Higher daily step count linked with lower all-cause mortality

Science Daily NIH/National Cancer Institute

In a new study, higher daily step counts were associated with lower mortality risk from all causes. The research team, which included investigators from the National Cancer Institute (NCI) and the National Institute on Aging (NIA), both parts of the National Institutes of Health, as well as from the Centers for Disease Control and Prevention (CDC), also found that the number of steps a person takes each day, but not the intensity of stepping, had a strong association with mortality.

The findings were published March 24, 2020, in the Journal of the American Medical Association.

"While we knew physical activity is good for you, we didn't know how many steps per day you need to take to lower your mortality risk or whether stepping at a higher intensity makes a difference," said Pedro Saint-Maurice, Ph.D., of NCI's Division of Cancer Epidemiology and Genetics, first author of the study. "We wanted to investigate this question to provide new insights that could help people better understand the health implications of the step counts they get from fitness trackers and phone apps."

Previous studies have been done on step counts and mortality. However, they were conducted primarily with older adults or among people with debilitating chronic conditions. This study tracked a representative sample of U.S. adults aged 40 and over; approximately 4,800 participants wore accelerometers for up to seven days between 2003 and 2006. The participants were then followed for mortality through 2015 via the National Death Index. The researchers calculated associations between mortality and step number and intensity after adjustment for demographic and behavioral risk factors, body mass index, and health status at the start of the study.

They found that, compared with taking 4,000 steps per day, a number considered to be low for adults, taking 8,000 steps per day was associated with a 51% lower risk for all-cause mortality (or death from all causes). Taking 12,000 steps per day was associated with a 65% lower risk compared with taking 4,000 steps. In contrast, the authors saw no association between step intensity and risk of death after accounting for the total number of steps taken per day.

"At NIA, we've long studied how exercise is important for older adults, and it's good to see further evidence from a large study with a broad sample that the main thing is to get moving for better overall health as we age," said Eric Shiroma, Ph.D., a co-author and NIA Intramural Research Program scientist.

In analyses by subgroups of participants, the authors found that higher step counts were associated with lower all-cause death rates among both men and women; among both younger and older adults; and among white, black, and Mexican-American adults. In secondary outcomes of the study, higher step counts were also associated with lower rates of death from cardiovascular disease and cancer.

Data collection was conducted through the CDC's National Health and Nutrition Examination Survey (NHANES), a program of studies designed to assess a nationally representative sample of the health and nutritional status of adults and children in the United States.

The researchers were surprised they didn't find an association between higher stepping intensity and all-cause mortality after adjusting for the total number of steps per day. Because few studies have investigated an association between mortality and intensity among adults going about their daily lives, the study authors wrote that future studies of walking intensity and mortality are warranted.

Although the study authors controlled for factors that could have affected the results, the study is observational and cannot prove causality. Nevertheless, their findings are consistent with current recommendations that adults should move more and sit less throughout the day. Adults who do any amount of physical activity gain some health benefits. For even greater health benefits, adults are recommended to get at least 150 minutes of moderate-intensity physical activity per week.

"Being physically active has many benefits, including reducing a person's risk of obesity, heart disease, type 2 diabetes, and some cancers. And on a daily basis, it can help people feel better and sleep better," said Janet Fulton, Ph.D., of CDC's Division of Nutrition, Physical Activity, and Obesity. "CDC is working with communities and partners across the country, as part of the Active People, Healthy Nation initiative, to make it easier, safer, and more convenient for people to be active in their own communities."

https://www.sciencedaily.com/releases/2020/03/200324202033.htm

Anxious about COVID-19? Stress can have lasting impacts on sperm and future offspring

Study identifies biological mechanism by which stress alters sperm and impacts brain development in next generation

March 23, 2020

Science Daily/University of Maryland School of Medicine

Prolonged fear and anxiety brought on by major stressors, like the coronavirus pandemic, can not only take a toll on a person's mental health, but may also have a lasting impact on a man's sperm composition that could affect his future offspring. That is the finding of a provocative new study published in the journal Nature Communications by researchers at the University of Maryland School of Medicine.

The research outlines a biological mechanism for how a father's experience with stress can influence fetal brain development in the womb. The effects of paternal stress can be transferred to offspring through changes in the extracellular vesicles that then interact with maturing sperm. Extracellular vesicles are small membrane-bound particles that transport proteins, lipids, and nucleic acids between cells. They are produced in large amounts in the reproductive tract and play an integral role in sperm maturation.

"There are so many reasons that reducing stress is beneficial especially now when our stress levels are chronically elevated and will remain so for the next few months," said study corresponding author Tracy Bale, PhD, Professor of Pharmacology and Director of the Center for Epigenetic Research in Child Health & Brain Development at the University of Maryland School of Medicine. "Properly managing stress can not only improve mental health and other stress-related ailments, but it can also help reduce the potential lasting impact on the reproductive system that could impact future generations."

She and her colleagues did not specifically study those who were under stress due to the coronavirus pandemic.

To examine a novel biological role for extracellular vesicles in transferring dad's stress to sperm, the researchers examined extracellular vesicles from mice following treatment with the stress hormone corticosterone. After treatment, the extracellular vesicles showed dramatic changes in their overall size as well as their protein and small RNA content.

When sperm were incubated with these previously "stressed" extracellular vesicles prior to fertilizing an egg, the resulting mouse pups showed significant changes in patterns of early brain development, and as adults these mice were also significantly different than controls for how they responded to stress themselves.

To see if similar differences occurred in human sperm, the researchers recruited students from the University of Pennsylvania to donate sperm each month for six months, and complete questionnaires about their perceived stress state in the preceding month. They found that students who had experienced elevated stress in months prior showed significant changes in the small RNA content of their sperm, while those who had no change in stress levels experienced little or no change. These data confirm a very similar pattern found in the mouse study.

"Our study shows that the baby's brain develops differently if the father experienced a chronic period of stress before conception, but we still do not know the implications of these differences," said Dr. Bale. "Could this prolonged higher level of stress raise the risk for mental health issues in future offspring, or could experiencing stress and managing it well help to promote stress resilience? We don't really know at this point, but our data highlight why further studies are necessary."

The research team did find that stress-induced changes in the male reproductive system take place at least a month after the stress is attenuated and life has resumed its normal patterns. "It appears the body's adaptation to stress is to return to a new baseline," Dr. Bale said, "a post-stress physiological state -- termed allostasis."

This research was funded by the National Institute of Mental Health and included co-authors from the Institute for Genome Sciences at the University of Maryland School of Medicine and the Department of Pharmaceutical Science at the University of Maryland School of Pharmacy, as well as the University of Pennsylvania.

"This research represents a critical step in understanding important mechanisms that underlie the field of intergenerational epigenetics," said UMSOM Dean E. Albert Reece, MD, PhD, MBA, who is also the Executive Vice President for Medical Affairs, University of Maryland, and the John Z. and Akiko K. Bowers Distinguished Professor. "Such knowledge is crucial to identify early interventions to improve reproduction and early childhood development down the road."

While the study did not test stress management interventions to determine what effects they might have on attenuating the changes in sperm composition, Dr. Bale, who goes for regular runs to reduce the stress of the current COVID-19 pandemic, contends that any lifestyle habits that are good for the brain are likely good for the reproductive system.

"It is important to realize that social distancing does not have to mean social isolation, especially with modern technologies available to many of us," said Joshua Gordon, Director of the National Institute of Mental Health in his web message about coping with coronavirus. "Connecting with our friends and loved ones, whether by high tech means or through simple phone calls, can help us maintain ties during stressful days ahead and will give us strength to weather this difficult passage."

The Centers for Disease Control and Prevention has tips on "stress and coping" page on their COVID-19 site that recommends the following to "support yourself":

• Take breaks from watching, reading, or listening to news stories, including social media. Hearing about the pandemic repeatedly can be upsetting.

• Take care of your body. Take deep breaths, stretch, or meditate. Try to eat healthy, well-balanced meals, exercise regularly, get plenty of sleep, and avoid alcohol and drugs.

• Make time to unwind. Try to do some other activities you enjoy.

• Connect with others. Talk with people you trust about your concerns and how you are feeling.

https://www.sciencedaily.com/releases/2020/03/200323132410.htm

ACE inhibitors and angiotensin receptor blockers may increase the risk of severe COVID-19

March 23, 2020

Science Daily/Louisiana State University Health Sciences Center

James Diaz, MD, MHA, MPH & TM, Dr PH, Professor and Head of Environmental Health Sciences at LSU Health New Orleans School of Public Health, has proposed a possible explanation for the severe lung complications being seen in some people diagnosed with COVID-19. The manuscript was published by Oxford University Press online in the Journal of Travel Medicine.

The SARS beta coronaviruses, SARS-CoV, which caused the SARS (Severe Acute Respiratory Syndrome) outbreak in 2003 and the new SARS-CoV-2, which causes COVID-19, bind to angiotensin converting enzyme 2 (ACE2) receptors in the lower respiratory tracts of infected patients to gain entry into the lungs. Viral pneumonia and potentially fatal respiratory failure may result in susceptible persons after 10-14 days.

"Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are highly recommended medications for patients with cardiovascular diseases including heart attacks, high blood pressure, diabetes and chronic kidney disease to name a few," notes Dr. Diaz. "Many of those who develop these diseases are older adults. They are prescribed these medications and take them every day."

Research in experimental models has shown an increase in the number of ACE2 receptors in the cardiopulmonary circulation after intravenous infusions of ACE inhibitors.

"Since patients treated with ACEIs and ARBS will have increased numbers of ACE2 receptors in their lungs for coronavirus S proteins to bind to, they may be at increased risk of severe disease outcomes due to SARS-CoV-2infections," explains Diaz.

Diaz writes, this hypothesis is supported by a recent descriptive analysis of 1,099 patients with laboratory-confirmed COVID-19 infections treated in China during the reporting period, December 11, 2019, to January 29, 2020. This study reported more severe disease outcomes in patients with hypertension, coronary artery disease, diabetes and chronic renal disease. All patients with the diagnoses noted met the recommended indications for treatment with ACEIs or ARBs. Diaz says that two mechanisms may protect children from COVID-19 infections -- cross-protective antibodies from multiple upper respiratory tract infections caused by the common cold-causing alpha coronaviruses, and fewer ACE2 receptors in their lower respiratory tracts to attract the binding S proteins of the beta coronaviruses.

He recommends future case-control studies in patients with COVID-19 infections to further confirm chronic therapy with ACEIs or ARBs may raise the risk for severe outcomes.

In the meantime he cautions, "Patients treated with ACEIs and ARBs for cardiovascular diseases should not stop taking their medicine, but should avoid crowds, mass events, ocean cruises, prolonged air travel, and all persons with respiratory illnesses during the current COVID-19 outbreak in order to reduce their risks of infection."

https://www.sciencedaily.com/releases/2020/03/200323101354.htm

How to manage cancer care during COVID-19 pandemic

March 18, 2020

Science Daily/National Comprehensive Cancer Network

Experts from the Seattle Cancer Care Alliance (SCCA) -- a Member Institution of the National Comprehensive Cancer Network® (NCCN®) -- are sharing insights and advice on how to continue providing optimal cancer care during the novel coronavirus (COVID-19) pandemic. SCCA includes the Fred Hutchinson Cancer Research Center and the University of Washington, which are located in the epicenter of the COVID-19 outbreak in the United States.

"Responding quickly and confidently to the COVID-19 crisis is the health care challenge of our generation," said co-lead author F. Marc Stewart, MD, Medical Director, SCCA. "Our overarching goal is to keep our cancer patients and staff safe while continuing to provide compassionate, high-quality care under circumstances we've never had to face before. We are working around the clock to develop new guidelines and policies to address situations that we couldn't have imagined several weeks ago. When the pandemic ends, we will all be proud of what we did for our patients and each other in this critical moment for humanity."

"The COVID-19 pandemic is impacting every facet of our global and domestic societies and health care systems in unprecedented fashion," said Robert W. Carlson, MD, Chief Executive Officer, NCCN. "People with cancer appear to be at increased risk of COVID-19, and their outcomes are worse than individuals without cancer. The NCCN Member Institutions are rapidly gaining experience in preventing and managing COVID-19. As is the nature of the NCCN Member Institutions, they are sharing their experience in organizing and managing institutional and care systems responses and best practices in this rapidly evolving global effort."

The article stresses the importance of keeping channels of communication open between administrators and staff, patients, caregivers, and the general public. The authors recommend forming an Incident Command Structure (as illustrated below) to provide early coordination of institution-wide efforts and to rapidly respond to changing information. They highlight the need to remain flexible and ready for unexpected challenges.

Some of the anticipated challenges include:

• Staff shortages due to potential exposure and/or school closings

• Limitations of resources such as hospital beds, mechanical ventilation, and other equipment

• Impact on treatment from travel bans, including reduced access to international donors for allogeneic stem cell transplantation

The authors recommend mitigating some of these concerns through proactive measures that include:

• Providing patient information via handouts, signs, web-based communication, and a dedicated phone line for questions and triage

• Rescheduling "well" visits and elective surgeries, and deferring second opinion consultations (where care is already appropriately established)

• Increasing hours of general hospital operations to reduce the unnecessary use of emergency department resources

• Reinforcing a strict "stay at home when ill" policy and insuring staff have access to testing

• Restricting travel and enabling work-from-home wherever possible

• Prioritizing the use of soap and water over hand gel

• Limiting the number of team members who enter patients' rooms

• Considering lower thresholds for blood transfusions

• Moving some procedures from inpatient to outpatient

• Adopting a no visitor policy with rare exceptions such as end-of-life circumstances

• Having upfront, proactive palliative and end-of-life conversations with cancer patients who may become infected with COVID-19

The article also addresses the importance of self-care within and beyond the medical community. The authors call for the prioritization of measures to protect health and frontline staff and assure a safe work environment in order to prevent provider burnout. Those measures include compensation policies, reassignments to administrative roles for immunocompromised staff, and the creation of a back-up labor pool.

NCCN is also gathering documents and links from the leading cancer centers that comprise the nonprofit alliance, and sharing them all online at NCCN.org/covid-19. These include print outs for patient information, screening tools, visitation policies, and other essential forms. Hospitals worldwide are free to use or adapt these resources immediately. The site will be continuously updated as new resources become available.

Article link at NCCN.org/covid-19.

https://www.sciencedaily.com/releases/2020/03/200318143632.htm

Study reveals how long COVID-19 remains infectious on cardboard, metal and plastic

People may acquire coronavirus through air and by touching contaminated surfaces

March 20, 2020

Science Daily/University of California - Los Angeles

The virus that causes COVID-19 remains for several hours to days on surfaces and in aerosols, a new study published in the New England Journal of Medicine found.

The study suggests that people may acquire the coronavirus through the air and after touching contaminated objects. Scientists discovered the virus is detectable for up to three hours in aerosols, up to four hours on copper, up to 24 hours on cardboard and up to two to three days on plastic and stainless steel.

"This virus is quite transmissible through relatively casual contact, making this pathogen very hard to contain," said James Lloyd-Smith, a co-author of the study and a UCLA professor of ecology and evolutionary biology. "If you're touching items that someone else has recently handled, be aware they could be contaminated and wash your hands."

The study attempted to mimic the virus being deposited onto everyday surfaces in a household or hospital setting by an infected person through coughing or touching objects, for example. The scientists then investigated how long the virus remained infectious on these surfaces.

The study's authors are from UCLA, the National Institutes of Health's National Institute of Allergy and Infectious Diseases, the Centers for Disease Control and Prevention, and Princeton University. They include Amandine Gamble, a UCLA postdoctoral researcher in Lloyd-Smith's laboratory.

In February, Lloyd-Smith and colleagues reported in the journal eLife that screening travelers for COVID-19 is not very effective. People infected with the virus -- officially named SARS-CoV-2 -- may be spreading the virus without knowing they have it or before symptoms appear. Lloyd-Smith said the biology and epidemiology of the virus make infection extremely difficult to detect in its early stages because the majority of cases show no symptoms for five days or longer after exposure.

"Many people won't have developed symptoms yet," Lloyd-Smith said. "Based on our earlier analysis of flu pandemic data, many people may not choose to disclose if they do know."

The new study supports guidance from public health professionals to slow the spread of COVID-19:

• Avoid close contact with people who are sick.

• Avoid touching your eyes, nose and mouth.

• Stay home when you are sick.

• Cover coughs or sneezes with a tissue, and dispose of the tissue in the trash.

• Clean and disinfect frequently touched objects and surfaces using a household cleaning spray or wipe.

https://www.sciencedaily.com/releases/2020/03/200320192755.htm

New coronavirus stable for hours on surfaces

SARS-CoV-2 stability similar to original SARS virus

March 17, 2020

Science Daily/NIH/National Institute of Allergy and Infectious Diseases

The virus that causes coronavirus disease 2019 (COVID-19) is stable for several hours to days in aerosols and on surfaces, according to a new study from National Institutes of Health, CDC, UCLA and Princeton University scientists in The New England Journal of Medicine.

The scientists found that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was detectable in aerosols for up to three hours, up to four hours on copper, up to 24 hours on cardboard and up to two to three days on plastic and stainless steel. The results provide key information about the stability of SARS-CoV-2, which causes COVID-19 disease, and suggests that people may acquire the virus through the air and after touching contaminated objects. The study information was widely shared during the past two weeks after the researchers placed the contents on a preprint server to quickly share their data with colleagues.

The NIH scientists, from the National Institute of Allergy and Infectious Diseases' Montana facility at Rocky Mountain Laboratories, compared how the environment affects SARS-CoV-2 and SARS-CoV-1, which causes SARS. SARS-CoV-1, like its successor now circulating across the globe, emerged from China and infected more than 8,000 people in 2002 and 2003. SARS-CoV-1 was eradicated by intensive contact tracing and case isolation measures and no cases have been detected since 2004. SARS-CoV-1 is the human coronavirus most closely related to SARS-CoV-2. In the stability study the two viruses behaved similarly, which unfortunately fails to explain why COVID-19 has become a much larger outbreak.

The NIH study attempted to mimic virus being deposited from an infected person onto everyday surfaces in a household or hospital setting, such as through coughing or touching objects. The scientists then investigated how long the virus remained infectious on these surfaces.

The scientists highlighted additional observations from their study:

• If the viability of the two coronaviruses is similar, why is SARS-CoV-2 resulting in more cases? Emerging evidence suggests that people infected with SARS-CoV-2 might be spreading virus without recognizing, or prior to recognizing, symptoms. This would make disease control measures that were effective against SARS-CoV-1 less effective against its successor.

• In contrast to SARS-CoV-1, most secondary cases of virus transmission of SARS-CoV-2 appear to be occurring in community settings rather than healthcare settings. However, healthcare settings are also vulnerable to the introduction and spread of SARS-CoV-2, and the stability of SARS-CoV-2 in aerosols and on surfaces likely contributes to transmission of the virus in healthcare settings.

The findings affirm the guidance from public health professionals to use precautions similar to those for influenza and other respiratory viruses to prevent the spread of SARS-CoV-2:

• Avoid close contact with people who are sick.

• Avoid touching your eyes, nose, and mouth.

• Stay home when you are sick.

• Cover your cough or sneeze with a tissue, then throw the tissue in the trash.

• Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe. 

  https://www.sciencedaily.com/releases/2020/03/200317150116.htm

Financial Assistance for Recovering Addicts

Article provided by LendEDU

Financial hardship is common among recovering addicts, but there are resources that provide financial aid for drug rehab. Individuals in recovery have access to grants, non-profit and private programs, personal funding, and insurance to manage the expense of rehab.

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For people living with addiction, as well as those who care for them, all aspects of life can be affected. Addiction not only creates emotional and physical wounds but can cause other hardships as well.

One significant hurdle faced by those recovering from addiction is financial instability. Substance abuse and drug addiction are expensive on their own, but living with addiction or going through recovery adds further financial challenges.

From rehabilitative therapy to prescription medication and more, the costs of treatment add up quickly – according to U.S  News and World Report, the “…annual economic impact from the misuse of prescription drugs, illicit drugs, or alcohol is $442 billion.”

Fortunately, financial aid for drug rehab comes in a variety of forms, from health insurance coverage to state and federal funding. This guide will outline some of the resources designed to provide financial assistance for recovering addicts.

In this guide:

• Financial aid for drug rehab

• Health insurance and the ACA

• Government grants for recovering addicts

• State-funded and local treatment programs

• VA benefits

• Financial aid directly from treatment centers

• Faith-based rehab programs

• National Foundation for Credit Counseling

• Crowdfunding

• Drug rehab loan

Financial aid for drug rehab

On average, drug rehab costs range from a few to several hundred dollars for a 30-day detox, and between $5,000 and $80,000 for residential recovery treatment. Many individuals in or contemplating recovery may see this as a deterrent to getting the help they need. However, several resources exist that offer financial assistance for drug rehab and associated programs.

Health insurance and the ACA

With the passage of the Affordable Care Act, pre-existing health conditions were no longer an exclusionary tactic for insurance providers. This drastically changed how addiction recovery was viewed under many health insurance plans.

Treatment for addiction is generally considered a covered medical condition. Additionally, The Mental Health Parity and Addiction Equity Act mandates that large group health insurance plans cannot impose less favorable limitations on mental health or substance use disorder treatment benefits than on medical or surgical benefits. The ACA amended this federal law to include individual health insurance coverage, not just large group plans. 

Any ACA-compliant health insurance policy may pay between 60% and 90% of the cost of rehabilitation. If you have been denied coverage or experienced benefit limits that are not in compliance with these laws, an appeals process may be necessary. 

To appeal a denial of benefits under an ACA health insurance plan, request a fair and full review of the denial with the insurance provider directly or follow your state’s external review process. More information about the appeals process can be found here. 

To understand what rehabilitation costs are covered with your specific insurance plan, get in contact with your health insurance provider or check policy limits online. 

Government grants for recovering addicts

In addition to health insurance coverage through ACA programs, grants may also be available from state and federal governments. Government grants for addiction recovery vary depending on financial circumstances and location, but the resources below are worth evaluating to determine the level of assistance available.

Substance Abuse and Mental Health Services Administration (SAMHSA)

One resource for federal grants for recovering addicts is the Substance Abuse and Mental Health Service Administration (SAMHSA) program. Through SAMHSA, block grants are provided to state addiction treatment providers to benefit those in need. Typically, receiving a SAMHSA grant requires meeting specific income requirements or participating in a qualified treatment program through the courts. 

To see eligibility information and complete the application process, visit the SAMHSA website. 

State-funded and local treatment programs

According to a recent study conducted by Pew Charitable Trusts, a significant portion of spending on drug and alcohol addiction treatment is done by state and local governments. Public assistance in this form often falls under the purview of specific agencies, such as human services or public health departments. 

Financial aid for drug rehab may be offered through reduced-cost or no-cost treatment facilities funded by the state. Additionally, assistance in getting back on one’s feet after treatment may also be available. This assistance often comes in the form of low or no-cost sober living for recovering addicts. 

Disability income can also be an option for those in recovery, although the definition of disability is quite strict. Other financial aid for recovering addicts on a state or local level include food stamps, health insurance through Medicaid, employment assistance, or training at little to no cost. 

Recovering addicts can visit their state or local government’s website or local human services office to determine what programs and partnerships are available. 

VA benefits

Another source of drug rehab assistance comes from the US Department of Veterans Affairs. Through the VA, several programs are made available to veterans of the military who are struggling with addiction. Treatment programs, including in-patient and out-patient services, medically-assisted treatment, and residential care, are offered at no cost to qualifying veterans. For help, veterans can speak with their VA healthcare provider, contact a local Vet Center, or call the VA hotline at 1-800-827-1000.

Financial aid directly from treatment centers

Financial assistance for recovering addicts may also be available directly from a treatment center. Because the cost of rehabilitation can be high in private facilities, many offer payment plans and financing to help ease the burden.

After discharge, an individual in recovery may have an option to establish a payment plan that requires installment payments over a period of several months or several years. Interest may or may not be charged, so it is necessary to fully understand the total cost of financing a treatment stay. 

You may also be able to find a free treatment center for drug addiction. Typically, centers that do not charge for outpatient or in-patient services for drug rehab have requirements that patients must meet. For instance, the Salvation Army offers little to no-cost drug rehab so long as the patient agrees to work 40 hours per week to help offset the cost. Check with local organizations to see if financing or free treatment is available, but be sure to understand everything that it entails.

Faith-based rehab programs

Many faith-based organizations offer treatment services to recovering addicts. In some cases, sponsorship is available for individuals in the community trying to get out of the throes of addiction. Although the cost of faith-based treatment may not be lower than other treatment centers, this sponsorship can bring down the expense.

Check with local religious organizations or leaders, such as churches, pastors, or priests, to ask about faith-based treatment services available. 

National Foundation for Credit Counseling

The National Foundation for Credit Counseling is a national non-profit that offers a variety of financial education and guidance to those struggling to manage their money. This organization does not provide financial assistance for drug rehab directly. However, people suffering from addiction can work with the counselors at the organization to gain a better understanding of what steps are necessary to improve their overall financial lives. 

Crowdfunding

In addition to assistance from treatment centers, the government, or other community-based programs, financial help for drug rehabilitation may come from raising money on your own or with the help of a family member or friend.

Crowdfunding platforms, including GoFundMe and Indiegogo, allow individuals or organizations to raise funds for specific campaigns or initiatives. Crowdfunding campaigns may be used to help fund an individual need – such as covering the cost of drug rehabilitation – with help from friends, family, and local communities easily and quickly. 

Drug rehab loan

Drug rehab loans offer another alternative to when recovering addicts need to secure financial aid. Although drug rehab loans are not free aid, they can be beneficial in getting the upfront funds needed to pay for treatment.

Loans for addiction treatment must be repaid with interest over the course of months or years, depending on terms, so it is essential to understand this difference from other forms of financial assistance when considering options.

This option should be a last resort and there should be a repayment plan in place before taking one out to ensure you don’t fall behind on payments.

Specialized lenders

A small number of specialized lenders offer loans to individuals entering or completing treatment programs. The most prominent is My Treatment Lender, which can finance co-pays, out-of-pocket expenses for rehabilitation, or an individual’s stay at an in-patient or residential treatment center.

Specialized lenders have various loan programs available with different costs, repayment terms, and qualification guidelines. Because of these variations, those interested in a specialized loan should evaluate the terms of all available loans before applying and receiving funds.

Personal loans

Finally, personal loans may also be a viable resource for drug rehab assistance. These loans are unsecured, meaning collateral such as a vehicle or home is not necessary to back them. They also offer fixed interest rates and predictable monthly payments that can help make repayment easier in recovery. 

Personal loan rates may be higher for individuals with lower credit scores, but many lenders allow for a cosigner. Having a family member or friend with a higher credit score cosign a personal loan application can increase your chances for approval and potentially lower interest rates, which affect the total cost of borrowing.

As with any financing agreement, be sure to read the fine print when getting a personal loan for drug rehab assistance. Take time to understand your obligations as a borrower, as well as the fees you will pay to get the loan and repay it over time. 

Author: Melissa Horton

Melissa Horton has an MBA in Finance and has worked as a financial professional for the past 13 years, helping clients understand the often complex vehicles available for both lending and investment needs. She is passionate about financial literacy and strives to educate clients and the general public to empower them in making smart financial decisions. Her work has been featured on Investopedia, iGrad, APRFinder, and more.

Music as medicine? 30 minutes a day shows benefits after heart attack

Daily music sessions found to reduce anxiety, pain and subsequent heart problems

March 18, 2020

Science Daily/American College of Cardiology

Listening to music can be enjoyable, but is it also good for your heart? Patients who suffered episodes of chest pain soon after a heart attack, known as early post-infarction angina, had significantly lower levels of anxiety and pain if they listened to music for 30 minutes a day, according to a study presented at the American College of Cardiology's Annual Scientific Session Together with World Congress of Cardiology (ACC.20/WCC).

Nearly 700,000 people survive a heart attack in the U.S. each year, and it is estimated that roughly 1 in 9 heart attack survivors experience subsequent episodes of chest pain and anxiety within the first 48 hours. The new research suggests music, combined with standard therapies such as medications, could be a simple, accessible measure that patients can do at home to potentially reduce these symptoms and help prevent subsequent cardiac events.

"There have been very few studies analyzing the effects of music on heart conditions," said Predrag Mitrovic, MD, PhD, professor of cardiology at the University of Belgrade School of Medicine and the study's lead author. "Based on our findings, we believe music therapy can help all patients after a heart attack, not only patients with early post-infarction angina. It's also very easy and inexpensive to implement."

The researchers recruited 350 patients diagnosed with heart attack and early post-infarction angina at a medical center in Serbia. Half were randomly assigned to receive standard treatment while half were assigned to regular music sessions in addition to standard treatment. For most patients, standard treatment included a variety of medications such as nitrates, aspirin, clot-preventing drugs, beta blockers, statins, calcium channel blockers, blood pressure-lowering medications and the angina-reducing drug ranolazine.

Patients receiving music therapy first underwent a test to determine which musical genre their body was likely to respond to positively. Participants listened to nine 30-second samples of music they found soothing, while researchers assessed each participant's body for automatic, involuntary responses to the music samples based on dilation or narrowing of the pupils. Researchers then fine-tuned the selection by working with the patient to determine the optimal music tempo and tonality.

Participants were asked to listen to their designated musical selection for 30 minutes each day whenever it was convenient for them to sit, ideally while resting with their eyes closed. Patients continued with these daily listening sessions for seven years, documenting their sessions in a log. They returned to the medical center for follow-up assessments every three months for the first year and annually thereafter.

At the end of seven years, music therapy was found to be more effective than standard treatment alone in terms of reducing anxiety, pain sensation and pain distress. The patients with music therapy, on average,

had anxiety scores one-third lower than those on standard treatment and reported lower angina symptoms by about one-quarter. These patients also had significantly lower rates of certain heart conditions, including an 18% reduction in the rate of heart failure; 23% lower rate of subsequent heart attack; 20% lower rate of needing coronary artery bypass graft surgery; and 16% lower rate of cardiac death.

Mitrovic said the music may work by helping to counteract the activity of the sympathetic nervous system, the part of the nervous system that drives the "fight-or-flight" response when a person faces a stressful situation. Because it increases heart rate and blood pressure, a sympathetic response can put added strain on the cardiovascular system.

"Unrelieved anxiety can produce an increase in sympathetic nervous system activity, leading to an increase in cardiac workload," Mitrovic said. He suggested regular sessions of listening to music could interrupt that cascade of events by reducing the anxiety associated with angina after a heart attack.

The researchers plan to further analyze the data to determine whether music therapy may show benefits for certain subgroups of patients, such as those in a certain age range or those with other health conditions like diabetes.

https://www.sciencedaily.com/releases/2020/03/200318104453.htm

Getting too little -- or too much -- sleep may be bad for the heart

Clocking seven or eight hours of shut eye a night seems to be sweet spot for heart health

March 18, 2020

Science Daily/American College of Cardiology

Whether you like to burn the midnight oil to check emails or binge watch your favorite series, toss and turn or sleep until mid-morning, it seems the amount of sleep you get matters when it comes to your future vascular and heart health. Compared with people who slept for longer or shorter periods of time, those who reported sleeping seven or eight hours a night had significantly less evidence of stiffness in their arteries, indicating a lower chance of developing heart disease or suffering a stroke, according to research presented at the American College of Cardiology's Annual Scientific Session Together with World Congress of Cardiology (ACC.20/WCC).

Even after accounting for other known risk factors for heart disease or stroke, people who slept less than six hours or more than eight hours a night had significantly greater odds of having plaque buildup in the walls of their carotid arteries -- a 54% and 39% increase, respectively -- compared with those who got seven or eight hours of shut eye. The study adds to mounting evidence that sleep patterns, similar to diet and exercise, may play a defining role in someone's cardiovascular risk.

"The message, based on our findings, is 'sleep well, but not too well.' Getting too little sleep appears bad for your health but too much seems to be harmful as well," said Evangelos Oikonomou, MD, consultant cardiologist and the study's lead author. "Unlike other heart disease risk factors such as age or genetics, sleep habits can be adjusted, and even after taking into consideration the impact of established risk factors for atherosclerosis and cardiovascular diseases -- for example age, gender, obesity, smoking, hypertension, diabetes, high blood pressure and even a history of coronary artery disease -- both short and long sleeping duration may act as additional risk factors."

For this analysis, researchers assessed sleep patterns in 1,752 people living in the Corinthia region of Greece using a standard questionnaire that was fielded by a trained cardiologist, primary care provider or nurse. Participants were then divided into one of four groups based on self-reported sleep duration: normal (seven to eight hours a night), short sleep duration (six to seven hours a night), very short sleep duration (less than six hours a night) or long sleep duration (greater than eight hours a night). Participants represented a broad spectrum of the general public, including healthy people as well as those with cardiovascular risk factors and established heart disease, and most were from rural areas with less than 1,000-2,000 inhabitants. They ranged in age from 40 to 98 years, with a mean age of 64 years old.

At the time of the study, each participant also underwent ultrasound imaging to measure the thickness of the inner part of the arterial wall. Thickening of the arterial walls reflects plaque buildup and is associated with an increased risk of stroke and other cardiovascular events. Intima media thickness of >1.5 mm or protrusion >50% compared to nearby segments of the artery wall was defined as atherosclerotic plaque.

Researchers uncovered a U-shaped pattern between sleep duration and early indicators of atherosclerosis, which underscores the need for a balanced sleep pattern, Oikonomou said. Intima media thickness and plaque build-up in the artery walls was greater in both the shorter and longer sleep duration groups as compared to normal sleep duration.

"We don't fully understand the relationship between sleep and cardiovascular health. It could be that sympathetic nervous system withdrawal or a slowing [of this system] that occurs during sleep may act as a recovery phase for [usual] vascular and cardiac strain," Oikonomou said. "Moreover, short sleep duration may be associated with increased cardiovascular risk factors -- for example, unhealthy diet, stress, being overweight or greater alcohol consumption -- whereas longer sleep duration may be associated with a less active lifestyle pattern and lower physical activity."

Researchers said that adopting a balanced sleep pattern of six to eight hours nightly may be just what the doctor ordered.

"It seems that this amount of sleep may act as an additive cardioprotective factor among people living in modern western societies, and there can be other health benefits to getting sufficient and quality sleep," Oikonomou added.

The amount of sleep someone needs depends on several factors, especially one's age. In the U.S., most guidelines recommend that adults sleep between seven and nine hours each night. Yet, one out of every three American adults do not get enough sleep, according to the Centers for Disease Control and Prevention. Poor sleep has also been linked to a higher risk of obesity, diabetes, high blood pressure, heart disease, poor mental health and even dying early.

This study is limited in that it relies on self-reported sleep patterns and is cross sectional in nature, so the relationship between sleep patterns and atherosclerotic activity is based on a single point in time. Further research is needed, especially to look at whether too much sleep is harmful, which hasn't been studied as well as getting too little.

https://www.sciencedaily.com/releases/2020/03/200318104451.htm

Heavy stress and lifestyle can predict how long we live

March 11, 2020

Science Daily/National Institute for Health and Welfare

Life expectancy is influenced not only by the traditional lifestyle-related risk factors but also by factors related to a person's quality of life, such as heavy stress. The biggest causes for shortened life expectancy for 30-year-old men are smoking and diabetes. Smoking takes 6.6 years and diabetes 6.5 years out of their life expectancy. Being under heavy stress shortens their life expectancy by 2.8 years.

These results are based on a study in which researchers from the Finnish Institute for Health and Welfare calculated the effects of multiple risk factors, including lifestyle-related ones, to the life expectancy of men and women.

The study also revealed that a lack of exercise strongly reduced the life expectancy of 30-year-old men -- by 2.4 years. On the other hand, things such as the consumption of plenty of fruits and vegetables could increase life expectancy: eating fruit by 1.4 years and eating vegetables by 0.9 years.

The same factors impacted the life expectancy of both men and women. For 30-year-old women, e.g. smoking shortened the life expectancy by 5.5 years, diabetes by 5.3 years, and heavy stress by 2.3 years.

The effects to the life expectancy of older people were similar but smaller than in younger age groups.

The golden middle seemed to have the most positive effect in some factors related to lifestyle. The experience of stress increased the life expectancy if the person felt the amount of stress they had was approximately the same as what other people typically experienced. Having more or less stress than that, on the other hand, reduced their life expectancy.

A new calculation method in use for a large group of risk factors for the first time

The study was based on data collected from men and women aged 25 to 74 in the Finnish National FINRISK Study 1987-2007 through questionnaires and measurements. The rate of mortality was followed until the end of 2014.

The researchers calculated the life expectancies by changing the values of each risk factor at a time and keeping the values of other factors constant. Only the BMI, blood pressure, and cholesterol levels were allowed to be changed when the values related to lifestyle factors were changed.

"Before, life expectancy has usually been assessed based on only a few sociodemographic background factor groups, such as age, sex, and education. In this study, we wanted to assess the impact of several different factors to a person's life expectancy, so we could compare their effects," says Research Manager Tommi Härkänen.

Differences between the life expectancies of men and women largely due to risk factors that can be changed

"What was interesting about the study was how small the difference in the life expectancy of 30-year men and women was based on the same risk factor values -- only 1.6 years. According to the statistics from Statistics Finland, the difference between the sexes has been over five years for all 30-year-olds, which comes down to women having healthier lifestyles than men," says Research Professor Seppo Koskinen.

In this study, the differences in the life expectancies of people with different levels of education were fairly small when the other risk factor values were the same. However, earlier studies have discovered large differences between the life expectancies of groups of people with different levels of education.

The lifestyle choices that increase mortality, such as smoking, heavy alcohol use, unhealthy diet, and lack of exercise, are most common in the population groups whose social position is the weakest.

The life expectancy of the whole population could be improved significantly through helping men and people with a lower level of education, in particular, make better lifestyle choices.

https://www.sciencedaily.com/releases/2020/03/200311100857.htm

Gratitude interventions don't help with depression, anxiety

Being grateful has benefits, but not for these issues

March 9, 2020

Science Daily/Ohio State University

Go ahead and be grateful for the good things in your life. Just don't think that a gratitude intervention will help you feel less depressed or anxious.

In a new study, researchers at The Ohio State University analyzed results from 27 separate studies that examined the effectiveness of gratitude interventions on reducing symptoms of anxiety and depression.

The results showed that such interventions had limited benefits at best.

"For years now, we have heard in the media and elsewhere about how finding ways to increase gratitude can help make us happier and healthier in so many ways," said David Cregg, lead author of the study and a doctoral student in psychology at Ohio State.

"But when it comes to one supposed benefit of these interventions -- helping with symptoms of anxiety and depression -- they really seem to have limited value."

Cregg conducted the study with Jennifer Cheavens, associate professor of psychology at Ohio State. Their results were published online recently in the Journal of Happiness Studies.

There are two commonly recommended gratitude interventions, Cheavens said. One is the "Three Good Things" exercise: At the end of the day, a person thinks of three things that went well for them that day, then writes them down and reflects on them.

Another is a "gratitude visit," when a person writes a letter thanking someone who has made a difference in their life and then reads the letter to that person.

The 27 studies involved in this analysis often had participants do one of these exercises or something similar. The studies included 3,675 participants.

In many studies, participants who did the gratitude interventions were compared with people who performed a similar activity that was unrelated to gratitude. For example, instead of writing about what they were grateful about, a college student sample might write about their class schedule.

The gratitude intervention was not much better at relieving anxiety and depression than the seemingly unrelated activity.

"There was a difference, but it was a small difference," Cheavens said. "It would not be something you would recommend as a treatment."

As an alternative, Cheavens and Cregg recommend people pursue treatments that have been shown to be effective with anxiety and depression, such as cognitive behavioral therapy.

The results suggest that it isn't helpful to tell people with symptoms of depression or anxiety to simply be more grateful for the good things they have, Cheavens said.

"Based on our results, telling people who are feeling depressed and anxious to be more grateful likely won't result in the kind of reductions in depression and anxiety we would want to see," she said.

"It might be that these sort of interventions, on their own, aren't powerful enough or that people have difficulty enacting them fully when they are feeling depressed and anxious."

The results don't mean that there are no benefits to being grateful or to using gratitude interventions, the researchers said. In fact, some studies show that such interventions are effective at improving relationships.

"It is good to be more grateful -- it has intrinsic virtue and there's evidence that people who have gratitude as a general trait have a lower incidence of mental health problems and better relationships," Cregg said.

"The problem is when we try to turn gratefulness into a self-help tool. Gratitude can't fix everything."

https://www.sciencedaily.com/releases/2020/03/200309130010.htm

Spending on experiences versus possessions advances more immediate happiness

March 9, 2020

Science Daily/University of Texas at Austin

Consumers are happier when they spend their money on experiential purchases versus material ones, according to new research.

Certain purchases are better than others at sparking people's in-the-moment happiness, according to new research from the McCombs School of Business at The University of Texas at Austin.

Lead author Amit Kumar, assistant professor of marketing, and his research team found that consumers are happier when they spend on experiential purchases versus material ones. The paper, "Spending on Doing Promotes More Moment-to-Moment Happiness than Spending on Having," is published in the May 2020 issue of the Journal of Experimental Social Psychology.

"One issue that hasn't really been examined much is what happens in the here and now -- are we happier spending our money on an experience or on a material item?" Kumar said. "The basic finding from a lot of experiments is that people derive more happiness from their experiences than from their possessions."

Kumar and his co-authors, Matthew Killingsworth from the University of Pennsylvania, and Thomas Gilovich from Cornell University, recruited 2,635 adults who were randomly assigned to a material or experiential group. The participants were sent random texts during the day to monitor their emotions and their purchasing behavior. Material purchasers bought things such as jewelry, clothing or furniture, while experiential shoppers attended sporting events, dined at restaurants, or engaged in other experiences. The results: Happiness was higher for participants who consumed experiential purchases versus material ones in every category, regardless of the cost of the item.

"It would be unfair to compare a shirt to a trip, but when we account for price, we still see this result where experiences are associated with more happiness," Kumar said.

To address possible differences in types of consumers, the researchers conducted a second study in which they asked more than 5,000 participants to first rate their happiness and then report whether they had used, enjoyed, or consumed either a material or experiential purchase within the past hour. If they responded "yes," participants were asked a series of questions and details about their purchase.

"We still observed the same effect," Kumar said. "When the very same person was consuming an experience, that was associated with more happiness."

The researchers concluded that people are happier with experiential purchases over material ones irrespective of when you measure happiness: before, during or after consumption. Experiences also provoke more satisfaction even though people typically spend more time using their material possessions. The researchers said a possible explanation is the endurance of experiences in people's memories, while the perceived value of material goods weakens over time.

"If you want to be happier, it might be wise to shift some of your consumption away from material goods and a bit more toward experiences," Kumar said. "That would likely lead to greater well-being."

https://www.sciencedaily.com/releases/2020/03/200309130020.htm

Understanding how COVID-19 affects children vital to slowing pandemic

March 19, 2020

Science Daily/University of Virginia Health System

Though COVID-19 so far appears to be largely sparing children, researchers are cautioning that it is critical to understand how the virus affects kids to model the pandemic accurately, limit the disease's spread and ensure the youngest patients get the care they need.The warning comes from Steven L. Zeichner, MD, PhD, the head of UVA Health's Division of Pediatric Infectious Diseases, and Andrea T. Cruz, MD, MPH, a pediatric emergency medicine physician at Houston's Baylor College of Medicine. They have authored a commentary in the journal Pediatrics accompanying a new article that reveals a small percentage of infected children become seriously ill. Those at greatest risk include babies and preschoolers.

"Many infectious diseases affect children differently than adults and understanding those differences can yield important insights," the commentary authors write. "This will likely be true for COVID-19, just as it was for older infectious diseases."

Assessing COVID-19 Risks

Zeichner and Cruz note that there are subgroups of children who appear to be at greater risk of COVID-19 complications, particularly those who are younger, immunocompromised or have other pulmonary health problems.

However, the presence of other viral infections in up to two-thirds of childhood coronavirus cases makes it very difficult to assess the true effect of COVID-19 on children, they state. (This figure is based on prior studies of children with coronaviruses detectable in the respiratory tract.)

While much remains unknown, Cruz and Zeichner caution that children, even asymptomatic children, could play a "major role" in disease transmission. For example, they cite a study that found the virus remained in children's stool for several weeks after diagnosis. That, combined with other routes of transmission such as nasal secretions, could pose a major challenge for schools, day care centers and the children's families, they note.

"Since many children infected with COVID-19 appear to have have mild symptoms, or even no symptoms at all, it is important to practice all the social distancing, hygiene and other precautions being recommended by public health authorities to minimize transmission from children to others, including family members who may be at greater risk from the infection, such as grandparents or family members with chronic medical conditions," said Zeichner, who is working on innovative potential COVID-19 vaccines in his lab. "In addition, studies of the reasons why children are affected differently than adults by the infection may yield insights that can be helpful in understanding the disease and ways to treat or prevent it."

https://www.sciencedaily.com/releases/2020/03/200319125201.htm

COVID-19 coronavirus epidemic has a natural origin

 March 17, 2020

Science Daily/Scripps Research Institute

An analysis of public genome sequence data from SARS-CoV-2 and related viruses found no evidence that the virus was made in a laboratory or otherwise engineered.

The novel SARS-CoV-2 coronavirus that emerged in the city of Wuhan, China, last year and has since caused a large scale COVID-19 epidemic and spread to more than 70 other countries is the product of natural evolution, according to findings published today in the journal Nature Medicine.

The analysis of public genome sequence data from SARS-CoV-2 and related viruses found no evidence that the virus was made in a laboratory or otherwise engineered.

"By comparing the available genome sequence data for known coronavirus strains, we can firmly determine that SARS-CoV-2 originated through natural processes," said Kristian Andersen, PhD, an associate professor of immunology and microbiology at Scripps Research and corresponding author on the paper.

In addition to Andersen, authors on the paper, "The proximal origin of SARS-CoV-2," include Robert F. Garry, of Tulane University; Edward Holmes, of the University of Sydney; Andrew Rambaut, of University of Edinburgh; W. Ian Lipkin, of Columbia University.

Coronaviruses are a large family of viruses that can cause illnesses ranging widely in severity. The first known severe illness caused by a coronavirus emerged with the 2003 Severe Acute Respiratory Syndrome (SARS) epidemic in China. A second outbreak of severe illness began in 2012 in Saudi Arabia with the Middle East Respiratory Syndrome (MERS).

On December 31 of last year, Chinese authorities alerted the World Health Organization of an outbreak of a novel strain of coronavirus causing severe illness, which was subsequently named SARS-CoV-2. As of February 20, 2020, nearly 167,500 COVID-19 cases have been documented, although many more mild cases have likely gone undiagnosed. The virus has killed over 6,600 people.

Shortly after the epidemic began, Chinese scientists sequenced the genome of SARS-CoV-2 and made the data available to researchers worldwide. The resulting genomic sequence data has shown that Chinese authorities rapidly detected the epidemic and that the number of COVID-19 cases have been increasing because of human to human transmission after a single introduction into the human population. Andersen and collaborators at several other research institutions used this sequencing data to explore the origins and evolution of SARS-CoV-2 by focusing in on several tell-tale features of the virus.

The scientists analyzed the genetic template for spike proteins, armatures on the outside of the virus that it uses to grab and penetrate the outer walls of human and animal cells. More specifically, they focused on two important features of the spike protein: the receptor-binding domain (RBD), a kind of grappling hook that grips onto host cells, and the cleavage site, a molecular can opener that allows the virus to crack open and enter host cells.

Evidence for natural evolution

The scientists found that the RBD portion of the SARS-CoV-2 spike proteins had evolved to effectively target a molecular feature on the outside of human cells called ACE2, a receptor involved in regulating blood pressure. The SARS-CoV-2 spike protein was so effective at binding the human cells, in fact, that the scientists concluded it was the result of natural selection and not the product of genetic engineering.

This evidence for natural evolution was supported by data on SARS-CoV-2's backbone -- its overall molecular structure. If someone were seeking to engineer a new coronavirus as a pathogen, they would have constructed it from the backbone of a virus known to cause illness. But the scientists found that the SARS-CoV-2 backbone differed substantially from those of already known coronaviruses and mostly resembled related viruses found in bats and pangolins.

"These two features of the virus, the mutations in the RBD portion of the spike protein and its distinct backbone, rules out laboratory manipulation as a potential origin for SARS-CoV-2" said Andersen.

Josie Golding, PhD, epidemics lead at UK-based Wellcome Trust, said the findings by Andersen and his colleagues are "crucially important to bring an evidence-based view to the rumors that have been circulating about the origins of the virus (SARS-CoV-2) causing COVID-19."

"They conclude that the virus is the product of natural evolution," Goulding adds, "ending any speculation about deliberate genetic engineering."

Possible origins of the virus

Based on their genomic sequencing analysis, Andersen and his collaborators concluded that the most likely origins for SARS-CoV-2 followed one of two possible scenarios.

In one scenario, the virus evolved to its current pathogenic state through natural selection in a non-human host and then jumped to humans. This is how previous coronavirus outbreaks have emerged, with humans contracting the virus after direct exposure to civets (SARS) and camels (MERS). The researchers proposed bats as the most likely reservoir for SARS-CoV-2 as it is very similar to a bat coronavirus. There are no documented cases of direct bat-human transmission, however, suggesting that an intermediate host was likely involved between bats and humans.

In this scenario, both of the distinctive features of SARS-CoV-2's spike protein -- the RBD portion that binds to cells and the cleavage site that opens the virus up -- would have evolved to their current state prior to entering humans. In this case, the current epidemic would probably have emerged rapidly as soon as humans were infected, as the virus would have already evolved the features that make it pathogenic and able to spread between people.

In the other proposed scenario, a non-pathogenic version of the virus jumped from an animal host into humans and then evolved to its current pathogenic state within the human population. For instance, some coronaviruses from pangolins, armadillo-like mammals found in Asia and Africa, have an RBD structure very similar to that of SARS-CoV-2. A coronavirus from a pangolin could possibly have been transmitted to a human, either directly or through an intermediary host such as civets or ferrets.

Then the other distinct spike protein characteristic of SARS-CoV-2, the cleavage site, could have evolved within a human host, possibly via limited undetected circulation in the human population prior to the beginning of the epidemic. The researchers found that the SARS-CoV-2 cleavage site, appears similar to the cleavage sites of strains of bird flu that has been shown to transmit easily between people. SARS-CoV-2 could have evolved such a virulent cleavage site in human cells and soon kicked off the current epidemic, as the coronavirus would possibly have become far more capable of spreading between people.

Study co-author Andrew Rambaut cautioned that it is difficult if not impossible to know at this point which of the scenarios is most likely. If the SARS-CoV-2 entered humans in its current pathogenic form from an animal source, it raises the probability of future outbreaks, as the illness-causing strain of the virus could still be circulating in the animal population and might once again jump into humans. The chances are lower of a non-pathogenic coronavirus entering the human population and then evolving properties similar to SARS-CoV-2.

Funding for the research was provided by the US National Institutes of Health, the Pew Charitable Trusts, the Wellcome Trust, the European Research Council, and an ARC Australian Laureate Fellowship.

https://www.sciencedaily.com/releases/2020/03/200317175442.htm

Median incubation period for COVID-19

March 17, 2020

Science Daily/University of Massachusetts Amherst

A new study calculates that the median incubation period for COVID-19 is just over 5 days and that 97.5% of people who develop symptoms will do so within 11.5 days of infection.

A University of Massachusetts Amherst biostatistician who directs the UMass-based Flu Forecasting Center of Excellence was invited by the White House Coronavirus Task Force to participate Wednesday morning in a coronavirus modeling webinar.

The four-hour, virtual gathering will include 20 of the world's leading infectious disease and pandemic forecasting modelers, from researchers at Harvard, Johns Hopkins and the Centers for Disease Control and Prevention (CDC) in the U.S. to those based at institutions in England, Hong Kong, South Africa and the Netherlands.

According to the White House Coronavirus Task Force coordinator Dr. Charles Vitek, "This webinar is designed to highlight for the Task Force what modeling can tell us regarding the potential effects of mitigation measures on the coronavirus outbreak. The unprecedented speed and impact of the nCoV-19 epidemic requires the best-informed public health decision-making we can produce."

Nicholas Reich, associate professor in the School of Public Health and Health Sciences, heads a flu forecasting collaborative that has produced some of the world's most accurate models in recent years. He and postdoctoral researcher Thomas McAndrew have been conducting weekly surveys of more than 20 infectious disease modeling researchers to assess their collective expert opinion on the trajectory of the COVID-19 outbreak in the U.S. The researchers and modeling experts design, build and interpret models to explain and understand infectious disease dynamics and the associated policy implications in human populations.

Reich is co-author of a new study in the Annals of Internal Medicine that calculates that the median incubation period for COVID-19 is just over five days and that 97.5 percent of people who develop symptoms will do so within 11.5 days of infection. The incubation period refers to the time between exposure to the virus and the appearance of the first symptoms.

The study's lead author is UMass Amherst biostatistics doctoral alumnus Stephen Lauer, a former member of the Reich Lab and current postdoctoral researcher at the Johns Hopkins Bloomberg School of Public Health.

The researchers examined 181 confirmed cases with identifiable exposure and symptom onset windows to estimate the incubation period of COVID-19. They conclude that "the current period of active monitoring recommended by the U.S. Centers for Disease Control and Prevention [14 days] is well supported by the evidence."

https://www.sciencedaily.com/releases/2020/03/200317175438.htm

COVID-19: The immune system can fight back

March 17, 2020

Science Daily/University of Melbourne

Melbourne researchers have mapped immune responses from one of Australia's first novel coronavirus (COVID-19) patients, showing the body's ability to fight the virus and recover from the infection.

Researchers at the Peter Doherty Institute for Infection and Immunity (Doherty Institute) -- a joint venture between the University of Melbourne and the Royal Melbourne hospital -- were able to test blood samples at four different time points in an otherwise healthy woman in her 40s, who presented with COVID-19 and had mild-to-moderate symptoms requiring hospital admission.

Published today in Nature Medicine is a detailed report of how the patient's immune system responded to the virus. One of the authors on the paper, research fellow Dr Oanh Nguyen said this was the first time that broad immune responses to COVID-19 have been reported.

"We looked at the whole breadth of the immune response in this patient using the knowledge we have built over many years of looking at immune responses in patients hospitalised with influenza," Dr Nguyen said.

"Three days after the patient was admitted, we saw large populations of several immune cells, which are often a tell-tale sign of recovery during seasonal influenza infection, so we predicted that the patient would recover in three days, which is what happened."

The research team was able to do this research so rapidly thanks to SETREP-ID (Sentinel Travellers and Research Preparedness for Emerging Infectious Disease), led by Royal Melbourne Hospital Infectious Diseases Physician Dr Irani Thevarajan at the Doherty Institute.

SETREP-ID is a platform that enables a broad range of biological sampling to take place in returned travellers in the event of a new and unexpected infectious disease outbreak, which is exactly how COVID-19 started in Australia.

"When COVID-19 emerged, we already had ethics and protocols in place so we could rapidly start looking at the virus and immune system in great detail," Dr Thevarajan said.

"Already established at a number of Melbourne hospitals, we now plan to roll out SETREP-ID as a national study."

Working together with University of Melbourne Professor Katherine Kedzierska, a laboratory head at the Doherty Institute and a world-leading influenza immunology researcher, the team were able to dissect the immune response leading to successful recovery from COVID-19, which might be the secret to finding an effective vaccine.

"We showed that even though COVID-19 is caused by a new virus, in an otherwise healthy person, a robust immune response across different cell types was associated with clinical recovery, similar to what we see in influenza," Professor Kedzierska said.

"This is an incredible step forward in understanding what drives recovery of COVID-19. People can use our methods to understand the immune responses in larger COVID-19 cohorts, and also understand what's lacking in those who have fatal outcomes."

Dr Thevarajan said that current estimates show more than 80 per cent of COVID-19 cases are mild-to-moderate, and understanding the immune response in these mild cases is very important research.

"We hope to now expand our work nationally and internationally to understand why some people die from COVID-19, and build further knowledge to assist in the rapid response of COVID-19 and future emerging viruses," she said.

https://www.sciencedaily.com/releases/2020/03/200317103815.htm

New Yorkers and Coronavirus -- Support for school closures, while most feel not at risk

Most people changing their behavior because of Coronavirus

March 16, 2020

Science Daily/CUNY Graduate School of Public Health and Health Policy

A new CUNY Graduate School of Public Health and Health Policy (CUNY SPH) survey released today found that 60% of New York State residents believe their chances of contracting the novel Coronavirus are low or very low. The survey of 1000 New York households, conducted between March 13-15, 2020 and considered accurate within a range of 3%, also found that more than half (55%) of all respondents live in households with one or more members over age 60, the highest risk age group for Coronavirus infection. However, just more than one-fourth (27%) of them believed that they were living with someone who has a high chance of becoming sick. In general, a bare majority of New Yorkers (51%) said they have some knowledge of Coronavirus, while 34% believed they know a lot about it.

A substantial majority of New York residents believe that current policies help in containing the virus, including closing schools and universities (68%), limiting travel to and from certain countries (69%), and two weeks of quarantine for people exposed to the virus (71%).

Messages about ways to prevent the spread of the virus have led many residents to change their plans and routines in the past week. Almost one-fourth (24%) of respondents reported they did not attend an event they had paid for due to concerns about the virus, and almost two in five respondents (39%) decided to stay home instead of going to work or changed existing travel plans (40%). Almost three in five (57%) said they had stayed at home instead of going to a restaurant or movie, and almost two-thirds (64%) say they have avoided shaking hands or hugging. The single recommendation that most respondents reported following regarded handwashing. Nine out of ten (88%) of New Yorkers reporting they increased the frequency of which they wash their hands or used hand sanitizer.

Almost three New Yorkers in ten (29%) rated television news ranked as the most trusted source of information about Coronavirus, followed by the CDC at 26%, and the WHO at 15%. Only 7% of respondents reported that President Trump was their most trusted source of information.

While an equally low percentage of respondents said social media were their most trusted information source, most people (51%) reported that they do share information on Coronavirus on these platforms at least once a day. Three in ten (30%) said they have passed along information on social media about Coronavirus without knowing it was accurate. The most frequently used online media sources respondents reported using were news media posts (36%), followed by friends (27%) and the government (20%).

"We conducted this survey and will update it regularly over the course of this public health crisis as a part of our unique mission within the City's largest public university," said CUNY SPH Dean Ayman El Mohandes. "Working together promoting evidence-based communication with innovative approaches for individual and community action, we can and will help address the threat of COVID-19."

The CUNY SPH survey was conducted by Emerson College Polling from March 13-15, 2020. The sample for the NY Statewide results, n=1,000, with a Credibility Interval (CI) similar to a poll's margin of error (MOE) of +/- 3 percentage points. The data sets were weighted by gender, age, ethnicity, education and region based on the 2018 1-year American Community Survey model. It is important to remember that subsets based on gender, age, ethnicity and region carry with them higher margins of error, as the sample size is reduced. Data was collected using an Interactive Voice Response (IVR) system of landlines (n=477), SMS-to-online (n=360) and an online panel provided by MTurk and Survey Monkey (n=166).

The CUNY Graduate School of Public Health and Health Policy (CUNY SPH) is committed to teaching, research and service that creates a healthier New York City and helps promote equitable, efficient and evidence-based solutions to pressing health problems facing cities around the world.

https://www.sciencedaily.com/releases/2020/03/200316141550.htm

Not finding new goals post-retirement associated with greater cognitive decline

Risk appears to be more prominent in women than men, study says

March 16, 2020

Science Daily/American Psychological Association

Certain middle-aged and older adults, especially women Certain middle-aged and older adults, especially women who tend to disengage from difficult tasks and goals after they retire, may be at greater risk of cognitive decline as they age, according to research published by the American Psychological Association.

"This study raises questions about how individual differences in motivation and gender may play a role in cognitive declines and points to the potential importance of continuing to engage in mentally stimulating activities in retirement," said lead author Jeremy Hamm, PhD, of North Dakota State University. "This may be a significant challenge for people who have a tendency to let go of goals when they encounter initial obstacles and setbacks."

The study, published in the journal Psychology and Aging, analyzed data from Midlife in the United States, a national longitudinal survey of 7,108 participants aimed at identifying the factors that influence health as people age. Hamm and his team used a subset of 732 participants from the survey to examine the differences in cognitive function between retired adults and similar others who chose to continue working past retirement age. Half of the participants were female and 94% of participants were white.

Previous research has shown that retiring is associated with an increased risk of cognitive decline, but little is known about the motivation factors that could make someone more susceptible to such a decrease, according to Hamm.

"Our premise was that not all those who retire are likely to be at higher risk of decline. We thought that individuals who retire may be more or less at risk, depending on their tendency to disengage from challenging tasks and goals that could otherwise provide a source of mental stimulation," he said.

Researchers measured participants' level of goal disengagement, or people's tendency to lower their ambitions and decrease commitment to personal goals. Participants were asked to rate their level of agreement with statements such as "To avoid disappointments, I don't set my goals too high" and "I feel relieved when I let go of some of my responsibilities" on a scale of one to four.

Participants also took a test by telephone to measure basic cognitive functions, such as memory, reasoning and processing speed.

The study found that retired women who were prone to disengagement had steeper declines in cognitive functioning than their peers who remained employed. However, no differences emerged between retired and working men who were prone to disengagement, whose higher socioeconomic status may have protected them from early declines, according to Hamm.

"Our findings suggest not everyone who retires is at greater risk of cognitive declines. There are many opportunities to engage in mentally stimulating activities in retirement, such as reading or playing word games," he said. "However, personal agency and motivation may come to the fore at this stage of the lifespan since these activities often need to be self-initiated and autonomously maintained."

https://www.sciencedaily.com/releases/2020/03/200316090346.htm

Music therapy helps stroke patients

Research examines benefits of sessions on a stroke and rehabilitation unit

March 5, 2020

Science Daily/Anglia Ruskin University

New research has found that music therapy sessions have a positive effect on the neurorehabilitation of acute stroke patients, as well as their mood.

The study -- the first large-scale investigation into the feasibility of delivering these exercises -- was led by Dr Alex Street, of Anglia Ruskin University (ARU), and was carried out on a 26-bed stroke and rehabilitation unit at Addenbrooke's hospital in Cambridge.

In total, 177 patients took part in 675 Neurologic Music Therapy (NMT) sessions over a two-year period. The researchers investigated its success among patients, their relatives, and health professionals, and the results are published in the journal Topics in Stroke Rehabilitation.

Music therapy is understood to help stroke patients through mood regulation, improved concentration, and promoting changes in the brain to improve function, known as neural reorganisation. Physical benefits include better arm function and gait.

Lots of repetition, or 'massed practice', is central to neurorehabilitation. In addition to playing physical instruments (keyboard, drums and hand-held percussion), iPads featuring touchscreen instruments were used in the trial to help patients with hand rehabilitation, through improving finger dexterity, and cognitive training.

NMT sessions were run alongside existing stroke rehabilitation treatment, including physiotherapy, occupational therapy, speech therapy, and clinical psychology.

Of the 139 patients, relatives and hospital staff who completed questionnaires, the average response was that NMT was "helpful" or "very helpful." And of the 52 patients who completed mood scale questionnaires, there was a reduction in "sad" and an increase in "happy" responses immediately following a session.

Speech and language therapists observed a positive impact on patient arousal and engagement, and reported that it may help patients overcome low mood and fatigue -- both common following stroke -- and therefore be beneficial for their rehabilitation.

Following the success of the trial, the Cambridge Institute for Music Therapy Research at Anglia Ruskin University (ARU) and Addenbrooke's hospital are developing a proposal to establish a permanent NMT post on the stroke ward, funded by the NHS.

Dr Alex Street, Senior Research Fellow within the Cambridge Institute for Music Therapy Research at Anglia Ruskin University (ARU), said: "Our study found that Neurologic Music Therapy was received enthusiastically by patients, their relatives, and staff.

"The fact 675 sessions were carried out in two years is in itself an indication of the success of the treatment. It shows that staff are referring patients because they understand the mechanisms of the exercises and can see how it can benefit their patients. It also shows that patients are willing to do the exercises, with each one participating in an average of five sessions.

"Staff felt that using music and instruments allowed patients to achieve a high amount of repetition to help achieve their goals. They felt that the exercises appear less clinical, because the patients are playing music with the music therapist, and they are receiving immediate feedback from the exercises, through the sounds they create. Further research is necessary to establish potential effects of music therapy on recovery rate and length of hospital stay."

https://www.sciencedaily.com/releases/2020/03/200305203539.htm

Caffeine boosts problem-solving ability but not creativity

While the drug is known to increase focus, alertness and motor skills, its effect on creative thinking had not been studied previously

March 5, 2020

Science Daily/University of Arkansas

Want to boost creativity? Caffeine may not be the way to go according to a news study.

Caffeine increases the ability to focus and problem solve, but a new study by a University of Arkansas researcher indicates it doesn't stimulate creativity.

"In Western cultures, caffeine is stereotypically associated with creative occupations and lifestyles, from writers and their coffee to programmers and their energy drinks, and there's more than a kernel of truth to these stereotypes," wrote Darya Zabelina, assistant professor of psychology and first author of the study recently published in the journal Consciousness and Cognition.

While the cognitive benefits of caffeine -- increased alertness, improved vigilance, enhanced focus and improved motor performance -- are well established, she said, the stimulant's affect on creativity is less known.

In the paper, Zabelina differentiates "convergent" from "divergent" thinking. The former is defined as seeking a specific solution to a problem, for example, the "correct" answer. The latter is characterized by idea generation where a large set of apt, novel or interesting responses would be suitable. Caffeine was shown to improve convergent thinking in the study, while consuming it had no significant impact on divergent thinking.

For the study, 80 volunteers were randomly given either a 200mg caffeine pill, equivalent to one strong cup of coffee, or a placebo. They were then tested on standard measures of convergent and divergent thinking, working memory and mood. In addition to the results on creativity, caffeine did not significantly affect working memory, but test subjects who took it did report feeling less sad.

"The 200mg enhanced problem solving significantly, but had no effect on creative thinking," said Zabelina. "It also didn't make it worse, so keep drinking your coffee; it won't interfere with these abilities."

https://www.sciencedaily.com/releases/2020/03/200305135050.htm