Obesity, depression linked in teen girls, new study shows

Depression and obesity have long been associated, but how they relate over time is less clear. New research from a Rutgers University-Camden professor shows that adolescent females who experience one of the disorders are at a greater risk for the other as they get older.”Adolescence is a key developmental period for both obesity and depression, so we thought it significant to look at the onset of these disorders at an early age,” says Naomi Marmorstein, an associate professor of psychology at Rutgers-Camden.By assessing a statewide sample of more than 1,500 males and females in Minnesota over a period of more than 10 years, Marmorstein and two colleagues found that depression occurring by early adolescence in females predicts obesity by late adolescence.Meanwhile, obesity that occurs by late adolescence in females predicts the onset of depression by early adulthood. No significant associations between the two disorders across time were found in males during the study.Marmorstein’s article, “Obesity and depression in adolescence and beyond: reciprocal risks,” was recently published in the International Journal of Obesity. She co-authored the study with University of Minnesota psychology professor William Iacono and research associate Lisa Legrand.”When researchers looked at this connection over time, data had been mixed,” Marmorstein says. “Some found that depression and obesity go hand-in-hand, while others did not see that connection. We tried to take the next step in clarifying this link by looking at a sample of youth that we followed from ages 11 to 24.”This method improves on past research that included recurrence or persistence of depression and obesity rather than focusing on the onset of each disorder. Participants in Marmorstein’s study were assessed at ages 11, 14, 17, 20, and 24 by using height and weight measurements and clinical, interview-based diagnosis of major depressive disorder. The researchers looked specifically for onsets of either disorder by age 14, between the ages of 14 and 20, and between ages 20 and 24.Marmorstein emphasizes that this study was not designed to investigate the reasons for these associations, but other theories and research speaks to possible explanations. She says depression can lead to obesity through an increased appetite, poor sleep patterns, and lethargy, while obesity can cause depression due to weight stigma, poor self-esteem, and reduced mobility.”When a person is young, she is still developing eating and activity patterns, as well as coping mechanisms,” Marmorstein explains. “So if she experiences a depressive episode at age 14, she may be more at risk for having an onset of unhealthy patterns that persist.”The Rutgers-Camden scholar says a child who is obese may be more susceptible to negative societal messages about obesity or teasing, which could contribute to depression.”At this age, adolescents are starting to establish relationships becoming self-conscious, so teasing can be particularly painful,” Marmorstein says.She says prevention efforts aimed at both of these disorders at the same time when one of them is diagnosed in adolescents might help in decreasing their prevalence and comorbidity.”When an adolescent girl receives treatment for depression, the clinician might consider incorporating something relating to healthy eating and activity,” she says. …

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Blood poisoning increases the risk of blood clots, new research shows

Every year, almost 10,000 Danes are admitted to hospital with blood poisoning, while more than 3,000 patients become infected while they are hospitalized. New research shows that Danes suffering from blood poisoning risk an extra challenge in the form of an increased risk of suffering a blood clot:”We have followed more than 4,000 people who have been admitted with blood poisoning. The study shows that the risk of suffering a blood clot in either the brain or the heart is twice as high for patients with blood poisoning in relation to other patients who are also admitted with acute illnesses,” says Michael Dalager-Pedersen , PhD student at Aarhus University and Registrar at Aalborg University Hospital. He has carried out the study in collaboration with colleagues from Aarhus University, Aarhus University Hospital, and Aalborg University Hospital.The risk of a blood clot was highest within the first 30 days after the infection, where the risk was 3.6 percent against 1.7 percent for the other acutely admitted patients, and only 0.2 percent among the population in general.The study has just been published in Circulation.In recent years there has been a growing level of interest for the correlation between the risk of blood clots and infections such as blood poisoning. The researchers hope that the new knowledge can be utilized to ensure better prevention and earlier treatment. “It is important that we have now documented that there is a clear correlation between blood poisoning and blood clots. The new knowledge can be used by the medical doctors to increase focus on this patient group so they can begin relevant treatment quicker,” says Reimar Wernich Thomsen from the Department of Clinical Epidemiology at Aarhus University and Aarhus University Hospital.He explains that the correlation may, among other things, be due to the fact that the blood clots arise due to the increased strain on the heart and blood vessels that the infection causes.Story Source:The above story is based on materials provided by Aarhus University. Note: Materials may be edited for content and length.

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Frequent school moves can increase the risk of psychotic symptoms in early adolescence

Researchers at Warwick Medical School have shown that frequently changing schools during childhood can increase the risk of psychotic symptoms in later years.The study, published in American Academy of Child and Adolescent Psychiatry, found that school mobility during childhood heightens the risk of developing psychotic-like symptoms in early adolescence by up to 60%.Suffering from psychotic-like symptoms at young age is strongly associated with mental health problems in adulthood, including psychotic disorders and suicide.Professor Swaran Singh, who led the study, explained, “Changing schools can be very stressful for students. Our study found that the process of moving schools may itself increase the risk of psychotic symptoms — independent of other factors. But additionally, being involved in bullying, sometimes as a consequence of repeated school moves, may exacerbate risk for the individual.”At the age of 12, participants in the study were interviewed to assess for the presence of psychotic-like symptoms including hallucinations, delusions and thought interference in the previous six months. Those that had moved school three or more times were found to be 60% more likely to display at least one definite psychotic symptom.The authors suggested that moving schools often may lead to feelings of low self-esteem and a sense of social defeat. This feeling of being excluded from the majority could also render physiological consequences leading to sensitisation of the mesolimbic dopamine system, heightening the risk of psychotic-like symptoms in vulnerable individuals.Dr Cath Winsper, Senior Research Fellow at Warwick Medical School and part of the study group said, “It’s clear that we need to keep school mobility in mind when clinically assessing young people with psychotic disorders. It should be explored as a matter of course as the impact can be both serious and potentially long lasting. Schools should develop strategies to help these students to establish themselves in their new environment.”Story Source:The above story is based on materials provided by University of Warwick. Note: Materials may be edited for content and length.

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Smoking linked with increased risk of most common type of breast cancer

Young women who smoke and have been smoking a pack a day for a decade or more have a significantly increased risk of developing the most common type of breast cancer. That is the finding of an analysis published early online in Cancer, a peer-reviewed journal of the American Cancer Society. The study indicates that an increased risk of breast cancer may be another health risk incurred by young women who smoke.The majority of recent studies evaluating the relationship between smoking and breast cancer risk among young women have found that smoking is linked with an increased risk; however, few studies have evaluated risks according to different subtypes of breast cancer.To investigate, Christopher Li, MD, PhD, of the Fred Hutchinson Cancer Research Center in Seattle, and his colleagues conducted a population-based study consisting of 778 patients with estrogen receptor positive breast cancer and 182 patients with triple-negative breast cancer. Estrogen receptor positive breast cancer is the most common subtype of breast cancer, while triple-negative breast cancer is less common but tends to be more aggressive. Patients in the study were 20 to 44 years old and were diagnosed from 2004-2010 in the Seattle-Puget Sound metropolitan area. The study also included 938 cancer-free controls.The researchers found that young women who were current or recent smokers and had been smoking a pack a day for at least 10 years had a 60 percent increased risk of estrogen receptor positive breast cancer. In contrast, smoking was not related to a woman’s risk of triple-negative breast cancer.”The health hazards associated with smoking are numerous and well known. This study adds to our knowledge in suggesting that with respect to breast cancer, smoking may increase the risk of the most common molecular subtype of breast cancer but not influence risk of one of the rarer, more aggressive subtypes,” said Dr. Li.Story Source:The above story is based on materials provided by Wiley. Note: Materials may be edited for content and length.

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Social or stinky? New study reveals how animal defenses evolve

When people see a skunk, the reaction usually is “Eww,” but when they see a group of meerkats peering around, they often think “Aww.”Why some animals use noxious scents while others live in social groups to defend themselves against predators is the question that biologists Tim Caro of the University of California, Davis and Theodore Stankowich of California State University, Long Beach and sought to answer through a comprehensive analysis of predator-prey interactions among carnivorous mammals and birds of prey.Their findings appear in the online edition of the journal Evolution.”The idea is that we’re trying to explain why certain antipredator traits evolved in some species but not others,” said Stankowich, who noted that this study not only explains why skunks are stinky and why banded mongooses live in groups but also breaks new ground in the methodology of estimating predation risks.Caro, Stankowich and Paul Haverkamp, a geographer who recently completed his Ph.D. at UC Davis, collected data on 181 species of carnivores, a group in which many species are small and under threat from other animals. They ran a comparison of every possible predator-prey combination, correcting for a variety of natural history factors, to create a potential risk value that estimates the strength of natural selection due to predation from birds and other mammals.They found that noxious spraying was favored by animals that were nocturnal and mostly at risk from other animals, while sociality was favored by animals that were active during the day and potentially vulnerable to birds of prey.”Spraying is a good close-range defense in case you get surprised by a predator, so at night when you can’t detect things far away, you might be more likely to stumble upon a predator,” Stankowich said.Conversely, small carnivores like mongooses and meerkats usually are active during the day which puts them at risk from birds of prey. Living in a large social group means “more eyes on the sky” in daytime, when threats can be detected further away.The social animals also use other defenses such as calling out a warning to other members of their group or even mobbing together to bite and scratch an intruder to drive it away.The project was a major information technology undertaking involving plotting the geographic range overlap of hundreds of mammal and bird species, but will have long-term benefits for ongoing studies. The researchers plan to make their database, nicknamed the “Geography of Fear,” available to other researchers.Story Source:The above story is based on materials provided by University of California – Davis. Note: Materials may be edited for content and length.

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Stress may lead to false confessions

Sep. 11, 2013 — Imagine if you were wrongly accused of a crime. Would you be stressed? Anyone would be, but Iowa State University researchers found the innocent are often less stressed than the guilty. And that could put them at greater risk to admit to a crime they didn’t commit.To better understand what leads to false confessions, Max Guyll, an assistant professor of psychology, and Stephanie Madon, an associate professor of psychology, measured various indicators of stress, such as blood pressure, heart rate and nervous system activity. In the study, published in Law and Human Behavior, stress levels increased for all participants when they were first accused. However, the levels for those wrongly accused were significantly lower. Researchers said that’s a concern because it can make the innocent less likely to vigorously defend themselves in a real interrogation.”The innocent are less stressed because they believe their innocence is going to protect them and they think everything is going to be OK, so there is no reason to get worked up over this accusation,” Madon said. “But if you’re going into a police interrogation and you’re not on your guard, then you could make decisions that down the line will put you at risk for a false confession. Because once you talk to police, you’re opening up the chance that they’re going to use manipulative and coercive tactics.”Minimization is one of those tactics used in interrogations and the tactic Madon and Guyll used in their study. …

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Five percent of US children, teens classified as ‘severely obese’

Sep. 9, 2013 — About 5 percent of U.S. children and teens are “severely obese” — a newly defined class of risk, according to an American Heart Association scientific statement published online in the journal Circulation.”Severe obesity in young people has grave health consequences,” said Aaron Kelly, Ph.D., lead author of the statement and a researcher at the University of Minnesota Medical School in Minneapolis. “It’s a much more serious childhood disease than obesity.”While childhood obesity rates are starting to level off, severe obesity has increased, Kelly said.Severely obese children have higher rates of type 2 diabetes and cardiovascular issues at younger ages, including high blood pressure, high blood cholesterol and early signs of atherosclerosis -the disease process that clogs arteries.Treatment options for children with this level of obesity are limited, as most standard approaches to weight loss are insufficient for them.The statement defines children over age 2 as severely obese if they either have a body mass index (BMI) that’s at least 20 percent higher than the 95th percentile for their gender and age, or a BMI score of 35 or higher. A child in the 95th percentile weighs more than 95 percent of other children of the same gender and age.BMI is a measurement based on weight and height. Age- and gender-specific growth charts are used to calculate BMI for children. Children at the 95th BMI percentile or higher are obese, and those between the 85th and 95th percentiles are overweight.A 7-year-old girl of average height weighing 75 pounds, or a 13-year-old boy of average height weighing 160 pounds, would be defined as severely obese.Most experts recommend a step-wise approach for treating severely obese children, with treatment getting gradually more intensive from lifestyle changes, to medication and potentially surgery.”But the step from lifestyle change and medication to surgery is unacceptably large because weight loss surgery isn’t appropriate for or available to all severely obese children,” Kelly said.The statement calls for “innovative approaches to fill the gap between lifestyle/medication and surgery.”The statement suggests ways to close the gap, including:conduct more research on bariatric surgery’s effects and safety; evaluate effectiveness of lifestyle modification interventions, including adherence to dietary and physical activity plans; fund research to find other useful interventions, including better drugs and medical devices; and recognize severe obesity as a chronic disease requiring ongoing care and management.

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Obese teenagers who lose weight are at risk for developing eating disorders

Sep. 5, 2013 — Obese teenagers who lose weight are at risk of developing eating disorders such as anorexia nervosa and bulimia nervosa, Mayo Clinic researchers imply in a recent Pediatrics article. Eating disorders among these patients are also not being adequately detected because the weight loss is seen as positive by providers and family members.In the article, Mayo Clinic researchers argue that formerly overweight adolescents tend to have more medical complications from eating disorders and it takes longer to diagnose them than kids who are in a normal weight range. This is problematic because early intervention is the key to a good prognosis, says Leslie Sim, Ph.D., an eating disorders expert in the Mayo Clinic Children’s Center and lead author of the study.Although not widely known, individuals with a weight history in the overweight (BMI-for-age greater than or equal to the 85th percentile but less than the 95th percentile, as defined by CDC growth chart) or obese (BMI-for-age greater than or equal to the 95th percentile, as defined by the CDC growth chart) range, represent a substantial portion of adolescents presenting for eating disorder treatment, says Dr. Sim.”Given research that suggests early intervention promotes best chance of recovery, it is imperative that these children and adolescents’ eating disorder symptoms are identified and intervention is offered before the disease progresses,” says Dr. Sim.This report analyzes two examples of eating disorders that developed in the process of obese adolescents’ efforts to reduce their weight. Both cases illustrate specific challenges in the identification of eating disorder behaviors in adolescents with this weight history and the corresponding delay such teenagers experience accessing appropriate treatment.At least 6 percent of adolescents suffer from eating disorders, and more than 55 percent of high school females and 30 percent of males report disordered eating symptoms including engaging in one or more maladaptive behaviors (fasting, diet pills, vomiting, laxatives, binge eating) to induce weight loss.Eating disorders are associated with high relapse rates and significant impairment to daily life, along with a host of medical side effects that can be life-threatening, says Dr. Sim.

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Chlamydia and gonorrhoea infections linked to pregnancy complications

Sep. 4, 2013 — Becoming infected with chlamydia or gonorrhoea in the lead-up to, or during, pregnancy, increases the risk of complications, such as stillbirth or unplanned premature birth, indicates research published online in the journal Sexually Transmitted Infections.The researchers analysed the birth records of more than 350,000 women who had had their first baby between 1999 and 2008 in New South Wales, Australia’s most heavily populated state.The researchers wanted to find out if infection with either chlamydia or gonorrhoea in the lead-up to, or during, pregnancy, had any impact on the baby or the birth itself, as there is continuing debate about whether these infections can increase the risk of complications.The women’s birth records were linked back to state records about notifiable conditions, such as chlamydia and gonorrhoea.Among the 354,217 women who had had their first child between 1999 and 2008, 3658 (1%) had had at least one notifiable chlamydia infection before the birth. And most (81%) of these had been diagnosed before the estimated date of conception.Just 196 (0.6%) had been diagnosed with gonorrhoea before the birth, with most diagnoses (just under 85%) made before the estimated conception date.Half of those diagnosed with gonorrhoea had also previously been infected with chlamydia.In all, 4% of the women had an unplanned premature birth; 12% had babies who were small for dates; and 0.6% (2234) of the babies were stillborn.Factors such as age, social disadvantage, smoking, and underlying conditions, such as diabetes and high blood pressure, can all increase the risk of birth complications, and this was evident among the women studied.But even after taking account of all these influential factors, women who had had a prior infection with either chlamydia or gonorrhoea were still at heightened risk.Women who had had chlamydia were not at increased risk of giving birth to a small for dates baby. But they were 17% more likely to have an unplanned premature birth and 40% more likely to have a stillborn baby.Women who had had gonorrhoea were more than twice as likely to have an unplanned premature birth, but they were not at increased risk of giving birth to a small for dates baby.There were too few women with a previous diagnosis of gonorrhoea to be able to assess the impact of the infection to stillbirth.For women previously diagnosed with chlamydia, the risk of an unplanned premature birth did not differ between those diagnosed more than a year before conception, within a year of conception, or during the pregnancy.The authors caution that their findings don’t allow them to prove cause and effect. The infections may simply be a marker for women at high risk of birth complications.And while there is some evidence to suggest that chronic inflammation―such as would arise particularly with chlamydia infection―can trigger an unplanned premature birth, trials of prophylactic antibiotics given to women during pregnancy, have not lowered this risk.Nevertheless, the authors conclude: “Our results suggest that sexually transmissible infections in pregnancy and the preconception period may be important in predicting adverse obstetric outcomes.”

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Combination of social media, behavior psychology leads to HIV testing, better health behaviors

Sep. 6, 2013 — Can social media be used to create sustainable changes in health behavior?A UCLA study published Sept. 3 in the peer-reviewed journal Annals of Internal Medicine demonstrates that an approach that combines behavioral science with social media and online communities can lead to improved health behaviors among men at risk of HIV infection.The evidence-based approach not only led to increased HIV testing and encouraged significant behavioral change among high-risk groups but also proved to be one of the best HIV-prevention and testing approaches on the Internet, according to the study’s lead investigator, Sean D. Young, an assistant professor of family medicine and director of innovation at the Center for Behavior and Addiction Medicine at the David Geffen School of Medicine at UCLA.And it’s not only applicable to HIV prevention efforts, he noted.”We found similar effects for general health and well-being,” said Young, who is also a member of the UCLA AIDS Institute. “Because our approach combines behavioral psychology with social technologies, these methods might be used to change health behaviors across a variety of diseases.”In an earlier study, published in February and also led by Young, researchers found that social media could be useful in HIV- and STD-prevention efforts by increasing conversations about HIV prevention.For the current study, the researchers recruited 112 men who have sex with men through banner ads placed on social networking sites like Facebook, through a Facebook fan page with study information, through banner ads and posts on Craigslist, and from venues such as bars, schools, gyms and community organizations in Los Angeles. Of the participants, 60 percent were African-American, 28 percent were Latino, 11 percent were white and 2 percent were Asian-American.The men were randomly assigned to one of two Facebook discussion groups — an HIV intervention group or a general health group (with the latter serving as a control in the study). Each participant was then randomly assigned to two “peer leaders” within their group. The peer leaders communicated with participants by sending messages, chats and wall posts.In addition to general conversation, peer leaders for the HIV group discussed HIV prevention and testing, while those in the control group communicated about the importance of exercising, eating right and maintaining a low-stress lifestyle.While the men were under no obligation to engage with the peer leaders or other participants or to even remain members of their respective Facebook groups, the authors found that the participants were highly engaged and maintained active participation during the 12-week study.Throughout the study, the men were able to request and receive home-based HIV self-testing kits. At baseline and again after 12 weeks, participants completed a 92-item survey that included questions about their Internet and social media use (including whether they discussed health and sexual risk behaviors), their general health behaviors (including exercise and nutrition), and their sex and sexual health behaviors (including HIV testing and treatment).Among other things, the researchers looked for evidence of behavioral change — such as reductions in the number of sexual partners — and requests for home-based HIV test kits, along with follow-ups to obtain test results.Among the findings:95 percent of the intervention group participants voluntarily communicated on Facebook, as did 73 percent of the controls. 44 percent (25 of 57) of the members of the intervention group requested the testing kits, compared with 20 percent (11 of 55) of the controls. …

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Childhood adversity linked to higher risk of early death

Sep. 4, 2013 — Traumatic childhood experiences are linked to an increased risk of early death, according to new research using data from the 1958 National Child Development Study.The research, led by the French National Institute of Health and Medical Research (INSERM), in collaboration with the ESRC International Centre for Lifecourse Studies in Society and Health at UCL, found that men and women who had suffered adversity in childhood were more likely to die before age of 50 than those who had not.The researchers compared premature death rates among more than 15,000 people to their experiences of adversity at ages 7, 11 and 16. This included spending time in care, suffering from neglect, parental separation or having a family member in prison.For women, the likelihood of dying before age 50 increased with the amount of adversity they had suffered in childhood. Women who had suffered one negative experience by age 16 were 66 per cent more likely to die before the age of 50 than those who had not faced any adversity. Women who had two or more adverse experiences in childhood had an 80 per cent increased risk of premature death.Men who had suffered two or more traumatic events in childhood were 57 per cent more likely to die by the time they were 50 than those who had not experienced any adversity growing up.The association between childhood adversity and premature death remained even after taking into account factors such as education level and social class, alcohol and tobacco use, and psychological problems in early adulthood.The researchers note that some causes of death in early adult life are related to mental stress, such as suicide or addiction to alcohol or drugs. However, they also suggest that children who suffer severe stress may experience imbalances in their hormone and immune systems that impact on their physical development and later health.For the first time in any study, the longitudinal nature of the data made it possible to link the risk of early death to experiences of adversity that have been recorded during childhood, rather than relying on adult recollections of early life experiences.Professor Mel Bartley, one of the UCL authors of the study, says: “Our Centre has been collaborating with public health researchers at INSERM to enable them to use unique British birth cohort data to test their ideas.”This work on early psychological trauma and premature death adds a whole new dimension to public health. It shows that if we are going to ensure better health in the population the work needs to begin early in life to support children experiencing severe adversities. Many people have suspected this but until now we have not had such high quality evidence from such a large cohort of people.”

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Can you predict complications with back surgery? Preoperative factors increase risk

Sep. 3, 2013 — For older adults undergoing surgery for spinal stenosis, some simple indicators of poor preoperative health predict a high risk of major medical complications, reports a study in the September 1 issue of Spine. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.In combination, these risk factors may help in identifying patients at increased risk of heart attack and other serious events after spinal stenosis surgery, according to the report by Dr Richard A. Deyo and colleagues of Oregon Health and Science University, Portland. They write, “These factors may help in selecting patients and planning procedures, improving patient safety.”Information on Risk Factors for Major Medical ComplicationsThe researchers analyzed data on more than 12,000 patients undergoing surgery for spinal stenosis in the lower (lumbar) spine at Veterans Affairs (VA) medical centers between 1998 and 2009. Patients with spinal stenosis have narrowing of the spinal canal, causing back pain, leg pain, and other symptoms. It is the most common reason for spine surgery in older adults.The analysis focused on identifying risk factors for major medical complications such as myocardial infarction, stroke, pneumonia, and sepsis. The overall rate of such major medical complications was 2.1 percent, along with a 0.6 percent risk of death within 90 days. By comparison, the rate of surgical wound-related complications was 3.2 percent.Risk of major medical complications increased steadily with age: from less than one percent for patients under 50 to four percent for those aged 80 or older. In contrast, the risk of wound complications was similar across age groups.A key risk factor for was the American Society of Anesthesiologists (ASA) class — a standard score for assessing patients’ fitness for surgery. …

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Stressful life events significantly raise the risk of falls in older men

Sep. 3, 2013 — A study of around 5,000 older men has shown that stressful life events such as death of a loved one, or serious financial problems, significantly raised the risk of falls in the year following the incident. The research is published online today in the journal Age and Ageing.Dr Howard A. Fink of the VA Medical Center in Minneapolis and colleagues conducted a study of 5,994 community-dwelling men over the age of 65 who were enrolled in the Osteoporotic Fractures in Men (MrOS) study in six locations across the United States. 5,125 participated in a second study visit and answered questions on stressful life events in the prior year. A further subset of 4,981 men reported complete data on falls for one year after the second visit.During the second visit, participants were asked their marital status, and if widowed, their spouse’s date of death. They were also asked to report occurrence of any of the following stressful life events: serious illness or accident of wife/partner; death of other close relative or close friend; separation from child, close friend, or other relative on whom the participant depended on for help; loss of pet; given up important hobby or interest; serious financial trouble; move or change in residence. Following the second visit, the participants were contacted every four months for one year regarding falls or fractures. Any fractures were confirmed by central review of radiography reports. Overall response rates exceeded 99%.Among the 4,981 men with complete stressful life event and falls data, 27.7% fell and 14.7% fell multiple times during the year after visit two. …

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Mediterranean diet is good for the mind, research confirms

Sep. 3, 2013 — The first systematic review of related research confirms a positive impact on cognitive function, but an inconsistent effect on mild cognitive impairment.Over recent years many pieces of research have identified a link between adherence to a Mediterranean diet and a lower risk of age-related disease such as dementia.Until now there has been no systematic review of such research, where a number of studies regarding a Mediterranean diet and cognitive function are reviewed for consistencies, common trends and inconsistencies.A team of researchers from the University of Exeter Medical School, supported by the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care in the South West Peninsula (NIHR PenCLAHRC), has carried out the first such systematic review and their findings are published in Epidemiology.The team analysed 12 eligible pieces of research, 11 observational studies and one randomised control trial. In nine out of the 12 studies, a higher adherence to a Mediterranean diet was associated with better cognitive function, lower rates of cognitive decline and a reduced risk of Alzheimer’s disease.However, results for mild cognitive impairment were inconsistent.A Mediterranean diet typically consists of higher levels of olive oil, vegetables, fruit and fish. A higher adherence to the diet means higher daily intakes of fruit and vegetables and fish, and reduced intakes of meat and dairy products.The study was led by researcher Iliana Lourida. She said: “Mediterranean food is both delicious and nutritious, and our systematic review shows it may help to protect the ageing brain by reducing the risk of dementia. While the link between adherence to a Mediterranean diet and dementia risk is not new, ours is the first study to systematically analyse all existing evidence.”She added: “Our review also highlights inconsistencies in the literature and the need for further research. In particular research is needed to clarify the association with mild cognitive impairment and vascular dementia. It is also important to note that while observational studies provide suggestive evidence we now need randomized controlled trials to confirm whether or not adherence to a Mediterranean diet protects against dementia.”

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Surprising result: Risk factors for cardiovascular problems found to be inverse to disease and deaths

Sep. 2, 2013 — Despite living with the highest risk factors for heart disease, people in high income countries suffer less from serious cardiovascular disease, says an international study by the global PURE (Prospective Urban Rural Epidemiology ) collaboration and led by McMaster University researchers.At the same time, the study found that people in low income countries, although living with fewer risk factors for heart disease, have a higher incidence of serious cardiovascular disease including death.”These findings were a total surprise,” says Dr. Salim Yusuf, lead author of the study being presented to the European Society of Cardiology today. Yusuf is also a professor of medicine of McMaster’s Michael G. DeGroote School of Medicine, vice president of research at the Hamilton Health Sciences and director of the Population Health Research Institute (PHRI).The study followed 155,000 people from 628 urban and rural communities in 17 countries over four continents for nearly four years.The international research team found risk factors for cardiovascular disease was lowest in low income countries, intermediate in middle income countries and highest in high income countries. However, the incidence of serious cardiovascular disease such as heart attacks, strokes, heart failure and deaths followed the opposite pattern: highest in the low income countries, intermediate in middle income countries and lowest in high income countries. Hospitalizations for less severe cardiovascular diseases were highest in the high income countries.”These results in the high income countries are likely due to earlier detection of disease, better hospital management of the disease and better prevention after an event,” said Yusuf. “While efforts to reduce the risk factors need to be pursued, there should be a major additional focus on strengthening health care systems.”Co-author Dr. Koon Teo, a professor of medicine of McMaster’s Michael G. DeGroote School of Medicine and at the Population Health Research Institute, agreed: “PURE emphasizes how important access to good health care is likely to be, as the differences in mortality rates between the richest and poorest countries are three-fold.””The study is important,” said co-author Dr. …

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Peru: Liver cancer like no other

Sep. 2, 2013 — Liver cancer is the sixth most common cancer worldwide and the third most deadly. It mainly affects men over the age of 40, most often with cirrhosis or hepatitis B or C. But in Peru, it also uncharacteristically affects young people, even children, who do not have the identified related risk factors. An anomaly that IRD researchers and their partners recently revealed in PLoS One. The Franco-Peruvian team highlights a disturbing fact: these patients, with an average age of 25, come from the same geographical area in the Andes.Very young patientsTo make up for the lack of knowledge on liver cancer in Latin America, the researchers performed a statistical analysis of clinical cases of the disease in Peru, the country reputed to have the highest incidence on the continent. They sifted through the demographic characteristics, risk factors and causes for more than 1,500 patients from throughout the country, admitted between 1997 and 2010 at the Instituto Nacional de Enfermedades Neoplásicas (Inen ) in Lima. Their results were unexpected: 50% of the people affected do not at all match the profile of those at risk. They are young people with an average age of 25, some even children, who for the most part do not have the hepatitis B or C virus nor do they suffer from cirrhosis. In addition, a third of those affected are women, contrary to findings elsewhere in the world, where the sex ratio is much more uneven. …

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Maternal posttraumatic stress disorder associated with increased risk for child maltreatment

Sep. 2, 2013 — Posttraumatic stress disorder (PTSD) in mothers appears to be associated with an increased risk for child maltreatment beyond that associated with maternal depression, according to a study published by JAMA Pediatrics, a JAMA Network publication.The psychopathology of a caregiver is understood to be an important risk factor for child maltreatment and maternal depression is associated with an increased use of corporal punishment and physical abuse of children. Until recently, research on maternal depression and maltreatment risk has largely ignored the high rate of comorbidity between depression and PTSD. The National Comorbidity Survey suggests that 24.7 percent of depressed women have PTSD and that 48.4 of women with PTSD have depression, according to the study background.Claude M. Chemtob, Ph.D., of the NYU School of Medicine, and colleagues examined the association of probable maternal depression, PTSD and comorbid PTSD and depression with the risk for child maltreatment and parenting stress and with the number of traumatic events that preschool children are exposed to.The study included 97 mothers of children ages 3 to 5 years old. About half of the children were boys.The children of mothers with PTSD (mean number of events the child was exposed to, 5) or with comorbid PTSD and depression (3.5 events) experienced more traumatic events than those of mothers with depression (1.2 events) or neither disorder (1.4 events). When PTSD symptom severity scores were high, psychological aggression and the number of traumatic events children experienced increased. Depressive symptom severity scores also were associated with the risk for psychological aggression and exposure to traumatic events only when PTSD symptom severity scores were low, according to the study results.”Mothers in the comorbid group reported the highest levels of physically and psychologically abusive behaviors and overall parenting stress. Although not statistically significant, mothers with depression alone showed a trend toward endorsing more physically abusive and neglectful parenting behaviors,” the study concludes. “Given the high comorbidity between PTSD and depression, these findings suggest the importance of measuring PTSD symptoms when considering the relationship between depression and increased risk for child maltreatment.”

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Physical activity decreases sudden cardiac death risk in unfit men

Sep. 1, 2013 — Physical activity decreases the risk of sudden cardiac death in unfit men, reveals research presented at the ESC Congress today by Dr Jari Laukkanen and Dr Magnus Hagnas from Finland.Dr Laukkanen said: “Sudden cardiac death (SCD) accounts for approximately 50% of deaths from coronary heart disease. SCD typically occurs shortly after the onset of symptoms, leaving little time for effective medical interventions, and most cases occur outside hospital with few or no early warning signs. Finding ways to identify individuals at elevated risk of SCD would allow early interventions on risk factors to be implemented.” The current study investigated the impact of high leisure-time physical activity (LTPA) combined with cardiorespiratory fitness (CRF) on risk of SCD. It included 2,656 randomly selected men aged 42 to 60 years from the Kuopio Ischemic Heart Disease Risk Factor Study, a Finnish study of risk predictors for cardiovascular outcomes and SCD in the general population. Baseline cycle exercise test and risk factor assessment were performed in 1984-89. SCD was defined as death with cardiac origin within 24 hours after onset of symptoms.LTPA was assessed using a 12-month physical activity questionnaire. One third of subjects had low LTPA (energy consumption <191 kcal/day, equal to around 35 minutes of slow walking or 25 minutes of jogging for a 70 kg male). CRF was assessed with a maximal symptom limited cycle exercise test and peak oxygen uptake was calculated in metabolic equivalents (MET). One third of men had a low CRF (<7.9 METs).</p>For the analyses the study population was divided into 4 groups: 1) high CRF and high LTPA, 2) high CRF and low LTPA, 3) low CRF and high LTPA and 4) low CRF and low LTPA. …

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Family history doubles aortic stenosis risk

Sep. 1, 2013 — Aortic stenosis is the most common heart valve disease in the elderly. It is associated with congenital bicuspid aortic valve and previous rheumatic heart disease, but is also often caused by calcification of a normal valve. Calcification of a normal valve may be associated with atherosclerotic changes in the portion of the aorta closest to the valve.Dr Ranthe said: “Genetic factors may play a role in the development of aortic stenosis. A single nucleotide polymorphism in the lipoprotein(a) locus has been associated with aortic valve calcification and aortic stenosis.1 Elevated lipoprotein(a) is a risk factor for atherosclerosis, including ischaemic heart disease, which is known to aggregate in families. Our aim was to discover whether aortic stenosis also aggregates in families.”The study used information from national Danish registers and included the 4.2 million Danes born in or after 1920. The cohort was followed for more than 73 million person-years, starting in 1977 (the year the Danish Hospital Discharge Register began) and ending in 2012. Cases of aortic stenosis were recorded when they occurred at age 35 years or older.Patients with any registration of a congenital heart defect and those with cardiovascular disease diagnosed at <35 years were excluded. Family history was defined as a first degree relative registered with aortic stenosis before the cohort member.</p>During the study period 29,983 patients were registered with aortic stenosis at age >35 years. Of those, 193 had a first degree relative with aortic stenosis and the relative risk was 2.04 (95% confidence interval [CI] 1.77-2.35). …

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