Burnout can exacerbate work stress, further promoting a vicious circle

November 10, 2020

Science Daily/Johannes Gutenberg Universitaet Mainz

Work stress and burnout are mutually reinforcing / Surprisingly, the effect of work stress on burnout is much smaller than the effect of burnout on work stress.

Stress and overload in the workplace are increasing worldwide and are often considered a cause of burnout. Indeed, a new study shows that work stress and burnout are mutually reinforcing. However, contrary to popular belief, burnout has a much greater impact on work stress than vice versa. "This means that the more severe a person's burnout becomes, the more stressed they will feel at work, such as being under time pressure, for example," said Professor Christian Dormann of Johannes Gutenberg University Mainz (JGU). Employees suffering from burnout should be timely provided with adequate support in order to break the vicious circle between work stress and burnout.

Symptoms of burnout include exhaustion, cynicism, and reduced performance. "The most important burnout symptom is the feeling of total exhaustion -- to the extent that it cannot be remedied by normal recovery phases of an evening, a weekend, or even a vacation," said Dormann. "To protect themselves from further exhaustion, some try to build a psychological distance to their work, that is, they alienate themselves from their work as well as the people associated with it and become more cynical," added Dr. Christina Guthier. She conducted the study as part of her doctoral thesis in Dormann's research group and was awarded with the dissertation prize of the Alfred Teves Foundation in 2020. The study has recently been published in Psychological Bulletin.

For the joint publication with Professor Christian Dormann and Professor Manuel Völkle of Humboldt-Universität zu Berlin, Christina Guthier evaluated 48 longitudinal studies of burnout and work stress comprising 26,319 participants. The average age in the initial survey was about 42 years, 44 percent of the respondents were men. The longitudinal studies from 1986 to 2019 came from various countries, including predominantly European countries as well as Israel, the USA, Canada, Mexico, South Africa, Australia, China, and Taiwan.

Stopping the downward spiral and reducing the effect of burnout on work stress

The results challenge, or at least relativize, the common perception that work stress is the driving force behind burnout. "Burnout can be triggered by a work situation, but that is not always the case," Dormann pointed out. Once burnout begins, it develops only very gradually, building up slowly over time. Ultimately it leads to work being increasingly perceived as stressful: The amount of work is too much, time is too short, and work stress is too great. "When exhausted, the ability to cope with stress usually decreases. As a result, even smaller tasks can be perceived as significantly more strenuous," explained Guthier, the first author of the article. "We expected an effect of burnout on work stress; the strength of the effect was very surprising," she noted. The effect of burnout on perceived work stress can be somewhat mitigated if employees have more control over their own work and receive support from colleagues or superiors.

According to Dormann, a new research area is emerging on the basis of this unique data because the strong boomerang effect of burnout on work stress has not yet been investigated. Key questions that need to be addressed are: how can the effects of burnout on perceived work stress be reduced and how can the development of this vicious circle be prevented? Dormann and Guthier suggest that the place to start is with management behavior. Employees should have the opportunity to give feedback on their work stress at any time and be appreciated. Last but not least, proper recovery could also help to stop the downward spiral.

https://www.sciencedaily.com/releases/2020/11/201110112522.htm

Emergency care doctors not getting sufficient 'down time'

November 2, 2020

Science Daily/University of Plymouth

A survey of more than 4,000 UK emergency care doctors has shown that they need more support to recover from work pressures between shifts.

Published today in the BMJ Open, the study highlighted how the doctors' 'need for recovery' was higher than anything recorded in previous studies of a similar nature -- and could be helped by factors such as reducing the number of antisocial shift patterns and improving access to leave.

Led by a newly formed Trainee Emergency Research Network, sponsored by University Hospitals Plymouth NHS Trust (UHPNT), and with collaboration from the University of Plymouth and the Royal College of Emergency Medicine, the research asked a total of 4,247 doctors in emergency departments from 112 NHS Trusts around the UK to complete a validated Need for Recovery (NFR) Scale. This 11-item questionnaire assesses how work affects inter-shift recovery, with items compiled to form a score between 0 and 100.

The median average NFR result was 70 -- higher than any scores reported in other professions or populations to date.

In addition, a higher proportion of antisocial working was associated with a higher NFR score, suggesting that any reduction in antisocial shifts could help improve wellbeing.

Known as the TIRED study, it was the largest healthcare study to date of a tool that assesses the need for staff to physically and psychologically recuperate following a period of work. The authors also propose that the use of this tool could identify staff wellbeing issues before they progress to burnout.

The research took place in 2019 before the COVID-19 pandemic, but authors suggest the study findings remain relevant given that pressures on emergency care doctors are only likely to have increased.

Lead author Dr Laura Cottey, Chief Investigator for the Trainee Emergency Research Network study, said: "We all know that emergency care can be a high-pressure environment, but these results provide the evidence of the impact this work demand is having on staff wellbeing. Previous Need for Recovery scores among a variety of population groups were reported between 36 and 44, so for the median score to be 70 among over 4,000 doctors is definitely something that needs to be addressed.

"Among our respondents, we saw that NFR scores were increased by difficulty accessing annual and study leave, as well as an increased proportion of antisocial working -- such as night shifts. Better access to leave and any reduction in antisocial shifts might result in direct improvements in NFR and help protect against the development of burnout."

Co-author Dr Blair Graham, Lecturer in Urgent and Emergency Care at the University of Plymouth and Specialty Registrar in Emergency Medicine at UHPNT, said: "The first step to overcoming any problem is recognising that there is one -- so having these results is a good start. Even if fewer antisocial shifts cannot be achieved, acknowledgement of a problem and the provision of rest facilities may help to mitigate the issue.

"The next step would be for us to carry out the research at different times of year to understand whether the results are seasonal, or affected by other factors. Although this study was conducted prior to COVID-19 arriving in the UK, we believe the findings still need to be taken into account as pressures on emergency care doctors are only likely to have increased during the pandemic."

Professor Gary Minto, Director of Research and Development at UHPNT, said: "Here at University Hospitals Plymouth, our research strategy is that, in addition to our longstanding strength in running clinical trials, we also expand our focus into other areas of social care, health and wellbeing. The TIRED study, which addresses mental health in Emergency Doctors, is a great example. This prominent nationwide study, initiated, led and delivered by doctors in training contains important messages about downtime and shift patterns which are relevant across the UK, particularly as the COVID-19 situation evolves."

https://www.sciencedaily.com/releases/2020/11/201102120031.htm

Exercise classes can reduce loneliness, social isolation in seniors

November 12, 2020

Science Daily/Cedars-Sinai Medical Center

Seniors who joined group exercise classes experienced decreased loneliness and social isolation, according to a new study conducted before the COVID-19 pandemic. The classes have continued virtually since March, and early results suggest the online versions are also effective.

Older adults who joined group exercise classes experienced decreased loneliness and social isolation, according to a new Cedars-Sinai study conducted before the COVID-19 pandemic. The classes have continued virtually since March, and early results suggest the online versions are also effective.

Seniors face increased risk for developing serious health issues or even death if they lack social connections or feel alone. Loneliness is connected to higher rates of depression, anxiety and suicide. Experts say social isolation can have the same impact on an older person's health as smoking 15 cigarettes a day.

Both loneliness and social isolation are widespread issues in the U.S., where more than a third of adults 45 and older feel lonely and nearly a quarter of those 65 and older are socially isolated, according to the National Academies of Sciences, Engineering, and Medicine. But few studies have examined the most effective ways to improve social connectedness among seniors.

"As the demographics of our country shift, more people are living alone than ever before," said the study's lead author, Allison Moser Mays, MD, a Cedars-Sinai geriatrician. "The number of adults over the age of 65 in the U.S. is expected to reach more than 70 million by 2030 -- double what it is now. We need sustainable ways to help this burgeoning population thrive as they age, or there will be widespread consequences."

Mays and her co-investigators partnered with local community groups to enroll participants in evidence-based exercise and health management classes for people over 50 at nine sites in Los Angeles neighborhoods with a known concentration of low-income older adults. All locations -- which included libraries, senior centers and recreation centers -- were accessible for those with mobility limitations and had access to parking and public transit.

The study tracked 382 participants ages 52 to 104 from July 2018 through March 2020, when the pandemic forced the classes to move online. Some people were referred by their Cedars-Sinai physician during an office visit. Others found the program through community outreach.

All participants met with a health coach who assessed their needs and helped them select one of four courses, which research has shown improve other aspects of health: Arthritis Exercise, EnhancedFitness, Tai Chi for Arthritis, and Chronic Disease Self-Management. The three exercise classes proved the most popular, and individuals had to attend at least one session to be included in the study.

Participants completed questionnaires about their social connections and loneliness prior to starting their course and after six months. At the end of that period, investigators found a 6.9% decrease in loneliness and a 3.3% improvement in social connectedness, after adjusting for age, gender and other characteristics. The study was published in the American Journal of Geriatric Psychiatry.

"These classes had already been shown to reduce the risk of falls in seniors, and this was the first demonstration that they also reduce social isolation, to the best of our knowledge," Mays said.

The Leveraging Exercise to Age in Place (LEAP) classes have been supported by a three-year grant from the AARP Foundation. Cedars-Sinai has adopted the successful programming under the Community Engagement Department.

"The results of this study are very exciting because we've provided a model that other health systems can easily replicate by integrating evidence-based programs in the community with their organizations. They don't need to reinvent the wheel," said senior study author Sonja Rosen, MD, chief of Geriatric Medicine at Cedars-Sinai. "The health coach is the key ingredient because they make sure that nobody falls through the cracks."

The health coach has been especially crucial since the pandemic began when classes moved online and participants sometimes have needed help figuring out how to log on to the platform. That effort has been paying off.

Of the 59 participants who continued with the virtual workouts, there has not been a statistically significant change in loneliness or social isolation one month after stay at home orders began, according to data Mays presented over the weekend at the Gerontological Society of America's annual meeting. The investigators will analyze further data as the classes continue. They're also piloting another program that pairs older adults with younger participants for one-on-one workout sessions online.

"Cedars-Sinai treats more patients over the age of 80 than any other academic health system in the country," Rosen said. "We're really at the epicenter of this growing population of older adults and figuring out the best ways to care for them so they can successfully age in place."

Rosen said efforts like the LEAP program helped Cedars-Sinai earn its designation as an Age-Friendly Health System Committed to Care Excellence earlier this year. The distinction, which highlights care tailored to older adults, is part of a national initiative of The John A. Hartford Foundation and the Institute for Healthcare Improvement, in partnership with the American Hospital Association and the Catholic Health Association of the United States.

https://www.sciencedaily.com/releases/2020/11/201112155830.htm

Social distancing is increasing loneliness in older adults

November 9, 2020

Science Daily/University of Stirling

Social distancing introduced in response to COVID-19 is increasing feelings of loneliness in Scotland's older population and impacting their wellbeing, according to a new University of Stirling study.

The research has identified a link between increases in loneliness in over 60s and the worsening of wellbeing and health. Increasing loneliness due to social distancing was associated with a smaller social network, lower perceived social support and a decrease in wellbeing, the study found.

The findings emerge from research launched under the Scottish Government's Chief Scientist Office Rapid Research in COVID-19 programme in May. Professor Anna Whittaker, of the University's Faculty of Health Sciences and Sport, led the work and hopes it will help to inform decision-making on the virus and support post-pandemic recovery strategies.

Professor Whittaker said: "Previous studies have demonstrated the negative impacts of social isolation and loneliness. This is a key issue for older adults who may be more likely to have few social contacts. We know that social distancing guidelines introduced in response to COVID-19 have restricted social activity engagement and impacted vulnerable groups, including older adults.

"Our study, which involved a survey of more than 1,400 older people, examined the impact of social distancing during the pandemic on social activity, loneliness and wellbeing. The majority of survey participants reported that social distancing has made them experience more loneliness, social contact with fewer people, and less social contact overall.

"We found that a larger social network and better perceived social support seems to be protective against loneliness and poorer health and wellbeing, due to social distancing. This underlines the importance of addressing loneliness and social contact in older adults, but particularly during pandemics or situations where the risk of isolation is high."

Of the 1,429 survey participants, 84 percent were aged 60 or over and had an average social network of five people. On average, the participants socialised five days per week, for more than 6.6 hours per week. Fifty-six percent reported that social distancing regulations made them experience more loneliness -- with scores that were significantly higher than reported norms; the same quality of perceived support; but social contact with fewer people and less social contact overall.

Greater loneliness was significantly associated with a smaller social network, lower perceived social support, and a decrease in social support frequency, quality, and amount -- and a worsening of wellbeing and health.

Physical activity

Using the same survey data, the research also considered the impact of social distancing on physical activity. The majority of participants reported continuing to meet physical activity guidelines during lockdown -- with 35 percent moderately active and 41 percent highly active. Walking was the greatest contributor to total physical activity, with just over a quarter (26.4%) walking more than before lockdown. Those living in rural areas reported greater volumes of physical activity.

Forty percent of people said they were walking less, compared to before lockdown, and a similar proportion were engaging in less moderate physical activity. Those who reported in engaging in lower physical activity had poorer wellbeing.

Individuals who reported no change in moderate physical activity were the most active pre-lockdown and those who reported no change in walking had significantly higher levels of total physical activity pre-lockdown.

Professor Whittaker said: "Physical activity engagement during lockdown varied and this study indicates a positive link with wellbeing -- supporting the notion that physical activity should be considered an important contributor in recovery strategies targeted at older adults as we emerge from the pandemic.

"There appears to be a relationship between pre-lockdown physical activity and physical activity changes due to lockdown. This may be of significance in the context of trying to get older adults to maintain or increase physical activity, where appropriate, as we emerge from this pandemic, given our understanding of the benefits of physical activity in this age group.

"Additionally, irrespective of pre-lockdown physical activity, older adults should continue to be encouraged to be active, and particularly to engage in some sort of strength and balance training -- such as tai chi, yoga, or weights -- which was very low in the sample but is vital for maintaining balance and physical function. Just 12 percent of the sample met the physical activity guidelines, which indicate strength training should be undertaken at least twice per week."

https://www.sciencedaily.com/releases/2020/11/201109110230.htm

Study helps explain why motivation to learn declines with age

Research on mice suggests aging affects a brain circuit critical for learning to make some types of decisions

October 28, 2020

Science Daily/Massachusetts Institute of Technology

As people age, they often lose their motivation to learn new things or engage in everyday activities. In a study of mice, MIT neuroscientists have now identified a brain circuit that is critical for maintaining this kind of motivation.

This circuit is particularly important for learning to make decisions that require evaluating the cost and reward that come with a particular action. The researchers showed that they could boost older mice's motivation to engage in this type of learning by reactivating this circuit, and they could also decrease motivation by suppressing the circuit.

"As we age, it's harder to have a get-up-and-go attitude toward things," says Ann Graybiel, an Institute Professor at MIT and member of the McGovern Institute for Brain Research. "This get-up-and-go, or engagement, is important for our social well-being and for learning -- it's tough to learn if you aren't attending and engaged."

Graybiel is the senior author of the study, which appears today in Cell. The paper's lead authors are Alexander Friedman, a former MIT research scientist who is now an assistant professor at the University of Texas at El Paso, and Emily Hueske, an MIT research scientist.

Evaluating cost and benefit

The striatum is part of the basal ganglia -- a collection of brain centers linked to habit formation, control of voluntary movement, emotion, and addiction. For several decades, Graybiel's lab has been studying clusters of cells called striosomes, which are distributed throughout the striatum. Graybiel discovered striosomes many years ago, but their function had remained mysterious, in part because they are so small and deep within the brain that it is difficult to image them with functional magnetic resonance imaging (fMRI).

In recent years, Friedman, Graybiel, and colleagues including MIT research fellow Ken-ichi Amemori have discovered that striosomes play an important role in a type of decision-making known as approach-avoidance conflict. These decisions involve choosing whether to take the good with the bad -- or to avoid both -- when given options that have both positive and negative elements. An example of this kind of decision is having to choose whether to take a job that pays more but forces a move away from family and friends. Such decisions often provoke great anxiety.

In a related study, Graybiel's lab found that striosomes connect to cells of the substantia nigra, one of the brain's major dopamine-producing centers. These studies led the researchers to hypothesize that striosomes may be acting as a gatekeeper that absorbs sensory and emotional information coming from the cortex and integrates it to produce a decision on how to act. These actions can then be invigorated by the dopamine-producing cells.

The researchers later discovered that chronic stress has a major impact on this circuit and on this kind of emotional decision-making. In a 2017 study performed in rats and mice, they showed that stressed animals were far more likely to choose high-risk, high-payoff options, but that they could block this effect by manipulating the circuit.

In the new Cell study, the researchers set out to investigate what happens in striosomes as mice learn how to make these kinds of decisions. To do that, they measured and analyzed the activity of striosomes as mice learned to choose between positive and negative outcomes.

During the experiments, the mice heard two different tones, one of which was accompanied by a reward (sugar water), and another that was paired with a mildly aversive stimulus (bright light). The mice gradually learned that if they licked a spout more when they heard the first tone, they would get more of the sugar water, and if they licked less during the second, the light would not be as bright.

Learning to perform this kind of task requires assigning value to each cost and each reward. The researchers found that as the mice learned the task, striosomes showed higher activity than other parts of the striatum, and that this activity correlated with the mice's behavioral responses to both of the tones. This suggests that striosomes could be critical for assigning subjective value to a particular outcome.

"In order to survive, in order to do whatever you are doing, you constantly need to be able to learn. You need to learn what is good for you, and what is bad for you," Friedman says.

"A person, or this case a mouse, may value a reward so highly that the risk of experiencing a possible cost is overwhelmed, while another may wish to avoid the cost to the exclusion of all rewards. And these may result in reward-driven learning in some and cost-driven learning in others," Hueske says.

The researchers found that inhibitory neurons that relay signals from the prefrontal cortex help striosomes to enhance their signal-to-noise ratio, which helps to generate the strong signals that are seen when the mice evaluate a high-cost or high-reward option.

Loss of motivation

Next, the researchers found that in older mice (between 13 and 21 months, roughly equivalent to people in their 60s and older), the mice's engagement in learning this type of cost-benefit analysis went down. At the same time, their striosomal activity declined compared to that of younger mice. The researchers found a similar loss of motivation in a mouse model of Huntington's disease, a neurodegenerative disorder that affects the striatum and its striosomes.

When the researchers used genetically targeted drugs to boost activity in the striosomes, they found that the mice became more engaged in performance of the task. Conversely, suppressing striosomal activity led to disengagement.

In addition to normal age-related decline, many mental health disorders can skew the ability to evaluate the costs and rewards of an action, from anxiety and depression to conditions such as PTSD. For example, a depressed person may undervalue potentially rewarding experiences, while someone suffering from addiction may overvalue drugs but undervalue things like their job or their family.

The researchers are now working on possible drug treatments that could stimulate this circuit, and they suggest that training patients to enhance activity in this circuit through biofeedback could offer another potential way to improve their cost-benefit evaluations.

"If you could pinpoint a mechanism which is underlying the subjective evaluation of reward and cost, and use a modern technique that could manipulate it, either psychiatrically or with biofeedback, patients may be able to activate their circuits correctly," Friedman says.

https://www.sciencedaily.com/releases/2020/10/201028171435.htm

Sweet taste reduces appetite?

The sweet taste of sugar, energy intake and the regulatory process of hunger and satiety

November 10, 2020

Science Daily/University of Vienna

The sweet taste of sugar is very popular worldwide. In Austria and Germany, the yearly intake per person adds up to about 33 and 34 kilograms, respectively. Thus, sugar plays an increasingly role in the nutrition and health of the population, especially with regard to body weight. However, little is known about the molecular (taste) mechanisms of sugar that influence dietary intake, independently of its caloric load.

Taste receptor and satiety regulation

"We therefore investigated the role of sweet taste receptor activation in the regulation of satiety," says Veronika Somoza, deputy head of the Department of Physiological Chemistry at the University of Vienna and director of the Leibniz Institute for Food Systems Biology at the Technical University of Munich.

For this purpose, the scientists conducted a blinded, cross-over intervention study with glucose and sucrose. A total of 27 healthy, male persons, between 18 and 45 years of age, received either a 10 percent glucose or sucrose solution (weight percent) or one of the sugar solutions supplemented with 60 ppm lactisole. Lactisole is a substance that binds to a subunit of the sweet receptor and reduces the perception of sweet taste. Despite different types of sugar, all solutions with or without lactisole had the same energy content.

Two hours after drinking each of the test solutions, the participants were allowed to have as much as breakfast they wanted. Shortly before and during the 120-min waiting period, the researchers took blood samples in regular intervals and measured their body temperature.

Additional 100 kilocalories on average

After the consumption of the lactisole-containing sucrose solution, the test persons had an increased energy intake from breakfast of about 13 percent, about 100 kilocalories more, than after drinking the sucrose solution without lactisole. In addition, the subjects of this group showed lower body temperature and reduced plasma serotonin concentrations. Serotonin is a neurotransmitter and tissue hormone which, among other things, has an appetite-suppressing effect. In contrast, the researchers observed no differences after administration of the lactisole-containing glucose solution and the pure glucose solution.

"This result suggests that sucrose, regardless of its energy content, modulates the regulation of satiety and energy intake via the sweet taste receptor," says Barbara Lieder, head of Christian Doppler Laboratory for Taste Research and also deputy head of the Department of Physiological Chemistry of the Faculty of Chemistry at University of Vienna.

The first study author of the study, Kerstin Schweiger, University of Vienna adds: "We do not know yet why we could not observe the lactisole effect with glucose. However, we suspect it is because glucose and sucrose activate the sweet receptor in different ways. We also assume that mechanisms independent of the sweet receptor play a role."

"So there is still a lot of research needed to clarify the complex relationships between sugar consumption, taste receptors and satiety regulation on the molecular level," says Veronika Somoza. In particular, as sweet receptors are also found in the digestive tract and little is known about their function there. The first steps have nevertheless been taken.

https://www.sciencedaily.com/releases/2020/11/201110112545.htm

Why consumers think pretty food is healthier

November 7, 2020

Science Daily/American Marketing Association

A researcher from University of Southern California published a new paper in the Journal of Marketingthat explores whether attractive food might seem healthier to consumers. The study forthcoming in the Journal of Marketing is titled "Pretty Healthy Food: How and When Aesthetics Enhance Perceived Healthiness" and is authored by Linda Hagen.

Consumers see almost 7,000 food and restaurant advertisements per year, with the vast majority touting fast food. In marketing materials, food is extensively styled to look especially pretty. Imagine the beautiful pizza you might see on a billboard -- a perfect circle of crust with flawlessly allocated pepperoni and melted cheese. Advertisers clearly aim to make the food more appetizing. But do pretty aesthetics have other, potentially problematic, effects on your impressions of food?

On one hand, beautiful aesthetics are closely associated with pleasure and indulgence. Looking at beautiful art and people activates the brain's reward center and observing beauty is inherently gratifying. This link with pleasure might make pretty food seem unhealthy, because people tend to view pleasure and usefulness as mutually exclusive. For instance, many people have the general intuition that food is either tasty or healthy, but not both.

On the other hand, a specific type of aesthetics called "classical" aesthetics is characterized by the ideal patterns found in nature. For instance, a key classical aesthetic feature is symmetry, which is also extremely common in nature. Another prominent classical aesthetic feature involves order and systematic patterns, which, again, are ubiquitous in nature. It seems possible that sporting more of these nature-like visual features might make food depictions feel more natural. Seeming more natural, in turn, may make the food seem healthier because people tend to consider natural things (e.g., organic food or natural remedies) to be healthier than unnatural things (e.g., highly processed food or synthetic chemicals). So, by virtue of reflecting nature, the same food may seem healthier when it is pretty (compared to when it is ugly).

In a series of experiments, the researcher tested if the same food is perceived as healthier when it looks pretty by following classical aesthetics principles (i.e., symmetry, order, and systematic patterns) compared to when it does not. For example, in one experiment, participants evaluated avocado toast. Everyone read identical ingredient and price information, but people were randomly assigned to see either a pretty avocado toast or an ugly avocado toast (the pictures had previously been, on average, rated as differentially pretty). Despite identical information about the food, respondents rated the avocado toast as overall healthier (e.g., healthier, more nutritious, fewer calories) and more natural (e.g., purer, less processed) if they saw the pretty version compared to the ugly version. As suspected, the difference in naturalness judgments drove the difference in healthiness judgments. Judgments of other aspects, like freshness or size, were unaffected. Experiments with different foods and prettiness manipulations returned the same pattern of results, suggesting that the effect is unlikely idiosyncratic to certain pictures.

Importantly, these healthiness judgments affect consumer behavior. In a field experiment, people were willing to pay significantly more money for a pretty bell pepper than an ugly one, and a substantial portion of this boost in reservation prices was attributable to an analogous boost in healthiness judgments. In another study, even when people had financial incentives to correctly identify which of two foods contained fewer calories, they were more likely to declare a target food to be the lower calorie option when it was pretty than when it was ugly -- even though this choice lost them money.

There are some key qualifications. First, the pretty=healthy effect is limited to classical aesthetics. "Expressive" aesthetics do not involve nature-like patterns, but instead please through imaginative execution of creative ideas, such as food cut into fun shapes or arranged to depict a scene. Second, the pretty=healthy bias can be muted by displaying a disclaimer next to the food reminding people that the food was artificially modified.

This effect of classical aesthetic principles has implications for marketers and public health advocates, albeit different ones. Hagen explains that "Classical aesthetics may be a costless and subtle new way to convey naturalness and healthfulness -- attributes that consumers increasingly demand in food products. At the same time, pretty food presentation may optimistically distort nutrition estimates and negatively impact dietary decisions. Given these findings, policy-makers may want to consider modification disclaimers as an intervention or strengthen regulations around providing objective nutrition information with food images."

https://www.sciencedaily.com/releases/2020/11/201107133908.htm

Avoiding inflammatory foods can lower heart disease, stroke risk

Study further examines connection between inflammation and heart disease through impact of inflammatory food consumption

November 2, 2020

Science Daily/American College of Cardiology

Diets high in red and processed meat, refined grains and sugary beverages, which have been associated with increased inflammation in the body, can increase subsequent risk of heart disease and stroke compared to diets filled with anti-inflammatory foods according to a study published today in the Journal of the American College of Cardiology. A separate JACC study assessed the positive effects eating walnuts, an anti-inflammatory food, had on decreasing inflammation and heart disease risk.

Chronic inflammation has been shown to play an important role in the development of heart disease and stroke. Certain inflammatory biomarkers, such as interleukins, chemokines and adhesion molecules, have been associated with early and late stages of atherosclerosis. Previous studies have found that diet can influence inflammation levels, but few healthy dietary patterns, such as the Mediterranean diet (rich in olive oil, nuts, whole grain, fruits and vegetables, and seafood consumption, and light on dairy and red/processed meat), have shown lower concentrations of some inflammatory biomarkers and lower heart disease risk. There has been less research focused on whether long-term adherence to proinflammatory diets are associated with increased rates of heart disease or stroke.

Researchers used the men and women from the Nurses' Health Studies I and II starting from 1986 and included up to 32 years of follow up. After excluding participants with missing diet information or previously diagnosed heart disease, stroke or cancer, over 210,000 participants were included in the analysis. The participants completed a survey every four years to ascertain dietary intake.

"Using an empirically-developed, food-based dietary index to evaluate levels of inflammation associated with dietary intake, we found that dietary patterns with higher inflammatory potential were associated with an increased rate of cardiovascular disease," said Jun Li, MD, PhD, lead author of the study and research scientist in the department of nutrition at Harvard T.H. Chan School of Public Health. "Our study is among the first to link a food-based dietary inflammatory index with long-term risk of cardiovascular disease."

The food-based proinflammatory dietary index based off 18 pre-defined food groups that together show the strongest associations with an increase in inflammatory biomarkers. After controlling for other risk factors such as BMI, physical activity, family history of heart disease and multivitamin use, the participants consuming proinflammatory diets had a 46% higher risk of heart disease and 28% higher risk of stroke, compared to those consuming anti-inflammatory diets.

The researchers suggested consuming foods with higher levels of antioxidants and fiber to help combat inflammation: Green leafy vegetables (kale, spinach, cabbage, arugula), yellow vegetables (pumpkin, yellow peppers, beans, carrots), whole grains, coffee, tea and wine. The researchers also suggested limiting intake of refined sugars and grains, fried foods, sodas, and restricting processed, red and organ meat. These foods are among the major contributors to the proinflammatory dietary index.

"A better knowledge of health protection provided by different foods and dietary patterns, mainly their anti-inflammatory properties, should provide the basis for designing even healthier dietary patterns to protect against heart disease," said Ramon Estruch, MD, PhD, senior consultant in the department of internal medicine at Hospital Clinic in Barcelona, Spain, and author of an accompanying editorial comment. "When choosing foods in our diet, we should indeed beware of their proinflammatory and anti-inflammatory potential!"

Incorporating Walnuts into Diet Decreases Inflammation

In another study, researchers assessed how incorporating walnuts into an individual's usual diet would improve inflammatory biomarkers. Previous studies have found that regular nut consumption is associated with lower heart disease risk and lower overall cholesterol; however, there has been limited research linking nut consumption with less inflammation in the body. A total of 634 participants were assigned either a diet without walnuts or a diet with regularly incorporated walnuts (about 30-60 grams per day). After a follow up period of two years, those who ate a diet with walnuts showed significantly reduced levels of inflammation in the body in 6 out of 10 of the inflammatory biomarkers tested.

"The anti-inflammatory effect of long-term consumption of walnuts demonstrated in this study provides novel mechanistic insight for the benefit of walnut consumption on heart disease risk beyond that of cholesterol lowering," said Montserrant Cofán, PhD, lead author of the study and a researcher at the August Pi i Sunyer Biomedical Research Institute in Barcelona, Spain.

https://www.sciencedaily.com/releases/2020/11/201102142257.htm

Children born extremely preterm are more likely to be diagnosed with depression

November 12, 2020

Science Daily/University of Turku

A study using extensive nationwide registry data showed that girls born extremely preterm, earlier than 28 weeks gestational age, were three times more likely to be diagnosed with depression than peers born close to the expected date of delivery. Increased risk of depression also applied to girls and boys with poor fetal growth born full-term and post-term. The effects of poor fetal growth were more evident with increasing gestational age.

All the results were adjusted for paternal psychopathology, paternal immigrant status, maternal psychopathology, maternal depression, maternal substance abuse, number of previous births, maternal marital status, maternal socio-economic status, maternal smoking during pregnancy, and the infant's birthplace.

Childhood depression can be addressed preventively

Depression is a common psychiatric disorder that has been reported to affect 1-2 percent of preschool and prepubertal children and 3-8 percent of adolescents. However, childhood depression is a severe disorder and its prevention can be advanced with the identification of at-risk groups.

"The study highlights the need for preventive interventions for high-risk infants and support programmes for parental mental health during pregnancy and neonatal care, especially for extremely preterm infants and growth-retarded full-term infants. Follow-up care practices should include psychosocial screening and developmental testing for children born preterm and their families, with appropriate support for sound mental health," says researcher Subina Upadhyaya from the Research Centre for Child Psychiatry, University of Turku.

"Future studies should examine the risk associated with preterm birth and infant long-term outcomes in the present era of family centered neonatal care practices," she continues.

The study included 37,682 children born in Finland between January 1987 and December 2007 and diagnosed with depression. They were compared with 148,795 matched controls without depression.

The study is part of a larger body of research that investigates the associations between antenatal risk factors and major psychiatric disorders.

"The results are significant both for understanding the risk factors for psychiatric disorders and for prevention, notes the primary investigator," Professor Andre Sourander.

The study belongs to the INVEST Research Flagship funded by the Academy of Finland Flagship Programme. INVEST aims at providing a new model for the welfare states that is more equal, better targeted to at risk groups, more anticipatory as well as economically and socially sustainable.

https://www.sciencedaily.com/releases/2020/11/201112103511.htm

High blood pressure complications in US pregnancies have nearly doubled

November 9, 2020

Science Daily/American Heart Association

Researchers found high blood pressure complicated about 80,000 pregnancies in 2018, nearly twice as many as in 2007. Women living in rural areas continue to be approximately 20% more likely to have high blood pressure before pregnancy than women living in urban communities.

Nearly twice as many pregnancies were complicated by high blood pressure in 2018 than in 2007, and women living in rural areas continue to have higher rates of high blood pressure compared to their urban counterparts, according to preliminary research to be presented at the American Heart Association's Scientific Sessions 2020. The meeting will be held virtually, Friday, November 13 -- Tuesday, November 17, 2020.

Pre-pregnancy hypertension is a well-established risk to the health of both mothers and infants, and mortality rates of mothers are increasing in the U.S. with significant rural-urban disparities. The goal of the study, "Trends and Disparities in Pre-pregnancy Essential Hypertension Among Women in Rural and Urban United States, 2007-2018," was to detail trends in maternal pre-pregnancy high blood pressure so geographically targeted prevention and policy strategies can be developed.

"We were surprised to see the dramatic increase in the percentage over the last 10 years of women entering pregnancy with hypertension. It was also shocking to see women as young as 15 to 24 years old with high blood pressure, and the statistics were worse in rural areas, leading us to be concerned these numbers may, in part, be driven by hospital closures and difficulty accessing care," said the study's lead author Natalie A. Cameron, M.D., a resident in the department of medicine at Northwestern University's Feinberg School of Medicine in Chicago.

Researchers collected maternal data from almost 50 million live births in women ages 15 to 44, between 2007 and 2018, from the national CDC Natality Database. They calculated rates of pre-pregnancy hypertension per 1,000 live births overall and by the type of community the women lived in (rural or urban). The annual percentage change was calculated to compare yearly rates between rural and urban settings.

Results from the analysis indicate:

• The rate of pre-pregnancy hypertension per 1,000 births nearly doubled in both rural (13.7 to 23.7) and urban (10.5 to 20) women.

• In both rural and urban areas, hypertension rates were lower among younger women (ages 15-19) than in older women (40-44), yet all age groups experienced similar rate increases between 2007 and 2018.

• The greatest annual percentage change of pre-pregnancy hypertension was nearly 10% for women in rural areas and 9% for women in urban areas.

"These data demonstrate unacceptable increases in the number of women with hypertension that need to be addressed urgently," says Cameron. "Preventive care must start before pregnancy. This is especially important in rural communities where there is a far greater burden of high blood pressure and much higher risks to the health of mother and baby. We also must address the structural and systemic racism that can be barriers to high quality care."

Important limitations of this work include the lack of data on continuous blood pressure measurements, as well as other important factors that can be related to high blood pressure such as body mass index.

Co-authors are Rebecca Molsberry, M.P.H.; Jacob B. Pierce, B.A.; Amanda M. Perak, M.D., M.S.; William A. Grobman, M.D., M.B.A.; Norrina B. Allen, Ph.D.; Philip Greenland, M.D.; Donald M. Lloyd-Jones, M.D., Sc.M.; and Sadiya S. Khan, M.D., M.Sc. Author disclosures are in the abstract.

https://www.sciencedaily.com/releases/2020/11/201109074122.htm

Mothers' lifestyle predicts when offspring will have first heart attack or stroke

November 4, 2020

Science Daily/European Society of Cardiology

Offspring of mothers with heart healthy lifestyles live nearly a decade longer without cardiovascular disease than those whose mothers have unhealthy lifestyles. That's the finding of a study published today in the European Journal of Preventive Cardiology, a journal of the European Society of Cardiology (ESC).

"Our study suggests that mothers are the primary gatekeepers of their children's health," said study author Dr. James Muchira of Vanderbilt University, Nashville and the University of Massachusetts, Boston. "This maternal influence persists into the adulthood of their offspring."

Previous research has shown that parents pass on health to their offspring through both genes and shared environment/lifestyle. This was the first study to examine whether parents' heart health was associated with the age at which offspring develop cardiovascular disease. In addition, it investigated the influence of each parent separately.

The study was conducted in offspring-mother-father trios from the Framingham Heart Study -- a total of 1,989 offspring, 1,989 mothers, and 1,989 fathers. Offspring were enrolled at an average age of 32 years and followed over 46 years (1971-2017) for the development of cardiovascular events. "Crucially, the study followed offspring into most of their adult life when heart attacks and strokes actually occur," explained Dr. Muchira.

Cardiovascular health of mothers and fathers was rated according to their attainment of seven factors: not smoking, healthy diet, physically active, and normal body mass index, blood pressure, blood cholesterol, and blood glucose. The three categories of cardiovascular health were: poor (0 to 2 factors achieved), intermediate (3 to 4), and ideal (5 to 7).

The researchers assessed the association between parental cardiovascular health and how long their offspring lived without cardiovascular disease. Links between each pair were assessed, i.e. mother-daughter, mother-son, father-daughter, and father-son.

Offspring of mothers with ideal cardiovascular health lived nine more years free of cardiovascular disease than offspring of mothers with poor cardiovascular health (27 versus 18 years, respectively). Poor maternal cardiovascular health was linked with twice the hazard of early onset cardiovascular disease compared with ideal maternal cardiovascular health. Fathers' heart health did not have a statistically significant effect on the length of time offspring lived without cardiovascular disease.

Dr. Muchira said the strong contribution of mothers was likely a combination of health status during pregnancy and environment in early life. He said: "If mothers have diabetes or hypertension during pregnancy, those risk factors get imprinted in their children at a very early age. In addition, women are often the primary caregivers and the main role model for behaviours."

Sons were more affected than daughters by the mother's unhealthy lifestyle. Dr. Muchira said: "This was because sons had more unfavourable lifestyle habits than daughters, making the situation even worse. It shows that individuals can take charge of their own health. People who inherit a high risk from their mother can reduce that risk by exercising and eating well. If they don't, the risk will be multiplied."

The authors state that optimising cardiovascular health among women of reproductive age and mothers with young children has the potential to break the intergenerational cycle of preventable cardiovascular disease.

"Family-based interventions should occur during pregnancy and very early in the child's life, so that the real impact of protective cardiovascular health tracks into adulthood," said Dr Muchira. "For example, pairing mothers and young children in an exercise or diet improvement programme. If children grow into healthy adults, they will not acquire the same cardiovascular risk as their parents, a situation that will raise the chances of having even healthier grandchildren."

https://www.sciencedaily.com/releases/2020/11/201104194708.htm

Vitamin D levels during pregnancy linked with child IQ

November 2, 2020

Science Daily/Seattle Children's

A study showed that mothers' vitamin D levels during pregnancy were associated with their children's IQ, suggesting that higher vitamin D levels in pregnancy may lead to greater childhood IQ scores.

Vitamin D is a critical nutrient and has many important functions in the body. A mother's vitamin D supply is passed to her baby in utero and helps regulate processes including brain development. A study published today in The Journal of Nutrition showed that mothers' vitamin D levels during pregnancy were associated with their children's IQ, suggesting that higher vitamin D levels in pregnancy may lead to greater childhood IQ scores. The study also identified significantly lower levels of vitamin D levels among Black pregnant women.

Melissa Melough, the lead author of the study and research scientist in the Department of Child Health, Behavior, and Development at Seattle Children's Research Institute, says vitamin D deficiency is common among the general population as well as pregnant women, but notes that Black women are at greater risk. Melough says she hopes the study will help health care providers address disparities among women of color and those who are at higher risk for vitamin D deficiency.

"Melanin pigment protects the skin against sun damage, but by blocking UV rays, melanin also reduces vitamin D production in the skin. Because of this, we weren't surprised to see high rates of vitamin D deficiency among Black pregnant women in our study. Even though many pregnant women take a prenatal vitamin, this may not correct an existing vitamin D deficiency," Melough said. "I hope our work brings greater awareness to this problem, shows the long-lasting implications of prenatal vitamin D for the child and their neurocognitive development, and highlights that there are certain groups providers should be paying closer attention to. Wide-spread testing of vitamin D levels is not generally recommended, but I think health care providers should be looking out for those who are at higher risk, including Black women."

Addressing disparities

According to Melough, as many as 80% of Black pregnant women in the U.S. may be deficient in vitamin D. Of the women who participated in the study, approximately 46% of the mothers were deficient in vitamin D during their pregnancy, and vitamin D levels were lower among Black women compared to White women.

Melough and her co-authors used data from a cohort in Tennessee called the Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE) study. CANDLE researchers recruited pregnant women to join the study starting in 2006 and collected information over time about their children's health and development.

After controlling for several other factors related to IQ, higher vitamin D levels in pregnancy were associated with higher IQ in children ages 4 to 6 years old. Although observational studies like this one cannot prove causation, Melough believes her findings have important implications and warrant further research.

Vitamin D deficiency 

"Vitamin D deficiency is quite prevalent," Melough said. "The good news is there is a relatively easy solution. It can be difficult to get adequate vitamin D through diet, and not everyone can make up for this gap through sun exposure, so a good solution is to take a supplement."

The recommended daily intake of vitamin D is 600 international units (IU). On average, Americans consume less than 200 IU in their diet, and so if people aren't making up that gap through sun exposure or supplementation, Melough says people will probably become deficient. Foods that contain higher levels of vitamin D include fatty fish, eggs and fortified sources like cow's milk and breakfast cereals. However, Melough notes that vitamin D is one of the most difficult nutrients to get in adequate amounts from our diets.

Additional research is needed to determine the optimal levels of vitamin D in pregnancy, but Melough hopes this study will help to develop nutritional recommendations for pregnant women. Especially among Black women and those at high risk for vitamin D deficiency, nutritional supplementation and screening may be an impactful strategy for reducing health disparities.

Key takeaways

Melough says there are three key takeaways from the study:

1. Vitamin D deficiency is common during pregnancy, and Black women are at greater risk because melanin pigment in the skin reduces production of vitamin D

2. Higher vitamin D levels among mothers during pregnancy may promote brain development and lead to higher childhood IQ scores

3. Screening and nutritional supplementation may correct vitamin D deficiency for those at high risk and promote cognitive function in offspring

"I want people to know that it's a common problem and can affect children's development," Melough said. "Vitamin D deficiency can occur even if you eat a healthy diet. Sometimes it's related to our lifestyles, skin pigmentation or other factors outside of our control."

https://www.sciencedaily.com/releases/2020/11/201102142242.htm

When kids watch a lot of TV, parents may end up more stressed

November 10, 2020

Science Daily/University of Arizona

There's bad news for parents who frequently plop their kids in front of the TV to give themselves a break: It might actually end up leaving moms and dads more stressed.

Why? Because the more television that kids watch, the more they're exposed to advertising messages. The more advertising they see, the more likely they are to insist on purchasing items when they go with their parents to the store -- and perhaps make a fuss if told "no." All that, researchers say, may contribute to parents' overall stress levels, well beyond a single shopping trip.

The findings come from a University of Arizona-led study, published in the International Journal of Advertising, that explores the potential effects of children's television watching habits on their parents' stress levels.

"The more advertising children see, the more they ask for things and the more conflict is generated," said lead study author Matthew Lapierre, an assistant professor in the UArizona Department of Communication in the College of Social and Behavioral Sciences. "What we haven't looked at before is what the potential effect is on parents. We know kids ask for things, we know it leads to conflict, but we wanted to ask the next question: Could this be contributing to parents' overall stress?"

The study suggests that it could.

There are a few things parents can do, perhaps the most obvious of which is limiting screen time.

"Commercial content is there for a reason: to elicit purchasing behavior. So, if this is a problem, maybe shut off the TV," Lapierre said.

Of course, that can be easier said than done, he acknowledged.

Another thing parents can try, especially as advertising geared toward children ramps up around the holidays: Consider how they talk to their kids about consumerism.

The researchers looked at the effectiveness of three types of parent-child consumer-related communication:

-- Collaborative communication is when a parent seeks child input on family purchasing decisions -- for example, saying things such as, "I will listen to your advice on certain products or brands."

-- Control communication is when a parent exhibits total control in parent-child consumer related interactions -- for example, saying things such as, "Don't argue with me when I say no to your product request."

-- Advertising communication is when parents talk to their children about advertising messages -- for example, saying things such as, "Commercials will say anything to get you to buy something."

They found that, in general, collaborative communication is associated with less parent stress. However, the protective effect of collaborative communication decreases as children's purchase initiation and coercive behaviors -- such as arguing, whining or throwing temper tantrums -- increase.

Both control communication and advertising communication are associated with more purchase initiations and children's coercive behavior, the researchers found, suggesting that engaging less in those communication styles could be beneficial.

However, when children have higher levels of television exposure, the protective effect of engaging in less advertising communication decreases.

"Overall, we found that collaborative communication between parents and children was a better strategy for reducing stress in parents. However, this communicative strategy shows diminishing returns when children ask for more products or engage in more consumer conflict with parents," said study co-author Eunjoo Choi, a UArizona doctoral student in communication.

The study is based on survey data from 433 parents of children ages 2 to 12. The researchers focused on younger children because they have less independent purchasing power and spend more time shopping with their parents than older kids, Lapierre said.

In addition to answering questions about their communication styles, the parents in the study also responded to questions designed to measure:

-- How much television their child watches in a day.

-- How often their child ask for or demands a product during shopping trips, or touches a product without asking.

-- How often their child engages in specific coercive behaviors during shopping trips.

-- Parent stress levels.

Advertisers Find a Way

Lapierre acknowledged that the way people consume entertainment is changing. With the rise of the DVR and streaming services, many viewers are no longer being exposed to the traditional advertising of network or cable TV. However, advertisers are finding creative ways around that, through tactics such as product placement and integrated branding -- incorporating product or company names into a show's narrative -- Lapierre said. And advertising toward children remains a multibillion-dollar industry.

"In general, more television exposure means more exposure to commercialized content. Even if I'm streaming, if I I'm watching more of it, I'm likely seeing more integrated branding," Lapierre said.

Advertising aimed at children -- which often features lots of bright colors, upbeat music and flashy characters -- can be especially persuasive, since, developmentally, children aren't fully capable of understanding advertising's intent, Lapierre said.

"Advertising for kids is generated to makes them feel excited. They do a lot of things in kids' advertising to emotionally jack up the child," Lapierre said. "Children don't have the cognitive and emotional resources to pull themselves back, and that's why it's a particular issue for them."

https://www.sciencedaily.com/releases/2020/11/201110151154.htm

Trees set sixth-graders up for success

November 9, 2020

Science Daily/University of Illinois College of Agricultural, Consumer and Environmental Sciences

The transition to middle school is undeniably tough for many sixth-graders, even in the best of times. Mounting academic demands, along with changes in peer dynamics and the onset of puberty, result in a predictable and sometimes irreversible slump in academic performance.

A new University of Illinois study suggests an unexpected but potentially potent remedy: trees.

"Hundreds of studies show a positive link between contact with nature and learning outcomes, but the studies on nature near schools focus on young children or older learners. We wanted to make sure the same pattern was true in this vulnerable and overlooked population," says Ming Kuo, associate professor in the Department of Natural Resources and Environmental Sciences at Illinois.

It was. Even after taking a whopping 17 variables into account including student demographics, school resources, and neighborhood characteristics, Kuo and her co-authors found that the more tree cover around a school, the better its standardized test scores in both math and reading. The study included 450 middle schools and nearly 50,000 students in urban, suburban, and rural communities in Washington State.

But why would trees boost test scores? Kuo's previous work points to a cause-and-effect relationship between nature and learning, with more exposure to nature resulting in improved concentration, greater classroom engagement, and less disruptive behavior. No surprise, then, that greener schools perform better.

Samantha Klein, a master's student who worked with Kuo on the study, made a point to compare different kinds of vegetation at different distances from schools.

"We wanted to offer concrete guidance to landscape architects, principals, and school boards interested in putting the greenness-achievement link to work, giving them clues as to what should be planted, and where," Klein says.

Kuo, Klein, and their team were able to differentiate tree cover from grass and shrubs using satellite imagery. "From a practical standpoint, trees cost more to install than grass. So if school districts could get away with just putting grass everywhere, that would be really helpful to know," Klein explains.

Unfortunately, that wasn't the case. Trees were far and away more impactful for test scores than other types of vegetation. Still, Kuo emphasizes that compared with other school resource investments planting trees around a schoolyard is still an incredibly cheap and effective intervention. But it could take a sea change before school districts accept school greening when other demands seem so much more pressing.

"I think school boards have always been faced with distributing very limited funds, especially in the poorest areas. They might think that, with all the other pressing needs for funding, school landscaping is the least of their concerns. Little do they suspect that a treeless schoolyard may actually be contributing to poor school performance," Kuo says.

The satellite images also helped Kuo's team pinpoint where tree cover mattered most. They compared the importance of greenness in different buffer zones around schools, within 250 meters (around two blocks) and 1000 meters. It turned out trees closer to the schools made all the difference, even when controlling for greenness at farther distances. In other words, even if the larger neighborhood was leafy, students were no better off if the schoolyard wasn't.

These findings extend previous discoveries in Chicago public schools. Kuo's work there showed the importance of tree cover near schools in low-income urban districts. But since her current study includes 450 schools across a wide spectrum of populations, she's confident her results apply more broadly.

"One of the nice things about this study is not only the sheer number of schools and students we're looking at, but the huge range in Washington State. We've captured everything from extremely urban to totally rural areas; rich schools and poor schools; schools with predominately white, Hispanic, Black, or American Indian student bodies; and every level of greenness represented within each of those samples," Kuo says. "The fact that the greenness-achievement link is true here is encouraging to me. It gives us some confidence that our recommendations apply to a whole variety of schools."

How does all this apply against the backdrop of remote learning during the COVID-19 pandemic? School greenness won't make much of a difference if kids aren't leaving the house. But whether they are physically in school or not, Kuo thinks contact with nature could be critical right now.

"I think the need for trees is more acute at this time. One of the big benefits of greenery, and one of the reasons we think it affects academic achievement, is it's a really potent stress reliever. Kids are aware that things are weird and that a lot of adults are kind of freaked out. And so having access to nature might be even more important than usual."

https://www.sciencedaily.com/releases/2020/11/201109124724.htm

Study finds surprising diversity in early child care

Seven pathways to kindergarten identified in one state

November 9, 2020

Science Daily/Ohio State University

A new study of kindergarteners in one Midwestern state identified seven different pathways the children took in their early education and care before arriving at school.

The researchers were surprised by the diverse experiences that kids brought with them to kindergarten: While some received care only in their home or mainly in a child care center, others switched back and forth between different types of care, or had other arrangements.

This study is one of the few that has looked at kids' child care experiences all the way from birth to kindergarten, which allowed the researchers to capture the broad range of pathways, said Nathan Helsabeck, lead author of the study and a graduate research associate in educational studies at The Ohio State University.

"There are more nuanced differences in children's experiences before kindergarten than we originally thought," said Helsabeck, who is also an associate of Ohio State's Crane Center for Early Childhood Education and Policy.

"Looking at how children get to kindergarten could help us better consider what they need when they are entering school."

The study was published online in the journal Early Education and Development.

The study is part of a larger federally funded project designed to improve understanding of what happens in classrooms from pre-school to third grade. Data was collected from two large, suburban school districts including 25 schools, 152 classrooms and 3,472 students. A subsample of 568 students was used in this study.

One part of the study involved having parents complete questionnaires about their children's education and care from birth to 5 years old.

The researchers found that the largest group of children -- 44% -- received care only in the home over the first five years of life.

About 10% spent their first two years at home and in the third year became increasingly likely to be in center-based care. Another 7% spent these early years mostly in center-based care.

Those were the three pathways that the researchers had hypothesized would occur before they conducted the study, said Kelly Purtell, co-author of the study and associate professor of human sciences at Ohio State and faculty associate at the Crane Center.

But they found four other pathways as well: The second-largest group, 21%, were at home most of the early years, but were enrolled in a preschool or pre-kindergarten program in the last year before kindergarten. Other groups included children mostly cared for in informal settings (5%); those who went between home and informal care (8%); and those had both home and center care through the whole 5 years (5%).

Why were there so many different pathways?

"It reflects the patchwork availability of child care in this country," Purtell said.

"Child care for infants and young kids is expensive, so there are not a lot of affordable options for parents. Parents have to find different ways to take care of their kids while they work."

Helsabeck said he was particularly struck by the children whose care shifted from year to year, often from home to informal care, as their parents' situations changed.

"There was more than I expected in this category," he said.

"We need to realize that some kids face a lot of instability and their child care situations may change a lot. That may affect how they do in school."

The study also looked at how children who took different pathways did in kindergarten.

Findings did not show differences in test scores between children from different pathways. That was surprising, because most studies show an advantage to kids who spent more time in center-based care, Helsabeck said.

But he cautioned against making too much of that finding. It could be that there were not enough children in each of the seven groups to reveal differences in this study.

Results confirmed other studies that found children who spent most of their time in center-based care during their first five years had more teacher-reported social and behavioral problems in kindergarten.

That may be because these kids are already comfortable in school-like settings and are not as shy about acting out, Purtell said. They may also be more easily bored because for them, the experience is not novel.

"This is a real challenge for kindergarten teachers to navigate children who are brand new to this setting with those kids who are already familiar with the classroom setting," she said.

The researchers said that the seven pathways to kindergarten found in this study may not be the same everywhere.

"We looked at only two school districts in one state. That's not going to represent the whole country," Helsabeck said.

"But what we can take away from this is the wide range of experiences kids bring to kindergarten. It is going to affect how they do in school."

https://www.sciencedaily.com/releases/2020/11/201109152239.htm

Conflicts in kindergarten can reduce children's interest in reading and math

November 6, 2020

Science Daily/University of Eastern Finland

Teacher-perceived conflict predicts lower interest and pre-academic skills in math and literacy among kindergarteners, a new study from Finland shows.

Kindergarten represents a crucial context in which children develop school-related skills and patterns of engagement that form the basis for the development of later competencies important for academic success. Kindergarten achievement has been found to be highly predictive of later academic skills.

Given the long-lasting effects that kindergarten experiences have on later schooling, it is important to understand the factors associated with children's learning and motivation during this time. The quality of teacher-student interaction has been found to be important in terms of many different academic and socio-emotional outcomes. However, much of the previous work in the field has focused on children in later grades in elementary school and has been conducted in the United States. Fewer studies have been conducted in other educational contexts and in kindergarten specifically.

Researchers from the University of Jyväskylä, the University of Eastern Finland and New York University of Abu Dhabi investigated bidirectional links between the quality of teacher-child relationships and children's interest and pre-academic skills in literacy and math in Finland. Participants were 461 Finnish kindergarteners (6-year-olds) and their teachers (48). The study is part of the Teacher Stress Study, led by Professor Marja-Kristiina Lerkkanen and Associate Professor Eija Pakarinen at the University of Jyväskylä.

The results indicated that teacher-perceived conflict predicted lower interest and pre-academic skills in both literacy and math. It is possible that when children experience conflict with teachers, the negative emotions attached to these conflicts are harmful for children's engagement in learning and diminish their interest in academic tasks. It is also possible that children experiencing conflicts are missing out on time on learning literacy and math, either because they are disengaged from instructional activities or because teachers have to spend more instructional time on behavioural management.

The findings highlight the importance of kindergarten teachers being aware of how their relationships with children can in?uence children's later schooling. It would be important to develop pre-service and in-service programmes and interventions to assist teachers in building supportive, low conflict relationships with children. Teacher education programmes may also benefit from educating teachers not only about academic content and pedagogical practices but also in strategies that build supportive relationships with children.

"Compared to daycare, kindergarten introduces children to a more structured learning environment. The experiences children gain in this environment may have long-term consequences on the development of their academic motivation and competencies. Therefore, it is essential that our teachers are aware of the power their interaction with children may have, and that they are supported in finding optimal ways to interact with each child, while taking individual strengths and needs into consideration," Professor Jaana Viljaranta from the University of Eastern Finland says.

https://www.sciencedaily.com/releases/2020/11/201106093037.htm

Teens who participate in extracurriculars, get less screen time, have better mental health

November 2, 2020

Science Daily/University of British Columbia

A new study from UBC researchers finds that teens, especially girls, have better mental health when they spend more time taking part in extracurricular activities, like sports and art, and less time in front of screens.

The study, published in the journal Preventive Medicine, found that spending less than two hours per day of recreational screen time (such as browsing the internet, playing video games, and using social media) was associated with higher levels of life satisfaction and optimism, and lower levels of anxiety and depressive symptoms, especially among girls, the researchers found. Similarly, extracurricular participation was associated with better mental health outcomes.

"Although we conducted this study before the COVID-19 pandemic, the findings are especially relevant now when teens may be spending more time in front of screens in their free time if access to extracurricular activities, like sports and arts programs is restricted due to COVID-19," says the study's lead author Eva Oberle, assistant professor with the Human Early Learning Partnership in the UBC school of population and public health. "Our findings highlight extracurricular activities as an asset for teens' mental wellbeing. Finding safe ways for children and teens to continue to participate in these activities during current times may be a way to reduce screen time and promote mental health and wellbeing."

Data for this study was drawn from a population-level survey involving 28,712 Grade 7 students from 365 schools in 27 school districts across B.C. The researchers examined recreational screen time such as playing video games, watching television, browsing the internet, as well as participating in outdoor extracurricular activities such as sport and art programs after school. They then compared its association with positive and negative mental health indicators.

Highlights of the study's findings include the following:

• Adolescents who participated in extracurricular activities were significantly less likely to engage in recreational screen-based activities for two or more hours after school

• Taking part in extracurricular activities was associated with higher levels of life satisfaction and optimism, and lower levels of anxiety and depressive symptoms

• Longer screen time (more than two hours a day) was associated with lower levels of life satisfaction and optimism, and higher levels of anxiety and depressive symptoms

• Differences among boys and girls, with longer screen time negatively affecting girls' mental health more significantly than boys

• Among both boys and girls, however, mental health was strongest when teens both participated in extracurricular activities and spent less than two hours on screen time

Oberle says further research is needed to examine why the negative effects of screen time were more detrimental for girls than for boys. She also hopes to focus future research on the effects of different types of screen time.

"We do know that some forms of screen time can be beneficial, like maintaining connections with friends and family members online if we cannot see them in person, but there are other types of screen time that can be quite harmful," she says. "There are many nuances that are not well understood yet and that are important to explore."

https://www.sciencedaily.com/releases/2020/11/201102124849.htm

Starting kindergarten on the right foot

November 2, 2020

Science Daily/University of Montreal

Everything you ever really needed to know you learned back in kindergarten -- that old saying gets some scientific support in a new study by researchers at Canada's Université de Montréal and Université Sainte-Anne.

"We've known for years that getting off to a good start in kindergarten leads to better achievement over the long-term," said lead author Caroline Fitzpatrick, an assistant professor of psychology at USA, in Nova Scotia.

"But now with our study we can really lock in the idea that early childhood skills help you achieve success and adopt a healthier lifestyle in emerging adulthood. And that's promising for society as a whole."

The study was published today in Pediatrics.

"Many children begin kindergarten inadequately prepared to benefit from classroom instruction," said senior author Linda Pagani, a professor at UdeM's School of Psycho-Education.

"Those who go in unprepared risk struggling throughout their academic journey. They arrive without the necessary tools in terms of cognitive skills, social skills and motor skills from physical activity," added Pagani, who is also Senior researcher at CHU Sainte-Justine pediatric hospital in Montreal.

Math skills important

Fitzpatrick and Pagani examined associations between kindergarten readiness and academic, psychological and health risks that mainfested themselves when a child reached the end of high school.

"Kindergarten math skills contributed to better end-of high-school achievement and a lower dropout risk, and that was supported by observations from teachers, who also noted a reduced risk of substance abuse later on, said Fitzpatrick.

"Kindergarten classroom engagement also predicted involvement in physical activity and a 65-per-cent drop in the risk of a child being overweight by age 17," added Pagani, who worked on the study with UdeM postdoctoral researcher Elroy Boers.

The authors came to their conclusions after examining Institut de la statistique du Québec data from a cohort of 2,000 children born in 1997 or 1998 who were part of the Quebec Longitudinal Study of Child Development .

At age 5, trained examiners assessed each child's knowledge of numbers and their receptive vocabulary. Each spring, teachers reported kindergarten classroom engagement, such as how a child did tasks, followed directions and worked with others. At age 17, participants reported on their academic grades, their feelings of connectedness, whether they abused drugs or alcohol, their involvement in physical activity, and their height and weight. The drop-out risk was also estimated for each participant based on their grades retention and engagement at school.

Confounding factors discarded

The researchers then analyzed the data to identify any significant link between kindergarten readiness and academic, psychological and health risks by the end of high school. They attempted to discard possible confounding factors by adjusting their analyses for key indicators in the children (their sex, weight per gestational age, non-verbal IQ and internalizing and externalizing behaviors) and in their families (parental involvement, maternal depression, immigration status, family configuration and socioeconomic status).

"Early childhood readiness forecasts a later protective edge in emerging adulthood and suggests that youngsters who begin school with the right preparedness gain a lifestyle advantage," said Fitzpatrick. "Our findings show a way to eliminate the established link between underachievement and disease by providing children with the conditions that will promote kindergarten readiness."

Added Pagani: "Promoting kindergarten readiness seems, over the long-term, to help reduce the lifestyle risks generated by dropping out of high school. Therefore, policies to promote and preserve children's early skills, such as providing stimulating childcare and diminishing family adversity, may thus represent a valuable policy strategy for governments to invest in."

https://www.sciencedaily.com/releases/2020/11/201102072909.htm

Positive student-teacher relationships benefit students' long-term health

Positive peer relationships don't show the same long-term health benefits, according to the research

October 29, 2020

Science Daily/American Psychological Association

Teens who have good, supportive relationships with their teachers enjoy better health as adults, according to research published by the American Psychological Association. Perhaps surprisingly, although friendships are important to adolescents, the study did not find the same link between good peer relationships and students' health in adulthood.

"This research suggests that improving students' relationships with teachers could have important, positive and long-lasting effects beyond just academic success," said Jinho Kim, PhD, an assistant professor in the Department of Health Policy and Management at Korea University and author of the study. It was published in the journal School Psychology. "It could also have important health implications in the long run."

Previous research has suggested that teens' social relationships might be linked to health outcomes in adulthood -- perhaps because poor relationships can lead to chronic stress, which can raise a person's risk of health problems over the lifespan, according to Kim. However, it is not clear whether the link between teen relationships and lifetime health is causal -- it could be that other factors, such as different family backgrounds, might contribute to both relationship problems in adolescence and to poor health in adulthood. Also, most research has focused on teens' relationships with their peers, rather than on their relationships with teachers.

To explore those questions further, Kim analyzed data on nearly 20,000 participants from the Add Health study, a nationally representative longitudinal study in the United States that followed participants for 13 years, from seventh grade into early adulthood. The participant pool included more than 3,400 pairs of siblings. As teens, participants answered questions such as, "How often have you had trouble getting along with other students?" "How much do you agree that friends care about you?" "How often have you had trouble getting along with your teachers?" and "How much do you agree that teachers care about you?" As adults, participants were asked about their physical and mental health. Researchers also took measures of physical health, such as blood pressure and body mass index.

Kim found that, as expected, participants who had reported better relationships with both their peers and teachers in middle school and high school also reported better physical and mental health in their mid-20s. However, when he controlled for family background by looking at pairs of siblings together, only the link between good teacher relationships and adult health remained significant.

This could be because previously reported links between peer relationships and physical health could actually reflect other, underlying factors about students' family background.

The results suggest that teacher relationships are even more important than previously realized and that schools should invest in training teachers on how to build warm and supportive relationships with their students, according to Kim.

"This is not something that most teachers receive much training in," he said, "but it should be."

https://www.sciencedaily.com/releases/2020/10/201029105030.htm

Sleep loss hijacks brain's activity during learning

Disruption could increase risks for sleepless workers

November 11, 2020

Science Daily/Elsevier

Sleep is crucial for consolidating our memories, and sleep deprivation has long been known to interfere with learning and memory. Now a new study shows that getting only half a night's sleep -- as many medical workers and military personnel often do -- hijacks the brain's ability to unlearn fear-related memories. That might put people at greater risk of conditions such as anxiety or posttraumatic stress disorder.

The study appears in Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, published by Elsevier.

"This study provides us with new insights into how sleep deprivation affects brain function to disrupt fear extinction," said Cameron Carter, MD, Editor of Biological Psychiatry: Cognitive Neuroscience and Neuroimaging.

The researchers, led by Anne Germain, PhD, at the University of Pittsburgh and Edward Pace-Schott, PhD, at Harvard Medical School and Massachusetts General Hospital, studied 150 healthy adults in the sleep laboratory. One third of subjects got normal sleep, one third were sleep restricted, so they slept only the first half the night, and one third were sleep deprived, so they got no sleep at all. In the morning, all the subjects underwent fear conditioning.

"Our team used a three-phase experimental model for the acquisition and overcoming of fearful memories while their brains were scanned using functional magnetic resonance imaging," said Dr. Pace-Schott. In the conditioning paradigm, subjects were presented with three colors, two of which were paired with a mild electric shock. Following this fear conditioning, the subjects underwent fear extinction, in which one of the colors was presented without any shocks to learn that it was now "safe." That evening, subjects were tested for their reactivity to the three colors, a measure of their fear extinction recall, or how well they had "unlearned" the threat.

Brain imaging recorded during the tasks showed activation in brain areas associated with emotional regulation, such as the prefrontal cortex, in people who got normal sleep. But the brain activity looked very different in people with restricted sleep, said Dr. Pace-Schott. "We found that among the three groups, those who had only gotten half a night's sleep showed the most activity in brain regions associated with fear and the least activity in areas associated with control of emotion."

Surprisingly, people who got no sleep lacked the brain activation in fear-related areas during fear conditioning and extinction. During the extinction recall 12 hours later, their brain activity looked more similar to those with normal sleep, suggesting that a limited night of sleep may be worse than none at all.

The researchers hypothesize that sleeping only half the night results in a loss of rapid eye movement (REM) sleep, which has been shown to be important for memory consolidation and usually happens toward the end of a normal sleep period.

Dr. Carter said the study used "noninvasive brain imaging to give us a novel window into how sleep deprivation disrupts the normal fear extinction mechanisms and potentially increases vulnerability to posttraumatic stress symptoms."

"Medical workers and soldiers often have curtailed or interrupted sleep rather than missing an entire night's sleep," Dr. Pace-Schott said. "Our findings suggest that such partially sleep-deprived individuals might be especially vulnerable to fear-related conditions such as posttraumatic stress disorder."

https://www.sciencedaily.com/releases/2020/11/201111092924.htm