New research digs into the interplay between the way parents feed their children and emotional eating by parents and children, as well as the influence the parent’s gender has on that association.

Most people are familiar with using food as a way to get through a trying time. Known as emotional eating, for some it can be a perfectly appropriate strategy for managing hard feelings, but for others it also can become a problematic way to cope.

The goal of the new research was to better understand how child emotional eating develops and inform interventions that aim to prevent such behaviors from becoming unhealthy.

The study surveyed Oregon parents and asked how often they and their child engage in emotional eating. The researchers then explored what roles three different feeding practices parents typically use with their children might play.

Those include limiting a child’s food intake, or restrictive eating; using food to help change a child’s emotions, known as emotion regulation; and using food to punish or reward child behavior, called instrumental feeding.

“We were really interested in comparing different ways that parents feed their children and whether those feeding practices accounted for some of the link between parent and child emotional eating,” says lead author Shaina Trevino, a graduate student in the College of Education at the University of Oregon who was the lead author of the study.

“That link between parent and child emotional eating has been shown in the literature for quite some time now, and so we were really looking to see, in general, how do parents feed their child and how that influences the relationship between parent and child emotional eating,” Trevino adds.

And even though that link has been previously established, the study is the first to examine the role each feeding practice might play in the emotional eating as well as the role of a parent’s gender.

“Because we did have this sample of both mothers and fathers, which is kind of rare in this type of literature—a lot of the literature is only on mothers—we really wanted to dig into that a little bit more and look at how gender influences those relations, too,” Trevino says.

They discovered that, overall, restrictive eating was the only feeding practice that linked parent and child emotional eating.

“We actually found that restriction accounted for the relationship of parent-child emotional eating above and beyond those other factors,” Trevino says. “That was just unexpected.”

And when it came to mothers, restricting their children’s food intake and a mother’s own emotional eating were the key factors influencing kids’ tendency to eat emotionally.

“For mothers, it’s their emotional eating possibly being modeled to the children, or that children are maybe around them more or just are seeing it more often,” Trevino says.

For fathers, however, all three types of eating practices were found to play a role in emotional eating for their children.

“What that means is that feeding for behavioral reasons, feeding for emotion regulation reasons, and then the restrictions, those all accounted for the emotional eating relation,” Trevino says. “There was no longer an association between a father’s emotional eating and a child’s emotional eating that was not accounted for by how fathers feed their children.”

This study, which surveyed 324 mothers and 86 fathers, is more of an early exploratory look at the issue because of the lack of participation by fathers.

“The main takeaway of the study is that emotional eating and feeding practices are operating differently for both mothers and fathers, and that really should influence the research in this area,” Trevino says.

Another finding that jumped out at Trevino and should be further explored is that father feeding practices seemed to be more important in the relationship between child emotional eating and parent emotional eating than mothers, while mothers have had the majority of the spotlight in this area.

“I think this sheds an initial light on the fact that fathers matter, too, and maybe even more in this context of parent-child emotional eating and feeding practices,” Trevino says.

“There are a lot of caveats that we need to take with these data,” says Nicole Giuliani, a Health Promotion Initiative faculty member. “Because it’s hard for us to know why there are these differences, If it has to do with the sample itself or if it has to do with something larger about how eating and feeding practices influence child eating behavior in mothers versus fathers.”

And not all emotional eating is bad, notes Nichole Kelly, also a Health Promotion Initiative faculty member. The issue arises when people over-rely on it as a way of dealing with emotions.

“There’s probably a healthy level of emotional eating and then there’s probably not, and we’re not actually quite sure where that is yet,” she says.

Trevino says the research marks another step toward heading off any unhealthy behaviors before they take root.

“And that’s one of the reasons why we chose feeding practices as a potential mediator to account for that emotional eating relationship, because you can train parents to change the way that they’re feeding their child and make them more aware of those things,” Trevino says.

“And then hopefully by choosing something that you can intervene on, you are influencing the emotional eating. So the hope is that we can use this type of model to reduce unhealthy child emotional eating by influencing how parents are feeding their children.”

The research appears in Frontiers in Psychology.

Source: University of Oregon

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Three-quarters of parents whose children are hospitalized want to talk to a hospital staff member about the projected cost of their child’s medical care, but less than 10% of families have such conversations, a new study shows.

The finding boosts the argument that patients and their families need better access to financial counselors at hospitals, researchers say.

The study, published in JAMA Network Open, is the first large assessment of parents’ preferences about receiving financial counseling when their children are hospitalized. Researchers surveyed 526 parents of inpatients at six pediatric academic medical centers across the United States.

“Part of what we hope this paper will do is to serve as a wake-up call to say, ‘We have to better counsel families on the anticipated cost of their child’s care,'” says lead author Hannah Bassett, a clinical assistant professor of pediatrics.

The US medical system pricing is complex, making it difficult for patients and families to predict what hospital care is likely to cost them. The cost is often unclear to physicians, too. But hospital financial counselors can help estimate out-of-pocket costs by considering many factors—including treatments prescribed, the patient’s insurance coverage, and such circumstances as whether a family’s annual deductible has been met. Only 7% of families in the study had a conversation with a hospital staff member about costs during their child’s stay.

Talking about hospital costs

Prior studies of patients’ concerns about medical costs have focused on care for adults with cancer. Most cancer patients want to have advance conversations about the costs of their treatments, research shows, and many oncologists facilitate such conversations. But very little research has explored cost concerns among other populations.

The new study focused on parents of children whose hospital stays were nearly over. These parents completed detailed questionnaires about what they wanted to know regarding the costs of their child’s care, when and with whom they wanted to discuss these costs, and perceived barriers they had to discussing the topic. In addition, they were asked to describe any cost-related conversations they had during their child’s hospitalization.

The researchers requested information about parental income and education levels; family members’ race and ethnicity; financial matters, such as whether a family had existing medical debt or other financial struggles; whether the patient had public or private insurance; and the amounts of their insurance deductibles. They also collected basic information about the child’s hospitalization, including length of stay and whether the child was in an intensive care unit.

In addition to finding that 76% of families wanted to have conversations about medical costs, the research team saw that 75% of families had concerns about how much their child’s hospitalization would cost them. This included 32% who were moderately or very concerned.

Forty-nine percent of parents surveyed reported wanting doctors to consider costs when making medical decisions for their child, while 35% did not want doctors to consider the cost of treatments. About half of parents says they wanted to have cost conversations before their child received tests and treatments, whereas 10% says they never wanted to have these conversations.

“It was interesting that there were opposite poles,” says senior author, Alan Schroeder, a clinical professor of pediatric critical care and of pediatric hospital medicine. “There are quite a few people who want to talk about cost, but a nonzero proportion that really do not.

“For the latter, we need to further explore the barriers and determine whether there are any acceptable approaches to cost discussions. In the meantime, hospital staff should begin any cost conversations by simply asking parents if they are interested in more information.”

Accurate cost estimates are ‘nearly impossible’

The researchers found that the severity of a child’s illness and the characteristics of a family’s financial situation—such as their levels of income or medical debt—could not predict whether they wanted to discuss costs.

“That was surprising,” Bassett says. “This is a fairly widely held preference, and an important topic for anyone, regardless of their sociodemographic characteristics or the clinical characteristics of their child.”

Many families appeared to be unsure when or how to ask for the financial information they needed: Only 30% of study participants could recall a specific time during their child’s hospitalization when they wanted to have a conversation about costs, likely because such conversations have not traditionally been a part of the existing culture of medicine, the researchers say.

The researchers plan to continue studying preferences about cost conversations in other settings such as in emergency departments, where patients with high-deductible insurance plans are especially vulnerable to unpredictable costs.

They hope the new data will help convince leaders, administrators, and clinicians within the medical system to offer upfront conversations about costs to families of hospitalized children. Part of the challenge is that physicians typically don’t have the information at their fingertips to determine a patient’s out-of-pocket cost.

“As a doctor, I have a ballpark idea that an MRI costs more than an ultrasound, but there are so many factors that trickle down to a family’s bill—their deductible, their copay, if they have coinsurance, whether they’ve hit their yearly maximum, and so on—that even if I know in general what something costs, it’s nearly impossible to give an accurate estimate to a family,” Bassett says.

While some doctors believe that conversations about costs could be uncomfortable, in the United States, where patients have to pay for their care, most patients and their families are eager for the information, Schroeder says. “Physicians and patients are completely disconnected from the cost of care. This research is one step toward better understanding that disconnect and remedying it.”

Kristopher Kapphahn, a biostatistician at Stanford is a coauthor of the study. Additional coauthors are from Seattle Children’s Hospital; the University of Wisconsin School of Medicine and Public Health in Madison; Primary Children’s Hospital, University of Utah in Salt Lake City; Boston Children’s Hospital; Harvard Medical School; Children’s Hospital Colorado, University of Colorado-Denver; Cincinnati Children’s Hospital Medical Center, University of Cincinnati; and Texas Children’s Hospital, Baylor College of Medicine in Houston.

Source: Stanford University

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Heart attack survivors who used a smartphone app to navigate their recovery process for things like medication management and lifestyle changes, were less likely to be readmitted to the hospital within 30 days of discharge.

According to the study of 200 survivors, patients who used the app experienced hospital readmission at half the rate of a comparable group given standard aftercare without the app.

According to the American Heart Association, one in six patients hospitalized after a heart attack return to the hospital within 30 days of discharge due to some medical issue. Some experts estimate that about 75% of readmissions are preventable and are often a result of complications such as medication errors or poor compliance with diet and other lifestyle changes.

“Historically, we too often hand a stack of papers about very complicated guidance to patients and then expect them to significantly change their lives,” says Francoise Marvel, assistant professor in the division of cardiology and co-director of Johns Hopkins Digital Health Lab at the Johns Hopkins University School of Medicine. “There had to be a better way to treat a patient. We thought: What if we completely re-engineered the recovery process for those who have a heart attack?”

Marvel, along with Seth Martin, associate professor in the division of cardiology and co-director of the Johns Hopkins mTECH Center and Digital Health Lab at the Johns Hopkins University School of Medicine, led a multidisciplinary team of physicians, nurses, pharmacists, engineers, and public health experts, along with patients and families, to develop an app known as Corrie—a play on the word “cor,” the Latin word for “heart”—which launched in 2015.

The app can track a heart attack survivor’s heartbeat and daily activity by using a smartwatch, and track blood pressure by connecting to a wireless device. The app acts as a management tool that alerts users to take medications and schedule follow-up appointments, and it serves as a hub for patient education materials related to heart-healthy lifestyles.

A better option for heart attack survivors

Once the digital health intervention was developed, Marvel and Martin collaborated with Erin Spaulding, from the Johns Hopkins University School of Nursing, who had strong research interest in patient engagement and digital health.

Together, the researchers conducted the MiCORE Study. MiCORE stands for Myocardial infarction, Combined Device, Recovery Enhancement. The study designers asked the research question: If a patient who experienced a heart attack uses a digital health program consisting of an app integrated with a smartwatch and wireless blood pressure monitor, would they have lower risk of 30-day hospital readmissions?

To answer this question, the app, smartwatches, and wireless blood pressure devices were given to 200 patients at four hospitals (Johns Hopkins Hospital, Johns Hopkins Bayview Medical Center, Reading Hospital in Pennsylvania, and Massachusetts General Hospital). The mean age of app users was 59 years old; 30% were women and 70% were white.

The researchers asked participants to use the app during hospitalization for a heart attack and to continue its use for 30 days following discharge. They then compared the collected data with a historical group of 864 patients with similar baseline characteristics who received a standard level of post-discharge care after a heart attack.

Traditionally, a standard level of post-discharge care includes providing the patient with generic discharge instructions composed of a diagnosis, medication information, and education materials on diet recommendations and lifestyle modifications.

More than a ‘snapshot’ of heart data

The MiCORE study showed that patients who used the digital health intervention had a 52% lower risk of going back to the hospital within 30 days of discharge for any health issue compared with the historical group.

The findings, published in Circulation: Cardiovascular Quality and Outcomes, also suggest those using the app were more motivated to improve their quality of life, with more than 90% of users saying they felt prepared to manage their health at home.

“We found that if you engage patients frequently on what they need to do to take care of themselves, they get really pumped up to do so,” says Marvel.

According to the data captured by the devices, patients used the app a median of 213 times during the 30-day period. That included tracking medications, entering vital signs like weight and blood pressure, and viewing educational content.

With standard practices to prepare patients to leave the hospital, like providing them with paper-based discharge instructions, clinicians can’t easily track how engaged people are with self-care instructions after a heart attack, according to Spaulding, co-first author of the MiCORE report. “The app provided insights into how a patient was doing and how engaged they were after leaving the hospital,” she says.

Martin says the team currently is creating a computer dashboard for clinicians to access patients’ key cardiovascular metrics in real time as part of a virtual cardiac rehab program that could be used to better inform in-person visits. “Providing more than just a day or a snapshot of data, you get a fuller picture of someone’s daily life. This can enhance patient and clinician collaboration in improving their health.”

The app technology was licensed through Johns Hopkins Technology Ventures to Corrie Health, a startup company Marvel and Martin founded.

Additional researchers are from Massachusetts General Hospital, Flowers of Reading Hospital, and Johns Hopkins.

The Maryland Innovation Initiative, Reading Hospital Foundation, Wallace H. Coulter Translational Research Partnership, Louis B. Thalheimer Fund, the Johns Hopkins Individualized Health Initiative, Ciccarone Center for the Prevention of Cardiovascular Disease, and the Pollin Digital Innovation Fund funded the work.

Under a license agreement between Corrie Health and Johns Hopkins University, the university owns equity in Corrie Health, and the university and Marvel, Lee, and Martin are entitled to royalty distributions related to technology described in the study. Additionally, Marvel, Lee, and Martin are co-founders of and hold equity in Corrie Health. This arrangement has been reviewed and approved by the Johns Hopkins University in accordance with its conflict of interest policies. The other authors report no conflicts.

Source: Johns Hopkins University

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Working out with more intensity than, say, walking 10,000 steps over the course of a day—drastically improves a person’s fitness, compared to milder forms of exercise, researchers report.

Exercise is healthy. That is common knowledge. But just how rigorous should that exercise be in order to really impact a person’s fitness level? And, if you sit all day at a desk, but still manage to get out and exercise, does that negate your six, seven, or eight hours of sedentary behavior?

These were the sort of questions Matthew Nayor and his team at Boston University School of Medicine set out to answer in the largest study to date aimed at understanding the relationship between regular physical activity and a person’s physical fitness.

The study of approximately 2,000 participants from the Framingham Heart Study appears in the European Heart Journal.

“By establishing the relationship between different forms of habitual physical activity and detailed fitness measures,” Nayor says, “we hope that our study will provide important information that can ultimately be used to improve physical fitness and overall health across the life course.”

Nayor, a Boston University School of Medicine assistant professor of medicine, is also a cardiologist specializing in heart failure at Boston Medical Center, the university’s primary teaching hospital and the city of Boston’s safety net hospital.

Here, Nayor explains the results of the study and what people should know about exercise in relation to fitness:

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A ninth-grade ethnic studies class has a remarkably prolonged and strong positive effect on students, increasing their overall engagement in school, probability of graduating, and likelihood of enrolling in college, according to a new study.

The findings, which follow up on earlier research by two of the authors indicating short-term academic benefits of the course, appear in the Proceedings of the National Academy of Sciences.

The study provides “compelling and causally credible evidence on the power of this course to change students’ life trajectories,” says Thomas S. Dee, a professor at Stanford Graduate School of Education and senior fellow at the Stanford Institute for Economic Policy Research.

Coauthors of the study are Sade Bonilla, an assistant professor at the University of Massachusetts at Amherst, and Emily K. Penner, an assistant professor at the University of California at Irvine.

9th grade ethnic studies

The study took place in collaboration with the San Francisco Unified School District (SFUSD) as part of a research-practice partnership with the GSE that began in 2009. In 2010, SFUSD launched a pilot program in which students were automatically assigned to an ethnic studies course as their first-year social studies requirement if they had a GPA of 2.0 or less. Approximately nine in 10 were Hispanic, Black, or Asian.

Once a student starts doing well, you’re “starting a stone rolling downhill.”

In 2017, Dee and Penner published a study showing academic gains at the end of ninth grade (e.g., higher attendance, grade-point averages, and credits) among students encouraged to take the course. The researchers weren’t sure the gains would last over time, as countless promising academic interventions fade quickly.

But this one stuck. For one thing, attendance improved: Students who participated in the course came to school more often during their remaining time in high school, for a total of one additional day of school every two weeks.

By their fourth year of high school, the students had also passed six more courses than a comparison group. More than 90% graduated within five years, versus 75% of their peers. They were also 15% more likely to enroll in college within six years. (At the time of the study, they were not yet old enough to graduate college.)

Students’ own experience

How could one class in ninth grade have such a large effect? While there are many theoretical perspectives on the academic impact of ethnic studies, Dee underscores its parallels with recent insights from social psychology. Targeted psychological interventions that promote a sense of belonging in school, affirm personal values, and forewarn about stereotypes have all shown promise in improving student engagement and motivation.

Dee notes that ethnic studies share these features and resemble “an unusually sustained and intensive social-psychological intervention.”

In SFUSD’s ethnic studies class, for example, students examine the role that their ancestors played in history, getting into the experiences of groups that have been literally pushed to the margins of textbooks. They study, in-depth, discrimination against various groups of people based on their race, social group, ethnicity, or country of origin.

“The biggest thing that happens in an ethnic studies course, I believe, is that students get to approach an academic course from the perspective of their own experience,” says Bill Sanderson, assistant superintendent of high schools at SFUSD. “Everything is approached in the course from the experience of the students.”

Though the principles of the class remain set, teachers tailor the content to the ethnic and racial communities at their school in order to “to bring relevant curriculum that these students can identify with,” Sanderson says.

Critiquing history cultivated students’ analytical abilities across classes, and the focus on anti-racism catalyzed their idealism. But the work of the course goes far deeper than that, the researchers said.

“There’s long-standing evidence that many historically underserved students experience school environments as unwelcoming, or even hostile,” says Dee. Those in this pilot, particularly, hadn’t done well academically and didn’t feel like they belonged. And ninth grade can be a nerve-wracking, transitional year.

Ethnic studies gave students “the opportunity to see their community reflected in the curriculum,” says Bonilla. Learning about their ancestors’ contributions made them feel proud and made school feel relevant, contributing to a sense of belonging. Learning about oppression and stereotypes in action reminded students that not every failure is an individual’s fault. Students conducted research projects out in the community and connected school with their lives.

Students gain momentum

From there, once a student starts doing well, you’re “starting a stone rolling downhill,” Dee says, catalyzing greater motivation.

“There’s a basis in the science of learning for why courses like this can change students’ learning trajectories,” Dee says. “And if the mechanisms we’re describing are really valid, then this goes well beyond ethnic studies,” encouraging schools to make their teaching culturally relevant across subjects.

“Ethnic studies is an important part of every young person’s education.”

Education policymakers have focused recently on “curricula as the low-hanging fruit of education reform,” or something comparatively simple to change, Dee says.

Nevertheless, the results might not be easy to replicate. The district honed the curriculum over several years with faculty at San Francisco State University, home of the nation’s first ethnic studies college program. Many of the initial set of teachers had studied in that department and learned how to manage debate on sensitive subjects, Sanderson says.

Efforts to replicate this success without similar teacher supports and careful implementation are unlikely to be successful, Dee says, and may even trigger unintended and negative consequences. “Consider the potential educational and political fallout of asking teachers to discuss unusually sensitive topics in the classroom without the proper training to do so effectively.”

This is an especially pertinent consideration now, in the middle of a new wave of political controversy about history curricula. While states and school districts are increasingly adopting requirements and standards for K-12 ethnic studies, some state legislatures are debating bills to ban the 1619 Project or critical race theory, a scholarly academic analysis of structural racism.

SFUSD, for one, isn’t going back. Its board voted this spring to make ethnic studies a high school graduation requirement.

“Ethnic studies is an important part of every young person’s education,” SFUSD board president Gabriela Lopez said in a statement issued by the district in March, which pointed to research showing the curriculum’s impact on GPA across disciplines, high school graduation rates, college-going rates, and sense of belonging.

Source: Danielle Dreilinger for Stanford University

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Researchers have discovered specific types of neurons within the memory center of the brain that are responsible for acquiring new associative memories.

Additionally, the researchers have found out how these associative memory neurons are controlled.

Has the scent of freshly baked chocolate chip cookies ever taken you back to afternoons at your parents’ house? Has an old song ever brought back memories of a first date? The ability to remember relationships between unrelated items (an odor and a location, a song and an event) is known as associative memory.

We rely on associative memories in our everyday lives and the new research is an important step in understanding the detailed mechanism of how these types of memories are formed in the brain.

Psychologists began studying associative memory in the 1800s, with William James describing the phenomenon in his 1890 classic The Principles of Psychology. Scientists today agree that the structures responsible for the formation of associative memory are found in the medial temporal lobe, or the famous “memory center” of the brain, but the particular cells involved, and how those cells are controlled, have remained a mystery until now.

“Although associative memory is one of the most basic forms of memory in our everyday life, mechanisms underlying associative memory remain unclear” says lead researcher Kei Igarashi, faculty fellow of the Center for the Neurobiology of Learning and Memory and assistant professor of anatomy and neurobiology at the the University of California, Irvine School of Medicine.

The new study reports for the first time that specific cells in the lateral entorhinal cortex of the medial temporal lobe, called fan cells, are required for the acquisition of new associative memories and that these cells are controlled by dopamine, a brain chemical known to be involved in our experience of pleasure or reward.

In the study, researchers used electrophysiological recordings and optogenetics to record and control activity from fan cells in mice as they learn to associate specific odors with rewards. This approach led researchers to discover that fan cells compute and represent the association of the two new unrelated items (odor and reward). These fan cells are required for successful acquisition of new associative memories. Without these cells, pre-learned associations can be retrieved, but the new associations cannot be acquired. Additionally acquiring new associations also requires dopamine.

“We never expected that dopamine is involved in the memory circuit. However, when the evidence accumulated, it gradually became clear that dopamine is involved,” says Igarashi. “These experiments were like a detective story for us, and we are excited about the results.”

This discovery is an important piece in the puzzle of understanding how memories are formed in the brain and lays a foundation on which other researchers can continue to build. Associative memory abilities are known to decline in neurodegenerative diseases like Alzheimer’s disease. Understanding the neurobiological mechanism of how these memories are formed is the first step to developing therapeutics to slow the loss of associative memory abilities in Alzheimer’s Disease.

The research appears in Nature. Additional researchers from the University of California, Irvine and the University of Fukui, Japan contributed to the work.

Support for the research came from the National Institute of Health, a PRESTO grant from Japan Science and Technology Agency, a Brain Research Foundation Fay-Frank Seed Grant, a Whitehall Foundation Research Grant, a BrightFocus Foundation Research grant, an Alzheimer’s Association Research Grant, and a New Vision Research Investigator Award to Kei Igarashi. The University of California, Irvine Medical Scientist Training Program (MSTP) and an NIH F31 grant supported coauthor Heechul Jun.

Source: UC Irvine

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New research found that infants of women who had only one male partner who abused them had worse cognitive delays compared to infants of women with multiple male partners, only some of whom were abusive.

Linda Bullock, a professor emerita at the University of Missouri Sinclair School of Nursing, conducted the study to examine the impact of multiple father figures on the cognitive development of the newborn infants after learning from home health visits that many of the abused women had up to nine different romantic partners during and following pregnancy.

While assessing a pregnant woman with premature labor in 1983, Bullock noticed bruises on the woman. When she asked what happened, the woman told Bullock a refrigerator had fallen on her while cleaning the kitchen.

“Something didn’t seem right, but I didn’t know what to say at the time. I just went on to the next question of the assessment,” says Bullock. “We stopped her labor and sent her home, but I will bet my last dollar I sent her back to an abusive relationship, and it sparked my interest in helping other nurses assist battered women. What we didn’t know at the time was the impact violence had on the baby.”

Bullock helped implement the Domestic Violence Enhanced Perinatal Home Visits (DOVE) program in rural Missouri, which empowered safety planning and reduced domestic violence for hundreds of abused pregnant women.

For the new study, researchers administered neurodevelopmental tests during home visits three, six, and 12 months after birth. Bullock was surprised to find the infants of women who had only one male partner who abused them had worse cognitive outcomes compared to infants of women with multiple male partners, only some of whom were abusive.

“The findings highlight the variety of ways the multiple father figures may have been helping the mom support her baby, whether it was providing food, housing, childcare, or financial benefits,” Bullock says.

“For the women with only one partner who abused them, the infant’s father, the father may not have provided any physical or financial support or played an active role in the child’s life. It can be difficult for busy, single moms struggling to make ends meet to provide the toys and stimulation their infants need to reach crucial developmental milestones.”

Bullock adds that infants coming from homes with domestic violence often go on to have worse academic outcomes in school due to neurodevelopmental lags and a higher risk for a variety of health issues, including gastrointestinal distress, trouble eating and sleeping, as well as stress and illness.

“When nurses are visiting homes to check in on pregnant women and their developing babies, we want them to be trained in recognizing the warning signs of potential intimate partner violence,” Bullock says.

“I still think back to 1983 when I sent that lady back home into a terrible situation, and I am passionate about making sure I can help nurses today not make the same mistake I made.”

Additional coauthors of the study, which appears in Maternal Child Health Journal, are from Johns Hopkins University and University of Virginia. The National Institutes of Nursing Research funded the work.

Source: University of Missouri

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Hospitals with more inpatient nurse practitioners have lower surgical mortality, lower cost of care, and more satisfied patients, research finds.

Nurse practitioners (NPs) are registered nurses (RNs) with advanced graduate education and expanded legal scope of practice to prescribe treatments including pain medications.

Researchers at the Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing and the Hospital of the University of Pennsylvania studied more than 1.4 million patients in 579 hospitals. Their findings appear in the journal Medical Care.

“This is the first large study to document the significant added value of hospitals employing nurse practitioners in acute inpatient hospital care as well as having good RN staffing,” says lead author professor Linda Aiken of Penn’s Center for Health Outcomes and Policy Research and the Leonard Davis Institute of Health Economics.

“When we compared hospitals with the most and fewest NPs, we estimated that hospitals with more NPs had 21% fewer deaths after common surgical procedures and 5% lower Medicare costs per beneficiary,” says Aiken.

The study also documented significantly higher patient satisfaction in hospitals employing more NPs as well as higher quality of care and patient safety ratings. Having more NPs also enhances the work and clinical environment of the RN staff. The researchers found that RNs practicing in hospitals with greater numbers of NPs had higher job satisfaction, lower burnout, and were more likely to intend to remain in their positions, all good signs given growing concerns over nurse shortages resulting from the COVID-19 pandemic.

Also, RNs in hospitals with more NPs reported greater confidence that their patients would be able to successfully manage their care after discharge. Indeed, independent measures of actual hospital readmissions show patients are significantly less likely to experience a hospital readmission when their surgery took place in a hospital that employed more NPs.

Funding for the study came from the National Institute of Nursing Research/NIH, the Robert Wood Johnson Foundation, and the National Council of State Boards of Nursing.

Source: Penn

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Eating spinach could prevent colon cancer, new research suggests.

In the United States, colon cancer is the fourth-most common cancer and second-leading cause of cancer-related deaths. Previous studies have shown that eating green vegetables and fiber reduces risk of colon cancer by as much as half.

The new study in the journal Gut Microbes explores the relationship between spinach, gut health, genes, and colon cancer outcomes.

The researchers used a model of a hereditary disease called familial adenomatous polyposis, an inherited disorder that causes young people to develop multiple noncancerous growths (polyps) in their colon.

Most people with this disease must have their colon surgically removed to prevent hundreds of tumors from growing in their colon as they age. They then undergo often-toxic NSAYS treatment to prevent additional tumors from forming in the duodenum, the first part of the small intestine.

The new study’s findings indicate spinach might aid in cancer prevention in these patients by delaying the need for colon removal and prolonged drug treatment.

Not all colon cancer is hereditary

After feeding freeze-dried spinach to an animal model of familial adenomatous polyposis for 26 weeks, the researchers observed significant antitumor activity in the colon and small intestine. Using an unbiased approach called multi-omics, they found that the tumor suppression from spinach involved increased diversity in the gut microbiome (helpful microbes) and changes in gene expression to help prevent cancer.

The researchers also found that fatty acids associated with regulation of inflammation, called linoleate metabolites, were brought up to a beneficial level after a spinach diet.

“We believe eating spinach can also be protective for people who do not have familial adenomatous polyposis,” says principal investigator Roderick Dashwood, director of the Center for Epigenetics & Disease Prevention at the Texas A&M University Health Institute of Biosciences and Technology.

Hereditary forms of colon cancer only account for about 10 to 15% of cases. The majority of colon cancers are sporadic, meaning they are not driven by a genetic predisposition inherited through a family. Over decades, exposure to carcinogens through diet and environment can change the way genes are expressed in the gastrointestinal (GI) tract, and this can cause people to develop polyps in the colon and lower GI tract later in life that can progress into cancer, Dashwood says. This is why the American Cancer Society recommends starting colon cancer screening at age 45.

Never too soon to start spinach

Dashwood’s lab previously noticed the benefits of spinach in a carcinogen-induced model of colorectal cancer that mimics sporadic cases. In that model, spinach was very effective in preventing polyps, which spurred the team to see how spinach might work in colon cancer driven by genetics.

“My bias was to focus on the chlorophyll story because of my long history examining anti-cancer effects of chlorophyll,” Dashwood says. “But it turned out the multi-omics approach prompted other ideas. When we looked at the metabolomic data, there was no chlorophyll. It was actually fatty acids and linoleic acid derivatives that were causing the beneficial effects.”

Multi-omics allows scientists to carefully analyze biological “big data” to find associations between different systems in the body, pinpoint biomarkers, and better understand the complex interrelationships that drive life.

Instead of traditional hypothesis-driven research, multi-omics is a hypothesis-generating approach in which scientists follow the data to land at explanations for results. The three omics used in this study were microbiome (helpful and harmful microbes), transcriptome (gene expression), and metabolome (metabolites, such as amino acids and fatty acids). The word “omics” comes from the “ome” in these words.

To crunch the metabolome data, Dashwood’s team used the Integrated Metabolomics Analysis Core facility established by Arul Jayaraman at the Texas A&M College of Engineering. First author Ying-Shiuan Chen worked closely with Jayaraman and his team for two years to analyze the hundreds of samples collected from the study’s models.

“This is one of the most comprehensive metabolomics analyses of its kind, especially in the context of cancer prevention by a whole food, spinach,” says Jayaraman, head of the department of chemical engineering at the College of Engineering.

The next step for the team is to validate some of the metabolomic aspects of their findings, such as concentrations of linoleic acid metabolites and short chain fatty acids with anticancer effects on the preclinical model, and ideally in human patients.

When it comes to how soon people should start adding spinach into their diet to help prevent colon cancer, it doesn’t hurt to start now.

“The sooner the better,” Dashwood says. “You shouldn’t wait until polyps arise in order to start to do these sorts of preventive things.”

Source: Lindsey Hendrix for Texas A&M University

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Primates are generally considered “smarter” than mice, but in a surprising finding, researchers have discovered that mice actually have more synapses connecting the neurons in their brains.

In a study comparing the brains of macaques and mice at the synaptic level, the researchers found that the primates had far fewer synapses per neuron compared to the rodents.

Using artificial recurrent neural network modeling, the team was further able to determine that the metabolic cost of building and maintaining synapses likely drives larger neural networks to be sparser, as seen in primates versus mouse neurons.

“This raises interesting questions, like what are the ramifications of building a larger neuronal network, like the ones seen in primates?”

The researchers leveraged recent advances in electron microscopy, as well as existing publicly available data sets, to compare the connectivity in both species. They chose to examine both excitatory and inhibitory synapses, as most previous research had focused on only excitatory synapses. Focusing on layer 2/3 neurons in the adult primary visual cortex made it easier to compare across species, as these neurons have distinct morphologies that are similar in both primates and mice.

After reconstructing the microscopy images and measuring the shapes of 107 macaque neurons and 81 mouse neurons, the researchers identified nearly 6,000 synapses in the macaque samples and over 9,700 synapses in the mouse samples. Upon comparing the datasets, they found that primate neurons receive two to five times fewer excitatory and inhibitory synaptic connections than similar mouse neurons.

“The reason why this is surprising is that there’s this quiet sort of assumption among neuroscientists and, I think, people in general that having more neuronal connections means that you’re smarter,” says Gregg Wildenberg, a staff scientist in the lab of Narayanan “Bobby” Kasthuri of Argonne National Laboratory.

“This work clearly shows that while there are more total connections in the primate brain overall because there are more neurons, if you look on a per-neuron basis, primates actually have fewer synapses.

“But we know that primate neurons can perform computations that mouse neurons can’t. This raises interesting questions, like what are the ramifications of building a larger neuronal network, like the ones seen in primates?”

What’s behind the synapse mismatch?

After uncovering this surprising finding, Wildenberg connected with Matt Rosen, a graduate student in the David Freedman lab at the University of Chicago, hoping Rosen could bring his computational expertise to better understanding the discrepancy in synapse number and its possible cause.

“We’ve had this expectation forever that the density of synapses in primates would be similar to what’s seen in rodents, or maybe even higher because there’s more space and more neurons in the primate brain,” says Rosen. “In light of Gregg’s surprising finding, we thought about why primate neurons would make fewer connections than expected. And we thought that perhaps it was driven by evolutionary forces—that perhaps the energetic costs associated with maintaining a brain might be driving this difference.

“The brain is only about 2.5% of our total body mass, but requires about 20% of the body’s total energy. It’s a very costly organ.”

“So we developed artificial neural network models and trained them to do tasks while we gave them constraints inspired by the metabolic costs that are faced by actual brains, to see how that affects the connectivity that arises in the networks that result.”

The modeling considered two potential metabolic costs: the cost of the individual electrical signals sent by neurons, called action potentials, which are energetically very expensive, and the cost of building and maintaining the synapses between different cells. What they found was that as the number of neurons increased in the network, growing metabolic constraints made it more difficult to create and maintain the connections between cells, leading to a reduced density of synapses.

“The brain is only about 2.5% of our total body mass, but requires about 20% of the body’s total energy,” says Wildenberg. “It’s a very costly organ. It’s believed that the majority of that energy is spent on the synapses, both in the energy to communicate across the synapses but also to build and maintain them. As the brain gets bigger, with more neurons, then there are likely to be trade-offs, metabolically speaking.”

Evolving different kinds of brains

The results, the researchers say, will help inform future research in both primates and mice, as well as comparisons between the two.

“Fundamentally, I think all neuroscientists want to understand what makes us human—what separates us from other primates, and from mice,” says Wildenberg. “We’re working on connectomics, which is focused on understanding neuroanatomy at the level of individual connections. Before this, it hadn’t been well described whether there were differences at the level of connections that might give us clues as to how evolution builds different kinds of brains

“Every brain is neurons, and every neuron connects to and communicates with other neurons in a stereotypic way. How does evolution work within those constraints to build different kinds of brains? You have to study mice, and primates, and a bunch of other species to really start to understand what’s going on here.”

Rosen also points out that understanding the differences between species can help clarify general principles of the brain to better understand behavior.

“The comparative approach allows us to think carefully about the anatomy of the brain in the context of the specific behaviors of an organism,” he says. “No one treats a mouse and a primate the same way; they behave differently. These fundamental observations of the anatomical differences between the two may allow us to extract general principles that can be applied across species, as well as what is unique for each animal.”

As an example, understanding synaptic density—and in particular the ratio of excitatory to inhibitory synapses—can inform research on neurological conditions such as Parkinson’s disease and autism.

“If we only measure excitatory/inhibitory ratio in mice, and we assume it’s the same across all species, how does that affect our understanding of the disease?” says Wildenberg. “We found differences in the excitatory/inhibitory ratio in primates versus mice; what are the implications about how we translate these models to humans?”

Future research will include examining similar questions during brain development, working to understand how synapse number and density affect the network over time, and how that development differs between mice and primates.

The results appear in Cell Reports.

Funding for the work came from the McKnight Foundation, the National Institutes of Health, and the National Science Foundation.

Source: University of Chicago

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Many people are coming across top-grade fertilizer in their yard, then simply raking it up and tossing it to the curb.

The underappreciated substance is fallen leaves, says Skip Richter, Texas A&M University AgriLife Extension Service horticulture agent.

“Most people don’t think of dead leaves as useful. They think it’s a mess, but it’s not a mess. It’s nature’s own, free, slow-release, plant-based fertilizer.”

Putting raked leaves in a landfill has a long-term cost for a community. Even recycling green waste via community-wide collection, while less problematic than throwing it away, is still not the simplest and most economical use of this gardening treasure.

“Leaves contain a wonderful blend of nutrients that a tree needed to grow those leaves in your yard in the first place,” Richter says. Getting rid of fallen leaves “doesn’t make any sense from an environmental standpoint, economic standpoint, or just the standpoint of how nature grows leaves.”

Using fallen leaves is easy. Richter explains three simple ways to use this bounty:

1. Mow leaves into your lawn to recycle nutrients

The simplest, easiest way to use the leaves, Richter says, is to mow over them with a mulching mower so that the leaf pieces can fall down between the grass blades. The leaf pieces will release nutrients as they decompose.

“Most people have a St. Augustine lawn, which tends to be coarse,” he says. “If you had a golf-course green, you wouldn’t be able to mow the leaves into it. But for most lawns, it’s easy. It requires no extra work because you’re mowing anyway.”

2. Collect and mulch fallen leaves

The next-simplest alternative is to collect the leaves and spread them around shrubs, trees or vegetables so they can work as mulch.

“I run over the leaves a few times with my mower to try to break them down,” Richter says. “When you grind them up a little bit, it gives them a nicer look, and they’re less likely to blow away.”

Mulch moderates soil temperature, prevents erosion and evaporation, greatly reduces weed problems, and provides nutrients for plant roots as it decomposes over time.

3. Use as compost

A third option for using falling leaves is to compost them, Richter says, pointing out that AgriLife Extension has plenty of information on how to compost at home. He has also created an online resource on composting for kids.

Composting leaves takes more commitment than mulching them, but it creates a nutrient-rich mix that can be mixed with soil to help plants thrive.

“Think about it like what happens in a coffee pot,” he says. “When water goes on top of the composted leaves, what comes out is nutrient-rich water that roots can use.”

“Most people don’t think of dead leaves as useful,” Richter adds. “They think it’s a mess, but it’s not a mess. It’s nature’s own, free, slow-release, plant-based fertilizer.”

The leaves have so many uses in the garden, Richter says, that he sometimes stockpiles them during “leaf season.”

“Your neighbors are so kind,” he says. “They bag the leaves up and set them right on the curb for you.”

Source: Texas A&M University

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A brief, standardized physical exam for sport-related concussive brain injuries in children and adolescents can identify who’s at risk for persistent post-concussion symptoms.

The Buffalo Concussion Physical Examination’s Risk of Delayed Recovery (RDR) score is the first decision rule to help clinicians who aren’t concussion specialists quickly identify which children are at risk for persistent post-concussion symptoms (PPCS) within 10 days of injury and should be referred to a specialist for focused treatment.

A decision rule is an evidence-based tool that helps clinicians make diagnostic and therapeutic decisions.

As reported in the British Journal of Sports Medicine, the decision rule proved to be highly accurate, correctly identifying who would go on to develop PPCS in 85% of cases.

“The Buffalo Concussion Physical Exam takes less than 10 minutes to do and uses physician exam techniques that every clinician already has,” says first author M. Nadir Haider, assistant director of research in the Concussion Management Clinic in the Jacobs School of Medicine and Biomedical Sciences at University at Buffalo and UBMD Orthopedics and Sports Medicine.

To promote the adoption of the Buffalo Concussion Physical Exam, Haider plans next to develop an app that can generate the RDR score identifying children who will experience delayed concussion recovery based on the findings from the exam.

‘Wait and see’ ups risk

Children and adolescents tend to take longer to recover from concussion than adults. Still, for the majority of those who experience a concussion, symptoms will resolve within a month or less without any treatment. For that reason, it is standard practice to wait a few weeks to see if symptoms resolve on their own before patients are referred for treatment. But as many as a third of concussed patients will experience PPCS and require focused treatment.

“The current standard of practice is to wait and see for the first four weeks,” says Haider. “But our research and other studies have shown that in children and adolescents, delayed treatment can lead to a higher risk of persistent impairments with poor outcomes.”

Students with PPCS continue to suffer, experience physical and cognitive symptoms, and start exhibiting difficulties with academic work and even in their social lives, Haider says. “So preventing these outcomes is pretty important.”

“Right now, there is no gold standard method to identify children within a few days of injury who will have delayed recovery from their concussion. So the current standard of practice is to see which children do not recover, and this leads to unnecessary delays,” says Haider.

“This scoring system may circumvent the waiting period for those children at higher risk, expediting the treatment they need for a full recovery.”

Primary signs of delayed concussion recovery

The new decision rule is based on an observational study conducted from 2016-19 on 270 children and adolescents with sport-related concussions who were seen within 14 days of injury at UBMD Orthopedics and Sports Medicine clinics in Western New York. (Physicians in UBMD Physicians’ Group are faculty members at the Jacobs School.)

Participants were aged 8-18 and 38% were female. Researchers followed them until they had recovered from their concussion and were cleared to return to school or sports without restrictions.

“The purpose was to identify what is predictive of delayed recovery in children and adolescents with concussion,” says Haider. “We wanted to develop something very straightforward that any provider, from a school nurse to a medical resident to a primary care provider, could easily do,” says Haider.

The researchers found that the primary signs that indicate that a child or adolescent with a concussion will have delayed recovery were:

• Lightheadedness and dizziness on standing up from a supine position.
• Problems with balance and vision that indicate issues with the vestibular ocular reflex, the reflex that allows us to maintain stability in vision while moving.
• Difficulty performing a tandem gait test, where participants are instructed to walk heel-to-toe.

The National Institute of Neurological Disorders and Stroke and the National Center for Advancing Translational Science, both of the National Institutes of Health, funded the work.

Source: University at Buffalo

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Researchers have found shell beads in a cave in Morocco that are at least 142,000 years old.

The researchers say they’re the earliest known evidence of humans communicating about themselves through their attire. The find also sheds new light on how humans’ cognitive abilities and social interactions evolved.

“They were probably part of the way people expressed their identity with their clothing,” says Steven L. Kuhn, a professor of anthropology in the University of Arizona College of Social and Behavioral Sciences.

“They’re the tip of the iceberg for that kind of human trait. They show that it was present even hundreds of thousands of years ago, and that humans were interested in communicating to bigger groups of people than their immediate friends and family.”

How does this ancient form of communication show up today? It happens often, Kuhn says.

“You think about how society works—somebody’s tailgating you in traffic, honking their horn and flashing their lights, and you think, ‘What’s your problem?'” Kuhn says. “But if you see they’re wearing a blue uniform and a peaked cap, you realize it’s a police officer pulling you over.”

Shells: a fossilized form of basic communication

Kuhn and an international team of archaeologists recovered the 33 beads between 2014 and 2018 near the mouth of Bizmoune Cave, about 10 miles inland from Essaouira, a city on Morocco’s Atlantic coast.

Kuhn co-directs archaeological research at Bizmoune Cave with Abdeljalil Bouzouggar, a professor at the National Institute of Archaeological Sciences and Heritage in Rabat, Morocco, and Phillipe Fernandez, from the University Aix-Marseille in France, who are coauthors of the study.

El Mehdi Sehasseh, a graduate student at the National Institute of Archaeological Sciences and Heritage, who did the detailed study of the beads, is lead author of the study, published in Science Advances.

The beads are made from sea snail shells, and each measures roughly half an inch long. Holes in the center of the beads, as well as other markings from wear and tear, indicate that they were hung on strings or from clothing, Kuhn says.

The beads are like many others found at sites throughout northern and southern Africa, but previous examples date back to no older than 130,000 years. Ancient beads from North Africa are associated with the Aterian, a Middle Stone Age culture known for its distinctive stemmed spear points, whose people hunted gazelles, wildebeest, warthogs, and rhinoceros, among other animals.

The beads serve as potential clues for anthropologists studying the evolution of human cognition and communication. Researchers have long been interested in when language appeared. But there was no material record of language until just a few thousand years ago, when humans began writing things down.

The beads, Kuhn says, are essentially a fossilized form of basic communication. “We don’t know what they meant, but they’re clearly symbolic objects that were deployed in a way that other people could see them,” he says.

More questions than answers

The beads are also notable for their lasting form. Rather than painting their bodies or faces with ochre or charcoal, as many people did, the beads’ makers made something more permanent, Kuhn says, suggesting the message they intended to convey was a lasting and important one.

In many ways, the beads raise more questions than they answer. Kuhn says he and his colleagues are now interested in learning why the Aterian people felt the need to make the beads when they did. They’re exploring several possible explanations. One, Kuhn says, involves a growing population; as more people began occupying North Africa, they may have needed ways to identify themselves.

It is also possible that people in North Africa started using the method of communication at a time when the climate was cold and dry. They may have developed clans or other allegiances to protect limited resources, then perhaps used the beads to express their ethnicity or other identity to show they belonged in a certain area, Kuhn says.

“It’s one thing to know that people were capable of making them,” Kuhn says, “but then the question becomes, ‘OK, what stimulated them to do it?'”

Source: University of Arizona

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Taking a break from marijuana use may significantly lower some of the epigenetic changes in sperm, research indicates.

The study in Environmental Epigenetics follows several others that link cannabis use to alterations in the epigenetic information present in sperm, including genes important for early development. Epigenetic changes can affect the activity of genes without changing the information of the genes themselves.

The results show that marijuana users who stopped using cannabis for 77 days produced sperm that no longer showed the majority of the significant changes that were present when the men were actively using cannabis.

Study author Susan Murphy, associate professor in the department of obstetrics & gynecology at Duke University School of Medicine, says the results point to the possibility that marijuana abstinence may allow for washout of sperm that harbor many of the drug’s epigenetic effects.

Quit cannabis for a bit?

Murphy says more research is needed to understand the smaller pool of remaining epigenetic changes in the sperm of marijuana users after cannabis abstinence, as these changes could still be significant, but she also says the findings have an immediate, practical application for some.

“Stopping cannabis use for as long as possible—at least for a 74-day period before trying to conceive—would be a good idea,” she says. “If someone is really serious about that, I would say to stop cannabis use for as long as possible prior to conception—meaning multiple spermatogenic cycles.”

“Is it going to fix everything? Probably not,” Murphy says. “We know there are other epigenetic changes that emerged in the ‘after’ sample that we don’t understand yet—and some of those changes are troubling, like an enrichment of other genes related to autism. But it does appear that the things that were the most severely affected in the ‘before’ sample seem to be mitigated by the abstinence period in the ‘after’ samples.”

The study took a baseline sperm sample from marijuana users and non-marijuana users, then followed both groups as the marijuana-using group abstained from cannabis for 77 days—a period spanning the average time it takes for a sperm to mature, which is 74 days. Researchers collected a second sample from both groups after the 77-day period.

During baseline tests, the marijuana-consuming group produced sperm with changes in line with previous studies, which showed altered epigenetic information, including changes in genes linked to early development and neurodevelopmental disorders. With a 77-day abstinence period, this same group was able to produce sperm that had far less altered epigenetic information at the same genes.

The post-abstinence sample was also much more in line with the samples produced by the non-cannabis-using control group.

What’s still unknown

Murphy says further research is needed to see if the remaining epigenetic changes observed in the sperm of cannabis consumers, when they abstain, carry over into development after fertilization.

“We don’t know yet whether the alterations that we’re seeing are at genes that have a stable characteristic,” she says, “or if they are in genes that get reprogrammed and really are going to be of no consequence to the child.”

In any case, Murphy says this work is not a commentary on legalization. She says it’s about giving people the power to make informed decisions for themselves.

“I think that we deserve to know what the biological consequences are so that if you are planning to have a child, or even for your own health, you can make an informed decision about whether you want to use it and when, and that’s not really an option right now because we don’t know what it does,” Murphy says.

Funding for the study came from the John Templeton Foundation and the National Institute of Environmental Health Science.

Source: Duke University

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Are employer vaccine mandates legal? Stacey Lee has answers about the implications and possible outcomes of requiring employees to get COVID-19 vaccines.

On September 9, President Biden ordered that businesses with more than 100 employees require workers to get the COVID-19 vaccine or test negative for the virus at least once a week. He earlier issued a similar order for most federal workers.

Even before the president took these steps, some had raised questions about the legality, medical necessity, and political wisdom of vaccine mandates. Do labor unions have much say about such mandates? Does a 1905 ruling by the US Supreme Court affirming mandatory vaccination still have teeth? And should employers worry that workers might walk off in significant numbers if forced to get the vaccine?

Here, Lee, an associate professor of practice at the Johns Hopkins Carey Business School and an expert in business law, health law, and negotiation, weighs in on these questions and more:

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New evidence suggests that where older adults live may help protect against dementia and Alzheimer’s disease.

A trio of studies shows that urban and suburban neighborhoods that provide opportunities for socialization, physical activity, and intellectual stimulation may help preserve older adults’ cognitive health.

“Neighborhoods matter. They are important spaces for older adults, and they really impact opportunities or barriers to age well in place,” says lead author Jessica Finlay, a research fellow at the University of Michigan Institute for Social Research Survey Research Center.

“These papers think through how neighborhoods might encourage healthy behaviors that could in turn benefit the brain, and for Alzheimer’s and dementia risks, which are among the greatest fears and greatest burdens that our aging population faces.”

Finlay and colleagues found older adults whose neighborhoods are conducive to physical activity and socialization were about three years younger, in terms of cognitive health, than those who had very little access to exercise and socialization. Those who had access to intellectually stimulating places such as museums, higher education campuses, and libraries had about a five-year difference in cognitive age compared to those who had little to no access to such places.

However, the study examining intellectually stimulating places shows a larger protective benefit for white adults than for Black older adults. The researchers think this likely reflects the impact of broad, structural systems of racism that constrain and distort Black populations’ access to such spaces.

“This isn’t a one-size-fits-all finding. We do see that access to these neighborhood sites diverges along different axes of power and privilege, including race, gender, and socioeconomic status,” says Michael Esposito, an assistant professor of sociology at Washington University in St. Louis who led the studies’ quantitative analysis. Each of the studies used a mixed method analysis, which compared interviews and analysis of a small group of older adults in an urban area to a survey of a much larger, nationally representative group of older adults.

In the first assessment, Finlay interviewed 125 older adults in the Minneapolis metropolitan area to learn about how those older adults lived in their communities. In each of the studies, Finlay’s team identified a connection between older adults’ cognitive health and proximity to places where they could socialize, exercise, and visit intellectually stimulating places.

One participant told Finlay about what she finds valuable about her exercise center.

“They built a YMCA for us 50-plus,” said the participant in an interview. “The people there, we’re all older. It’s just like a big social club. We work out, but we also laugh and have fun. It’s just a bunch of old people getting together and hanging out. I always felt that laughter is very healthy for you. I feel rejuvenated going there, both mentally and spiritually. It’s just like a safe haven to go to, plus we get healthy.”

Esposito tested Finlay’s observations against a much larger group, using results from an ongoing study of just over 30,000 people, called the REGARDS study. The REGARDS study recruited participants with an average age of 64 between 2003 and 2007. In 2006, the participants’ cognitive health was first assessed, with a follow-up every two years after.

“Jessica’s qualitative work gave us clues about where people might have these interactions they need to promote their cognitive health, and we used that as a starting point to build out quantitative models, to see if these observations held,” Esposito says. “Using the REGARDS data, we could figure out what environmental conditions people with higher cognitive function scores experienced and what external conditions people who displayed lower cognitive function scores had in common.”

The researchers found that places of socialization that were more positively associated with protecting cognitive health were senior centers and organizations such as Veterans of Foreign Wars or racial or ethnic organizations. Living in neighborhoods with high densities of parks, fitness and sports recreation centers, and walkable destinations were associated with better cognitive health.

In the study examining intellectually stimulating centers, the researchers found that museums and other cultural sites provided the best cognitive health benefit—but again, the effect was larger for white people.

“Moving forward, we’re looking at differences by person and by place—so for example, differences in protective cognitive benefits by men or women or nonbinary adults, by education levels and by race,” says Finlay, who is also a postdoctoral fellow at the University of Michigan School of Public Health’s Center for Social Epidemiology and Population Health.

“Understanding these differences might help inform community-level interventions that are more targeted to those who are most at risk, which include marginalized and underserved communities, who have higher rates of dementia and Alzheimer’s risk.”

Senior study author Philippa Clarke says understanding the neighborhood environments that can support cognitive health is essential for mitigating the future burden of dementia in America’s aging population.

“Additionally, as COVID-19 has changed the day-to-day lives of aging Americans, it is critical to understand which neighborhood environments can buffer the impact of the pandemic on cognitive decline,” says Clarke, professor of epidemiology at the School of Public Health and research professor at ISR’s Survey Research Center.

The research appears in the Journal of Aging and Health; Preventive Medicine; and Wellbeing, Space & Society.

Source: University of Michigan

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Researchers have come up with a new reason for a lack of liquid water on the surface of Mars: The red planet may be just too small to hold onto large amounts of water.

Water is essential for life on Earth and other planets, and scientists have found ample evidence of water in Mars’ early history. Remote sensing studies and analyses of Martian meteorites dating back to the 1980s posit that Mars was once water-rich, compared with Earth. NASA’s Viking orbiter spacecraft—and, more recently, the Curiosity and Perseverance rovers on the ground—returned dramatic images of Martian landscapes marked by river valleys and flood channels.

Despite this evidence, no liquid water remains on the surface. Researchers have proposed many possible explanations, including a weakening of Mars’ magnetic field that could have resulted in the loss of a thick atmosphere.

But the new study, published in the Proceedings of the National Academy of Sciences, offers a more fundamental reason why today’s Mars looks so drastically different from the “blue marble” of Earth.

“Mars’ fate was decided from the beginning,” says senior author Kun Wang, assistant professor of earth and planetary sciences at Washington University in St. Louis. “There is likely a threshold on the size requirements of rocky planets to retain enough water to enable habitability and plate tectonics, with mass exceeding that of Mars.”

Potassium on Mars

For the study, Wang and his collaborators used stable isotopes of the element potassium (K) to estimate the presence, distribution, and abundance of volatile elements on different planetary bodies.

Potassium is a moderately volatile element, but the scientists decided to use it as a kind of tracer for more volatile elements and compounds, such as water. This is a relatively new method that diverges from previous attempts to use potassium-to-thorium (Th) ratios gathered by remote sensing and chemical analysis to determine the amount of volatiles Mars once had. In previous research, members of the research group used a potassium tracer method to study the formation of the moon.

Wang and colleagues measured the potassium isotope compositions of 20 previously confirmed Martian meteorites, selected to be representative of the bulk silicate composition of the red planet.

Using this approach, the researchers determined that Mars lost more potassium and other volatiles than Earth during its formation, but retained more of these volatiles than the moon and asteroid 4-Vesta—two much smaller and drier bodies than Earth and Mars.

The researchers found a well-defined correlation between body size and potassium isotopic composition.

“The reason for far lower abundances of volatile elements and their compounds in differentiated planets than in primitive undifferentiated meteorites has been a longstanding question,” says coauthor Katharina Lodders, research professor of earth and planetary sciences.

“The finding of the correlation of K isotopic compositions with planet gravity is a novel discovery with important quantitative implications for when and how the differentiated planets received and lost their volatiles.”

“Martian meteorites are the only samples available to us to study the chemical makeup of the bulk Mars,” Wang says. “Those Martian meteorites have ages varying from several hundred millions to 4 billion years and recorded Mars’ volatile evolution history. Through measuring the isotopes of moderately volatile elements, such as potassium, we can infer the degree of volatile depletion of bulk planets and make comparisons between different solar system bodies.

“It’s indisputable that there used to be liquid water on the surface of Mars, but how much water in total Mars once had is hard to quantify through remote sensing and rover studies alone,” Wang says. “There are many models out there for the bulk water content of Mars. In some of them, early Mars was even wetter than the Earth. We don’t believe that was the case.”

Search for life on other planets

The findings have implications for the search for life on other planets besides Mars, the researchers note.

Being too close to the sun (or, for exoplanets, being too close to their star) can affect the amount of volatiles that a planetary body can retain. This distance-from-star measurement is often factored into indexes of “habitable zones” around stars.

“This study emphasizes that there is a very limited size range for planets to have just enough but not too much water to develop a habitable surface environment,” says coauthor Klaus Mezger of the Center for Space and Habitability at the University of Bern, Switzerland. “These results will guide astronomers in their search for habitable exoplanets in other solar systems.”

Wang now thinks that, for planets that are within habitable zones, planetary size probably should be more emphasized and routinely considered when thinking about whether an exoplanet could support life.

“The size of an exoplanet is one of the parameters that is easiest to determine,” Wang says. “Based on size and mass, we now know whether an exoplanet is a candidate for life, because a first-order determining factor for volatile retention is size.”

Source: Washington University in St. Louis

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The pandemic has created a cyclical public health problem by harming mental health while also making it more difficult for people to maintain physical activity, report researchers.

Their study also reveals that lower-income households struggled more with both mental health challenges and maintaining physical activity levels.

“We know that physical activity is important for helping people maintain their mental health, but this study reveals the unforgiving cycle that the pandemic has imposed on many people,” says Lindsey Haynes-Maslow, coauthor of the study and an associate professor of agricultural and human sciences at North Carolina State University.

“The pandemic has increased psychological distress, which makes it more difficult for people to maintain their physical activity levels. This, in turn, further hurts their mental health, which makes them less likely to be active, and so on. Once you get on this roller coaster ride, it’s hard to get off. And all of this is exacerbated by the pandemic making it harder for people to find safe spaces in which to exercise.”

For this study researchers were focused on two questions: How is the pandemic influencing physical activity and mental health status? And how, if at all, do physical activity and mental health status relate to each other?

To address those questions, the researchers conducted an in-depth, online survey of 4,026 adults in Louisiana, Montana, North Carolina, Oregon, and West Virginia. The survey took place between April and September of 2020.

The researchers found that the more physically active people were, the better their mental health status. That held true even when accounting for an individual’s race/ethnicity, household income, and other socioeconomic demographic variables.

The researchers also found that the higher an individual’s household income, the more likely they were to be able to maintain pre-pandemic physical activity levels. Specifically, people in households that earned less than $50,000 per year were 1.46 times less likely to maintain their pre-pandemic levels physical activity as compared to people in households that earned more than $50,000 per year.

In addition, the survey found that participants in urban areas were more likely to report difficulty maintaining their pre-pandemic physical activity levels, as compared to study participants in rural areas.

“This rural/urban finding was somewhat surprising, because normally—when we’re not in a pandemic—people in rural areas tend to report more mental health challenges than their urban counterparts,” Haynes-Maslow says.

“Fortunately, the survey was designed to help understand each study participant’s mental health and physical activity levels before and during the pandemic,” says Shelly Maras, coauthor of the paper and a PhD candidate at NC State. “The survey also included open-ended questions that allowed us to analyze rich, qualitative data related to respondents’ mental health and physical activity.”

The open-ended survey results revealed that many participants struggled with staying active during stay-at-home orders, but rural participants talked about how their open spaces and places provided more opportunities to get outside and get moving. Participants also talked about how caregiving, exhaustion, and mental health stressors kept them from being active, perpetuating the cycle.

“Our findings drive home that mental health is a persistent challenge during this pandemic,” says Annie Hardison-Moody, coauthor of the study and an associate professor of agricultural and human sciences at NC State. “This survey data helps us understand what people were going through during those early months of the pandemic. It also helps us understand the importance of having access to open spaces and the barriers that are in place preventing people from accessing those spaces.”

“We’re still in a pandemic,” Haynes-Maslow says. “But it’s clear that we need a playbook in place for what we do in future crises to help people be active and protect their mental health.

“We need structural changes in communities to ensure people have equitable access to safe spaces where they can be active. That will require policy changes and funding to create the necessary infrastructure: sidewalks, streetlights, green spaces. This will require significant investment, and it will take time, so we need to begin acting on this now. It is much less expensive to invest now than it is to pay for the long-term consequences of poor physical and mental health.”

The paper appears in the journal Preventive Medicine Reports. Collaborators on the work are from Montana State University, West Virginia University, Louisiana State University, Western Oregon University, and the Gretchen Swanson Center for Nutrition.

The National Institutes of Health provided funding for the work.

Source: NC State

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Telehealth smoking cessation treatment programs can reduce tobacco-related disparities among incarcerated smokers, according to a new study.

The study in the Journal of Telemedicine and Telecare finds that video conferencing with tobacco treatment specialists may help smokers in rural prisons quit tobacco smoking.

“Tobacco use is an important public health issue, especially among people who are incarcerated, in the US,” says Pamela Valera, assistant professor in the urban-global public health department at Rutgers University.

“Currently, tobacco cessation programs are not offered consistently in US prisons due to a lack of resources and limited certified tobacco treatment specialists. This is especially true for prisons in rural parts of the country.”

Inmates are three to four times more likely to smoke than the general population, contributing to high levels of chronic health conditions, like cancer, heart disease, and stroke. Smoking is also more common in rural prisons, which often lack cessation resources and have few medical professionals to care for a population with more health needs.

To address the lack of resources, the researchers were the first to use video conferencing to deliver group-based smoking cessation counseling to inmates in rural prisons. They also provided inmates with nicotine replacement therapy patches to aid in the cessation process.

“Our experience with the implementation and production of remote group-based smoking cessation treatment allows us to suggest that virtual platforms may be one solution to addressing inequities in access to tobacco cessation among people who are incarcerated,” Valera says.

Telehealth, which includes the use of apps, social media, and text messaging, has become more popular in health care settings due to the removal of physical barriers like distance and time. Providers can also ensure adequate services are extended to those who lack access to health care settings and treatment with the recent coverage of telehealth services to Medicare and Medicaid recipients.

“Improving inmate access to telehealth is vital to reduce barriers to care, treatment, and existing tobacco-related health disparities,” says coauthor Sara Malarkey, a student at the Rutgers School of Public Health.

“In a time of uncertain budget constraints due to the COVID-19 pandemic, using novel approaches like telehealth or virtual tobacco cessation treatment programs can be an inexpensive and effective approach to address smoking in rural populations,” says coauthor Nadia Smith, also a student at the Rutgers School of Public Health.

Source: Rutgers University

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Researchers have designed a living bioengineered nerve circuit that mimics the pain transmission pathway in the spinal cord.

They designed the living circuit to help scientists test the effectiveness of non-addictive alternatives to opioid painkillers.

In 2019, nearly 50,000 people in the United States died from opioid overdoses, bringing the total of number of deaths from the opioid crisis to half a million over the past 10 years, according to the US Centers for Disease Control. The circuit of living cells aims to turn those statistics around.

“We show that this model system behaves physiologically similar to the circuit that carries the pain signal, and we show that it responds to pain drugs, like morphine and lidocaine, in ways that are reproducible and measurable and distinct for each type of drug,” says Michael J. Moore, a professor of biomedical engineering at Tulane University School of Science and Engineering.

“What we hope is that we will be able to use this model system to more quickly identify possible candidates for new painkillers, which right now can only be done through an arduous series of behavioral studies with animals.”

The study is his first paper under the HEAL Initiative, or Helping to End Addiction Long-term Initiative, a $945 million, multi-university funding endeavor sponsored by the National Institutes of Health.

HEAL was launched in April 2018 to provide scientific solutions to the national opioid overdose crisis, including improved treatment strategies for pain as well as opioid use disorders (OUDs). Funded by Congress, the initiative involves numerous universities and almost every NIH institute and center in order to approach the crisis from all angles and disciplines.

Moore is continuing to work with Randolph Ashton, an associate professor of biomedical engineering at the University of Wisconsin, and Swaminathan Rajaraman, an assistant professor of electrical and computer engineering at the University of Central Florida. Ashton is developing human stem-cell derived spinal neurons, and Rajaraman is developing specially-made microelectrodes for taking electrical measurements from the cells.

“In this next phase of the project,” Moore says, “we will seek to better characterize the physiology of our model system, improve its physiological relevance, and determine whether we can mimic some of the biological processes associated with drug tolerance.”

The paper appears in the journal Science Advances.

Source: Tulane University

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