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Belief in a Caring God Improves Response to Medical Treatment for Depression

Research suggests that religious belief can help protect against symptoms of depression, but a study at Rush University Medical Center goes one step further.

February 2010

In patients diagnosed with clinical depression, belief in a concerned God can improve response to medical treatment, according to a paper in the Journal of Clinical Psychology.

A total of 136 adults diagnosed with major depression or bipolar depression at inpatient and outpatient psychiatric care facilities in Chicago participated in the study. The patients were surveyed shortly after admission for treatment and eight weeks later, using the Beck Depression Inventory, the Beck Hopelessness Scale, and the Religious Well-Being Scale – all standard instruments in the social sciences for assessing intensity, severity and depth of disease and feelings of hopelessness and spiritual satisfaction.

Response to medication, defined as a 50-percent reduction in symptoms, can vary in psychiatric patients. Some may not respond at all. But the study found that those with strong beliefs in a personal and concerned God were more likely to experience an improvement. Specifically, participants who scored in the top third of the Religious Well-Being Scale were 75-percent more likely to get better with medical treatment for clinical depression.

The researchers tested whether the explanation for the improved response was linked instead to the feeling of hope, which is typically a feature of religious belief. But degree of hopefulness, measured by feelings and expectations for the future and degree of motivation, did not predict whether a patient fared better on anti-depressants.

"In our study, the positive response to medication had little to do with the feeling of hope that typically accompanies spiritual belief," said Patricia Murphy, PhD, a chaplain at Rush and an assistant professor of religion, health and human values at Rush University. "It was tied specifically to the belief that a Supreme Being cared."

"For people diagnosed with clinical depression, medication certainly plays an important role in reducing symptoms," Murphy said. "But when treating persons diagnosed with depression, clinicians need to be aware of the role of religion in their patients' lives. It is an important resource in planning their care."

George Fitchett, PhD, also a chaplain at Rush and the director of the religion, health and human values program at Rush University, co-authored the study.

Rush University Medical Center is an academic medical center that encompasses a 600-bed hospital (including Rush Children’s Hospital), the Johnston R. Bowman Health Center and Rush University. Rush University, with more than 1,730 students, is home to one of the first medical schools in the Midwest, and one of the nation’s top-ranked nursing colleges. Rush University also offers graduate programs in allied health and the basic sciences. Rush is noted for bringing together clinical care and research to address major health problems, including arthritis and orthopedic disorders, cancer, heart disease, mental illness, neurological disorders and diseases associated with aging.

Source: Rush University Medical Center http://www.rush.edu/

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UBC helps lead a new scholarly focus on wellbeing

by Lorraine Chan
UBC Public Affairs

February 2010

With the world gathered to admire those faster, better and stronger, many of us would assume that “richer” tops that list of desired traits.

New evidence from leading UBC happiness scholars, however, cautions against equating more money with more happiness. If anything, the truth may be closer to the sentiments of the late Notorious BIG in his hit rap song “Mo Money Mo Problems.”


Wealth can limit ability to savour life

In the first study of its kind, UBC psychology researcher Elizabeth Dunn discovered that wealth and even thinking about wealth robs a person of the ability to stay in the moment and reap enjoyment from life’s daily pleasures. The paper, “Money Giveth, Money Taketh Away: The Dual Effect of Wealth,” will appear in a forthcoming issue of the journal Psychological Science.

“While wealth opens doors to great experiences, it appears to undercut people’s ability to savour,” says Dunn, an assistant professor in the UBC Dept. of Psychology.

“We found that wealthier individuals reported lower ability to savour,” says lead author Jordi Quoidbach, a visiting PhD student from Belgium’s University of Liege working in Dunn’s lab. In addition to Dunn, study co-investigators are Dino Petrides, University College London, England, and Moira Mikolajczak, with the Catholic University of Louvain, Belgium

The researchers recruited more than 350 working adults to answer questions about their ability to savour life in six different situations, among them finishing an important task or spending a romantic weekend away. Respondents were also asked about their level of happiness, desire for future wealth and current wealth. The study primed a number of participants’ thoughts toward money by displaying a photo of a large stack of bills in the questionnaire. Participants in the control group received a questionnaire with the same photo of money, but blurred beyond recognition.

In a related experiment on money and people’s savouring ability, the researchers timed how long respondents took to enjoy a piece of chocolate. Participants were told they were part of a taste test and given a questionnaire in a binder that primed their thoughts with a photo of money. Participants who received these binders with the money photo spent less time eating the chocolate. They showed lower levels of enjoyment than the control group whose binder contained no such photo.
Money misleads

A joint UBC and Harvard Business School study further illustrates how people overestimate the impact of income on life satisfaction. The researchers looked at nationally representative data from Americans across the income spectrum. Participants were asked to report their own happiness and to predict the happiness of others and themselves at 10 different income levels, from US$5,000 to US$1 million. They reported their predictions using a 0-10 scale where 0 equals the worst possible life overall and 10 equals the best possible life overall. The researchers then compared the participants’ predictions to existing data on happiness and income levels.

The study shows that participants accurately predicted happiness levels – approaching 7 and 8 – for people with household incomes of US$90,000 and above. However, participants were wide off the mark when it came to lower-income households. For example, they predicted a happiness rating of 4 for people with household incomes of US$25,000 when existing data suggest it is closer 6.

“There is a real but modest relationship between money and happiness,” says lead author Lara Aknin, a UBC PhD student working with Dunn, whose findings were published in the November 2009 issue of the Journal of Positive Psychology. “But our studies show that adult Americans erroneously believe that earning less than the median household income is associated with severely diminished happiness.”

Aknin says such a false belief may lead many people to chase opportunities for increased wealth or forgo a reduction in income for increased free time to spend on themselves, family or other worthwhile endeavours.

On occasion money does buy happiness – when you share your wealth with others. In a study that appeared in Science last year, Dunn and her colleagues gave people $5 or $20 in the morning and asked them to spend it on themselves or other people by the end of the day. People who were asked to spend the money on others were happier at the end of the day.


The trust factor

For UBC economist John Helliwell, trust is a vital support for better lives.

“If employees are higher by one point on a 10-point scale in their assessment of the trustworthiness of their managers, the effect on their life satisfaction is equal to a pay increase of more than 30 per cent,” says Helliwell, who carried out the groundbreaking work with UBC graduate student Haifang Huang, now teaching at the University of Alberta.

Trust in multiple domains increases a person’s sense of well being even further, says Helliwell who is also the co-director of the Social Interactions, Identity and Well-Being program at the Canadian Institute for Advanced Research.

In a paper for the October 2009 Organization for Economic Cooperation and Development World Forum in Busan, Korea, Helliwell and UBC economics graduate student Shun Wang used well-being data from the Gallup World Poll and the Canadian General Social Survey. Both of these surveys also asked respondents whether their wallets, if lost, would be returned to them if found by different individuals such as neighbours, police and strangers.

“Those who think their lost wallet would be returned if found by a neighbour or the police report an increase in subjective well-being similar to that associated with an increase of household income of about two-thirds,” says Helliwell.

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People with Prediabetes Not Taking Adequate Precautions to Avoid Diabetes

New Study Published in the American Journal of Preventive Medicine

San Diego, CA, March 2, 2010 – In 2005–2006, almost 30% of the U.S. adult population had prediabetes, but over 90% were unaware of their prediabetes status. Although it is known that diabetes can be prevented or delayed among adults at high risk through modest weight loss and increased physical activity, a study published in the April 2010 issue of the American Journal of Preventive Medicine revealed that only about half of U.S. adults with prediabetes reported that in the past year they tried to lose weight or exercise more.

Researchers from the Division of Diabetes Translation of the Centers for Disease Control and Prevention, Emory University, and the National Institute of Diabetes and Digestive and Kidney Diseases examined whether people with prediabetes are adopting preventive measures and what demographic factors might influence these behaviors. Survey data from 1402 adults with prediabetes who participated in the 2005-2006 National Health and Nutrition Examination Survey (NHANES) was analyzed. Survey participants were interviewed and given a fasting plasma glucose test (FPG) and an Oral Glucose Tolerance Test (OGTT).

All survey participants were asked whether in the past 12 months, they had: (1) tried to control or lose weight, (2) reduced the amount of fat or calories in their diet, and (3) increased physical activity or exercise. They were also asked whether they had been told by a doctor or other health professional in the past 12 months to perform each of these three risk reduction behaviors. In addition, they were asked if they had been screened for diabetes or high blood sugar in the past 3 years. Demographic factors such as gender, age, race/ethnicity, family history, and education level were also self-reported.

The researchers found that in 2005–2006, 29.6% of U.S. adults aged ≥20 years had prediabetes. Only 7.3% of those with prediabetes reported that they had been told that they had a prediabetes condition. Less than half (47.7%) of adults with prediabetes reported a test for diabetes or high blood sugar in the past 3 years.

Although adults with and without prediabetes were similar in race and ethnicity, adults with prediabetes were more likely than those without prediabetes to be male, older, and have lower educational attainment. They were also somewhat more likely to report that an immediate family member had diabetes. Also, adults with prediabetes were more likely to have higher levels of well known cardiovascular disease risk factors, including higher mean weight, waist circumference, systolic blood pressure, and triglycerides, as well as a higher prevalence of hypertension.

Writing in the article, the team of investigators led by Linda Geiss of the Division of Diabetes Translation, Centers for Disease Control and Prevention, states, “Reversing the growing diabetes problem will require multiple levels of interventions, including promotion of healthy lifestyles and increased availability of evidence-based community prevention programs for people at high risk. More efficient identification and awareness of prediabetes is a key first step to implementing these changes.”

The article is “Diabetes Risk Reduction Behaviors Among U.S. Adults with Prediabetes” by Linda S. Geiss, MA, Cherie James, MSPH, Edward W. Gregg, PhD, Ann Albright, PhD, RD, David F. Williamson, PhD, and Catherine C. Cowie, PhD. The article appears in the American Journal of Preventive Medicine, Volume 38, Issue 4 (April 2010) published by Elsevier.

# # #
Full text of the article is available upon request; contact eAJPM@ucsd.edu to obtain copies.

To schedule an interview with the authors, please contact Elizabeth Greene at 770-488-5000 or CDC’s Division of Media Relations at 404-639-3286.
ABOUT THE AMERICAN JOURNAL OF PREVENTIVE MEDICINE
The American Journal of Preventive Medicine (http://www.ajpm-online.net) is the official journal of The American College of Preventive Medicine (http://www.acpm.org) and the Association for Prevention Teaching and Research (http://www.atpm.org). It publishes articles in the areas of prevention research, teaching, practice and policy. Original research is published on interventions aimed at the prevention of chronic and acute disease and the promotion of individual and community health. The journal features papers that address the primary and secondary prevention of important clinical, behavioral and public health issues such as
injury and violence, infectious disease, women's health, smoking, sedentary behaviors and physical activity, nutrition, diabetes, obesity, and alcohol and drug abuse. Papers also address educational initiatives aimed at improving the ability of health professionals to provide effective clinical prevention and public health services. The journal also publishes official policy statements from the two co-sponsoring organizations, health services research pertinent to prevention and public health, review articles, media reviews, and editorials.
The American Journal of Preventive Medicine is ranked 12th out of 105 Public, Environmental & Occupational Health titles and 16th out of 107 General and Internal Medicine titles according to the 2009 Journal Citation Reports© published by Thomson Reuters.
ABOUT ELSEVIER
Elsevier is a world-leading publisher of scientific, technical and medical information products and services. The company works in partnership with the global science and health communities to publish more than 2,000 journals, including The Lancet (http://www.thelancet.com) and Cell (http://www.cell.com), and close to 20,000 book titles, including major reference works from Mosby and Saunders. Elsevier’s online solutions include ScienceDirect (http://www.sciencedirect.com), Scopus (http://www.scopus.com), Reaxys (http://www.reaxys.com), MD Consult (http://www.mdconsult.com) and Nursing Consult (http://www.nursingconsult.com), which enhance the productivity of science and health professionals, and the SciVal suite (http://www.scival.com) and MEDai’s Pinpoint Review (http://www.medai.com), which help research and health care institutions deliver better outcomes more cost-effectively.
A global business headquartered in Amsterdam, Elsevier (http://www.elsevier.com) employs 7,000 people worldwide. The company is part of Reed Elsevier Group PLC (http://www.reedelsevier.com), a world-leading publisher and information provider, which is jointly owned by Reed Elsevier PLC and Reed Elsevier NV. The ticker symbols are REN (Euronext Amsterdam), REL (London Stock Exchange), RUK and ENL (New York Stock Exchange).

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UA Psychologist 'Eavesdrops' on Happiness

Matthias Mehl and his colleagues listened to thousands of recorded snippets of daily conversations to find behavioral clues to why some people are happier than others.

By Jeff Harrison,
University of Arizona Communications

March 3, 2010

Since the age of Socrates, trying to figure out just what makes people happy has thwarted more than a few researchers in various scientific disciplines.

A group of researchers led by University of Arizona psychologist Matthias Mehl is pursuing answers to happiness through what people talk about. Mehl is interested in learning about whether people are happiest while bantering in day-to-day chatter or engaged in more substantive conversations.

The long-term implications of happiness have been studied extensively; little is known, though, about the daily social behavior of happy people, due primarily to the difficulty of objectively measuring that behavior.

Mehl, an assistant professor in the UA's psychology department and his colleague, Simine Vazire from Washington University in St. Louis, and their students have observed and reported what they found about happiness from people and their conversations.

The results of their investigation – "Eavesdropping on Happiness: Well-being is Related to Having Less Small Talk and More Substantive Conversations” – are published in the current issue of Psychological Science.

The researchers recorded 79 people and thousands of their conversations over a four-day period.

Participants were equipped with a digital recording device called Electronically Activated Recorder, or EAR, that sampled 30-second snippets every 12.5 minutes. The EAR captured not only conversations but also other ambient sounds as participants went about their daily lives and thereby provided the researchers essentially with an acoustic log of their days.

Each recording was codified as to whether a participant was alone, talking with others and whether those conversations were superficial or more complex. Participants’ well-being was assessed with self and friend reports of life satisfaction and happiness.

What Mehl and his team found was that, consistent with prior research, higher well-being was associated with spending less time alone and more time talking to others.

Furthermore, and maybe more surprisingly, they found that higher well-being was robustly related to having less small talk and more substantive conversations.

Compared with the unhappiest participants in the study, the happiest participants had roughly one-third as much small talk and twice as many substantive conversations.

The initial indication, Mehl said, is that the happy life is social rather than solitary and conversationally deep rather than superficial.

Although the current study cannot answer the question of what causes what, it raises the possibility that happiness can be increased by facilitating substantive conversation, a hypothesis he would like to see explored in future research.

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Weekly Internet Usage Overtakes Television Watching
For the First Time, Weekly Hours Spent Online (18.1 hours) is Higher Than the Number of Hours Spent Watching Television (16.9 hours)

March 2010

Calgary, AB

Ipsos reports that for the first time ever in their tracking research, the weekly Internet usage of online Canadians has moved ahead of the number of hours spent watching television. This latest finding comes from the Inter@ctive Reid Report, a syndicated Ipsos Reid study that tracks online Canadians usage of the Internet. Overall, online Canadians are now spending more than 18 hours a week online, compared to 16.9 hours watching television. Internet usage is up from 14.9 hours last year. The number of hours watching television also experienced an increase in the last year, rising from 15.8 hours. Other media, such as newspapers, radio and magazines have all remained relatively stable in the last year.


Interestingly, males are spending significantly more time online than females (20 hours compared to 16). Also of interest is the minimal gap between age groups - on average, 18-34 year olds are spending 20 hours a week online, compared to 18 hours for those over the age of 35.

“In previous years we’ve seen significant differences between the generations and the amount of time they spend online,” notes study author Mark Laver, “The data indicates that not only are people of all ages spending more and more time online, but it also points to a shift in how online Canadians are consuming media and where they are spending their free time. Today, online Canadians are finding a myriad of entertainment options available to them within the walls of their homes. While some entertainment content has simply shifted from television to online, the Internet is also providing new content to Canadians.”

Television, on the other hand is different. Canadian adults aged 55+ are significantly more likely to be watching more television each week (20 hours of television each week compared to 15 hours for those aged 35-54 and 13 hours for those aged 18-34). Those with university educations watch significantly less television each week - 15 hours, compared to approximately 17.5 hours for those without university educations.

Laver continues: “Our look at online television and media in the Inter@ctive Reid Report shows that Canadians are consuming more and more content online than they were previously watching on television or content that they simply did not have access to. Not only has the recession likely acted as a disrupting factor, but the Internet is poised to take the next step in our lives as it delivers more and more entertainment content to Canadians in their homes and on the go.”

This release is based on the findings of an Ipsos Reid syndicated study, the Inter@ctive Reid Report, fielded in Q4, 2009. This online survey of 839 Canadian adults was conducted via the Ipsos Online Panel. The results are based on a sample where quota sampling and weighting are employed to balance demographics and ensure that the sample's composition reflects that of the actual Canadian population according to Census data. Quota samples with weighting from the Ipsos online panel provide results that are intended to approximate a probability sample. An unweighted probability sample of this size, with a 100% response rate, would have an estimated margin of error of +/- 3.38 percentage points, 19 times out of 20.

Follow the Ipsos Reid Interactive Group at http://twitter.com/interactivereid and http://www.ipsos.ca/reid/interactive/

For more information on this news release, please contact:
Mark Laver
Associate Vice-President
Ipsos Reid
Direct: (403) 294-7393
Mobile: (403) 870-9146
mark.laver@ipsos.com

About Ipsos Reid

Ipsos Reid is Canada's market intelligence leader, the country's leading provider of public opinion research, and research partner for loyalty and forecasting and modelling insights. With operations in eight cities, Ipsos Reid employs more than 600 research professionals and support staff in Canada. The company has the biggest network of telephone call centres in the country, as well as the largest pre-recruited household and online panels. Ipsos Reid's marketing research and public affairs practices offer the premier suite of research vehicles in Canada, all of which provide clients with actionable and relevant information. Staffed with seasoned research consultants with extensive industry-specific backgrounds, Ipsos Reid offers syndicated information or custom solutions across key sectors of the Canadian economy, including consumer packaged goods, financial services, automotive, retail, and technology & telecommunications. Ipsos Reid is an Ipsos company, a leading global survey-based market research group.

To learn more, please visit www.ipsos.ca .

About Ipsos

Ipsos is a leading global survey-based market research company, owned and managed by research professionals. Ipsos helps interpret, simulate, and anticipate the needs and responses of consumers, customers, and citizens around the world.

Member companies assess market potential and interpret market trends. They develop and build brands. They help clients build long-term relationships with their customers. They test advertising and study audience responses to various media. They measure public opinion around the globe. Ipsos member companies offer expertise in advertising, customer loyalty, marketing, media, and public affairs research, as well as forecasting, modeling, and consulting. Ipsos has a full line of custom, syndicated, omnibus, panel, and online research products and services, guided by industry experts and bolstered by advanced analytics and methodologies. The company was founded in 1975 and has been publicly traded since 1999. In 2008, Ipsos generated global revenues of €979.3 million.

Visit www.ipsos.com to learn more about Ipsos offerings and capabilities.

Ipsos, listed on the Eurolist of Euronext – Comp B, is part of SBF 120 and the Mid-100 Index, adheres to the Next Prime segment and is eligible to the Deferred Settlement System. Isin FR0000073298, Reuters ISOS.PA, Bloomberg IPS:FP

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Pharmacy Professor Navindra Seeram has made some exciting discoveries about the health benefits of maple syrup,
and the announcement of his research at a meeting of the American Chemical Society has created quite the buzz.
The study focused on maple syrup from Canada . . .


Maple Syrup Study Finds 20 Disease-Fighting Antioxidants in Pure Canadian Maple Syrup

NEW YORK — March 24, 2010

In a new research study conducted by the University of Rhode Island, Dr. Navindra Seeram discovered more than 20 compounds linked to human health in Canadian maple syrup, 13 of which were discovered for the first time in maple syrup. Seeram, assistant professor of biomedical and pharmaceutical sciences in URI’s College of Pharmacy, unveiled his findings Sunday, March 21 at the American Chemical Society’s Annual Meeting.

“We already know the maple tree has strong antioxidant mechanisms,” Seeram said. “Now we are looking more closely at the tree’s sap.” Several of these antioxidant compounds are also reported to have anti-cancer, anti-bacterial and anti-diabetic properties. “People are increasingly interested in healthier food alternatives,” Seeram said.

Prior to the study, The Federation of Quebec Maple Syrup Producers and the Canadian maple syrup industry knew the product was full of natural minerals and vitamins, including zinc, manganese and calcium, providing the basis for a research study with comprehensive health findings. The Federation awarded Seeram a two-year grant funded in conjunction with the Conseil pour le développement de l'agriculture du Québec (CDAQ) and Agriculture and Agrifood Canada (AAC).

Seeram found the same antioxidant compounds also contained in berries, an exciting development because he would not previously have associated a sweetener with healthy biological properties. “Today, Americans have great interest in learning the health benefits of unique foods,” Seeram said.

Seeram also advised that when choosing syrup as a sweetener, it is healthier to use 100 percent pure maple syrup. He referred to a survey conducted by the Federation, which found that 50 percent of Americans are unaware if the syrup they consume is real maple syrup or pancake syrup.

“Many Quebec producers come from a family with a long tradition of maple syrup production and we are committed to the product because we know that maple syrup is a sustainable and versatile product,” Serge Beaulieu, president of the Federation said. Geneviève Béland, marketing executive, adds, “A healthful alternative to other sugars, pure maple syrup is a flavourful staple for cooking and has various culinary uses beyond breakfast, from a touch of sweet in tea, drizzled over vegetables, or as a glaze for grilled poultry and fish.”

“In a certain sense, people view sap as the life blood of the tree,” Seeram said. “Maple syrup is unique in that it is the only product in our diet that comes from a plant’s sap.” Historically, many cultures have benefited from its health benefits as a homeopathic remedy for ailments, including flu, stomach aches, high blood pressure and cholesterol. Maple syrup’s high levels of zinc and manganese can assist in heart health and boosting the immune system.

About the Federation and the Canadian maple syrup industry

The Federation of Quebec Maple Syrup Producers was founded in 1966 with the mission of defending and promoting the economic, social and moral interests of its 7,400 maple family farms businesses. These men and women are working together to collectively work on quality standards, create knowledge and market their products. Quebec is responsible for 93 percent of the Canadian production and close to 80 percent of today’s global maple syrup output. Therefore the Federation is proud to lead scientific research in the name of the entire Canadian maple syrup industry. Ontario, New Brunswick and Nova Scotia contribute 7 percent of the total Canadian production.


To learn more please visit http://www.purecanadamaple.com
- - -

URI pharmacy researcher finds beneficial compounds in pure maple syrup

KINGSTON, R.I. – March 22, 2010 – Before you dig in to your next stack of French toast or waffles, you might want to pour on pure maple syrup.

That’s because University of Rhode Island researcher Navindra Seeram, who specializes in medicinal plant research, has found more than 20 compounds in maple syrup from Canada that have been linked to human health, 13 of which are newly discovered in maple syrup. In addition, eight of the compounds have been found in the Acer (maple) family for the first time.

The URI assistant professor of biomedical and pharmaceutical sciences in URI’s College of Pharmacy presented his findings Sunday, March 21 at the American Chemical Society’s Annual Meeting in San Francisco. The project was made possible by Conseil pour le développement de l'agriculture du Québec (CDAQ), with funding provided by Agriculture and Agri-Food Canada's Advancing Canadian Agriculture and Agri-Food (ACAAF) program. (Seeram will be interviewed about this on NPR's Science Friday, March 26.)

Several of these anti-oxidant compounds newly identified in maple syrup are also reported to have anti-cancer, anti-bacterial and anti-diabetic properties.

Prior to the study, the Federation of Quebec Maple Syrup Producers already knew that its product was full of naturally occurring minerals such as zinc, thiamine and calcium. But it enlisted Seeram to research the presence of plant anti-oxidants. The Federation awarded Seeram a two-year, $115,000 grant with the help of the CDAQ and Agriculture and Agri-Food Canada. His research continues to determine if the compounds exist in beneficial quantities.

Serge Beaulieu, president of the Federation of Quebec Maple Syrup Producers, said Seeram’s lab is but one in an expanding multi-national network of research facilities dedicated to the study of maple products from Canada.

“We are proud that our producers are generously supporting this research, bringing to light a greater understanding of the gastronomic and health benefits of maple products. It is not just for Canada, but for the welfare of consumers around the world,” Beaulieu said.

Geneviève Béland, federation marketing director, said the group has learned that maple products are much more than sugars with only calories to contribute.
“Recent research findings, such as those by Dr. Seeram, reveal a whole array of bioactive compounds that promise to offer many health benefits,” she said. “Our journey to understanding these benefits has just begun.”

Seeram, who was named the 2009 Young Scientist of the Year by the American Chemical Society’s Division of Agricultural and Food Chemistry, said his goal is to educate the research community and the public about the many benefits of a variety of plant and berry foods, as well as natural products. His message is receiving widespread attention. Seeram had two of the Top Ten Most Accessed Articles in the Journal of Agricultural and Food Chemistry in 2008.

“We know that plants must have strong anti-oxidant mechanisms because they are in the sun throughout their lives,” Seeram said. “We already know that berries, because of their bright colors, are high in anti-oxidants.

“Now we are looking at maple syrup, which comes from the sap located just inside the bark, which is constantly exposed to the sun.”

During his maple syrup research, Seeram and his research team found phenolics, the beneficial class of anti-oxidant compounds also found in berries. “We speculated that the sugar maple is wounded when it is tapped for its sap, and that it secretes phenolics as a defense mechanism.”

Seeram said the sap probably has low concentrations of these native phenolics. “But when you boil the sap down, there could be higher levels because syrup is a highly concentrated liquid. Plus, the natural plant bioactives could remain intact or undergo process-induced chemical changes during the heating process resulting in further–derived bioactive compounds.”

The biomedical scientist said such early research is exciting because many people would not associate such a sugary product with healthy biological properties.
“At this point, we are saying, if you choose to put syrup on your pancakes, it may be healthier to use real maple syrup,” he said. “The Federation of Quebec Maple Syrup Producers found that 50 percent of consumers don’t know whether the syrup they consume is real maple syrup.”

Seeram acknowledges that real maple syrup is pricier than commercial brands with maple flavoring or even those with no or very little maple syrup. “But you pay for what you get and you get what you pay for, meaning there are consequences for what you eat.

“We know that anti-oxidants are present in the leaves, bark and twigs of the maple tree, so looking at the sap make sense.”

Seeram now has a sugar maple tree trunk sitting in his lab so he can begin a more comprehensive study of the entire tree.

“In a certain sense, people view sap as the life blood of the tree,” Seeram said. “Maple syrup is unique in that it is the only commercial product in our diet that comes from a plant’s sap. This is a niche resource for northeast North America. Canada is the biggest producer of maple syrup and the United States is the biggest consumer.”

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Scripps Research Study Shows Compulsive Eating Shares Same Addictive Biochemical Mechanism with Cocaine, Heroin Abuse

The Research Provides New Clues to Obesity Epidemic

JUPITER, FL, March 23, 2010

In a newly published study, scientists from The Scripps Research Institute have shown for the first time that the same molecular mechanisms that drive people into drug addiction are behind the compulsion to overeat, pushing people into obesity.

The new study, conducted by Scripps Research Associate Professor Paul J. Kenny and graduate student Paul M. Johnson, was published March 28, 2010 in an advance online edition of the journal Nature Neuroscience.

The study's startling findings received widespread publicity after a preliminary abstract was presented at a Society for Neuroscience meeting in Chicago last October. Articles heralding the new discovery appeared in news publications around the world, focusing on the point obese patients have been making for years – that, like addiction to other substances, junk food binging is extremely difficult to stop.

The study goes significantly further than the abstract, however, demonstrating clearly that in rat models the development of obesity coincides with a progressively deteriorating chemical balance in reward brain circuitries. As these pleasure centers in the brain become less and less responsive, rats quickly develop compulsive overeating habits, consuming larger quantities of high-calorie, high-fat foods until they become obese. The very same changes occur in the brains of rats that overconsume cocaine or heroin, and are thought to play an important role in the development of compulsive drug use.

Kenny, a scientist at Scripps Research's Florida campus, said that the study, which took nearly three years to complete, confirms the "addictive" properties of junk food.

The new study, unlike our preliminary abstract, explains what happens in the brain of these animals when they have easy access to high-calorie, high-fat food," said Kenny. "It presents the most thorough and compelling evidence that drug addiction and obesity are based on the same underlying neurobiological mechanisms. In the study, the animals completely lost control over their eating behavior, the primary hallmark of addiction. They continued to overeat even when they anticipated receiving electric shocks, highlighting just how motivated they were to consume the palatable food."

The scientists fed the rats a diet modeled after the type that contributes to human obesity—easy-to-obtain high-calorie, high-fat foods like sausage, bacon, and cheesecake. Soon after the experiments began, the animals began to bulk up dramatically.

"They always went for the worst types of food," Kenny said, "and as a result, they took in twice the calories as the control rats. When we removed the junk food and tried to put them on a nutritious diet – what we called the 'salad bar option' – they simply refused to eat. The change in their diet preference was so great that they basically starved themselves for two weeks after they were cut off from junk food. It was the animals that showed the "crash" in brain reward circuitries that had the most profound shift in food preference to the palatable, unhealthy diet. These same rats were also those that kept on eating even when they anticipated being shocked."

Lethally Simple

What happens in addiction is lethally simple, Kenny explained. The reward pathways in the brain have been so overstimulated that the system basically turns on itself, adapting to the new reality of addiction, whether its cocaine or cupcakes.

"The body adapts remarkably well to change—and that's the problem," said Kenny. "When the animal overstimulates its brain pleasure centers with highly palatable food, the systems adapt by decreasing their activity. However, now the animal requires constant stimulation from palatable food to avoid entering a persistent state of negative reward".

After showing that obese rats had clear addiction-like food seeking behaviors, Johnson and Kenny next investigated the underlying molecular mechanisms that may explain these changes. They focused on a particular receptor in the brain known to play an important role in vulnerability to drug addiction and obesity—the dopamine D2 receptor. The D2 receptor responds to dopamine, a neurotransmitter that is released in the brain by pleasurable experiences like food or sex or drugs like cocaine. In cocaine abuse, for example, the drug alter the flow of dopamine by blocking its retrieval, flooding the brain and overstimulating the receptors, something that eventually leads to physical changes in the way the brain responds to the drug.

The new study shows that the same thing happens in junk food addiction.

"These findings confirm what we and many others have suspected," Kenny said, "that overconsumption of highly pleasurable food triggers addiction-like neuroadaptive responses in brain reward circuitries, driving the development of compulsive eating. Common mechanisms may therefore underlie obesity and drug addiction."

Consistent with common mechanisms explaining addiction and obesity, levels of the D2 dopamine receptors were significantly reduced in the brains of the obese animals, similar to previous reports of what happens in human drug addicts, Kenny noted. Remarkably, when the scientists knocked down the receptor using a specialized virus, the development of addiction-like eating was dramatically accelerated.

This addiction-like behavior happened almost from the moment we knocked down the dopamine receptors," Kenny noted. "The very next day after we provided access to the palatable food, their brains changed into a state that was consistent with an animal that had been overeating for several weeks. The animals also became compulsive in their eating behaviors almost immediately. These data are, as far as we know, the strongest support for the idea that overeating of palatable food can become habitual in the same manner and through the same mechanisms as consumption of drugs of abuse."

The study, "Addiction-Like Reward Dysfunction and Compulsive Eating in Obese Rats: Role for Dopamine D2 Receptors," was supported by a Bank of America Fellowship, The Margaret Q. Landenberger Research Foundation and the National Institutes of Health.

About The Scripps Research Institute

The Scripps Research Institute is one of the world's largest independent, non-profit biomedical research organizations, at the forefront of basic biomedical science that seeks to comprehend the most fundamental processes of life. Scripps Research is internationally recognized for its discoveries in immunology, molecular and cellular biology, chemistry, neurosciences, autoimmune, cardiovascular, and infectious diseases, and synthetic vaccine development. Established in its current configuration in 1961, it employs approximately 3,000 scientists, postdoctoral fellows, scientific and other technicians, doctoral degree graduate students, and administrative and technical support personnel. Scripps Research is headquartered in La Jolla, California. It also includes Scripps Florida, whose researchers focus on basic biomedical science, drug discovery, and technology development. Scripps Florida is located in Jupiter, Florida.

Keith McKeown
10550 North Torrey Pines Road
La Jolla, California 92037
Tel: 858.784.8134
Fax: 858.784.8118
kmckeown@scripps.edu

[admin]

Spanking sparks aggression, does little to reduce behavior problems

Apr. 1, 2010

ANN ARBOR, Mich.—Discipline—whether it's spanking, yelling or giving time-outs—may sometimes do little to reduce children's behavior problems, a new study indicates.

Researchers at the University of Michigan and five other universities looked at practices and perceptions of discipline in six countries. They found that spanking leads to more child aggression and anxiety, regardless of the country.

So what should parents do to teach children right from wrong?

"It may be that the long-term investments that we make in children, like spending time with them, showing that we love them and listening to them, have a more powerful positive effect on behavior than any form of discipline," said Andrew Grogan-Kaylor, U-M associate professor of social work.

The study, appearing in the March/April issue of the journal Child Development, examined the associations of mothers' discipline techniques with children's aggressive and anxious behaviors in China, India, Italy, Kenya, Thailand and the Philippines.

Unlike other studies, this project collected information from both mothers and their children. Participants included 292 mothers and their 8- to 12-year-old children.

Researchers used the sample to address two questions:

--When multiple discipline techniques are considered at the same time, which forms of discipline emerge as having the strongest associations with children's aggressive and anxious behaviors?

--Are significant associations between discipline practices and child behaviors moderated by the extent to which mothers and children perceive these practices to be normal in their communities?

The 11 discipline techniques analyzed included: teach about good and bad behavior; get child to apologize; give a time-out; take away privileges, spank; express disappointment; shame; yell/scold; withdraw love for misbehavior; threaten punishment; and promise a treat/privilege.

Mothers and children were asked about the frequency with which others in their communities used each discipline technique.

"When children perceive a discipline technique to be (normal) within their culture or community, they may be less likely to evaluate their parents' use of it as aberrant or objectionable," Grogan-Kaylor said.

The research, he said, showed that the relationship of some kinds of discipline with behavior problems varied according to how common that type of discipline was used in the community. However, despite small variations, there was a strong consistency in the results across countries.

The bottom line: giving a time-out, using corporal punishment, expressing disappointment and shaming were significantly related to greater child anxiety symptoms. Child aggression resulted from spanking, expressing disappointment and yelling.

Other researchers include lead author Elizabeth Gershoff, University of Texas; Jennifer Lansford and Kenneth Dodge, Duke University; Arnaldo Zelli, Istituto Universitario di Scienze Motorie; Lei Chang, Chinese University of Hong Kong; and Kirby Deater-Deckard, Virginia Polytechnic Institute and State University.
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Also of interest on this topic . . .
http://www.docstoc.com/docs/33317867/Open-Letter-to-Members-of-Parliament

[admin]

Spanking Out, Talking In: Most Parents Opt to Talk with Misbehaving Kids

4/16/2010
University of Michigan Health System

Nearly 9 in 10 parents choose to discuss and reason with their misbehaving children, while 1 in 5 use spanking, and 1 in 10 use paddling for discipline, the C.S. Mott Children’s Hospital National Poll on Children’s Health finds.


Misbehaving is part of growing up and learning right from wrong.
Parents’ choices of discipline for their kids today include a wide range of options, from verbal discussions to physical punishment.
But these days, how do parents let kids know they have stepped out of line?

In the latest C.S. Mott Children’s Hospital National Poll on Children’s Health, the three most common discipline strategies parents report they are very likely to use include:

- Explain or reason with the child – 88 percent
- Take away a privilege or something the child enjoys – 70 percent
- Put child in a time a out or grounding – 59 percent

“Results of this national study indicate that the vast majority of parents are choosing not to spank or paddle their kids,” says Matthew Davis, M.D., M.A.P.P., associate professor of pediatrics and communicable diseases in the CHEAR Unit at the U-M Medical School. “While physical discipline is an option for some parents, the majority of parents are opting for verbal ways to get their points across.”

“Especially in light of recent research that points out how spanking can have negative affects on children, it’s important to know that spanking and paddling are not the national norm among parents today,” Davis adds.
Results of this poll show that 22 percent of parents report that the they are very likely to spank their children, while 10 percent paddle their children. Parents of preschool children are more likely to spank than parents of older children.

Researchers also found differences in choices of discipline by region. Parents who live in the West (31 percent) and South (20 percent) are more likely to spank their children compared to parents in the Midwest (16 percent) and Northeast (6 percent).

“These regional differences are a reminder that parents’ choices of discipline are rooted in strong cultural traditions,” Davis says. “Even as national trends have shifted away from physical to verbal discipline, there are likely community cues and informal networks of parents and grandparents that influence how parents discipline their kids. These intergenerational factors can affect how discipline strategies change over time.”

To understand parents’ discipline strategies, the C.S. Mott Children’s Hospital National Poll on Children’s Health presented 1,532 parents from across the U.S. with a series of situations that they might face with their own children. Parents were asked to select from a list of discipline choices, and could indicate as many choices as they wished. Parents were asked to report how likely they were to use a given discipline strategy.

“We found lower rates of spanking than reported by some other researchers in the past,” says Davis, who is also associate professor of internal medicine and associate professor of public policy at the Gerald R. Ford School of Public Policy. “That is likely because we asked parents to answer questions about what they might do, rather than what they have actually done. Because spanking is more common at younger ages, it is likely that other studies that have asked parents about ever spanking their children would find higher rates.

“I think one of the most important results from this poll is that we learned that most parents consider more than one strategy when figuring out what discipline to use for their kids. Now, the research community needs to help parents understand what discipline strategies can be the most effective for children and parents, and in which situations,” he says.

Resources:

Full report (PDF):http://www.med.umich.edu/mott/npch/pdf/041510report.pdf

Survey questions (PDF): http://www.med.umich.edu/mott/npch/pdf/041510Questions.pdf

Figures (PDF): http://www.med.umich.edu/mott/npch/pdf/041510figures.pdf

Parenting Resources about discipline: http://www.webmd.com/parenting/discipline-tactics

Methodology: This report presents findings from a nationally representative household survey conducted exclusively by Knowledge Networks, Inc, for C.S. Mott Children’s Hospital via a method used in many published studies. The survey was administered January 1-18, 2010 to a randomly selected, stratified group of parents aged 18 and older (n=1,532) from the Knowledge Networks standing panel that closely resembles the U.S. population. The sample was subsequently weighted to reflect population figures from the Census Bureau. The survey completion rate was 71 percent among panel members contacted to participate.

To learn more about Knowledge Networks, visit www.knowledgenetworks.com.

Purpose/Funding: The C.S. Mott Children’s Hospital National Poll on Children’s Health – funded by the Department of Pediatrics and Communicable Diseases and part of the CHEAR Unit at the U-M Health System – is designed to measure major health care issues and trends for U.S. children and their families.

To learn more about the National Poll on Children’s Health, visit: www.med.umich.edu/mott/npch.

[admin]

Poorer people more likely to be obese . . .

UC Davis study links obesity with lowest earnings

May 10, 2010
(SACRAMENTO, Calif.) — A new UC Davis study has found that minimum-wage employees are more likely to be obese than those who earn higher wages, adding to growing evidence that being poor is a risk factor for unhealthy weight.

“Our study clarifies a link that has been assumed but difficult to prove,” said Paul Leigh, senior author of the study and professor in the UC Davis Center for Healthcare Policy and Research. “The correlation between obesity and poverty-level wages was very strong.”

Public-health scientists have identified several potential reasons why lower wages could support the tendency for obesity. One is that poorer people tend to live in less-safe neighborhoods with reduced access to parks and other low-cost means of physical activity. Healthy, lower-calorie foods also tend to be more expensive and less available in poorer communities. California’s Obesity Prevention Plan, for instance, notes that many low-income families have less access to healthier foods and often have to travel greater distances than others to find healthier food options at lower prices.

“The outcome leads us to believe that raising minimum wages could be part of the solution to the obesity epidemic. Doing so could increase purchasing power enough to expand access to healthier lifestyle choices,” Leigh said.

Published in the May issue of the Journal of Occupational and Environmental Medicine, the finding is the result of the novel use of a statistical technique known as instrumental variables, which is often used by economists and other social scientists to determine causal rather than coincidental relationships between, for instance, education and earnings.

“Instrumental variables gave us the chance to evaluate an independent factor that is definitely not caused by obesity — minimum wages,” said Leigh, who is an expert in health and labor economics. “After adjusting for inflation, minimum wages have been stagnant or falling over the past three decades, placing most full-time workers near the poverty line. It is also during those same three decades that we have seen the prevalence of obesity soar.”

In gathering data to assess through instrumental variables, the team started with the Panel Study of Income Dynamics. This longitudinal, representative sample of people in the United States includes information on height and weight, which were used to calculate body mass index (BMI), in addition to demographics and earnings. The researchers isolated data collected in 2003, 2005 and 2007 from 6,312 full-time workers in over 40 states who were 20-to-65 years of age and identified themselves as heads of households. State-established minimum-wage data for those same three years was obtained from the U.S. Department of Labor.

The results showed that people earning the lowest wages were more likely to have weights in the obese range, or BMIs of 30 or greater. People living in the southern United States – where state minimum-wage levels are among the lowest – were more likely to be obese than people in other regions.

Leigh noted that one limitation of the study is its sample. Those identifying themselves as household heads were 85 percent men and 90 percent Caucasian.

“Future research should address wage and obesity correlations among samples that include more African-Americans, Hispanics, Asians and women,” said Leigh. “Obesity is a complex problem that likely has multiple causes. The more we can pinpoint those causes for specific populations, the greater chances there are for reducing its impact.”

The study was supported in part by the National Institute for Occupational Safety and Health. Leigh co-authored the study with DaeHwan Kim, who recently obtained his doctorate in economics at UC Davis and is now a research fellow at the Korea Insurance Research Institutes in Seoul.

A copy of the "Estimating the Effects of Wages on Obesity" can be requested from the journal by e-mailing Marjory Spraycar at m.spraycar@verizon.net

About the UC Davis Center for Healthcare Policy and Research
The Center for Health Policy Research conducts research on health-care access, delivery, costs, outcomes and related health policy to improve the organization, quality and effectiveness of the practice of medicine, especially primary care. The center is a resource on comparative effectiveness research, and its faculty conducts original research, offers consulting services to public- and private-sector agencies and provides research training to fellows, graduate students and junior faculty. Established as an interdisciplinary unit, the center includes more than 80 health-care researchers who represent disciplines ranging from business management and psychiatry to preventive medicine and epidemiology. For more information, visit the center’s website

[admin]

Moderate alcohol consumption may represent a marker of higher social level, superior health status and lower cardiovascular disease (CV) risk. . .

European Journal of Clinical Nutrition , (19 May 2010)

Relationship between alcohol intake, health and social status and cardiovascular risk factors
in the urban Paris-Ile-De-France Cohort: is the cardioprotective action of alcohol a myth?

B Hansel, F Thomas, B Pannier, K Bean, A Kontush, M J Chapman, L Guize and E Bruckert
Abstract

Background/Objectives:

Observational studies document the inverse relationship between cardiovascular disease (CVD) and moderate alcohol intake. However, the causal role for alcohol in cardioprotection remains uncertain as such protection may be caused by confounders and misclassification. The aim of our study was to evaluate potential confounders, which may contribute to putative cardioprotection by alcohol.

Subjects/Methods:

We evaluated clinical and biological characteristics, including cardiovascular (CV) risk factors and health status, of 149 773 subjects undergoing examination at our Center for CVD Prevention (The Urban Paris-Ile-de-France Cohort). The subjects were divided into four groups according to alcohol consumption: never, low (less than or equal to10 g/day), moderate (10–30 g/day) and high (>30 g/day); former drinkers were analyzed as a separate group.

Results:

After adjustment for age, moderate male drinkers were more likely to display clinical and biological characteristics associated with lower CV risk, including low body mass index, heart rate, pulse pressure, fasting triglycerides, fasting glucose, stress and depression scores together with superior subjective health status, respiratory function, social status and physical activity. Moderate female drinkers equally displayed low waist circumference, blood pressure and fasting triglycerides and low-density lipoprotein-cholesterol. Alcohol intake was strongly associated with plasma high-density lipoprotein-cholesterol in both sexes. Multivariate analysis confirmed that moderate and low drinkers displayed better health status than did never drinkers. Importantly, few factors were causally related to alcohol intake.

Conclusions:

Moderate alcohol drinkers display a more favorable clinical and biological profile, consistent with lower CV risk as compared with nondrinkers and heavy drinkers. Therefore, moderate alcohol consumption may represent a marker of higher social level, superior health status and lower CV risk.

[admin]

Note from the editor of Turtle Island Native Network:
It is known that many First Nations and Aboriginal people are being treated for depression, anxiety disorders and those types of ailments
attributed in part to the abuse many have suffered in residential schools and foster care.

It is also known that prescription drug use by them is very high, so this latest research information is worth noting . . .

MAY 20, 2010

Long-term use of anti-anxiety drugs continues in B.C. despite known health risks: UBC study

Drugs to treat anxiety and sleep disorders are still being prescribed for extended periods to British Columbian patients – and increasingly so for baby boomers – despite warnings against long-term use, according to a University of British Columbia study.

Published online in the journal Health Policy, the study by researchers at UBC’s Centre for Health Services and Policy Research (CHSPR) is the first of its kind to examine the use of benzodiazepines such as Xanax and Ativan for an entire population over time. It’s also the first to pinpoint the socio-economic characteristics associated with long-term users of such drugs.

Results show that seniors and low-income earners are more likely to be long-term users of benzodiazepines, with rates remaining steady over a 10-year period. Meanwhile, use among the middle-aged population has increased. Harms associated with long-term use (more than 100 days in a year) can include dependence and tolerance, cognitive impairment, and increased risks of falls in the elderly.

"Given the potential for dependence and harms associated with these drugs, they are recommended to be used sparingly for short periods," says Colleen Cunningham, CHSPR researcher and lead author of the study. "However, our study suggests that a significant number of British Columbians – especially the elderly who suffer greater health risks from falls – are using them for long periods."

Benzodiazepines are one of the most commonly prescribed types of neurological drugs in developed countries. The UBC study compared health records of B.C. residents from 1996 and 2006. Of the 4.9 per cent of the overall B.C. population who were given short-term benzodiazepine prescriptions in 2006 and 3.5 per cent who were given long-term prescriptions:

• Nearly half of long-term users were over age 65, and more than a quarter were 75 or older
• Two out of three were women, both for short- and long-term use
Long-term users were more likely to be in the lowest income bracket than short-term or non-users

Cunningham and co-authors Gillian Hanley and Steve Morgan found long-term use in 2006 was associated with early use – half of all 2006 long-term users had been prescribed benzodiazepines in 1996. The researchers are calling for prescribing practices and policies that target populations younger than conventionally studied (i.e. under age 65) to reduce rates of long-term use.

This study was funded by the Canadian Institutes of Health Research.

The UBC Centre for Health Services and Policy Research (CHSPR) is part of the UBC School of Population and Public Health in the Faculty of Medicine. The Centre is committed to making lasting advances to population health and health services in Canada as leaders of independent, policy relevant research, graduate training and data resources. For more information, www.chspr.ubc.ca.

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[admin]

"A look into the future of Canadian health care by Canada’s top electronic health information strategist suggests physicians and patients alike should prepare for futuristic-sounding scenarios in which clinical care is increasing influenced by computerized decision-making of the sort first seen in the 1968 movie 2001: A Space Odyssey."

CMAJ News
May 20, 2010
New electronic health record blueprint to call for increased patient participation

In late April, Ron Parker, group director of solutions projects for Canada health Infoway Inc., previewed his new national electronic health record (EHR) blueprint before more than 200 EHR experts at a conference in Montréal, Quebec. The conference was organized by Infoway, a federal agency that has received $2.1 billion since 2001 to build a national health “infostructure.”

The blueprint, scheduled for publication in September, will be based on a vision in which computers will be used to “materially affect the behavior of the patient and the provider,” Parker said, while enabling patients to “actively participate in events affecting their health.”

In this “new world,” Parker enthused, “interoperable” computer systems capable of communicating with multiple health care facilities and jurisdictions that rely on computerized medical taxonomies will serve as “clinical support” mechanisms for physicians and other care providers.

“The implications of what we’re proposing are pretty significant administratively and from a clinical practice perspective,” says Parker, who is responsible for the strategic development and execution of federal electronic health information systems architecture, standards and security. Parker was the lead architect for Infoway’s current EHR solution blueprint, which was first outlined in 2003.

Patients, too, can expect changes of a very futuristic sort, Parker said. Canadian patients are “overwhelmingly unhappy” about “the lack of continuity, the lack of having a sense of what their course of treatment will be and what that path will look like, and what will come next and where will be the key decision points where certain things need to be determined,” Parker argues.

The blueprint he is now drafting envisions addressing these complaints by providing patients access to individualized personal health information, as well as by allowing patients to schedule appointments online and choose from lists of facilities available for some types of treatment.

After noting that people often do their own health care research online, Parker said that patients can become better informed than their physicians. “It’s a tough pill for the clinicians to swallow, because how can they possibly be aware of all of this emerging
information?” he asked. “This is one of the things that we are going to attempt to address in terms of improving the provider experience.”

He did not provide details on how this could be addressed. “The biggest thing that we are enabling in the future vision,” Parker said, “is the capacity for the participant in the system to be more aware and to be able to adapt behavior depending on the evidence.”

Parker said the new blueprint is being developed around the objectives of “enabling and improving patient access and participation. Enabling interprofessional collaboration. Enabling integrated service delivery and enabling information for decision support and better utilization of health care services and — not a small point — for quality improvement.”

Infoway previously revealed that patient self-management is part of its plans, along with automated “decision support” systems for physicians and care providers, in the document 2015: Advancing the Next Generation of Health
([url]www2.infoway-inforoute.ca/Documents/Vision_2015_Advancing_Canadas_next_generation_of_healthcare%5B1%5D.pdf[/url]).

But Parker offered a far more detailed picture of a brave new world for Canadian health care than has ever been publicly offered by Infoway.

In Parker’s account of the coming era, clinical information added to an EHR will pass through automated decision-support “rules” to guide physician and care-giver decisions. “For example,” he said. “I’m brokering an appointment and I declare that’s when the appointment’s going to be, and I confirm that, and that information flows up to the infostructure. We could have a business rule that looks at the interval between now and when we think that appointment is going to occur and says ‘sorry, for hip replacement, which is what this intervention is intended to be, that’s well outside our window.’”

Within this type of computer-assisted clinical decision-making process, says Parker, “best practice or whatever has been established — whether it’s regional or jurisdictional or by discipline — that asserts that, ‘You know what? You need to know the following things.’ And that content — it could be an alert, a notification — it could be, ‘You know what? Now is the time to fill out this assessment tool.’ It could be, ‘OK, now we’re in a chronic disease management pattern where we have multiple providers and now we need to coordinate a care plan.’”

“Lots of different kinds of content, can be pushed back down the appointment service” by computers, says Parker, to guide the decisions expected from physicians and caregivers. “What we’re talking about is elevating our capacity to be able to…provide appropriate contextually based responses back to the provider at the point of care or back to the patient.”

Parker notes that the degree of automated control over clinical decision-making could vary. “Trigger thresholds are defined and managed to different levels” within the new blueprint Infoway is drafting, says Parker, “by authoritative and assigned authors and requires a new type of governance.” To help ensure caregiver compliance with computer prompts, in Parker’s logic, “there needs to be a degree of shared governance.”

In forging the new standards for automated decision-making strategies, cautions Parker, care providers will need to be permitted to override some of these rules.
While the new blueprint from Infoway will recognize that physicians and other health care providers may not warm to the presence of a government-designed-and-
operated HAL in their clinics, Parker believes that “interactive behavior must be standardized.” He said he was shocked after joining Infoway “to realize just how poorly information technology was used in operations in terms of supporting the business of health care.”

The fix will require much stronger automation, he believes. “A system means you have feedback mechanisms. You have information flow. You have ways of knowing how things are happening. That allows the system to be adaptive. To self adjust. And that didn’t seem to be true for health care.”

But in Parker’s view, creating the new world order for Canadian health care is not principally a matter of developing new technologies. “It’s actually about behaviour, and it’s about everyone agreeing to adhere to a particular pattern,” he told participants at the Infoway conference. “That’s not small. That’s big.” — Paul Christopher Webster, Toronto, Ont.
CMAJ

[admin]

May 31, 2010 marks World No Tobacco Day (WNTD); an initiative of The World Health Organization.

This year, WNTD will "draw particular attention to the harmful effects of tobacco marketing towards women" and will emphasize "the importance of controlling the epidemic of tobacco" among this population." Women account for approximately 20 percent of the world's 1 billion smokers and 17.4 percent of adult women in the U.S. smoke.

Cigarette smoking kills more than 173,000 women in the United States each year. In addition to the risks both men and women face from smoking, women are at risk for a unique set of complications, including certain cancers and problems with fertility and pregnancy.

A cycle of addiction
Even with all these risks, many women continue to smoke cigarettes. This may be because cigarettes contain a very addictive chemical called nicotine.

"Nicotine is highly addictive, and smoking should be treated as a chronic, relapsing medical condition," explains Carol Southard, RN, MSN, and tobacco treatment specialist with the Northwestern Memorial Physicians Group at the Center for Integrative Medicine and Wellness.

"Seeing your health care provider is an important first step and can be a good source of support to discuss options to help you stop smoking. There are seven FDA approved medications to help people quit smoking. Medications constitute an important cessation intervention, and it is recommended that clinicians should encourage every patient willing to make a quit attempt to use medication and counseling treatments. By using some of the medications, you may be able to at least double your chance of quitting," adds Southard.

Overcoming the urge
When smokers try to quit, they may experience withdrawal symptoms that cause them to slip up and have a cigarette.

People trying to quit can:

* Work with a health care provider to set up and stick to a quit plan. Discuss the option of using tobacco dependence counseling and medication treatments, which may be more effective than either alone.

* Ask friends and family to help them stay away from cigarettes and "triggers" that make them want to smoke.

It's never too late to try quitting
At any stage of life, smokers can decrease their health risks by quitting. Also, women who quit smoking before becoming pregnant or trying to become pregnant can reduce the risk of infertility, miscarriage, low birth weight and infant heart defects.

One study that examined female nurses between the ages of 30 and 55 across the U.S. from 1976 to 2004 shows that quitting smoking is beneficial to a woman's health. Some examples from this study of the potential impact of quitting on a smoker's health include:

* 20 years after quitting smoking, a woman's overall risk of dying may decrease to the level of a nonsmoker.

*Within five years of quitting smoking compared with continuing to smoke, a woman's risk of dying may decrease by 13 percent.

* Within five years of quitting smoking compared with continuing to smoke, the excess risk of death from coronary heart disease decreases 62 percent; death from cerebrovascular disease (stroke) decreases 42 percent and death from lung cancer decreases 21 percent.

* Within 10 years of quitting smoking compared with continuing to smoke, the risk of dying of respiratory disease decreases by 18 percent.

To learn more about quitting smoking, visit www.mytimetoquit.com for resources including a useful checklist to make it easier to talk to a doctor about quitting.

This information is courtesy of Pfizer Inc.

[admin]

Quit-Tobacco Programs Effective in Dental Clinics, Study Finds

People who received an intervention – advice and assistance including nicotine patches or lozenges – were two to three times more likely to have quit smoking 7.5 months afterward than participants who received the usual care.

By Rebecca Ruiz-McGill, University Communications June 7, 2010

In the largest study of its kind, University of Arizona researcher Judith Gordon and her colleagues have proven the effectiveness of quit-tobacco interventions in public dental care settings serving low-income patients.

People who received an intervention – advice and assistance including nicotine patches or lozenges – were two to three times more likely to have quit smoking 7.5 months afterward than participants who received the usual care.

"The dental setting is different from a medical clinic in that physicians can't pull out a lung and show the patient the damage caused by smoking. The oral health team has a unique opportunity to show the immediate effects of smoking or tobacco use to their patients," said Gordon, an associate professor in the UA's department of family and community medicine.

"A dentist or dental hygienist can use something as simple as a hand mirror to show the patient what their tobacco use is doing to them right now," she said.

The study, the first to be conducted in public dental clinics, focused on people who are at increased risk for a variety of health problems because of high rates of smoking and reduced access to healthcare services.

More than 2,000 patients – all of whom were at or below 200 percent of the federal poverty threshold – were enrolled in the nationwide study from January 2006 through March 2008.

Funded by the National Institutes of Health National Cancer Institute, the study involved 14 federally funded community health center dental clinics in Mississippi, New York and Oregon that serve racially/ethnically diverse patients.

In randomly selected clinics, staff members were trained to provide interventions as recommended by the U.S. Public Health Service. The training included a 3-hour, in-service workshop on integrating and delivering a brief, tailored tobacco intervention including self-help materials, referral to a tobacco quit line, as well as training on the proper use of nicotine replacement therapy.

Patients who were treated in non-intervention clinics received the usual quit-tobacco protocol established within the clinics, which varied in approach to implementing the Public Health Service recommendations.

The intervention was done in the dental setting because dentists see their patients more frequently than physicians do.

"Over time, the dental team, especially the hygienist, develops a strong relationship with its patients. They spend more time with patients than a primary care provider can," Gordon said. "The dental team has multiple opportunities to educate, motivate and assist."

Published in the May issue of the American Journal of Public Health, the study assessed participants' quitting, reduction in tobacco use, number of quit attempts and change in readiness to quit.

"With empirical evidence of the success of this type of program, we have the potential to improve the health and well-being of millions of Americans," Gordon added. "These data can be used to advocate for routine treatment of tobacco dependence and adequate coverage for these types of interventions in dental settings."

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Quitting Smoking Before Pregnancy Could Save Babies' Lives
6/8/2010

If more women quit smoking before they became pregnant, it would save infant lives, concludes a new study from the Centers for Disease Control and Prevention (CDC).
Despite a decline over the past decade in the number of women who smoke during pregnancy, smoking is still a major cause of newborn deaths, early births and babies born with low birth weight.

“We know about half of women quit when they find out that they are pregnant, but a lot of women are still smoking during pregnancy,” said Patricia Dietz, DrPh, lead study investigator.

The study appears online and in the July issue of the American Journal of Preventive Medicine.

Dietz and co-investigators examined data from the US Linked Birth/Infant Death Data Set, which included all 3.3 million births of single babies that occurred in the United States (with the exception of California) during 2002. About 11.5 percent of babies, or 386,000, had mothers who smoked during pregnancy.

Researchers determined that prenatal smoking caused 5 percent to 8 percent of premature births and 13 percent to 19 percent of cases of low birth weight in babies carried to full term. Of infants who died, 5 percent to 7 percent of preterm-related deaths and 23 percent to 34 percent of deaths caused by sudden infant death syndrome (SIDS) might have been preventable if the mother had not smoked before pregnancy.

In addition, the researchers wrote that if all women quit smoking during pregnancy, it could cut health care costs by about $232 million every year — and improve overall health for both mothers and children.

“The percentage of SIDS deaths that might be avoided with smoking cessation is a significant number,” said Diane Ashton, M.D., deputy medical director of the March of Dimes. “For women who smoke and are considering pregnancy, we strongly recommend that they get preconception counseling for smoking cessation.”

Given these sobering statistics, why do some women continue to smoke during pregnancy?

“Studies have shown that these women may be dealing with a lot of stress, such as economic hardship, or they might be dealing with depression or other mental health issues,” Dietz said. “Most of them are living with other smokers that make it difficult to quit. They may be living in communities where it’s acceptable to smoke — where everyone is smoking. So it’s really complex.”

“This is an addiction,” Ashton said. “If pregnancy could cure addiction then none of these issues would be a problem. During pregnancy, women tend to be a little more highly motivated to address their addictions, but a lot of it depends on the level of readiness of the individual.”

Source: Health Behavior News Service
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Secondhand Smoke Associated With Psychiatric Distress, Illness
6/7/2010
Newswise — Exposure to secondhand smoke appears to be associated with psychological distress and the risk of future psychiatric hospitalization among healthy adults, according to a report posted online today that will appear in the August print issue of Archives of General Psychiatry, one of the JAMA/Archives journals.

“A growing body of literature has demonstrated the harmful physical health effects of secondhand smoke exposure,” the authors write as background information in the article. “Given the highly prevalent exposure to secondhand smoke—in the United States, an estimated 60 percent of American non-smokers had biological evidence of exposure to secondhand smoke—even a low level of risk may have a major public health impact.”

Mark Hamer, Ph.D., of University College London, and colleagues studied 5,560 non-smoking adults (average age 49. and 2,595 smokers (average age 44. who did not have a history of mental illness and participated in the Scottish Health Survey in 1998 or 2003. Participants were assessed with a questionnaire about psychological distress, and admissions to psychiatric hospitals were tracked over six years of follow-up. Exposure to secondhand smoke among non-smokers was assessed using saliva levels of cotinine—the main product formed when nicotine is broken down by the body—“a reliable and valid circulating biochemical marker of nicotine exposure,” the authors write.

A total of 14.5 percent of the participants reported psychological distress. Non-smokers with a high exposure to secondhand smoke (cotinine levels between 0.70 and 15 micrograms per liter) had higher odds of psychological distress when compared with those who had no detectable cotinine.

Over the six-year follow-up, 41 individuals were newly admitted to psychiatric hospitals. Smokers and non-smokers with high exposure to secondhand smoke were both more likely than non-smokers with low levels of secondhand smoke exposure to be hospitalized for depression, schizophrenia, delirium or other psychiatric conditions.

Animal data have suggested that tobacco may induce a negative mood, and some human studies have also identified a potential association between smoking and depression.

“Taken together, therefore, our data are consistent with other emerging evidence to suggest a causal role of nicotine exposure in mental health,” the authors write.

“To our knowledge, this is the first study to demonstrate a prospective association between objectively assessed secondhand smoke exposure and mental health in a representative sample of a general population,” they conclude.

(Arch Gen Psychiatry. 2010;67[8]:(doi:10.1001/archgenpsychiatry.2010.76). Available pre-embargo to the media at www.jamamedia.org.)
Source: American Medical Association (AMA)