Sunday, March 31, 2013

Autism: 'Gordon,' a supercomputer with unique flash memory

Gordon, a completely new kind of supercomputer that uses massive amounts of flash memory, helps researchers study transcription factors that can be targeted for treatment of mental disorders. 

Credit: UC San Diego Publications/Erik Jepsen 

When it officially came online at the San Diego Supercomputer Center (SDSC) in early January 2012, Gordon was instantly impressive. In one demonstration, it sustained more than 35 million input/output operations per second—then, a world record.

Input/output operations are an important measure for data intensive computing, indicating the ability of a storage system to quickly communicate between an information processing system, such as a computer, and the outside world. Input/output operations specify how fast a system can retrieve randomly organized data common in large datasets and process it through data mining applications.

The supercomputer's record-breaking feat wasn't a surprise; after all, Gordon is named after a comic strip superhero, Flash Gordon. Gordon's new and unique architecture employs massive amounts of the type of flash memory common in cell phones and laptops—hence its name.

The system is used by scientists whose research requires the mining, searching and/or creating of large databases for immediate or later use, including mapping genomes for applications in personalized medicine and examining computer automation of stock trading by investment firms on Wall Street.

"Gordon is a unique machine in NSF's Advanced Cyberinfrastructure/XSEDE portfolio," said Barry Schneider, NSF program director for advanced cyberinfrastructure.

"It was designed to handle scientific problems involving the manipulation of very large data. It is differentiated from most other resources we support in having a large solid-state memory, 4 GB per core, and the capability of simulating a very large shared memory system with software."

Last month, a team of researchers from SDSC, the United States and the Institute Pasteur in France reported in the journal Genes, Brain and Behaviour that they used Gordon to devise a novel way to describe a time-dependent gene-expression process in the brain that can be used to guide the development of treatments for mental disorders such as autism-spectrum disorders and schizophrenia.

Reference: 
onlinelibrary.wiley.com/journal/10.1111/(ISSN)1601-183X

Read more at: www.sdsc.edu/supercomputing/gordon/

Cystic fibrosis bug 'can spread between patients'

A dangerous infection which is becoming more common in people with cystic fibrosis can spread between patients, UK researchers say in The Lancet.

Doctors previously thought the Mycobacterium abscessus bacteria could only be caught from water and soil.

But hospitals around the world may now have to change the way patients are treated, the study says.

Around 3-10% of cystic fibrosis patients in Europe and the US are infected with the hard-to-treat bug.

There are around 9,000 people with cystic fibrosis in the UK although around one-in-25 people carries the faulty gene which causes the condition.

It affects the internal organs, especially the lungs and digestive system, by clogging them with thick sticky mucus which makes it hard to breathe and digest food.

Researchers writing in The Lancet do not know exactly why Mycobacterium abscessus - which is distantly related to the bacteria that causes tuberculosis - is more likely to infect people with cystic fibrosis but it could be related to problems with the immune system.

It causes lung damage, and can be incredibly hard to treat with infected patients needing months of treatment with toxic drugs.

Mycobacterium abscessus bacteria
Although the infection has been on the rise over the past decade, doctors always believed it could not spread between humans.

But by looking at DNA from almost 170 samples of the bacterium, and using that to create a family tree, researchers found that it can indeed spread from person to person.

Infection control
Study leader Dr Andres Floto, research director of the Cystic Fibrosis Unit at Papworth Hospital in Cambridge, UK and principal investigator at the Cambridge Institute for Medical Research, said the results had prompted them to completely rethink their infection control, despite already having strict policies in place.
He explained they already treated all in-patients in individual rooms without exposing them to other patients and out-patient clinics were set up so individuals did not have direct contact with each other.

"But despite that we were seeing transmission events in hospital which tells us that transmission is likely to be indirect," Dr Floto said.

Dr Andres Floto
"We are doing more research into that but we believe it gets aerosolised, for example, when people cough and because this bacteria is tough it hangs around in the air."

All inpatients at Papworth are now treated in negative pressure rooms to prevent the spread of airborne bugs and those with the infection are cared for away from the cystic fibrosis unit.

"And in outpatients for people with this bug, we use clinic rooms only once and then not for other patients until the next day when it has been deep cleaned."

Dr Floto said his team had already been in touch with hospitals in the UK and abroad to inform them of their findings and encourage them to change their practices and prevent the infection spreading as much as possible.

"Our results will help to protect patients from this serious infection."

Co-author Professor Julian Parkhill, head of pathogen genomics at the Wellcome Trust Sanger Institute, said: "By sequencing the complete genomes of bacteria we can accurately describe where they have emerged from and how they pass from person to person.

"This new information has led to rapid changes in how people with cystic fibrosis are cared for in hospital to protect them from this emerging threat."

Jo Osmond, director of Clinical Care and Commissioning at the Cystic Fibrosis Trust (UK), said: "We will work closely with clinicians and the NHS to ensure appropriate measures are in place to deal with this issue.

"It is reassuring that this issue has been picked up early and that we are working positively to put in place measures to ensure cross-infection risks are reduced to a minimum.

"People with cystic fibrosis who have concerns about this issue should speak to their clinician."

Saturday, March 30, 2013

ADHD Medication Mis-use

In the past decade or so, psychostimulants like Adderall have exploded in popularity among people without a diagnosis or prescription.

Studies indicate that as many as one in three students on major college campuses have used ADHD medications illicitly, most commonly as a study aid.

The insatiable demand has led to shortages at pharmacies across the country. The law draws a bright line between the use of Adderall by people with ADHD and by those without.

For the former, it’s therapy. For the latter, it’s felony drug abuse, punishable by up to a month in jail.

The drug itself, however, does not draw the same bright line and neither do a growing number of high-achieving, non-ADHD users who see it as the perfect cognitive-enhancement drug—a way to work more, sleep less, and get a better handle on their busy lives.

In today's competitive economy, some might label that cheating, akin to athletes taking anabolic steroids to gain an unfair edge.

Others might suspect that nonprescription Adderall users are only cheating themselves — that the drug won’t really help you if you don’t have ADHD, or that deleterious side effects will counteract any short-term advantages the drug may confer.

But Adderall is not the first prescription medication to find a black market among the tired and ambitious.

As Joshua Foer noted in a Slate story in 2005, Jack Kerouac wrote On the Road while dosed up on Benzedrine, a stimulant that was once prescribed as a nasal decongestant.

But the prevalence of ADHD, about one in 10 children in the United States meet the diagnostic criteria, according to a recent survey, and the popularity of Ritalin and Adderall for treatment mean that they are far more widely available than other types of brain drugs.

That’s especially so because inexperienced doctors have a hard time distinguishing a patient who has ADHD from one who’s faking the symptoms to get a fix.

Some people take the prevalence and subjectivity of the symptoms to mean that ADHD is not even a real disorder, that it’s simply an excuse for lazy parents to medicate their kids.

It’s true that the disorder lies on a spectrum, as opposed to something like juvenile diabetes that you either have or you don’t.

Scott Kollins
But as psychiatric disorders go, ADHD is in fact “quite discrete and very diagnosable,” says Scott Kollins, director of the ADHD program at Duke’s medical school.

“It’s just not easy to diagnose within 15 minutes,” the length of a standard primary-care doctor visit. In a health care system that isn’t set up to reward careful psychiatric evaluations, some doctors simply shrug and write out the prescription.

Others, wary of being played for fools, refuse prescriptions to patients who could really use them.

By law, Adderall is a controlled substance, in the same class as cocaine and methamphetamine but many of the college students who are taking it don’t see it that way, says Alan DeSantis, a sociologist at the University of Kentucky who studies the culture of ADHD drug use on campus.

He got interested in the topic a decade ago while conducting research for a book on fraternities and sororities. “I was asking students about drugs, and they kept saying something very interesting.

They kept saying, ‘I don’t do drugs, but I do Adderall.’ The difference, in the students’ minds, is that drugs are bad for you and make you unproductive.

They view Adderall more like a study aid, DeSantis says, and talk about it openly. In his surveys, up to 50 percent of University of Kentucky upperclassmen have reported using ADHD stimulants at one time or another, most often to cram for midterms or finals.

To some, those numbers are cause for alarm. “The evidence is pretty clear that these are potent stimulants,” says Craig Rush, a professor of behavioural science at Kentucky.

"They produce euphoria, and they have significant abuse potential.” Nora Volkow, director of the National Institute on Drug Abuse, told 60 Minutes in 2010 that she believes even casual use can lead to addiction. “It’s not worth the risk to be playing with a drug that has potentially very adverse affects.”

Children With Sleep Apnea Have Higher Risk of Behavioral, Adaptive and Learning Problems

A new study found that obstructive sleep apnea, a common form of sleep-disordered breathing (SDB), is associated with increased rates of ADHD-like behavioural problems in children as well as other adaptive and learning problems.

Michelle Perfect
"This study provides some helpful information for medical professionals consulting with parents about treatment options for children with SDB that, although it may remit, there are considerable behavioral risks associated with continued SDB," said Michelle Perfect, PhD, the study's lead author and assistant professor in the school psychology program in the Department of disability and psychoeducational studies at the University of Arizona in Tucson.

"School personnel should also consider the possibility that SDB contributes to difficulties with hyperactivity, learning and behavioural and emotional dysregulation in the classroom."

The five-year study, which appears in the April issue of the journal SLEEP, utilised data from a longitudinal cohort, the Tucson Children's Assessment of Sleep Apnea Study (TuCASA).

The TuCASA study prospectively examined Hispanic and Caucasian children between 6 and 11 years of age to determine the prevalence and incidence of SDB and its effects on neurobehavioral functioning.

The study involved 263 children who completed an overnight sleep study and a neuro-behavioral battery of assessments that included parent and youth reported rating scales.

Results show that 23 children had incident sleep apnea that developed during the study period, and 21 children had persistent sleep apnea throughout the entire study.

Another 41 children who initially had sleep apnea no longer had breathing problems during sleep at the five-year follow-up.

The odds of having behavioral problems were four to five times higher in children with incident sleep apnea and six times higher in children who had persistent sleep apnea.

Compared to youth who never had SDB, children with sleep apnea were more likely to have parent-reported problems in the areas of hyperactivity, attention, disruptive behaviors, communication, social competency and self-care.

Children with persistent sleep apnea also were seven times more likely to have parent-reported learning problems and three times more likely to have school grades of C or lower.

The authors report that this is the first sleep-related study to use a standardized questionnaire to assess adaptive functioning in typically developing youth with and without SDB.

"Even though SDB appears to decline into adolescence, taking a wait and see approach is risky and families and clinicians alike should identify potential treatments," said Perfect.

Reference
Risk of Behavioral and Adaptive Functioning Difficulties in Youth with Previous and Current Sleep Disordered Breathing. SLEEP, 2013; DOI: 10.5665/sleep.2536

Facial Palsy in Children: Bell's Palsy


About 40,000 people in the United States develop facial paralysis each year with children comprising a small percentage of that population.

There are more than 50 known causes of facial paralysis but the most common in children is “Bell’s palsy,” the cause of which is not certain.

This disorder effects one side of the facial muscles due to dysfunction of the seventh cranial nerve, usually thought to stem from a viral infection; Bell’s palsy is found in 20 out of 100,000 Americans, with the incidence increasing with each decade of life.

What causes Bell’s palsy?
In Bell’s palsy, facial paralysis results from damage (e.g., possibly from viral infection) to the facial nerve.

Adults and children will either wake up to find they have facial paralysis or palsy, or have symptoms such as a dry eye or tingling around their lips that progress to Bell’s palsy during that same day.

Occasionally symptoms may take a few days to progress to facial weakness or paralysis. Physical trauma to the head and neck region at birth and during childhood may cause facial paralysis.

Other causes are:

  • Chicken pox: Chicken pox and shingles are both caused by a single virus of the herpes family known as varicella-zoster virus (VZV). Varicella is the primary infection that causes chickenpox; Herpes zoster is the reactivation of the virus that causes shingles. Research studies suggest that Bell’s palsy may be due to a reactivation of herpes simplex virus (HSV). Between 75 percent and 90 percent of chickenpox cases occur in children under 10 years of age. According to a 2001 study, about 10 percent of children between ages five and nine and about two percent of 10 to 14 year olds get chicken pox each year.
  • Infectious mononucleosis: This condition, with a peak incidence in the 15- 17 age group, can be caused by several different viruses. The leading causes are the Epstein-Barr virus and cytomegalovirus, both members of the herpes virus family. The infection is transmitted by saliva, sexual contact, respiratory droplets, and blood transfusions.
  • Lyme disease: Lyme disease is an infection that’s spread by Ixodes ticks (black-legged or deer ticks in the eastern United States, and western black-legged ticks in the west). The second stage of Lyme disease usually appears two to three months after the tick bite, and may include facial palsy or paralysis among other symptoms.

Treatments for Facial Paralysis:
If infection is the cause, then an antibiotic to fight bacteria (as in middle ear infections) or antiviral agents (to fight syndromes caused by viruses like herpes zoster (Ramsay Hunt Syndrome) may be used.

The prognosis for children with facial paralysis is generally very good. The extent of nerve damage determines the extent of recovery.

With or without treatment, studies indicate that most pediatric patients with the disorder begin to get better within two weeks after the initial onset of symptoms and recover completely within three to six months. Adults may find residual symptoms remaining for an indefinite period of time.

What happens during the diagnosis?
After an examination, the otolaryngologist- head and neck surgeon may conduct a hearing test to determine if the cause of damage to the nerve has involved the hearing nerve, inner ear, or delicate hearing mechanism.

Additional tests in the physician’s office include a balance test and a tear test, to measure the eye’s ability to produce tears.

Eye drops may be necessary to prevent drying of the surface of the eye cornea. In some circumstances, the physician may recommend a CT (computerized tomography) or MRI (magnetic resonance imaging) test to determine if there is infection, tumor, bone fracture, or other abnormality in the area of the facial nerve.

An additional diagnostic tool is the Electro neuronography (ENOG), which stimulates the facial nerve to assess how badly the nerve is damaged. This test may have to be repeated at frequent intervals to see if the disease is progressing.

Sources:
National Institute of Neurological Disorders and Stroke
Bell’s Palsy Research Foundation (US)
Bell's Palsy Association (UK)

Greek Physician Told Everyone Not to Carry Around Their Baby Boys

The ancient Greek physician Soranus thought that babies, especially boys, should not be carried until four months of age.

Carrying posed the risk of severe testicular injury, Soranus thought.

Today we worry about raising children who aren’t well-adjusted; the Greeks worried about raising children who weren’t eunuchs.

This bias against carrying continued through medieval times.

Meanwhile, at the same time Soranus pronounced this, the many hunter-and-gatherer societies south of him in Africa were regularly carrying their infants. They had always carried their infants. Given their lifestyle, it was essential.

John Whiting
There is some logic here; the anthropologist John Whiting established that infants in cold climates are more likely to be swaddled and put down in a cradle, while those in hot climates are more likely to be carried in a sling.

But once we could control the temperature indoors, we had an infinite amount of choices and a variety of information from well-meaning pseudo-experts.

In the US, for the first half of the 20th century, the medical consensus was something like, “Carry your child? Why are you even touching your child?”

This was an era when experts were telling parents not to kiss their babies. Thankfully most people ignored this dubious advice.

The sudden popularity of slings, beginning in the 1970s, was a radical reversal. It swept away decades of child-rearing wisdom.

If you take the long view all this indecision dates back to a pivot point in human development.

Our hominid ancestors carried their infants without trying, that was the advantage of having a hairy body they could cling to and an opposable toe to assist the infant in gripping.

When they lost both, they squandered an extremely efficient method of child care. Suddenly, parents had to think about what to do with this helpless creature.

Some invented slings, mainly for convenience, to allow them to work and function in a hand-to-mouth environment.

In a sense, the search for infant daycare began with the moment, millions of years ago, that those hominid infants no longer stuck to their parents. In those societies the extended family (sisters, granny, aunts, etc) was readily available to perform this service.

It’s always tempting to see the present as the final point in a journey. It is convenient to believe that we have corrected the mistakes of the past.

We now understand that babies have basic socio-emotional needs; we let ourselves pick up our babies; we carry them when they want to be carried.

The real answer is that we have more time and energy to spend on a small number of children and are charged with guilt that they will become 'psychologically damaged' if we do not attend to their demands for attention.

Questions and Answers to child-rearing will see-saw wildly as our society changes. So watch this space for emerging theories and possible solutions to questions that have yet to be asked.

Wednesday, March 27, 2013

Allergic Asthma: Oral Allergy Drops Are a Pretty Good Option?

Sandra Lin, M.D., holds a test vial of allergy drops. 

Credit: Keith Weller, Johns Hopkins Medicine

A scientific review of 63 published studies affirms that putting small amounts of purified grasses, ragweed, dust mites, pollen and mold, in liquid drops under the tongue is a safe and effective alternative to weekly injections of those allergens or the use of other medications, in treating symptoms of allergies and allergic asthma in some people.

Results of the review, conducted by researchers at Johns Hopkins, are contained in a report to be published in the Journal of the American Medical Association online March 27.

The report is believed to be the largest synopsis of its kind, reviewing previous research comparing various therapies designed to stop the wheezing, sneezing and runny nose that accompany allergic rhino-conjunctivitis and allergic asthma, researchers say.

Specifically, the Johns Hopkins team analysed 63 studies, involving some 5,131 participants, almost all in Europe, where allergy drops, or so-called sublingual immunotherapy, have been widely available for nearly two decades.

Sublingual therapies have not been approved for use by the U.S. Food and Drug Administration (FDA), but physicians in the United States do use the drops "off-label" for some patients.

In eight of 13 studies evaluated, researchers found what they say is "strong evidence" that drop therapy produced a 40 percent or greater reduction in coughing, wheezing, and tightness in the chest compared with other treatments, including inhaled steroids.

In nine of 36 studies comparing allergy drops to other allergy treatments, including antihistamines and nasal steroid sprays, researchers found that allergy drops produced a 40 percent or greater reduction in symptoms of runny nose, sneezing and nasal congestion, results which they describe as "moderate evidence" in support of using sublingual immunotherapy.

"Our findings are clear evidence that sublingual immunotherapy in the form of allergy drops are an effective potential treatment option for millions of Americans suffering from allergic asthma and allergic rhinoconjunctivitis," says senior study investigator Sandra Lin, M.D.

According to Lin, an associate professor of otolaryngology-head and neck surgery at the Johns Hopkins University School of Medicine, allergy drops are more convenient for many people because they can be taken at home, and allow such individuals to avoid the discomfort and travel time needed for regularly scheduled trips to the physician's office for an allergy shot.

Lin says that, according to current estimates, as many as 40 percent of Americans suffer from some form of allergic rhinitis or allergic asthma.

Lin cautions that drop therapies may not be for all sufferers of allergic rhinoconjunctivitis and allergic asthma, but that many will want to weigh the risks and benefits of sublingual immunotherapy before deciding on long-term treatment options.

Reference 
Sublingual Immunotherapy for the Treatment of Allergic Rhinoconjunctivitis and AsthmaA Systematic ReviewImmunotherapy for Rhinoconjunctivitis and Asthma. JAMA, 2013; 309 (12): 1278 DOI: 10.1001/jama.2013.2049

Telling Personal Stories Help Children Develop Emotional Skills


A new study finds that mothers tell better, more emotional stories about past experiences which help children develop their emotional skills.

Credit: © Pavel Losevsky / Fotolia

A new study finds that mothers tell better, more emotional stories about past experiences which help children develop their emotional skills.

The act of talking is not an area where ability is usually considered along gender lines.

However, a new study published in Springer's journal Sex Roles has found subtle differences between the sexes in their story-relating ability and specifically the act of reminiscing.

Widaad Zaman
The research by Widaad Zaman from the University of Central Florida and her colleague Robyn Fivush from Emory University in Atlanta, Georgia, discusses how these gender differences in parents can affect children's emotional development.

Previous research in this area has concluded that the act of parents reminiscing with their children enables children to interpret experiences and weave together the past, present and future.

There is also evidence that parents elaborate less when talking to sons than daughters.

The primary objective of Zaman's study was to compare the reminiscing styles of mothers and fathers with their pre-school daughters and sons.

This included how they elaborated on the story and the extent to which their children engaged with the story while it was being told.

Robyn Fivush
The researchers studied 42 families where the participating children were between four and five years old.

Parents were asked to reminisce about four past emotional experiences of the child (happy, sad, a conflict with a peer and a conflict with a parent) and two past play interactions they experienced together.

The parents took turns talking to the child on separate visits.

The researchers found that mothers elaborated more when reminiscing with their children than fathers.

Contrary to previous research, however, Zaman's study found no differences in the extent to which either parent elaborated on a story depending on the sex of the child.

Mothers tended to include more emotional terms in the story than fathers, which they then discussed and explained to the child.

This increased maternal engagement has the effect of communicating to the child the importance of their own version, perspective and feelings about the experience.

The authors contend that through their increased interaction with the child, mothers are helping their children work through and talk about their experiences more than fathers, regardless of the type of experience.

This may reflect the mother's efforts to try and help her child deal with difficult emotions, especially about negative experiences, all of which is related to better emotional well-being.

The authors conclude that "these results are intriguing, and a necessary first step to better understanding how parents socialise gender roles to girls and boys through narratives about the past, and how girls and boys may then incorporate these roles into their own narratives and their own lives."

Reference
Gender Differences in Elaborative Parent–Child Emotion and Play Narratives. Sex Roles, 2013; DOI: 10.1007/s11199-013-0270-7

Mindfulness Improves Reading Ability, Working Memory, and Task-Focus

If you think your inability to concentrate is a hopeless condition, think again -- and breathe, and focus.

According to a study by researchers at the UC Santa Barbara, as little as two weeks of mindfulness training can significantly improve one's reading comprehension, working memory capacity, and ability to focus.

Their findings were recently published online in the empirical psychology journal Psychological Science.

Michael Mrazek
"What surprised me the most was actually the clarity of the results," said Michael Mrazek, graduate student researcher in psychology and the lead and corresponding author of the paper, "Mindfulness Training Improves Working Memory Capacity and GRE Performance While Reducing Mind Wandering."

"Even with a rigorous design and effective training program, it wouldn't be unusual to find mixed results. But we found reduced mind-wandering in every way we measured it."

Many psychologists define mindfulness as a state of non-distraction characterized by full engagement with our current task or situation.

For much of our waking hours, however, we are anything but mindful. We tend to replay past events -- like the fight we just had or the person who just cut us off on the freeway -- or we think ahead to future circumstances, such as our plans for the weekend.

Mind-wandering may not be a serious issue in many circumstances, but in tasks requiring attention, the ability to stay focused is crucial.

To investigate whether mindfulness training can reduce mind-wandering and thereby improve performance, the scientists randomly assigned 48 undergraduate students to either a class that taught the practice of mindfulness or a class that covered fundamental topics in nutrition.

Both classes were taught by professionals with extensive teaching experience in their fields. Within a week before the classes, the students were given two tests: a modified verbal reasoning test from the GRE (Graduate Record Examination) and a working memory capacity (WMC) test. Mind-wandering during both tests was also measured.

The mindfulness classes provided a conceptual introduction along with practical instruction on how to practice mindfulness in both targeted exercises and daily life.

Meanwhile, the nutrition class taught nutrition science and strategies for healthy eating, and required students to log their daily food intake.

Within a week after the classes ended, the students were tested again. Their scores indicated that the mindfulness group significantly improved on both the verbal GRE test and the working memory capacity test.

They also mind-wandered less during testing. None of these changes were true of the nutrition group.

"This is the most complete and rigorous demonstration that mindfulness can reduce mind-wandering, one of the clearest demonstrations that mindfulness can improve working memory and reading, and the first study to tie all this together to show that mind-wandering mediates the improvements in performance," said Mrazek.

He added that the research establishes with greater certainty that some cognitive abilities often seen as immutable, such as working memory capacity, can be improved through mindfulness training.

Mrazek and the rest of the research team are extending their work by investigating whether similar results can be achieved with younger populations, or with web-based mindfulness interventions.

They are also examining whether or not the benefits of mindfulness can be compounded by a program of personal development that also targets nutrition, exercise, sleep, and personal relationships.

Saliva Testing Predicts Aggression in Boys

A new study indicates that a simple saliva test could be an effective tool in predicting violent behaviour.

The pilot study, led by Cincinnati Children's Hospital Medical Center and published this week online in the journal Psychiatric Quarterly, suggests a link between salivary concentrations of certain hormones and aggression.

Drew Barzman
Researchers, led by Drew Barzman, MD, a child and adolescent forensic psychiatrist at Cincinnati Children's, collected saliva samples from 17 boys ages 7-9 admitted to the hospital for psychiatric care to identify which children were most likely to show aggression and violence.

The samples, collected three times in one day shortly after admission, were tested for levels of three hormones: testosterone, dehydroepiandrosterone (DHEA) and cortisol.

The severity and frequency of aggression correlated with the levels of these hormones.

Barzman's team focused on rapid, real-time assessment of violence among child and adolescent inpatients, a common problem in psychiatric units, but he believes a fast and accurate saliva test could eventually have several other applications.

"We believe salivary hormone testing has the potential to help doctors monitor which treatments are working best for their patients," said Barzman. "And because mental health professionals are far more likely to be assaulted on the job than the average worker, it could offer a quick way to anticipate violent behaviour in child psychiatric units. Eventually, we hope this testing might also provide a tool to help improve safety in schools."

For this study, the saliva test was used in combination with other aggressive behavior tools, including the Brief Rating of Aggression by Children and Adolescents (BRACHA) questionnaire, an assessment tool also developed by Barzman's team to predict aggression and violence in the hospital.

"This study sample, while small, gives us the data we need to move forward," added Barzman. "We have more studies planned before we can reach a definitive conclusion, but developing a new tool to help us anticipate violent behaviour is our ultimate goal."

Reference
The Association Between Salivary Hormone Levels and Children’s Inpatient Aggression: A Pilot Study. Psychiatric Quarterly, 2013; DOI: 10.1007/s11126-013-9260-8

Violent Video Games Are a Risk Factor for Criminal Behaviour and Aggression

Iowa State researchers say there is a strong connection between violent video games and youth violence and delinquency. 

Credit: Photo by Bob Elbert


People are quick to point the finger or dismiss the effect of violent video games as a factor in criminal behaviour.

New evidence from Iowa State researchers demonstrates a link between video games and youth violence and delinquency.

Matt DeLisi
Matt DeLisi, a professor of sociology, said the research shows a strong connection even when controlling for a history of violence and psychopathic traits among juvenile offenders.

"When critics say, 'Well, it's probably not video games, it's probably how antisocial they are,' we can address that directly because we controlled for a lot of things that we know matter," DeLisi said.

"Even if you account for the child's sex, age, race, the age they were first referred to juvenile court -- which is a very powerful effect -- and a bunch of other media effects, like screen time and exposure. Even with all of that, the video game measure still mattered."

Douglas Gentile
The results were not unexpected, but somewhat surprising for Douglas Gentile, an associate professor of psychology, who has studied the effects of video game violence exposure and minor aggression, like hitting, teasing and name-calling.

"I didn't expect to see much of an effect when we got to serious delinquent and criminal level aggression because youth who commit that level of aggression have a lot of things going wrong for them. They often have a lot of risk factors and very few protective factors in their lives," Gentile said.

The study published in the April issue of Youth Violence and Juvenile Justice examined the level of video game exposure for 227 juvenile offenders in Pennsylvania.

The average offender had committed nearly nine serious acts of violence, such as gang fighting, hitting a parent or attacking another person in the prior year.

The results show that both the frequency of play and affinity for violent games were strongly associated with delinquent and violent behavior.

Craig Anderson
Craig Anderson, Distinguished Professor of psychology and director of the Center for the Study of Violence at Iowa State, said violent video game exposure is not the sole cause of violence, but this study shows it is a risk factor.

"Can we say from this study that Adam Lanza, or any of the others, went off and killed people because of media violence?

You can't take the stand of the NRA that it's strictly video games and not guns," Anderson said.

"You also can't take the stand of the entertainment industry that it has nothing to do with media violence that it's all about guns and not about media violence. They're both wrong and they're both right, both are causal risk factors."

Researchers point out that juvenile offenders have several risk factors that influence their behavior. The next step is to build on this research to determine what combination of factors is the most volatile and if there is a saturation point.

"When studying serious aggression, looking at multiple risk factors matters more than looking at any one," Gentile said.

"The cutting edge of research is trying to understand in what combination do the individual risk factors start influencing each other in ways to either enhance or mitigate the odds of aggression?"

Parents
Just because a child plays a violent video game does not mean he or she is going to act violently.

Researchers say if there is a take away for parents, it is an awareness of what their children are playing and how that may influence their behavior.

"I think parents need to be truthful and honest about who their children are in terms of their psychiatric functioning," DeLisi said.

"If you have a kid who is antisocial, who is a little bit vulnerable to influence, giving them something that allows them to escape into themselves for a long period of time isn't a healthy thing."

Reference
Violent Video Games, Delinquency, and Youth Violence: New Evidence. Youth Violence and Juvenile Justice, 2012; 11 (2): 132 DOI: 10.1177/1541204012460874

Dyslexia and 4 Misconceptions that surround it

Dyslexia is a frequently misunderstood (and often hidden) disability.

Much has changed in the past few decades but unfortunately there are some misconceptions that still exist.

These misconceptions are often perpetuated through a lack of understanding or sympathy, often by people who know little of the difficulties faced by people with dyslexia on a daily basis.

In this article we will explore some of these misconceptions.

1: People with Dyslexia “don’t work hard enough.”
One of the most pervasive myths is that people with dyslexia lack motivation or academic ability.

This is of course completely incorrect, but can also be very damaging to an individual’s self-confidence if they are constantly labelled in this way.

A recent example of this belief was exhibited on ITV’s The Jeremy Kyle Show: Jeremy Kyle Dyslexia Clip - NB: This is very difficult to watch.

2: Dyslexia only affects spelling
In the above video Glyn, a guest, is berated by Kyle for his difficulties with remembering information, in this case his children’s birthdays.

Arguably Kyle has some empathy - he states he has a friend with the disability - however if this is true he should really know that there is a much wider range of dyslexia-related issues than problems with spelling.

People with dyslexia often have difficulties with:
  • Reading
  • Memory
  • Organization
  • Speech
  • Concentration
You can find out more on the NHS Choices website.

3: Dyslexics are a small minority
The British Dyslexia Association (BDA) states that 10% of the UK population is dyslexic. However, not all people with dyslexia are diagnosed and receive help, so this figure could well be higher.

Furthermore, many people with dyslexia don't want anyone else to know, for fear of discrimination in the workplace or when applying for jobs.

4: People with Dyslexia can never improve
While dyslexia is not curable, the notion that someone with the disability is doomed to struggle for life is completely false.

While people with dyslexia certainly flourish in creative industries, there are a wealth of coping strategies and techniques availalable, not to mention a wide range of assistive technology to suit a range of needs.

If you want to find out more about dyslexia, the British Dyslexia Association has an extensive collection of information available here.

Tuesday, March 26, 2013

Children: TV, Games consoles and other Electronic Devices

Spending hours watching TV or playing computer games each day does not harm young children's social development, say some experts.

The Medical Research Council (MRC) team who studied more than 11,000 primary school pupils says it is wrong to link bad behaviour to TV viewing.

Although researchers found a small correlation between the two, they say other influences, such as parenting styles, most probably explain the link but they do still say that parents should "limit screen time".

This cautionary advice is because spending lots of time in front of the TV every day might reduce how much time a child spends doing other important activities such as playing with friends and doing homework, they say.

Paediatric Research
US Paediatric research suggests watching TV in early childhood can cause attention problems at the age of seven.

In the US, paediatric guidelines recommend that total screen time should be limited to less than two hours of educational, non-violent programmes per day.

The UK has no intentions of providing funds to support research on non-profitable parental issues and therefore there are currently no formal guidelines in the UK now, nor will there be in the foreseeable future.

For the MRC study, published in Archives of Diseases in Childhood, Dr Alison Parkes and colleagues asked UK mothers from all walks of life to give details about their child's TV viewing habits and general behaviour.

Electronic entertainment
Almost two-thirds (65%) of the 11,014 five-year-olds included in the study watched TV between one and three hours a day, 15% watched more than three hours and less than 2% watched no television at all.

Watching more than three hours' TV a day at this age predicted a very small increase in "conduct" problems at the age of seven.

After their seventh birthday, these boys and girls were slightly more likely to get into fights, tell lies or be bullies than their peers, according to their mothers' reports.

Time spent playing computer games bore no such relationship.

Hyperactivity and ADHD
There was no association found between TV or any screen time and other behavioural issues; ADHD, hyperactivity or problems interacting with friends.

Dr Parkes, head of the MRC's social and public health sciences unit in Glasgow, said it was wrong to blame social problems on TV.

"We found no effect with screen time for most of the behavioural and social problems that we looked at and only a very small effect indeed for conduct problems, such as fighting or bullying.

"Our work suggests that limiting the amount of time children spend in front of the TV is, in itself, unlikely to improve psycho-social adjustment."

Parenting and Family Dynamics
She said interventions focusing on the family dynamic and the child were more likely to make a difference and that much may depend on what children are watching and whether they were supervised.

Sonia Livingstone
Sonia Livingstone, professor of social psychology, at the London School of Economics, said the findings were a "good reason to ask why some children spend so much time watching television".

Prof Annette Karmiloff-Smith, of Birkbeck, University of London, said that rather than focusing on the possible adverse effects of TV and video games, it would be better to look at what positive impact they could have on children.

Prof Hugh Perry, chair of the MRC's neurosciences and mental health board, said: "We are living in a world that is increasingly dominated by electronic entertainment, and parents are understandably concerned about the impact this might be having on their children's wellbeing and mental health.

"This important study suggests the relationship between TV and video games and health is complex and influenced by many other social and environmental factors."

Monday, March 25, 2013

UK Young cancer deaths 'halved in last 30 years'

The number of teenagers and young adults dying from cancer in the UK has halved since the 1970s, according to a report from Cancer Research UK.

Deaths fell from about 580 per year to 300 in this age group while the largest drop was in those with leukaemia.

More specialised treatments are likely to be behind the trend, the report said.

However, a teenage cancer expert said more young people should be enrolled on clinical trials.

Cancer remains the main cause of death from any disease in teenagers and young adults. Only transport accidents account for more deaths in this age group.

The report, Cancer Statistics Report: Teenage and Young Adult Cancer, calculated that about 2,100 young people aged 15-24 years old are diagnosed with cancer each year in the UK.

But in the past 30 years or so, death rates have fallen in males from 88 deaths per million (in 1975-1977) to 44 deaths per million (in 2008-2010) and in females from 61 deaths per million to 31.

Leukaemia
Leukaemia deaths among teenagers and young adults have seen the greatest drop since 1995 in the UK - from an average of 54 per year to 39 in 2006-2010 in young males and from 38 to 21 deaths per year among females.

Brain tumours were the most common cause of cancer deaths in this age group between 2008 and 2010.

Simon Davies
Simon Davies, chief executive of Teenage Cancer Trust, said he was pleased by the figures but wanted to see greater improvements.

"More investment in rare cancer research is urgently needed. We want to work with Cancer Research UK and the pharmaceutical industry to ensure better access to clinical trials for young people with cancer."

The report said that less than 20% of patients aged 15-24 with cancer take part in clinical trials, compared to 50-70% of child cancer patients under 15 in the UK.

It added that broadening access to clinical trials was essential to improve knowledge of the best treatments for cancers.

Dr Harpal Kumar
Dr Harpal Kumar, chief executive of Cancer Research UK, said more needed to be done to make treatments kinder and more effective.

"Drug development and clinical trials are at the heart of helping more teenagers and young adults both survive cancer and live a full life after their treatment.

"Too many young people are left out of clinical trials due to rigid age restrictions and this must change for us to continue to see improvements across all cancer types."

Those restrictions exist because there are potential dangers in giving young cancer patients adult doses of drugs, therefore researchers are often reluctant to develop trials which cover this age group. Children's cancer drug trials are also very specialised.

Although cancer mortality rates for young people are falling, the incidence of all types of teenage and young adult cancers combined has been rising since the 1990s.

The report was a collaboration between the North West Cancer Intelligence Unit, on behalf of the National Cancer Intelligence Network, and the Paterson Institute of Cancer Studies, at the University of Manchester.

Amniotic fluid 'may heal premature baby gut'

Amniotic fluid, a clear liquid that surrounds the unborn baby (fetus) during pregnancy, may hold the key to healing a fatal gut disease which affects premature babies, doctors say.

Severe inflammation, called necrotizing enterocolitis, can destroy the gut's tissues and lead to major organ failure.

Early animal tests, published in the journal Gut, showed that stem cells inside amniotic fluid could heal some of the damage and increase survival.

Further tests are still needed before it is tried in premature babies.

Pregnancy fluid 
Babies born too soon are not ready for the world outside the womb and their guts are ill-prepared to deal with food.

About one in 10 premature babies in a neonatal intensive care will develop necrotizing enterocolitis.

The inflammation can cause tissue death and lead to a hole in the baby's intestines which can result in a serious infection.

Breast Milk
Breast milk can reduce the risks, but the only major treatment is surgery to remove the diseased tissue. However, 40% of those needing an operation will not survive.

Dr Simon Eaton
"It is quite a problem and we think it is on the increase," said Dr Simon Eaton, from the Institute of Child Health at University College London.

He was part of a team investigating the use of stem cells, which are able to become any other type of cell in the body from nerve to bone, taken from the amniotic fluid which surrounds a developing foetus in the womb.

In experiments on laboratory rats, which are programmed to develop fatal necrotizing enterocolitis, injections of stem cells appeared to increase survival times.

Dr Eaton stated: "We're able to prolong survival by quite a long way.

"What appears to be happening is a direct effect on calming inflammation and also stimulating resident stem cells in the gut to be more efficient at repairing the intestines."

The study showed the intestines were also working better after the treatment.

Dr Paolo De Coppi
Cancer risk?
Fellow researcher Dr Paolo De Coppi said: "Stem cells are well known to have anti-inflammatory effects, but this is the first time we have shown that amniotic fluid stem cells can repair damage in the intestines.

"Although amniotic fluid stem cells have a more limited capacity to develop into different cell types than those from the embryo, they nevertheless show promise for many parts of the body including the liver, muscle and nervous system."

Far more testing would be required to work out if the treatment would work in babies and if it would be safe.

The stem cells would have to be taken from a donor as it would not be practical to store fluid from every birth, just in case. This means there is the risk of rejection.

As the stem cells are capable of becoming other types of cells there is also concern that they may pose a cancer risk.

However, in the future doctors hope they could harness a drug instead.

"It's not the cells, they're delivering something and if we knew what that was then we could deliver that directly," said Dr Eaton.

Sunday, March 24, 2013

Down's syndrome 'linked to brain protein loss'

A lack of a protein in Down's syndrome brains could be the cause of learning and memory problems, says a US study.

Writing in Nature Medicine, Californian researchers found that the extra copy of chromosome 21 in people with the condition triggered the protein loss.

Their study found restoring the protein in Down's syndrome mice improved cognitive function and behaviour.

The Down's Syndrome Association said the study was interesting but the causes of Down's were very complex.

Prof Huaxi Xu, senior author of the study from the Sanford-Burnham Medical Research Institute, said that in experiments on mice they discovered that the SNX27 protein was important for brain function and memory formation.

Mice with less SNX27 had fewer active glutamate receptors and therefore had impaired learning and memory.

The SNX27-deficient mice shared some characteristics with Down's syndrome, so the researchers looked at human brains with the condition.

This confirmed their findings in the lab - that people with Down's syndrome also have significantly lower levels of SNX27.

Neurons from a normal mouse (left) are longer and fuller than neurons from a mouse lacking SNX27 (right)

"So, in Down's syndrome, we believe lack of SNX27 is at least partly to blame for developmental and cognitive defects," Prof Xu said.

In the lab, the research team increased the levels of the protein in mice brains to see if the problem could be resolved.

"Everything goes back to normal after SNX27 treatment," said Xin Wang, a graduate member of the research team.

"First we see the glutamate receptors come back, then memory deficit is repaired in our Down's syndrome mice."

But Prof Xu cautioned that science still had work to do to develop a safe technique of delivering genes into the human brain.

Dyslexia: Cultural Diversity and Biological Unity

Positron emission tomography (Pet)
Abstract
The recognition of dyslexia as a neuro-developmental disorder has been hampered by the belief that it is not a specific diagnostic entity because it has variable and culture-specific manifestations.

In line with this belief, we found that Italian dyslexics, using a shallow orthography which facilitates reading, performed better on reading tasks than did English and French dyslexics.

However, all dyslexics were equally impaired relative to their controls on reading and phonological tasks.

Positron emission tomography (Pet) scans during explicit and implicit reading showed the same reduced activity in a region of the left hemisphere in dyslexics from all three countries, with the maximum peak in the middle temporal gyrus and additional peaks in the inferior and superior temporal gyri and middle occipital gyrus.

We conclude that there is a universal neuro-cognitive basis for dyslexia and that differences in reading performance among dyslexics of different countries are due to different orthographies.

Read Full Text

Dyslexia: A New Synergy Between Education and Cognitive Neuroscience

Abstract 
Reading is essential in modern societies, but many children have dyslexia, a difficulty in learning to read.

Dyslexia often arises from impaired phonological awareness, the auditory analysis of spoken language that relates the sounds of language to print.

Behavioural remediation, especially at a young age, is effective for many, but not all, children.

Neuroimaging in children with dyslexia has revealed reduced engagement of the left temporo-parietal cortex for phonological processing of print, altered white-matter connectivity, and functional plasticity associated with effective intervention.

Behavioural and brain measures identify infants and young children at risk for dyslexia, and preventive intervention is often effective.

A combination of evidence-based teaching practices and cognitive neuroscience measures could prevent dyslexia from occurring in the majority of children who would otherwise develop dyslexia.

Full Text

Sugary Soft Drinks: 180,000 Deaths Worldwide Each Year + Obesity, Diabetes, etc

Sugar-sweetened sodas, sports drinks and fruit drinks may be associated with about 180,000 deaths around the world each year, according to research presented at the American Heart Association's Epidemiology and Prevention/Nutrition, Physical Activity and Metabolism 2013 Scientific Sessions.

Sugar-sweetened beverages are consumed throughout the world, and contribute to excess body weight, which increases the risk of developing diabetes, cardiovascular diseases and some cancers.

Using data collected as part of the 2010 Global Burden of Diseases Study, the researchers linked intake of sugar- sweetened beverages to 133,000 diabetes deaths, 44,000 deaths from cardiovascular diseases and 6,000 cancer deaths.

Seventy-eight percent of these deaths due to over-consuming sugary drinks were in low and middle-income countries, rather than high-income countries.

"In the U.S., our research shows that about 25,000 deaths in 2010 were linked to drinking sugar-sweetened beverages," said Gitanjali M. Singh, Ph.D., co-author of the study and a postdoctoral research fellow at the Harvard School of Public Health in Boston, Mass.

Researchers calculated the quantities of sugar-sweetened beverage intake around the world by age and sex; the effects of this consumption on obesity and diabetes; and the impact of obesity and diabetes-related deaths.

Of nine world regions, Latin America/Caribbean had the most diabetes deaths (38,000) related to the consumption of sugar-sweetened beverages in 2010.

East/Central Eurasia had the largest numbers of cardiovascular deaths (11,000) related to sugary beverage consumption in 2010.

Among the world's 15 most populous countries, Mexico -- one of the countries with the highest per-capita consumption of sugary beverages in the world -- had the highest death rate due to these beverages, with 318 deaths per million adults linked to sugar-sweetened beverage intake.

Japan, one of the countries with lowest per-capita consumption of sugary beverages in the world, had the lowest death rate associated with the consumption of sugary beverages, at about 10 deaths due to per million adults.

"Because we were focused on deaths due to chronic diseases, our study focused on adults. Future research should assess the amount of sugary beverage consumption in children across the world and how this affects their current and future health," Singh said.

The Global Burden of Disease Study 2010 is an international, collaborative, systematic effort to quantify the global distribution and causes of major diseases, injuries and health risk factors.

The American Heart Association recommends adults consume no more than 450 calories per week, from sugar-sweetened beverages , based on a 2,000 calorie diet and offers tips on how Life's Simple 7™ can help you make better lifestyle choices and eat healthier.

The American Beverage Association, in a statement released on its website, disputed the findings of the study and said that they found this report 'hard to swallow.'