Michael Bernstein, American Chemical Society

New evidence puts into doubt the long-standing belief that a deficiency in serotonin — a chemical messenger in the brain — plays a central role in depression. In the journal ACS Chemical Neuroscience, scientists report that mice lacking the ability to make serotonin in their brains (and thus should have been “depressed” by conventional wisdom) did not show depression-like symptoms.

Donald Kuhn and colleagues at the John D. Dingell VA Medical Center and Wayne State University School of Medicine note that depression poses a major public health problem. More than 350 million people suffer from it, according to the World Health Organization, and it is the leading cause of disability across the globe. In the late 1980s, the now well-known antidepressant Prozac was introduced. The drug works mainly by increasing the amounts of one substance in the brain — serotonin. So scientists came to believe that boosting levels of the signaling molecule was the key to solving depression. Based on this idea, many other drugs to treat the condition entered the picture. But now researchers know that 60 to 70 percent of these patients continue to feel depressed, even while taking the drugs. Kuhn’s team set out to study what role, if any, serotonin played in the condition.

To do this, they developed “knockout” mice that lacked the ability to produce serotonin in their brains. The scientists ran a battery of behavioral tests. Interestingly, the mice were compulsive and extremely aggressive, but didn’t show signs of depression-like symptoms. Another surprising finding is that when put under stress, the knockout mice behaved in the same way most of the normal mice did. Also, a subset of the knockout mice responded therapeutically to antidepressant medications in a similar manner to the normal mice. These findings further suggest that serotonin is not a major player in the condition, and different factors must be involved. These results could dramatically alter how the search for new antidepressants moves forward in the future, the researchers conclude.

The authors acknowledge funding from the Department of Veterans Affairs and the Department of Psychiatry and Behavioral Neurosciences at Wayne State University.

Chuck Bednar for redOrbit.com – Your Universe Online
In a finding that could forever alter our perception of bonding with our significant others, researchers from the University at Buffalo School of Public Health and Health Professions and Research Institute on Addictions (RIA) have discovered fewer incidents of domestic violence among married couples who smoke pot together.
The study, which appears in the August online edition of Psychology of Addictive Behaviors, looked at the marijuana use of both husbands and wives and predicted the number of frequent intimate partner violence (IPV) incidents perpetrated by husbands. They found that those who used pot at least two or three times per month frequently reported the least-frequent number of IPV incidents.
According to Taryn Hillin of the Huffington Post, the Buffalo researchers, along with colleagues from Yale and Rutgers, recruited 634 couples applying for marriage licenses in New York between 1996 and 1999. After an initial interview, the authors followed the couples over a nine-year period using mail-in surveys to measure marijuana’s impact on domestic violence.
For the purposes of the study, incidents of domestic violence or IPV were defined as acts of physical aggression, such as slapping, hitting, beating and choking, Hillin said. The study authors measured incidents by asking couples to report violence committed by them or toward them in the last year, and at the end of the first year, they found that 37.1 percent of all husbands had committed acts of domestic violence against their wives.
Marijuana use was measured by asking participants how often they used marijuana over the last year, she added. They also asked the participants about other drug use, including alcohol, which they noted is often used in conjunction with marijuana. They suspected that, since alcohol and other substance abuse have been known to increase IPV rate, the same would be true with pot use. However, that was not the case.
Over the course of the first nine years of marriage, the researchers found that more frequent marijuana use by husbands and wives predicted less frequent incidents of intimate partner violence perpetration by husbands, and that the male’s marijuana use also predicted less frequent IPV perpetration by wives. Couples in which both spouses frequently used pot reported the least frequent domestic violence perpetration, and the link was most evident in women who did not have histories of prior antisocial behavior.
“These findings suggest that marijuana use is predictive of lower levels of aggression towards one’s partner in the following year,” lead investigator Dr. Kenneth Leonard, director of the UB Research Institute on Addictions, said in a statement. “As in other survey studies of marijuana and partner violence, our study examines patterns of marijuana use and the occurrence of violence within a year period. It does not examine whether using marijuana on a given day reduces the likelihood of violence at that time.”
“Although this study supports the perspective that marijuana does not increase, and may decrease, aggressive conflict, we would like to see research replicating these findings, and research examining day-to-day marijuana and alcohol use and the likelihood to IPV on the same day before drawing stronger conclusions,” he added. “While couples who reported marijuana use also reported less marital aggression, previous research with these couples found that couples who smoked marijuana were not less likely to divorce.”
The authors emphasize that while the findings are predictive, they do not necessarily indicate that there is a causal relationship between the two behaviors, said Washington Post reporter Christopher Ingraham. It could simply be that smoking pot makes couples happy, and therefore less likely to fight, or it could be that chronic cannabis use decreases the likelihood of aggressive behavior.
Dr. Leonard and his colleagues note that their paper “does not address the potential impact of parental marijuana use on children in the family and other problems associated with daily marijuana use.” Furthermore, it also does not explore other areas of marijuana use, including abuse, dependence and withdrawal – all of which could impact how spouses interact with one another, Ingraham noted.
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Chuck Bednar for redOrbit.com – Your Universe Online

Men looking to reduce their risk of developing prostate cancer could benefit by consuming at least 10 servings of tomatoes per week, according to new research appearing in a recent edition of the journal Cancer Epidemiology, Biomarkers & Prevention.

Doing so can decrease the risk of contracting the disease by 18 percent, Vanessa Er of the University of Bristol’s School of Social and Community Medicine and her colleagues claim in the UK National Institute for Health Research (NIHR)-funded study. The findings follow an in-depth analysis of the diets and lifestyles of 1,806 men between the ages of 50 and 69 with prostate cancer, as well as those of 12,005 cancer-free male patients.

According to BBC News online health editor Helen Briggs, not only did they find that men consuming a total of at least 10 portions of fresh tomatoes, tomato juice, baked beans and other similar products experienced the 18 percent reduction in prostate cancer risk, but they also discovered that eating five servings of fruits or vegetables per day decreased the risk by 24 percent versus men eating half that amount.

“Our findings suggest that tomatoes may be important in prostate cancer prevention,” Er, a Ph. D. student at the university, said in a statement. “However, further studies need to be conducted to confirm our findings, especially through human [clinical] trials. Men should still eat a wide variety of fruits and vegetables, maintain a healthy weight and stay active.”

Er, who also worked with scientists from the University of Cambridge and Oxford University, explained that the reason tomato products appeared to be the most beneficial in reducing prostate cancer risk was due to lycopene, an antioxidant which helps combat toxins that can cause DNA and cell damage. They note that this is the first study of its kind to develop an index of dietary components that have been linked to prostate cancer.

“Only the recommendation on plant foods – high intake of fruits, vegetables and dietary fiber – was found to be associated with a reduced risk of prostate cancer,” the university explained. “As these recommendations are not targeted at prostate cancer prevention, researchers concluded that adhering to these recommendations is not sufficient and that additional dietary recommendations should be developed.”

In addition, Anna Hodgekiss of the Daily Mail reported that Er believes the best way to get lycopene – as well as other cancer-fighting dietary components such as selenium and calcium – is directly from food, not through supplements. In all, the study calls for men to make sure they ingest between 750mg and 1,200mg of calcium and between 105mcg to 200mcg of selenium daily.

Er and her colleagues are now calling for additional research to aid in the development of additional dietary recommendations to help prevent prostate cancer. She also told Hodgekiss that it was important to be cautious with the study because while they have found “a link,” their findings do not indicate “a proof of causation.”

Similarly, Tom Stansfeld of Cancer Research UK told Briggs that while “eating foods rich in lycopene – such as tomatoes – or selenium may be associated with a reduction in the risk of prostate cancer, this has not been proven, and this study can’t confirm whether there is a link between diet and prostate cancer risk. Diet and cancer prevention is a complex issue with few black and white answers; we encourage everyone to eat a balanced diet which is high in fruit and vegetables and low in red and processed meat, fat and salt.”

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The Too Many Tomatoes Cookbook: Classic & Exotic Recipes from around the World by Brian Yarvin

Jim Sliwa, American Society for Microbiology

The predominant strain of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infecting people in Europe, the Middle East and northern Africa derived from a single sub-Saharan ancestor, a team of international researchers reported this week in mBio®, the online open-access journal of the American Society for Microbiology.

CA-MRSA refers to MRSA infections occurring in healthy people with no recent hospitalizations. The infections, which are typically skin infections, can be transmitted through close person-to-person contact or contact with a contaminated item like a towel or clothing.

“With increasing levels of CA-MRSA reported from most parts of the Western world, there is a great interest in understanding the origin and factors associated with the emergence of these epidemic lineages,” said lead study author Marc Stegger, PhD, of the Department of Microbiology and Infection Control at the Statens Serum Institut in Denmark. “Our study determined that a single descendant of a methicillin-sensitive ancestor circulating in sub-Saharan Africa rose to become the dominant CA-MRSA clone in Europe, the Middle East and north Africa.”

In Europe, the predominant CA-MRSA strain belongs to a family called clonal complex 80 (CC80), which are resistant to the antibiotics kanamycin/amikacin, tetracyclin and fusidic acid, in addition to beta-lactams. It was first identified sporadically in the late 1990s, but has since been identified throughout northern Africa, the Middle East and Europe, with only sporadic reports from Asia, Australia and South America.

For the study, Stegger and colleagues at 19 other institutions around the world analyzed 97 S. aureus CC80 samples from 22 countries in Europe, North Africa, sub-Saharan Africa, the Middle East and Asia isolated between 1993 and 2010. Twenty-three samples were sensitive to methicillin while 74 were resistant to methicillin. The investigators performed whole genome sequencing, a technique that determines the complete DNA sequence of an organism’s genetic material at a single time, and other tests to trace the origin, evolution and dissemination pattern of the European CA-MRSA clone CC80.

Within the samples, the team identified two distinct groups of S. aureus: a methicillin-sensitive clone from sub-Saharan Africa that was susceptible to all antibiotics, and the rest from all other areas that were MRSA and most often resistant to other antibiotics. Studying family trees among the bacteria, they found that the European CC80 clone evolved from the strain from sub-Saharan Africa. They also noted that in the transition from a methicillin-sensitive line to a CA-MRSA clone, the bacteria simultaneously acquired two highly specific genetic elements making them resistant to methicillin and became resistant to fusidic acid.

The methicillin-sensitive S. aureus resided in sub-Saharan Western Africa, potentially as a result of the local human migration patterns, Stegger said. The investigators hypothesize that CC80 moved to other countries starting in the mid-1980s due to several factors, including increased migration from sub-Saharan Africa in search of better economics, and as a result of an increase in European tourism to this region of Africa, he said. The simultaneous acquisition of methicillin and fusidic acid resistance determinants and their stability in the European CA-MRSA could be a result of a higher selective pressure in North Africa and Europe.

The study was supported by Pfizer and the Foundation pour la Recherche Médicale. A copy of the article can be found online at http://bit.ly/asmtip0814d.

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Noah Brown, Massachusetts General Hospital
Previously reported autism risk appears to be attributable to mother’s illness, not medication
Previous studies that have suggested an increased risk of autism among children of women who took antidepressants during pregnancy may actually reflect the known increased risk associated with severe maternal depression. In a study receiving advance online publication in Molecular Psychiatry, investigators from Massachusetts General Hospital (MGH) report that – while a diagnosis of autism spectrum disorder was more common in the children of mothers prescribed antidepressants during pregnancy than in those with no prenatal exposure – when the severity of the mother’s depression was accounted for, that increased risk was no longer statistically significant. An increased risk for attention-deficit hyperactivity disorder (ADHD), however, persisted even after controlling for factors relating to a mother’s mental health.
“We know that untreated depression can pose serious health risks to both a mother and child, so it’s important that women being treated with antidepressants who become pregnant, or who are thinking about becoming pregnant, know that these medications will not increase their child’s risk of autism,” says Roy Perlis, MD, MSc, MGH Department of Psychiatry, senior author of the report.
The authors note that, while genetic factors are known to play a substantial role in autism, exactly how that risk may be exacerbated by environmental factors is not well understood. While animal studies and investigations based on health records have suggested an increased risk associated with prenatal antidepressant exposure, others found no such association. And since discontinuing antidepressant treatment significantly increases the risk of relapse – including an increased risk of postpartum depression – the current study was designed to clarify whether or not any increased autism risk could actually be attributed to the medication.
To investigate this possibility, the research team analyzed electronic health record data for children born at MGH, Brigham and Women’s Hospital, or Newton Wellesley Hospital – hospitals belonging to Partners HealthCare System – for whom a diagnostic code for pervasive developmental disorder, a category that includes autism, was entered at least once between 1997 and 2010. They matched data for almost 1,400 such children with that of more than 4,000 controls with no autism diagnoses, born the same years and matched for a variety of demographic factors.
The children’s information was paired with that of their mothers, noting any factors related to the diagnosis and treatment of major depression or other mental illness, including prescriptions for antidepressants and other psychotropic drugs. A similar analysis was done for almost 2,250 children with an ADHD diagnosis, compared with more than 5,600 matched controls with no ADHD diagnoses.
While prenatal exposure to antidepressants did increase the risk for either condition, in the autism-focused comparison, adjusting for factors indicating more severe maternal depression reduced the strength of that association to an insignificant level. Taking antidepressants with stronger action in the serotonin pathway, which has been suspected of contributing to a possible autism risk, did not increase the incidence of the disorder. In addition, the children of mothers who took a serotonin-targeting non-antidepressant drug for severe morning sickness had no increased autism incidence. Prescriptions for antipsychotic drugs sometimes used to treat severe, treatment-resistant depression, as well as psychotic disorders, did appear to increase the risk for autism. For ADHD, however, the increased risk associated with prenatal antidepressant exposure remained significant, although reduced, even after adjustment for the severity of maternal depression.
“There are a range of options – medication and non-medication – for treating depression and anxiety in pregnancy,” says Perlis, an associate professor of Psychiatry at Harvard Medical School. “But if antidepressants are needed, I hope parents can feel reassured about their safety.”
Caitlin Clements of the MGH Department of Psychiatry is lead author of the Molecular Psychiatry paper. Additional coauthors are Sarah Blumenthal, Hannah Rosenfield, Maurizio Fava, MD, Alysa Doyle, PhD, and Jordan Smoller, MD, ScD, MGH Psychiatry; Victor Castro , MD, and Shawn Murphy, MD, PhD, Partners Research Computing; Anjali Kaimal, MD, MAS, MGH Obstetrics and Gynecology; Elise Robinson, PhD, MGH Center for Human Genetic Research; Jane Erb, MD, and Isaac Kohane, MD, Brigham and Women’s Hospital, and Susanne Churchill, PhD, Partners Information Systems. Support for the study includes National Institute of Mental Health grant R01MH086026 and support from the Stanley Center for Psychiatric Research.
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Emma Mason, European Society of Cardiology

Cardiovascular patients should be cautious when exposed to high altitudes for leisure or work

An expedition to Mount Everest by Italian researchers has shown for the first time that blood pressure monitored over a 24-hour period rises progressively as people climb to higher altitudes. The researchers also found that while a drug used for lowering blood pressure, called telmisartan, was effective in counteracting the effects of altitude up to 3400 meters, it was not effective at 5400 meters above sea level – the height of the Everest base camp.

The study is published online Aug. 27 in the European Heart Journal, and its findings have implications not just for people who live, work or undertake recreational activities such as skiing and trekking at high altitudes, but also for people at lower altitudes who may be temporarily deprived of an adequate oxygen supply – a condition known as hypoxia. Hypoxia can lead to altitude sickness at high altitudes, but is also seen at sea level in people who suffer from sleep apnea when their breathing is temporarily interrupted by a blocked airway.

For the study, 13 of the 15 authors of the EHJ paper joined an expedition of 47 volunteers to the Mount Everest south base camp (altitude 5400 meters). They flew from Milan, Italy (altitude 120 meters) to Kathmandu, Nepal (1355 meters) where they stayed for three days. Then they went to Namche Bazaar (3400 meters) where they stayed for another three days before spending the next five days climbing to the Everest base camp where they stayed for 12 days.

During the expedition, the volunteers had their blood pressure taken in the conventional way over a five-minute period in the morning, but they also wore a device that measured their blood pressure every 15-20 minutes over a 24-hour period – giving readings for ambulatory blood pressure, which is a much more accurate measure of a person’s true blood pressure. It also has the advantage of being able to measure night-time blood pressure, which is normally 10-20% lower than daytime blood pressure, and which is a better predictor of outcome than other blood pressure measurements. When the blood pressure does not “dip” at night despite the person being asleep, this may indicate a problem in the regulation of the heart and blood vessels.

The participants were randomized to receive either 80 mg of a blood pressure lowering drug, telmisartan, or placebo. Telmisartan is known as an “angiotensin receptor blocker” (ARB) because it blocks the effects of a peptide called angiotensin II, which causes blood vessels to narrow. The researchers collected blood samples as well.

The researchers found that exposure to the very high altitude of 5400 meters was responsible for an increase of 14 mmHg in ambulatory systolic blood pressure and 10 mmHg in ambulatory diastolic blood pressure, averaged over a 24-hour period. They also found that telmisartan significantly reduced ambulatory blood pressure at sea level and at 3400 meters, while no effects could be seen soon after arriving at 5400 meters.

Professor Gianfranco Parati, professor of cardiovascular medicine at the University of Milano-Bicocca and Director of the Cardiology Research Laboratory at the Istituto Auxologico Italiano (Milan, Italy), who led the research, said:

“Our study provides the first systematic demonstration that exposure to progressively higher altitudes is associated with a progressive and marked increase in ambulatory blood pressure. The increase occurred immediately after the high altitude was reached, persisted during prolonged altitude exposure, was seen throughout the 24-hour period but was particularly pronounced at night when there was a reduction in the night-time ‘dip’, and disappeared after return to sea level. After reaching Everest base camp, the effect of high altitude was greater on systolic blood pressure in people aged 50 and over compared with younger people.

“The blood pressure increase seen with exposure to progressively more severe oxygen deprivation at higher altitude among volunteers in the placebo group and in both groups at 5400 meters may have implications for the management of patients with chronic diseases, including chronic heart failure in which breathing is interrupted periodically, acute worsening of chronic obstructive pulmonary disease, obstructive sleep apnea, and severe obesity. Together, these conditions affect more than 600 million people worldwide, making our results highly significant from a clinical perspective.

“This blood pressure increase is due to several factors, the most important being the effects of oxygen deprivation in increasing activity in the body’s sympathetic nervous system. This leads to the heart working harder and the peripheral blood vessels constricting.

“Our paper also provides the first demonstration of the efficacy at high altitude of one of the most common drugs used to treat high blood pressure. The ability of telmisartan in blocking the angiotensin II receptors is preserved during acute exposure to moderately high altitudes up to 3400 meters, but is impaired when people move to the very high altitudes of 5400 meters.

“At a practical level this implies that for people already being treated with angiotensin II receptor blockers such as telmisartan, the treatment will remain effective at altitudes reached by trekkers, climbers, skiers and workers, but will not work at very high altitudes where their blood pressure will probably become uncontrolled more easily.

“Our findings will also enable us to take appropriate action to warn cardiovascular patients of the need for caution whenever they are going to be exposed to high altitudes for leisure or work. In addition, this study emphasizes the importance of ambulatory blood pressure monitoring as compared to conventional blood pressure measurements in characterizing blood pressure levels in people’s real lives; this is particularly important when focusing on the effects of hypoxia, which can be much less evident at rest than during daily life activities.”

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David Engblom, Linköping University
Fever is a response to inflammation, and is triggered by an onset of the signaling substance prostaglandin. Researchers at Linköping University can now see precisely where these substances are produced – a discovery that paves the way for smarter drugs.
When you take an aspirin, all production of prostaglandins in the body is suppressed. All symptoms of inflammation are eased simultaneously, including fever, pain and loss of appetite. But it might not always be desirable to get rid of all symptoms – there is a reason why they appear.
”Perhaps you want to inhibit loss of appetite but retain fever. In the case of serious infections, fever can be a good thing,” says David Engblom, senior lecturer in neurobiology at Linköping University.
Eleven years ago he had his first breakthrough as a researcher when he uncovered the mechanism behind the formation of prostaglandin E2 during fever. These signaling molecules cannot pass the blood-brain barrier, the purpose of which is to protect the brain from hazardous substances. Engblom showed that instead, they could be synthesized from two enzymes in the blood vessels on the inside of the brain, before moving to the hypothalamus, where the body’s thermostat is located.
Previous work from the research team described a very simple mechanism, but there was not yet proof that it was important in real life. The study to be published in The Journal of Neuroscience with David Engblom and his doctoral student Daniel Wilhelms as lead authors is based on tests with mice that lack the enzymes COX-2 and mPGES-1 in the brain’s blood vessels. When they were infected with bacterial toxins the fever did not appear, while other signs of inflammation were not affected.
”This shows that those prostaglandins which cause fever are formed in the blood-brain barrier – nowhere else. Now it will be interesting to investigate the other inflammation symptoms. Knowledge of this type can be useful when developing drugs that ease certain symptoms, but not all of them,” explains David Engblom.
For many years there has been debate as to where the fever signaling originates. Three alternative ideas have been proposed. Firstly, that it comes from prostaglandins circulating in the blood, secondly that it comes from immune cells in the brain, and thirdly Engblom’s theory, which stresses the importance of the brain’s blood vessels. The third proposal can now be considered confirmed.
Article: Deletion of prostaglandin E2 synthesizing enzymes in brain endothelial cells attenuates inflammatory fever by Daniel Björk Wilhelms, Milen Kirilov, Elahe Mirrasekhian, Anna Eskilsson, Unn Örtegren Kugelberg, Christine Klar, Dirk A. Ridder, Harvey R. Herschman, Markus Schwaninger, Anders Blomqvist and David Engblom. Journal of Neuroscience, 27 August 2014. DOI:10.1523/JNEUROSCI.1838-14-2014 http://www.jneurosci.org/
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Jen Middleton, University of Edinburgh

Genetic changes that occur in patients with the bowel condition Crohn’s disease could hold clues to fighting the illness.

Scientists have identified chemical changes in the DNA of patients with Crohn’s disease that could help to screen people for the disease.

These changes can be detected in blood samples, opening the door to a simple test for Crohn’s disease.

The findings also offer clues to how the condition develops and reveal possible targets for new treatments.

Several genes have been linked to Crohn’s disease but not everybody who inherits these genes will develop the condition. The discovery sheds light on how environmental factors that vary between individuals – such as diet and gut bacteria – can trigger Crohn’s disease in some people who have inherited these genes.

A study involving children with Crohn’s disease in Edinburgh, Aberdeen, and Glasgow – led by the University of Edinburgh – identified chemical changes in their DNA that affect how their genes work.

The genes that are affected by these changes could represent useful targets for new treatments, the scientists say.

A DNA test alone would not be enough to diagnose the disease but it could pinpoint those at most risk and help to reduce the number of people who are put forward for further tests, researchers say.

It could also help to monitor progression of the disease and how patients respond to treatment.

Crohn’s disease is a type of inflammatory bowel disease and a common cause of chronic ill-health in the UK. It is a particular problem in children in Scotland, where the incidence of the disease has increased by 500 percent in the past 50 years.

At present there is no way to prevent Crohn’s disease and therapy is focused on treating the symptoms, which may include abdominal pain, diarrhea and severe weight loss.

Professor Jack Satsangi, from the Centre for Genomic and Experimental Medicine at the University of Edinburgh, said: “Our study gives the strongest evidence yet that epigenetic changes are involved in Crohn’s disease. The findings provide a potential mechanism whereby diet or other environmental factors may modify genetic material to cause Crohn’s disease. We hope the findings will help to identify much-needed treatment opportunities for this debilitating condition.”

Reference: A.T. Adams et al. Two-stage Genome-wide Methylation Profiling in Childhood-onset Crohn’s Disease Implicates Epigenetic Alterations at the VMP1/MIR21 and HLA Loci. Inflammatory Bowel Diseases, August 2014.

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April Flowers for redOrbit.com – Your Universe Online

Pets are our companions, our friends and our caregivers. They are good for our mental well-being, but what about our physical well-being? A new study from the University of Liverpool indicates that the well-being of both the pet and the owner could be improved with education and pet-friendly facilities.

The study, published in the International Journal of Behavioral Nutrition and Physical Activity, suggests that communities invest in dog owner education and facilities to target inactivity and obesity in both pets and their owners.

The research team, led by population health scientist Dr. Carri Westgarth from Liverpool’s Department of Epidemiology and Population Health, conducted a literature review of studies published since 1990. They found that access to dog-friendly walking environments and better education about dogs’ physical needs motivate people to get out and take more exercise with their pets.

Studies estimate that at least 40 percent of dog owners do not walk their pets. Nearly one-quarter of all households in the UK own a dog, but less than 50 percent of adults meet the recommended level of 150 minutes of physical activity a week.

The research team from the University’s Institute of Infection and Global Health analyzed the results of 31 studies from the UK, US, Australia and Japan to understand how to motivate people to exercise using dog walking.

One common thread throughout the studies was the wide variety of understanding among dog owners of how much exercise their animal needs. This understanding had a direct effect on how much they walked their dog. The research team believes this could be addressed with education programs.

The researchers also found that people without access to high quality areas that support dog walking (dog parks that allow dogs off leash and provide waste disposal facilities, for example), are less likely to walk with their dog. Both the owner and the pet miss out on the associated health benefits.

Westgarth said, “It is easy to assume that people who own dogs are more likely to take exercise, but the reality can be very different. If all people who owned a dog walked with it every day, physical activity levels would be much improved, benefiting the health of both the owners and their canine companions.”

“There are a large number of reasons why people do or don’t walk their dog and it is worth considering how we can address this when designing strategies for reducing obesity, or when planning urban areas and public open space. Not being able to let their dog off the leash is a particular put-off.”

One finding that did not surprise the researchers is that the strength of the dog-owner bond is important. Dog owners with high attachments to their pets, and those who felt a great degree of support from their pets, were more likely to walk with them.

Dr. Westgarth said, “The study also found that some people are worried about their dogs’ behavior and may be less likely to take it out to the park – potentially out of embarrassment or worry about how it might act – but lack of walks may also be causing this bad behavior, due to boredom, frustration or lack of socialization.

“There aren’t many studies in this area at the moment, but with such a large proportion of people having a dog, it seems that better education, facilities and improved relationships with our pets could be a great way for a large portion of the population to feel encouraged to exercise.”

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Sonia Caprio (Yale University), Diabetologia

New research published in Diabetologia (the journal of the European Association for the Study of Diabetes) shows that children exposed to gestational diabetes in the wombs of their mothers are themselves around six times more likely to develop diabetes or prediabetes than children not exposed. The research is by Dr Sonia Caprio, Yale University School of Medicine, New Haven, CT, USA, and colleagues.

With the increase in gestational diabetes (GDM), there is a growing need to understand the effects of glucose exposure on the newborn in the womb, at birth and later in life. The risk of developing impaired glucose tolerance (IGT) (prediabetes) in individuals exposed to diabetes in the womb has not, say the authors, been adequately investigated. Thus in this new study, the authors examined the risk in obese youths of developing IGT after exposure to GDM in the womb. The authors say: “We hypothesized that prenatal exposure to GDM in obese children with normal glucose tolerance (NGT) would be associated with development of altered glucose metabolism over time, driven by an impairment of beta cell secretion relative to the insulin sensitivity.”

255 obese adolescents with a normal glucose tolerance were selected for the study. All of them were investigated for in utero exposure to GDM and underwent an OGTT, which was repeated after approximately 3 years. The authors found that 210 (82%) participants were not exposed to GDM (called the NGDM group), and 45 (18%) were exposed to GDM (the EGDM group). In the NGDM group, only 9% (n=18) developed either IGT or type 2 diabetes compared with 31% (n=14) of the EGDM group who developed either IGT or type 2 diabetes, with both results statistically significant.. “Exposure to GDM was the most significant predictor of developing IGT or type 2 diabetes, with an increased risk of almost six times for those children exposed to GDM in the womb,” say the authors.

At baseline, the EGDM group showed a reduction in beta cell function (the cells that produce insulin), and, at follow-up, they also displayed a reduction in insulin sensitivity compared with the NGDM group.

“Our study demonstrates that obese normal glucose-tolerant children of GDM mothers have pre-existing defects in beta cell function,” say the authors. “This is in turn a strong risk factor for these children to develop prediabetes or diabetes.”

They add: “The ever growing number of women with gestational diabetes (18%) suggests that the future will be filled with children with early diabetes at a rate that far exceeds the current prevalence.”

They conclude: ” Offspring of GDM mothers ought to be screened for IGT and/or impaired fasting glucose (another form of prediabetes), and preventive and therapeutic strategies should be considered before the development of full clinical manifestation of diabetes. While we cannot use this analysis for development of definitive screening guidelines, we strongly suggest that, among obese children and adolescents exposed to GDM, specifically if additional risk factors are present—such as severe obesity or being of ethnicity minorities at higher risk—oral glucose tolerance tests should be performed at baseline (specifically in mid-pubertal adolescents) and potentially repeated based on clinical judgment. Furthermore, the need for studies aimed at unravelling the role of genetic or epigenetic factors and environmental postnatal factors that might be causing functional defects in the beta cell has never been more urgent.”

American Heart Association
Aspirin may be a promising alternative for those who can’t take long-term anticoagulant drugs that prevent clots from reoccurring in the veins, according to new research in the American Heart Association journal Circulation.
In a combined analysis of two similar independent studies, 1,224 patients who received 100 mg of aspirin a day to treat blood clots were monitored for at least two years. In the International Collaboration of Aspirin Trials for Recurrent Venous Thromboembolism or INSPIRE analysis, researchers found that aspirin reduced the risk of recurring blood clots by up to 42 percent.
Venous thromboembolism (VTE) are blood clots in veins. The blood clot can occur in the deep veins of the legs (deep vein thrombosis) and can break apart and travel to the lungs, where they block off arteries in the lungs (pulmonary embolism).
According to researchers, without treatment, people who have blood clots in their veins with no obvious cause have on average a 10 percent risk of another clot within the first year and a 5 percent risk per year thereafter.
“The treatment is warfarin or a newer anticoagulant usually given for at least six to 12 months to prevent a further blood clot,” said John Simes, M.D., lead author of study and director of the National Health and Medical Research Council Clinical Trials Centre and professor at the University of Sydney in Australia. “However, these people continue to be at risk.”
Co-author Cecilia Becattini, M.D., added, “Aspirin does not require laboratory monitoring, and is associated with about a 10-fold lower incidence of bleeding compared with oral anticoagulants. We are convinced that it will be an alternative for extended prevention of venous thromboembolism after 6–12 months of anticoagulant treatment.”
Although the study yielded clear results, researchers advise patients to talk to their doctor about taking aspirin after stopping treatment with anticoagulants.
“It is not recommended that aspirin be given instead of anticoagulant therapy, but rather be given to patients who are stopping anticoagulant therapy or for whom such treatments are considered unsuitable,” Simes said.
“Although less effective, aspirin is inexpensive, easily obtainable, safe and familiar to patients and clinicians worldwide. If cost is the main consideration, aspirin is a particularly useful therapy. The costs of treating future thromboembolic events is greater than the cost of the preventive treatment.”
Other co-authors are Giancarlo Agnelli, M.D.; John W. Eikelboom, M.B., B.S.; Adrienne C. Kirby, M.Sc.; Rebecca Mister, M.Sc.; Paolo Prandoni, M.D.; and Timothy A. Brighton, M.B., B.S. Author disclosures and funding information are on the manuscript.

Shawna Williams, Johns Hopkins Medicine

Chemical alterations to genes appear key to tumor development

Regardless of their stage or type, cancers appear to share a telltale signature of widespread changes to the so-called epigenome, according to a team of researchers. In a study of a broad variety of cancers, published online in Genome Medicine on Aug. 26, the investigators say they have found widespread and distinctive changes to chemical marks known as methyl groups attached to DNA. Those marks help govern whether genes are turned “on” or “off,” and ultimately how the cell behaves. Such reversible chemical marks on DNA are known as epigenetic, and together they make up the epigenome.

“Regardless of the type of solid tumor, the pattern of methylation is much different on the genomes of cancerous cells than in healthy cells,” says Andrew Feinberg, M.D., M.P.H., a professor of medicine, molecular biology and genetics, oncology, and biostatistics at the Johns Hopkins University School of Medicine. Feinberg led the new study along with Rafael Irizarry, Ph.D., a professor of biostatics at Harvard University and the Dana-Farber Cancer Institute. “These changes happen very early in tumor formation, and we think they enable tumor cells to adapt to changes in their environment and thrive by quickly turning their genes on or off,” Feinberg says.

Feinberg, along with Johns Hopkins University School of Medicine oncology professor Bert Vogelstein, M.D., first identified abnormal methylation in some cancers in 1983. Since then, Feinberg’s and other research groups have found other cancer-associated changes in epigenetic marks. But only recently, says Feinberg, did researchers gain the tools needed to find out just how widespread these changes are.

For their study, the research team took DNA samples from breast, colon, lung, thyroid and pancreas tumors, and from healthy tissue, and analyzed methylation patterns on the DNA. “All of the tumors had big blocks of DNA where the methylation was randomized in cancer, leading to loss of methylation over big chunks and gain of methylation in smaller regions,” says Winston Timp, Ph.D., an assistant professor of biomedical engineering at Johns Hopkins. “The changes arise early in cancer development, suggesting that they could conspire with genetic mutations to aid cancer development,” he says.

The overall effect, Feinberg says, appears to be that cancers can easily turn genes “on” or “off” as needed. For example, they often switch off genes that cause dangerous cells to self-destruct while switching on genes that are normally only used very early in development and that enable cancers to spread and invade healthy tissue. “They have a toolbox that their healthy neighbors lack, and that gives them a competitive advantage,” Feinberg says.

“These insights into the cancer epigenome could provide a foundation for development of early screening or preventive treatment for cancer,” Timp says, suggesting that the distinctive methylation “fingerprint” could potentially be used to tell early-stage cancers apart from other, harmless growths. Even better, he says, would be to find a way to prevent the transition to a cancerous fingerprint from happening at all.

Other authors on the paper are Hector Corrada Bravo of the University of Maryland, College Park, and Oliver G. McDonald, Michael Goggins, Chris Umbricht and Martha Zeiger, all of The Johns Hopkins University.

The study was funded by the National Human Genome Research Institute (grant number HG003223), the National Cancer Institute (grant number CA054358), the National Institute of General Medical Sciences (grant numbers GM083084 and GM103552) and the National Center for Research Resources (grant number RR021967).

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April Flowers for redOrbit.com – Your Universe Online

There has been a great deal of research into food allergies lately — ranging from the effect of race on food allergies to how tap water might be linked to the development of allergies. The latest study, from the University of Chicago, shows that the presence of a common gut bacteria, Clostridia, may help protect against food allergies.

The findings, published in Proceedings of the National Academy of Sciences, show that by inducing immune responses designed to prevent food allergies from entering the food stream, Clostridia is able to minimize allergen exposure and prevent sensitization in mice. Sensitization is a necessary step in the development of food allergies. The researchers hope that their results will lead toward probiotic therapies for food allergies, which so far, have been untreatable.

Food allergies are an immune system response to certain foods that can sometimes be deadly. Scientists do not know the cause of these allergies, but some studies have indicated that part of the cause might be modern hygienic and dietary practices – specifically by the way they disturb the body’s natural bacterial composition. Food allergy rates among children have risen significantly in recent years, approximately 50 percent between 1997 and 2011. Other studies have revealed a link between antibiotic and antimicrobial use and the rise of food allergies, as well.

“Environmental stimuli such as antibiotic overuse, high fat diets, caesarean birth, removal of common pathogens and even formula feeding have affected the microbiota with which we’ve co-evolved,” said Cathryn Nagler, PhD, Bunning Food Allergy Professor at the University of Chicago, in a recent statement. “Our results suggest this could contribute to the increasing susceptibility to food allergies.”

Nagler and her colleagues used food allergen responses in mice to test the effect of gut bacteria on food allergies. A group of germ-free mice that were born and raised in sterile conditions (thus having no resident microorganisms), and a group of mice treated with antibiotics as newborns to reduce gut bacteria were both exposed to peanut allergens. Strong immunological responses were seen in both groups of mice. These responses produced significantly higher levels of antibodies against the allergens than mice with normal gut bacteria.

The team was then able to reverse the sensitization to the allergens by reintroducing a mix of Clostridia bacteria into the mice. Introducing another major gut bacteria, Bacteroides, was unsuccessful in reversing the sensitization. This suggests that Clostridia has a unique, protective role in the body’s fight against food allergens.

The team continued their investigation, trying to discover the mechanism by which Clostridia’s protective role was affected. They studied the cellular and molecular responses that occur in the gut, using genetic analysis to discover Clostridia causes innate immune cells to produce high levels of a signaling molecule known to decrease the permeability of the intestinal lining known as interleukin-22 (IL-22).

“We’ve identified a bacterial population that protects against food allergen sensitization,” Nagler said. “The first step in getting sensitized to a food allergen is for it to get into your blood and be presented to your immune system. The presence of these bacteria regulates that process.” Nagler cautions that people with food allergies should not get their hopes up yet. The study findings are most likely applicable at a population level, not an individual one yet.

Factors such as genetics have a great effect on an individual’s chances of developing a food allergy, as well as how those allergies manifest. The identification of a bacteria-induced barrier-protective response, however, represents a sea change in the understanding of how to prevent sensitization to food. Common in the human gut, Clostridia provides a clear target for potential therapies to prevent or treat food allergies. The researchers are continuing their work by developing and testing compositions to be used for probiotic therapy, for which they have filed a provisional patent.

“It’s exciting because we know what the bacteria are; we have a way to intervene,” Nagler said. “There are of course no guarantees, but this is absolutely testable as a therapeutic against a disease for which there’s nothing. As a mom, I can imagine how frightening it must be to worry every time your child takes a bite of food.”

“Food allergies affect 15 million Americans, including one in 13 children, who live with this potentially life-threatening disease that currently has no cure,” said Mary Jane Marchisotto, senior vice president of research at Food Allergy Research & Education. “We have been pleased to support the research that has been conducted by Dr. Nagler and her colleagues at the University of Chicago.”

April Flowers for redOrbit.com – Your Universe Online

Despite controversy and federal laws, a few states have made marijuana legal for medical use to manage chronic pain and other conditions. A new study, published in JAMA Internal Medicine, reveals that those states have a 25 percent lower rate of death by prescription drug overdose than in states where marijuana remains illegal.

The research team included scientists from Johns Hopkins Bloomberg School of Public Health, the Philadelphia Veterans Affairs Medical Center, and the Perelman School of Medicine at the University of Pennsylvania. Medical marijuana laws are controversial, and opponents have raised concerns that such laws might promote the use of marijuana among children. The study findings, however, show that these laws have unintended benefits, as well. The researchers acknowledge that more research is needed, but suggest that the broader availability of medical marijuana might help reduce the alarming growth in overdose deaths attributed to prescription pills.

In particular, the study looked at opioid analgesics such as Vicodin, OxyContin and Percocet, which are all prescribed for moderate to severe pain. These drugs work by suppressing a person’s perception of pain.

“Prescription drug abuse and deaths due to overdose have emerged as national public health crises,” Colleen L. Barry, PhD, an associate professor in the Department of Health Policy and Management at the Bloomberg School, said in a statement. “As our awareness of the addiction and overdose risks associated with use of opioid painkillers such as Oxycontin and Vicodin grows, individuals with chronic pain and their medical providers may be opting to treat pain entirely or in part with medical marijuana, in states where this is legal.”

The researchers used Centers for Disease Control and Prevention (CDC) death certificate data, finding that the rate of prescription painkiller overdose deaths increased across all 50 states from 1999 to 2010. The rates of opioid analgesic overdose deaths, however, was approximately 25 percent lower in 13 states with medical marijuana laws active during the study period.

As of June 2014, 23 states and Washington DC have enacted medical marijuana laws. These laws allow patients with chronic or severe pain from conditions such as cancer or multiple sclerosis to use marijuana to relieve their symptoms. Patients with nausea and depressed appetite have also found relief.

“In absolute terms, states with a medical marijuana law had about 1,700 fewer opioid painkiller overdose deaths in 2010 than would be expected based on trends before the laws were passed,” said Marcus Bachhuber, MD, of the Philadelphia Veterans Affairs Medical Center and the University of Pennsylvania. The mechanism underlying these results is not yet clear, but Bachhuber says that it might be due to people with chronic pain choosing alternative treatments. Medical marijuana laws could also be causing the decrease in overdose deaths by changing the way people abuse or misuse prescription pain medications.

Most deaths, approximately 60 percent, resulting from opioid analgesic overdoses occur in patients who have legitimate prescriptions. The rate of non-cancer patients who are prescribed opioids for pain has almost doubled in the last ten years. States that allow medical marijuana use also allow doctors to prescribe marijuana instead of such opioids. Trevor Hughes of USA Today reports that more than 15,000 US citizens die annually from prescription painkiller overdose.

“People already taking opioids for pain may supplement with medical marijuana and be able to lower their painkiller dose, thus lowering their risk of overdose,” Bachhuber said in a separate statement.

The benefits and risks of using medical marijuana to treat pain remain unclear, according to Brendan Saloner, PhD, an assistant professor in the Department of Health Policy and Management at the Bloomberg School. “Given the fast pace of policy change, more research is critical to understand how medical marijuana laws might be influencing both overdose deaths and the health trajectories of individuals suffering from chronic pain,” he said.

Other key findings of the study suggest that the relationship between medical marijuana laws and lower overdose rates has strengthened overtime. The first year after the state’s law was implemented, deaths decreased by nearly 20 percent, while five years after the rate was 33.7 percent lower. The authors suggest that more states should enact such laws and that more studies are needed to understand the relationship between medical marijuana use and the decrease in opioid overdoses.

In a related commentary, Marie J. Hayes, Ph.D., of the University of Maine, Orno, and Mark S. Brown, M.D., of the Eastern Maine Medical Center, Bangor, write, “If medical marijuana laws afford a protective effect, it is not clear why. If the decline in opioid analgesic-related overdose deaths is explained, as claimed by the authors, by increased access to medical marijuana as an adjuvant medication for patients taking prescription opioids, does this mean that marijuana provides improved pain control that decreases opioid dosing to safer levels?”

Kevin Sabet, director of the Drug Policy Institute at the University of Florida College of Medicine, expressed concern over the method of data collection and analysis in this study. He told Hughes that the study should have differentiated between states with strict and lax medical marijuana laws, as well as examine emergency-room admissions and prescription data. He would also like to have seen them include data on the impact of methadone clinics, finding it hard to believe that there is such a sweeping reduction in predicted deaths.

“In today’s supercharged discussions, it could be easily misunderstood by people,” he said of the study, which he faulted for drawing distinct conclusions based on limited data. “There may be promise in marijuana-based medications but that’s a lot different than ‘here’s a joint for you to smoke.'”

redOrbit Staff & Wire Reports – Your Universe Online
While the data suggests that the e-cigarettes appear to be less harmful than traditional cigarettes and could in some cases help people kick the habit, the American Heart Association said on Sunday that since the products contain nicotine, they should be classified as tobacco products and subject to all applicable laws.
The policy statement, which has been published in the organization’s journal Circulation, explained that there has been little research into whether or not the electronic devices work as smoking cessation aids, with just two randomized controlled trials, one large cross-sectional study, and some anecdotal reports and online surveys analyzing the issue.
“The overall health effects of e-cigarettes should be considered both in the context of the intrinsic toxicity of e-cigarettes and with regard to their relative toxicity compared with the well-known injurious effects of smoking conventional cigarettes,” the panel of authors, who completed the work on the group’s Advocacy Coordinating Committee, Council on Care and Outcomes Research, wrote in their report.
“Even if there are some intrinsic adverse health effects of e-cigarettes, there would be a public health benefit if e-cigarettes proved to be much less hazardous than combustible cigarettes and if smokers could switch entirely from conventional cigarettes to e-cigarettes,” they added. “However, in general, the health effects of e-cigarettes have not been well studied, and the potential harm incurred by long-term use of these devices remains completely unknown.”
According to AP Chief Medical Writer Marilynn Marchione, the American Heart Association’s policy statement takes a similar stance as that unofficially assumed by the American Cancer Society back in May. Both groups are concerned about the products and in favor of additional regulation, especially when it comes to younger smokers, and both encourage smokers to try proven traditional cessation methods first.
However, if those established techniques fail, Heart Association president Dr. Elliott Antman said that it would be “reasonable to have a conversation” about e-cigarettes, which are battery-powered devices that vaporize nicotine, Marchione said. Similarly, the Cancer Society had previously said that e-cigarettes “may be a reasonable option” for those who had already unsuccessfully tried to quit using methods like nicotine patches, she added.
However, in a statement, Heart Association CEO Nancy Brown emphasized the group’s concerns over the use of the devices by adolescents and teenagers. In fact, the organization said that a recent survey of 6th through 12th grade students found that 1.78 million high school and middle school students in the US had tried e-cigarettes as of 2012, and that 76.3 percent of e-cigarette users said they also smoked conventional cigarettes.
“Over the last 50 years, 20 million Americans died because of tobacco. We are fiercely committed to preventing the tobacco industry from addicting another generation of smokers,” she said. “Recent studies raise concerns that e-cigarettes may be a gateway to traditional tobacco products for the nation’s youth, and could renormalize smoking in our society.”
“Nicotine is a dangerous and highly addictive chemical no matter what form it takes – conventional cigarettes or some other tobacco product,” added Dr. Antman. “Every life that has been lost to tobacco addiction could have been prevented. We must protect future generations from any potential smokescreens in the tobacco product landscape that will cause us to lose precious ground in the fight to make our nation 100 percent tobacco-free.”
E-cigarettes, which were created in China and first sold in 2003, are available in over 7,000 different flavors, including many that are attractive to youngsters (such as bubble gum, caramel, chocolate, fruit and mint) the Heart Association said. In April, the US Food and Drug Administration (FDA) proposed rules banning the sale of e-cigarettes to people under the age of 18 and subjecting industry to federal regulation for the first time.
However, the organization said that the proposal “fell short” of what they had been hoping for. The Heart Association said that e-cigarettes “should be regulated under the same laws as other tobacco products and prohibited from being marketed or sold to young people,” and that the FDA’s proposal “did not go far enough in limiting online sales, advertising and flavored products, all tactics used to make e-cigarettes appealing to young people.”

University of Waterloo

Cigarettes with very low levels of nicotine may reduce addiction without increasing exposure to toxic chemicals, according to a new study from the University of Waterloo.

The study published in the journal Cancer Epidemiology monitored the smoking behaviors of 72 adults as they switched to three types of cigarettes with markedly reduced nicotine levels.

Unlike when smokers switch between conventional cigarette brands—all of which have very similar levels of nicotine content—the study found no change in participants’ puffing behavior, number of cigarettes consumed or levels of toxic chemicals in their systems.

The landmark findings may ease concerns that smokers would increase their consumption of cigarettes or puff harder if governments reduced nicotine levels to negligible amounts.

“One of the primary barriers to reducing nicotine levels is the belief that individuals who continue to smoke will smoke more cigarettes in an effort to extract the same nicotine levels, thereby exposing themselves to greater amounts of toxic chemicals. Our findings suggest this is not the case,” said Professor David Hammond, of the Faculty of Applied Health Sciences at Waterloo, and lead author on the paper. “The smokers were unable or unwilling to compensate when there was markedly less nicotine in the cigarette and when the experience of smoking is far less rewarding.”

The cigarettes used in the study—Quest 1, Quest 2 and Quest 3—had a nicotine content of 8.9, 8.4 and 0.6 mg, respectively, as opposed to an average of 12 mg in a regular cigarette.

“There is ample evidence from inside and outside the tobacco industry that major reductions in the nicotine content of cigarettes would result in a less-addictive product,” said Professor Hammond. “Overall, the impact of a less-addictive cigarette on reducing smoking uptake and cancer prevention is potentially massive.”

At time of the study, Quest cigarettes were the only commercially available cigarettes in the world with significantly reduced nicotine levels.

Brigham Young University

Study breaks down prevalence of apps using game-like rewards to motivate

For many people, finding motivation to exercise is a challenge. Thankfully, there are Zombies chasing you.

At least that’s the approach of Zombies, Run! — one of more than 31,000 health and fitness apps on the market today, and one of the growing number of apps that use games to increase physical activity.

Gamification is currently the popular trend for mobile fitness app makers looking to cash in to help people get fit. Whether or not it’s the best way to exercise remains to be seen.

“It’s just been assumed that gamified apps will work, but there has been no research to show that they’re effective for people long-term,” said Cameron Lister, lead author of a new BYU study on gamified health apps appearing in the Journal of Medical Internet Research. “Does earning a badge on your screen actually change your health behavior?”

Lister, along with BYU health science professor Josh West, analyzed more than 2,000 health and fitness apps and found that the majority of the most popular and widely used apps feature gamification.

As part of their study, the duo also downloaded and used 132 of the apps personally to see how well they worked. In addition to Zombies, Run! they tried out:

– Pact: An app that pits users against friends to see who keeps their exercise routine. Those who keep their goals make money at the expense of those who don’t.

– Fitbit: Users can enlist friends to help them reach goals by sharing stats, joining fitness challenges or competing on leaderboards.

– DietBet: Like Pact, users put their money on the line to keep weight loss goals. Those who lose 4 percent of their starting weight in four weeks earn money from those who don’t.

The researchers are concerned that gamification is ignoring key elements of behavior change and could be demotivating in the long run. For example, over time people can view the rewards and badges on these apps as work instead of play. Once the rewards disappear, the motivation drops.

One suggestion is for the apps to also focus on skill development.

“There’s a missed opportunity to influence healthy behavior because most gamified health apps are only aimed at motivation,” West said. “Motivation is important, but people also need to develop skills that makes behavior change easy to do.”

According to the study, the most common form of motivation in the apps centered on social or peer pressure (45% of apps), followed by digital rewards (24%), competitions (18%), and leaderboards (14%).

“It’s like people assuming that you hate health and you hate taking care of your body so they offer to give you some stuff in order for you to do what they want you to do,” Lister said. “But really, you should intrinsically want to be healthy and be engaged in healthy activity.”

While they found the health games are fun and engaging, West and Lister aren’t sure they can sustain major changes in healthy behavior. They believe more research needs to be carried out in an industry projected to hit the $2.8 billion mark by 2016.

But funding for this type of research is scarce because the technology is so new and developers either don’t have the money or are conflicted about subjecting their apps to scrutiny.

“I would caution developers and users to not have unrealistic expectations about the potential impact of gamified apps,” West said. “Everybody wants to know if they result in more sustainable behavior change but we just don’t know yet.”

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redOrbit Staff & Wire Reports – Your Universe Online

The chances that a person suffering from severe, nonchronic depression will make a full recovery increases by up to 30 percent if the individual is treated using a combination of cognitive therapy and antidepressant medication, a team of experts led by Vanderbilt University professor Steven Hollon claim in a new study.

Hollon and his colleagues conducted a randomized clinical trial involving 452 adult outpatients dealing with chronic or recurrent major depressive disorder (MDD). The patients were treated at university medical centers in Philadelphia, Chicago and Nashville, and either received antidepressants alone or in combination with cognitive therapy.

Those treatments lasted for up to 42 months until the patient had recovered. For the purposes of the study, the researchers declared that a patient was in remission if they experienced four consecutive weeks of minimal symptoms, and that they had recovered if they lasted another 26 consecutive weeks without suffering a relapse.

The results of the study, which were published online in the journal JAMA Psychiatry, found that combined treatment involving both cognitive therapy and antidepressant improved recovery rates when compared to drugs alone (72.6 percent vs. 62.5 percent).

However, the main effects of treatment on recovery were impacted by the severity and the chronic nature of the condition, the researchers explained. The advantage for combined treatment was limited to the 146 patients suffering from severe, nonchronic depression (81.3 percent vs. 51.7 percent). Recovery rates were also found to be similar in the two groups for patients suffering from less severe MDD or chronic MDD, they added.

“Our results indicate that combining cognitive therapy with antidepressant medicine can make a much bigger difference than we had thought to about one-third of patients suffering from major depressive disorder,” Hollon explained. “On the other hand, it does not appear to provide any additional benefit for the other two-thirds.”

“Now, we have to reconsider our general rule of thumb that combining the two treatments keeps the benefits of both,” the lead investigator and Vanderbilt psychology professor added in a statement Wednesday. “This provided us with enough data so that we could drill down and see how the combined treatment was working for patients with different types and severity of depression: chronic, recurrent, severe and moderate.”

According to Hollon, the results could have a significant impact on the way that MDD is treated – especially in the UK, which he said is a decade ahead of the US in terms of treatment for the condition. The use of combined cognitive therapy and antidepressive medicine is already standard for severe cases in the UK, and health officials there are training therapists in cognitive therapy and other empirically-supported forms of psychotherapy.

Other scientists involved in the study included Robert DeRubeis and Jay Amsterdam from the University of Pennsylvania; Jan Fawcett from the University of New Mexico; Richard Shelton from the University of Alabama-Birmingham; John Zajecka and Paula Young from Rush University; and Robert Gallop from West Chester University. The research was funded in part by grants from the National Institute of Mental Health.

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American Chemical Society

As anyone who has bitten into a chili pepper knows, its burning spiciness — though irresistible to some — is intolerable to others. Scientists exploring the chili pepper’s effect are using their findings to develop a new drug candidate for many kinds of pain, which can be caused by inflammation or other problems. They reported their progress on the compound, which is being tested in clinical trials, in ACS’ Journal of Medicinal Chemistry.

Laykea Tafesse and colleagues explain that decades ago, scientists had pegged a compound called capsaicin as the active ingredient in chili peppers that causes fiery pain. In the 1990s, researchers were able to sequence the genetic sequence for the protein “receptor” that capsaicin attaches to in the body. The receptor is a protein on cells that acts as a gate, allowing only certain substances into a cell. The advance launched a hunt for compounds that can block this gate, cut off the pain signal and potentially treat pain that current drugs are no match for. Some of the molecules resulting from this search have been tested in people but cause unwanted side effects, or they wouldn’t work well as oral medication. Tafesse’s team wanted to explore variations on this theme to find a better drug candidate.

They produced more than two dozen similar compounds, each with its own unique molecular tweak. They tested them in the lab and in animals for the traits they were looking for, such as potency, safety, the ability to dissolve in water and whether they can be taken orally. One prospect showed the most promise, and it has advanced into clinical trials.

Reference: “Structure-Activity Relationship Studies and Discovery of a Potent Transient Receptor Potential Vanilloid (TRPV1) Antagonist 4-[3-Chloro-5-[(1S)-1,2-dihydroxyethyl]-2-pyridyl]-N-[5-(trifluoromethyl)-2-pyridyl]-3,6-dihydro-2H-pyridine-1-carboxamide (V116517) as a Clinical Candidate for Pain Management” – Journal of Medicinal Chemistry

Kobi Print, University of Sydney
Emergency department nurses aren’t like the rest of us – they are more extroverted, agreeable and open – attributes that make them successful in the demanding, fast-paced and often stressful environment of an emergency department, according to a new study by University of Sydney.
“Emergency nurses are a special breed,” says Belinda Kennedy from Sydney Nursing School, a 15 year critical care veteran who led the study.
“Despite numerous studies about personalities of nurses in general, there has been little research done on the personalities of nurses in clinical specialty areas.
“My years working as a critical care nurse has made me aware of the difficulty in retaining emergency nurses and I have observed apparent differences in personality among these specialty groups. This prompted me to undertake this research which is the first on this topic in more than 20 years.
“We found that emergency nurses demonstrated significantly higher levels of openness to experience, agreeableness, and extroversion personality domains compared to the normal population.
“Emergency departments (ED) are a highly stressful environment – busy, noisy, and with high patient turnover. It is the entry point for approximately 40 per cent of all hospital admissions, and the frequency and type of presentations is unpredictable.
“Emergency nurses must have the capacity to care for the full spectrum of physical, psychological and social health problems within their community.
“They must also able to develop a rapport with individuals from all age groups and socioeconomic and cultural backgrounds, in time-critical situations and often at a time when these individuals are at their most vulnerable.
“For these reasons, ED staff experience high levels of stress and emotional exhaustion, so it’s understandable that it takes a certain personality type to function in this working environment.
“Our research findings have potential implications for workforce recruitment and retention in emergency nursing.
“With ever-increasing demands on emergency services it is necessary to consider how to enhance the recruitment and retention of emergency nurses in public hospitals. Assessment of personality and knowledge of its influence on specialty selection may assist in improving this.
“The retention of emergency nurses not only has potential economic advantages, but also a likely positive impact on patient care and outcomes, as well as improved morale among the nursing workforce,” she said.
The research team consisted of Associate Professor Kate Curtis and Associate Professor Donna Waters from Sydney Nursing School, University of Sydney.
Research published in Australasian Emergency Nursing Journal.
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Rayshell Clapper for redOrbit.com – Your Universe Online

Most people know that the sun damages skin. This damage can lead to freckles, wrinkles, sun spots, or even cancer. Of all the skin cancers, melanoma is the most deadly. Yet many people do not wear sunscreen on a daily basis. Some refuse to do so for one reason or another while others simply have not incorporated it into their morning routine out of laziness or even simply because they have just forgotten to do so. Some actively choose not to wear sunscreen out of disbelief or a lack of information. But an NBC News article shows how one photographer and artist by the name of Thomas Leveritt creates a visual argument that should convince everyone to wear sunscreen.

Leveritt took one camera that showed people as they see themselves in a mirror and had an ultraviolet camera that showed their reflections with a UV lens. The difference was astonishing. Where in the first camera, skin looked flawless and clear, and in the other the person could see all the sun damage, from major to minor. Someone with no freckles as we see them normally might have hundreds under the UV camera. It really was enlightening.

Then he asked each person to put on sunscreen, and wham! They each saw an incredible difference. A Slate article about the video explains that “The camera detects UV from the Sun that’s reflected off people’s skin; the point of sunscreen is to absorb that UV so it doesn’t even reach the skin. Since no UV is reflected from sunscreen, it appears black in the video, even though in visible light it looks white. It looks like people are smearing crude oil on their faces.”

By watching this video, viewers can see how dramatic the protection is that sunscreen provides. It is obvious that the skin is protected with even just a little smudge.

Slate writer Phil Plait identifies the three varieties of UV: UVA, UVB, UVC. UVC is the worst and brings enough energy to kill cells. The good news is that the sun does not emit a ton of UVC and what it does emit, the Earth’s air and the ozone layer absorb. UVB is the next most dangerous, and most of it is also absorbed in the ozone. Too much UVB exposure, though, damages skin, causes sunburn, destroys vitamin A, and causes cancer. In small amounts, UVB is good for producing vitamin D in the skin, but too much can be deadly. UVA is the least dangerous but still not completely safe. Serious long-term exposure can lead to cancer and it also destroys collagen in the skin thus causing aging such as wrinkles, freckles and sun spots. All three can lead to melanoma, which leads to the death of 9,000 people a year.

What is of particular interest here is that Leveritt simply wanted to shoot the video for the art of it as well as to showcase the cool technology. As he told Fast Company reporter Jeff Beer, he primarily used three Canon cameras: a modified Canon 7D, a regular Canon 7D, and a Powershot.

“I figured out how to get enough light into a DSLR to let it record at sub 380nm wavelengths–it’s a pretty interesting problem–and then had this almost magical camera lying around, which takes great pictures. (I) found that people reacted so strongly and interestingly to seeing themselves in UV, I decided I should capture that. I messed around with various beamsplitter/teleprompter/coaxial rigs to get the right shot, before getting something which looked about right,” Leveritt told Beer.

Despite the fact that Leveritt’s sole purpose was not to inform others of the impressive benefits of sunscreen, his project does just that. Through the visual, we see the argument supporting the necessity of sunscreen. When a face goes from freckled and speckled to completely black and obviously protected, even the staunchest suspect cannot deny that sunscreen blocks out dangerous UVA and UVB rays. Plus, it is pretty emotional to see the reactions of those who participate as they see their faces first in the regular camera and then in the UV one.

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