed journals with a worldwide readership.

Posted in Hypertension, Pregnancy, Pregnancy: Complications, Pregnancy: Preeclampsia | Leave a comment

Opioid overdose: FDA approves Adapt Pharma’s nasal spray

The U.S. Food and Drug Administration approved the first-ever nasal spray emergency treatment for opioid overdose on Wednesday.

The spray, developed by privately held Adapt Pharma Ltd, uses naloxone, a drug used to treat opioid overdose for nearly 45 years but approved only in injectable forms. (1.usa.gov/1Qv4gU7)

Data from the Centers for Disease Control and Prevention indicates opioid overdose led to about 23,500 deaths in the United States in 2013, a four-fold jump from 1999.

A majority of these deaths occur in non-medical settings, stressing the need for user-friendly treatments that can be administered without the help of a medical practitioner, Adapt Chief Executive Seamus Mulligan told Reuters.

The treatment, Narcan, which Adapt plans to launch by January, is expected to have wide coverage under health insurance with affordable co-pays, Mulligan added.

Read more at Reutershttp://www.reuters.com/article/2015/11/19/us-adaptpharma-fda-idUSKCN0T739N20151119#MMrRw67KqHgXfTHa.99


Posted in Drug Addiction, Drugged Driving, Opioids, Pain, Painkillers | Leave a comment

Burnout: 8 ways to turn it around

There’s nothing that puts a damper on your creativity quite like feeling burned out. As the owner of a digital marketing agency serving enterprise clients around the world, I know how tough it can be to have to be creative at a moment’s notice — especially when you’re swamped with other work. And while a modern work ethic tells you to just power through it, that usually doesn’t get the creative juices flowing.

Related: How to Avoid Burnout in Your Team

Ready to try something different? Here are eight proven ways you can get creative when you’re feeling burned out:

1. Take a break.

For starters, take a tip from Tim Holmgren, founder of NewsMeister, who told FreshInfo: “If you are unproductive or spinning your tires on a problem, take a break and enjoy yourself. Once you have that nagging idea in your head or solution to your problem, get back work.”

You may be one of those people who feels like they don’t have time to take a break, but it’s probably exactly what you need to get more done in the long run.


Posted in Burnout, Human Behavior: Stress, Workaholism, Workplace Issues | 1 Comment

Gratitude: 9 ways to promote it in your life

Gratitude is good for us every way you look at it.

According to Sonja Lyubomirsky, PhD, professor of psychology at the University of California in Riverside, it boosts our happiness levels in a number of ways: by promoting the savoring of positive life experiences, by bolstering self-worth and self-esteem and thereby helping to cope with stress and trauma, by building social bonds and encouraging moral behavior, and by diminishing negative emotions and helping us adjust to new situations.

Gratitude has a number of health benefits as well. “Research suggests that individuals who are grateful in their daily lives actually report fewer stress-related health symptoms, including headaches, gastrointestinal (stomach) issues, chest pain, muscle aches, and appetite problems,” says Sheela Raja, PhD, an assistant professor and clinical psychologist in the Colleges of Medicine and Dentistry at the University of Illinois in Chicago.

But how do we get there? For some folks, gratitude is much easier than for others. I, for one, have to work really hard at it because my cup usually appears one-third full. With a few exercises, though, I can become a more grateful person and promote gratitude in my life, which brings many emotional and physical gifts.

1. Go Ahead and Compare

I constantly compare myself to people who are more productive than I am (have more energy and need less sleep), who go to a doctor once a year, and who are resilient to stress. “Why can’t I be like her?” I ask myself.



Posted in Human Behavior: Gratitude | Leave a comment

T1D Bulletin: Judge says Medicare Must Cover CGM

A Medicare provider must cover a continuous blood glucose monitor (CGM) for one of its patients with type 1 diabetes, an administrative law judge has ruled.

The patient, Jill Whitcomb, had recently become eligible for Medicare, which does not cover continuous glucose monitoring devices, provided through United Healthcare of Wisconsin/Secure Horizons. Whitcomb has had type 1 diabetes for more than 35 years, with diabetic neuropathy and a history of hypoglycemia unawareness. A video of Whitcomb having a severe episode of hypoglycemia when she was not using a CGM because she lacked a Certificate of Medical Necessity from the doctor was used as evidence in a trial earlier this year.

United has not yet offered to cover the device and has until Dec. 14 to appeal the decision, said Dan Kraft, Whitcomb’s caretaker.

George Grunberger, MD, president of the American Academy of Clinical Endocrinologists (AACE), said in an interview with MedPage Today that he has been following this case with interest for several years. The AACE has tried to convince the Centers for Medicare & Medicaid Services to cover CGM for patients with type 1 diabetes who age into Medicare coverage, he added.


Posted in Diabetes: Continuous Glucose Monitoring, Diabetes: Type 1 | Leave a comment

7 Ways to Converse With Negative People

You know them. Maybe you work with them, live with them, or hang out with them. They complain, they vent, they criticize, they blame. These people always seem to look at the world cynically. Are you’re tired of dealing with them

Unfortunately, dealing with negative people is part of our daily lives we must learn to cope with. It behooves you to be polite, yet firm, when dealing with negativity to keep the conversation and the relationship alive. Here are seven ways to deal with a negative thinker and get the topic back on track.

1. Empathize.

When someone starts off negatively, recognize their pain and then move them toward another topic. You can respond with a heartfelt, “Oh, I’m so sorry to hear that,” followed by a more positive suggestion, like, “Let’s go get a cup of coffee and talk about the Wick project. I’d love to get your ideas.”

Related: 7 Strategies for Dealing With Negative People

2. Compliment.

Without reinforcing the negative behavior, compliment the person on how well they handled the situation. Say something like, “Wow, I’m impressed that you were able to solve the situation before it got out of hand.” That can turn the conversation to a more positive one.


Posted in Human Behavior: Empathy, Human Behavior: Negativity, Human Behavior: Optimism | Leave a comment

Wheelchairs: Majority of Car-Pedestrian Deaths Happen to Those in Wheelchairs, Most Often at Intersections

Newswise — WASHINGTON — An investigation into how often wheelchair users are killed in car-pedestrian crashes finds they are a third more likely to die than non-wheelchair users; more than half of those deaths occur at intersections.

The study, led by Georgetown University researchers, also finds that men who use wheelchairs are five times more likely than women to die in pedestrian crashes. The researchers report their findings today in BMJ Open (link active after 6:30pm ET).

“Understanding and describing risks are the first steps to reversing them,” says John Kraemer, JD, MPH, assistant professor of health systems administration at Georgetown’s School of Nursing & Health Studies and a scholar at the university’s O’Neill Institute for National and Global Health Law. “While there was a little data on non-fatal pedestrian injuries among people who use wheelchairs, there were almost none on fatal injuries.”

According to the U.S. Department of Transportation, nearly 5,000 pedestrians are killed in traffic crashes each year and an estimated 76,000 are injured.

Using data from the National Highway Traffic Safety Administration’s Fatality Analysis Reporting System (FARS) (based on police reports of road traffic collisions on U.S. roads) and data from news stories about car crash fatalities published on the LexisNexis U.S. newspaper database, the researchers were able to estimate how many wheelchair users were pedestrian fatalities.

The researchers calculated that about 528 pedestrians using wheelchairs were killed in road traffic collisions in the U.S. between 2006 and 2012. This equates to a pedestrian wheelchair user’s risk of death being about 36 percent higher than non-wheelchair users.

They also found the risk of car-related death was over five times higher for men in wheelchairs than for women, particularly among men aged 50 to 64.

Almost half (47.5 percent) of the fatal crashes occurred at intersections, and in almost four out of 10 (39 percent) of these cases, traffic flow was not controlled.

“A high proportion of crashes occurred at locations without traffic controls or crosswalks,” explains Kraemer, whose work focuses on the intersection of public health and law. “When there is poor pedestrian infrastructure or it’s poorly adapted to people with mobility impairments, people who use wheelchairs often are forced to use the streets, or are otherwise exposed to greater risk. It also may be telling that, in three-quarters of crashes, there was no evidence that the driver sought to avoid the crash.”

Kraemer says while the research wasn’t designed to determine the cause of the disparity between wheelchair pedestrians and others, prior research has suggested that “wheelchair users may be less conspicuous to drivers (because of speed, location, and height), and this is a topic that needs to be explored more.”

“It is important to make sure that communities are designed to meet the requirements of the Americans with Disabilities Act so that people with disabilities can use them fully and safely,” says Kraemer.

Kraemer’s co-author is Connor Benton, MD, a resident at MedStar Georgetown University Hospital. The researchers did not use any specific grant funding for this work.

About Georgetown University Medical Center
Georgetown University Medical Center (GUMC) is an internationally recognized academic medical center with a three-part mission of research, teaching and patient care (through MedStar Health). GUMC’s mission is carried out with a strong emphasis on public service and a dedication to the Catholic, Jesuit principle of cura personalis — or “care of the whole person.” The Medical Center includes the School of Medicine and the School of Nursing & Health Studies, both nationally ranked; Georgetown Lombardi Comprehensive Cancer Center, designated as a comprehensive cancer center by the National Cancer Institute; and the Biomedical Graduate Research Organization, which accounts for the majority of externally funded research at GUMC including a Clinical and Translational Science Award from the National Institutes of Health.

Posted in Disabilities | Leave a comment

Knee osteoarthritis: new early warning signs

CHICAGO — People who are at higher risk to develop knee osteoarthritis (OA) from being overweight or having injured their knee in the past may have normal x-rays, but worsening lesions or damage appearing on their MRIs predicts a significantly higher risk of soon developing knee osteoarthritis or painful symptoms, reports a new Northwestern Medicine study.

Depending on the type of lesion, their risk of developing knee OA within three years as diagnosed by x-ray is three to 20 times greater.

“These worsening lesions are an early warning sign and an opportunity to intervene before a person develops the debilitating disease,” said lead investigator Dr. Leena Sharma. “If we employ aggressive prevention strategies in persons with these lesions before they develop knee osteoarthritis, we may be able to delay disease development or alter its course.”

Sharma is a professor of medicine at Northwestern University Feinberg School of Medicine and a Northwestern Medicine rheumatologist.

Prevention strategies include paying attention to weight and carefully reviewing physical activity to avoid potentially damaging activity and injury, said Sharma, also the Solovy Arthritis Research Society Research Professor.

This is the first study to examine and determine the impact of knee lesions in persons at higher risk for knee OA with normal x-rays. Previously, it wasn’t known whether the lesions predicted the new development of OA or future symptoms such as frequent knee pain. Many scientists had thought these lesions were insignificant and simply the result of aging, though in the last few years, the lesions have sparked more suspicion.

The study was published in October in the Annals of the Rheumatic Diseases.

Among Americans 55 years and older, 40 percent have frequent knee pain or knee osteoarthritis. In the elderly, knee OA is responsible for as much chronic disability as cardiovascular disease. Current treatments may help symptoms but do not delay progression of the disease.

Factors that placed the study sample at higher risk included being overweight (21.3 percent), frequent knee bending activity (71 percent), climbing more than 10 flights of stairs most days (54 percent), squatting or deep knee bending 30 minutes or more at least one day in the past 30 days, (13 percent) and lifting or moving objects weighing more than 25 pounds at least one day in the past 30 days (34.5 percent).

The study included 849 Osteoarthritis Initiative (OAI) study participants, an average age of 60, without evidence of OA in either knee on the baseline x-ray. The OAI is a National Institutes of Health sponsored prospective, observational study of persons with or at higher risk for knee OA who have undergone annual evaluations for several consecutive years.  Sharma and colleagues assessed cartilage damage, bone marrow lesions and a tear in the meniscus on the MRI images for at two time points three years apart. If damage on MRIs worsened during that period, study participants were at higher risk for the new development of knee OA during the three-year period of the MRI imaging or knee symptoms (pain, stiffness and/or swelling) in the subsequent three years.

Other Northwestern authors include Orit Almagor and Joan S. Chmiel.

The study was funded by grants R01 AR52918, R01 AR065473, P60 AR064464 from the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health.


Posted in Arthritis: Osteoarthritis, Knee Replacement, Sports Medicine: Injuries: Concussion | Leave a comment

5 clean eating strategies for Thanksgiving

Newswise — ST. LOUIS — After months of being a “clean” eater who pooh-poohs processed foods, shies away from cream and has trained your palate to prefer vegetables and fruits, along comes Thanksgiving.

The rich meal of stuffing, classic green bean casserole, mashed potatoes and pecan pie can be a shock to your system if you’re not accustomed to eating such heavy foods, says Whitney Linsenmeyer, instructor of nutrition and dietetics at Saint Louis University, and a confessed clean eater.

“People can feel uncomfortable and have gastrointestinal distress if they eat a large amount of indulgent foods, even for a day,” Linsenmeyer says. “It’s like putting fuel in a car. When you put in a different type that is not what the car is built for, it will react differently. Your body becomes accustomed to eating certain foods, and switching can be difficult.”

Of course, you can take steps to avoid a food hangover by bringing a healthy dish to the buffet, eating a decent breakfast and lunch before the big meal, and consuming more salad, vegetables, white meat turkey and cranberry sauce than anything else. There’s no sin in eating healthy, even on Thanksgiving. Don’t be afraid to embrace it, Linsenmeyer says.

At the same time, many families serve once-a-year, special foods on Thanksgiving. “You want to be able to partake in those because they are part of your family’s customs and traditions,” she says.

So, if you refuse to wear elastic waist pants to Thanksgiving dinner and detest that too full feeling even more than you love yeast rolls slathered in butter, Linsenmeyer offers these strategies for enjoying the heaviest meal of the year.

Make one your magic number: While others are going through the food buffet line for seconds and thirds, make only one trip.

Say yes and praise effusively: Instead of turning down your mother’s cream-infused and buttery mashed potatoes, take a golf ball sized portion. Or enjoy two bites of pumpkin pie instead of a large slice. Then, rave about how delicious these foods are and ask if you can bring some home to enjoy later.

Eat like a European: Across the pond, a meal can take hours as those in Europe enjoy multiple courses and eat very slowly with conversation and socializing to spice up the gathering. Savor every bite as you give your body time to digest your food. It’s not a race, it’s a dinner where you have plenty of time to talk about your blessings.

Aim for seven: Practice mindful eating and gauge how full you are before you start eating, as you eat and after your meal. With one being famished and 10 being ready to pop a button, aim for winding up at a seven to avoid being uncomfortable.

Take a food break: After the main meal and before you enjoy dessert, convince your family to join you for physical activity such as a walk or game of soccer or touch football.

“Thanksgiving can derail an entire year of healthy eating and start a holiday season of eating a totally different diet. Some people continue to eat poorly during the Christmas holiday season and come January, they make an annual resolution to change their habits,” Linsenmeyer says.

“Instead of falling into a yoyo pattern of weight gain and weight loss, try to maintain your weight throughout the holiday season. It’s generally easier to maintain your weight than it is to try to lose weight after gaining a few pounds.”

Long a leader in educating health professionals, Saint Louis University offered its first degree in an allied health profession in 1929. Today the Doisy College of Health Sciences offers degrees in physical therapy and athletic training, biomedical laboratory science, nutrition and dietetics, health informatics and information management, health sciences, medical imaging and radiation therapeutics, occupational science and occupational therapy, and physician assistant education. The college’s unique curriculum prepares students to work with health professionals from all disciplines to ensure the best possible patient care.

Posted in Nutrition: Habits | Leave a comment

For first-episode psychosis, a new treatment plan

As with other chronic health conditions, there is no magic bullet for schizophrenia. At least as important as the search for magic bullets, however, is an increasing focus on early intervention and integrating existing treatments. This year, we’ve had encouraging news about integrated, comprehensive approaches for treating people with first episode psychosis, most recently from a major NIMH initiative, the Recovery After an Initial Schizophrenia Episode, or RAISE project. RAISE looked at coordinated specialty care for first episode psychosis. With coordinated specialty care, the young person experiencing first episode psychosis works with a team of specialists to create a personal treatment plan, combining recovery-oriented psychotherapy, low-dose medication management, family education and support, case management, and work or education support. Coordinated specialty care emphasizes shared decision making, including family members, when possible.

RAISE began as two separate studies back in 2008. Each study looked at a different aspect of coordinated specialty care. One study, the RAISE Implementation and Evaluation Study, focused on the best way for clinics to start using the treatment program. The other project, the RAISE Early Treatment Program (RAISE-ETP), studied whether or not the treatment worked better than care typically available in community settings. John M. Kane, M.D., of the North Shore – Long Island Jewish Health System and the Zucker Hillside Hospital, led RAISE-ETP and, today, his team released the primary outcomes from this large clinical trial.1

The RAISE-ETP research team spent five years testing their coordinated specialty care model, called NAVIGATE, at 34 real-world clinics across the country. They compared their treatment program to typical treatment and found that 223 clients who received the NAVIGATE coordinated specialty care program stayed in treatment longer; experienced greater improvement in their symptoms, interpersonal relationships, and quality of life; and were more involved in work or school compared with 181 clients at the typical-care sites. NAVIGATE clients who had a shorter duration of untreated psychosis (the time between the beginning of psychotic symptoms and the beginning of treatment) when they started the study showed greater improvements than those with longer duration of untreated psychosis.

Two other research teams have reported findings in recent months from trials of coordinated care for first episode psychosis. A team at Yale University collaborated with a center run by Connecticut’s mental health agency to test whether a comprehensive first episode psychosis service in the context of a public sector clinic could improve outcomes. After a year, those who received comprehensive care had fewer hospitalizations than those in standard care, were more likely to remain employed, and did better on overall measures of functioning.2 A Danish team also reported that, in a trial of specialized, intensive treatment, patients receiving the intervention for two years had reduced psychotic and negative symptoms, were more satisfied and adherent with treatment, and were hospitalized less than patients receiving standard care.3 As a result of this study, the treatment has been implemented throughout Denmark.

The information coming from these trials shows that coordinated specialty care is an incremental but positive step in treating first episode psychosis. Coordinated specialty care—and ongoing testing of these approaches, with continuous incorporation of findings into practice—brings us closer to being able to intervene in a way that will enable young people with psychosis to avoid the long-term disability and vulnerability that too many experience. It is encouraging to note that more and more states—32 to date—are adopting coordinated specialty care programs to treat first episode psychosis. Their efforts have been supported by additional funding coming from the Community Mental Health Services Block Grant  program administered by the Substance Abuse and Mental Health Services Administration . Based on the RAISE results, NIMH is launching the Early Psychosis Intervention Network (EPINET), aimed at creating a network of clinical sites offering evidence-based specialty care to persons experiencing signs of first episode psychosis. Using data sharing agreements, EPINET centers will gather participant-level data which can then drive improvements in clinical practice, a “learning health-care system.”

It should perhaps be no surprise that, given the complexity and variability of schizophrenia, outcomes will be better with treatment that is individualized, multi-faceted, and attuned to the preferences of each patient. While we have a long way to go, these recent reports suggest we’re headed in the right direction


1 Kane, et al. Comprehensive Versus Usual Community Care for First Episode Psychosis: Two-Year Outcomes From the NIMH RAISE Early Treatment Program.  American Journal of Psychiatry (in press). doi: 10.1176/appi.ajp.2015.15050632. Epub 2015 Oct 20.

2 Srihari VH et al. First-Episode Services for Psychotic Disorders in the U.S. Public Sector: A Pragmatic Randomized Controlled Trial.  Psychiatr Serv. 2015 Jul;66(7):705-12. doi: 10.1176/appi.ps.201400236. Epub 2015 Feb 2.

3 Nordentoft M et al. From research to practice: how OPUS treatment was accepted and implemented throughout Denmark.  Early Interv Psychiatry. 2015 Apr;9(2):156-62. doi: 10.1111/eip.12108. Epub 2013 Dec 5.


Posted in Mental Health: Psychosis | Leave a comment

‘Healthy’ foods differ by individual

Ever wonder why that diet didn’t work? An Israeli study tracking the blood sugar levels of 800 people over a week suggests that even if we all ate the same meal, how it’s metabolized would differ from one person to another. The findings, published November 19 in Cell, demonstrate the power of personalized nutrition in helping people identify which foods can help or hinder their health goals.

Blood sugar has a close association with health problems such as diabetes and obesity, and it’s easy to measure using a continuous glucose monitor. A standard developed decades ago, called the glycemic index (GI), is used to rank foods based on how they affect blood sugar level and is a factor used by doctors and nutritionists to develop healthy diets. However, this system was based on studies that average how small groups of people responded to various foods.

The new study, led by Eran Segal and Eran Elinav of the Weizmann Institute of Science in Israel, found that the GI of any given food is not a set value, but depends on the individual. For all participants, they collected data through health questionnaires, body measurements, blood tests, glucose monitoring, stool samples, and a mobile-app used to report lifestyle and food intake (a total of 46,898 meals were measured). In addition, the volunteers received a few standardized/identical meals for their breakfasts.




Posted in Nutrition: Habits, Personalized Medicine | Leave a comment

How weight-loss surgery reduces sugar cravings

Weight loss surgery curbs the sweet tooth by acting on the brain’s reward system, according to a study published November 19 in Cell Metabolism. The researchers found that gastrointestinal bypass surgery, which is used to treat morbid obesity and diabetes, reduced sugar-seeking behavior in mice by reducing the release of a reward chemical called dopamine in the brain. The findings suggest that positive outcomes are more likely if sugary foods seem less rewarding after surgery.

“The problem of how and why bariatric surgery works has been perplexing scientists for years,” says senior study author Ivan de Araujo of Yale University School of Medicine. “By shedding light on how bariatric surgeries affect brain function, our study could pave the way for the development of novel, less-invasive interventions, such as drugs that reduce sugar cravings by preventing sugar absorption or metabolism upon arrival in the gastrointestinal tract.”

Patients, anecdotally, have reported a change in the type of food they preferred after weight-loss surgery. Although the four different operations commonly offered in the United States are effective at reversing obesity and diabetes, it is not entirely clear how these surgeries work. It is likely that there are a number of different mechanisms at play. Bariatric surgeries are more likely to succeed when patients substantially reduce their caloric intake, and reducing sugary foods is an important part of these behavioral changes.

Building on past studies that showed that the brain dopamine reward system regulates caloric intake as well as findings from his team that nutrient sensing in the gastrointestinal tract stimulates dopamine release in the dorsal striatum, de Araujo set out to test whether bariatric surgery relies on the same brain circuitry to curb sugary food preference. They performed surgery in mice to bypass the first part of the small intestine, directly connecting the stomach to a lower section of the gastrointestinal tract. The same procedure is performed in humans, and it mimics the bypass component of the commonly used Roux-en-Y intervention, but no gastric pouch was constructed to limit food intake.

The gastrointestinal rerouting procedure performed in mice suppressed their sweet tooth by reducing sugar-induced dopamine release in the dorsal striatum, essentially diminishing the rewarding effects of sugar. Due to the addictive properties of sweets, infusions of sugar into the stomach would typically cause mice to persistently lick a spout that released a sugary liquid, despite the sensation of fullness. But bypass surgery inhibited the sweet-seeking impulse, almost as if it prevented the sugar addiction from taking hold.

Moreover, using optogenetics, an advanced neuroscience technique, to directly activate the dopamine neural circuit in free-living animals, the researchers saw a striking increase in sugar consumption, overturning the effects of bypass surgery. Mice that underwent this procedure consumed virtually no sweetener following sugar infusions into the stomach, but optical stimulation of the dorsal striatum caused the mice to plant themselves in front of the sugar spout.

“Our findings provide the first evidence for a causal link between striatal dopamine signaling and the outcomes of bariatric interventions,” de Araujo says. “However, we certainly do not want to give the impression that we have an answer for how and why bariatric surgery works. Much more research is needed in this field.”

For his own part, de Araujo plans to directly compare the impact on the brain’s dopamine cells produced by different types of bariatric surgeries. “We hope our work will provide new insights into how different bariatric interventions may lead to a diverse repertoire of behavioral modifications,” de Araujo says. “However, ultimately we would like to help patients lose weight and reverse their diabetes without going under the knife.”


This work was supported by the National Institutes of Health, the China Scholarship Council, and FAPESP.

Cell Metabolism, Han et al.: “Striatal Dopamine Links Gastrointestinal Rerouting to Altered Sweet Appetite” http://dx.doi.org/10.1016/j.cmet.2015.10.009

Cell Metabolism (@Cell_Metabolism), published by Cell Press, is a monthly journal that publishes reports of novel results in metabolic biology, from molecular and cellular biology to translational studies. The journal aims to highlight work addressing the molecular mechanisms underlying physiology and homeostasis in health and disease. For more information, please visit http://www.cell.com/cell-metabolism.


Posted in Nutrition: Calorie Restriction, Nutrition: Food: Sugar, Obesity, Obesity: Bariatric Surgery | Leave a comment

Youth violence undermines social and economic development in poorest corners of the world

Youth violence undermines social and economic development, especially in the poorest corners of the world, according to research from McGill University. However, increased government spending on education may be the key to facilitate policy efforts to protect youth.

Using data from two international school-based surveys, the Health Behaviour in School-aged Children and Global School-based Health Survey, Frank Elgar, a professor at the Institute for Health and Social Policy (IHSP) at McGill University reports on rates of lng and physical fighting in 79 countries in The Journal of Adolescent Health. The study focused on bullying victimisation (repeated physical or verbal aggression, involving a power imbalance between victim and aggressor) during the previous two months and frequent physical fighting (4+ episodes) in the previous year) in over 330,000 youths 11- to 16-years-old.

Elgar and colleagues linked these records to information about the countries’ per capita income, income inequality, and government spending on education.

“Bullying and physical fighting are far more prevalent in poorer countries”, says Elgar, “However, we found that in wealthy but unequal countries, physical fighting may be reduced through greater government investment in education.”

Higher rates of bullying in Canada

“We were surprised by the rate of bullying in Canada — about 7 percentage points higher than the international average. About 37% of Canadian youth have been the target of bullying in the past two months. This is higher than the United States and most European countries.”


  • Largest study to date on youth violence on an international level
  • Study found large country differences in youth violence: a six-fold difference in school bullying and 12-fold difference in fighting between rich and poor countries
  • Globally, about 30% of youth has been the target of school bullying during the previous month. In Africa, the figure is about 50%.
  • 10.7% of males and 2.7% of females were involved in four or more episodes of physical fighting in the past year.
  • Canada has higher levels of school bullying than many countries of similar wealth: 37.6% of males and 37.2% of females have been the target of bullying.
  • Fighting in Canadian youth is near international norms: 10.3% of males and 3.8% of females were involved in 4 or more episodes of fighting in the past year.
  • In the US, fighting is twice as common in males (8.4%) than in females (3.9%). Bullying is near the international norm: 30.8% of males and 29.7% females in the US have been the target of bullying.
  • European countries have the lowest rates of youth violence – in terms of fighting (4.1% males, 1.1% females) and bullying 12.4% males, 8.7% females).
  • Physical fighting in affluent but economically unequal countries might be reduced through increased government spending on education.


‘Structural determinants of youth bullying and fighting in 79 countries’ by Frank Elgar et al. is published in the : Journal of Adolescent Health.


Posted in Human Behavior: Aggression, Human Behavior: Bullying, Human Behavior: Violence, Poverty, Terrorism, World Health | Leave a comment

One in two healthy adults will develop pre-diabetic high blood sugar: The Lancet Diabetes and Endocrinology

(Reuters Health) – Almost half of 45-year-olds will develop so-called prediabetes, an elevated blood sugar level that often precedes diabetes, according to a large study from The Netherlands using population estimates.

Prediabetes, sometimes called impaired glucose metabolism, has no clear symptoms, but people with higher than normal blood sugar based on a blood test should be tested for diabetes every one or two years, according to the American Diabetes Association.

“We have known this from previous studies – but what this study adds is a method of communicating risk in a better way – a person’s lifetime risk of developing diabetes,” said Dr. Kamlesh Khunti of Leicester General Hospital in the U.K., who coauthored an editorial accompanying the new results.

One in three healthy 45-year-olds will develop diabetes in his or her lifetime, Khunti said.

Researchers from Erasmus University Medical Center in Rotterdam and the Harvard School of Public Health in Boston used long-term data on about 10,000 adults in The Netherlands, including medical records, hospital discharge letters, pharmacy dispensing data and fasting blood sugar measurements.

They followed people for about 15 years, categorizing their blood sugar levels according to World Health Organization standards. Blood sugar levels of 6 millimoles/per liter (108 milligrams per deciliter) or less are considered normal or healthy.


Posted in Diabetes, Diabetes: Type 4, Prediabetes, World Health: Diabetes | Leave a comment

10 Success Secrets For Entrepreneurial Women (And What Holds Them Back)

Women are the fastest growing segment of business owners in the United States today. That’s great news – but there’s a caveat.

Compared to men business owners, women tend to have smaller companies. Their companies tend to generate less revenue and they tend to employ fewer people. What can be done to support women business owners?

For answers, we turned to three women entrepreneurs who had extensive experience working with and mentoring other women as they launched and built their businesses: Jane Wesman, founder of Jane Wesman Public Relations, Inc.; Sandi Webster, Consultants 2 Go, LLC; and Nina Kaufmann, Esq., Entrepreneur.com Legal Expert.

What’s Holding Women Back?

The panelists devoted extensive time to discussing key factors that hold back women from enjoying greater success as business owners. All agreed there was nothing gender-specific about entrepreneurship. Instead, they talked about some of the psychological aspects that can influence women in particular on their path to success – including external obstacles like lack of visible role models and gender stereotypes that can result in subtle dissuasion by otherwise supportive family members and friends.

But the biggest challenge of all facing women business owners was internal: fear. The panelists shared their experience watching women manage their businesses and discussed the various ways they’ve seen internalized fears impact a woman’s success – whether it is fears about change, money, or mastering the numbers needed to run a business effectively.


Posted in Business, Human Behavior: Bias, Human Behavior: Gender Differences | Leave a comment