In The News
Emerging research explores the function of sex among humans finding that sex is quite wonderful when the goal is to have children, but can also serve as a “glue” in a committed relationship.
Norwegian investigators explain that most animals have periods when they come into heat, and outside these periods they don’t find sex interesting at all. Humans, however, are constantly interested in sex. This sex interest can seem like a waste of energy, but an evolutionary perspective may explain why we function this way.
In a new study, investigators from the Norwegian University of Science and Technology (NTNU) and the University of New Mexico confirm that sex is important for pair-bonding between men and women in relationships. The researchers also found a correlation between the type of oral contraceptive women use and how often couples have sex.
The findings appear in the scientific journal Evolution & Human Behavior.
“The function of sex in humans outside ovulation is an evolutionary mystery. But we believe that it has to do with binding the parties in the relationship together,” says Leif Edward Ottesen Kennair, a professor of psychology at NTNU.
Kennair worked with Trond Viggo Grøntvedt, Nick Grebe and University of New Mexico Professor Steve Gangestad to ask hundreds of Norwegian heterosexual women about contraception, sex, and relationships.
Their results show that of women in long-term relationships and who are using hormonal contraception, those who are more committed to their relationships have more sex with partners, as one might expect.
“But this association was especially true when the contraceptive that women used had potent levels of synthetic hormones that mimic the effects of the natural hormone progesterone, and lower levels of the hormone estrogen,” Gangestad said.
“We’re talking about intercourse here, not other types of sex like oral sex, masturbation, and such. This strengthens the idea that sex outside the ovulation phase has a function besides just pleasure,” says Grøntvedt.
Researchers were surprised to discover that the hormonal composition of birth control pills influence desire for sex.
Hormonal contraceptives, like birth control pills, implantable rods, and patches, contain two types of hormones. Estrogen, which naturally peaks just before ovulation when naturally cycling women can conceive offspring, and hormones that have the same effect as progesterone, which naturally peaks during the extended sexual phase, a time when offspring cannot be conceived.
The levels of each hormone type vary in different contraceptives. Hence, some contraceptives mimic hormones that are more characteristic of ovulation, whereas others mimic hormones when women can’t conceive.
The women who used contraception with more estrogen were most sexually active when they were in a less committed relationship. On the other hand, women who used contraception with more progesterone were the most sexually active when they were faithful and loyal to their partners.
“Before we did this study, we didn’t know how much difference there was between the two types of hormonal contraceptives,” says Grøntvedt.
In the study, researchers surveyed two groups of women. All the women were using hormonal contraception and were in committed, heterosexual relationships. One group consisted of 112 women that researchers followed over a 12-week period. The women were asked how often and when in their cycle they had sex.
The second sample group consisted of 275 women in long-term relationships who used hormonal contraception. This group was not followed over time, but the researchers asked them how many times they had had sex in the past week.
This type of study — using data collected at a specific point in time — is called a cross-sectional study. Both groups were asked to indicate the type of contraception they were using, and if a pill, which brand it was.
“Since we examined these two groups using different methods — a snapshot for the one group and a longitudinal study for the other — we can be confident that the results provide a reliable overall picture,” says Dr Grøntvedt.
The basis for the NTNU study was a 2013 American study, where 50 women and their partners answered a series of questions about their relationships, menstrual cycles, and frequency of sex.
None of these women were using any kind of hormonal contraception, so only their natural hormones were involved. The study showed that women initiated sex more in the extended sexual phase — when they were not ovulating and progesterone was the dominant hormone — if they were invested in the relationship.
NTNU researchers wanted to verify the American results in their study, but with participants who were using a hormonal contraceptive that simulates a natural cycle. Their results were the same as in the US study, in which women were not using any hormonal birth control.
The researchers were thus able to show that how often women have sex is linked to how committed they feel towards their partner and the type of hormone they are governed by, whether natural or synthetic.
“A lot of social psychology studies that have led to cool discoveries through the ages have lost status, because it hasn’t been possible to copy them and verify the results. We are extremely pleased to have been able to verify the results of the study by Grebe and his colleagues, and we are equally pleased that we have also made new discoveries,” Kennair says.
Different types of relationships — whether friendship, long-term marriage, or a new intimate partnership — significantly influence the well-being and quality of life of older adults in assisted-living facilities, according to new research published in the journal The Gerontologist.
The study explored the benefits and downsides of a variety of relationships among married and unmarried couples in assisted living facilities. The findings reveal the complexity and range of later-life couples’ intimate and social lives.
Older adults typically move to assisted living because of declining health, shifting dependence patterns, and an inability or reluctance to stay in their former homes. While married couples are still a minority in assisted living facilities, they may become more common as the population ages.
Until now, there has been very little research exploring the complexity of later-life couples’ daily lives and experiences, particularly in the contexts of advanced age, health decline, and long-term care settings such as assisted living.
For the study, the researchers collected data for one year on 29 couples (26 married and three unmarried) in eight diverse assisted-living facilities in Georgia. The 26 married couples were in long-term relationships, while the three unmarried couples had met in the assisted living facility, which shows that intimate relationships can develop late in life and in assisted living.
“The nice thing about these communal settings is there are a lot of widowed, divorced, and never married people, and there is potentially opportunity to develop relationships,” said Dr. Candace Kemp, associate professor in the Gerontology Institute and Department of Sociology at Georgia State University.
“It makes a huge difference in the quality of life and the day-to-day life experience to have that intimate connection with somebody else. These were probably unexpected relationships for the unmarried couples, but very fulfilling relationships for those who manage to find a partner.”
The small number of couples in the study is due to high impairment levels and gender imbalance in assisted living.
Researchers found significant benefits in having late-life intimate partnerships including companionship, support, and affection. However, some of the downfalls included feeling the burden of caregiving, feeling defined by one’s spouse and having limited choices.
Other negatives of couplehood in assisted living included the potential for other partners, induced jealousy and marital infidelity. Unmarried couples, particularly women, were gossiped about, revealing the different cultural norms that still apply to older men and women and married and unmarried couples.
“I think doing work in this setting is important and it’s quite possible with people living longer that there will be more couples in these situations, whether they’re married or unmarried. We certainly know very little about unmarried couples in later life,” said Kemp.
“These are important relationships and to the extent that they can be supported have really significant implications for well-being and quality of life for older adults. In some cases, particularly with the married couples, these are marriages that are 60 and 70 years in the making, and to separate people and not facilitate them aging in place together can be problematic.”
For example, one person in the partnership might become ill while the other remains healthy. If a husband or wife suffers from cognitive impairment, the assisted-living facility might decide to move the ailing person to a dementia care unit and leave his or her spouse on the assisted-living side, which separates the couple, Kemp said.
Friendships were found to be of particular importance as well. While many assume couples have each other and don’t necessarily need other types of relationships, the frailty of participants in this study and the range of marital quality revealed that coupled residents could not always depend on their intimate partners for support.
In fact, fellow residents may step in to act as important confidantes, companions and friends to coupled residents in assisted living. Friends can also help buffer against negative health outcomes associated with marital transitions, such as when a spouse is ill or passes away.
The researchers suggest that strategies aimed at supporting couples in assisted living should focus on individual needs and shared needs as a couple, particularly as couples experience physical and cognitive decline over time.
“There are some scenarios, particularly if the caregiving spouse is doing so much work and worrying so much, that they can compromise their health by trying to do more than they’re able to do,” Kemp said. “I think it’s finding that balance between what’s best for both the individual and the couple and sometimes those are in conflict.”
Source: Georgia State University
New research suggests heavy alcohol use during adolescence alters the development of brain.
Investigators from the University of Eastern Finland and Kuopio University Hospital found cortical thinning in young people who had been heavy drinkers throughout their adolescence.
Researchers performed magnetic resonance imaging of the brain structure on young and healthy, but heavy-drinking adults who had been heavy drinkers throughout their adolescence. As a comparison, they also used MRI to study age-matched light-drinking participants.
Researchers performed three cross-sectional studies conducted over the course of ten years, in 2005, 2010 and 2015. The participants were 13 to 18 years old at the onset of the study.
All participants were academically successful, and the prevalence of mental health problems did not differ between the two groups. Although the heavy-drinking participants had used alcohol regularly for ten years, approximately six to nine ounces roughly once a week, none of them had a diagnosed alcohol use disorder.
Imaging results, however, revealed statistically significant differences between the groups. Among the heavy-drinking participants, grey matter volume was decreased in the parts of the brain known as the anterior cingulate cortex bilaterally as well as in the right insula.
“The maturation of the brain is still ongoing in adolescence, and especially the frontal areas and the cingulate cortex develop until the twenties. Our findings strongly indicate that heavy alcohol use may disrupt this maturation process,” says Ph.D. Student Noora Heikkinen, the first author of the study.
The effects of heavy teen alcohol consumption may not become evident until later in life. Researchers note that cingulate cortex has an important role in impulse control, and volumetric changes in this area may play an important role in the development of a substance use disorder later in life.
Structural changes in the insula, on the other hand, may reflect a reduced sensitivity to alcohol’s negative subjective effects, and in this way contribute to the development of a substance use disorder.
“The exact mechanism behind these structural changes is not known. However, it has been suggested that some of the volumetric changes may be reversible if alcohol consumption is reduced significantly. As risk limits of alcohol consumption have not been defined for adolescents, it would be important to screen and record adolescent substance use, and intervene if necessary.”
Source: University of Eastern Finland
It is a sad reality that being overweight or obese is prevalent among teens as well as adults. Currently, a third of the adolescent population in many developed countries are overweight or obese.
While it is well known that teen obesity can lead to a bevy of physical health issues, new research suggests problems with weight during adolescence, coupled with social economic status and physical development, can also impact mental health during adulthood.
To shed light on this issue, scientists at the Hebrew University-Hadassah Braun School of Public Health and Community Medicine set out to determine the association between cumulative life course burden of high-ranked body mass index (BMI), and cognitive function in midlife.
The research, which will appear in the Journal of Alzheimer’s Disease 55(3), was led by Prof. Jeremy Kark from the Braun School, in the Hebrew University of Jerusalem’s Faculty of Medicine, working with colleagues in Israel and the United States.
Investigators used weight and height data from 507 individuals tracked from over 33 years starting at age 17. The participants completed a computerized cognitive assessment at ages 48-52, and their socioeconomic position was assessed by multiple methods.
Using mixed models (quantitative and qualitative research) the researchers calculated the life-course burden of BMI from age 17 to midlife. They then used statistical methods to assess associations of BMI and height with global cognition and its component domains.
“In this population-based study of a Jerusalem cohort, followed longitudinally from adolescence for over 33 years, we found that higher BMI in late adolescence and the long-term cumulative burden of BMI predicted poorer cognitive function later in life.
“Importantly, this study shows that an impact of obesity on cognitive function in midlife may already begin in adolescence, independently of changes in BMI over the adult life course,” said the paper’s senior author, Prof. Jeremy Kark of the Hebrew University-Hadassah Braun School of Public Health and Community Medicine.
The effect of obesity on cognitive decline in adulthood was also associated with physical development.
“Our results also show that taller stature was associated with better global cognitive function, independent of childhood and adult socioeconomic position, and that height increase in late adolescence, reflecting late growth, conferred a protective effect, but among women only,” added Irit Cohen-Manheim, doctoral candidate at the Braun School and lead author.
Moreover, the researchers point out that while socioeconomic position may have a particularly important role in the trajectory of a person’s lifetime cognitive function, it has rarely been adequately taken into account.
“To the best of our knowledge, the association between BMI and cognition as a function of childhood and adult socioeconomic position has not been previously reported. Childhood household socioeconomic position appears to strongly modify the association between adolescent BMI and poorer cognition in midlife, the inverse association being restricted to low childhood socioeconomic position,” said Prof. Kark.
“Our results are consistent with the hypothesis that childhood living conditions, as reflected also by height, infuence cognitive function later in life. However, our study is unique in showing that an adverse association of higher BMI with cognitive function appears to begin in adolescence and that it appears to be restricted to adults with lower childhood socioeconomic position,” said Prof. Kark.
“Evidence for the association between impaired cognitive function in midlife and subsequent dementia supports the clinical relevance of our results. Findings of the relation of BMI in adolescence with poorer midlife cognitive status, particularly in light of the ongoing epidemic of childhood obesity, require confirmation,” said Irit Cohen-Manheim.
New research finds that the way your teen perceives your parenting tactics, makes a big difference in whether they will comply or rebel with your admonitions.
Researchers at the University of California, Riverside (UCR), found that when teens viewed their parents’ parenting tactics more negatively that parents did, they showed elevated levels of aggressive behaviors.
“Most, if not all, parents agree that they and their teenage children hold different views about how parenting is going at home,” explains Misaki Natsuaki, a psychology professor at UCR.
“In some cases, teens perceive parenting to be harsher than how their parents intend to — in other cases, teens perceive parenting to be more lenient than how parents intend to. With this study, it’s become clear that both the teens’ and parents’ views of how parents manage their teens’ difficult behaviors were uniquely important in predicting teenage problem behaviors.”
The study, authored by Natsuaki and graduate student Laura Dimler, is called “Parenting Effects are in the Eye of the Beholder: Parent-Adolescent Differences in Perceptions Affects Adolescent Problem Behaviors. The work appears in the Journal of Youth and Adolescence.
Investigators focused on how parents manage their teenagers’ challenging behaviors (e.g., anger) and examined teen-parent discrepancies in views about those behaviors. Using data from 220 families, the researchers found that, when teens viewed parenting more negatively than parents did, they showed more elevated levels of problem behaviors, such as aggression.
“This effect of teen-parent discrepancies in perceptions of parenting behaviors was above and beyond how negatively the adolescent and parent each felt about the parenting,” Natsuaki said.
“Therefore, nuanced characteristics of the family, such as who holds more negative views than whom and how much the differences in views exists within the relationship, contribute to teens’ problem behaviors.”
The study also highlights the importance of adolescents’ evaluation on how mothers and fathers handle their difficult behaviors.
Mother’s perception of her response to her teenager’s anger was significantly correlated with externalizing behavior, but not with aggressive behaviors. Father’s perception of his response to his teenager’s anger was significantly correlated with externalizing behaviors and with aggressive behaviors.
“Fathers are relatively understudied compared to mothers, but our findings show that the father-teen relationship is a unique one, and has the potential to exacerbate or hinder the teens’ problem behavior, including aggressive behavior,” Natsuaki said.
New research has discovered that a damaging chemical imbalance in the brain may contribute to schizophrenia.
Using a new kind of MRI measurement, neuroscientists reported higher levels of oxidative stress in patients with schizophrenia, when compared both to healthy individuals and those with bipolar disorder.
“Intensive energy demands on brain cells leads to accumulation of highly reactive oxygen species, such as free radicals and hydrogen peroxide,” said the study’s lead investigator, Dr. Fei Du, an assistant professor of psychiatry at Harvard Medical School.
In schizophrenia, excessive oxidation, which involves the same type of chemical reaction that causes metal to corrode into rust, is widely thought to cause inflammation and cellular damage. However, measuring this process in the living human brain has been a challenge.
Du and his colleagues at McLean Hospital measured oxidative stress using a novel magnetic resonance spectroscopy technique. This technique uses MRI scanners to non-invasively measure brain concentrations of two molecules, NAD+ and NADH, that give a readout of how well the brain is able to buffer out excessive oxidants.
Among 21 patients with chronic schizophrenia, Du observed a 53 percent elevation in NADH compared to healthy individuals of similar age.
A similar degree of NADH elevation was seen in newly diagnosed schizophrenia, suggesting that oxidation imbalance is present even in the early stages of illness, according to the researchers.
More modest NADH increases were also seen in bipolar disorder, which shares some genetic and clinical overlap with schizophrenia.
In addition to offering new insights into the biology of schizophrenia, this finding also provides a potential way to test the effectiveness of new interventions, according to Du.
“We hope this work will lead to new strategies to protect the brain from oxidative stress and improve brain function in schizophrenia,” he said.
The research was presented at the 2016 American College of Neuropsychopharmacology Annual Meeting in Hollywood, Florida.
The link between gut bacteria and mood and anxiety received strong scientific support during a series of presentations at the recent meeting of the American College of Neuropsychopharmacology.
“Current state-of-the-art research in both animal models as well as humans point to the link between the gut microbiota and mood and anxiety models, as well as the potential for psychiatric medications to directly affect the gut microbiome,” said Dr. Vicki Ellingrod, chair of this session.
The gut-mood connection was most profoundly demonstrated during a study in which researchers measured the microorganism changes in rats’ gastrointestinal systems as the rats were subjected to chronic stress for seven weeks. Not only did the number of microorganisms decrease as stress became more chronic, behavioral changes suggested that the rats also began experiencing loss of pleasure and “despair-like” behavior.
When these microorganisms were transferred from the stressed rats to a new group of animals that had not been stressed, Dr. Emily Jutkiewicz found that these new animals also began to exhibit these same despondent behaviors after five days, suggesting that a change in gut bacteria may directly cause mood and behavior changes.
Furthermore, a series of human studies explored the treatment implications of the gut-mood link. The researchers found similar reductions in the microbiome in participants suffering from both major depression and bipolar disorder. These changes were linked to greater levels of anxiety and sleep problems as well as increased reports of general health problems.
“The data support the hypothesis that targeting the microbiome may be an effective treatment paradigm for bipolar disorder,” said Dr. Simon Evans.
Researchers also discussed the role of medications during the final two presentations. By studying individuals over time, Dr. Chadi Calarge was able to examine microbiome changes when individuals were depressed or in remission, and when they were and were not receiving anti-depressant medications (SSRIs).
While no changes in gut bacterial diversity were observed in patients with depression, the researchers did find species-level differences. Furthermore, starting SSRI treatment was associated with an increase in the production of indoles, suggesting changes in tryptophanase-producing bacteria.
New evidence also indicates the presence of increased intestinal permeability in depression, potentially leading to increased bacterial translocation.
Finally, one of the troubling side effects of atypical antipsychotic (AAP) medication is how it changes the body’s ability to metabolize energy, often resulting in weight gain. Dr. Stephanie Flowers demonstrated how female bipolar patients who gained weight with AAP treatment had a greater reduction in microbiome diversity than did female bipolar patients who were being treated with the same medications but did not gain weight.
This finding suggests that the health of our gut may also put us at increased risk for certain medication side effects, she said.
Abstract summaries of this research are published in the journal Neuropsychopharmacology.
Two decades of research into false memories, that is, “remembering” events that never actually happened, have established such vagaries of memory as a widespread phenomenon. Now, a new “mega-analysis” from the University of Warwick in England involving eight peer-reviewed studies finds that nearly half of participants believed, to some degree, a completely fictitious event from their lives.
Study leader Dr. Kimberley Wade from the Department of Psychology and colleagues found that it can be very difficult to determine when a person is recollecting actual past events, or if they are recalling false memories, even in a controlled research environment, and more so in real life situations.
These findings carry significant implications in many areas, raising questions around the authenticity of memories used in forensic investigations, courtrooms, and therapy treatments.
In addition, the collective memories of a large group of people or society could be incorrect due to misinformation in the news, for example, and have a striking effect on people’s perceptions and behavior.
“We know that many factors affect the creation of false beliefs and memories — such as asking a person to repeatedly imagine a fake event or to view photos to “jog” their memory. But we don’t fully understand how all these factors interact. Large-scale studies like our mega-analysis move us a little bit closer,” said Wade.
“The finding that a large portion of people are prone to developing false beliefs is important. We know from other research that distorted beliefs can influence people’s behaviors, intentions and attitudes.”
The eight “memory implantation” studies involved 400 participants who were given fictitious autobiographical events about their lives. Participants in these studies said they recalled a range of false events, such as taking a childhood hot air balloon ride, playing a prank on a teacher, or creating havoc at a family wedding.
A total of 30 percent of the participants appeared to “remember” the event in that they accepted the suggested event as fact, even going as far as to elaborate on how the event occurred and to describe images of what the event was like. Another 23 percent of the subjects showed signs that they accepted the suggested event to some degree and believed it really happened.
Scientists have been using variations of this procedure for 20 years to study how people create false memories.
Wade and colleagues also stated that their mega-analysis can systematically combine data that are not amenable to meta-analysis, and provided the most valid estimate of false memory formation, and moderating factors, within the research literature on implantation.
Source: University of Warwick
A new study has found that the long-term threat of losing their jobs leads to heightened levels of fear and distress in older workers.
Unlike previous studies that tracked workers for just a few years, the new study tracked the same workers for 25 years.
“Our data give us the unique opportunity to examine…how the persistence of job insecurity is related to greater psychological distress in later life,” said Dr. Sarah Burgard, an associate professor of sociology and research associate professor at the Institute for Social Research at the University of Michigan.
Burgard, the study’s lead author, and researcher Sarah Seelye said persistent job insecurity that extends over a 25-year career — and the chronic employment stress associated with it — is a reality for many Americans.
Researchers used data from the Americans’ Changing Lives study, in which nearly 435 people completed five surveys from 1989 to 2011 about how they felt during the past week and any concerns about job security. Respondents were interviewed before and after the Great Recession (December 2007 to June 2009) to capture their perceptions of their job standing in the wake of that massive downturn.
The findings indicate stress from perceived job insecurity was high among minorities and those without a high school diploma.
In addition, older workers may experience distress due to their circumstances. Burgard said age discrimination or an employer’s perception that health problems could become more prevalent later in life could endanger older workers’ ability to keep a job.
When researchers adjusted the findings based on age, race, and educational attainment, they found that health changed significantly more for those who were persistently concerned about job loss.
Employers can do several things to help workers stay healthy even if job threats loom, according to the researchers.
“It is important to keep people informed about what’s going on,” said Seelye, a doctoral student in sociology. “Not knowing whether a pink slip may be coming or not is very stressful.”
Providing information about impending layoffs or office relocations, for instance, rather than letting rumors circulate, allows workers to think about a response and do some advance planning, researchers said.
Burgard also suggested that policymakers and employers think about the health care costs and productivity losses that could occur in a workforce composed of many insecure employees, especially during and following economic downturns.
“Those who face the worst burden are those who have faced uncertainty the longest, and it is important to think about the costs of restructuring a labor force and social supports in ways that create such vulnerable workers,” she said.
The study was published in Society and Mental Health.
Source: University of Michigan
People with Parkinson’s disease and cognitive impairment have disruptions in their brain networks that can be seen on a specific type of MRI, according to a new study.
Parkinson’s disease (PD) is a progressive disorder of the central nervous system characterized by tremors or trembling and stiffness in the limbs, impaired balance, and coordination. It affects about 10 million people worldwide.
As the disease progresses, many patients develop mild cognitive impairment (MCI), a decline in cognitive abilities, including thinking, memory, and language. MCI can be identified in approximately 25 percent of newly diagnosed PD patients, and patients with MCI progress to dementia more frequently than those with normal cognitive performance.
For the new study, lead investigator Massimo Filippi, M.D., from the Neuroimaging Research Unit at San Raffaele Scientific Institute in Milan, Italy, coauthors Federica Agosta, M.D., Ph.D., and Sebastiano Galantucci, M.D., and other colleagues used an MRI technique called diffusion tractography to look for differences in the neural networks of PD patients with and without MCI.
Increasingly, the human brain is understood as an integrated network, or connectome, that has both a structural and functional component, the researchers noted. By applying an analytical tool called graph analysis to the imaging results, researchers can measure the relationships among highly connected and complex data like the network of connections in the human brain.
“Cognitive impairment in PD is one of the major non-motor complications of the disease, as well as one of the major concerns of patients and caregivers at the time of diagnosis,” Agosta said. “Study of the changes related to cognitive impairment in PD is imperative in order to be able to answer patients’ questions and finally be able to predict the future development of this condition.”
The study group was made up of 170 PD patients, including 54 with MCI and 116 without, and 41 healthy controls.
Analysis of imaging results showed that only PD patients with MCI had significant alterations at the brain network level. Measurements of the movement and diffusion of water in the brain, an indicator of the condition of the brain’s signal-carrying white matter, differentiated PD patients with MCI from healthy controls and non-MCI PD patients with a good accuracy, according to the study’s findings.
According to researchers, the results show that cognitive impairment in PD is likely the consequence of a disruption of complex structural brain networks rather than degeneration of individual white matter bundles.
The results may offer markers to differentiate PD patients with and without cognitive deficits, Agosta said.
“If confirmed and replicated by other studies, these results would suggest the use of MRI in PD to support the clinicians in monitoring the disease and predicting the occurrence of cognitive complications,” she said.
The study appeared in the journal Radiology.
Drivers who miss one to two hours of the recommended seven hours of sleep in a 24-hour period nearly double their risk for a crash, according to new research from the AAA Foundation for Traffic Safety.
According to the Centers for Disease Control and Prevention, 35 percent of U.S. drivers sleep less than the recommended seven hours daily.
With drowsy driving involved in more than one in five fatal crashes on U.S. roads each year, AAA officials warn drivers that getting less than seven hours of sleep may have deadly consequences.
“You cannot miss sleep and still expect to be able to safely function behind the wheel,” said Dr. David Yang, executive director for the AAA Foundation for Traffic Safety. “Our new research shows that a driver who has slept for less than five hours has a crash risk comparable to someone driving drunk.”
The report reveals that drivers missing two to three hours of sleep in a 24-hour period more than quadrupled their risk of a crash compared to drivers getting the recommended seven hours of sleep. This is the same crash risk the National Highway Traffic Safety Administration associates with driving over the legal limit for alcohol, according to AAA officials.
The report found that in a 24-hour period, crash risk for sleep-deprived drivers increased steadily when compared to drivers who slept the recommended seven hours or more:
- six to seven hours of sleep: 1.3 times the crash risk;
- five to six hours of sleep: 1.9 times the crash risk;
- four to five hours of sleep: 4.3 times the crash risk;
- less than four hours of sleep: 11.5 times the crash risk.
The report is based on the analysis of a representative sample of 7,234 drivers involved in 4,571 crashes. All data is from the NHTSA’s National Motor Vehicle Crash Causation Survey, which comprised a representative sample of police-reported crashes that involved at least one vehicle that was towed from the scene and resulted in emergency medical services being dispatched to the scene.
While 97 percent of drivers told the AAA Foundation they view drowsy driving as a completely unacceptable behavior that is a serious threat to their safety, nearly one in three admit that at least once in the past month they drove when they were so tired they had a hard time keeping their eyes open.
“Managing a healthy work-life balance can be difficult and far too often we sacrifice our sleep as a result,” said Jake Nelson, director of Traffic Safety Advocacy and Research for AAA. “Failing to maintain a healthy sleep schedule could mean putting yourself or others on the road at risk.”
Symptoms of drowsy driving include having trouble keeping eyes open, drifting from lanes, or not remembering the last few miles driven. However, more than half of drivers involved in fatigue-related crashes experienced no symptoms before falling asleep behind the wheel, according to AAA officials.
AAA urges drivers to not rely on their bodies to provide warning signs of fatigue and should instead prioritize getting plenty of sleep — at least seven hours — in their daily schedules.
For longer trips, drivers should also:
- travel at times when normally awake;
- schedule a break every two hours or every 100 miles;
- avoid heavy foods;
- travel with an alert passenger and take turns driving; and
- avoid medications that cause drowsiness or other impairment.
Video: Drivers who miss between one to two hours of the recommended seven hours of sleep in a 24-hour period nearly double their risk for a crash, according to new research from the AAA Foundation for Traffic Safety. Credit: AAA Foundation for Traffic Safety.
Unemployment appears to play a role in the risk for nonmedical use of prescription opioids and stimulants, according to a new study at Columbia University’s Mailman School of Public Health. The findings show that unemployed workers are at the highest risk for misusing prescription opioids, and those out of the workforce entirely are most at risk for misusing prescription stimulants.
The study, published in the journal Social Psychiatry and Psychiatric Epidemiology, is among the first to investigate the link between employment status and nonmedical prescription drug-users over the age of 25 and show how social characteristics influence nonmedical prescription drug use.
For the study, the researchers sampled 58,486 adults 25 years and older based on combined data from 2011 to 2013 from the National Survey on Drug Use and Health.
People who were currently unemployed reported the highest risk of prescription opioid misuse at seven percent. Those out of the workforce reported the highest odds of misusing prescription stimulants at two percent. Overall, there were more users of nonmedical prescription opioids (3.5 percent) compared with nonmedical users of prescription stimulants (.72 percent).
Nonmedical prescription opioid use is defined as any self-reported use of prescription pain relievers that were not prescribed or are taken for the experience or sensation they impart.
“Our results confirm the need for adult prevention and deterrence programs that target nonmedical prescription drug use, especially among those unemployed or not in the workforce,” said senior author Silvia Martins, M.D., Ph.D., associate professor at the Mailman School and epidemiologist.
Of greatest concern are unemployed adults between the ages of 26-34, since the risk for nonmedical prescription opioid use is higher in this age group compared to older adults. The findings also showed higher odds of prescription stimulant misuse among those only employed part-time compared with persons employed full time.
“Our findings on these associations between employment status and nonmedical prescription drug use parallel other research about emerging adulthood and taking on new social roles, such as marriage and parenthood,” said Martins.
The observation that unemployment is linked to a variety of diseases, including mental disorders, is of utmost importance to those instituting policies regulating control of nonmedical prescription drugs.
“Physicians, in particular, should be aware of patients’ employment status and the elevated risk between unemployment and non-medical drug use and drug and mental disorders prior to prescribing,” said Martins.
The connection between employment status and the misuse of opioids and stimulants also has important public health implications. Furthermore, having sensitivity to non-full-time employed people — a population that the data suggests experiences greater social disadvantage — is vital, according to Martins.
“By improving our understanding of these associations and the role of employment in drug use behaviors and modes of access, drug prevention, and deterrence programs can target users more effectively, especially when combined with regulation,” said Martins.
“Non-full-time employed people may suffer disproportionately from the indirect harms of nonmedical use of prescription opioids and stimulants insomuch that they have less family-, neighborhood-, and community-level social ties that would help mitigate harms related to misuse.”
“With substance use disorders increasingly recognized as a public health issue — and not one of criminal justice — withholding social support, including treatment, from those with the highest need will contribute to increasing social inequalities.”
Would you rather receive a vacuum cleaner or a pair of theater tickets this holiday? Which would you rather give? As we enter the season of gift-giving, a new study finds that gift givers and gift receivers tend to focus on different outcomes, often resulting in disappointment.
The findings show that gift givers tend to focus on the moment of exchange when selecting a gift, often hoping for that look of excitement on the recipient’s face, whereas gift receivers are more focused on the long-term use or practical attributes of the gift.
“We studied many existing frameworks from research in this area, trying to find a common ground between them. What we found was that the giver wants to ‘wow’ the recipient and give a gift that can be enjoyed immediately, in the moment, while the recipient is more interested in a gift that provides value over time,” said study leader Jeff Galak, Ph.D., at Carnegie Mellon University Tepper School of Business.
“We are seeing a mismatch between the thought processes and motivations of gift givers and recipients. Put another way, there may be times when the vacuum cleaner, a gift that is unlikely to wow most recipients when they open it on Christmas day, really ought to be at the top of the shopping list as it will be well used and liked for a long time.”
Galak conducted the study with co-authors Dr. Elanor Williams at Indiana University Kelley School of Business and Ph.D. student Julian Givi at Tepper School.
The researchers found that this differential focus on the moment of exchange and the desirability of the gift showed up in a number of different ways. For example, one common gift-giving error was giving unrequested gifts in an effort to surprise the recipient, when they are likely hoping for a gift from a pre-constructed list or registry.
Another potential error may occur when the giver is focused on tangible, material gifts, such as a new pair of shoes, when experiential gifts, such as theater tickets or a massage, would result in more enjoyment later on. Or vice versa, depending on the person.
Finally, giving socially responsible gifts, such as donations to a charity in the recipient’s name, may seem special at the moment of gift exchange but will provide almost no value to recipients down the road.
The researchers make recommendations for those hoping to choose better gifts, advising them to better empathize with gift recipients when thinking about gifts that would be both appreciated and useful.
“We exchange gifts with the people we care about, in part, in an effort to make them happy and strengthen our relationships with them,” Galak added. “By considering how valuable gifts might be over the course of the recipient’s ownership of them, rather than how much of a smile it might put on recipients’ faces when they are opened, we can meet these goals and provide useful, well-received gifts.”
The findings are published in the journal Current Directions in Psychological Science.
As many will attest, the hard work and discipline accompanying a diet and weight loss may be quickly wiped out by a weight rebound. For obese people, the dilemma can be health threatening.
The phenomenon is known as “recurrent” or “yo-yo” obesity and for obese people, a vast majority of individuals not only rebound to their pre-dieting weight, but also gain more weight with each dieting cycle.
During each round of dieting-and-weight-regain, their proportion of body fat increases, and so does the risk of developing the manifestations of metabolic syndrome, including adult-onset diabetes, fatty liver, and other obesity-related diseases.
In a new study, researchers at the Weizmann Institute of Science have shown in mice that intestinal microbes — collectively termed the gut micro biome — play an unexpectedly important role in exacerbated post-dieting weight gain.
Investigators believe this common phenomenon may in the future be prevented or treated by altering the composition or function of the microbiome. The study appears in Nature.
Dr. Eran Elinav of the Immunology Department and Prof. Eran Segal of the Computer Science and Applied Mathematics Department led the research team. The investigators found that after a cycle of gaining and losing weight, all the mice’s body systems fully reverted to normal — except the microbiome. For about six months after losing weight, post-obese mice retained an abnormal “obese” microbiome.
“We’ve shown in obese mice that following successful dieting and weight loss, the microbiome retains a ‘memory’ of previous obesity,” says Elinav.
“This persistent microbiome accelerated the regaining of weight when the mice were put back on a high-calorie diet or ate regular food in excessive amounts.” Segal elaborates, “By conducting a detailed functional analysis of the microbiome, we’ve developed potential therapeutic approaches to alleviating its impact on weight regain.”
In a series of experiments, the scientists demonstrated that the makeup of the “obese” microbiome was a major driver of accelerated post-dieting weight gain. For example, when the researchers depleted the intestinal microbes in mice by giving them broad-spectrum antibiotics, the exaggerated post-diet weight gain was eliminated.
In another experiment, when intestinal microbes from mice with a history of obesity were introduced into germ-free mice (which, by definition, carry no microbiome of their own), their weight gain was accelerated upon feeding with a high-calorie diet, compared to germ-free mice that had received an implant of intestinal microbes from mice with no history of weight gain.
Next, the scientists developed a machine-learning algorithm, based on hundreds of individualized microbiome parameters, which successfully and accurately predicted the rate of weight regain in each mouse, based on the characteristics of its microbiome after weight gain and successful dieting.
The combination of genomic and metabolic approaches helped scientists identify two molecules driving the impact of the microbiome on regaining weight. These molecules — belonging to the class of organic chemicals called flavonoids that are obtained through eating certain vegetables — are rapidly degraded by the “post-dieting” microbiome.
The rapid reduction causes the levels of these molecules in post-dieting mice to be significantly lower than those in mice with no history of obesity.
The researchers found that under normal circumstances, these two flavonoids promote energy expenditure during fat metabolism. Low levels of these flavonoids in weight cycling prevented this fat-derived energy release, causing the post-dieting mice to accumulate extra fat when they were returned to a high-calorie diet.
Finally, the researchers used these insights to develop new proof-of-concept treatments for recurrent obesity.
First, they implanted formerly obese mice with gut microbes from mice that had never been obese. This fecal microbiome transplantation erased the “memory” of obesity in these mice when they were re-exposed to a high-calorie diet, preventing excessive recurrent obesity.
Next, the scientists used an approach that is likely to be more unobjectionable to humans: They supplemented post-dieting mice with flavonoids added to their drinking water.
This brought their flavonoid levels, and thus their energy expenditure, back to normal levels. As a result, even on return to a high-calorie diet, the mice did not experience accelerated weight gain.
Segal said, “We call this approach ‘post-biotic’ intervention. In contrast to probiotics, which introduce helpful microbes into the intestines, we are not introducing the microbes themselves but substances affected by the microbiome, which might prove to be more safe and effective.”
Recurrent obesity is an epidemic of massive proportions, in every meaning of the word. “Obesity affects nearly half of the world’s adult population, and predisposes people to common life-risking complications such as adult-onset diabetes and heart disease,” says Elinav.
“If the results of our mouse studies are found to be applicable to humans, they may help diagnose and treat recurrent obesity, and this, in turn, may help alleviate the obesity epidemic.”
Source: Weizmann Institute of Science
A new UK study finds that creative achievement can provide a buffer against being anxious about death.
Psychologists at the University of Kent discovered that those with high levels of creative ambition and achievement are particularly likely to be more resilient to death concerns.
Creative people, such as newly-announced Nobel Prize for Literature winner Bob Dylan, are often thought to be motivated by the desire to leave an enduring cultural legacy.
Through their creative work, creatives such as Leonard Cohen and David Bowie continue to live on in our culture even after passing away.
Conversely, the destruction of ancient monuments and artifacts in Iraq in 2015 by members of Islamic State could be interpreted as a symbolic act aimed at achieving high negative impact on society through the destruction of a cultural legacy.
In the new study, Rotem Perach, a postgraduate researcher under the supervision of Dr. Arnaud Wisman, performed what is thought to be the first empirical study of the anxiety-buffering functions of creativity.
Investigators studied 108 students for whom creativity constitutes a central part of their cultural worldview. Participants completed two questionnaires to gauge their level of creative achievement and creative ambition.
Those with a record of creative achievement, coupled to high levels of creative ambition, were found to make less death associations in their thought processes after thinking about their own demise in comparison to those in the control condition.
In comparison, among those with low levels of creative ambition — whatever their record of creative achievement — thinking about their own mortality did not affect their levels of death-thought accessibility in comparison to controls.
The findings suggest that those who pursue creativity and produce significant creative contributions may benefit from existential security in the face of death.
The paper, entitled “Can Creativity Beat Death? A Review and Evidence on the Existential Anxiety Buffering Functions of Creative Achievement”, is published in the Journal of Creative Behavior.
Source: University of Kent
Women with dementia make fewer visits to the doctor, receive less health monitoring, and take more potentially harmful drugs than their male counterparts, according to a new study at the University College London (UCL).
The findings also show that only half of all dementia patients have a documented annual review. Furthermore, women were found to be at particular risk of staying on antipsychotic or sedative medication for a longer period of time. This might be because they have fewer appointments where their treatment can be reviewed.
“As women tend to live longer than men, they are more likely to live alone without a family carer to help them access healthcare,” says Dr. Claudia Cooper (UCL Psychiatry) who led the research.
“Perhaps because of this, they are more at risk of missing out on medical help that might help them stay well for longer. We found that women were more likely to be on psychotropic drugs – sedatives or anti-psychotics — which can be harmful in the long term and may not be appropriate. Women tended to stay on such drugs for longer, perhaps because they have fewer check-ups to see if the drugs were still needed.”
Cooper added that women with dementia who live on their own may need additional support accessing healthcare services. In addition, general practitioners (GP) need to be given the resources to proactively engage with these patients and review their condition regularly to make sure their treatment plan, including any drugs, are appropriate.
“Improving access to healthcare and reducing psychotropic drug use in people with dementia, especially women, could help them to live well with dementia for longer,” said Cooper.
For the study, the researchers evaluated the records of 68,000 dementia patients and 259,000 people without dementia to compare their access to healthcare services, using the Health Improvement Network (THIN) database. Overall, they found that dementia patients received less medical care than those without dementia even though they are more vulnerable to physical and mental illnesses.
“Dementia can cause a wide range of physical complications, including difficulties swallowing and mobility problems,” said Cooper. “People with dementia are particularly susceptible to malnutrition, as they may have difficulties eating, preparing food, or remembering to eat.”
Prior research has found that up to 45 percent of dementia patients experience clinically significant weight loss, which can lead to further physical problems and frailty. However, despite this high risk, less than half of dementia patients are currently having a yearly check-up.
“The good news is that things seem to be improving: only 24 percent of patients had their weight monitored in 2002 compared with 43 percent in 2013,” said Cooper.
Improvements may be associated with the government’s National Dementia Strategy which launched in 2009. Around the time this was launched, GP surgeries were offered additional financial incentives through the NHS Quality and Outcomes Framework to review dementia patients annually.
However, these findings suggest that there is still more work to be done to ensure that people with dementia, particularly women, are able to access the services they need.
The findings are published in the journal Age and Ageing.
Source: University College London
New research suggest that stigma and discrimination may alter gay men’s cortisol balance resulting in stress. Moreover, black gay men, a double minority, are likely to experience more stress that white gay men.
Investigators explain that research over the past two decades has shown that cortisol is a life sustaining adrenal hormone essential to maintaining the natural balance of the body.
Cortisol is often referred to as “the stress hormone,” as it influences, regulates, and modulates many of the changes that occur in the body in response to stress.
New studies measure cortisol at various times during the day on a 24-hour basis to examine possible adrenal imbalances. The majority of these diurnal cortisol studies have been conducted among white heterosexuals, with very little research examining HPA-axis functioning between different minorities.
However, individuals who identify as both sexual and racial minorities may experience increased stigma and discrimination that can affect this HPA-axis functioning.
To address this need for more expansive research, investigators led by Stephanie H. Cook, DrPH, conducted a study, “Cortisol profiles differ by race/ethnicity among young sexual minority men”, examining differences in diurnal cortisol rhythm between young, self-identified, white gay men (WGM) and black gay men (BGM).
The research appears in the journal Psychoneuroendocrinology.
Researchers followed healthy men (n=68) with a mean age of twenty-three. Study methodology included a daily diary which consisted of researchers collecting four saliva samples daily for five days to measure their cortisol levels at different times of day throughout the week.
“Sexual minorities are more likely to experience discrimination based on their sexual orientation compared to heterosexual individuals,” said Dr. Cook.
“Recent research shows that sexual orientation-related stress and stigma can modulate HPA-axis (the biological response) reactivity among sexual minority individuals compared to heterosexual individuals.”
The research data showed a flattened 24-hour cortisol curve between BGM to WGM, with statistically significant differences found in bedtime levels of cortisol.
In the current study, the observed flattened diurnal pattern observed among BGM combined with their elevated evening levels suggests less daily variation in cortisol that may be indicative of an unhealthy stress response among BGM.
While beyond the scope of the current analysis, these findings suggest that social factors associated with being a “double minority” may differentially calibrate circadian HPA-axis functioning in BGM compared to WGM.
“We must conduct additional studies to confirm these study findings because in the current study we cannot make definitive conclusions about our “double minority” hypothesis because we did not have a majority Black referent group,” cautions Dr. Cook.
“However, with this being said, we believe this research study presents a first step in understanding differences in the HAP axis functioning among racial/ethnic and sexual minority men.”
The current study expands on previous research indicating that those individuals at the intersection of multiple stigmatized identities may indeed experience distinct diurnal cortisol profiles which should be explored further.
“The results of the present study expand health disparities research that has often focused solely on race/ethnic differences by using approaches that assess intersecting identities, which is the cornerstone of the work we undertake at CHIBPS,” said Dr. Cook.
“This study highlights these disparities and calls for further research on these topics.”
Source: New York University
In a new study, researchers from Case Western Reserve University found that evading existential concerns is linked with higher levels of depression, anxiety, and difficulty regulating emotions.
“Religious and spiritual struggles — conflicts with God or religious people, tough questions about faith, morality, and the meaning of life — these are often taboo topics, and the temptation to push them away is strong,” said Dr. Julie Exline, professor of psychological sciences and co-author of the research.
“When people avoid these struggles, anxiety and depression tend to be more intense than if they faced these struggles head-on.”
People who more fully embrace these struggles with fundamental beliefs and values report better mental health than those who don’t, Exline added.
The study, based on a survey of 307 adults about recent life experiences, appears in the Journal of Contextual Behavioral Science.
Among the study’s findings:
- An unwillingness to accept spiritual struggle could contribute to major social ills, leading to lost opportunities to engage with people of different faith beliefs and backgrounds and come to view them as threatening. “This avoidance may lead to the rejection of whole groups of people based on their religious differences or perceived incongruence between, for example, their sexuality or gender-based identity and religious teachings,” Exline said.
- Mental health providers may find it useful to help clients with spiritual struggles face their difficulties in a more proactive way. “People seem to be more emotionally healthy if they’re able to accept troubling thoughts,” Exline said. “Looking at spiritual doubts in an objective way seems to help. You may or may not work through them, but at least you can tolerate having them.”
- Avoidance itself is not a problem; rather, the behavior can become problematic when escaping becomes harmful or contrary to personal goals and sets a rigid pattern of experiencing and responding to the world. “Regular spiritual avoidance can make it difficult to identify, work toward, or experience the qualities that lend a sense of purpose to life,” she said.
- Using emotional and cognitive energy to push thoughts away will not stop them from continuing to intrude over time. “Continually being revisited by these thoughts can create strains on emotional health, especially if a person sees this kind of questioning as morally unacceptable and dangerous,” Exline said.
A new comprehensive research review suggests that for some people, social media use correlates with narcissism.
University of Georgia psychology researchers performed a statistical review of 62 studies involving over 13,000 individuals. They discovered narcissism has a modest but reliable positive relationship with a range of social media behaviors.
The largest influences included the number of friends/followers narcissists had, the frequency of status updates and then selfie posting.
The two strains of narcissistic behavior — grandiose narcissism and vulnerable narcissism — showed different relationships to social media use.
Grandiose narcissism, the more extroverted, callous form, was positively related to time spent on social media, the frequency of updates, number of friends/followers, and the frequency of posting selfies.
Vulnerable narcissism, the more insecure form, did not show any relationship to social media, but there was relatively little research on this form of narcissism.
“The stories you have heard about grandiose narcissism on social media are probably true,” said the study’s senior author, Dr. Keith Campbell, a professor of psychology in the University of Georgia Franklin College of Arts and Sciences.
Campbell, co-author of “The Narcissism Epidemic,” notes that “when you engage with social media, you will be engaging with more narcissism than might really exist in the world. This might distort your view of the world as being more narcissistic than it is.”
“It is important to remember that these are only correlations, however,” said the study’s lead author, Jessica McCain, a graduate student in the Behavioral and Brain Sciences Program.
”Theoretically, we suspect that individuals with pre-existing narcissism are drawn to social media, but the present evidence only establishes that the two are related.”
“Networks on social media aren’t designed by people in Silicon Valley,” Campbell said. “They are built one link at a time by users. And narcissists seem to be central to this build-out.”
The study appears in the early online edition of Psychology of Popular Media Culture.
Source: University of Georgia
The evolution of how prisoners in substance-abuse programs communicate is a good indicator of whether they’ll return to crime, new research has found.
A new study finds that the ability to use written words to communicate and interact with others is related to successful rehabilitation among incarcerated individuals.
In the research, Ohio State social work investigators examined the relationships between prisoners enrolled in “therapeutic communities,” groups that focus on rehabilitation from drug and alcohol addiction. Keith Warren, Ph.D., an associate professor of social work at Ohio State University, said learning communication skills is the key to this rehabilitation approach.
Warren said the theory behind these efforts rests on the idea that peer interaction will support learning that displaces ingrained (and unhealthy) ways of thinking that stand in the way of people leaving addiction behind.
In this study, the first to test that theory, Warren and co-author Nathan Doogan, Ph.D., a postdoctoral researcher in Ohio State’s College of Public Health, analyzed tens of thousands of written communications collected at four minimum-security facilities in Ohio with programs designed as an alternative to traditional prison time.
The more a participant’s language choices changed during rehab, the less likely he was to return to prison, they found. The study appears in the Journal of Substance Abuse Treatment.
“It’s not just being in the program that seems to help, it’s the cognitive engagement in it,” Warren said.
The messages exchanged between program participants come in two forms.
The first, called “pushups,” are congratulatory notes to a peer — something like, “Good job talking about your triggers in group today, man.”
The second, called “pull-ups,” are meant to steer a fellow prisoner toward better choices — something like, “Hey brother, next time try talking to me instead of getting into a fight.”
Once approved as appropriate for group consumption, the written notes are typically read aloud to the group during meal time or a meeting.
Doogan and Warren examined how these communications changed for each of 2,342 men included in their study. They looked at pushups and pull-ups in each inmate’s first two to three months in the program and held those up against the messages they sent fellow prisoners in the second two to three months.
In all, the researchers analyzed about 267,000 messages. Only graduates of the program were included in the study.
The more their word combinations shifted, the greater the chance the men didn’t return to prison. In cases where the inmates did return, those who showed the least change in how they thought and wrote tended to return to prison most quickly.
The study didn’t focus on “positive” or “negative” word choice, but on change in general, with the goal of getting a handle on whether the program was reshaping the participant’s way of thinking, Doogan said.
“It wasn’t so much sentiment, but whether we could measure some form of change in the individual,” he said.
The sheer number of interactions for an individual resident didn’t seem to make a difference, only the changing nature of those notes. That’s important because it seems to mean that simply interacting isn’t enough and that a person has to be engaged and evolve in his thinking, the researchers said.
Shifts in how we put together our thoughts and express them in writing are a good indication of a true evolution in how we think, Warren said.
“Learning is a change in connections between ideas,” he said. “In a therapeutic community, you would hope that they are abandoning some old connections and developing some new ones.”
The researchers created a tool for analyzing word choices, identifying 500 words that could potentially be combined in a note to one participant from another. Doogan and Warren counted change when inmates added new word combinations or abandoned old ones. They attempted to control for variables outside of changed language including race, age, and education level.
Understanding — and being able to measure — changes linked to reduced rates of repeat incarceration could eventually help program directors refine how they approach different participants, the researchers said.
For instance, if it was clear an addict’s communications with others in the program were not changing in nature, it might be a clue that the individual needed more one-on-one attention, Doogan said.
Source: Ohio State University