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10/15/2008

A surprising link to obesity

Childhood ear infections may pave the way for weight gain in adulthood.
By Michael PriceMonitor staff Print version: page 18
They say the best way to a man's heart is through his stomach, but new evidence suggests the best way to his stomach may be through his ears. Research presented at APA's Annual Convention suggests that ear infections in early childhood have a profound effect on obesity later in life. Researchers presented findings that children who suffer from repeated middle-ear infections, or otitis media, are much more likely to be overweight as children and as adults.
The possible link first came to light when in 1993 University of Florida School of Dentistry researcher Linda Bartoshuk, PhD, and her colleagues administered general health questionnaires to 7,000 Americans, looking for correlations between taste perceptions and health.
"An unexpected finding emerged," Bartoshuk said. A history of otitis media was associated with a higher body mass index. Using statistical analysis, she determined that these ear infections weren't just a correlation; they made an independent contribution to being overweight, she said.
In her studies since, she's found that males may be particularly susceptible: Those with a history of otitis media are almost twice as likely to be overweight or obese as men who have no history of the condition.
"This is not a small effect," she said.
How could an ear infection influence someone's weight? Derek Snyder, a Yale University neuroscience graduate student, explained that a damaged nerve might be the culprit. An important taste nerve, the chorda tympani, runs from the tongue up through the middle ear and into the brain. If the middle ear is infected, the nerve can get damaged. The effect is that certain nontaste sensations, like the creaminess of fat, get intensified.
"When we perceive food in the mouth, several nerves are at work," Snyder said. "Each of these nerves carries a distinct array of sensory information."
The chorda tympani is responsible for the taste perception on the front of the tongue. If that nerve becomes damaged, tastes at the back of the tongue actually get enhanced to preserve overall "taste constancy." But other cues that go into our sensory experience of flavor, including texture, smells and chemical sensitivity, are also enhanced.
Snyder and the other presenters think that the tongue's texture detectors pull double duty when the chorda tympani is damaged. These texture detectors latch onto the intensified creamy, fat sensation. The result is that overall taste perception remains the same, but a person's food preferences shift toward fatty and creamy foods.
"Over time, a history of ear infection may contribute to a more energy-dense diet," Snyder said. After a number of years, this can lead to obesity.
Especially susceptible are a subgroup of people known as supertasters, who, Bartoshuk explained, have an abnormally high number of taste buds. These people make up about 25 percent of the world population.
"These people live in a neon taste world," Bartoshuk said. For them, damage to the chorda tympani might pose an even bigger danger, as their enhanced taste perceptions would amplify the effects.

Cocaine addicts' brains predisposed to abuse: study

CHICAGO - Cocaine addicts may have brain deficits that predispose them to drug abuse, and abusing drugs appears to make matters worse, U.S. researchers said on Wednesday.
They said images of cocaine addicts' brains reveal abnormalities in the cerebral cortex -- the brain's outer surface -- and these changes relate to dysfunction in areas responsible for attention and decision-making.

"These data point to a mixture of both drug effects and predisposition underlying the structural alterations we observed," said Dr. Hans Breiter of Massachusetts General Hospital, whose research appears in the journal Neuron.

Breiter and colleagues compared magnetic resonance images, or MRIs, of 20 cocaine addicts with 20 carefully matched volunteers to map out cocaine-related differences in the brain.
Compared to their healthy counterparts, cocaine addicts had far less overall volume in the cortex, the outer layer that helps plan, execute and control behavior. These differences were especially pronounced in areas regulating reward, attention and decision-making.
They also noticed that while the healthy volunteers tended to have thicker areas in some frontal regions on the right side of the brain, this was reversed in the addicts. And overall, the addicts had less variation in the thickness of their cortex.
Differences in the right and left side of the brain are important because they typically suggest a genetic cause, Breiter said.
The researchers also found changes in the cingulate -- another reward center -- that appeared to correspond with the length of cocaine use but not nicotine or alcohol use, suggesting that these changes were the result of long-term cocaine exposure.
"Human studies have shown differences in how addicts make judgments and decisions, but it is not well understood how these differences relate to alterations in the structure of the brains of addicts," Breiter said in a statement.
The researchers said the findings underscore the importance of keeping vulnerable people from using cocaine. And they said follow-up studies should be done to see if similar changes are present in people with other addictions.

2008 Reuters

Some depressed patients opt for assisted suicide

By Anthony J. Brown, MD
NEW YORK (Reuters Health) - The results of a survey in Oregon suggest that the Death with Dignity Act enacted in the state in 1997 does not always prevent patients with depression, a treatable condition, from receiving a prescription for a lethal drug.
The findings indicate that "most people in Oregon who request physician aid in dying do not have clinical depression," but yet there are "small number of patients with clinical depression who are able to access lethal medications," lead investigator Dr. Linda Ganzini, from Portland Veterans Affairs Medical Center, told Reuters Health.

"The Oregon law," she explained, "requires that if the prescribing physician is concerned that the patient might have depression influencing their judgment, that they be evaluated by a psychiatrist or psychologist. The proportion of requesting patients who are evaluated by a mental health professional has been dropping over the last decade and last year no mental health assessments occurred among the 46 people who died by physician-assisted suicide in Oregon."
The survey, reported in the Online First issue of the British Medical Journal, looked at 58 state residents with a terminal illness, usually cancer or ALS, who had requested assistance in dying, either directly from a physician or through an advocacy organization.
Using standard measures, including the structured clinical interview of the Diagnostic and Statistical Manual of Mental Disorders, the investigators identified 15 people with depression and 13 with anxiety.
Forty-two people died by the end of the study, including 18 who had received a prescription for a lethal drug. Three of the 18 individuals met criteria for depression and all three died from lethal ingestion within 2 months of the study survey.
"Physicians need to do a better job in screening for depression among terminally ill patients who wish to die," Ganzini emphasized. She added that her group "is continuing to analyze data from this data set regarding these patients' views on their medical care."
In a related editorial, Dr. Marije L. van der Lee, from the Helen Dowling Institute in Utrecht, the Netherlands, comments that while the current study examined how well depressed patients are protected from assisted suicide, the focus should be on "trying to prevent patients from becoming depressed in the first place."
She added that "depression has a strong negative effect on the quality of life of terminally ill patients and their family, but depression could potentially be treated."
SOURCE: British Medical Journal, online October 8, 2008.

2008 Reuters.

A study that could improve our health and well-being at work is about to start at The University of Nottingham.

Patients who were depressed had higher heart rate, study finds

NEW YORK - In people who have suffered a heart attack, depression and a high heart rate at night, while often coexistent, are independent predictors of death, according to research published in the journal Psychosomatic Medicine.
Dr. Robert M. Carney of Washington University School of Medicine in St. Louis, Mo., and colleagues conducted a series of tests in 333 depressed patients and 383 non-depressed patients who'd recently suffered a heart attack and were followed for up to 30 months.
After accounting for a number of potential factors that might influence the results, depressed patients had higher nighttime heart rate (70.7 versus 67.7 beats per minute) and daytime heart rate (76.4 versus 74.2 beats per minute) than non-depressed patients.

Overall, 33 depressed patients (9.9 percent) and 14 non-depressed patients (3.7 percent) died during follow-up. Twenty-four of the deaths among the depressed patients (73 percent) and 10 of the deaths among the non-depressed patients (71 percent) were classified as likely due to cardiovascular causes.
Carney and colleagues also report that "nondepressed patients with low heart rate had the best survival, and depressed patients with high heart rate had the worst."

After adjusting for other major predictors and for each other, depression and a high nighttime, but not daytime, heart rate independently increased the risk of death in these post-heart attack patients.
According to the investigators, disturbed sleep, which is frequently reported in patients with depression, may help explain the association of nighttime elevated heart rate with mortality.
There is evidence that arousals from sleep that are associated with increased heart rate may provoke events related to ischemia (restriction of the blood supply and thus oxygen to the tissues) and abnormal heart rhythms in patients with heart disease, they note.

2008 Reuters

Major Study Begins Into Work-Related Health And Well-Being

A study that could improve our health and well-being at work is about to start at The University of Nottingham. In 2006 and 2007 more than half a million individuals in Britain reported experiencing work-related stress at a level that was making them ill. Dr Maria Karanika-Murray, a Research Fellow in Occupational Health Psychology, has received funding from the Economic and Social Research Council to spend the next two and a half years researching the impact of organisational level factors on employee health and well-being. Until now most investigations into the impact of work on health have been limited to the person in the context of their immediate job. This study will take a different perspective and could potentially have a major impact on theory and our knowledge, as well as on practice and how we manage work-related health. This research looks at the impact of the organisation itself: its structure and culture. Maria Karanika-Murray and her research staff, will examine the organisation and work systems of some 40 companies - large, small, and medium sized enterprises. Information on hundreds of employees, their work and their organisations will be sampled over a period of 20 months. Maria Karanika-Murray said: "A large body of academic research has been carried out on the subject. For example, we know that characteristics of the job such as the level of demands and job variety, relationships and support at work, the work-life balance, and so on, impact on job satisfaction, absence and productivity. But very few studies have considered what impact organisational factors such as culture, leadership, policies, strategies, change and development goals can have on such outcomes." Health and safety at work is one of the most concentrated and most important social policy sectors in Europe. Since the 1990's the increasingly recognised importance of health at work has given rise to policy and national guidance on its management in the UK and in Europe. Between 2006 and 2007 30 million working days were lost due to work-related ill health and six million working days were lost due to workplace injury. More than two million people suffer from an illness they believe was caused or made worse by work. Maria Karanika-Murray, who is based at the Institute of Work, Health and Organisations (I-WHO), says the problem has been identified in research which shows many organisational interventions are not as successful as they might have been expected and that the wider organisational environment may affect the success or failure of an intervention. She said: "Research into occupational health often neglects to look at the broader organisational system within which employees carry out their work. This may be due to shortcomings in research methodology and can have important implications for theory and what we know about the causes of work-related health. The importance of this study lies in its implications for the successful and sustainable management of work-related health." With a total cost of £320,000 the research will use a multilevel longitudinal approach, which is appropriate for estimating the cause and effect of relationships. Tom Cox, Professor of Organisational Psychology & Head of I-WHO said: "This is an important development in occupational health psychology and for the health and well-being of working people. It is clear that the nature of their employing organisations, and their cultures, determine many aspects of their behaviour at work, the quality of their working lives and ultimately their well-being. As a result of this research, we can learn much more about these important relationships."

Being Altruistic May Make You Attractive

Displays of altruism or selflessness towards others can be sexually attractive in a mate. This is one of the findings of a study carried out by biologists and a psychologist at The University of Nottingham. In three studies of more than 1,000 people Dr Tim Phillips and his fellow researchers discovered that women place significantly greater importance on altruistic traits that anything else. Their findings have been published in the British Journal of Psychology. Dr Phillips said: "Evolutionary theory predicts competition between individuals and yet we see many examples in nature of individuals disadvantaging themselves to help others. In humans, particularly, we see individuals prepared to put themselves at considerable risk to help individuals they do not know for no obvious reward." Participants in the studies were questioned about a range of qualities they look for in a mate, including examples of altruistic behaviour such as 'donates blood regularly' and 'volunteered to help out in a local hospital'. Women placed significantly greater importance on altruistic traits in all three studies. Yet both sexes may consider altruistic traits when choosing a partner. One hundred and seventy couples were asked to rate how much they preferred altruistic traits in a mate and report their own level of altruistic behaviour. The strength of preference in one partner was found to correlate with the extent of altruistic behaviour typically displayed in the other, suggesting that altruistic traits may well be a factor both men and women take into account when choosing a partner. Dr Phillips said: "For many years the standard explanation for altruistic behaviour towards non-relatives has been based on reciprocity and reputation - a version of 'you scratch my back and I'll scratch yours'. I believe we need to look elsewhere to understand the roots of human altruism. The expansion of the human brain would have greatly increased the cost of raising children so it would have been important for our ancestors to choose mates both willing and able to be good, long-term parents. Displays of altruism could well have provided accurate clues to this and genes linked to altruism would have been favoured as a result." Dr Phillips concluded: "Sexual selection could well come to be seen as exerting a major influence on what made humans human." Dr Tom Reader in the School of Biology said: "Sexual preferences have enormous potential to shape the evolution of animal behaviour. Humans are clearly not an exception: sex may have a crucial role in explaining what are our most biologically interesting and unusual habits." ----------------------------Article adapted by Medical News Today from original press release.---------------------------- Source: Lindsay Brooke University of Nottingham

Chair Of Joint Chiefs Calls For Broader PTSD Screenings

Michael Mullen, chair of the Joint Chiefs of Staff, recently proposed that all returning combat troops undergo screening for post-traumatic stress disorder with a mental health professional, according to USA Today. Troops currently fill out questionnaires after combat tours that aid in assessing their mental health and are examined by physicians for physical injuries, but they do not meet with a mental health professional. According to USA Today, a trained mental health professional can determine signs of PTSD within five minutes in an in-person meeting.Mullen said troops often are reluctant to acknowledge psychological problems because they are hesitant to show weakness. According to Terri Tanielian, co-director of RAND's Center for Military Health Policy Research, troops are concerned that seeking mental health treatment could negatively affect their military career. Mullen said the Pentagon has yet to address the negative connotation associated with mental health care. Mullen said, "I'm at a point where I believe we have to give a (mental health) screening to everybody to help remove the stigma of raising your hand." There currently are no estimates regarding the potential cost of Mullen's proposal or a start date. A shortage of available mental health professionals could hinder adoption of the proposal, although the military has increased signing and retention bonuses in recent years to address the issue. Another concern is that troops often know how to evade certain health questions to avoid treatment.According to a RAND study, one in five combat veterans from Iraq and Afghanistan suffer from PTSD or depression. RAND estimates that 300,000 veterans have been affected and that it may cost more than $6.2 billion to treat them. The study also showed rates of PTSD and depression were highest among soldiers and Marines (Vanden Brook, USA Today, 10/13). Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.

Psychological Effects Of Abortion Deserve 'New Dialogue,' Editorial Says

Although it is "well-known" that a woman has choices when she is pregnant, "what is not fully known ... is that each of these choices has long-term effects for both the parents," a Washington Times editorial says, adding, "An abortion, much like" carrying a pregnancy to term or choosing adoption, is "not consequence-free." According to the editorial, abortion-rights advocates are "still in denial that there is a mental health impact" associated with the procedure, and many members of the scientific community "insist there is no proof of a causal relationship between abortion and mental health problems." The editorial concludes that "the dialogue on abortion can benefit from a fresh perspective: The discussion should not be centered solely on whether girls and women should be permitted to have an abortion. Women must fully grasp that abortion actually causes mental health problems" (Washington Times, 10/14). Reprinted with kind permission from http://www.nationalpartnership.org. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.

Adolescent Brain Function Adversely Affected By Marijuana Use

Brain imaging shows that the brains of teens that use marijuana are working harder than the brains of their peers who abstain from the drug. At the 2008 annual meeting of the American Academy of Pediatrics in Boston, Mass., Krista Lisdahl Medina, a University of Cincinnati assistant professor of psychology, presented collaborative research with Susan Tapert, associate professor of psychiatry at the University of California, San Diego. Medina's Oct. 12 presentation, titled, "Neuroimaging Marijuana Use and its Effects on Cognitive Function," suggests that chronic, heavy marijuana use during adolescence - a critical period of ongoing brain development - is associated with poorer performance on thinking tasks, including slower psychomotor speed and poorer complex attention, verbal memory and planning ability. Medina says that's evident even after a month of stopping marijuana use. She says that while recent findings suggest partial recovery of verbal memory functioning within the first three weeks of adolescent abstinence from marijuana, complex attention skills continue to be affected. "Not only are their thinking abilities worse, their brain activation to cognitive tasks is abnormal. The tasks are fairly easy, such as remembering the location of objects, and they may be able to complete the tasks, but what we see is that adolescent marijuana users are using more of their parietal and frontal cortices to complete the tasks. Their brain is working harder than it should," Medina says. She adds that recent findings suggest females may be at increased risk for the neurocognitive consequences of marijuana use during adolescence, as studies found that teenage girls had marginally larger prefrontal cortex (PFC) volumes compared to girls who did not smoke marijuana. The larger PFC volumes were associated with poorer executive functions of the brain in these teens, such as planning, decision-making or staying focused on a task. Medina says adolescence is a critical time of brain development and that the findings are yet another warning for adolescents who experiment with drug use. She says more study is needed to see if the thinking abilities of adolescent marijuana users improve following longer periods of abstinence from the drug. "Longitudinal studies following youth over time are needed to rule out the influence of pre-existing differences before teens begin using marijuana, and to examine whether abstinence from marijuana results in recovery of cognitive and brain functioning," says Medina. ----------------------------Article adapted by Medical News Today from original press release.---------------------------- The research was supported by the National Institute on Drug Abuse (NIDA). Source: Dawn Fuller University of Cincinnati

No Friend to Turn to

Chicago Tribune -

Maybe you and your friends have stopped talking politics.
Then again, maybe you've stopped talking altogether.
"Loneliness," a new book by University of Chicago psychology professor John T. Cacioppo and science writer William Patrick, sounds a wake-up call for those of us walking around in a state of isolation - and we are plenty. Roughly 60 million Americans, according to the book, feel lonely to the point of unhappiness at any given moment.
That's about 20 percent of us.
Part of our problem, according to Cacioppo's book, is an alarming trend in American communities: We've stopped confiding in each other.
In 1985, the General Social Survey talked to nearly 1,500 adults about their network of confidants. In 2004, sociologists repeated the same survey and found Americans had onethird fewer confidants - defined as people with whom you "discuss important matters." A quarter of the respondents in 2004 said they had no one with whom they talk openly and intimately.
What about you? Are you swimming in confidants, or treading water on your own? We came up with a little quiz to help you decide.
If your answers leave you feeling a little lonely, it may be time to take action. Cacioppo and Patrick report that "social isolation has an impact on health comparable to the effect of high blood pressure, lack of exercise, obesity or smoking."
"Loneliness is not only a sad event, it's a threatening event," Cacioppo said in a recent phone interview.
"Loneliness is a pain signal calling attention to an important need. It's the same as hunger, thirst and pain."
And although he stresses that the quality of your relationships is far more important than the quantity, ("A few close friends and confidants make a big difference"), it helps to branch out beyond your immediate family.
Answer these questions:
- Do you regularly discuss your health, job, current events or other "important matters" with someone outside your family?
- Who could you call on to pick up your child(ren) from school or day care?
- Do you belong to a community organization?
- How many of your neighbors do you know?
- Do you play on a sports team?
- Do you have a regular hangout (coffee shop, diner, bookstore)?
- How many of your online friends do you socialize with face-to-face?
- Who feeds your pet/collects your mail/waters your plants when you leave town?
- Who would you call if your car broke down?
- What are you doing next Saturday?
If you continually answered "my spouse" to the "who would you turn to"-type questions, consider this: "Ties outside the family are the most likely to connect respondents to people from different parts of society," according to the most recent issue of Contexts, a magazine published by the American Sociological Association.
"Family members tend to be similar in class, religion and race. Therefore, if the majority of a person's connections are through family, their social world is limited."
This may not seem like such a bad thing, but the Contexts report (which centered on the same confidant study mentioned in "Loneliness") makes this point: "The tangible, material help we get from others leads to longer, healthier lives."
"People stranded on rooftops after Hurricane Katrina perhaps didn't know anyone with a car and didn't have a close friend they could stay with for a few days," it says.
So it behooves us to make some time for relationships.
"We are fundamentally a social species," notes Cacioppo, who says he was surprised to learn how profoundly we are affected by our connectedness.
"It affects our ability to think, to self-regulate, our sense of self-worth. Exactly how central our social existence is to us as human beings, that was a surprise. That changed how I started to think about human nature."
---
GET THE BALL ROLLING
BetterTogether.org, an initiative by Harvard University to rebuild civic trust among Americans and their communities, offers "150 Things You Can Do to Build Social Capital." In other words, make some friends. From the list:
- Surprise a new neighbor by making a favorite dinner - and include the recipe.
- Organize or participate in a sports league.
- Audition for community theater or volunteer to usher.
- Volunteer in your child's classroom or chaperone a field trip.
- Participate in a political campaign.
- Help coach Little League or other youth sports - even if you don't have a kid playing.
- Start a lunch gathering or discussion group with co-workers.
- Start or join a carpool.
- Plant tree seedlings along your street with neighbors and rotate care for them.
- See if your neighbor needs anything when you run to the store.

Internet searching increases brain function: study

WASHINGTON, Oct 14, 2008 (Xinhua via COMTEX) -- A new study by U.S. scientists shows that for computer-savvy middle-aged and older adults, searching the Internet triggers key centers in the brain that control decision-making and complex reasoning.
The findings, released on Tuesday, demonstrated that Web search activities may help stimulate and possibly improve brain function. The study, the first of its kind to assess the impact of Internet searching on brain performance, will appear in the American Journal of Geriatric Psychiatry.
"The study results are encouraging, that emerging computerized technologies may have physiological effects and potential benefits for middle-aged and older adults," said principal investigator Gary Small, a professor from University of California, Los Angeles. "Internet searching engages complicated brain activity, which may help exercise and improve brain function."
As the brain ages, a number of structural and functional changes occur, including atrophy, reductions in cell activity, and increases in deposits of amyloid plaques and tau tangles, which can impact cognitive function.
Small noted that pursuing activities that keep the mind engaged may help preserve brain health and cognitive ability. Traditionally, these include games such as crossword puzzles, but with the advent of technology, scientists are beginning to assess the influence of computer use -- including the Internet.
For the study, the UCLA team worked with 24 neurologically normal research volunteers aged between 55 and 76. Half of the participants had experience searching the Internet, while the other half had no such experience.
Internet searches revealed a major difference between the two groups. While all participants demonstrated the same brain activity that was seen during the book-reading task, the Web-savvy group also registered activity in the frontal, temporal and cingulate areas of the brain, which control decision-making and complex reasoning.
"Our most striking finding was that Internet searching appears to engage a greater extent of neural circuitry that is not activated during reading -- but only in those with prior Internet experience," said Small.
In fact, researchers found that during Web searching, volunteers with prior experience registered a twofold increase in brain activation when compared with those with little Internet experience. The tiniest measurable unit of brain activity is called a voxel. Scientists discovered that during Internet searching, those with prior experience sparked 21,782 voxels, compared with only 8,646 voxels for those with less experience.
Compared with simple reading, the Internet's wealth of choices requires that people make decisions about what to click on to pursue more information, an activity that engages important cognitive circuits in the brain.

Drinking alcohol associated with smaller brain volume: study

WASHINGTON, Oct 13, 2008 (Xinhua via COMTEX) -- The more alcohol an individual drinks, the smaller his or her total brain volume, according to a report in the October issue of U.S. journal Archives of Neurology.
Brain volume decreases with age at an estimated rate of 1.9 percent per decade, accompanied by an increase in white matter lesions, according to background information in the article.
Lower brain volumes and larger white matter lesions also occur with the progression of dementia and problems with thinking, learning and memory. Moderate alcohol consumption has been associated with a lower risk of cardiovascular disease; because the brain receives blood from this system, researchers have hypothesized that small amounts of alcohol may also attenuate age- related declines in brain volume.
Researchers from Wellesley College, Mass., and colleagues studied 1,839 adults (average age 60). Between 1999 and 2001, participants underwent magnetic resonance imaging (MRI) and a health examination. They reported the number of alcoholic drinks they consumed per week, along with their age, education and other factors.
"Most participants reported low alcohol consumption, and men were more likely than women to be moderate or heavy drinkers," the authors write. "There was a significant negative linear relationship between alcohol consumption and total cerebral brain volume."
Although men were more likely to drink alcohol, the association between drinking and brain volume was stronger in women, they note. This could be due to biological factors, including women's smaller size and greater susceptibility to alcohol's effects.
"The public health effect of this study gives a clear message about the possible dangers of drinking alcohol," the authors write. "Prospective longitudinal studies are needed to confirm these results as well as to determine whether there are any functional consequences associated with increasing alcohol consumption."
This study suggests that, unlike the associations with cardiovascular disease, alcohol consumption does not have any protective effect on brain volume.

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