Mind over matter: Helping amputees regain their independence
September 15, 2022
Science Daily University of Nevada, Las Vegas
New research says adopting a new, attentional mindset in the field of physical therapy can help amputees live with prosthesis more naturally.
There are more than two million people living with an amputation in the United States, with about 400 being added daily. For many of them, prostheses or artificial limbs are a part of their lives, and they need to relearn how their bodies move with their new limbs all over again.
The trick to learning how to use a new limb -- and regaining confidence in movement -- has less to do with the prosthesis itself and more to do with the mind, according to newly published research by UNLV physical therapy researcher Szu-Ping Lee. By adopting the right attentional focus during rehab, patients can learn new skills better and faster.
"Vascular diseases and diabetes are becoming more common and one of the long-term consequences is amputation," said Lee. "It is important that clinicians like prosthetists and physical therapists apply the newest science so that their patients can learn faster and retain the skills that they learned better."
The current standard of practice in rehabilitating the millions of amputees in the country prioritizes internally focused instructions where the patients are told to move their joints or contract their muscles in certain ways, which is a suboptimal mindset that Lee says we should think about changing. And the science is grounded in sports kinesiology research built by fellow UNLV professor Gabriele Wulf.
Let's go golfing for a better understanding:
After approaching the ball and reading the green, you square your shoulders -- lining up the putt. At this point, most of us are concentrating on our form and measuring every muscle movement like a pseudo-pro. This is the standard process for rehab, internal focus.
But there's another path forward. Instead of prioritizing our body movement, focusing on the path of the ball or simply the hole is more intuitive and works better. This is what Wulf and Lee are talking about -- the focus is on the outcome, not the movement itself.
Professor Wulf's research over the last 20 years has shown that external-focus for motor tasks leads to faster learning and improved movement effectiveness and neuromuscular efficiency. Lee is hoping that this technique can help amputees more quickly master the use of artificial limbs.
"With the wrong kind of focus or instruction being used during physical therapy, the consequences can be catastrophic-the artificial leg becomes a paperweight in a closet," said Lee. "We want to advance clinical practice and that's the ultimate goal. We want physical therapy to get better and better for the patients."
The lower-limb prosthesis rehabilitation of 21 adults was monitored for this research, along with the verbal instructions provided. Results showed that most of the verbal interactions were internally-focused (standard) on patients' body movements and not externally on the movement effects. More research is being done to evaluate how motor learning outcomes such as balance and fall prevention may be improved with better instructions.
https://www.sciencedaily.com/releases/2022/09/220915123621.htm
Mild traumatic brain injury increases risk of behavioral and emotional problems in kids
September 13, 2022
Science Daily University of Rochester Medical Center
University of Rochester researchers have been at the forefront of efforts to understand how blows to the head impact the brain, including how concussions change brain structure . Now researchers at the Del Monte Institute for Neuroscience have found that kids who experience a traumatic brain injury (TBI), even a mild one, have more emotional and behavioral problems than kids who do not.
"These hits to the head are hard to study because much of it depends on recall of an injury since the impacts do not all require a visit to a doctor," said Daniel Lopez, a Ph.D. candidate in the Epidemiology program and first author of the study out today in NeuroImage. "But being able to analyze longitudinal data from a large cohort and ask important questions like this gives us valuable information into how a TBI, even a mild one, impacts a developing brain."
Researchers used MRI and behavioral data collected from thousands of children who participated in the Adolescence Brain Cognitive Development (ABCD) Study. They revealed children with a mild TBI experienced a 15-percent increased risk of an emotional or behavioral problem. The risk was the highest in children around ten years old. Researchers found that children who had a significant hit to the head but did not meet diagnostic criteria for a mild TBI also had an increased risk of these behavioral and emotional problems.
The University of Rochester Medical Center is one of 21 research sites collecting data for the National Institutes of Health ABCD Study. Since 2017, 340 children from the greater Rochester area have been part of the 10-year study that is following 11,750 children through early adulthood. It looks at how biological development, behaviors, and experiences impact brain maturation and other aspects of their lives, including academic achievement, social development, and overall health.
Researchers hope future ABCD Study data will better reveal the impact these head hits have on mental health and psychiatric problems. "We know some of the brain regions associated with increased risk of mental health problems are impacted during a TBI," said Ed Freedman, Ph.D., associate professor of Neuroscience and co-principal investigator of the ABCD Study at the University of Rochester. Freedman also led this study. "With more time and data, we hope to gain a better understanding of the long-term impact of even a mild TBI."
https://www.sciencedaily.com/releases/2022/09/220913183124.htm
Daytime eating may benefit mental health
A study on meal timing found that eating at night increased depression and anxiety-related mood levels among participants
September 12, 2022
Science Daily/Brigham and Women's Hospital
Investigators have designed a study that simulated night work and then tested the effects of daytime and nighttime eating versus daytime eating only. The team found that, among participants in the daytime and nighttime eating group, depression-like mood levels increased by 26 percent and anxiety-like mood levels by 16 percent. Participants in the daytime-only eating group did not experience this increase, suggesting that meal timing may influence mood vulnerability.
Beating the blues with food? A new study adds evidence that meal timing may affect mental health, including levels of depression- and anxiety-related mood. Investigators from Brigham and Women's Hospital, a founding member of the Mass General Brigham healthcare system, designed a study that simulated night work and then tested the effects of daytime and nighttime eating versus daytime eating only. The team found that, among participants in the daytime and nighttime eating group, depression-like mood levels increased by 26 percent and anxiety-like mood levels by 16 percent. Participants in the daytime-only eating group did not experience this increase, suggesting that meal timing may influence mood vulnerability. Results are published in the Proceedings of the National Academy of Sciences.
"Our findings provide evidence for the timing of food intake as a novel strategy to potentially minimize mood vulnerability in individuals experiencing circadian misalignment, such as people engaged in shift work, experiencing jet lag, or suffering from circadian rhythm disorders," said co-corresponding author Frank A. J. L. Scheer, PhD, Director of the Medical Chronobiology Program in the Brigham's Division of Sleep and Circadian Disorders. "Future studies in shift workers and clinical populations are required to firmly establish if changes in meal timing can prevent their increased mood vulnerability. Until then, our study brings a new 'player' to the table: the timing of food intake matters for our mood."
Shift workers account for up to 20 percent of the workforce in industrial societies and are directly responsible for many hospital services, factory work, and other essential services. Shift workers often experience a misalignment between their central circadian clock in the brain and daily behaviors, such as sleep/wake and fasting/eating cycles. Importantly, they also have a 25 to 40 percent higher risk of depression and anxiety.
"Shift workers -- as well as individuals experiencing circadian disruption, including jet lag -- may benefit from our meal timing intervention," said co-corresponding author Sarah L. Chellappa, MD, PhD, who completed work on this project while at the Brigham. Chellappa is now in the Department of Nuclear Medicine, University of Cologne, Germany. "Our findings open the door for a novel sleep/circadian behavioral strategy that might also benefit individuals experiencing mental health disorders. Our study adds to a growing body of evidence finding that strategies that optimize sleep and circadian rhythms may help promote mental health."
To conduct the study, Scheer, Chellappa, and colleagues enrolled 19 participants (12 men and 7 women) for a randomized controlled study. Participants underwent a Forced Desynchrony protocol in dim light for four 28-hour "days," such that by the fourth "day" their behavioral cycles were inverted by 12 hours, simulating night work and causing circadian misalignment. Participants were randomly assigned to one of two meal timing groups: the Daytime and Nighttime Meal Control Group, which had meals according to a 28-hour cycle (resulting in eating both during the night and day, which is typical among night workers), and the Daytime-Only Meal Intervention Group, which had meals on a 24-hour cycle (resulting in eating only during the day). The team assessed depression- and anxiety-like mood levels every hour.
The team found that meal timing significantly affected the participants' mood levels. During the simulated night shift (day 4), those in the Daytime and Nighttime Meal Control Group had increased depression-like mood levels and anxiety-like mood levels, compared to baseline (day 1). In contrast, there were no changes in mood in the Daytime Meal Intervention Group during the simulated night shift. Participants with a greater degree of circadian misalignment experienced more depression- and anxiety-like mood.
"Meal timing is emerging as an important aspect of nutrition that may influence physical health," said Chellappa. "But the causal role of the timing of food intake on mental health remains to be tested. Future studies are required to establish if changes in meal timing can help individuals experiencing depressive and anxiety/anxiety-related disorders."
https://www.sciencedaily.com/releases/2022/09/220912152846.htm
Cravings for fatty foods traced to gut-brain connection
Mouse research reveals fat sensors in the intestines that stimulate the brain and drive food desires
September 7, 2022
Science Daily/Columbia University
A dieter wrestling with cravings for fatty foods might be tempted to blame their tongue: the delicious taste of butter or ice cream is hard to resist. But new research investigating the source of our appetites has uncovered an entirely new connection between the gut and the brain that drives our desire for fat.
At Columbia's Zuckerman Institute, scientists studying mice found that fat entering the intestines triggers a signal. Conducted along nerves to the brain, this signal drives a desire for fatty foods. Published September 7, 2022, in Nature, the new study raises the possibility of interfering with this gut-brain connection to help prevent unhealthy choices and address the growing global health crisis caused by overeating.
"We live in unprecedented times, in which the overconsumption of fats and sugars is causing an epidemic of obesity and metabolic disorders," said first author Mengtong Li, PhD, a postdoctoral researcher in the lab of the Zuckerman Institute's Charles Zuker, PhD, supported by the Howard Hughes Medical Institute. "If we want to control our insatiable desire for fat, science is showing us that the key conduit driving these cravings is a connection between the gut and the brain."
This new view of dietary choices and health started with previous work from the Zuker lab on sugar. Researchers found that glucose activates a specific gut-brain circuit that communicates to the brain in the presence of intestinal sugar. Calorie-free artificial sweeteners, in contrast, do not have this effect, likely explaining why diet sodas can leave us feeling unsatisfied.
"Our research is showing that the tongue tells our brain what we like, such as things that taste sweet, salty or fatty," said Dr. Zuker, who is also a professor of biochemistry and molecular biophysics and of neuroscience at Columbia's Vagelos College of Physicians and Surgeons. "The gut, however, tells our brain what we want, what we need."
Dr. Li wanted to explore how mice respond to dietary fats: the lipids and fatty acids that every animal must consume to provide the building blocks of life. She offered mice bottles of water with dissolved fats, including a component of soybean oil, and bottles of water containing sweet substances known to not affect the gut but that are initially attractive. The rodents developed a strong preference, over a couple of days, for the fatty water. They formed this preference even when the scientists genetically modified the mice to remove the animals' ability to taste fat using their tongues.
"Even though the animals could not taste fat, they were nevertheless driven to consume it," said Dr. Zuker.
The researchers reasoned that fat must be activating specific brain circuits driving the animals' behavioral response to fat. To search for that circuit, Dr. Li measured brain activity in mice while giving the animals fat. Neurons in one particular region of the brainstem, the caudal nucleus of the solitary tract (cNST), perked up. This was intriguing because the cNST was also implicated in the lab's previous discovery of the neural basis of sugar preference.
Dr. Li then found the communications lines that carried the message to the cNST. Neurons in the vagus nerve, which links the gut to the brain, also twittered with activity when mice had fat in their intestines.
Having identified the biological machinery underlying a mouse's preference for fat, Dr. Li next took a close look at the gut itself: specifically the endothelial cells lining the intestines. She found two groups of cells that sent signals to the vagal neurons in response to fat.
"One group of cells functions as a general sensor of essential nutrients, responding not only to fat, but also to sugars and amino acids," said Dr. Li. "The other group responds to only fat, potentially helping the brain distinguish fats from other substances in the gut."
Dr. Li then went one important step further by blocking the activity of these cells using a drug. Shutting down signaling from either cell group prevented vagal neurons from responding to fat in the intestines. She then used genetic techniques to deactivate either the vagal neurons themselves or the neurons in the cNST. In both cases, a mouse lost its appetite for fat.
"These interventions verified that each of these biological steps from the gut to the brain is critical for an animal's response to fat," said Dr. Li. "These experiments also provide novel strategies for changing the brain's response to fat and possibly behavior toward food."
The stakes are high. Obesity rates have nearly doubled worldwide since 1980. Today, nearly half a billion people suffer from diabetes.
"The overconsumption of cheap, highly processed foods rich in sugar and fat is having a devastating impact on human health, especially among people of low income and in communities of color," said Dr. Zuker. "The better we understand how these foods hijack the biological machinery underlying taste and the gut-brain axis, the more opportunity we will have to intervene."
Scott Sternson, PhD, a professor of neuroscience at University of California, San Diego, who was not involved in the new research highlighted its potential for improving human health.
"This exciting study offers insight about the molecules and cells that compel animals to desire fat," said Dr. Sternson, whose work focuses on how the brain controls appetite. "The capability of researchers to control this desire may eventually lead to treatments that may help combat obesity by reducing consumption of high-calorie fatty foods."
https://www.sciencedaily.com/releases/2022/09/220907133226.htm
Stress in the kids room
The birth of a younger sibling activates long-lasting stress reactions in young bonobos
September 7, 2022
Science Daily/Deutsches Primatenzentrum (DPZ)/German Primate Center
Researchers examined various markers in the urine of wild bonobos (Pan paniscus). The researchers found that the birth of a second young animal resulted in the older sibling in a five-fold increase in the stress hormone cortisol and a reduced immune response. The physiological changes were detectable up to seven months after birth and were independent of the usual weaning processes the young animals experience with age.
The birth of a second child is a remarkable experience not only for the parents, but also for the older sibling. From human behavioral studies it is known that the change in the family constellation is a confusing and stressful time for the older child, frequently accompanied by clinginess, depressive conditions, and temper tantrums. So far, it was unknown to which extent this stress is also physiologically detectable.
Verena Behringer, a scientist at the German Primate Center (DPZ) -- Leibniz Institute for Primate Research in Göttingen, has investigated this question in one of our closest living relatives. In a study she conducted with Andreas Berghänel, Konrad Lorenz Institute for Comparative Behavioral Research, University of Veterinary Medicine, Vienna, and an international research team, she examined various markers in the urine of wild bonobos (Pan paniscus). The researchers found that the birth of a second young animal resulted in the older sibling in a five-fold increase in the stress hormone cortisol and a reduced immune response. The physiological changes were detectable up to seven months after birth and were independent of the usual weaning processes the young animals experience with age (eLife).
The study was conducted at the LuiKotale research station in the Congolese rainforest. Two habituated bonobo groups live close to the field station. For more than 650 hours, the researchers observed the behavior of 17 young animals that had become a sibling for the first time and were between two and eight years old at sibling birth. At the same time, they collected 319 urine samples from the bonobos before and after the birth of the sibling.
"As the young animals grow up, there are various processes of social weaning or food change that can also stimulate stress reactions," says Verena Behringer, a scientist in the Endocrinology Laboratory at the German Primate Center and lead author of the study. "These include, for example, that the young do no longer suckle or is carried less after a certain moment. To disentangle the weaning process with age from sibling birth, we analyzed urine samples and behavioral observations before and after the birth of the sibling in the older bonobo and put them into perspective."
Verena Behringer analyzed the urine samples in the laboratory for the concentrations of three different substances: cortisol, neopterin and triiodothyronine (T3). Cortisol is a hormone secreted in response to a stressor, neopterin is produced by the activated defense cells of the immune system, and T3 is a thyroid hormone that regulates metabolic activity in the body. The concentration of these markers in urine provides insides into the physiological state of young bonobos. The research showed that urinary cortisol levels in the older siblings increased fivefold when their younger sibling was born and remained at that level for up to seven months. At the same time, neopterin concentrations decreased, suggesting a reduced immune response. The thyroid hormone T3, on the other hand, showed no significant change.
"The young bonobos suddenly experience an extreme state of stress with the birth of their sibling," Verena Behringer explains these results. "The cortisol levels were unusually high for a long period, regardless of whether the youngster was two or already eight years old at sibling birth. This persistent stress reaction has a negative effect on the immune defense. Since the concentration of thyroid hormone showed no change, we can assume that the stress response is not stimulated by energetic stressors, such as sudden end of suckling."
This assumption was also confirmed by the recorded behavioral data. For example, the researchers observed the extent to which the older sibling were suckling, how much body contact they still had with their mother, and how often they were carried. All weaning processes, which can appear as additional stressors, were either completed before sibling birth, showed no sudden change with birth, or were only significant in young individuals and disappeared as the young bonobos grew older.
"For the first time, our study shows that sibling birth is a really stressful event for the older sibling," Verena Behringer summarizes. "However, there is no need to worry. It is very likely that this stress is tolerable, and maybe leads to a higher stress resistance of the older siblings later in life. After all, younger siblings are not only competitors, but they are also important social partners who have a positive influence on our development."
https://www.sciencedaily.com/releases/2022/09/220907105437.htm
Eating behaviors of parents play a role in teens' emotional eating
September 7, 2022
Science Daily/Elsevier
Emotional eating, or eating as a coping mechanism for negative, positive, or stress-driven emotions, is associated with unhealthy dietary patterns and weight gain. A research article featured in the Journal of Nutrition Education and Behavior, published by Elsevier, discusses adolescent vulnerability to emotional eating and how various feeding practices used by parents, such as restriction, food as reward, and child involvement, influence eating behavior.
"Emotional eating was previously found to be more learned than inherited. This study examined not only the interaction between parents when feeding their children, but also what children learned from watching their parents eat," said lead author Joanna Klosowska, MSc, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
The initial study was conducted in 2017 with 218 families. Additionally, longitudinal data collected in 2013 were also available. One parent from each family completed the Child Feeding Questionnaire, as well as the Child Feeding Practices Questionnaire, and both adolescent and parent completed the Dutch Eating Behavior Questionnaire. Emotion regulation was assessed with the Dutch version of the child-reported FEEL-KJ questionnaire. The adolescent's body weight and height were measured by researchers.
Over the four years between 2013 and 2017, covering the time from late childhood to middle adolescence, changes occurred in some parental practices. Parents reported higher monitoring and healthy modeling feeding practices, while the reported levels of food restriction and the healthy environment remained unchanged. During the same time period, adolescents reported a considerable increase in emotional eating from below the average in 2013 to above the average in 2017, according to the norms for the Dutch population. Additionally, the maladaptive way in which they regulated their emotions was also associated with emotional eating.
Food as a reward and monitoring food increased emotional eating especially in instances where the adolescent employed maladaptive strategies in regulating their emotions. Child involvement in meals had an opposite effect since it was associated with higher levels of emotion regulation and lower levels of emotional eating. Interestingly, a parent's restrained eating behavior was linked to less emotional eating in adolescents.
"This study suggests that parents continue to play an important role in their child's eating behavior into their teen years," said Klosowska. "Additional research is needed to understand the impact restrained eating demonstrated by a parent impacts the emotional eating of a child."
https://www.sciencedaily.com/releases/2022/09/220907093354.htm
A consistent lack of sleep negatively impacts immune stem cells, increasing risk of inflammatory disorders and heart disease
September 21, 2022
Science Daily/The Mount Sinai Hospital / Mount Sinai School of Medicine
Chronic, insufficient sleep can negatively affect immune cells, which may lead to inflammatory disorders and cardiovascular disease, according to a new study from the Icahn School of Medicine at Mount Sinai. More specifically, consistently losing an hour and a half of sleep a night potentially increases the risk.
The research, published September 21 in the Journal of Experimental Medicine,is the first to show that sleep alters the structure of DNA inside the immune stem cells that produce white blood cells -- also known as immune cells -- and this can have a long-lasting impact on inflammation and contribute to inflammatory diseases. Immune cells fight infection, but if the number of these cells gets too high, they overreact and cause inflammation. The study is also the first to show that catching up on sleep doesn't reverse the effects of sleep disruption.
"This study begins to identify the biological mechanisms that link sleep and immunological health over the long-term. It shows that in humans and mice, disrupted sleep has a profound influence on the programming of immune cells and rate of their production, causing them to lose their protective effects and actually make infections worse -- and these changes are long-lasting. This is important because it is yet another key observation that sleep reduces inflammation and, conversely, that sleep interruption increases inflammation," says lead author Filip Swirski, PhD, Director of the Cardiovascular Research Institute at Icahn Mount Sinai. "This work emphasizes the importance of adults consistently sleeping seven to eight hours a day to help prevent inflammation and disease, especially for those with underlying medical conditions."
A team of investigators analyzed 14 healthy adults who regularly sleep eight hours a night. First, researchers monitored them sleeping at least eight hours a night for six weeks. They drew their blood and analyzed their immune cells. Then, the same group of adults reduced their sleep time by 90 minutes every night for six weeks, and had their blood and immune cells reanalyzed. At the end of the study researchers compared the blood and cell samples from the full night's sleep and restricted sleep periods. All participants had significant changes in their immune cells (also known as hematopoietic cells) due to a lack of sleep -- there were more of them, and the DNA structure was altered. After six weeks of sleep restriction, they had an increased number of immune cells.
Researchers also analyzed sleep in mouse models. Groups of mice were either allowed to sleep undisturbed, or had sleep fragmentation, where they were awakened throughout the night for 16 weeks. Then, mice with sleep fragmentation went through uninterrupted sleep recovery for ten weeks. Investigators took immune stem cells and immune cells from mice during these undisturbed, fragmented, and sleep recovery phases, analyzed them and compared them at the end of the experiment. Results in mice were consistent with results in humans. They showed that all mice with fragmented sleep had significant changes to their immune stem cells, producing an increased number of immune cells, and also showed evidence of rewiring and reprogramming. A notable finding from the mouse group was that even after sleep recovery, the immune stem cells retained this rewiring structure, and they continued to produce additional white blood cells, making the mice susceptible to inflammation and disease.
"Our findings suggest that sleep recovery is not able to fully reverse the effects of poor-quality sleep. We can detect a molecular imprint of insufficient sleep in immune stem cells, even after weeks of recovery sleep. This molecular imprint can cause the cells to respond in inappropriate ways leading to inflammation and disease," says co-lead investigator Cameron McAlpine, PhD, Assistant Professor of Medicine (Cardiology) at Icahn Mount Sinai. "It was surprising to find that not all clusters of stem cells responded to insufficient sleep in the same way. There were some stem cell clusters that proliferated and grew in number, while other clusters became smaller. This reduction in overall diversity and aging of the immune stem cell population is an important contributor to inflammatory diseases and cardiovascular disease."
https://www.sciencedaily.com/releases/2022/09/220921104752.htm
People who are 'night owls' could have greater risk of type 2 diabetes and heart disease than those who are 'early birds'
September 20, 2022
Science Daily/The Physiological Society
Are you an early bird or a night owl? Our activity patterns and sleep cycles could influence our risk of diseases, such as type 2 diabetes and heart disease. New research published in Experimental Physiology found wake/sleep cycles cause metabolic differences and alter our body's preference for energy sources. The researchers found that those who stay up later have a reduced ability to use fat for energy, meaning fats may build-up in the body and increase risk for type 2 diabetes and cardiovascular disease.
The metabolic differences relate to how well each group can use insulin to promote glucose uptake by the cells for storage and energy use. People who are 'early birds' (individuals who prefer to be active in the morning) rely more on fat as an energy source and are more active during the day with higher levels of aerobic fitness than 'night owls'. On the other hand, 'night owls' (people who prefer to be active later in the day and night) use less fat for energy at rest and during exercise.
Researchers from Rutgers University, New Jersey, USA classified participants (n=51) into two groups (early and late) based on their 'chronotype' -- our natural propensity to seek activity and sleep at different times. They used advanced imaging to assess body mass and body composition, as well as insulin sensitivity and breath samples to measure fat and carbohydrate metabolism.
Participants were monitored for a week to assess their activity patterns across the day. They ate a calorie and nutrition-controlled diet and had to fast overnight to minimise dietary impact on the results. To study fuel preference, they were tested while at rest before completing two 15-minute bouts of exercise: one moderate and one high intensity session on a treadmill. Aerobic fitness levels were tested through an incline challenge where the incline was raised 2.5% every two minutes until the participant reached a point of exhaustion.
Researchers found that early birds use more fat for energy at both rest and during exercise than night owls. Early birds were also more insulin sensitive. Night owls, on the other hand, are insulin resistant, meaning their bodies require more insulin to lower blood glucose levels, and their bodies favoured carbohydrates as an energy source over fats. This group's impaired ability to respond to insulin to promote fuel use can be harmful as it indicates a greater risk of type 2 diabetes and/or heart disease. The cause for this shift in metabolic preference between early birds and night owls is yet unknown and needs further investigation.
Senior author Professor Steven Malin, Rutgers University, New Jersey, USA said:
"The differences in fat metabolism between 'early birds' and 'night owls' shows that our body's circadian rhythm (wake/sleep cycle) could affect how our bodies use insulin. A sensitive or impaired ability to respond to the insulin hormone has major implications for our health. This observation advances our understanding of how our body's circadian rhythms impact our health. Because chronotype appears to impact our metabolism and hormone action, we suggest that chronotype could be used as a factor to predict an individual's disease risk."
"We also found that early birds are more physically active and have higher fitness levels than night owls who are more sedentary throughout the day. Further research is needed to examine the link between chronotype, exercise and metabolic adaptation to identify whether exercising earlier in the day has greater health benefits."
https://www.sciencedaily.com/releases/2022/09/220920100754.htm
Survey finds stress and worry over the state of the world keeps some Americans up at night
Many partake in certain habits like looking at screens before bed, which can be detrimental to healthy sleep
September 14, 2022
Science Daily/Ohio State University Wexner Medical Center
A new national survey by The Ohio State University Wexner Medical Center finds many Americans are losing sleep over stress and worry about the current state of the world. After a global pandemic, polarizing political division and more than two years of turbulent events, nearly one in five survey respondents report struggling to fall asleep at night.
"Here at Ohio State Wexner Medical Center, there was a 29% increase in referrals for insomnia from 2018 to 2021," said Dr. Aneesa Das, professor of internal medicine. "Stress can increase your heart rate, increase your blood pressure, make you have an upset stomach and cause muscle tension. All of those things increase our alertness, making it harder to fall asleep."
The survey also found many Americans try to mitigate sleep issues by using habits that may be detrimental to a good night's sleep. Nearly half of Americans say they scroll their phones right before bed and 37% fall asleep with the TV on.
"Our circadian drive is that central clock telling us when we're supposed to be awake and asleep, and that is driven by light more than anything," said Das. "When we use our smartphones and our TVs right before bed, we increase that bright light exposure at the wrong time."
Instead, Das suggests increasing natural light exposure by getting outside during the day as much as possible. Once the sun sets, limiting light exposure is essential to obtaining better sleep. Also, consistent exercise during the week is key to helping your body get on an optimal sleep routine.
Other simple behavioral adjustments that can help improve sleep patterns include:
Keeping your bedroom cool, dark and quiet
Spending time in bed only when it is time to sleep
Using cognitive behavioral therapies like meditation and muscle relaxation
Keeping bedtimes and wake times consistent, even on the weekends
If you're unable to improve your sleep, experts recommend speaking with your primary care physician as a first step. They can help determine if additional methods, like sleep restriction, may be beneficial or if the insomnia could be a symptom of an underlying health condition.
https://www.sciencedaily.com/releases/2022/09/220914102252.htm
Can the flu shot reduce your risk of stroke?
September 7, 2022
Science Daily/American Academy of Neurology
Getting an annual flu shot may be associated with a lower risk of stroke, according to a study published in the September 7, 2022, online issue of Neurology®, the medical journal of the American Academy of Neurology.
"Studies have shown that getting the flu increases your risk of having a stroke, but research is still being collected on whether getting the flu vaccine can help protect against a stroke," said study author Francisco J. de Abajo, MD, MPH, PhD, of the University of Alcalá in Madrid, Spain. "This observational study suggests that those who have a flu shot have a lower risk of stroke. To determine whether this is due to a protective effect of the vaccine itself or to other factors, more research is needed."
The study looked at ischemic stroke, which is caused by a blockage of blood flow to the brain and is the most common type of stroke.
For the study, researchers looked at a health care database in Spain and identified people who were at least 40 years old and had a first stroke over a 14-year period. Each person who had a stroke was compared to five people of the same age and sex. There were 14,322 people who had a stroke and 71,610 people who did not have a stroke.
Then the researchers looked at whether people had received the influenza vaccine at least 14 days before the stroke or before that same date for those who did not have a stroke.
A total of 41.4% of those who had a stroke had received the flu shot, compared to 40.5% of those who did not have a stroke. But the people who got the shot were more likely to be older and to have other conditions such as high blood pressure and high cholesterol that would make them more likely to have a stroke. Once researchers adjusted for those factors, they found that those who received a flu shot were 12% less likely to have a stroke than those who did not.
The researchers also looked at whether the pneumonia vaccine had any effect on the risk of stroke and found no protective effect.
"These results are yet another reason for people to get their yearly flu shot, especially if they are at an increased risk of stroke," de Abajo said. "To be able to reduce your risk of stroke by taking such a simple action is very compelling."
Since the study was observational, it does not prove that getting the flu shot reduces the risk of stroke. It only shows an association. There could be other factors that were not measured that could affect the risk of stroke.
https://www.sciencedaily.com/releases/2022/09/220907192600.htm
How changes in length of day change the brain and subsequent behavior
Role of key neurons, which alter function in response to seasonal changes in light exposure
September 7, 2022
Science Daily/University of California - San Diego
Seasonal changes in light -- longer days in summer, shorter in winter -- have long been associated with human behaviors, affecting everything from sleep and eating patterns to brain and hormonal activity. Seasonal affective disorder (SAD) is a prime example: A type of depression related to diminished exposure to natural sunlight, typically occurring during winter months and more often at higher latitudes when daylight hours are shortest.
Bright light therapy has proven an effective remedy for treating SAD, plus maladies such as non-seasonal major depression, postpartum depression and bipolar disorder, but how seasonal changes in day length and light exposure affect and alter the brain at the cellular and circuit levels has kept scientists largely in the dark.
In a new study, publishing September 2, 2022 in Science Advances, researchers at University of California San Diego School of Medicine used a mouse model to illuminate a process in which affected neurons switch expression of neurotransmitters in response to day length stimuli, triggering related behavioral changes.
The work was led by senior study author Davide Dulcis, PhD, associate professor in the Department of Psychiatry at UC San Diego School of Medicine and a member of the Center for Circadian Biology at UC San Diego.
Tucked within the hypothalamus of the human brain is a small structure called the suprachiasmatic nucleus (SCN), each consisting of approximately 20,000 neurons. (The average human brain contains roughly 86 billion neurons and another 85 billion non-neuronal cells.)
The SCN is the body's timekeeper, regulating most circadian rhythms -- physical, mental and behavioral changes that follow a 24-hour cycle and affect everything from metabolism and body temperature to when hormones are released. The SCN operates based on input from specialized photosensitive cells in retina, which communicate changes in light and day length to our body.
In the new study, Dulcis and colleagues describe how SCN neurons coordinate with each other to adapt to different lengths of daylight, changing at cellular and network levels. Specifically, they found that in mice, whose brains function similarly to humans, the neurons changed in mix and in expression of key neurotransmitters that, in turn, altered brain activity and subsequent daily behaviors.
Seasonal changes in light exposure have also been shown to alter the number of neurotransmitter-expressing neurons in the paraventricular nucleus (PVN), a region of the brain that plays essential roles in controlling stress, metabolism, growth, reproduction, immune and other autonomic functions.
"The most impressive new finding in this study is that we discovered how to artificially manipulate the activity of specific SCN neurons and successfully induce dopamine expression within the hypothalamic PVN network," said Dulcis.
"We revealed novel molecular adaptations of the SCN-PVN network in response to day length in adjusting hypothalamic function and daily behavior," added first author Alexandra Porcu, PhD, a member of Dulcis' lab. "The multi-synaptic neurotransmitter switching we showed in this study might provide the anatomical/functional link mediating the seasonal changes in mood and the effects of light therapy."
The authors suggest their findings provide a novel mechanism explaining how the brain adapts to seasonal changes in light exposure. And because the adaptation occurs within neurons exclusively located in the SCN, the latter represents a promising target for new treatments for disorders associated with seasonal changes in light exposure.
https://www.sciencedaily.com/releases/2022/09/220907093419.htm
Replacing social media use with physical activity
September 7, 2022
Science Daily/Ruhr-University Bochum
If you spend 30 minutes less on social media every day and engage in physical activity instead, you do a lot to improve your mental health. This is shown in a study conducted by a team from the Mental Health Research and Treatment Center at Ruhr-Universität Bochum headed by assistant professor Dr. Julia Brailovskaia. Participants who followed this advice for two weeks felt happier, more satisfied, less stressed by the Covid-19 pandemic and less depressed than a control group. These effects lasted even six months after the study had ended. The researchers published their findings in the Journal of Public Health on Sept. 2, 2022.
The downside of social media
In times of lockdowns and contact restrictions due to the Covid-19 pandemic, social media channels like Instagram, TikTok, Facebook, Twitter and WhatsApp ensured that we still felt connected to other people. They distracted us from the stress brought about by the pandemic, which caused many people to experience anxiety, insecurities, and hopelessness. But social media consumption has also its drawbacks. Heavy use can lead to addictive behaviour that manifests itself in, for example, a close emotional bond to the social media. In addition, fake news and conspiracy theories can spread uncontrollably on social channels and trigger even more anxiety.
"Given that we don't know for certain how long the coronavirus crisis will last, we wanted to know how to protect people's mental health with services that are as free and low-threshold as possible," explains Julia Brailovskaia. To find out whether the type and duration of social media use can contribute to this, she conducted an experimental study as part of her fellowship at the Center for Advanced Internet Studies (CAIS).
A two-week experiment
She and her team recruited a total of 642 volunteers, assigning them randomly to one of four groups of roughly equal size. The first group reduced the daily social media consumption by 30 minutes during an intervention period of two weeks. Since previous studies had shown that physical activity can increase well-being and reduce depressive symptoms, the second group increased the duration of physical activity by 30 minutes daily during this period, while continuing to use social media as usual. The third group combined both, reducing social media use and increasing physical activity. A control group didn't change the behaviour during the intervention phase.
Before, during and up to six months after the two-week intervention phase, the participants responded to online surveys on the duration, intensity and emotional significance of their social media use, physical activity, their satisfaction with life, their subjective feeling of happiness, depressive symptoms, the psychological burden of the Covid-19 pandemic and their cigarette consumption.
Healthy and happy in the age of digitalisation
The findings clearly showed that both reducing the amount of time spent on social media each day and increasing physical activity have a positive impact on people's well-being. And particularly the combination of the two interventions increases one's satisfaction with life and subjective feeling of happiness and reduces depressive symptoms. The effects last for a long time: even six months after the two-week intervention phase had ended, participants in all three intervention groups spent less time on social media than before: namely about a half hour in the groups that had either reduced social media time or increased their daily exercise, and about three-quarters of an hour in the group that had combined both measures. Six months after the intervention, the combination group engaged one hour and 39 minutes more each week in physical activity than before the experiment. The positive influence on mental health continued throughout the entire follow-up period.
"This shows us how vital it is to reduce our availability online from time to time and to go back to our human roots," concludes Julia Brailovskaia. "These measures can be easily implemented into one's everyday life and they're completely free -- and, at the same time, they help us to stay happy and healthy in the digital age."
https://www.sciencedaily.com/releases/2022/09/220907105433.htm
Insomnia increases the likelihood of memory decline in older adults
Longitudinal study shows the psychological disorder is an important comorbidity for dementia and other cognitive impairments
September 6, 2022
Science Daily/Concordia University
A new Canadian study has found that older people with insomnia are at greater risk of developing memory decline and long-term cognitive impairment such as dementia.
The study, published in the journal SLEEP, is based on data from more than 26,000 participants of the Canadian Longitudinal Study on Aging, all aged between 45 and 85. The researchers compared completed self-reported evaluations of sleep and memory and neuropsychological testing in several cognitive domains from 2019 and a follow-up in 2022. Participants who reported worsening sleep quality in that three-year interval also had greater odds of reporting subjective memory decline.
"We found that insomnia specifically was related to worse memory performance compared to those who have some insomnia symptoms alone or no sleep problems at all," says the study's co-lead author Nathan Cross, a postdoctoral fellow at the Sleep, Cognition and Neuroimaging Lab. "This deficit in memory was specific, as we also looked at other cognitive function domains such as attention span multi-tasking. We only found differences in memory."
Jean-Louis Zhao at the Université de Montréal was the study's co-lead. Lisa Kakinami and Thanh Dang-Vu of the PERFORM Centre contributed to the study, as did Chun Yao and Ronald Postuma from McGill University and Julie Carrier and Nadia Gosselin at UdeM.
Big data and a sharp focus
Unlike previous studies on sleep quality, Cross says, this one benefits from its very large data set and its focus on sleep disorders. Insomnia, he points out, has been classified as a psychological disorder in the Diagnostic and Statistical Manual of Mental Disorders, the primary reference handbook used by physicians worldwide. Insomnia is not just tossing and turning for a time before bed: "A diagnosis requires symptoms of difficulty falling asleep, staying asleep or waking too early three nights a week over a period of three months. Additionally, those with insomnia must report that this sleep problem causes them difficulty in the daytime," Cross explains.
For this study, the researchers grouped their subjects into one of three categories: those who reported no sleep problems at the 2019 baseline, those who had some insomnia symptoms and those who developed probable insomnia. When they looked at the data from 2022 follow-up, those who had reported a worsening of sleep quality -- from no symptoms to some or probable insomnia, or from some symptoms to probable insomnia -- were more likely to report memory decline or have it diagnosed by their physician. They were also more likely to show higher prevalence of anxiety, depression, daytime sleepiness, have breathing interruptions during sleep, other sleep-related issues, smoking and a greater body mass index (BMI) score. All of these are considered risk factors for cognitive decline and dementia. Additionally, the study found that men with insomnia perform worse on memory tests than women, suggesting that older men may be at greater risk.
"However, there is some good news: sleep disorders like insomnia can be treated," Cross adds. "This highlights the importance of properly diagnosing and managing insomnia as early as possible in older adults. Adequately treating insomnia disorder might become an important preventive measure for cognitive decline and mitigate the incidence of dementia in later life."
https://www.sciencedaily.com/releases/2022/09/220906134013.htm
How does nature nurture the brain?
Study shows that a one-hour walk in nature reduces stress-related brain activity
September 6, 2022
Science Daily/Max Planck Institute for Human Development
Living in a city is a well-known risk factor for developing a mental disorder, while living close to nature is largely beneficial for mental health and the brain. A central brain region involved in stress processing, the amygdala, has been shown to be less activated during stress in people who live in rural areas, compared to those who live in cities, hinting at the potential benefits of nature. "But so far the hen-and-egg problem could not be disentangled, namely whether nature actually caused the effects in the brain or whether the particular individuals chose to live in rural or urban regions," says Sonja Sudimac, predoctoral fellow in the Lise Meitner Group for Environmental Neuroscience and lead author of the study.
To achieve causal evidence, the researchers from the Lise Meitner Group for Environmental Neuroscience examined brain activity in regions involved in stress processing in 63 healthy volunteers before and after a one-hour walk in Grunewald forest or a shopping street with traffic in Berlin using functional magnetic resonance imaging (fMRI). The results of the study revealed that activity in the amygdala decreased after the walk in nature, suggesting that nature elicits beneficial effects on brain regions related to stress.
"The results support the previously assumed positive relationship between nature and brain health, but this is the first study to prove the causal link. Interestingly, the brain activity after the urban walk in these regions remained stable and did not show increases, which argues against a commonly held view that urban exposure causes additional stress," explains Simone Kühn, head of the Lise Meitner Group for Environmental Neuroscience.
The authors show that nature has a positive impact on brain regions involved in stress processing and that it can already be observed after a one-hour walk. This contributes to the understanding of how our physical living environment affects brain and mental health. Even a short exposure to nature decreases amygdala activity, suggesting that a walk in nature could serve as a preventive measure against developing mental health problems and buffering the potentially disadvantageous impact of the city on the brain.
The results go in line with a previous study (2017, Scientific Reports) which showed that city dwellers who lived close to the forest had a physiologically healthier amygdala structure and were therefore presumably better able to cope with stress. This new study again confirms the importance for urban design policies to create more accessible green areas in cities in order to enhance citizens' mental health and well-being.
In order to investigate benedicial effects of nature in different populations and age groups, the researchers are currently working on a study examining how a one-hour walk in natural versus urban environments impacts stress in mothers and their babies.
https://www.sciencedaily.com/releases/2022/09/220906114334.htm
How the gut may help to drive COVID-19
September 3, 2022
Science Daily/Flinders University
New findings from Flinders University have demonstrated a molecular link between COVID-19 and serotonin cells in the gut.
The research could help provide further clues to what could be driving COVID-19 infection and disease severity and supports previous evidence that antidepressants, known as selective serotonin reuptake inhibitors (SSRIs), could reduce the severity of COVID symptoms.
COVID-19 displays an array of symptoms, which can regularly include gastrointestinal issues such as diarrhoea. Recent research has indicated that these gut symptoms in COVID-19 patients worsen with the severity of the disease, and this is linked to heightened gut-derived serotonin, released to cause gut dysfunction, increasing the body's immune response and potentially worsening patient outcomes.
Published in the world's leading gastrointestinal research journal Gut, this new collaborative study involved three Flinders research teams, including teams led by ARC DECRA Fellow Dr Alyce Martin and FAME Director of Bioinformatics and Human-Microbe Interactions, Professor Robert Edwards.
"Our study endeavoured to understand whether the gut could be a site of disease transmission and what genes might be associated with the virus entering the cells lining the gut wall," says study senior author Professor Damien Keating, Deputy Director of the Flinders Health and Medical Research Institute and Head of the Gut Sensory Systems research group.
The researchers looked at gene expression amongst the different cell types that line the gut wall, analysing whole genome sequences from thousands of individual cells from within the intestine.
They found specialised cells within the gut that synthesised and released serotonin had a highly enriched expression of a particular SARS-CoV-2 receptor and were the only type of cell that expressed all the genes associated with COVID-19.
"Many genes linked to COVID-19 were found expressed in the different cell types lining the gut wall but only serotonin cells expressed all three receptors for the virus," says Professor Keating.
"Expression of all three SARS-CoV-2 receptors triples the rate of cell infectivity, compared to expression of only two receptors."
With the exact sites of infection and the primary drivers of COVID-19 disease severity not yet fully understood, the authors say this study provides important information on the gut's role in the virus.
"Our study adds further evidence that COVID-19 is far more likely to infect cells in the gut and increase serotonin levels through direct effects on specific gut cells, potentially worsening disease outcomes," says Professor Keating.
"It also provides further support to emerging clinical evidence that antidepressant drugs, which block serotonin transport around the body, may serve as a beneficial treatment.
"As COVID-19 continues to circulate, further research will be required to advance our understanding of the gut's role in this virus and continue to find treatment options to work alongside vaccinations."
https://www.sciencedaily.com/releases/2022/09/220901135944.htm
Study calls for change in guidance about eating fish during pregnancy
September 6, 2022
Science Daily/University of Bristol
A woman's mercury level during pregnancy is unlikely to have an adverse effect on the development of the child provided that the mother eats fish,
The findings, which drew together analyses on over 4,131 pregnant mothers from the Children of the 90s study in the UK, with similar detailed studies in the Seychelles, are published in NeuroToxicology.
Importantly, the researchers also found that it does not appear to matter which types of fish are eaten because the essential nutrients in the fish could be protective against the mercury content of the fish. The more important factor was whether the woman ate fish or not. This contrasts with current advice warning pregnant women not to eat certain types of fish that have relatively high levels of mercury.
Although there are several studies that have considered this question, this research has looked at two contrasting studies of populations with mercury levels measured during pregnancy where the children were followed up at frequent intervals during their childhood.
The first is a study focused on a population in the Seychelles, where almost all pregnant women are fish eaters. The second study considered analyses of data from the University of Bristol's Children of the 90s study (also known as the Avon Longitudinal Study of Parents and Children (ALSPAC)), based in a relatively industrialised area in south-west England where fish are consumed far less frequently. No summary of the findings from this study has been published before.
Although it has been known for some time that the children of women who eat fish in pregnancy are likely to benefit in various ways in regard to their eyesight and intellectual abilities, official advice has included the warning not to eat certain types of fish that have relatively high levels of mercury. As a result, there is the possibility that some women will stop eating any fish 'to be on the safe side'.
Dr Caroline Taylor, Senior Research Fellow and co-author of the study, said: "We found that the mother's mercury level during pregnancy is likely to have no adverse effect on the development of the child provided that the mother eats fish. If she did not eat fish, then there was some evidence that her mercury level could have a harmful effect on the child. This could be because of the benefits from the mix of essential nutrients that fish provides, including long-chain fatty acids, iodine, vitamin D and selenium."
Professor Jean Golding, co-author and Emeritus Professor of Paediatric and Perinatal Epidemiology at the University of Bristol, said: "It is important that advisories from health professionals revise their advice warning against eating certain species of fish. There is no evidence of harm from these fish, but there is evidence from different countries that such advice can cause confusion in pregnant women. The guidance for pregnancy should highlight 'Eat at least two portions of fish a week, one of which should be oily' -- and omit all warnings that certain fish should not be eaten."
https://www.sciencedaily.com/releases/2022/09/220906114315.htm
Frequency of premenstrual anxiety, mood swings a public health issue
More than 64% of women experience mood swings or anxiety
September 6, 2022
Science Daily/University of Virginia Health System
Premenstrual mood swings and anxiety are so common -- experienced by more than 64% of women -- that they represent a "key public health issue globally," according to a new UVA Health study.
The UVA Health study found that most women have premenstrual symptoms every menstrual cycle, and those symptoms regularly affect their day-to-day lives. One of the most common symptoms, regardless of age, is mood swings or anxiety, the researchers found. At least 61% of women in all age groups surveyed reported mood-related symptoms every menstrual cycle, which the researchers say suggests "that premenstrual mood symptoms are a key public health issue globally."
"Our study demonstrates that premenstrual mood symptoms are incredibly common worldwide," said Jennifer L. Payne, MD, the study's senior author and director of the Reproductive Psychiatry Research Program at the University of Virginia School of Medicine. "More important, a majority of women reported that their premenstrual symptoms interfered with their everyday life at least some of the time."
Better Understanding Premenstrual Symptoms
To better understand the type of premenstrual symptoms women experience and how those symptoms affect their daily lives, the researchers analyzed more than 238,000 survey responses from women ages 18-55 from 140 countries on the Flo app, which helps women track their menstrual cycle or track their mood or physical symptoms during and after pregnancy.
The most common symptoms reported were food cravings, experienced by 85.28% of the women surveyed, followed by mood swings or anxiety (64.18%) and fatigue (57.3%), according to researchers from the UVA School of Medicine, Johns Hopkins University and Flo Health. Among the study respondents, 28.61% said their premenstrual symptoms interfered with their everyday life during every menstrual cycle, while an additional 34.84% said their premenstrual symptoms interfered with their everyday life sometimes.
"The incidence of reported premenstrual mood and anxiety symptoms varied significantly by country from a low of 35.1% in Congo to a high of 68.6% in Egypt," Payne said. "Understanding whether differences in biology or culture underlie the country level rates will be an important future research direction."
A group of symptoms -- absentmindedness, low libido, sleep changes, gastrointestinal symptoms, weight gain, headaches, sweating or hot flashes, fatigue, hair changes, rashes and swelling -- was significantly more frequent among older survey respondents, the researchers found. The increase in physical symptoms among older survey respondents "makes sense," the researchers said, as many of these symptoms are associated with perimenopause, a transition period to menopause marked by irregular menstrual cycles.
Payne is hopeful that this survey data will help women get better care by making healthcare providers more aware of how frequently these symptoms -- especially anxiety and mood-related symptoms -- occur.
"There are a number of treatment strategies that are available to treat premenstrual symptoms that interfere with a woman's every day functioning," she said. "Increasing awareness of how common these symptoms are, and that if they impact functioning that there are treatments available, will help women improve their quality of life."
https://www.sciencedaily.com/releases/2022/09/220906083535.htm
High blood pressure awareness, control improved with better access to primary health care
Better access to primary health care was associated with improved high blood pressure awareness and control
September 6, 2022
Science Daily/American Heart Association
Having easier access to primary care physicians may increase high blood pressure awareness and control regardless of where a person lives, according to new research published today in Circulation: Cardiovascular Quality and Outcomes, a peer-reviewed journal of the American Heart Association.
According to the American Heart Association, nearly half of all Americans have hypertension (high blood pressure), and many don't even know they have it. High blood pressure is often called the "silent killer" because high blood pressure often has no obvious symptoms. The best ways to protect yourself are to be aware of the risks and make healthy life changes that matter.
In a new study, researchers note that health care professionals at community clinics and primary care practices may help expand awareness and detection of high blood pressure by providing affordable treatment and management. High blood pressure is a leading preventable risk factor for cardiovascular disease, and effective blood pressure control reduces the associated cardiovascular health risks.
"Access to primary care is the key to hypertension management, however, many Americans have limited access to primary care where they live. This is especially true of people in economically disadvantaged neighborhoods or people from diverse racial and ethnic groups, particularly among African American individuals," said senior study author Brisa Aschebrook-Kilfoy, Ph.D., an associate professor of public health sciences at the University of Chicago in Illinois.
It is well known that better access to primary health care is linked to improved high blood pressure awareness and control. This study sought to clarify if people living in disadvantaged neighborhoods may benefit from better access to primary care health professionals.
In this study, neighborhood socioeconomic status was assessed using the Area Deprivation Index (ADI) created by the Health Resources & Services Administration (HRSA) over three decades ago. The ADI was chosen because it allows for rankings of neighborhoods by socioeconomic disadvantage in a region of interest (e.g., at the state or national level), and it is valuable to inform health delivery and policy, especially for the most disadvantaged neighborhood groups. ADI is composed of 17 indicators covering income, education, employment and housing quality. In this study, socioeconomically disadvantaged neighborhoods were defined as those in census tracts ranked in the 50th percentile and above.
"Some argue that minority health disparities are solely the product of socioeconomic factors, or that increasing the number of primary care professionals in diverse racial and ethnic neighborhoods would not reduce health disparities and improve public health. To our knowledge, there is little research to support or rebut this argument," said first study author Jiajun Luo, Ph.D., a post-doctoral fellow at the University of Chicago's Institute for Population and Precision Health. "We conducted this study to examine whether accessibility of primary care is associated with better hypertension control and awareness across various socioeconomic and neighborhood factors."
The study examined Chicago, one of the most racially segregated cities in the U.S. Chicago's South Side is the largest African American urban community in the U.S., with substantial challenges including poverty, violence and decreased access to fresh, healthy foods. According to the study, a 30-year gap in life expectancy has been observed between people who live in the South Side neighborhoods and Chicago's wealthier northern neighborhoods, which may be largely attributable to higher rates of high blood pressure, heart disease and stroke.
The researchers analyzed the health data for more than 5,000 predominantly African American adults who participated in the Chicago Multiethnic Prevention and Surveillance Study (COMPASS) between 2013 to 2019. COMPASS is a long-term initiative at the University of Chicago exploring the health of Chicagoans, primarily those who live in communities on the South Side. MAPSCorps, a non-profit organization, provided location information for primary care professionals providing care in those Chicago neighborhoods.
More than half of the study participants were smokers, and they reported an annual household income of less than $15,000 and more than 37% were obese according to body mass index (BMI). Most of the study population resided in a Chicago neighborhood with an ADI rank higher than the 70th percentile (communities with the most disadvantages).
Researchers also evaluated spatial accessibility, which is a composite score that considers the distance between an individual's residence and local primary health care facilities; the number of physicians-to-population ratio; and the effect of distance to primary care on an individual's willingness to seek primary health care. A higher spatial accessibility score indicated better accessibility to primary care. The primary health care professionals included family physicians, general practitioners and general internists.
The research found: ®
Nearly 80% of the COMPASS participants had documented hypertension, using the standard American Heart Association guideline-based blood pressure criteria of measures ?130 mm Hg systolic (top number) or ?80 mm Hg diastolic (bottom number).
Nearly 38% of those with hypertension did not have their blood pressure under control (were not receiving treatment based on self-report), and 41% were not aware they had high blood pressure.
Spatial accessibility scores ranged from 16.4 (lower access to primary care) to 86.6 (higher access) per 100,000 residents.
Adults living in areas with the fewest primary health care professionals had 37% increased odds of having hypertension when compared to the adults living in neighborhoods with the most primary care physicians.
The listed associations existed in both poor and wealthy neighborhoods, suggesting that residents in all neighborhoods may benefit from increasing the number of primary care professionals.
When stratified by neighborhood type (advantaged or disadvantaged), accessibility to primary care was not associated with use of anti-hypertension medications among those who reported they had hypertension prior to enrolling in the study.
"Based on these findings, we need to encourage primary care physicians to expand access to people who live in underserved communities with the fewest primary care professionals," Aschebrook-Kilfoy said. "Mobile health units may be one approach to increase primary care service in underserved areas by eliminating the challenge of getting transportation to and from an office visit. The use of anti-hypertension medications also needs to be studied and addressed, especially as it was not linked to primary care accessibility in this study."
While the method used in this study to measure spatial accessibility can be used anywhere with sufficient location information about primary care professionals, a major limitation of this study is that these specific results may not be representative of other communities and population groups, such as middle-class urban communities or people from other diverse racial and ethnic groups, etc.
https://www.sciencedaily.com/releases/2022/09/220906083550.htm
Low testosterone may increase risk of COVID-19 hospitalization for men
Boosting testosterone in men with low levels may reduce serious illness
September 2, 2022
Science Daily/Washington University School of Medicine
Among men diagnosed with COVID-19, those with low testosterone levels are more likely to become seriously ill and end up in the hospital than men with normal levels of the hormone, according to a study by researchers at Washington University School of Medicine in St. Louis and Saint Louis University School of Medicine.
The team analyzed the cases of 723 men who tested positive for COVID-19, mostly in 2020 before vaccines were available. The data indicate that low testosterone is an independent risk factor for COVID-19 hospitalization, similar to diabetes, heart disease and chronic lung disease.
They found that men with low testosterone who developed COVID-19 were 2.4 times more likely to require hospitalization than men with hormone levels in the normal range. Further, men who were once diagnosed with low testosterone but successfully treated with hormone replacement therapy were no more likely to be hospitalized for COVID-19 than men whose testosterone levels had always tested in the normal range.
The findings, published Sept. 2 in JAMA Network Open, suggest that treating men with low testosterone may help protect them against severe disease and reduce the burden on hospitals during COVID-19 waves.
"It is very likely that COVID-19 is here to stay," said co-senior author Abhinav Diwan, MD, a professor of medicine at Washington University. Diwan, who treats patients at Barnes-Jewish Hospital, is also a professor of cell biology & physiology, and of obstetrics & gynecology. "Hospitalizations with COVID-19 are still a problem and will continue to be a problem because the virus keeps evolving new variants that escape immunization-based immunity. Low testosterone is very common; up to a third of men over 30 have it. Our study draws attention to this important risk factor and the need to address it as a strategy to lower hospitalizations."
Diwan and co-senior author Sandeep Dhindsa, MD, an endocrinologist at Saint Louis University, previously had shown that men hospitalized with COVID-19 have abnormally low testosterone levels. However, severe illness or traumatic injury can cause hormone levels to drop temporarily. Data from men who are already hospitalized with COVID-19 doesn't really answer the question of whether low testosterone is a risk factor for severe COVID-19 or a result of it. For that, the researchers needed to know whether men with chronically low testosterone levels get sicker than men with normal levels.
Diwan, Dhindsa and colleagues -- including co-author Cosette Champion, MD, an internal medicine resident at Barnes-Jewish -- conducted a chart review of patients at SSM Health and BJC HealthCare, two major hospital systems in the St. Louis area. They identified 723 men whose testosterone levels had been measured between Jan. 1, 2017, and Dec. 31, 2021, and who had documented cases of COVID-19 in 2020 or 2021. In some cases, testosterone levels were measured after the patient recovered from COVID-19. Since low testosterone is a chronic condition, men who tested low a few months after recovering from COVID-19 probably had low levels before as well, Dhindsa said.
The researchers identified 427 men with normal testosterone levels, 116 with low levels, and 180 who previously had low levels but were being successfully treated, meaning that they were on hormone replacement therapy and their testosterone levels were in the normal range at the time they developed COVID-19.
"Low testosterone turned out to be a risk factor for hospitalization from COVID, and treatment of low testosterone helped to negate that risk," Dhindsa said. "The risk really takes off below a level of 200 nanograms per deciliter, with the normal range being 300 to 1,000 nanograms per deciliter. This is independent of all other risk factors that we looked at: age, obesity or other health conditions. But those people who were on therapy, their risk was normal."
Men with low testosterone levels can experience sexual dysfunction, depressed mood, irritability, difficulty with concentration and memory, fatigue, loss of muscular strength and a reduced sense of well-being overall. When a man's quality of life is clearly diminished, he is typically treated with testosterone replacement therapy. When the symptoms are mild, though, doctors and patients may hesitate to treat.
The two main concerns related to testosterone therapy are an increased risk of prostate cancer and heart disease. Prostate cancer is common in older men, and it is often driven by testosterone. Boosting testosterone could possibly speed the growth of such cancers, worsening the disease. For heart disease, the evidence for risk is more ambiguous. A large clinical trial on the relationship between heart health and testosterone supplementation is expected to be completed soon.
"In the meantime, our study would suggest that it would be prudent to look at testosterone levels, especially in people who have symptoms of low testosterone, and then individualize care," said Diwan, whose specialty is cardiology. "If they are at really high risk of cardiovascular events, then the doctor could engage the patient in a discussion of the pros and cons of hormone replacement therapy, and perhaps lowering the risk of COVID hospitalization could be on the list of potential benefits."
This study is observational, so it only suggests -- not proves -- that boosting testosterone levels may help men avoid severe COVID-19, Diwan cautioned. A clinical trial would be needed to demonstrate conclusively whether such a strategy works.
https://www.sciencedaily.com/releases/2022/09/220902111333.htm
COVID rekindled an appreciation of nature for many
An opportunity to rediscover why the great outdoors are so great in the first place
September 2, 2022
Science Daily/University of Connecticut
The pandemic has impacted our lives in a multitude of ways, many of which will no doubt be felt for years to come. While many of those effects are clearly negative, UConn researchers have identified at least one positive impact -- our perception of natural spaces changed. The findings are published in Nature Scientific Reports.
As people flocked to outdoor spaces for recreation in the spring of 2020, Sohyun Park, assistant professor in UConn's College of Agriculture, Health and Natural Resources Department of Plant Science and Landscape Architecture, noticed some interesting trends: more people were on the trails, and many of those people had traveled from far away to enjoy nature.
Park was also part of the team for the Connecticut Trail Census and co-wrote a paper about the trends.
Sohyun Park of the Department of Plant Science and Landscape Architecture in her office in the W.B. Young Building. Mar. 8, 2022. (Jason Sheldon/UConn Photo)
"What's interesting was rural trail use increased compared to urban trails," Park says. "I wanted to try to find out how people were changing their mindset or their attitudes or perceptions."
To do this, Park and co-authors Seungman Kim and Jaehoon Lee of Texas Tech University, and Biyoung Heo of James Corner Field Operations, looked to social media data and machine learning techniques to help make sense of the vast quantities of information on Twitter and try to find a pattern among those data, says Park. They utilized Twitter's Application Programming Interface (API), which allows researchers to obtain aggregated data from Twitter posts.
"We wanted to know from the people who have been in greenspaces, what were they doing and what they were writing about on Twitter. We utilized very innovative and advanced levels of machine learning methods," says Park. "The machine categorized the keywords and classified them into several human-recognizable groups. One group was nature related. The second group is all traditional park-related activities and the third one is obviously the COVID-related one, so mask wearing and social distancing, and things like that."
A newfound appreciation for nature
Though what people were doing in the parks did not change significantly, the researchers noticed some significant changes in keyword usage between pre-pandemic and pandemic Twitter, with people frequently referencing nature, and their experiences within it.
"Users began to put the word 'nature' and nature-related activities or nature-related pictures on their Twitter," Park says. "It was very interesting because, in the past, there were not many keywords like that, but people used keywords like 'playing', 'walking the dog', 'baseball', and other traditional, active park activities that they were enjoying while they were there in the parks. If you look at post- 2020 Twitter, you can also see keywords thanking God or showing appreciation for nature, describing the birds singing or water sounds."
What the researchers found was people seemed to have realized a newfound appreciation for nature and greenspaces, especially true for those in urban settings. As a landscape architect, Park was interested to see if there was something more to the findings and perhaps if there might be some design implications for the results.
Common features in modern parks include benches, walking paths, and sports fields, for instance. However, Park says the results of the paper seem to suggest that natural greenspaces appeal to people differently.
"We might want to go back to the origin of public parks like those Olmsted designed," Park says. "In his time in 19th century, there was a lot of hustle and bustle in the city, and they wanted to have space for people to find respite and peace. We might want to go back to that era living with a 21st century health crisis and try to rethink about the design principles."
Park says to imagine Manhattan's Central Park, which hosts ponds, wooded areas, and meadows. Most of those natural features were introduced artificially and were not there in the first place. Compare this with contemporary parks:
"Modern parks may be well managed, maintained, and manicured, everything is clean and tidy," Park says. "There are some seating areas, paved surfaces, and structures where you can play something with your friends and family members, but not really in a naturalistic style. People can feel that in public spaces."
The outdoors as essential resource for overall well-being
Greenspaces impact mental, physical, and spiritual health, and Park reasons that these natural elements might be essential in public spaces, particularly for those who have less access to the public parks, or marginalized communities that don't have any green areas at their residences.
"I'm arguing that parks are not only recreational spaces; greenspaces and parks serve as essential amenities for all including those with low incomes or disabilities, and the elderly," Park says. "Parks need inclusive planning approaches that might be added to the current principles for park development."
Park explains that many people are involved in the planning, design, and management of parks and greenspaces. The tricky part is that the more naturalistic, garden concept for public parks may require more planning and maintenance, and therefore these design features rely more heavily on resources and budgets.
"In the long term, I think that will be the direction that we need to go and now officials and park managers need to work together with those who are living nearby so that we can have some kind of co-managing type of approaches to the future," Park says.
This study highlights the importance of those design features and their roles in our emotional and spiritual well-being, and Park says it is important for the public to advocate for our greenspaces. Research like this can inform decision-making.
"It is important for the public and decision-makers to understand that ultimately, we need to have a budget to have more natural features and nature-oriented programs in the park. We all need to be more active in terms of the things that towns are doing. That can start with joining your town's Conservation Commission or attending monthly meetings. Participate and make your voice heard. That makes a huge change and can impact big decisions. Sometimes these decision makers are really grounded by how the stakeholders are feeling so giving some input and feedback on the public decision-making should be the first step. It is empowering and more people need to be involved in public planning."
https://www.sciencedaily.com/releases/2022/09/220902103241.htm