In The News
A new study has found that teachers in the United States work largely in isolation.
According to the Teaching and Learning International Survey (TALIS), U.S. teachers report they engage less often in collaborative efforts with colleagues.
Working with colleagues could benefit not only the teachers, but also students, according to the findings of TALIS, a 34-country survey of 100,000 teachers and principals conducted by the Organization for Economic Cooperation and Development in 2013.
“TALIS is teaching us the value of professional collaboration among teachers in terms of its benefits for both students and teachers, but we need to know more about what kinds of collaboration are more effective than others,” said Boston College Professor Andrew Hargreaves.
The findings from TALIS were presented during the American Educational Research Association annual meeting.
According to the study’s findings, 53 percent of U.S. teachers reported they never teach with a colleague in the same classroom, compared to 42 percent of the international sample. Half of U.S. teachers report they rarely observe their peers teaching or provide feedback to colleagues.
Approximately 42 percent of U.S. teachers report they never undertake joint projects across classes or grade levels, compared to just 22 percent of teachers internationally, according to the study’s findings.
“TALIS evidence on the U.S. shows that high numbers of teachers are experiencing the impact of accountability for results but insufficient support to work together so they can achieve those results,” said Hargreaves.
Source: Boston College
More than one percent of American preschool children on Medicaid are taking psychiatric drugs, such as antidepressants, mood stabilizers, and medications for attention-deficit disorder, according to a new study.
“Although the absolute numbers and percentages of these drugs were small, these findings are worrying in so far as they indicate the use of psychotropic drugs among very young children,” the authors wrote in the study.
Researchers from Brown School at Washington University in St. Louis and Washington University School of Medicine in St. Louis evaluated data from the 2000-2003 Medicaid Analytic Extract from 36 states and found that preschoolers are receiving psychotropic (affecting mood, perception or behavior) medications despite limited evidence supporting safety or efficacy.
“Because we don’t have indications in our data, it is not entirely clear why these children are receiving psychotropic drugs,” said lead author Lauren Garfield, Ph.D.
The researchers used logistic regression to determine the odds of receiving medications for attention-deficit disorder/attention-deficit hyperactivity disorder (ADHD), depression or anxiety and psychotic illness or bipolar.
“It is possible that some of these children have brain injuries or insults, such as traumatic brain injuries, fetal alcohol syndrome, or the like, for which treatment is being provided.
“But if these medications are being used solely for behavioral control, then it seems clear that we need to better assess these children, and see if they might be better served by the use of evidence-based behavioral interventions,” said co-author Ramesh Raghavan, M.D., Ph.D.
“The fact that any children this small are using psychotropic drugs is very worrisome.”
Between 2000 and 2003, 1.19 percent of children received a prescription for ADHD, depression or anxiety, or psychotic illness or bipolar medication. In addition, 0.17 percent of infants younger than one year old and 0.34 percent of children between one and two years were being prescribed psychotropic drugs.
Overall, 0.61 percent of children received a prescription for ADHD, 0.59 percent for depression or anxiety and 0.24 percent for psychotic illness or bipolar disorder.
JooYeun Chang, associate commissioner of the Children’s Bureau at the administration for Children and Families (ACF), is helping to lead the effort on the federal level to reduce unnecessary psychotropic medication use among child welfare populations.
“Increased access to timely and effective screening, assessment, and non-pharmaceutical treatment will reduce over-prescription of psychotropic medication as a first-line treatment strategy, improve their emotional and behavioral health, and increase the likelihood that children in foster care will exit to positive, permanent settings, with the skills and resources they need to be successful in life,” said Chang.
The results of the study are published in the American Journal of Public Health.
Researchers at Saint Louis University have found that sending supportive text messages to low-income mothers with postpartum depression can be a useful, low-cost adjunct therapy to counseling.
For the study, at-risk, low-income mothers of racial and ethnic minority backgrounds were sent supportive text messages four times a week for six months in addition to traditional counseling services in an academic pediatric office. By the end of the study, 4,158 text messages were successfully delivered to 54 mothers.
At Cardinal Glennon Children’s Medical Center in St. Louis, all mothers who brought in an infant for a well-child visit was screened for postpartum depression between December 2012 and June 2014.
English-speaking mothers living in the City of St. Louis who scored above 10 on the Edinburgh Postnatal Depression Scale (EPDS) were asked by researchers to join the study. Most of the study’s participants were unmarried and did not have a deep support system.
Over the six month time frame, each participant received the same, non-randomized message script, which had been developed by members of the project team. Some of the messages allowed for a yes/no response in regards to whether the mother would like a follow-up phone call.
The messages ranged from informational (“Having a routine is comforting for babies.”) to motivational and reflective (“Today let’s focus on making decisions from the facts, not our feelings.”)
“There is a cultural norm in this community of strength, of absorbing whatever comes at them,” said study author Matthew A. Broom, M.D., assistant professor of pediatrics at Saint Louis University and SLUCare physician at SSM Cardinal Glennon Children’s Medical Center.
“We want to break that barrier that equates reaching out for help as weakness.”
The researchers found that text messaging is a relatively low-cost and useful way to serve as adjunct therapy to provide private support for at-risk mothers suffering from postpartum depression.
“The study shows us that there is another way to make contact with a group that has an extreme need,” Broom said. “This is a relatively low-cost way to reach people.”
Broom noted that improving maternal health, including a mother’s mental state, is good for her child.
“Moms that are well from a mental health perspective have children with better developmental outcomes,” he said. “If we can provide more support and services for the high-risk mothers we serve, we will be able to create a greater positive impact for their children.”
The study is published in the journal JMIR Mental Health.
Source: Saint Louis University
Journal writing may be an effective way for moms of autistic children to lower their stress levels and improve their relationship with their child, according to a new paper published in the Journal for Autism and Developmental Disorders.
“If people can really comprehend what’s happening to them, if they find meaning in it and find tools for managing it, they are healthy and resilient,” said associate professor Dr. Rondalyn V. Whitney, author of the paper and director and founding chair of the occupational therapy program at Clarkson University in New York State.
“Journal writing is one of their tools in their toolkit, and it helps them find meaningful coping strategies.”
Moms of children with autism can get burned out because if there is no one there to help them, they can’t get out of the house to participate in any interventions for themselves, said Whitney. She compares the situation to the oxygen mask advisory on airplanes: Mothers need to help themselves first before they can help others.
“High maternal stress causes paternal stress, and high maternal stress decreases the child’s ability to benefit from treatment,” she said.
As a result, Whitney wanted to provide an intervention that is available to mothers where they often already are — online. As she observed moms of autistic children relay their feelings into an online journal, Whitney found that it decreased their stress levels and also encouraged an improvement in the mom-child relationship.
Whitney said the journal gives mothers a safe place to talk about any negative feelings they may have without having an impact on the child, helping them reframe their problems, and work toward finding solutions.
“There was a shift in what the mothers attributed the stress to,” she said. “Instead of saying, ‘My stress is due to being a mother,’ it shifts to, ‘I have a stressful life.'”
Whitney said the journal-writing sessions were designed to focus on emotional disclosure through the act of writing itself, and so the participants did not receive feedback on what they had written. The next step in her research will be a quantitative analysis of common themes in the moms’ journals.
Whether or not mothers perceive they have support is a big factor in their stress levels, Whitney said.
Some scenarios that can lead to a mother feeling isolated include the following: the father being unavailable, the mother feeling unappreciated, the mother feeling estranged from her family due to the child’s behavior, the mother being unable to socialize with friends, or the mother feeling that no one else can keep her child safe.
“The mothers really love these children, but they feel alone in that understanding of their child,” Whitney says.
Source: Clarkson University
Emergency departments (ED) have the opportunity to play a key role in preventing opioid deaths by offering overdose education and explaining how one should respond while witnessing an overdose, according to a new study published in the Western Journal of Emergency Medicine.
As part of this effort, ED’s also have the potential to equip patients with nasal naloxone rescue kits.
The study is the first to demonstrate the potential positive outcome of ED-based opioid overdose prevention education and naloxone distribution to trained laypersons, patients, and their social network.
Deaths from prescription opioid overdose increased in the U.S. from 4,041 people in 1999 to 16,651 in 2010. In 2011, an estimated 420,040 ED visits were related to overdose of prescription opioids and 258,482 heroin overdoses.
Since 1993, Boston Medical Center’s (BMC) Project ASSERT has offered alcohol and drug use screening, brief intervention and referral to treatment to patients treated for intoxication in the ED.
In 2009, Project ASSERT, with support from Boston Public Health Commission and Massachusetts Department of Public Health, also began offering overdose prevention education and naloxone rescue kits to emergency department patients at risk for opioid overdose.
In an effort to evaluate the usefulness of this program and describe the overdose risk knowledge, opioid use, and overdose response actions among patients receiving overdose prevention education, researchers from Boston University School of Medicine (BUSM) and BMC conducted a telephone survey of Project ASSERT patients.
Of the 415 patients who had been given overdose education, 51 patients were surveyed. Of these 51 patients, 73 percent had received a naloxone rescue kit either in the emergency department or elsewhere, such as a detox facility. About one third of them reported opioid use within the last 30 days.
Furthermore, more than half had reported witnessing an overdose and calling 911 for help. Among those with naloxone rescue kits, about one-third administered naloxone during the rescue.
“This study confirms that the emergency department provides a promising opportunity for opioid overdose harm reduction measures through overdose education and naloxone rescue kit distribution,” said lead author Kristin Dwyer, M.D., emergency physician at BMC.
“Our program reached a high-risk population that commonly witnessed overdoses, called for help and used naloxone to rescue people, when available,” she added.
Although the study was retrospective with a low response rate, the researchers believe the findings should lead to larger studies and programs to further evaluate the benefits and harms of overdose prevention efforts in EDs.
Source: Boston University Medical Center
A new brain imaging study has found another dimension to the so-called “achievement gap,” where students from lower-income families lag behind wealthier students in standardized test scores and other measures of academic success.
The study, led by researchers from the Massachusetts Institute of Technology (MIT) and Harvard University, found that higher-income students had thicker brain cortex in areas associated with visual perception and knowledge accumulation.
Furthermore, these differences correlated with one measure of academic achievement — performance on standardized tests, the researchers discovered.
“Just as you would expect, there’s a real cost to not living in a supportive environment. We can see it not only in test scores, in educational attainment, but within the brains of these children,” said Dr. John Gabrieli, an MIT professor of brain and cognitive sciences, and one of the study’s authors.
“To me, it’s a call to action. You want to boost the opportunities for those for whom it doesn’t come easily in their environment.”
He noted that the new study did not explore possible reasons for these differences in brain anatomy. However, previous studies have shown that lower-income students are more likely to suffer from stress in early childhood, have more limited access to educational resources, and receive less exposure to spoken language early in life.
These factors have all been linked to lower academic achievement.
In recent years, the achievement gap in the U.S. between high- and low-income students has widened, even as gaps along lines of race and ethnicity have narrowed, said Martin West, Ph.D., an associate professor of education at the Harvard Graduate School of Education and an author of the new study.
“The gap in student achievement, as measured by test scores between low-income and high-income students, is a pervasive and longstanding phenomenon in American education and, indeed, in education systems around the world,” he said.
“There’s a lot of interest among educators and policymakers in trying to understand the sources of those achievement gaps, but even more interest in possible strategies to address them.”
The study included 58 students, 23 from lower-income families and 35 from higher-income families, all aged 12 or 13. Low-income students were defined as those who qualify for a free or reduced-price school lunch.
The researchers compared students’ scores on the Massachusetts Comprehensive Assessment System (MCAS) with scans of the cortex, which is key to functions such as thought, language, sensory perception, and motor command.
Using magnetic resonance imaging (MRI), the researchers discovered differences in the thickness of parts of the cortex in the temporal and occipital lobes, whose primary roles are in vision and storing knowledge. Those differences correlated to differences in both test scores and family income, according to the study’s findings.
In fact, differences in cortical thickness in these brain regions could explain as much as 44 percent of the income achievement gap found in the study, the researchers claimed.
In most other measures of brain anatomy, the researchers found no significant differences. The amount of white matter — the bundles of axons that connect different parts of the brain — did not differ, nor did the overall surface area of the brain cortex, according to the study’s findings.
The researchers point out that the structural differences they did find are not necessarily permanent.
“There’s so much strong evidence that brains are highly plastic,” said Gabrieli. “Our findings don’t mean that further educational support, home support, all those things, couldn’t make big differences.”
In a follow-up study, the researchers hope to learn more about what types of educational programs might help to close the achievement gap and, if possible, investigate whether these interventions also influence brain anatomy.
“Over the past decade we’ve been able to identify a growing number of educational interventions that have managed to have notable impacts on students’ academic achievement as measured by standardized tests,” West said.
“What we don’t know anything about is the extent to which those interventions — whether it be attending a very high-performing charter school, or being assigned to a particularly effective teacher, or being exposed to a high-quality curricular program — improves test scores by altering some of the differences in brain structure that we’ve documented, or whether they had those effects by other means.”
The study, which was funded by the Bill and Melinda Gates Foundation and the National Institutes of Health, was published in the journal Psychological Science.
A new analysis has discovered that sexual education programs that address gender and power in relationships are far more effective than programs that do not.
Adolescents around the world face significant reproductive health challenges, including high rates of unintended pregnancy and sexually-transmitted infections, noted Population Council researcher Nicole Haberland, M.P.H.
According to the U.S. Centers for Disease Control and Prevention, people in the United States between the ages of 15 and 24 account for half of all new sexually transmitted infections. Globally, young people in this age range account for 40 percent of all new HIV infections, according to UNAIDS.
While sex education, including education about HIV, is considered a key strategy to improving adolescent reproductive health, the results have been disappointing, despite extensive investments in these programs, the researcher noted.
Studies have shown that when people hold biased beliefs about appropriate roles and behavior for males and females, or when they report unequal power in their intimate relationships, they are more likely to experience poor reproductive health outcomes.
For example, women who report low power in their sexual relationships tend to have higher rates of sexually transmitted infections and HIV than women who report more equitable relationships, the researcher noted. That has led some researchers to theorize that sex education should help young people reflect critically about issues of gender and power in relationships.
“We wanted to know whether programs that take such an empowerment approach perform better than the majority of programs, which do not,” said Haberland.
“To do so, I wanted to set a very high bar and look at whether these curricula actually reduced rates of unintended pregnancy and sexually transmitted infections.”
For her study, Haberland searched electronic databases for evaluations of programs that were assessed by measuring impact on sexually transmitted infections or unintended pregnancy, aimed at adolescents 19 or younger, and evaluated using a rigorous study design. She identified evaluations of 22 sexuality and HIV education programs from various countries.
She divided the programs into two groups based on whether they addressed — or ignored — issues of gender and power, such as notions of masculinity and femininity, gender inequality in society, unequal power in relationships, and young women’s empowerment. She found that 10 programs addressed these issues, while 12 did not.
Haberland reports that the impact of including gender or power content was dramatic.
“The programs that addressed gender or power were five times more likely to be effective than those that did not,” said Haberland. “Fully 80 percent of them were associated with a significantly lower rate of sexually transmitted infections or unintended pregnancy.
“In contrast, among the programs that did not address gender or power, only 17 percent had such an association. It is striking that the two sets of programs — sexuality education programs that address gender and power and programs that do not — have nearly opposite outcomes.”
The impact of gender and power content held true even when considering other variables, such as program duration or whether the program had multiple components versus a single component, she noted.
Furthermore, all of the programs that included gender or power content and were associated with positive health outcomes were also significantly associated with other beneficial outcomes, such as reported safer sexual behavior or improved knowledge, she found.
After studying the common characteristics of the effective interventions, Haberland offered several recommendations for integrating content on gender equality and power dynamics into sexuality and HIV education:
- Include explicit content about gender equality and power dynamics;
- Use methods that encourage participants to reflect in meaningful ways on how gender stereotypes and power inequalities affect their own relationships, sexual and reproductive health, and HIV risk; and
- Help participants recognize their potential power in their own lives, relationships, or communities.
To enable programs to implement such an approach, the Population Council has published a resource — It’s All One Curriculum — with culturally sensitive content and 54 teaching activities. It is available in several languages at no cost at ItsAllOne.org.
The study was published in International Perspectives on Sexual and Reproductive Health, published by the Guttmacher Institute.
Source: Population Council
A new study shows that when stakes are high, using self-affirmations can boost confidence, especially in people who are in low positions of power.
“Most people have experienced a time in their lives when they aren’t performing up to their potential. They take a test or have a performance review at work, but something holds them back,” said lead researcher Sonia Kang, Ph.D., an assistant professor of organizational behavior and human resource management at the University of Toronto.
“Performance in these situations is closely related to how we are expected to behave.”
“You should reflect on things that you know are good about yourself,” she continued. “Anyone has the potential to do really well. It’s how you respond under pressure that makes a key difference.”
For the study, researchers conducted three experiments to measure performance in pressure-filled situations.
They found that when participants were in a position of high power, they tended to perform better under pressure, while those with less power performed worse.
Self-affirmations, however, helped to level the playing field and effectively reduced the power differences, the researchers noted in the study, which was published in the Personality and Social Psychology Bulletin.
In the first experiment, 134 participants (60 percent women) were assigned in same-sex pairs to portray a recruiter or job candidate in a competitive negotiation involving the setting of salary, vacation time, and other job benefits. To increase the pressure, half of the participants were told the negotiation was an accurate gauge of their negotiating skills.
Participants in the low-pressure situation were told the exercise would teach them negotiation concepts and was not an accurate gauge of their negotiating abilities.
Job candidates, who had a lower power role, performed significantly worse in the high-stakes negotiations than those in the low-pressure group. Recruiters, who held a more powerful role, actually performed better under pressure because their initial expectations for success were magnified, Kang said.
In a second experiment, 60 male MBA students were paired together as the buyer or seller of a biotechnology plant. The sellers, who were in a position of power, were more assertive under pressure and negotiated a higher selling price, while the buyers performed worse under pressure.
The final experiment used the same biotechnology plant exercise with 88 MBA students — 33 male pairs and 11 female pairs — but all participants were told the exercise would gauge their negotiating skills to raise the stakes.
Before the negotiation, half of the participants wrote for five minutes about their most important negotiating skill, while the remaining half wrote about their least important negotiating skill.
Buyers who completed the positive self-affirmation performed significantly better in negotiating a lower sale price for the biotechnology plant, effectively reducing the power differences between the buyer and seller, the researchers noted.
Writing down a self-affirmation may be more effective than just thinking it, but both methods can help, according to Kang.
She suggests that before a performance review, an employee could write or think about his best job skills. Writing or thinking about one’s family or other positive traits that aren’t associated with the high-stakes situation also may boost confidence and performance, she noted.
“Anytime you have low expectations for your performance, you tend to sink down and meet those low expectations,” Kang said. “Self-affirmation is a way to neutralize that threat.”
A new UK study urges healthcare professionals to appreciate the psychological maelstrom that accompanies infertility.
As discussed in the journal The Obstetrician & Gynaecologist (TOG), researchers explain that infertility is a complex state and life crisis and much more than a biological malfunction.
Authors advise the medical community to understand the psychological anguish and to not neglect the emotional impact of involuntary childlessness.
The article provides an introduction to infertility counselling in the UK within the context of fertility treatment and a nationalized health system. This includes an explanation of the differences between the three main types of counselling, implications, support, and therapeutic counselling, and the role of various National associations and organizations.
In the UK, counselling plays a major complementary role in providing holistic patient-centered care by multidisciplinary staff in fertility clinics.
Authors explain that counselling is an amalgam of medicine and mental health. They believe the intervention should be viewed as a continuation of the medical process, where the medical and psychological aspects of infertility treatment are integrated.
At present, the counselling role occupies a unique and diverse position within the infertility field, including that of patient advocate, gatekeeper, researcher, educator, supportive resource to colleagues, confidante, and point of liaison.
The authors acknowledge that as reproductive laws continue to develop, they will influence the role of the counselling provider. However, whatever the extent of these changes, counselling practitioners must continue to work within the boundaries of acceptable practice as outlined by their professional body.
Infertility counseling is a specialized field demanding the professional receive continuous training and professional development. The article summarizes the often complex assisted reproductive technology (ART) options for infertile patients, including gamete/embryo donation, egg/sperm sharing, surrogacy, adoption, and fertility preservation.
It also explores the under-recognized and unregulated phenomenon of fertility tourism, including the current legal and regulatory parameter regarding these options. Authors also review important considerations — such as the welfare of the child or children when surrogacy and adoption are considered options.
Counselling practitioners play a critical role in explaining some or all of these options to patients and in ensuring that they are well informed before making any treatment choices, conclude the authors.
Jolly Joy, Consultant Gynaecologist and Subspecialist in Reproductive Medicine, Origin Fertility Care in Belfast and co-author of the article says: “It is vital that clinicians focus on the changing psychosocial needs of their patients, as well as on the advances in infertility treatment, if they are going to fully meet the needs of people affected by infertility.”
Jason Waugh, TOG Editor-in-chief adds: “It is important that all the interested statutory and professional bodies that produce guidelines on standards of multidisciplinary practice within the field of infertility continue to communicate with each other.
This will help achieve the best standards of practice. It will also have a positive and active influence on the growing global nature of infertility counselling and treatment.”
Repeated childhood emotional trauma appears to be linked to elevated blood pressure, suggests new research.
A new study discovered the experience of multiple traumatic events during childhood — from emotional and sexual abuse, to neglect — is related to a 10 point difference in systolic pressure.
This increase puts the young people at higher risk for hypertension and coronary artery disease by middle and/or old age, says Dr. Shaoyong Su, a genetic epidemiologist at the Medical College of Georgia at Georgia Regents University.
As an example, comparing two white males in the study with the same body mass index, the one who reported no adverse childhood events, or ACEs, had a systolic pressure of 117. His peer with four or more ACEs had a reading of 127.
“That is a big difference,” said Su, corresponding author of the study in the American Heart Association journal Circulation.
“You can predict that five years later, these young people may be hypertensive.” He noted that an exponential increase in pressure correlated with an increasing number of bad events.
ACEs include emotional, physical, and sexual abuse; emotional and physical neglect; and household dysfunction, such as substance abuse or domestic violence.
In the study, researchers found the blood pressure increase resulting from experiencing multiple ACEs wasn’t fully explained by known concurrent risk factors such as being male, black, a low socioeconomic status, inactivity, obesity, and smoking.
“We hope these studies will reinforce the need to screen children and young adults for adverse childhood events so this increased risk can be identified early to enhance resiliency and recovery and lessen the burden of cardiovascular disease later in life,” said Su.
“First we have to know and accept that these difficult problems occur to some extent in the majority of our children.”
Researcher looked at data collected from young people — now a mean age of 30 — who are part of a long-terms study at MCG’s Georgia Prevention Institute looking at cardiovascular risk factor development.
ACEs were assessed in an equal number of males and females and blacks and whites, 213 and 181, respectively. Blood pressure was measured an average of 13 times over a 23-year period. Information about ACEs was gathered after study participants reached 18.
Sadly, about 70 percent of the children from the Richmond County public school system reported at least one ACE; 18 percent reported more than three. About 30 percent of that 18 percent came from well-educated families with good incomes.
In fact, in conflict with associations between ACEs and a lower socioeconomic status, the researchers found that 50 percent of their participants with a history of childhood abuse and 40 percent who reported neglect came from medium or high income families.
While the blood pressure of black males tended to run higher generally and blacks had slightly more exposure to ACEs, there was not a significant difference in the impact of ACEs on blood pressure between blacks and whites, the researchers found.
The new study reemphasized that adverse events were common, and that a greater number of ACEs resulted in an increase in both the top and bottom measure of blood pressure in young adults, suggesting a cumulative effect.
Prior research on ACE’s suggest that the experiences are risk factors for many of the leading causes of illness and death as well as poor life quality.
A national study of nurses published in 2010 in the Journal of Epidemiology and Community Health found an association between childhood maltreatment and self-reported hypertension in middle-aged women.
Those researchers noted that adverse childhood events may also trigger unhealthy habits such as smoking and inactivity that also can increase blood pressure. Gender and ethnicity, along with socioeconomic status, including parents’ educational level also could have an impact on overall health and well-being.
Su notes that percentages of children experiencing ACEs are similar whether looking across Georgia, the nation, or the world. His study participants were not asked how often or how long their bad experiences occurred, just whether they had one or more from the different categories.
People who snore heavily or suffer from sleep apnea may be at greater risk for memory and thinking decline at a younger age, according to a new study. The findings suggest that the use of a breathing machine may help intervene.
“Abnormal breathing patterns during sleep such as heavy snoring and sleep apnea are common in the elderly, affecting about 52 percent of men and 26 percent of women,” said study author Ricardo Osorio, M.D., with the New York University Langone Medical Center in New York.
For the study, researchers evaluated the medical histories of 2,470 people ages 55 to 90. Participants were categorized as one of the following: free of memory and thinking problems, in early stages of mild cognitive impairment (MCI), or diagnosed with Alzheimer’s disease.
The researchers also compared people with untreated sleep breathing problems to those without sleep breathing problems, as well as untreated versus treated people with sleep breathing problems.
The findings show that those with sleep breathing problems were diagnosed with MCI an average of nearly 10 years earlier than people without sleep breathing problems. For example, when researchers examined only people who developed MCI or Alzheimer’s disease during the study, those with sleep breathing problems developed MCI at an average age of 77, compared to an average age of 90 for those without sleep breathing problems.
Among that group, those who had sleep breathing problems also developed Alzheimer’s disease five years earlier than those who did not have sleep breathing problems, at an average age of 83 versus 88.
The findings also showed that people who treated their sleep breathing problems with a continuous positive airway pressure (CPAP) machine were diagnosed with MCI about 10 years later than those whose problems were not treated, or at age 82 instead of age 72.
“The age of onset of MCI for people whose breathing problems were treated was almost identical to that of people who did not have any breathing problems at all,” Osorio said.
“Given that so many older adults have sleep breathing problems, these results are exciting — we need to examine whether using CPAP could possibly help prevent or delay memory and thinking problems.”
“These findings were made in an observational study and as such, do not indicate a cause-and-effect relationship,” said Osorio.
“However, we are now focusing our research on CPAP treatment and memory and thinking decline over decades, as well as looking specifically at markers of brain cell death and deterioration.”
The study is published in Neurology, the medical journal of the American Academy of Neurology.
Source: American Academy of Neurology
A new study suggests seniors should forget the maid as the physical act of performing housework can improve their emotional and physical fitness.
Moreover, living in a neat, tidy, well-organized environment may be linked to better health and improved satisfaction with life.
In the study, Kathy D. Wright, Ph.D., RN, CNS, a postdoctoral researcher at the Case Western Reserve University found that older adults who keep a clean and orderly home — because of the exercise it takes to get the job done — tend to feel emotionally and physically better after tackling house chores.
“House cleaning kept them up and moving,” said Wright. “A clean environment is therapeutic.”
Wright and a research team set out to test a theory called House’s Conceptual Framework for Understanding Social Inequalities in Health and Aging. It’s considered a blueprint for understanding how factors such as income, education, environment and health behaviors, like smoking and exercise, influence an older person’s health.
The study’s 337 participants, from 65 to 94 years old, had to have at least one chronic illness, be enrolled in both Medicare and Medicaid, have physical restrictions that prevented them from doing at least one basic daily task, such as bathing and dressing, and be unable to manage such responsibilities as taking medicines, handling finances, or accessing transportation.
All lived in Ohio’s Summit and Portage counties.
Researchers discussed participant’s backgrounds and determined physical and emotional well-being from personal interviews. They then used the University of Utah’s Digit Lab, to link geographic and socioeconomic information on the neighborhoods with health data.
Wright said she was surprised to learn that housework and maintaining their property affected the participants’ physical and mental well-being more than such factors as neighborhood or income.
“What I found was that neighborhood poverty did not directly affect mental or physical health,” she said.
The study provided evidence that Wright had observed in her visits: people living in a chaotic environment seemed less satisfied than those in a place that was neat and tidy.
Wright hopes the study shows how important it is for sedentary older adults with disabilities and chronic illnesses to continue physical activities, such as doing reaching exercises while sitting, arm curls and standing up and sitting down in a chair.
The study, “Factors that Influence physical function and emotional well-being among Medicare-Medicaid enrollees” has recently been published in the journal Geriatric Nursing.
Can smelling another person’s sweat help us understand that the other person is happy?
New research suggests this may be so, that humans may be able to communicate positive emotions like happiness through the smell of sweat.
As published in the journal Psychological Science, investigators believe the findings show that we produce chemical compounds, or chemosignals, when we experience happiness. In turn, the compounds are detectable by others who smell our sweat.
While previous research has shown that negative emotions related to fear and disgust are communicated via detectable regularities in the chemical composition of sweat, few studies have examined whether the same communicative function holds for positive emotions.
“Our study shows that being exposed to sweat produced under happiness induces a simulacrum of happiness in receivers, and induces a contagion of the emotional state,” explains psychological scientist Gün Semin of Utrecht University in the Netherlands, senior researcher on the study.
“This suggests that somebody who is happy will infuse others in their vicinity with happiness. In a way, happiness sweat is somewhat like smiling — it is infectious.”
To determine whether this emotional chemosignaling extends to positive emotions, Semin and colleagues examined whether sweat taken from people in a happy state would influence the behavior, perception, and emotional state of people exposed to the sweat.
The researchers recruited 12 Caucasian males to provide the sweat samples for the study. The participants did not smoke or take any medications, and had no diagnosed psychological disorders. They were prohibited from engaging in alcohol use, sexual activity, consumption of smelly food, or excessive exercise during the study.
The sweat donors came to the lab, rinsed and dried their armpits, and had absorbent pads attached to each armpit. They donned a prewashed T-shirt and sat down to complete the study tasks.
They watched a video clip intended to induce a particular emotional state (fear, happiness, neutral) and they also completed a measure of implicit emotion, in which they were asked to view Chinese symbols and rate how pleasant or unpleasant each one was.
The sweat pads were then removed and stored in vials.
For the second part of the study, the researchers recruited 36 Caucasian females, with no psychological disorder, respiratory disease, or other illness.
The researchers note that only females were included in this part of the study as women generally have both a better sense of smell and a greater sensitivity to emotional signals than men do.
The study was double-blind, such that neither the researcher nor the participant knew which sweat sample the participant would be exposed to at the time of the experiment.
The women were seated in a chair and placed their chins on a chin rest. The vial containing the sweat sample was placed in a holder attached to the chin rest and was opened immediately prior to the target task.
The women were exposed to a sweat sample of each type (fear, happiness, neutral), with a five minute break in between samples.
Initial data analyses confirmed that the videos did influence the emotional states of the male participants — men who watched the fear video showed predominantly negative emotion afterward and men who watched the happiness video showed predominantly positive emotion.
But were these emotions conveyed to the female participants? Some behavioral results suggest the answer is ‘yes.’
Facial expression data revealed that women who were exposed to “fear sweat” showed greater activity in the medial frontalis muscle, a common feature of fear expressions. And women who were exposed to “happy sweat” showed more facial muscle activity indicative of a Duchenne smile, a common component of happiness expressions.
There was no observable association, however, between the women’s facial responses and their explicit ratings of how pleasant and intense the sweat was. These findings, the researchers say, suggest a “behavioral synchronization” between the sender (the sweat donor) and receiver (the sweat smeller).
Additional data indicated that women exposed to happy sweat showed a more global focus in perceptual processing tasks, in line with previous research showing that participants induced to experience positive mood tended to show more global processing styles.
But the sweat samples did not seem to impact the women’s ratings on the Chinese symbols task, suggesting that the sweat-based chemosignals did not bias their implicit emotional states.
These findings, while preliminary, suggest that we communicate our positive and negative emotional states via distinct chemosignals, such that the receiver produces a simulacrum of the sender’s emotional state.
The researchers note that the fact that some measures indicated emotional contagion, while others did not, may highlight the difference between measures of emotion that draw on language versus those that don’t.
The findings have broad relevance — emotion and sweat are two core features of the human experience, after all. But the fact that happiness may be communicated chemically could be of particular interest to the “odor industry,” says Semin, due to its potential commercial applications.
“This is another step in our general model on the communicative function of human sweat, and we are continuing to refine it to understand the neurological effects that human sweat has on recipients of these chemical compounds,” Semin concludes.
New research provides the first direct evidence that a low dose of electric current can enhance a specific brain pattern to boost creativity in healthy adults.
University of North Carolina School of Medicine investigators found the e-stim increased creativity by an average of 7.4 percent according to a common, well-validated test. Although the researchers do not believe the technique should be commercialized as a creativity edge, they do believe the findings can help people with complex illnesses.
Researchers ran a 10-Hertz current run through electrodes attached to the scalp and found that the stimulation enhanced the brain’s natural alpha wave oscillations — prominent rhythmic patterns that can be seen on an electroencephalogram, or EEG.
The study has been published in the journal Cortex.
“This study is a proof-of-concept,” said senior author Flavio Frohlich, Ph.D., assistant professor of psychiatry, cell biology and physiology, biomedical engineering, and neurology.
“We’ve provided the first evidence that specifically enhancing alpha oscillations is a causal trigger of a specific and complex behavior — in this case, creativity. But our goal is to use this approach to help people with neurological and psychiatric illnesses.
“For instance, there is strong evidence that people with depression have impaired alpha oscillations. If we could enhance these brain activity patterns, then we could potentially help many people.”
Researchers are now using this particular kind of brain stimulation in two clinical trials for people with major depressive disorder and premenstrual dysphoric disorder, or PMDD — a severe form of premenstrual syndrome. Participant enrollment is now underway for both trials.
“The fact that we’ve managed to enhance creativity in a frequency-specific way — in a carefully-done double-blinded placebo-controlled study — doesn’t mean that we can definitely treat people with depression,” Frohlich cautioned.
“But if people with depression are stuck in a thought pattern and fail to appropriately engage with reality, then we think it’s possible that enhancing alpha oscillations could be a meaningful, noninvasive, and inexpensive treatment paradigm for them — similar to how it enhanced creativity in healthy participants.”
Frohlich’s research is based on neural oscillations — the naturally occurring rhythmic electrical patterns that neurons generate and repeat throughout the brain. Alpha oscillations occur within the frequency range of eight and 12 Hertz nine (or cycles per second).
They were discovered in 1929 by Hans Berger, who invented EEG. Alpha oscillations occur most prominently when we close our eyes and shut out sensory stimuli — things we see, feel, taste, smell, and hear.
“For a long time, people thought alpha waves represented the brain idling,” Frohlich said. “But over the past 20 years we’ve developed much better insight. Our brains are not wasting energy, creating these patterns for nothing. When the brain is decoupled from the environment, it still does important things.”
When alpha oscillations are prominent, your sensory inputs might be offline as you daydream, meditate, or conjure ideas. But when something happens that requires action, your brain immediately redirects attention to what’s going on around you. You come fully online, and the alpha oscillations disappear. Other oscillations at higher frequencies, such as gamma oscillations, take over.Proving the Concept
This gradual accumulation of knowledge helped researchers to associate alpha oscillations with creativity. Frohlich set out to prove this concept. His idea was simple.
If he could enhance the rhythmic patterns of alpha oscillations to improve creativity, then it might be possible to enhance alpha oscillations to help people with depression and other conditions of the central nervous system that seem to involve the same brain patterns.
For three years, his lab has used computer simulations and other experiments to hone a technique to improve alpha oscillation.
For the Cortex study, Frohlich’s team enrolled 20 healthy adults. Researchers placed electrodes on each side of each participant’s frontal scalp and a third electrode toward the back of the scalp. This way, the 10-Hertz alpha oscillation stimulation for each side of the cortex would be in unison. This is a key difference in Frohlich’s method as compared to other brain stimulation techniques.
Then Frohlich’s team compared each participant’s creativity score for each session. He found that during the 30-minute stimulation sessions, participants scored an average 7.4 percentage points higher than they did during the control sessions.
“That’s a pretty big difference when it comes to creativity,” Frohlich said. “Several participants showed incredible improvements in creativity. It was a very clear effect.”
But there was a question. What if the electrical stimulation merely caused a general electric effect on the brain, independent of the alpha oscillation? To find out, Frohlich’s team conducted the same experiments but used 40 Hertz of electrical current, which falls in the gamma frequency band typically associated with sensory processing — when the brain is computing what we see or touch or hear.
“Using 40 Hertz, we saw no effect on creativity,” Frohlich said. “The effect we saw was specific to the 10-hertz alpha oscillations. There’s no statistical trickery. You just have to look at each participant’s test to see these effects.”
Frohlich said he understood some people might want to capitalize on this sort of study to boost creativity in their everyday lives, but he cautioned against it. “We don’t know if there are long-term safety concerns,” he said. “We did a well-controlled, one-time study and found an acute effect.”
“Also, I have strong ethical concerns about cognitive enhancement for healthy adults, just as sports fans might have concerns about athletic enhancement through the use of performance-enhancing drugs.”
Instead, Frohlich is focused on treating people with depression and other mental conditions, such as schizophrenia, for which cognitive deficits during everyday life is a major problem.
“There are people that are cognitively impaired and need help, and sometimes there are no medications that help or the drugs have serious side effects,” Frohlich said.
“Helping these populations of people is why we do this kind of research.”
Gestational diabetes mellitus (GDM) diagnosed by 26 weeks is linked to a greater risk for autism spectrum disorder (ASD) in the child, according to a new study. No significant link was found, however, between maternal pre-existing type II diabetes and ASD.
Earlier research has shown greater risks for obesity and related metabolic disorders in the children of women who had diabetes prior to pregnancy, as well as women with hyperglycemia first detected during maternal GDM.
Whether such exposure can disrupt fetal brain development and heighten risk of neurobehavioral developmental disorders in offspring has been less clear, however.
For the study, Anny H. Xiang, Ph.D., of Kaiser Permanente Southern California, Pasadena, California, and colleagues analyzed data from a single health care system to determine a potential link between maternal diabetes, both known prior to pregnancy and diagnosed during pregnancy, and the risk of ASD in children.
The researchers analyzed data on 322,323 children born from 1995-2009 at Kaiser Permanente Southern California (KPSC) hospitals. Children were followed from birth until the first of the following: date of clinical diagnosis of ASD, last date of continuous KPSC health plan membership, death due to any cause, or December 31, 2012.
Of all the children in the study, 6,496 (2.0 percent) were exposed to pre-existing type II diabetes, 25,035 (7.8 percent) were exposed to GDM, and 290,792 (90.2 percent) were unexposed.
At a median age of five years old, 3,388 children were diagnosed as having ASD: 115 had been exposed to pre-existing type II diabetes, 130 exposed to GDM at 26 weeks or less, 180 exposed to GDM at more than 26 weeks, and 2,963 unexposed.
After adjusting for various factors, including maternal age, household income, race/ethnicity, and sex of the child, the researchers found that GDM diagnosed by 26 weeks was significantly associated with risk of ASD in offspring, but maternal pre-existing type II diabetes was not.
The increased ASD risk was independent of maternal smoking, prepregnancy body mass index, and gestational weight gain. Use of antidiabetic medication by the mother was not independently associated with ASD risk in children.
The researchers write that the biological link between gestational diabetes and ASD may be the result of multiple pathways, such as hypoxia (a lower-than-normal concentration of oxygen in the blood) in the fetus, oxidative stress in cord blood and placental tissue, chronic inflammation, and epigenetics (something that affects a cell, organ, or individual without directly affecting its DNA).
The findings are published in the journal JAMA.
In a new study, Case Western Reserve researchers discovered a social strategy using service activities helps addicted teens avoid relapse and successfully transition back to society.
Psychiatry professor Maria Pagano, Ph.D., studied a group of nearly 200 teenagers admitted to a residential treatment center in the northeastern United States. The adolescents displayed a high prevalence of social anxiety issues that had preceded initial use of alcohol and other drugs by an average of two years, Pagano discovered.
She also found that 42 percent of youths in the study acknowledged severe social fears and 15 percent of youths in the study met diagnostic criteria for social anxiety disorder.
“Drinking and drug use relieved a pervasive sense of not fitting in for many youths addicted to alcohol and illicit drugs, and hypersensitivity to criticism is common,” said Pagano, the lead author of the study published in the journal Alcoholism: Clinical and Experimental Research.
“The incidence of higher rates of heroin use among young adults living in this region is distressing. A sense of belonging is important to live sober and to thrive, and 12-step service offers a venue for those impaired by social anxiety.”
Along with colleagues at Case Western Reserve, Baylor University, and the University of Akron, Pagano examined the participation of youths in Alcoholics Anonymous service activities, such as setting up chairs or making coffee, as a way to facilitate the youth’s transition back into the community following treatment and a sober peer group.
Service participation during treatment was higher among youths with social anxiety and cut the risk of relapse and incarceration approximately in half in the six months post-treatment. Forty-three percent of youths with social anxiety were high helpers during treatment, compared to 30 percent of youths without social anxiety.
Pagano and her colleagues noted that most formal treatment modalities are delivered in groups that can trigger the fear of negative peer appraisal among those with social anxiety. That’s where service activities can be particularly useful for those with social anxiety.
Service activities allow for conversations to occur naturally, do not involve speaking in front of others, and allow youths to contribute and benefit from the 12-step program.
Youths with social anxiety who did not get active in service during treatment had the greatest risk of relapse, whereas high helpers with or without social anxiety were less likely to relapse and be incarcerated post-treatment.
“Low-intensity service is a more gentle way for youths to feel like they belong and to connect with other people who are facing similar challenges,” Pagano said.
“Getting active in helping others through AA motivates them to stay long enough to benefit from other AA activities and increase their chances of turning their life around toward a positive life trajectory.”
Ongoing AA meetings provide an environment for engaging with a caring network of people. Programs encourage ongoing attendance at AA meetings, particularly during the high-risk six months after treatment when 60 to 90 percent relapse and AA meeting attendance dramatically declines.
Pagano also recommends a full diagnostic evaluation of youths entering addiction treatment who appear to be socially anxious. These evaluations may lead to a definitive diagnosis of social anxiety disorder and an opportunity to treat affected adolescents with medication.
Having a social network and feeling that one “fits in” with other peers is vitally important. Pagano observed in her earlier work with adults and adolescents suffering addiction that many commonly described feeling like a social misfit.
The closest condition she could find to the feeling of not belonging was social anxiety disorder. In future research, Pagano plans to assess and quantify the feeling of not fitting in — a social misfit syndrome, of sorts — and how that relates to substance addiction.
“Social anxiety disorder is the most common anxiety disorder among individuals with addiction,” Pagano said. “I believe the feeling of being a social misfit is lurking behind social anxiety and is common among those suffering with the disease of addiction.”
Why do some young people react adaptively while others brood and ruminate?
In a new study, researchers wanted to learn why some youth learn to handle their emotions better than others. They found adolescents who mentally take a step back from their own point of view when thinking about something troubling can deal with negative emotions more effectively and become less upset by them.
The study, conducted by researchers at the University of Pennsylvania and University of Michigan, appears in the journal Child Development.
The researchers looked at 226 African American 11- to 20-year-olds from an urban public school in Washington, D.C., asking them about a recent event that made them extremely angry (such as a fight).
The youth then reflected on their experiences and why they felt angry, then told researchers about how they felt and thought about the experiences.
For example, the researchers assessed self-distancing by asking the youth: “When you saw the fight again in your imagination a few minutes ago, how much did you feel like you were seeing it through your own eyes versus watching the fight happen from a distance (like watching yourself in a movie)?” and “When you saw the fight again in your imagination a few moments ago, how far away from the fight did you feel?”
Prior work with adults has shown that self-distancing helps adaptive self-reflection. However, no research has investigated whether adolescents spontaneously engage in this process or whether doing so is linked to adaptive outcomes, say the researchers.
In the study, investigators discovered youth who reflected on their experiences from a self-distanced perspective became less upset than those who reflected from a self-immersed perspective. In part, this was because adolescents who saw their experience from a distance thought about it differently.
These youth were more likely to reconsider the events in meaningful and insightful ways, and less likely to simply replay the upsetting events in their minds. They were also less likely to continue to blame the other person involved in the event (though not less likely to forgive him or her). In turn, these new insights were associated with less emotional distress.
“Mentally stepping back from the event didn’t mean the youth were avoiding their problems,” said Dr. Rachel E. White, postdoctoral researcher at the University of Pennsylvania, the study’s lead author. “In fact, they were dealing with them in a more adaptive way.”
The study also found that self-distancing strategies seemed to grow more powerful with age. Older youth who self-distanced became even less upset than younger adolescents who did so.
“These results show that teens can use self-distancing strategies in much the same way as adults,” White notes. “They also suggest that the teen years could be critical in developing this way to regulate emotions.”
A topic not addressed in the current research is if teens can be trained to use these strategies. Prior research does suggest that adults could help youth learn and implement these strategies.
Early studies have shown that the techniques can be taught to children just entering into adolescence as experiments have shown that fifth graders can use self-distancing techniques when instructed to do so — and handle their emotions better as a result.
A new Duke Medicine study has discovered that divorce seems to increase medical risks more in women than in men.
Researchers discovered divorced women suffer heart attacks at higher rates than women who are continuously married. Furthermore, a woman who has been through two or more divorces is nearly twice as likely to have a heart attack when compared to their stably-married female peers.
A man’s risk for heart attack is typically higher than a woman’s. However, the effects of divorce seem to disproportionally affect women’s cardiac health more than men although the results were not statistically significant.
Men who had been divorced had about the same risk as those who stayed married. It was only after two or more divorces that the risk for men went up, the study found.
As discussed in the journal Circulation: Cardiovascular Quality and Outcomes, a salient finding is that even among women who remarry after the stress of divorce, their heart attack risk remains elevated.
“Divorce is a major stressor, and we have long known that people who are divorced suffer more health consequences,” said Matthew Dupre, Ph.D., associate professor of medicine at Duke and the study’s lead author.
“But this is one of the first studies to look at the cumulative effect of divorce over a long period. We found that it can have a lasting imprint on people’s health.”
Researchers used data gathered from the responses of a nationally representative group of 15,827 people ages 45 to 80 who had been married at least once. Participants were interviewed every two years from 1992 to 2010 about their marital status and health. About one-third of participants had been divorced at least once during the 18-year study.
Another finding from the study was that men who remarried also fared better than women. These men experienced the same risk of heart attack as men who had been married continuously to one partner.
Source: Duke Medicine/EurekAlert!
A recent survey suggests that a significant proportion of doctors in the Netherlands are prepared to carry out assisted suicide for people with mental illness.
The survey was undertaken in 2011-2012 by Dr. Eva Bolt and colleagues at the EMGO Institute for Health and Care Research, Amsterdam, the Netherlands. They sent questionnaires to 2,269 randomly selected general practitioners (family doctors) and specialists in elderly care, cardiology, respiratory medicine, intensive care, neurology, and internal medicine. Of these, 1,456 completed the survey.
Respondents were asked if they had ever helped a patient who was suffering with cancer, another physical disease, a mental illness, dementia, or without a severe physical disease but was “tired of living” to die.
This showed that a large majority (86 percent) would consider helping a patient to die. Six out of ten had actually done so.
Overall, 77 percent (and more than 90 percent of GPs) had been asked at least once for help to die. Only a few of the respondents (seven percent) had actually helped a patient who did not have cancer or another severe physical illness to die, whereas over half (56 percent) had helped a cancer patient to die, and around a third (31 percent) had assisted someone with another physical disease.
But feelings about euthanasia and assisted death varied for each health condition. The likelihood of helping was high for cancer patients (85 percent) and those with another physical disease (82 percent).
For mental illness, only 34 percent would consider helping the patient die, and 40 percent would help someone with early-stage dementia to die. The rate was slightly lower for late-stage dementia, at 33 percent.
Just over a quarter (27 percent) would be prepared to help someone tired of living to die if they had a severe medical condition. But fewer than one in five (18 percent) would do so in these circumstances if the person had no other medical grounds for suffering.
Full results are published in the Journal of Medical Ethics. The current situation in The Netherlands is that euthanasia or assisted suicide is legally permissible “for those whose suffering is psychiatric/psychological in nature,” but it rarely occurs.
The authors write, “Euthanasia and physician-assisted suicide (EAS) in patients with psychiatric disease, dementia, or patients who are tired of living (without severe morbidity) is highly controversial. Although such cases can fall under the Dutch Euthanasia Act, Dutch physicians seem reluctant to perform EAS, and it is not clear whether or not physicians reject the possibility of EAS in these cases.
“This study shows that a minority of Dutch physicians find it conceivable that they would grant a request for EAS from a patient with psychiatric disease, dementia, or a patient who is tired of living. For physicians who find EAS inconceivable in these cases, legal arguments and personal moral objections both probably play a role.”
Said Bolt, “Each physician needs to form his or her own standpoint on euthanasia, based on legal boundaries and personal values. We would advise people with a future wish for euthanasia to discuss this wish with their physician in time, and we would advise physicians to be clear about their standpoint on the matter.”
In The Netherlands, the “Termination of Life on Request and Assisted Suicide Act” took effect on April 1, 2002. It legalizes euthanasia and physician-assisted suicide under very specific circumstances. Several stringent conditions must be fulfilled including that “the patient’s suffering is unbearable with no prospect of improvement.”
This legal requirement, the question of unbearable suffering, was explored by a related team of researchers at Radboud University Nijmegen Medical Centre, the Netherlands. They state in the journal Psycho-Oncology, “Unbearable suffering is difficult to assess, so evaluation of the current knowledge of unbearable suffering is needed in the ongoing debate about the conditions on which EAS can be approved.”
They evaluated a range of definitions of suffering and studies on suffering, but “found no definition of unbearable suffering in the context of a request for EAS.” They also report that they “found no studies that brought together the views of the patients, relatives, and healthcare professionals.”
The experts propose their own conceptual definition: “Unbearable suffering in the context of a request for EAS is a profoundly personal experience of an actual or perceived impending threat to the integrity or life of the person, which has a significant duration and a central place in the person’s mind.”
Bolt, E. E. et al. Can physicians conceive of performing euthanasia in case of psychiatric disease, dementia or being tired of living? Journal of Medical Ethics, 18 February 2015 doi 10.1136/medethics-2014-102150
Dees, M. et al. Unbearable suffering of patients with a request for euthanasia or physician-assisted suicide: an integrative review. Psycho-oncology, 19 April 2010 doi: 10.1002/pon.1612.
Gambling has become a serious problem on college campuses with more than 1.6 million college-aged adults meeting the criteria for problem gambling.
Experts say the gambling habit can lead to difficulties at work, school or home, and with relationships, personal finances, and mental and physical health.
While individual counseling for problem gamblers is often effective, the intervention can be expensive and time consuming. A new study suggest a new treatment option for college-aged adults as University of Missouri researchers showed that personalized feedback from computers significantly changed the behavior of problem gamblers.
“We don’t want to replace the one-on-one counseling work that is being done. This is another tool that could be very useful for gamblers who might not be interested in seeking personal counseling services, for counselors who are looking to supplement what they offer, or for college wellness centers who want to mitigate risky behavior before it gets worse,” said Dr. Matt Martens, professor of counseling psychology in the College of Education.
“Typically, younger problem gamblers are not interested in seeking help. While their behavior might not be at a significant risk level yet, this tool would allow them to receive an assessment without talking directly to a counselor.”
In the study, Martens identified 333 college-aged adults and, after determining the level of gambling for each individual, gave them one of three interventions.
One group was provided with standard information about the effects of problem gambling; the second group was not provided with any information; the third group answered survey questions and was provided with individualized feedback from a computer based on their answers.
Martens followed up with each group three months after the initial intervention and found that those who received the personalized feedback generated by the computer assessment tool experienced a significant decline in problem gambling behavior compared to the other two groups.
Prior to the intervention, Martens asked study participants to describe their current gambling behaviors, which included how many times they gambled each week or month, how much money was wagered, how much money was lost, and what problems they experienced based on their gambling.
Participants also were asked about the types of gambling games they played, including slot machines and games of skill such as golf or bowling. They also reported on how often they purchased lottery tickets, played cards for money, or wagered money on sports games.
Age, gender, mental health issues, and personality traits all influence gambling risks.
“At-risk gambling rates are particularly high in the college-age population, and these problem gamblers may not recognize that they are experiencing problems,” Martens said. “They may think that they are gambling at the same rate as their peers, when that’s really not the case.
“That’s where these types of programs can help because individuals receive an unbiased, personalized assessment that shows them the social norms of their gambling activity and how they compare.”
Martens said this type of intervention could be used most effectively on college campuses at health centers or as a part of comprehensive wellness programs targeting students. Targeting those individuals who might be at a greater risk could help prevent them from developing behaviors that would have negative effects on the rest of their lives.
Researchers believe future research should investigate if this intervention is more effective with certain types of gambling behaviors, such as those individuals who only bet on games of skill compared to those who bet on games of chance.