Nurses burned out and want to quit

August 28, 2020

Science Daily/European Society of Cardiology

A survey of nurses caring for children with heart problems has revealed that more than half are emotionally exhausted. The analysis, presented today at ESC Congress 2020, also found that good working environments were linked with less burnout.

"Nurses' wellbeing is central to ensuring the best outcomes for patients," said study author Dr. Annamaria Bagnasco of the University of Genoa, Italy. "When wards have poor leadership and fragmented teams with no development prospects for nurses this should raise an alarm that there is a risk of burnout."

Previous research has shown that burnout rates are higher in paediatrics than in other specialties, and that burnout is connected to patient safety. Strategies to reduce burnout and its impact on patient safety are needed.

This study examined emotional exhaustion in nurses providing routine care on paediatric cardiology wards and whether it was related to the working environment.

Data were obtained from the RN4CAST@ITPed study. A web survey was distributed to 2,769 nurses working in children's hospitals throughout Italy between September 2017 and January 2018. A total of 2,205 (80%) nurses responded, of whom 85 worked in cardiology wards and intensive care units (ICUs). Additional data were collected from hospital administrations. Topics included workload, skill mix, work environment, and emotional exhaustion.

The following definitions were used: Workload referred to how many patients each nurse was caring for (nurse-patient ratio). Skill mix included both the education level of nurses working in one unit and the number of nursing assistants providing support during each shift.

Work environment was measured with the Practice Environment Scale of the Nursing Work Index (PES-NWI), which covers issues such as: having a nurse manager or immediate supervisor who is a good manager and leader; opportunities for advancement; opportunities to participate in policy decisions; and collaboration between nurses and doctors.

Emotional exhaustion was investigated using the Maslach Burnout Inventory, which measures feelings about work. For example, feeling emotionally drained, used up, fatigued in the morning, burned out, frustrated, working too hard, stressed, or "at the end of my rope."

This analysis focused on responses from the 85 nurses working in cardiology wards and ICUs at five hospitals. Interviews were also conducted with these nurses. More than half (58%) were emotionally exhausted. The main causes were related to working conditions, including being responsible for high numbers of patients and the complexity of caring for sick children.

"The most important consequence was that 30% of the nurses we interviewed wanted to either go and work in another hospital or even change their career," said Dr. Bagnasco.

The researchers then analysed the relationship between emotional exhaustion and the working environment. Improving the workplace environment was associated with an 81% fall in emotional exhaustion -- even with the same skill mix and nurse-patient ratio.

"Our study shows that nurses value good leadership, being involved in decision-making, having chances to develop their career, and team working," said Dr. Bagnasco. "The lack of these conditions is connected to burnout, which we know from prior research could compromise patient safety."

Dr. Bagnasco noted that paediatric cardiac nurses must collaborate with children and their families, who often feel concerned and afraid. She said: "Establishing a trusting relationship is essential but burned out nurses may find it 'too heavy' to bear emotionally. If the working environment is positive for the nurses who work in it, children and their families will receive better and safer care."

https://www.sciencedaily.com/releases/2020/08/200828081037.htm

Police officers face multifaceted, compounding stressors that can lead to adverse events

August 18, 2020

Science Daily/University of Texas Health Science Center at Houston

Repeated exposure to high-stress calls for service and ongoing exposure to stress without relief were two of the contributing factors that could lead law enforcement officers to become susceptible to adverse events while performing their duties, according to a new study published in BMC Public Health by researchers at The University of Texas Health Science Center at Houston (UTHealth).

The study team aims to use this research to develop intervention models that can address and help prevent these multifaceted stressors from affecting an officer's ability to respond to high-stress calls confidently.

"If we can develop innovative interventions for law enforcement officers that address their unique occupational demands, we can help mitigate compounding stress factors that affect their overall mental health," said Katelyn Jetelina, PhD, MPH, the study's lead author and an assistant professor at UTHealth School of Public Health in Dallas.

The research team collected data from three law enforcement agencies in the Dallas-Ft. Worth metroplex: a large urban department, a suburban department, and a rural department. The researchers met with officers in focus group settings to identify stressors and to gain insight on how to prevent future adverse effects such as use of force, officer or civilian injury, civilian complaints, or discharge of a weapon.

The study participants were 86% male and 14% female with an average tenure of 12 years. Five themes emerged that influenced an officer's perception of the stress level of a call -- officer characteristics such as former military experience or gender, civilian behavior, supervisor factors such as the tendency to micromanage, environmental factors, and situational factors.

The data revealed several factors that contributed to officer stress accumulation, including not "resetting" stress levels after a high-stress call, burnout from answering numerous back-to-back calls, and feeling pressure to move on to the next call quickly. Experience from a previous adverse event was also a contributing factor to cumulative stress. However, according to the focus group responses, behaviors such as taking a break between calls, practicing breathing exercises, and addressing one's mental health over time can help lower levels of chronic stress.

The researchers noted that the combination of the perceived stress level of a call and other cumulative stress factors increase the likelihood for adverse events between police and the public. If the cycle of chronic stress is addressed and limitations placed on the number of high-stress calls an officer responds to during a shift, adverse events may be limited as well. Previous studies have shown that for other occupations, reduced levels of stress increase productivity and job satisfaction.

Irving Police Chief Jeff Spivey, whose officers participated in the study, said the results will help them find additional ways to assist their officers with mental health needs.

"Providing multiple resources for our officers to support and focus on their mental health needs, like our internal peer support groups, is a cause I am very proud to champion," Spivey said. "Peer support services have proven to be effective in helping police officers appropriately manage their mental health; that's why we have teamed up with the Caruth Police Institute and other departments across the state to create a peer network for first responders throughout Texas."

Jetelina and her team are currently testing the feasibility of using smart watches to break cumulative, real-time stress for officers. Additional research on the prevalence of undiagnosed mental health disorders among law enforcement officers is necessary to assess the effectiveness of current mental health resources and to ensure that new resources are developed.

https://www.sciencedaily.com/releases/2020/08/200818142143.htm

Loneliness predicts development of type 2 diabetes

September 15, 2020

Science Daily/King's College London

Published in the journal Diabetologia (the journal of the European Association for the Study of Diabetes [EASD]), the study shows that it is the absence of quality connections with people and not the lack of contact that predicts the onset of type 2 diabetes, suggesting that helping people form and experience positive relationships could be a useful tool in prevention strategies for type 2 diabetes.

The results have implications in light of recent findings that people with diabetes are at greater risk of dying from COVID-19. The study indicates that prolonged loneliness may influence the development of diabetes, suggesting the experience of lockdown could potentially compound people's vulnerability in this pandemic if the loneliness continues for some time.

Loneliness occurs when an individual perceives that their social needs are not being met and reflects an imbalance between desired and actual social relationships. A fifth of adults in the UK and a third of adults in the USA report feeling lonely sometimes.

There is a growing interest in the role of loneliness in health and previous research has associated loneliness with increased risk of death and heart disease. This is the first study to investigate the experience of loneliness with later onset of type 2 diabetes.

The study analysed data from the English Longitudinal Study Ageing on 4112 adults aged 50 years and over which was collected at several times from 2002 to 2017. At the start of data collection all participants were free of diabetes and had normal levels of blood glucose.

The study showed that over a period of 12 years 264 people developed type 2 diabetes. and the level of loneliness measured at the start of data collection was a significant predictor of the onset of type 2 diabetes later on in life. This relationship remained intact when accounting for smoking, alcohol, weight, level of blood glucose, high blood pressure and cardiovascular disease. The association was also independent of depression, living alone and social isolation.

Lead author Dr Ruth Hackett from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) King's College London said: 'The study shows a strong relationship between loneliness and the later onset of type 2 diabetes. What is particularly striking is that this relationship is robust even when factors that are important in diabetes development are taken into account such as smoking, alcohol intake and blood glucose as well as mental health factors such as depression. The study also demonstrates a clear distinction between loneliness and social isolation in that isolation or living alone does not predict type 2 diabetes whereas loneliness, which is defined by a person's quality of relationships, does.

She continued: 'I came up with the idea for the research during UK lockdown for the COVID-19 pandemic as I became increasingly aware and interested in how loneliness may affect our health, especially as it is likely that many more people were experiencing this difficult emotion during this period.'

According to the study a possible biological reason behind the association between loneliness and type 2 diabetes could be the impact of constant loneliness on the biological system responsible for stress, which, over time affects the body and increases the risk for diabetes.

'If the feeling of loneliness becomes chronic,' explained Dr Hackett. 'Then everyday you're stimulating the stress system and over time that leads to wear and tear on your body and those negative changes in stress-related biology may be linked to type 2 diabetes development.'

Another explanation for the findings could be biases in our thinking that may perpetuate the association between loneliness and diabetes as when people feel lonely, they expect people will react to them negatively which makes it more difficult to form good relationships.

https://www.sciencedaily.com/releases/2020/09/200915105943.htm

Pain 'catastrophizing' may lead to little exercise, more time sedentary

August 27, 2020

Science Daily/Penn State

Chronic pain affects the majority of older adults in the U.S., and getting enough exercise plays a key role in pain management. New research suggests that how people think about their pain can have a significant effect on whether they get enough physical activity -- or if they spend more time sedentary.

In a study, a team led by Penn State researchers found that when people with knee osteoarthritis "catastrophized" -- feeling an exaggerated helplessness or hopelessness -- about their pain more than usual, they were less likely to be physically active later in the day, contributing to a domino effect of sedentary behavior followed by even more pain catastrophizing.

According to the researchers, the results -- recently published in the journal PAIN -- have potential implications for pain management and wellness in older adults, and suggest that pain catastrophizing could be an important therapeutic target for interventions and pain treatment.

"Reducing daily pain catastrophizing may help older patients to be more active and less sedentary on a daily basis," said Ruixue Zhaoyang, assistant research professor. "This could help improve their chronic pain condition, physical function, and overall health, and reduce the possibility of hospitalization, institutionalization, and healthcare costs in the long term."

According to the researchers, chronic or persistent pain affects between 60 and 75 percent of older adults in the U.S., making pain management strategies like engaging in enough physical activity an important part of many older adults' lives.

Zhaoyang said that catastrophizing about pain -- thought patterns like "the pain is terrible and is never going to get any better" or "I can't stand the pain anymore" -- may lead some older adults to avoid exercise in an effort to also avoid pain. But if exercise is put off for too long, it can lead to spirals of depression and even worse pain.

"Staying physically active is one of the most important self-management strategies for chronic pain patients," said Lynn Martire, professor of human development and family studies. "However, many chronic pain patients avoid physical activities that they are actually capable of doing. Our study focused on one critical psychological factor that may explain why patients avoid physical activity despite its importance for pain management: their catastrophic thinking about their pain."

For the study, the researchers used data from 143 older adults with knee osteoarthritis. The participants kept daily diaries and wore accelerometers -- a wearable device for measuring physical activity -- for 22 days. Each morning, the participants would report how they felt about their pain that day and the accelerometer would gather information on physical activity and sedentary behavior.

After analyzing the data, the researchers found that on mornings when participants catastrophized about their pain more than usual, they ended up engaging in less moderate to vigorous physical activity later that day.

Additionally, the researchers found that catastrophizing about pain in the morning lead to more time in sedentary behavior the same and the following day, as well. In turn, more time spent sedentary lead to increased pain catastrophizing on the following day.

"One particularly interesting finding is that the detrimental influence of catastrophizing thinking about pain is independent of the pain experience itself," Zhaoyang said. "In other words, how patients think about their pain, rather than the level of experienced pain, had a more powerful impact on their daily physical activity."

Martire said the results suggest that pain catastrophizing can kick-start a potentially harmful cycle -- greater pain catastrophizing in the morning leads to avoid of physical activity, which in turn worsens catastrophizing about pain on the following day.

The researchers added that these findings suggest that pain catastrophizing could be a good target for interventions aimed at managing chronic pain and increasing physical activity.

"Our study demonstrated that patients' catastrophizing thinking can change from day to day and can be modified by their everyday activity behavior," Martire said. "Future interventions may get better results from using mobile technology to monitor patients' activity levels in everyday life and provide just-in-time adaptive interventions targeting patients' pain catastrophizing to reduce their sedentary behavior."

The researchers added that while their study looked specifically at people with knee osteoarthritis, catastrophizing can happen with any type of pain. They said the implications of their findings could potentially apply to pain management in patients with other types of chronic pain.

https://www.sciencedaily.com/releases/2020/08/200825160549.htm

Older adults with existing depression show resilience during the pandemic

August 19, 2020

Science Daily/University of California - Los Angeles Health Sciences

A study involving older adults with pre-existing major depressive disorder living in Los Angeles, New York, Pittsburgh, and St Louis found no increase in depression and anxiety during the COVID-19 pandemic.

Researchers from five institutions, including UCLA, found that the older adults, who were already enrolled in ongoing studies of treatment resistant depression, also exhibited resilience to the stress of physical distancing and isolation. The findings were published in peer-reviewed journal, The American Journal of Geriatric Psychiatry.

"We thought they would be more vulnerable to the stress of COVID because they are, by CDC definition, the most vulnerable population," said Helen Lavretsky, MD, a professor-in-residence of psychiatry and biobehavioral sciences at the Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA. "But what we learned is that older adults with depression can be resilient. They told use that coping with chronic depression taught them to be resilient"

For the study, researchers conducted interviews with the participants, all of whom were over the age of 60, with an average age of 69, during the first two months of the pandemic. Using two screening assessments of depression and anxiety, PHQ-9 and PROMIS, researchers found no changes in the participants' depression, anxiety or suicidality scores before and during the pandemic.

Researchers further determined that:

• Participants were more concerned about the risk of contracting the virus than the risks of isolation.

• While all maintained physical distance, most did not feel socially isolated and were using virtual technology to connect with friends and family.

• While they were coping, many participants said their quality of life was lower, and they worry their mental health will suffer with continued physical distancing.

• Participants were upset by the inadequate governmental response to the pandemic.

Based on the findings, the study authors wrote that policies and interventions to provide access to medical services and opportunities for social interaction are needed to help older adults maintain mental health and quality of life as the pandemic continues.

Lavretsky said many participants reported their quality of life to be lower, and they worried that their mental health will suffer with continued physical distancing. She said further research is needed to determine the impact of the pandemic over time.

She added that the findings offer takeaways for others while weathering the pandemic. "These older persons living with depression have been under stress for a longer time than many of the rest of us. We could draw upon their resilience and learn from it."

The study identified several self-care and coping strategies used by the participants, which included maintaining regular schedules; distracting themselves from negative emotions with hobbies, chores, work or exercise; and using mindfulness to focus on immediate surroundings and needs without thinking beyond the present.

The authors further emphasized that access to mental health care and support groups, and continued social interaction are needed to help older adults whether the pandemic.

https://www.sciencedaily.com/releases/2020/08/200819170223.htm

World first study links obesity with reduced brain plasticity

September 24, 2020

Science Daily/University of South Australia

A world-first study has found that severely overweight people are less likely to be able to re-wire their brains and find new neural pathways, a discovery that has significant implications for people recovering from a stroke or brain injury.

In a new paper published in Brain Sciences, researchers from UniSA and Deakin University show that brain plasticity is impaired in obese people, making it less likely that they can learn new tasks or remember things.

Using a series of experiments involving transcranial magnetic stimulation, the researchers tested 15 obese people aged between 18 and 60, comparing them with 15 people in a healthy-weight control group.

Repeated pulses of electrical stimulation were applied to the brain to see how strongly it responded. The healthy-weight control group recorded significant neural activity in response to the stimulation, suggesting a normal brain plasticity response. In contrast, the response in the obese group was minimal, suggesting its capacity to change was impaired.

UniSA researcher Dr Brenton Hordacre says the findings provide the first physiological evidence of a link between obesity and reduced brain plasticity.

Obesity is based on body mass index (BMI) which calculates the ratio between height and weight to determine body fat. An adult who has a BMI between 25 and 29.9 is considered overweight. Anything above that is obese.

"Obesity is already associated with a raft of adverse health effects, including a higher risk of cardiovascular disease, metabolic disorders and dementia," Dr Hordacre says.

"For the first time, we found that obesity was associated with impaired brain function, adding further support for the need to address the obesity epidemic.

"A growing number of people are obese -- 650 million according to the World Health Organization -- which not only has health consequences but is a serious financial burden for global health systems," he says.

"These new findings suggest that losing weight is particularly important for healthy brain ageing or for recovery in people who suffer strokes or brain injuries, where learning is fundamental for recovery."

Stroke is the third most common cause of death in Australia and the leading cause of disability, affecting speech, cognition and memory.

The ability of the brain to find new pathways is crucial to recovery, Dr Hordacre says. Worldwide, 15 million people suffer strokes each year, a third of whom die.

https://www.sciencedaily.com/releases/2020/09/200924101936.htm

Probiotics may help manage childhood obesity

September 7, 2020

Science Daily/European Society of Endocrinology

Probiotics may help children and adolescents with obesity lose weight when taken alongside a calorie-controlled diet, according to a study being presented at e-ECE 2020. The study found that obese children who were put on a calorie-restricted diet and given probiotics Bifidobacterium breve BR03 and Bifidobacterium breve B632, lost more weight and had improved insulin sensitivity compared with children on a diet only. These findings suggest that probiotic supplements and a calorie-controlled diet may help manage obesity in the younger population and reduce future health risks, such as heart disease and diabetes.

Obesity is a global health concern and can lead to a number of life-threatening conditions, such as diabetes and heart disease. Treatment and prevention is a serious public health challenge, especially in children and adolescents. Bifidobacteria are a group of probiotic bacteria that are part of the natural gut microbiome and help with preventing infection from other bacteria, such as E.coli, and digestion of carbohydrates and dietary fibre. During digestion, they release chemicals called short-chain fatty acids, which play an important role in gut health and controlling hunger. Low numbers of Bifodobacteria may impair digestion, affect food intake and energy expenditure, leading to body weight gain and obesity.

Previous studies suggested that probiotic supplementation with Bifidobacteria could help restore the composition of the gut microbiome, which may aid weight loss and could be a potential approach for obesity management. However, current research uses mixtures of different strains of probiotics and does not examine the effects of administering Bifidobacteria alone.

Dr Flavia Prodam and her team at the University of Piemonte Orientale, aimed to assess the impact of Bifidobacteria probiotic treatment in children and adolescents with obesity on a controlled diet, on weight loss and gut microbiota composition. 100 obese children and adolescents (6-18 years) were put on a calorie-controlled diet and randomly given either probiotics Bifidobacterium breve BR03 and Bifidobacterium breve B632, or a placebo for 8 weeks. Clinical, biochemical and stool sample analyses were carried out to determine the effect of probiotic supplementation on weight gain, gut microbiota and metabolism.

The results suggested that children who had taken probiotics had a reduction in waist circumference, BMI, insulin resistance and E.coli in their gut. These beneficial effects demonstrate the potential of probiotics in helping to treat obesity in children and adolescents, when undergoing dietary restrictions.

"Probiotic supplements are frequently given to people without proper evidence data. These findings start to give evidence of the efficacy and safety of two probiotic strains in treating obesity in a younger population," Dr Prodam comments.

The study suggests that supplementation with probiotics could modify the gut microbiome environment and beneficially affect metabolism, helping obese children or adolescents who are also undergoing a restricted diet to lose weight. However, larger studies over a longer period of time are needed to investigate this.

Dr Prodam explains, "The next step for our research is to identify patients that could benefit from this probiotic treatment, with a view to creating a more personalised weight-loss strategy. We also want to decipher more clearly the role of diet and probiotics on microbiome composition. This could help us to understand how the microbiota is different in young people with obesity."

https://www.sciencedaily.com/releases/2020/09/200907080342.htm

Spouses shed more pounds together than alone

August 27, 2020

Science Daily/European Society of Cardiology

Weight loss is most successful in heart attack survivors when partners join in the effort to diet, according to research presented today at ESC Congress 2020.

"Lifestyle improvement after a heart attack is a crucial part of preventing repeat events," said study author Ms. Lotte Verweij, a registered nurse and PhD student, Amsterdam University of Applied Sciences, the Netherlands. "Our study shows that when spouses join the effort to change habits, patients have a better chance of becoming healthier -- particularly when it comes to losing weight."

The RESPONSE-2 trial previously found that heart attack survivors referred to programmes for weight reduction, physical activity, and smoking cessation were more likely to modify behaviours compared to those receiving usual care. In both groups, living with a partner was linked with greater success in shifting bad habits. The most notable improvements were in patients who took part in lifestyle programmes and lived with a partner.

This follow-up study investigated whether partner involvement in lifestyle programmes had an impact on behaviour change. "If partners contribute to adopting healthy habits, it could become an important recommendation to avoid recurrent heart attacks," explained Ms. Verweij.

A total of 824 patients were randomly assigned to the intervention group (lifestyle programmes on top of usual care) or control group (usual care alone).

This analysis focused on the 411 patients in the intervention group, who were referred to up to three lifestyle programmes for weight reduction, physical activity, and smoking cessation depending on their needs and preferences. Partners could attend for free and nurses encouraged them to participate. Partner participation was defined as attending at least once.

Nearly half (48%) of partners participated in the lifestyle interventions. Compared to those without a partner, patients with a participating partner were more than twice as likely (odds ratio 2.45) to improve in at least one of the three areas (weight loss, exercise, smoking cessation) within a year.

When the influence of partners was analysed on the three areas separately, patients with a participating partner were most successful in reducing weight compared to patients without a partner (odds ratio 2.71).

"Patients with partners who joined the weight loss programme lost more weight compared to patients with a partner who did not join the programme," said Ms. Verweij.

She continued: "Couples often have comparable lifestyles and changing habits is difficult when only one person is making the effort. Practical issues come into play, such as grocery shopping, but also psychological challenges, where a supportive partner may help maintain motivation."

Ms. Verweij noted that the study did not find more improvement in smoking cessation or physical activity when partners actively participated. "These lifestyle issues might be more subject to individual motivation and persistence, but this hypothesis needs more investigation," she said.

Note: Three lifestyle programmeswere used in their existing format:

1) Weight loss: weekly group sessions with a Weight Watchers coach for one year.

2) Physical activity: accelerometer to measure activity and an online coach for personalised feedback for one year (Philips Direct Life).

3) Smoking cessation: motivational interviewing by telephone by trained professionals from Luchtsignaal for three months plus prescription of nicotine replacement or varenicline therapy as appropriate.

https://www.sciencedaily.com/releases/2020/08/200827101837.htm

How microbes in a mother's intestines affect fetal neurodevelopment

September 23, 2020

Science Daily/University of California - Los Angeles

During pregnancy in mice, the billions of bacteria and other microbes that live in a mother's intestines regulate key metabolites, small molecules that are important for healthy fetal brain development, UCLA biologists report Sept. 23 in the journal Nature.

While the maternal gut microbiota has been associated with abnormalities in the brain function and behavior of offspring -- often in response to factors like infection, a high-fat diet or stress during pregnancy -- scientists had not known until now whether it influenced brain development during critical prenatal periods and in the absence of such environmental challenges.

To test the impact the gut microbiata has on the metabolites and other biochemicals that circulate in maternal blood and nurture the rapidly developing fetal brain, the researchers raised mice that were treated with antibiotics to kill gut bacteria, as well as mice that were bred microbe-free in a laboratory.

"Depleting the fetal braina, using both methods, similarly disrupted fetal brain development," said the study's lead author, Helen Vuong, a postdoctoral scholar in laboratory of UCLA's Elaine Hsiao.

Depleting the maternal gut microbiota altered which genes were turned on in the brains of developing offspring, including many genes involved in forming new axons within neurons, Vuong said. Axons are tiny fibers that link brain cells and enable them to communicate.

In particular, axons that connect the brain's thalamus to its cortex were reduced in number and in length, the researchers found.

"These axons are particularly important for the ability to sense the environment," Vuong said. "Consistent with this, offspring from mothers lacking a gut microbiota had impairments in particular sensory behaviors."

The findings indicate that the maternal gut microbiota can promote healthy fetal brain development by regulating metabolites that enter the fetal brain itself, Vuong said.

"When we measured the types and levels of molecules in the maternal blood, fetal blood and fetal brain, we found that particular metabolites were commonly decreased or missing when the mother was lacking a gut microbiota during pregnancy," she said.

The biologists then grew neurons in the presence of these key metabolites. They also introduced these metabolites into the microbiata-depleted pregnant mice.

"When we grew neurons in the presence of these metabolites, they developed longer axons and greater numbers of axons," Vuong said. "And when we supplemented the pregnant mice with key metabolites that were decreased or missing when the microbiata was depleted, levels of those metabolites were restored in the fetal brain and the impairments in axon development and in offspring behavior were prevented.

"The gut microbiota has the incredible capability to regulate many biochemicals not only in the pregnant mother but also in the developing fetus and fetal brains," Vuong said. "Our findings also pinpoint select metabolites that promote axon growth."

The results suggest that interactions between the microbiota and nervous system begin prenatally through the influence of the maternal gut microbiota on the fetal brain, at least in mice.

The applicability of the findings to humans is still unclear, said the study's senior author, Elaine Hsiao, a UCLA associate professor of integrative biology and physiology, and of microbiology, immunology and molecular genetics in the UCLA College.

"We don't know whether and how the findings may apply to humans," said Hsiao, who is also an associate professor of digestive diseases at the David Geffen School of Medicine at UCLA. "However, there are many neurodevelopmental disorders that are believed to be caused by both genetic and environmental risk factors experienced during pregnancy. Our study suggests that maternal gut microbiota during pregnancy should also be considered and further studied as a factor that could potentially influence not only the health of the mother but the health of the developing offspring as well."

Hsiao, Vuong and colleagues reported in 2019 that serotonin and drugs that target serotonin, such as antidepressants, can have a major effect on the gut's microbiota. In 2018, Hsiao and her team established a causal link between seizure susceptibility and gut microbiota and identified specific gut bacteria that play an essential role in the anti-seizure effects of the ketogenic diet.

https://www.sciencedaily.com/releases/2020/09/200923164601.htm

Prenatal cannabis exposure associated with adverse outcomes during middle childhood

The findings are reported as use of cannabis during pregnancy has 'skyrocketed'

September 23, 2020

Science Daily/Washington University in St. Louis

While cannabis use during pregnancy is on the rise, researchers at Washington University in St. Louis have found evidence that the resulting children are more likely to have psychopathology in middle childhood.

The team's analysis are the first steps in studying the effects of cannabis on children as attitudes surrounding its use change rapidly -- recreational adult cannabis use is now legal in 11 states and the District of Columbia. Patterns of usage, too, are changing; one of the fastest-growing subsets of cannabis users may come as a surprise: the pregnant.

"There have been increasingly permissive and lenient attitudes toward cannabis use among pregnant people," said Sarah Paul, a clinical psychology graduate student. "It has skyrocketed in the past few years," she added, with data indicating a quick rise from 3% to 7% past-month use.

"Unfortunately, despite the increase in use, we know remarkably little about the potential consequences of prenatal cannabis exposure," Paul said. "Prior studies have linked prenatal cannabis exposure to birth-related outcomes such as lower birth weight and infant characteristics like disrupted sleep and movement. Relatively fewer studies have examined behavior and problems as children age," and, she said, "findings have been tenuous due to inconsistent replication and an inability to account for potential confounding variables."

Working with Ryan Bogdan, associate professor of psychological & brain sciences in Arts & Sciences, and director of the Brain Lab at Washington University, and faculty from the School of Medicine, a team of researchers led by Paul and Alexander Hatoum, a postdoc research scholar, poured through data to examine what, if any, effect maternal use of cannabis during pregnancy may have on children.

Their findings were published today in JAMA Psychiatry.

They looked at data from the Adolescent Brain and Cognitive Development Study (ABCD Study), an ongoing longitudinal study of nearly 12,000 children ages 9-11 and their parent or caregiver from 22 sites across the United States that began in 2016.

The researchers grouped participants into three mutually exclusive groups: Children who were not exposed to cannabis prenatally; children who were prenatally exposed to cannabis before the pregnancy was known, but not after; and children who had been exposed to cannabis after the pregnancy was known, regardless of exposure before.

The receptors that cannabis influences are not known to be expressed prior to five- to six-weeks' gestation. Researchers expected associations with the children's outcomes would only be present if cannabis exposure happened once those receptors had been expressed. Most people said they learned of their pregnancy after about seven weeks, which aligned with the time of endocannabinoid type 1 receptor expression.

The group hypothesized that prenatal exposure, regardless of when it occurred, would be characterized by adverse outcomes in childhood, but that only continued exposure after the pregnancy was known would have an independent association with these outcomes (after considering potential confounds -- things such as family history of psychopathology, whether alcohol or tobacco or prenatal vitamins were used during the pregnancy, as well as whether children had tried alcohol, among a host of others).

The data showed children who were exposed to cannabis in the womb (regardless of when that exposure occurred) were slightly more likely to have adverse outcomes. They had elevated psychopathology -- more psychotic-like experiences; more problems with depression and anxiety as well as impulsivity and attention; and social problems as well as sleep disturbance. They also had lower cognitive performance, lower indices of global brain structure during middle childhood as well as lower birth weight.

However, when the researchers included important familial, pregnancy and child-related covariates, Bogdan said, "This is when things got really interesting. All associations with prenatal exposure only prior to maternal knowledge of pregnancy were nowhere near significantly associated." This suggests that the association between prenatal cannabis exposure during early stages of pregnancy may not be independent of these confounding factors.

"Cutting to the chase ... clinicians and dispensaries should discourage cannabis use among those who are pregnant or are considering becoming pregnant.

"However, when we look at exposure after maternal knowledge of pregnancy, which corresponds to when endocannabinoid type 1 receptors are expressed in the fetal brain, the associations with child psychopathology largely remain -- these children tend to have more psychotic-like experiences, more impulsivity and attention problems, and social problems," he said. "This raises the intriguing possibility that prenatal cannabis exposure may plausibly impact child behavior. It in no way shows causation, but documenting that effects are independent of common confounding factors provides incremental support for potential causation."

"There are certainly other plausible reasons for this pattern of results," Hatoum said. It could be that the behaviors are a byproduct of genetic and environmental similarity and not causally related to cannabis use.

"However, that our measures of these potential confounds accounted for the associations with use prior to maternal knowledge, but not after, suggests that prenatal cannabis exposure may independently contribute, in a small way, to child outcomes," he said. "Potential causation underlying this association should be further evaluated using experimental non-human animal models, additional replication and other approaches (e.g., siblings discordant for exposure)."

"Cutting to the chase, my interpretation of these findings, is that clinicians and dispensaries should discourage cannabis use among those who are pregnant or are considering becoming pregnant," Bogdan said.

"Being attentive to substance use problems among family members and providing them with support and access to help is critical for anyone regardless of pregnancy status," Bogdan said. "Learning of one's pregnancy may produce additional reason to stop use. Someone who has just learned of a pregnancy and has previously used cannabis, might think, well I have already exposed the fetus to cannabis, so I may as well not stop. The current data might provide the clinician and parent-to-be with evidence that stopping after learning of the pregnancy may reduce the likelihood of negative outcomes among their children."

At the same time, Bogdan said, "It is also important not to stigmatize expecting parents who may be experiencing difficulties. Quitting substance use during pregnancy, which is already a challenging time, may not be straightforward. Physician support and empirical paradigms for quitting during pregnancy will be important. Lastly, couples who are planning to have a child may wish to consider combatting cannabis use before they begin attempting to conceive and the additional stressors of pregnancy begin to mount."

From a public health perspective, Bogdan suggested looking to the highly effective public health campaigns and clinician attention directed at reducing the use of tobacco and alcohol during pregnancy. In fact, he said, "This study found that prenatal cannabis exposures were more strongly and consistently associated with adverse child outcomes than prenatal tobacco or alcohol exposure."

https://www.sciencedaily.com/releases/2020/09/200923143550.htm

Higher dementia risk in women with prolonged fertility

September 17, 2020

Science Daily/University of Gothenburg

Women with a longer reproductive period had an elevated risk for dementia in old age, compared with those who were fertile for a shorter period, a population-based study from the University of Gothenburg shows.

"Our results may explain why women have a higher risk of developing dementia and Alzheimer's disease than men after age 85, and provide further support for the hypothesis that estrogen affect the risk of dementia among women," says Jenna Najar, a medical doctor and doctoral student at Sahlgrenska Academy who also works at AgeCap, the Centre for Ageing and Health at the University of Gothenburg.

The study, now published in the journal Alzheimer's & Dementia, covers 1,364 women who were followed between 1968 and 2012 in the population studies collectively known as the "Prospective Population-based Study of Women in Gothenburg" (PPSW) and the "Gothenburg H70 Birth Cohort Studies in Sweden" (the H70 studies). The "reproduction period" spans the years between menarche (onset of menstruation) and menopause, when menstruation ceases.

Of the women studied with a shorter reproductive period (32.6 years or less), 16 percent (53 of 333 individuals) developed dementia. In the group of women who were fertile a longer period (38 years or more), 24 percent (88 of 364) developed dementia. The difference was thus 8 percentage points.

The study shows that risk for dementia and Alzheimer's disease increases successively for every additional year that the woman remains fertile. The association was strongest for those with dementia onset after age 85, and the effect was most strongly associated with age at menopause.

These results persisted after adjustment for other factors with an influence, such as educational attainment, physical activity, BMI, smoking, and cardiovascular disease. On the other hand, no association was found between dementia risk and age at menarche, number of pregnancies, duration of breastfeeding, or exogenous estrogen taken in the form of hormonal replacement therapy (HRT) or oral contraceptives.

Several studies have investigated how estrogen in the form of HRT affects dementia risk. Some studies show that dementia risk falls and others that it rises, especially in women who take estrogen late in life.

In the current study Jenna Najar has, instead, investigated the long-term association between factors related to endogenous estrogen and dementia.

"What's novel about this study, too, is that we've had access to information about several events in a woman's life that can affect her estrogen levels. Examples are pregnancies, births, and breastfeeding. Being pregnant boosts estrogen levels tremendously; then they decline once the baby is born, and if women breastfeed the levels fall to extremely low levels. The more indicators we capture, the more reliable our results are," Najar says.

Ingmar Skoog, professor of psychiatry at Sahlgrenska Academy, University of Gothenburg and head of AgeCap, led the study.

"The varying results for estrogen may be due to it having a protective effect early in life but being potentially harmful once the disease has begun."

At the same time, Skoog points out that the duration of women's fertile periods is one risk factor for dementia among many.

Most women whose menopause is delayed do not develop dementia because of this factor alone. However, the study may provide a clue as to why women are at higher risk than men for dementia after age 85, the most common age of onset. Alzheimer's disease, on the other hand, starts developing some 20 years before symptoms of the disorder become apparent.

"Most people affected are over 80 and female," Najar says.

"As a result of global ageing, the number of people affected by dementia will increase. To be able to implement preventive strategies, we need to identify people with an elevated risk of dementia."

https://www.sciencedaily.com/releases/2020/09/200917105419.htm

Many women suffering from severe migraine might avoid pregnancy, but should they?

September 15, 2020

Science Daily/Elsevier

A survey of 607 women who suffer from severe migraine found twenty percent of the respondents are currently avoiding pregnancy because of their migraines. The women avoiding pregnancy due to severe migraine tend to be in their thirties, are more likely to have migraine triggered by menstruation, and are more likely to have very frequent attacks (chronic migraine) compared to their counterparts who are not avoiding pregnancy, according to a new study in Mayo Clinic Proceedings. Their decision appears to be based on perceived fears about their own health and the health of their child, even though evidence shows that migraine improves in up to 75 percent of women during pregnancy.

Migraine is one of the leading causes of disability worldwide, particularly affecting women during their childbearing years. "A large number of women with migraine might avoid pregnancy due to migraine. So they can make informed decisions, it is important that women with migraine have access to reliable information about the relationship between migraine and pregnancy," explained lead author Ryotaro Ishii, MD, PhD., a visiting scientist at Mayo Clinic, Phoenix, AZ, USA.

The study investigated the impact of migraine on pregnancy plans among patients being treated in headache specialty clinics and enrolled in the American Registry for Migraine Research (ARMR), the American Migraine Foundation's national prospective longitudinal patient registry and biorepository. Corresponding author Todd J. Schwedt, Mayo Clinic, Phoenix, AZ, USA, and Principal Investigator of ARMR, remarked, "ARMR is a multicenter patient registry that collects in-depth clinical data, biospecimens, and neuroimaging data from a large number of individuals with migraine and other headache types. ARMR provides deep insights into the clinical manifestations, management, and outcomes of patients with headache."

Patients provide demographic data when they enroll in ARMR and complete questionnaires about their medical history. A family planning questionnaire is included. The database includes a specialist's diagnosis of migraine subtypes, such as migraine with aura, migraine without aura, chronic migraine (at least 15 headache days per month), and/or menstrual migraine.

The family planning questionnaire was completed by 607 patients within ARMR between February 2016 and September 2019. Patients were asked, "Have migraines impacted your plans for pregnancy?" They selected one of the following answers: "Avoid pregnancy -- Significant;" "Avoid pregnancy -- Somewhat;" "No Impact/Not Sure;" "Increased Desire to Get Pregnant -- Somewhat;" and "Increased Desire to Get Pregnant -- Significant." Six individual questions that asked about how migraine might impact pregnancy, the ability to raise a child, and the child's health were rated on a scale from "Strongly agree" to "Strongly disagree."

Patients were divided into two groups according to whether or not they reported avoiding pregnancy because of migraine. Twenty percent of the patients indicated that they avoided pregnancy because of their migraine. The average age for those who reported avoiding pregnancy was 37.5 years, younger than that of the group who reported no impact of migraine on their pregnancy plans (47.2 years). Women who experienced migraine attacks associated with their menstrual cycle more commonly avoided pregnancy compared to those who did not experience menstrual-related migraine attacks. They more frequently reported a history of depression, a higher monthly frequency of days with headache, and higher migraine-related disability over the three previous months.

Among those who avoided pregnancy due to migraine, 72.5 percent believed that their migraine would be worse during or just after pregnancy, 68.3 percent believed their disability would make pregnancy difficult, and 82.6 percent believed that the disability caused by migraine would make raising a child difficult. There were also concerns that medications they take would negatively affect their child's development and that they would pass on genes to their baby that increase the risk of the child having migraine.

The investigators noted that research does not support what the patients in the ARMR believed about the impact of migraine on pregnancy. About one half to three fourths of women with migraine experience a marked improvement during pregnancy, with a significant reduction in the frequency and intensity of attacks according to published literature. Because the prognosis of migraine during pregnancy is generally good, it may be possible to limit the use of medications, thereby reducing the risk of medication-related adverse events. Migraine does not appear to increase the risk for fetal malformations, although some studies suggest a small increase in poor pregnancy and fetal outcomes.

The authors cautioned that because ARMR patients are enrolled from specialty headache centers and are more severely affected by migraine, the results cannot necessarily be generalized to the general population of people with migraine. There may be certain patient characteristics associated with an individual being more likely to enroll.

It is essential that women of childbearing potential with migraine receive education about the potential impact of migraine on pregnancy, the authors observed. "As the leading cause of years lived with disability in the world, and one that affects one in three women during their lifetime, these data highlight the substantial impact migraine has on pregnancy and family planning," added co-author David Dodick, MD, Mayo Clinic, Phoenix, AZ, USA, and Principal Investigator of ARMR. "Clinicians must be alert to and proactively manage these important concerns of their female patients."

"This study is a testament to the unrelenting, destructive nature of this chronic invisible diagnosis, which can permeate all aspects of life if left unchecked, including potentially depriving women of the opportunity of motherhood should they desire as well as other important relationships," commented Rashmi B. Halker Singh, MD, Department of Neurology, Mayo Clinic, Phoenix, AZ, USA, and Joseph I. Sirven, MD, Department of Neurology, Mayo Clinic, Jacksonville, FL, USA, in an accompanying editorial. "We need to not only support women who have migraine by addressing this patient education gap and improving our treatments to better meet their needs, but also must be deliberate in our efforts to improve societal understanding and acceptance of this prevalent neurobiological disease."

https://www.sciencedaily.com/releases/2020/09/200915090104.htm

Study tracks human milk nutrients in infant microbiome

September 1, 2020

Science Daily/Cornell University

A new study in mice helps explain why gut microbiomes of breastfed infants can differ greatly from those of formula-fed infants.

The study, "Dietary Sphinganine Is Selectively Assimilated by Members of the Mammalian Gut Microbiome," was published in July in the Journal of Lipid Research.

Sphinganine from milk Johnson Lab/Provided A new technique allows researchers to track specific nutrients as they are taken up by gut microbes in a mouse's digestive tract. The image shows certain microbes (red) taking in a nutrient common in human milk called sphinganine; blue microbes have not taken it in.

The paper describes an innovative technique developed at Cornell to track the fate of metabolites -- nutrients formed in or necessary for metabolism -- through a mouse's digestive tract and identify how they interact with specific gut microbes.

"We think the methods are expandable to many different microbiome systems," said senior author Elizabeth Johnson, assistant professor of nutritional sciences in the College of Agriculture and Life Sciences. She noted that researchers investigating effects of a high-fat vs. low-fat diet, or a keto diet, might use the technique to track metabolites.

The methodology could reveal how specific metabolites promote specific bacteria. This could allow nutritionists to prescribe that patients eat foods containing specific metabolites to intentionally change the composition of their microbiomes, Johnson said.

Human milk and many other foods contain a class of lipid metabolites called sphingolipids. Previous research suggested that these metabolites help shape an infant's microbiome, but it was not known if they actually interact with the microbiome.

The study identified two types of gut microbes, Bacteroides and Bifidobacterium, that use sphingolipids for their own metabolism.

While very little is known about the specific roles of gut microbes in human health, Bacteroides have been implicated in both beneficial and not-so-beneficial effects, depending on context. They are generally associated with microbiomes of healthy breastfed infants. Bifidobacterium, shown for the first time in this study to process dietary sphingolipids, are considered the quintessential beneficial bacteria, comprising up to 95% of breastfed infants microbiome.

They're also a highly popular over-the-counter probiotic.

"Our lab is very interested in how the diet interacts with the microbiome in order to really understand how you can best modulate it to have positive effects on health," Johnson said. "In this study, we were able to see that yes, these dietary lipids that are a big part of [breastfed] infants diets, are interacting quite robustly with the gut microbiome."

Sphingolipids originate from three main sources: diet; bacteria that can produce them; and most host tissues.

Johnson, along with first author Min-Ting Lee, a doctoral student, and Henry Le, a postdoctoral researcher, both in Johnson's lab, created a technique to specifically track dietary sphingolipids as they passed through the mouse gut.

"We custom synthesized the sphingolipid we added to the diet," Johnson said. "It is almost identical to ones derived from breast milk but with a small chemical tag so we could trace the location of the sphingolipid once it was ingested by the mice."

Lee then used a fluorescent label that attached to cells or microbes that absorbed the tagged lipid, such that any bacteria that had taken up sphingolipids lit up red. Microbes from the mice's microbiomes were then isolated and analyzed. Populations with red microbes were separated from the others, and these were then genetically sequenced to identify the species of bacteria.

With further investigation, Le was able to identify the metabolites that Bacteroides and Bifidobacterium produce when exposed to dietary sphingolipids. Further investigations are underway to determine whether these microbially-produced metabolites are beneficial for infant health.

Johnson recently received a five-year, $1.9 million Maximizing Investigators' Research Award from the National Institutes of Health (NIH) to expand on this work, to better understand how lipid-dependent host-microbe interactions affect human health..

The study was supported by seed funds from the Genomics Facility of the Biotechnology Resource Center at Cornell's Institute of Biotechnology.

https://www.sciencedaily.com/releases/2020/09/200901142725.htm

Women with higher neuroticism are less physically active

Personality traits help to understand why some people are physically active and others are not

August 28, 2020

Science Daily/University of Jyväskylä - Jyväskylän yliopisto

Personality traits help to understand why some people are physically active and others are not. A new study from the Gerontology Research Center and the Faculty of Sport and Health Sciences at the University of Jyväskylä, Finland, shows that the role of personality may vary depending on how physical activity is measured.

Personality traits reflect people's characteristic patterns of thinking, feeling and behaving. A study at the University of Jyväskylä focused on two traits: extraversion and neuroticism. Individuals who score high in extraversion are typically social, active and talkative. High scores in neuroticism indicate a tendency to have negative feelings, such as anxiety and self-pity.

The results showed that high extraversion and low neuroticism were linked to higher leisure time physical activity in middle-aged women. Women who scored high in extraversion reported more physical activity, but this was not seen in the physical activity measured by an activity monitor. Women who scored high in neuroticism reported less physical activity and had less physical activity captured by activity monitors.

"Even though both methods assess the frequency, duration and intensity of physical activity, they measure partly different aspects of physical activity," explains postdoctoral researcher Tiia Kekäläinen from the Gerontology Research Center. "Activity monitors are better at capturing all daily stepping activities whereas self-reporting better accounts for all types of physical activities. Therefore, it is natural that results are partly different between different physical activity measures. It is important to use both ways to assess physical activity behavior."

Personality traits may explain individual tendencies to estimate one's own physical activity level

Personality may explain the way individuals assess their own level of physical activity. The results showed that older adults scoring high in neuroticism reported less physical activity than what was measured by accelerometers.

"Neuroticism describes a predisposition to experience negative feelings," Kekäläinen says. "In addition to lower willingness to participate in physical activities, this kind of tendency seems to be related to underreporting physical activity behavior. The information about the role of personality could be used to help identify risk groups for inactivity and in physical activity promotion work."

Two larger research projects conducted at the Gerontology Research Center and Faculty of Sport and Health Sciences provided data for the study: from a total of 314 older men and women aged 70 to 85 years who participated in the PASSWORD study, and from 1,098 middle-aged women aged 47 to 55 years who participated in the ERMA study.

https://www.sciencedaily.com/releases/2020/08/200828092006.htm

Complications from diabetes linked to worse memory, IQ in children

Cognitive problems stem from episodes of diabetic ketoacidosis

September 22, 2020

Science Daily/University of California - Davis Health

Diabetic ketoacidosis (DKA), a serious but common complication of type 1 diabetes, is linked to lower IQ scores and worse memory in children with type 1 diabetes, according to a study led by UC Davis Health researchers. The study published Sept. 22 in Diabetes Care is also the first large-scale work to differentiate between DKA's impact on children with a new diagnosis and children with a previous diagnosis of type 1 diabetes.

DKA happens when diabetes goes undiagnosed or is poorly managed. With DKA, blood sugar gets very high as acidic substances called ketones build up to dangerous levels in the body. Early signs of DKA include excessive thirst, frequent urination, and nausea, abdominal pain, weakness and confusion.

"We assessed the neurocognitive effects of DKA in children with known type 1diabetes as well as in those who were just diagnosed with it," said Simona Ghetti, professor of psychology at UC Davis and the lead author on the study. "Our study uncovered that even one severe episode of DKA in children newly diagnosed with type 1 diabetes is linked to cognitive problems; and among children with a previous diagnosis, repeated DKA exposure predicted lower cognitive performance after accounting for glycemic control."

The study included 376 children with type 1 diabetes and no DKA history and 758 children with type 1 diabetes and a history of DKA. These children, ages 6-18 years, were participating in a DKA clinical trial at the Pediatric Emergency Care Applied Research Network (PECARN) sites led by two of the study's co-authors, Nathan Kuppermann and Nicole Glaser.

One severe DKA episode can hurt memory and IQ

The study found that among children newly diagnosed with type 1 diabetes, those who experienced moderate and severe DKA had lower long-term memory compared to children with diabetes and no exposure to DKA. Greater severity of DKA was also associated with lower IQ in these children.

Children with a previous diagnosis showed lower performance compared with children with new onset in measures of memory and IQ, suggesting that cognitive deficits may worsen over time.

The study's large sample allowed the researchers to capture complex associations of DKA severity, socioeconomic status and glycemic control among previously diagnosed patients. These associations revealed that patients with repeated DKA exposure and poorly controlled type 1 diabetes are at substantial risk of cognitive deficits.

"The results from the study emphasize the importance of prevention of DKA in children with known type 1 diabetes and of timely diagnosis during new onset before the development of DKA," said Glaser, professor of pediatrics at UC Davis Health and senior author of the study. "There is an opportunity to prevent DKA with proper management of the glucose level in the blood."

https://www.sciencedaily.com/releases/2020/09/200922172622.htm

Perfectionists may be more prone to helicopter parenting

Parents with perfectionist tendencies may see their children's successes as a reflection on them.

September 16, 2020

Science Daily/University of Arizona

The negative effects of over-parenting on children are well documented, but less is known about why certain people become helicopter parents. A new study suggests perfectionism is one driver.

Perfectionists often have high standards, not only for themselves but for their children. Yet, in their quest for perfection, they might find themselves with a less-than-ideal label: helicopter parent.

So-called helicopter parents engage in what's known as "over-parenting" -- hovering over their young adult children and taking care of tasks that the children should be able to do themselves, such as cooking, cleaning or paying bills.

"Over-parenting is when you apply what we call developmentally inappropriate parenting or guidance structure for the child," said University of Arizona researcher Chris Segrin, who studies the parenting style.

"By developmentally inappropriate, we mean we're providing to the child that which the child could easily do him or herself. People who engage in over-parenting are not adjusting their parenting and letting the child have greater autonomy; they still want to control all the child's outcomes."

The negative effects of over-parenting are well documented. Researchers have found it can lead to psychological distress, narcissism, poor adjustment, alcohol and drug use, and a host of other behavioral problems in emerging adults ages 18 to 25.

Yet, far less is known about why certain people become helicopter parents in the first place.

In a new study, Segrin and co-authors Tricia Burke from Texas State University and Trevor Kauer from the University of Nebraska find that perfectionism might be one driver of over-parenting.

"Perfectionism is a psychological trait of wanting to be prefect, wanting success, wanting to have positive accolades that you can point to," said Segrin, professor and head of the UArizona Department of Communication in the College of Social and Behavioral Sciences.

Perfectionist parents may see their children's success as a reflection on them, Segrin said, and they may engage in over-parenting in an effort to achieve "perfect" results.

"They want to live vicariously through their children's achievements. They want to see their children achieve because it makes them look good," he said. "I'm not saying they don't care about their children; of course they do. But they measure their self-worth by the success of their children. That's the yardstick that they use to measure their own success as a parent."

Segrin and his collaborators conducted two studies looking at the link between perfectionism and over-parenting, the results of which are published together in the journal Couple and Family Psychology: Research and Practice.

In the first study, 302 parents of young adults were asked to rate a series of statements designed to measure their levels of engagement in over-parenting and their levels of perfectionism. In the second, the researchers surveyed 290 parent-young adult pairs. The young adults responded to statements designed to measure their perception of their parent's parenting style.

The findings from both studies confirmed that perfectionism is indeed associated with helicopter parenting.

'Anxious Parents' May Also be Prone to Helicoptering

It's important to understand what motivates over-parenting in order to determine how to intervene in the potentially harmful behavior, Segrin says.

"All the research thus far on helicopter parenting, or over-parenting, has focused on what are the outcomes for the children who are the recipients of over-parenting, and no one has been looking at who does this in the first place," he said. "We think knowing more about the motivations of the parents has important implications for understanding what happens to the children."

Although he doesn't specifically address it in the study, Segrin suspects that middle-aged moms and dads who grew up in the "self-esteem era" of the 1970s and 1980s might be especially prone to perfectionism that can lead to over-parenting. In that era, children's bad behavior was often blamed on low self-esteem, and the remedy for low self-esteem was lots of praise, Segrin said.

"We started giving kids trophies at the end of the season just for being on the team, not because they actually achieved anything," he said. "Fast-forward 35, 40 years and these people are now adults who have children who are entering into adulthood. They were raised in a culture of 'you're special, you're great, you're perfect,' and that fuels perfectionistic drives. 'If I really am special, if I really am great, then my kids better be special and great, too, or it means I'm not a good parent.'"

Perfectionism isn't the only characteristic that can lead to over-parenting. Previous research by Segrin showed there's also a link between over-parenting and its close cousin: anxious parenting.

Anxious parents tend to worry a lot and ruminate on bad things that could happen to their child, so they parent with risk aversion in mind, Segrin said. His previous work showed that parents who have many regrets in their own lives may engage in this type of parenting as they try to prevent their children from repeating similar mistakes.

Just because someone engages in anxious parenting doesn't mean they engage in over-parenting, but anxious parenting is "one of the ingredients in the over-parenting stew," Segrin said, adding that anxious parenting can sometimes lead to over-parenting.

More Moms Than Dads Fall in the Over-parenting Trap

The parents in the study were mostly moms, and there's an explanation for that, Segrin said.

"When we recruit young people into the study and ask them to get a parent to also fill out the survey for us, we let them pick the parent, with the understanding that they will naturally lead us to the helicopter parent among their parents," Segrin said. "The one who's super involved in the child's life is, of course, going to want to participate in the research project with their child. So, like a moth to the flame, these young adults draw us right to the parent who delivers the most over-parenting, and we're finding that it is the mothers, usually."

That's not to say that dads can't be helicopter parents. They certainly can and in some cases are, Segrin said, but it seems to be less common.

"We know that in our culture, for better or worse, women end up getting strapped with child-rearing responsibilities to a much greater extent than men, so it stands to reason that as the child matures and gets older, the mother sort of stays on board with that job," he said.

Segrin hopes his research illuminates the hazards of helicopter parenting, not only for the young adults on the receiving end, but the parents themselves.

For perfectionism-driven helicopter parents to change their ways, they first need to recognize their own value, independent of their children, Segrin said.

"I sometimes see, especially in mothers, that they define their whole universe as 'mother' -- not spouse, not wife, not worker, not hobbyist but 'mother.' I think those blurred boundaries between parent and child can be harmful to the psychological landscape of the parent," Segrin said. "We need the parents to realize they have some element of their own life -- whether it's their career, their personal relationships, their hobbies -- that's independent of their role as a parent, so they don't get caught up in this trap of wanting to just keep parenting their children until they're 40 years old."

Avoiding that trap is also important for the well-being of emerging adults, as a growing body of research shows.

"Parents need to learn to accept their children's own goals and give them the chance to explore," Segrin said. "Young adults need the room to go out and explore and find their own life and their own ambitions."

https://www.sciencedaily.com/releases/2020/09/200916131032.htm

Late childhood peer group status linked to heightened adult circulatory disease risk

Unpopular pre-teens at significantly higher risk of heart and blood vessel conditions

September 15, 2020

Science Daily/BMJ

Late childhood peer group status may be linked to a heightened risk of developing circulatory system disease -- conditions that affect the normal functioning of the heart and blood vessels -- in later life, indicates research published in the online journal BMJ Open.

13-year olds who aren't very popular with their classmates seem to be at significantly increased risk, the findings indicate.

Childhood family circumstances and living conditions are important predictors of subsequent mental and physical health. But it's not entirely clear what impact peer group status might have.

To explore this further, the researchers looked at whether peer group status among 13 year- olds might be associated with the risk of developing conditions in adulthood that affect the normal functioning of the heart and blood vessels, such as narrowed and hardened arteries and abnormal heartbeat (atrial fibrillation).

They drew on data from the Stockholm Birth Cohort Multigenerational Study (SBC Multigen), which includes everyone born in 1953 and resident in the greater metropolitan area of Stockholm in 1963 (n=14,608).

The health of 5410 men and 5990 women, whose peer group status was known at the age of 13, was tracked into their 60s, using data from inpatient care registers.

To gauge peer group status, the 13 year olds were asked whom among their classmates they preferred to work with. Four categories were created: zero nominations (marginalised); 1 (low status); 2 or 3 (medium status); and 4 or more (high status).

Information was also obtained on family factors, such as number and position of siblings, parental education and mental health, socioeconomic conditions, and school factors, such as intellect, academic performance, and any criminal behaviour.

Slightly more of the boys enjoyed high peer group status at the age of 13 (33%; 1788) than did the girls (28.5%;1710). And more of the girls were marginalised:16% (940) vs 12% (652).

Circulatory disease was more common among the men than it was among the women:18.5% (999) vs 11% (669).

But peer group marginalisation at age 13 was associated with a significantly higher 33-34% higher risk of circulatory disease in adulthood in both sexes.

Compared with boys and girls who were very popular (high peer group status), those who were marginalised at the age of 13 remained at significantly increased risk of circulatory disease as adults after accounting for potentially influential family and school factors as well as adult mental health.

Although no longer statistically significant, a graded association was observed for girls: the less popular they were, the higher their risk of circulatory disease in adulthood.

GIrls who enjoyed medium to high peer group status were still at greater risk of circulatory disease in later life than their most popular classmates.

This is an observational study, and as such can't establish cause. Childhood peer group status was assessed at a single time point, and there was little information available about health and health behaviours from childhood into adult life, which may have skewed the findings.

But, write the researchers: "Peer relations play an important role for children's emotional and social development and may have considerable long-term implications on their health."

They add: "There is convincing evidence from neuroscience regarding how social relationships modulate neuroendocrine responses that subsequently affect the circulatory system, increasing the risk for stroke and cardiovascular diseases."

https://www.sciencedaily.com/releases/2020/09/200915194255.htm

Concussions are a risk for young athletes in all sports -- not just football

Retrospective study reveals that younger brains take longer to heal

September 15, 2020

Science Daily/Henry Ford Health System

A recent study from the Henry Ford Sports Medicine Research team suggests that high school athletes competing, not only in football, but in soccer, hockey, basketball, swimming, cheerleading and other sports are not only at risk for concussions, but may need a longer recovery than first thought.

The study's results published by Orthopedics, a nationally recognized, peer-reviewed journal for orthopedic surgeons found that the most common sports for brain injuries were indeed football, hockey and soccer.

"We thought that concussion issues would be very short-lived," said Vasilios (Bill) Moutzouros, M.D., chief of Sports Medicine at Henry Ford and a study co-author, "That they wouldn't have as many attention issues, that they'd be able to recover for their sport much more quickly. Our study found just the opposite."

"The two sports, other than football, where concussions are common are soccer and hockey, although brain injuries can happen in any sport," said Meaghan Rourke, one of more than 30 Henry Ford athletic trainers who support sports programs at over 20 high schools, colleges and universities and professional teams in the tri-county area.

Michigan Gov. Gretchen Whitmer's latest executive order allows the high school football season to begin September 18. Football was reinstated by the Michigan High School Athletic Association (MHSAA) after initially being postponed until spring 2021. With football back in action with an adjusted six-game season, athletic trainers will once again be patrolling the sidelines and be on the lookout for signs of concussions. Other sports given the green light to compete this fall include soccer, volleyball, swimming and diving. These competitions will also present the potential for brain injuries from collisions, falls and impacts with the field of play.

"I went through a four-year period as an athletic trainer where I had at least one swimmer suffer a concussion. That's a sport you don't really think about in terms of concussions," said Rourke. She explained that in one instance a swimmer miscalculated her distance to the pool wall while doing the backstroke and bumped her head against the wall. As a result, the swimmer was out for more than a month with a concussion. Diving is another sport susceptible to brain injuries as the divers' heads impact the surface of the water at high speeds generated from their dives. In reality, all sports have the potential for concussions since athletics involve physical activity and competition.

"Competitive cheerleading is another sport where I've seen concussions happen. The kids get very high in the air, and if they slip and fall when they are coming down, they can suffer serious head injuries," said Rourke, "We usually have one or two athletes in that sport suffer concussions. Overall, I've probably had to deal with a concussion in every sport, including golf."

The retrospective study looked at Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) scores at baseline testing and following concussions performed by neuropsychologists. The study found that memory ImPACT scores increased as players suffered repeated concussions.

ImPACT is the brain injury testing protocol developed in the late 1990s at the University of Pittsburgh and released in the early 2000s. The testing protocol is the only FDA-approved tool for concussion assessment and is the national testing used by healthcare, educational and sports organizations to help assess and manage concussions. The protocol defines a concussion as "a disturbance in brain function that occurs following either a blow to the head or as a result of the violent shaking of the head." Symptoms of a concussion can include a combination of headaches, nausea, vomiting, balance problems, dizziness, fatigue, visual problems and a host of other brain-associated symptoms.

The study examined the records of 357 high school athletes who were treated for concussions at Henry Ford from 2013 to 2016. The athletes age averaged between 14-18 with nearly 62% being males. Football yielded the most concussions (27.7%), followed by hockey (21.8%), soccer (17%), basketball (9 %) and cheerleading (4.2%). From the study's participants, 72 played in "Other" sports and accounted for 20.3% of the total number of concussions. Overall, 14 % reported suffering from amnesia and 33 % reported a history of concussions.

Henry Ford athletic trainers use internationally approved guidelines to accurately diagnose concussions, appropriately manage the recovery process, and safely return athletes back to their game. They use sideline tools such as the Sports Concussion Assessment Tool 5 (SCAT5) to immediately evaluate cognitive function and, if needed, additional neuropsychological tests may be administered by a physician to track progression through the recovery process. SCAT5 is a standardized concussion assessment used by licensed healthcare providers when a concussion is suspected in athletes ages 12 and older.

Current MHSAA protocols call for a player showing concussion symptoms to be sidelined for at least 24 hours. Athletes at high schools staffed with a Henry Ford athletic trainer are sidelined for at least five days and follow a strict return to play protocol, "We're going to slowly bring them back," said Rourke. "We don't want to just throw them out there where they're going to get hit again, and then they're dealing with prolonged symptoms."

The Henry Ford research team found that athletes with only one concussion required at least 30 days of recovery prior to returning to their sport while others who reported a second or more concussions required more recovery time. They also learned that visual motor speed and reaction time scores decreased with recurrent concussions, and that male and female athletes with a previous history of concussion, and those with delayed diagnosis, required more time before returning to competition.

The study team hopes that the results help start the conversation on how to more safely return student athletes to their sport after a brain injury. "When you recognize that it can be up to 30 days to get a young student athlete back, you're going to change your mind-set on how you advance them, in terms of how you push them, in terms of how you test them," said Dr. Moutzouros.

Previously, it was believed that brain injuries were related to a player's age. The younger the player, the shorter the recovery time. "We need more studies on the younger athletes," said Dr. Moutzouros, "Many of us have children. We're all worried about them and we want them to be safe. So, we need to recognize that this is a problem for the youth athlete."

https://www.sciencedaily.com/releases/2020/09/200915110014.htm

How screen time and green time may affect youth psychological outcomes

September 5, 2020

Science Daily/PLOS

Less screen time and more green time are associated with better psychological outcomes among children and adolescents, according to a study published September 2 in the open-access journal PLOS ONE by Tassia Oswald of the University of Adelaide, and colleagues.

The prevalence of mental illness among children and adolescents is increasing globally. Technological developments in recent decades have increased young people's engagement with screen-based technologies (screen time), and a reduction in young people's contact with nature (green time) has been observed concurrently. This combination of high screen time and low green time may affect mental health and well-being. But research investigating the psychological impacts of screen time or green time typically considers each factor in isolation and fails to delineate the reciprocal effects of high technology use and low contact with nature on mental health and cognitive outcomes. To address this question, Oswald and colleagues analyzed the findings of 186 studies to collate evidence assessing associations between screen time, green time, and psychological outcomes (including mental health, cognitive functioning, and academic achievement) for children and adolescents.

In general, high levels of screen time appeared to be associated with unfavorable psychological outcomes, while green time appeared to be associated with favorable psychological outcomes. Young people from low socioeconomic backgrounds were underrepresented in the literature overall and may be disproportionately affected by high screen time and low green time, making this a priority group for future research. However, additional longitudinal studies and RCTs are needed to determine whether decreasing screen time and increasing green time would improve psychological outcomes. According to the authors, preliminary evidence suggests that green time could potentially buffer the consequences of high screen time, meaning nature may be an under-utilized public health resource to promote youth psychological well-being in a high-tech era. Investment in more rigorous research is needed to explore this.

Oswald adds: "This systematic scoping review highlights that nature may currently be an under-utilised public health resource, which could potentially function as an upstream preventative and psychological well-being promotion intervention for children and adolescents in a high-tech era. However, robust evidence is needed to guide policies and recommendations around appropriate screen time and green time at critical life stages, to ultimately ensure optimal psychological well-being for young people."

https://www.sciencedaily.com/releases/2020/09/200902152132.htm

Heavy electronic media use in late childhood linked to lower academic performance

Findings could help guide parents, teachers, clinicians in planning kids' screen time

September 2, 2020

Science Daily/PLOS

A new study of 8- to 11-year olds reveals an association between heavy television use and poorer reading performance, as well as between heavy computer use and poorer numeracy -- the ability to work with numbers. Lisa Mundy of the Murdoch Children's Research Institute in Melbourne, Australia, and colleagues present these findings in the open-access journal PLOS ONE on September 2, 2020.

Previous studies of children and adolescents have found links between use of electronic media -- such as television, computers, and videogames -- and obesity, poor sleep, and other physical health risks. Electronic media use is also associated with better access to information, tech skills, and social connection. However, comparatively less is known about links with academic performance.

To help clarify these links, Mundy and colleagues studied 1,239 8- to 9-year olds in Melbourne, Australia. They used a national achievement test data to measure the children's academic performance at baseline and again after two years. They also asked the children's parents to report on their kids' use of electronic media.

The researchers found that watching two or more hours of television per day at the age of 8 or 9 was associated with lower reading performance compared to peers two years later; the difference was equivalent to losing four months of learning. Using a computer for more than one hour per day was linked to a similar degree of lost numeracy. The analysis showed no links between use of videogames and academic performance.

By accounting for baseline academic performance and potentially influencing factors such as mental health difficulties and body mass index (BMI) and controlling for prior media use, the researchers were able to pinpoint cumulative television and computer use, as well as short-term use, as associated with poorer academic performance.

These findings could help parents, teachers, and clinicians refine plans and recommendations for electronic media use in late childhood. Future research could build on these results by examining continued associations in later secondary school.

The authors add: "The debate about the effects of modern media on children's learning has never been more important given the effects of today's pandemic on children's use of time. This is the first large, longitudinal study of electronic media use and learning in primary school children, and results showed heavier users of television and computers had significant declines in reading and numeracy two years later compared with light users."

https://www.sciencedaily.com/releases/2020/09/200902152150.htm