Cambridge launch new open access journal – Global Health, Epidemiology and Genomics

GHEG cover_final2

Cambridge unveils new Open Access journal – Global Health, Epidemiology and Genomics (GHEG)

Cambridge University Press is delighted to announce a major new open access journal, Global Health, Epidemiology and Genomics (GHEG), dedicated to publishing and disseminating research that addresses and increases understanding of global and population health issues through the application of population science, genomics and applied technologies.

Global Health, Epidemiology and Genomics is the Press’s second Open Access journal in the field of global health, joining Global Mental Health which launched in 2014. Spanning both non-communicable and communicable diseases, GHEG will specifically integrate epidemiology, genomics and related technological advances in the global health context. Topics relevant to GHEG will include studies, methods and resources relating to global population health, disease aetiology, variation in disease susceptibility, drug resistance and surveillance, health care and health care systems, pharmacogenomics and stratified medicine, as well as the challenges of implementing new developments into clinical practice and the community, globally. In addition to more traditional Original Research and Review Articles, GHEG will support submission of Resources and Analyses that provide a framework for integrating and facilitating genomics and global health studies.

The Editor-in-Chief of GHEG is Dr Manjinder Sandhu, head of the Global Health Group based at the University of Cambridge and the Wellcome Trust Sanger Institute. The international Editorial team includes recognised leaders in global health, epidemiology and genomics from around the world who have taken a lead in shifting attention and action to global health and populations, as well as a wider Editorial Board that will reflect and emphasize the broad scope of the field.

Dr Sandhu said, “I am committed to making GHEG an innovative, engaging and practical resource for the global health research community through which we can publish new scientific research, exchange ideas within and across our related disciplines and share resources to facilitate efforts to increase our understanding of human health and shape effective disease management worldwide.”

Professor Alex Brown, Deputy Director of the South Australia Health & Medical Research Institute (SAHMRI) and one of the journal’s Associate Editors commented, “I am delighted to be involved with GHEG, an exciting venture which recognises the relevance and importance of the work being undertaken in the field of global health, epidemiology and genomics and the widespread benefits to be gained by applying technological advances and innovations to research into population health including within disadvantaged population groups. By facilitating discussion and encouraging the sharing of resources GHEG looks to actively support contributions in these areas.”

Katy Christomanou, Publishing Director for STM Journals at Cambridge University Press, added, “This launch affirms our long-term commitment in the global health field and reflects our strong investment in maintaining and extending our successful presence in this area. We are highly enthusiastic at the prospect of working alongside such an outstanding editorial team.”

Global Health, Epidemiology and Genomics will be hosted on Cambridge’s industry-leading platform, Cambridge Journals Online (CJO). The Journal will benefit from a range of the latest author services including article level usage metrics and Altmetric data. In addition, for articles submitted during 2015 and 2016, Cambridge University Press will waive all article processing charges.

For more information please visit the journal website: journals.cambridge.org/gheg

Psychotic symptoms in frontotemporal dementia: a diagnostic dilemma?

shutterstock_213453766

The April International Psychogeriatrics Article of the Month is entitled “Psychotic symptoms in frontotemporal dementia: a diagnostic dilemma?” by Maria Landqvist Waldö, Lars Gustafson, Ulla Passant and Elisabet Englund.

Despite all attempts to develop clinical diagnostic criteria with high specificity and sensitivity early diagnosis in FTD remains a challenge, even for the experienced clinician. The patients may present with a wide range of symptoms that often mimic other psychiatric disorders and initial psychiatric diagnoses are common. Psychotic symptoms are known to be prominent symptoms in several neurodegenerative diseases including AD and DLB, and have previously been thought to be quite rare in FTD. There are indications that a high prevalence of psychotic symptoms seems to be associated with specific molecular and genetic subgroups of FTD, but as this has not been adequately studied we examined prevalence of psychotic symptoms and possible correlations to brain pathology in FTD. Furthermore we evaluated clinical diagnostic accuracy as well as family history in our cohort of 97 neuropathologically diagnosed FTD cases.

We found that psychotic symptoms were present at some time during the course of dementia in 32% of our cases. There were no significant differences in gender, age at onset or disease duration between patients with and without psychotic symptoms. The most common type of psychotic symptoms was paranoid ideas (20.6%) followed by hallucinations and delusions (17.5%) in equal measure. There was a strong significant correlation between psychotic symptoms and predominantly right-sided brain degeneration.

We could see a trend with more frequent psychotic symptoms in tau-negative cases, however not statistically significant. Psychotic symptoms were particularly common in the cases with FUS pathology and in those without identified brain protein pathology.

The majority of patients received other first diagnoses than FTD, often psychiatric diagnoses. The patients with an initial psychiatric diagnosis were significantly younger than patients with other first diagnoses. About 80% patients where subsequently diagnosed with FTD and among these the median time from symptom onset until diagnosis was 4 years with median disease duration of 7.5 years, however with large variations. A clinical diagnosis of psychosis was almost exclusively given to tau-negative cases.

This is one of the largest studies aimed at assessing the prevalence of psychotic symptoms in FTD and relating them to neuropathology. Compared to many other studies we found a higher prevalence of psychotic symptoms. A correlation between psychotic symptoms and right-sided predominant pathology has been suggested earlier, but to our knowledge never shown in such a large neuropathological study. Although previous studies have found differences in the prevalence of psychotic symptoms between tau-positive and tau-negative cases, we did not find any significant differences between the groups. We identified two groups with particular high prevalence of psychotic symptoms: the FUS pathology cases and those with no identified protein pathology. Our FUS cases share many features with previous reports of this specific group such as young age at onset, no heredity for dementia and prominent neuropsychiatric symptoms. Interestingly, the cases from the group without specific protein pathology also display prominent psychiatric symptoms.

Read the full paper “Psychotic symptoms in frontotemporal dementia: a diagnostic dilemma” by Maria Landqvist Waldö, Lars Gustafson, Ulla Passant and Elisabet Englund

Read the commentary paper “Commentary on:  in frontotemporal dementia: a diagnostic dilemma?” by John T. O’Brien

Dodo bird verdict given new life by psychosis therapy study | The University of Manchester

alice and the dodo- shutterstock_75202624
A study by researchers at The University of Manchester and the University of Liverpool has examined the psychological treatment of more than 300 people suffering from psychosis, showing that, whatever the therapy, it is the relationship between the patient and therapist which either improves or damages wellbeing.

The research relates to one of the more controversial ideas in psychotherapy research – the Dodo bird conjecture.  Named after a bird in Alice’s Adventures in Wonderland which sent several characters on a race and then declared them all winners, this conjecture states that all types of psychotherapy, even though often appearing to be very different from each other, are equally beneficial to patients.

In this case, the research showed that it is the quality of the relationship between the therapist and patient which causes improvement and not the different techniques employed in the two therapies that were compared.

Many studies have looked at types of talking treatment which can help people recover from psychotic episodes.  These include cognitive behavioural therapy (CBT) and family therapy. High quality research uses a comparison group which also receives some kind of less structured treatment, for example supportive counselling or befriending.

Surprisingly, patients in these comparison groups often benefit from the comparison treatment as much as those receiving the specific, targeted therapies (CBT or family therapy). Both groups who receive a psychosocial treatment fare much better than those offered only medication and usual care.

The researchers explored in depth the causative effect of the ‘therapeutic alliance’ or relationship of trust between patient and psychologist when schizophrenia patients were treated during a trial of this kind.

Lucy Goldsmith, a PhD candidate from The University of Manchester’s Institute of Brain, Behaviour and Mental Health, carried out the research in collaboration with the researchers who had carried out the original trial: Manchester professors Shôn Lewis and Graham Dunn, and Liverpool professor Richard Bentall. She said: “The quality of the therapeutic relationship has been linked to outcomes before, but we wanted to see whether the it really causes the changes in wellbeing occurring during therapy.

“Does successful treatment make patients feel well disposed towards their therapist or is the relationship actually at the heart of whether therapy succeeds?”

By using already established rating systems of these relationships and taking data from the earlier study of 308 patients, the researchers found that a good level of therapeutic alliance had a beneficial impact on wellbeing, but where the relationship was poor, the treatment could actually be damaging.

“The implications are that trying to keep patients in therapy when the relationship is poor is not appropriate,” Lucy said.  “More effort should be made to build strong, trusting and respectful relationships, but if this isn’t working, then the therapy can be detrimental to the patient and should be discontinued.

“The study clearly shows that the two types of therapy are equally beneficial to the patient – as long as the trust, shared goals and mutual respect between client and psychologist are in place.”

The paper, ‘Psychological treatments for early psychosis can be beneficial or harmful, depending on the therapeutic alliance: an instrumental variable analysis,’ was published in the journal, Psychological Medicine.

via Dodo bird verdict given new life by psychosis therapy study | The University of Manchester.

The paper, “Psychological treatments for early psychosis can be beneficial or harmful, depending on the therapeutic alliance: an instrumental variable analysis” has been published gold Open Access, and can be found using this link. 

 

The importance of Youth Mental Health

young children jumping_2

Find out the Guest Editors’ (Mary Cannon and John Lyne) response to questions about youth mental health following a recent special issue in Irish Journal of Psychological Medicine.

What is Youth Mental Health?

Youth Mental Health refers to mental health among adolescents and young adults. The time period covered by the term “youth mental health” typically ranges between 15-25 years of age though some would advocate that this should extend from 12-30 years. Youth mental health focuses on the well-being of young people, and aims to ensure that young people transition between childhood and adulthood with positive mental health. With this in mind a recently published issue of the Irish Journal of Psychological Medicine provided a focus on mental health during this youth phase of people’s lives.

Why highlight the Youth Mental Health agenda?

It is now recognised that many so-called “adult” mental health difficulties have their origins during adolescence and young adulthood. An illness prevention focus has been very effective in reducing the prevalence of some illnesses, such as heart attacks and cancers, however similar strategies have lagged behind in the field of mental health. Appropriate help for young people early in their lives has the potential to reduce later mental health morbidity. However, despite the high levels of mental health issues among young people, services for this age-group remain fragmented and difficult to access.  The delivery of tailored youth-friendly services could help address this need and is a particular focus of youth mental health advocates.

Why publish this special issue now?

This Special Issue follows on from the adoption of Youth Mental Health as the official annual theme by the College of Psychiatry of Ireland in 2013. Several annual Youth Mental Health Research conferences have been held in Ireland since 2011, establishing Ireland as one of the leading international countries in the field of youth mental health. This special issue aims to harness the large amount of research activity in this area in Ireland and internationally.

What does the issue include?

Scientific papers were contributed by several high profile national and international researchers. New data papers are included which report the prevalence of mental disorders among young Irish adults. Risk and protective factors for mental illness in young people and the importance of early intervention in psychosis and bipolar disorder are also addressed.  Editorials and perspective pieces by experts in the field address the challenges in providing seamless care during transition from childhood to adulthood, and give examples of youth services developed in United Kingdom, Canada and Ireland. Overall this special issue brings together high quality research which highlights that youth mental health should be prioritised on health policy agendas.

 

Read the full contents of the special issue free of charge here for a limited time period

If you are using a mobile device please click here to view the issue

 

Variability in estimating the self-awareness of memory deficits

shutterstock_140571478

The March International Psychogeriatrics Article of the Month is entitled ‘Awareness of memory deficits in subjective cognitive decline, mild cognitive impairment, Alzheimer’s disease and Parkinson’s disease’ by Johann Lehrner, Sandra Kogler, Claus Lamm, Doris Moser, Stefanie Klug, Gisela Pusswald, Peter Dal-Bianco, Walter Pirker and Eduard Auff

As the world population ages, we face sharp rises in prevalence rates for neurodegenerative diseases. In order to minimize entailing individual and societal burdens, early diagnosis is becoming increasingly important. Efforts to enable early recognition of impending cognitive decline led to the development of the concept of Mild Cognitive Impairment (MCI), which describes a transitional stage between normal age-related memory decline and dementia. Yet, not all individuals diagnosed with MCI can be considered as being in a prodromal phase of dementia. Accordingly, ongoing research is now focusing on the identification of (a) those individuals with MCI who are most likely to convert to dementia and (b) asymptomatic individuals in a pre-MCI stage. Yet, which early markers are available for their identification?

With some evidence pointing towards a connection between low memory awareness – an inability to (fully) recognize memory deficits – and subsequent memory decline, awareness measures bear potential as an important marker of underlying dementia pathologies. However, as research in this field is defined by inconsistencies, this hypothesis needs further investigation.

We therefore used data concerning our patients’ subjective memory appraisals and objective memory performance to create an awareness index, which allowed us to compare levels of awareness (and frequencies of memory overestimation) across healthy elderly people and patients with varying degrees of memory impairment. Our question was whether our approach would reveal characteristic awareness differences similar to prior research.

As expected, our findings suggest that self-awareness of memory deficits decreases as cognitive deficits – especially memory deficits – increase. Accordingly, the highest rate of overestimation of memory function was found among patients suffering from Alzheimer’s disease (63%), followed by amnestic MCI patients without and with Parkinson’s disease (46%, 38%), while patients with cognitive deficits other than memory (non-amnestic MCI) showed a tendency towards underestimation of memory function. Our analyses further revealed considerable between-group overlaps in awareness scores and strong influences of non-cognitive factors such as depression.

The main implication of our study is that memory awareness reflects objective deterioration to some extent, but that there is considerable inter-individual variability in awareness. It is this variability which gives rise to the question whether differences in awareness are predictive of future conversion to dementia.

We hold the view that research in this field is important insofar as awareness measures are of high practical relevance: As opposed to biomarkers and neuroimaging technologies, which are of restricted availability in primary care settings, both measures of subjective memory complaint and objective memory performance provide easily, time- and cost efficiently accessible sources of information. Moreover, they count among the standard repertoire of diagnosis in MCI and other dementia-related diseases. Researchers could use these data to further explore the diagnostic and predictive validity of awareness measures. We hope that our work inspires further research concerning memory awareness and strongly welcome any comments and remarks.

The full paper “Awareness of memory deficits in subjective cognitive decline, mild cognitive impairment, Alzheimer’s disease and Parkinson’s disease” is available free of charge for a limited time here.

The commentary on the paper, “Awareness of memory deficits in subjective cognitive decline, mild cognitive impairment, Alzheimer’s disease and Parkinson’s disease” is also available free of charge here.

Are men with moustaches more likely to carry nasal bacteria?

Featured image

This paper discusses the results of an investigation concentrating on men with and without a moustache, to explore whether having facial hair may lead to an increase in nasal Staphylococcus aureus (S aureus) colonisation.

S. aureus can be considered as a serious public health issue. It can cause a range of illnesses, from minor skin infections to life-threatening diseases such as pneumonia, meningitis, and food poisoning, although the presence of S. aureus does not always indicate infection.

The anterior nares (nostrils) are where S. aureus resides in human beings, and it has been shown that nasal carriers of S aureus have an increased risk of acquiring an infection with this pathogen. Despite antibiotic therapy, nasal infections occur frequently in hospitalised patients, often with severe consequences.  In order to fully address this public health problem, it is important to understand whether the presence of a moustache effects the colonisation of nasal infections.

To test this hypothesis the researchers took men who had been wearing a moustache for at least one year and compared them to the participants in the control group who had shaved the hair in this region daily over the previous year. None of the participants had been hospitalised or treated with antibiotics in the previous three months nor were they smokers or had any previous respiratory infections in the past.

The study group consisted of 118 adult men with a moustache and 123 men without a moustache, all of whom gave samples from their right nasal cavity for the study of cytology and the left nasal for microbiology testing.

The results of the swab testing indicated that nasal Staphylococcus aureus carriage is similar in men with (19.5%) and without (20.3%) a moustache.

As a moustache is situated at the entrance to the nostrils, some bacterial contamination might be possible, especially in nasal S aureus carriers. Nevertheless, this study indicated that nasal S aureus carriage is similar in men with and without a moustache. The carrier rate of S aureus observed here is comparable to those rates reported in the literature. Therefore, having a moustache does not increase the risk of S aureus colonisation in the nose.

The full paper, published in The Journal of Laryngology & Otology, “Effect of a moustache on nasal Staphylococcus aureus colonisation and nasal cytology results in men” by E. Soylu, I. Orhan, A. Cakir, A. Istanbullu, G. Altin, R. Yilmazer and O. F. Calim can be viewed free of charge here for a limited period.

A provisional consensus clinical and research definition for Agitation in cognitive disorders

Cloud 3 (1)

The January International Psychogeriatrics Article of the Month is entitled ‘Agitation in cognitive disorders: International Psychogeriatric Association provisional consensus clinical and research definition’ by Jeffrey Cummings, Jacobo Mintzer, Henry Brodaty, Mary Sano et al.

Agitation is common across neuropsychiatric disorders and contributes to disability, institutionalization, and diminished quality of life for patients and their caregivers. There is no consensus definition of agitation and no widespread agreement on what elements should be included in the syndrome.

Agitation is a common clinical manifestation of many neuropsychiatric disorders. It is a frequent manifestation of Alzheimer’s disease (AD), frontotemporal dementia (FTD), dementia with Lewy bodies (DLB), and other dementia but also occurs in schizophrenia, bipolar illness, and depression. While agitation may include aggressive behaviors, it is not identical to aggression, and agitation can occur without aggression (e.g. pacing, rocking, repetitious mannerisms).

The International Psychogeriatric Association (IPA) formed an Agitation Definition Work Group (ADWG) to develop a provisional consensus definition of agitation in patients with cognitive disorders that can be applied in epidemiologic, non-interventional clinical, pharmacologic, non-pharmacologic interventional, and neurobiological studies. A consensus definition will facilitate communication and cross-study comparison and may have regulatory applications in drug development programs.

The ADWG implemented a transparent process that included nearly 1,000 survey respondents and engaged the memberships of the IPA, IPA affiliates, and other organizations involved in the care and research of neuropsychiatric disorders in patients with cognitive impairment. The group used a combination of electronic, face-to-face, and survey-based strategies to develop a consensus based on agreement of a majority of participants. Nine-hundred twenty-eight respondents participated in the different phases of the process.

An initial survey provided valuable insights from those involved in the care of agitated patients, and key elements of the definition were identified. Of the items listed as possible behaviors to be included in a definition of agitation, the following were endorsed by at least 50% of the respondents: pacing, aimless wandering, verbal aggression, constant unwarranted requests for attention or help, hitting others, hitting self, pushing people, throwing things, general restlessness, screaming, resistiveness, hurting self, hurting others, tearing things or destroying property, shouting, and kicking furniture. This information guided the elements included in the definition by the ADWG.

Agitation was defined broadly as: (1) occurring in patients with a cognitive impairment or dementia syndrome; (2) exhibiting behavior consistent with emotional distress; (3) manifesting excessive motor activity, verbal aggression, or physical aggression; and (4) evidencing behaviors that cause excess disability and are not solely attributable to another disorder (psychiatric, medical, or substance-related). A majority of the respondents rated all surveyed elements of the definition as “strongly agree” or “somewhat agree” (68–88% across elements). A majority of the respondents also agreed that the definition is appropriate for clinical and research applications.

The development of a provisional definition of agitation is the first step in advancing a research agenda for the definition. Not all elements were unanimously endorsed; a consensus was achieved on all aspects of the definition. Validity studies using other agitation assessments, reliability of the application of the definition, usefulness in clinical trials, usefulness in non-pharmacologic research, and real-world application in clinical and healthcare settings will lead to refinements and adjustments that will enhance the definition and advance the study of neuropsychiatric syndromes in cognitive impairment disorders.

 

The full paper “Agitation in cognitive disorders: International Psychogeriatric Association provisional consensus clinical and research definition” has been published Open Access and is available here.

The commentary on the paper, “Defining agitation in the cognitively impaired–a work in progress” is also available free of charge here.

A looming danger…

shutterstock_222042955 - loom bands
This paper reports on four paediatric patients who presented with a loom band associated foreign body in the nose over a 7-day period at a district general hospital in Scotland. The patients were two three-year old and two four-year old children with either loom bands or the S-shaped hooks in their noses.

There has been a surge in the popularity of loom bands amongst children in recent months. These small rubber bands, which can be woven together to make colourful bracelets and necklaces, have become the world’s most popular toy. Foreign bodies in paediatric nasal and aural cavities are a common presentation to ENT units across the country. Whilst most are removed without incident, foreign bodies in nasal passages represent a potential risk for inhalation, leading to airway obstruction.

Two of the cases resulted in the item being removed with local anaesthetic and forceps, and in one case, forceps without anaesthetic. In the fourth case, the hook was originally visible deep within the nasal passage, but partial inhalation into the posterior nasal passage meant that the hook was no longer visible. Whilst waiting for a senior medical review, the patient was observed to choke.  After examination, it was assumed that the patient had ingested the foreign body and after a short period of observation, the patient was released.

Although the four cases presented were resolved without the need for general anaesthetic, the ever-soaring prevalence and popularity of loom bands necessitates a degree of caution and vigilance from parents, retailers and manufacturers alike.

The authors said, “Foreign body airway obstructions in children are potentially avoidable, life-threatening events. The case series presented reflects a poor public understanding of the complications of inhaled foreign bodies in children and limited hazard advertising by the manufacturers of loom bands. There is a great urgency to rectify this in light of the ever-increasing popularity and availability of loom bands.”

 

 The full paper, published in The Journal of Laryngology & Otology, “Loom bands and young children – a tragedy waiting to happen?” by I R M Bohler, C Douglas and S Ansari, can be viewed free of charge here for a limited period.

Pregnant women are exceeding weight gain guidelines

Mums-to-be are advised to watch their “overall food intake and takeaway consumption” following the results of a new study on the health behaviours and psychological well-being of pregnant women in Ireland.

The findings published in the scientific journal Public Health Nutrition reveal that almost two-thirds (62.5%) of women in Ireland exceed the recommended levels* of weight gain during pregnancy.

According to the study, pregnant women who report eating “a little more food” during their pregnancy are 60% more likely to gain excessive weight over the course of their pregnancy than those women who report eating “about the same” as before they became pregnant. It also shows that women who report eating “a lot more food” during their pregnancy are twice as likely to exceed weight gain guidelines.

The study identifies “increased food intake and takeaway consumption” as two key drivers of weight gain during pregnancy. To conduct the study researchers at University College Dublin and the National Maternity Hospital examined four health behaviours of almost 800 pregnant women: food intake, physical activity, sleep and smoking. They also assessed additional dietary behaviours including the frequency of takeaway and fried food consumption and the number of snacks eaten per day.

The findings show that foreign nationals living in Ireland are almost twice as likely as women born in Ireland to gain excessive weight over the course of their pregnancy.

“Excessive weight gain during pregnancy has significant implications for infant growth and obesity, with potential implications for later adult health,” says Fionnuala McAuliffe, Professor of Obstetrics and Gynaecology at UCD School of Medicine & Medical Science, University College Dublin, and the National Maternity Hospital, Holles Street, Dublin, who co-authored the study.

“With these findings, public health campaigns can be better designed to target the types of dietary changes required to bring weight gain during pregnancy into line with the recommended guidelines.”

Women who were overweight before they became pregnant were also shown to be the most likely to gain excessive weight during their pregnancy. This matches findings from many other studies in this area. “To our knowledge, this is the first study to find an independent association between consumption of takeaway meals and weight gain during pregnancy,” says Dr Emily Heery of the UCD School of Public Health, Physiotherapy and Population Science, University College Dublin, the lead author of the study. 53% of the women who took part in the study were first time mums-to-be, 30% were foreign nationals, and almost half (47%) had obtained at least a degree qualification. Over half (55%) of the women had private health insurance.

The article is freely available until 27 February 2015.

– Dr Emily Heery

How to measure mood in nutrition research

The January Nutrition Society Paper of the Month is from Nutrition Research Reviews  and is entitled “’How to Measure Mood in Nutrition Research”.

Mood is widely assessed in nutrition research, usually with rating scales. We have been researching the effects of food on mood for over twenty years, which has highlighted concerns about how mood is measured, one result of which is this review; we have been working on it intermittently ever since.

From early on, we had serious concerns because the mood effects of food are often fragile and hard to replicate, yet many foodstuffs are marketed and consumed on the assumption that they affect mood, at least by being pleasurable, and perhaps also by having functional effects on the nervous system. One of the striking but hard to substantiate claims made repeatedly since the 1960s was that sugar has drug-like effects by artificially elevating mood, followed by a rebound ‘sugar blues’ requiring further consumption of sugar. Consequently, we have largely focused on sucrose in our research.

There are some basic problems with how mood is measured. The questionnaires used to rate mood have not always been shown to be sensitive to relatively rapid ‘transient’ changes in mood because they were designed to compare mood over different days or weeks, as in the study of depression.  It is therefore possible that nutrition research often fails to detect mood effects of food that actually exist.

Another difficulty is that the use of different rating scales in different combinations, given at different times, in different experimental designs, propagates inconsistent and uncertain results. Mood rating can be affected by many aspects of an experiment other than the food given, and generally research participants should be blind to the experimental manipulation.

There are other more theoretical difficulties: It is commonly assumed that mood is what mood scales measure, most often arousal, and positive versus negative mood; It is also often assumed that rated mood is an unproblematic measure of experienced subjective mood, which is in turn related to underlying physiological condition. So for instance rating oneself aroused means you feelaroused and are aroused by measures such as skin conductance and heart rate. In reality, rated mood, phenomenological mood and physiological state are correlated with each other, but can vary separately and be affected by different causes. For instance, it is possible for mood ratings to change without there being an underlying conscious experience of change. As well as improving methods of rating mood, there is a need for a better theory of how mood and mood rating work. This review along with an earlier paper in Neuroscience and Biobehavioral Reviews is our attempt to improve practice in the assessment and understanding of mood in nutrition research.

– Professor Richard Hammersley

This paper is freely available for one month via the following link: journals.cambridge.org/ns/Jan15

Common mental disorders prevalent in UK military « King’s College London

tank - iStock_000021677595Medium
Symptoms of anxiety and depression appear to be twice as frequent in the UK military as in the general working population, according to research carried out at the King’s Centre for Military Health Research (KCMHR), King’s College London and published in Psychological Medicine.

The study compared data from over 7,000 personnel serving in the UK Armed Forces with 7,000 people from the general population identified as being in employment from the Health Survey for England. Both surveys used the General Health Questionnaire (GHQ) and it was found that symptoms of common mental disorders (CMD) (i.e. anxiety and depression), appeared to be twice as frequent in the military as in the general working population. In fact, 18% of men and 25% of women serving in the Armed Forces reported symptoms of CMD compared to 8% of men and 12% of women in the general working population.  This difference was apparent at both time points of the study, 2003 and 2008.

Lead author, Dr Laura Goodwin from KCMHR said ‘This is the first formal comparison of common mental disorders between the serving military and the general working population. Whilst symptoms of common mental disorders appear to be twice as common in the military after accounting for age, gender and social class, there is more to be done to understand these differences.’

The researchers had previously found that there is a tendency for over reporting of symptoms of anxiety and depression in occupational studies aimed at specific groups such as police, teachers and social workers. The Health Survey for England was a population study in which an individual’s occupation was not the main focus, which is likely to have had some effect on the results.

One way it was a considerable improvement on earlier research was that previous studies have all been forced to compare different measures of CMD, which is a major limitation, whereas in this study all participants completed the same questionnaire, the GHQ. Also, some previous surveys have included individuals who are unemployed and those with long-term health problems and disabilities and these groups are more likely to report symptoms of depression and anxiety, so this comparison of military employees with only those in employment from the general population is a fairer like-for-like comparison.

The survey included questions such as whether the subject felt they were ‘playing a useful part in things’, and military respondents were almost three times more likely to disagree with this statement than the general population at both time points. On the other hand, the smallest difference between the military and general population was found for the statement ‘felt constantly under strain’.

The researchers suggest that differences in the prevalence of symptoms of depression and anxiety in this extensive study could be explained by the frequency and intensity of stressful events experienced by military personnel and that military life requires extended periods spent away from family and friends, for training and exercises as well as for deployment.

Professor Nicola Fear, KCMHR concludes: ‘This highlights that symptoms of depression and anxiety are common in the Armed Forces, in fact, they are more common than alcohol misuse or post-traumatic stress disorder (PTSD).  The findings draw attention to the need for Defence Medical Services to continue to focus on identifying and treating depression and anxiety in addition to PTSD.’

Paper reference: Goodwin, L. et al. ‘Are common mental disorders more prevalent in the UK serving military compared to the general working population?’ published in Psychological Medicine DOI: http://dx.doi.org/10.1017/S0033291714002980

via King’s College London – Common mental disorders prevalent in UK military.

International Psychogeriatrics – Special issue on Young Onset Dementia

iStock_000050807864Large
International Psychogeriatrics
has published a special issue on Young Onset Dementia, guest edited by Raymond Koopmans and Tor Rosness.

The rising prevalence of dementia includes an increase of people with Young Onset Dementia (YOD). Studies have scrutinized the literature and documented distinct differences in traits between younger and older persons with dementia in several areas such as medical treatment, physical activity, functional level, activities of daily living, comorbidity, risk profiles, and caregiver distress. However, the cut-off of 65 years is arbitrary and there is still no consensus on if a diagnosis of dementia has to be made before the age of 65 years or if it is sufficient that the first symptoms are detected before the age of 65 years?

YOD is being steadily recognized as an important psychosocial and medical health problem with specific-age-related adverse consequences for both these younger persons and their families, however, many countries lack specific plans in their dementia strategies and do not offer any specific form of services or support for this group of individuals. Therefore the International Psychogeriatric Association (IPA) established a taskforce on YOD. The idea of composing a special issue on YOD was raised during The Hague meeting in 2011, and the issue consists partially of papers that have been presented during the symposia and workshop-meetings of the taskforce.

The YOD special issue provides an overview of important topics including unmet needs of carers, different clinical approaches to YOD diagnoses, needs of children with YOD parents, and medical treatment of behavioral symptoms of YOD patients.

We are offering limited time free access to the articles from this issue – simply register using our short form, using the code IPGYOD2

Socio-economic inequalities in diet in UK adults

The December Nutrition Society Paper of the Month is from British Journal of Nutrition and is entitled “Socio-economic dietary inequalities in UK adults: an updated picture of key food groups and nutrients from national surveillance data”.

Study written in the British Journal of Nutrition found that those higher up on the socio-economic ladder are generally healthier and are less likely to be obese, and what people eat varies across different social groups.  It’s a reasonable assumption that these two phenomena are connected, but in the UK social inequalities in diet have not been comprehensively assessed in recent years.  While plenty of studies have documented socioeconomic differences in fruit and vegetable consumption, less is known about other food groups and nutrients, including fish and processed meat.  We also need to better understand the extent to which inequalities in diet differ across different indicators of socioeconomic position such as income, education and occupation.  This matters because unless we can understand the social and economic pattern of diet we will struggle to find the right strategies to improve public health for everyone.

Our study examined foods and nutrients eaten in a nationally-representative sample of 1491 UK adults stratified by socioeconomic position (SEP).  Data came from the rolling programme of the National Diet and Nutrition Survey 2008-2011. We calculated average intakes of five foods and nutrients across three indicators of SEP: equivalised household income, occupational social class, and highest educational qualification. The choice of foods and nutrients for this study was informed by the Scientific Advisory Committee on Nutrition’s (SACN) 2008 report on the nutritional status of the British population. This report expressed concern over whether people in the UK were eating enough fruit, vegetables and oily fish; and whether they were eating too much red and processed meat, sugar and saturated fat.

We found that, not only did the sample as a whole not meet recommended intakes, those of a lower SEP fared the worst.  For the food groups, the least educated adults ate 128grams a day less fruit and vegetables than the most educated; the lowest occupational class consumed 26grams a day more red and processed meat than those in higher managerial occupations; and the highest income group were four times more likely than the lowest to have consumed any oily fish.  The amount of calories from sugars (non-milk extrinsic sugars) was around two percentage points higher in the lower SEP groups. No pattern of saturated fat consumption was found for any of the socio-economic indicators.

So, what does this mean for action to tackle health inequalities?  Our study provides up-to-date evidence about specific food groups  that are of concern for public health nutrition, and is a reminder of the importance of monitoring dietary trends in a time of entrenched and rising inequality. It also adds important detail in terms of how different aspects of life experience and social position can affect what we eat. For instance, income or occupation may affect our material ability to access a healthy diet, or education may equip us to make healthier choices. When developing policies and interventions to tackle unhealthy diet, it is vital to take into account these different aspects of our lives.

This paper is freely available for one month via the following link: journals.cambridge.org/ns/dec14

Calorie-focused thinking when it comes to obesity may mislead and harm public health

Perhaps not all calories are created equal. A new paper, co-authored by Saint Luke’s Mid America Heart Institute cardiovascular research scientist James J. DiNicolantonio, PharmD, challenges the prevailing belief that all consumed calories—regardless of their sources—are equivalent, and that focusing on calories is a good thing.

Primarily authored by Sean C. Lucan, M.D., M.P.H., M.S., Department of Family and Social Medicine, Albert Einstein College of Medicine, the paper is titled “How calorie-focused thinking about obesity and related diseases may mislead and harm public health. An alternative,” and is being published in the journal Public Health Nutrition.

The paper discusses various problems with the idea that “a calorie is a calorie,” and with the primarily quantitative focus on food calories. Instead, the authors argue for a greater qualitative focus—paying more attention to the foods from which the consumed calories derive—and on the metabolic changes that result from consuming foods of different types. In particular, Lucan and DiNicolantonio consider how calorie-focused thinking is inherently biased against high-fat foods, many of which may be protective against obesity and related diseases (e.g. nuts, olive oil, oily fish, whole milk), and supportive of starchy and sugary replacements, which are likely detrimental.

The idea that “a calorie is a calorie” implies that any two different foods, which have equivalent amounts of potential energy, will produce identical biological effects with regard to body weight/body fatness when consumed. By this thinking, a calorie’s worth of salmon, olive oil, white rice, or vodka would each be equivalent and expected to have the same implications for body weight and body fatness.

But a calorie’s worth of salmon, which is largely protein, and a calorie’s worth of olive oil, which is purely fat, have very different biological effects than a calorie’s worth of white rice, a refined carbohydrate, or a calorie’s worth vodka, mostly alcohol—particularly with regard to body weight/body fatness. In fact, studies in humans have shown that calorie-providing proteins, fats, carbohydrates, and alcohol each have substantially different effects on a variety of physiologic pathways and hormones relevant to perceived fullness, subsequent food consumption, weight maintenance, and body composition.

The paper specifically discusses the harmful effects of rapidly absorbable carbohydrates—sugars and refined starches, such as white rice and foods consisting substantively of white flour. These foods cause blood sugar and insulin to rise quickly, which then causes a rapid drop in blood sugar. The result is food cravings, particularly for something sweet.

“The fact is that some calories will squelch a person’s appetite and promote energy utilization, while others will promote hunger and energy storage,” DiNicolantonio said. “So while some calories send messages to the brain and body that say ‘I’m full and ready to move,’ other calories are send messages that says ‘I’m still hungry and just want to lie down on the couch.’ Not all calories are the same, and in order to promote healthy weight and better health, we need to take special note of the calories we are choosing to consume.”

Lucan and DiNicolantonio stress in their paper that public health should work primarily to support the consumption of whole/minimally processed foods—which help protect against obesity-promoting energy imbalance and metabolic dysfunction—and not continue to promote calorie-directed messages that may create and blame victims and possibly exacerbate epidemics of obesity and related diseases.

Read the full article here until 24th December 2014.

Posted on behalf of Dr James DiNicolantonio,  Saint Luke’s Mid America Heart Institute

Male sexual orientation influenced by genes

shutterstock_137191982
Results of a five-year study of 409 independent pairs of homosexual brothers in 384 families find that genetics play a key role in male sexual orientation. Alan Sanders, M.D., a psychiatrist who studies behavioral genetics at NorthShore University HealthSystem Research Institute, was the principal investigator of the molecular genetics study that scanned the entire human genome to search for evidence of genetic links to variation in sexual orientation in men.

“We found two strong links in chromosome 8 and chromosome Xq28, which supports that this is not a one-gene, one-trait scenario,” said Dr. Sanders. “These genetic variations contribute to the development of the important psychological trait of male sexual orientation.

The new evidence “is not proof but it’s a pretty good indication” that genes on the two chromosomes have some influence over sexual orientation.”

Participants in the study were gay men with at least one living gay brother (full brothers, half brothers or fraternal twins). They were asked to provide DNA samples through blood or saliva and to complete a questionnaire about their sexual and personal history and that of immediate family members. The study was funded by the US National Institutes of Health from the National Institute for Child Health and Human Development.

“Understanding the origins of sexual orientation enables us to learn a great deal about sexual motivation, sexual identity, gender identity and sex differences,” Dr. Sanders added.

The full paper, “Genome-wide scan demonstrates significant linkage for male sexual orientation”, which is published in Psychological Medicine can be read free of charge for a limited time here.

Explore the online archive of AGMG

AGMG cover-1
Cambridge University Press and Twin Research and Human Genetics (TRHG) are proud to announce the release of the online archive of AGMG, the predecessor journal to TRHG. AGMG was the official journal of the International Society for Twin Studies (ISTS) from 1952-1998 when TRHG took over this role. However, both journals have always had a wider interest in the field of human genetics.

Twins can provide unique and powerful opportunities to study genetic and environmental factors that make people differ in how they look, behave and how healthy they are. Monozygotic [identical] twins share all their genetic variation and dizygotic [non-identical] twin pairs, on average, share about 50% of their genetic variation. Both types of twin pairs often but not always share similar pre- and post-natal environments as well. Having twins participate in these studies helps to continue important research for common human conditions such as diseases, health, and behaviors, leading to advances in science, medicine and future potential therapies.

Much effort has gone into creating this digitised archive and making it available online to the research community because we believe that many of the classic papers published in AGMG reveal the academic foundations of the subject and still have relevance today. Below is a link to the 20 most cited papers from the AGMG archive to demonstrate the wide scope of interest. We encourage you to explore and enjoy this fascinating resource.

View the 20 most-cited papers from the AGMG archive here .

The papers cover a wide spectrum of topics and include the following articles:

  • Population-Based Twin Registries: Illustrative Applications in Genetic Epidemiology and Behavioral Genetics from the Finnish Twin Cohort Study (1990)
  • Resting Metabolic Rate in Monozygotic and Dizygotic Twins (1985)
  • Causes of Variation in Drinking Habits in a Large Twin Sample (1984)
  • The Vanishing Twin (1982)

 

DMPHP Special Issue on Ebola

ebola blog pic
Accurate knowledge regarding Ebola is critical and pertinent for practicing physicians and clinicians given the current risk of hazardous global outbreak and epidemic. Disaster Medicine and Public Health Preparedness has launched a special issue, Ebola Virus and Public Health, to surround the public, medical professionals and media with necessary knowledge in this critical societal moment.

As part of this special issue, the journal has published A Primer on Ebola for Clinicians. The primer was prepared by Dr. Eric Toner, internist and emergency physician, as well as Amesh A. Adalja and Thomas V. Inglesby (all of the University of Pittsburgh Medical Center). The primer discusses the history, epidemiology, microbiology, clinical manifestations, biosafety, prevention, treatment and experimental vaccines to offer an informative and inclusive background on the Ebola virus for clinicians.

The scale of the uncontrolled outbreak in Western Africa makes further exportation to other parts of the world an unfortunate possibility (as citizens across the globe have already witnessed, with cases appearing in Europe and the United States). Those who serve at the frontlines of emergency medicine, critical care, infectious diseases and infection control are in high need and demand, and in some cases, high risk. The primer provided by the UPMC professionals offers clear and concise information on the fundamentals of the virus, including its diagnosis, treatment and control. The public and media are especially apt to benefit from the clear and accurate information provided by the primer, as the popularity of social media makes misinformation about Ebola easily (and rapidly) sharable, believed and misattributed.

The DMPHP Special Edition on Ebola has been designed from the outset to be a conduit for operational and policy level information that will improve outcomes and decision making, and to ensure that this information is available to all practitioners.

As such, published contributions will go online immediately after appropriate review and placed chronologically to ensure a ready historical track for future review and debate. The Special Edition will be made available to everyone in the field as well as at the policy level decision makers worldwide.

View the special issue contents here free of charge. More articles will be added as soon as they become available online.

 
The SDMPH have released press releases on some of these papers- you can view these by using the links below:

Volunteer guidelines for clinicians in the ebola epidemic
A Primer on Ebola for Clinicians
Special issue on Ebola

 

 

Follow

Get every new post delivered to your Inbox.

Join 1,654 other followers

%d bloggers like this: