The richer the reward, the faster you’ll likely move to reach it, study shows

If you are wondering how long you personally are willing to stand in line to buy that hot new holiday gift, scientists at Johns Hopkins Medicine say the answer may be found in the biological rules governing how animals typically forage for food and other rewards.

They report that results of a new study in people affirm the theory known as “optimal foraging,” which holds that animals are innately wired to maximize the rewards they acquire based on such factors as the value of the reward itself and the time and effort spent to reach that reward. They also add to evidence that the richer the reward, the faster people will move to get it. In other words, if buying that awesome gift really matters, you’ll not only spend more, you may rush to be first in line to nab it.

A description of the study was published online Oct. 15 in Proceedings of the National Academy of Sciences.

“Because animals that maximize optimal foraging live longer, in general, and are more ‘fit,’ traits that support such behavior are highly conserved in evolution and therefore are likely to inform human as well as other animal behavior,” says Reza Shadmehr, Ph.D., professor of biomedical engineering at the Johns Hopkins University School of Medicine. “We believe that the speed at which an animal moves to the next reward, which we call ‘vigor,’ is related to this principle in people too.”

To study vigor in people, Shadmehr and his colleagues tracked the speed and direction of eye movements among 92 people (average age 27; 51 men and 41 women) as they looked at images on a computer screen. Studying rapid eye movements between objects (motions known as “saccades”) is a frequent model for analyzing reward systems, says Shadmehr, because the sheer number of saccades—2.5 of them per second, on average—provides an enormous amount of information about our innate preferences.

On the computer screens, the scientists displayed images of human faces (which most people prefer to focus on) as the high-value “reward” and inanimate objects, such as a door, as the less valued reward in different locations on the screen. They tracked how quickly the research participants switched their focus from one object to another and how long the object or face held their gazes.

In a subgroup of 16 of the 92 research participants, the scientists also controlled the amount of time that subjects could view an image of a person’s face. As the researchers decreased the amount of time for gazing, the participants moved their eyes, on average, more quickly between the facial images.

“For us, that experiment confirms in people our animal models of optimal foraging, which holds that when the environment is rich, animals tend to move more quickly between rewards,” says Shadmehr.

“Think of children during Halloween,” he says, “when they have a relatively short time to canvass a neighborhood known for generous candy givers. Most of them will be running, not casually strolling, from house to house.”

In another experiment with 17 of the 92 subjects, the scientists displayed two images on the screen, sometimes a face and other times an inanimate object. When the scientists displayed more faces, the participants spent less time gazing at one individual face and more time moving their eyes between the faces.

“This tells us that when the environment is rich (i.e., more faces), the participants not only moved quickly between the rewards, but spent less time focusing on each individual reward,” says Shadmehr. He says researchers have observed this phenomenon among crows on the Pacific coast that forage beaches for clams. They, like the human subjects in the computer experiments, spent energy digging for a clam, determining its size and opening it only if it was large enough to be worth the effort.

To the researchers’ surprise, Shadmehr reports, one experiment failed to match current theories of reward and effort. A group of 22 research participants was shown a series of images placed at greater distances apart on the screen, requiring more extensive eye movements to focus on each image. In other words, participants had to spend more effort to get their reward. A dot on the screen indicated where the next image would appear.

Conventional wisdom would say that, in a difficult environment, animals should conserve their efforts and move more slowly toward rewards. But the opposite happened. Research participants spent more effort to get their reward by moving their eyes twice as fast between images of any type when they were farther apart than among images that were closer together.

Shadmehr speculates that the unexpected results could be explained by understanding the variations in how some people value certain rewards. “A history of high effort to reach a reward may make that reward seem much more valuable, and we’ll spend more energy to get that reward,” says Shadmehr.

The researchers note there also are vigor differences among individuals. Some people have twice the vigor of eye movements than others. And results may vary with age and gender, as well. Shadmehr says most humans have the fastest eye movements at age 14, on average, and this speed declines with each additional decade of life.

Shadmehr notes that understanding the principles of vigor may do far more than tell us about foraging for food or trendy gifts. It may also inform scientists about conditions that link human movement and cognition, such as Parkinson’s disease, a disease of the nervous system that affects movement and memory, and depression, which is characterized by slower movement as well as sadness and other mood problems.

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Study finds higher risk of breast cancer for women after giving birth

Younger women who have recently had a child may have a higher risk of breast cancer than their peers of the same age who do not have children, according to a large-scale analysis co-led by a University of North Carolina Lineberger Comprehensive Cancer Center researcher.

The findings, published in the Annals of Internal Medicine, may seem contrary to conventional wisdom that childbirth is protective against breast cancer. Researchers say childbirth still does become protective, but it can take more than two decades for benefits to emerge. Breast cancer is more common in older women, with the median age of 62 at diagnosis in the United States. Researchers who led the study from the Premenopausal Breast Cancer Collaborative Group identified elevated breast cancer risk after childbirth in women younger than 55.

“What most people know is that women who have children tend to have lower breast cancer risk than women who have not had children, but that really comes from what breast cancer looks like for women in their 60s and beyond,” said UNC Lineberger’s Hazel B. Nichols, Ph.D., a professor in the UNC Gillings School of Global Public Health Department of Epidemiology. “We found that it can take more than 20 years for childbirth to become protective for breast cancer, and that before that, breast cancer risk was higher in women who had recently had a child.”

Other studies have shown an increase in breast cancer risk in younger women after childbirth, but have not had access to information about other factors that might impact risk, such as breastfeeding or family history of breast cancer, researchers said. For their analysis, researchers pooled data from 15 prospective studies from the around the globe that included 889,944 women. In addition to looking at breast cancer risk after childbirth, they also evaluated the impact of other factors, such as breastfeeding and a family history of breast cancer.

They found that, in women 55 years and younger, breast cancer risk peaked about five years after they gave birth, with risk for mothers 80 percent higher compared with women who did not give birth. Twenty-three years after giving birth, women saw their risk level off, and pregnancy started to become protective. The increased risk after childbirth was higher for women who also had a family history of breast cancer or who had a greater number of births or were older at first birth. The pattern looked the same whether or not women breastfed.

“We need to recognize that the traditional risk factors for breast cancer do not always operate the same way at younger ages,” Nichols said.

While breast cancer risk increased for mothers after pregnancy, researchers also noted that the overall risk of breast cancer is still low in this group. Between the ages of 41 and 45, there were 41 more cases of breast cancer diagnosed in every 100,000 women who had given birth in the previous three to seven years compared with women who did not have children. By age 50, there 247 more cases per 100,000 women in the group that had recently given birth.

“In this age group, breast cancer is uncommon,” Nichols said. “The risk of developing breast cancer is still low overall, even if you’ve had a child five years ago.”

Their findings were also not the same for all younger women. Risk was higher for women who had their first child after 35, but there was no increased risk of breast cancer after a recent birth for women who had their first child before 25. And while pregnancy did become protective against estrogen receptor-positive breast cancer years later, it did not become protective for estrogen-receptor negative breast cancer during the study.

“This is evidence of the fact that just as breast cancer risk factors for young women can differ from risk factors in older women, there are different types of breast cancer, and the risk factors for developing one type versus another can differ,” Nichols said.

The study’s findings could be used to develop better breast cancer risk prediction models to help inform screening decisions and prevention strategies, Nichols said.

“There are many ongoing studies that are trying to improve our ability to do breast cancer risk prediction on the individual level,” Nichols said. “This is one piece of evidence that can be considered for building new prediction models.”

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Chemo-brain IS real: How cancer treatment causes mental fog

Chemo-brain IS real: Scientists discover how cancer treatments damage white matter to cause mental fog

  • More than half of cancer patients treated with chemo experience brain fog 
  • ‘Chemo-brain’ is a recognized phenomenon, but poorly understood
  • Stanford University researchers found that chemo affects three types of cells in the white matter 
  • They also discovered that a drug that may block and reverse these effects 

Scientists have finally begun to work out what exactly ‘chemo-brain’ is – and may have found a way to reverse the brain fog cancer treatment cause, a new study reveals. 

More than half of patients that receive chemotherapy report experiencing a cognitive fog for months and sometimes years after undergoing the intensive cancer treatment, but doctors haven’t really understood what causes this. 

A team of Stanford University scientists, however, have identified chemo’s effects on three different types of brain cells. 

They think that chemo causes a sort of arrested development for some brain cells and blocks the activity of cells that help ensure our brain cells are well-fed with nutrients because the drug triggers an overly-active immune response. 

In their experiments on mice, a drug to quell those immune cells helped to reverse chemo’s cognitive effects, giving the team hope that a treatment could be on the horizon.  

More than half of cancer patients who undergo chemotherapy experience ‘brain-fog.’ A new study reveals how the drug affects three types of brain cells – and a potential way to reverse it

The advent of chemotherapy was a revolution in the treatment of cancer.

Around the time of World War II, the US military’s tests of mustard gas led to the discovery that compound based on mustard gas could combat some cancers. 

Soon thereafter, the predecessor to the now commonly-used methotrexate was discovered. 

Tumors grow when a DNA mutation allows cells to divide and multiply out of control. But methotrexate’s predecessor blocked that DNA from replicating, so it blocked cancer growth, too. 

Chemo’s roots in poisons and warfare are telling. Any chemotherapy is toxic to us – it’s just most toxic to carcinogenic cells.   

And our body responds accordingly. chemo often makes patients nauseous, unable to eat, makes them achy and tired and makes their hair fall out. 

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Most worryingly to many cancer patients, chemo often comes with a decline in cognitive function that can last far longer than the treatments – or even the cancers, in some cases – themselves do. 

Chemo-brain was once dismissed as a wive’s tale. 

Even the world-renowned Mayo Clinic still calls the term ‘misleading’ and says that it is ‘unlikely that chemotherapy is the sole cause of concentration and memory problems in cancer survivors. 

We are at last beginning to understand what role it does play, however. 

The Stanford researchers focused on the neuron-supporting brain cells in the white matter. 

Three particular types seemed implicated in chem-brain: oligodendrocytes, astrocytes and microglia. 

Oligondendrocytes produce myelin, the coating that protects neurons. If these sheaths are damaged incomplete or missing, signals sent between brain cells are liable to interference. Like a radio, the signals might not come through clearly – or at all. 

Astrocytes lay important supporting roles for neurons, making sure that they are running smoothly and getting sufficient nutrition. 

And microglia are the brain’s own personal immune system. 

The researchers gave some mice with cancer chemotherapy, and left the others untreated.   

In the brains of those who had had chemotherapy, the myelin-producing cells never reached maturity, so they couldn’t produce sufficient myelin to protect the neurons. 

As a result, the mice moved more slowly, and had a harder time recalling elements of an environment that should  have been familiar to them. 

Even when they were injected with cells that would become oligondendrocytes from healthy mice, the cells got stuck in a state of arrested development in the chemo-treated mice’s brains, suggesting it was something about the toxicity of the brain environment that was interfering with this process. 

On the other hand, chemo seemed to supercharge the brain’s immune cells. The microglia were ‘persistently activated’ for at least six months after chemo was administered. 

They were on the defensive, behaving as if there was an infection or other pathogen to fight off, which likely meant prioritizing defensive action over other functions like nutrition. 

Indeed, the overactivity in the microglia interfered with the astrocytes, and the neurons struggled to get enough nutrition, which could be an additional cause of brain-fog. 

Remarkably, the Stanford researchers discovered that they could use a drug that attacked the microglia to restore the balance between them and the nutrient-feeding cells – reversing the cognitive effects of the chemo. 

‘The biology of this disease really underscores how important intercellular crosstalk is,’ lead study author and Stanford neurologist Dr Michelle Monje said. 

‘In addition to existing symptomatic therapies – which many patients don’t know about – we are now homing in on potential interventions to promote normalization of the disorders induced by cancer drugs. 

‘There’s real hope that we can intervene, induce regeneration and prevent damage in the brain.’     

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Study suggests physical changes to the brain due to learning happen differently than thought

A team of researchers from the University of Tübingen and the Max-Planck Institute for Biological Cybernetics, both in Germany, has found evidence that suggests new-learning plasticity of the brain occurs faster than has been previously thought—and in different ways. In their paper published in the journal Science, the group describes their study of the brain using a less well-known kind of MRI. Yaniv Assaf from Tel Aviv University has written a Perspective piece on the work done by the team in the same journal issue.

Prior research has suggested that learning is progressive—as people absorb new information, it is stored in physical locations in the brain that already exist. The brain changes to accommodate new knowledge as more learning occurs. Assaf notes that prior research has also shown that the hippocampus is the main brain region involved in memory retention. In this new effort, the researchers challenge both of these assumptions. But Assaf also points out that at this time, nobody really knows how memories are stored in the brain.

To learn more about what happens physically in the brain when a person is learning something new, the researchers studied volunteers with diffusion-weighted magnetic resonance imaging (DW-MRI). This less well-known MRI technique detects how water is diffused in the body. The researchers used it to watch how water was diffused in the brain as volunteers learned new material. They suggest the results offer a new view of plasticity in the brain.

The researchers report that they were able to see physical changes in the brain that occurred within hours of the volunteer’s exposure to the new material. They also found that brain plasticity was occurring in the posterior parietal cortex, not the hippocampus. They further report that they found that memory engram (the physical changes the brain undergoes when learning something new) was also localized, which, Assaf suggests, strengthens theories that memory is not stored in brain “memory banks,” but is instead stored in localized places throughout the brain.

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Donated Kidneys From Pot Users Seem Safe: Study

MONDAY, Nov. 26, 2018 — Marijuana use by live donors has no effect on kidney transplant outcomes for donors or recipients, a new study finds.

National Kidney Registry recommendations exclude substance abusers from donating kidneys, and transplant centers may refuse live donors with a history of marijuana use. Until this study, however, there had been no evidence about how marijuana use may affect transplant outcomes.

For the study, researchers reviewed kidney transplants from live donors performed between January 2000 and May 2016 at one U.S. transplant center.

Of 294 donors, 31 were marijuana users. Of 230 recipients, 27 used marijuana.

There were no differences in outcomes among donors or recipients related to the donors’ use of marijuana, according to the study published recently in the Clinical Kidney Journal.

“A significant shortage in available potential kidney donors exists. Our goal with this study was to start a conversation on this topic and to encourage other centers to study this important question,” lead author Duane Baldwin said in a journal news release.

“It is our hope that considering marijuana-using donors could ultimately save lives,” he added.

Baldwin is a urologist at Loma Linda University Health in Loma Linda, Calif.

In the United States, nearly 100,000 patients are on the list for kidney transplants, with wait times of 3 to 10 years. Some do not survive long enough on dialysis to receive a transplant.

More information

The National Kidney Foundation has more on kidney transplants.

Posted: November 2018

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Occupational health study links air pollution and cancer

University of Stirling experts have discovered new evidence of the link between air pollution and cancer as part of a new occupational health study.

The team, from the Faculty of Health Sciences and Sport, analysed the case of a woman who developed breast cancer after spending 20 years working as a border guard at the busiest commercial border crossing in North America.

The woman was one of, at least, five other border guards who developed breast cancer within 30 months of each other and, at another nearby crossing, a cluster of seven other cases was noted.

Dr. Michael Gilbertson, who worked with colleague Dr. Jim Brophy, said their findings “infer a causal relationship” between breast cancer and very high exposures to traffic-related air pollution containing mammary carcinogens. A link between nightshift work and cancer was also identified.

Dr. Gilbertson said: “This new research indicates the role of traffic-related air pollution in contributing to the increasing incidence of breast cancer in the general population.

“With this new knowledge, industry and government can plan for new designs for industrial and commercial facilities to cut down on the occupational exposures to traffic-related air pollution and for scheduling shift work to minimise disruption of sleep patterns.”

Drs Gilbertson and Brophy focused on the worker compensation case of the woman, who was employed by the Canada Border Services Agency for two decades at the Ambassador Bridge, which crosses the Detroit River between Windsor, Ontario, and Detroit, Michigan.

The bridge – the busiest commercial border crossing in North America – carries 12,000 trucks and 15,000 cars each day. The air pollution is severe and border guards in the traffic booths inhale many carcinogens, including those that result in breast cancer.

The woman – one of at least five colleagues who developed breast cancer within 30 months of each other – was diagnosed with her first bout of breast cancer at the age of 44 and second at 51. Notably, another cluster of seven cancer cases occurred at a second crossing point, the Detroit-Windsor Tunnel, which lies four miles from the bridge.

The cluster of cases in staff at the bridge was 16 times higher than the rate in the rest of the country – there is less than a one in 10,000 probability that this could have occurred by chance. In addition, the clusters were characterised by breast cancer cases that were early onset and premenopausal with recurrences.

The scientists analysed the circumstances of the case – heard by the Workplace Safety and Insurance Appeals Tribunal (WSIAT) – by applying the Bradford Hill criteria – a group of nine principles that are useful in establishing epidemiologic evidence of a causal relationship between a presumed cause and an observed effect. The criteria considers strength, consistency, specificity, temporality, biological gradient, plausibility, coherence, experiment and analogy.

The case focused on whether the woman had a genetically inherited predisposition to develop breast cancer because of dysfunctional BRCA1/2 tumour suppressor genes. It was found that her BRCA1/2 tumour suppressors were not working – but that was not connected to her inherited genes. This condition is known as “BRCAness” and is sporadic, rather than an inherited breast cancer.

The Stirling team investigated whether the dysfunction was potentially caused by occupational exposures to pollution. A review of previous research confirmed that BRCA1 can be “silenced” by exposures to dioxins and polycyclic aromatic hydrocarbons – both found in exhaust fumes.

In addition, other research has shown that BRCA2 is rapidly degraded in the presence of aldehydes – also components of exhaust fumes.

“There is much more research to be undertaken,” Dr. Gilbertson said. “But we now have plausible mechanisms for inferring how the BRCA1/2 tumour suppressors in this highly-exposed border guard became dysfunctional and likely contributed to the ongoing epidemic of sporadic, early onset, premenopausal breast cancer among her colleagues.

“These outbreaks of breast cancer represent a new occupational disease that we are provisionally calling ‘occupational BRCAness’.”

The front-line workers also identified nightshift work as a potential contributing factor to their high incidence of breast cancer.

Drs Gilbertson and Brophy considered whether nightshift work might exacerbate the exposures to mammary carcinogens in traffic-related air pollution.

They pointed to a previous study involving rats that found those exposed to continuous daylight developed tumours 36 per cent faster – and had 60 per cent more tumours – than those subjected to a normal photoperiod.

Significantly, the WSIAT rejected the woman’s case.

Reflecting on the findings, Dr. Gilbertson continued: “Reweighing the scientific evidence using a consensus medico-legal framework – the Hill Bradford criteria – enabled us to show the amount of evidence that the WSIAT had ignored in dismissing this worker compensation case.”

He added: “This kind of forensic research depends on asking new questions based on conclusions from the existing evidence and a willingness to follow leads into unfamiliar areas of science.

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Dementia study first in a series on health needs and challenges of LGBTQ seniors

In the first paper to emerge from a series of research projects aimed at understanding the health needs of older adults who identify as lesbian, gay, bisexual, transgender and queer (LGBTQ), Jason Flatt of the Institute for Health & Aging at the UC San Francisco School of Nursing found that nearly 25 percent of the LGBT adults aged 50 and older in his study had subjective cognitive decline, a potential indicator of a future Alzheimer’s diagnosis. According to the Alzheimer’s Association, only 10 percent of the overall population of the United States aged 65 and older has Alzheimer’s dementia.

The disparity not only invites further questions about how the incidence and prevalence rates of dementia among LGBTQ adults compare with those in other populations and why they may differ, but it also speaks to the importance of the entire body of research that Flatt is pursuing.

An Understudied Population

According to the American Psychological Association, 2.4 million people over age 65 in the U.S. identify as LGBT. In this community, the common challenges of aging are often compounded by health disparities that can arise in connection with decades of discrimination. The disparities include reduced access to health care, minority stress and lack of social support. Through his diverse and expanding research program, Flatt is uncovering new insights about this understudied population to better understand its challenges and needs.

Flatt’s interest in the health of older people began in high school, when he volunteered as a social activity coordinator for assisted living and skilled nursing facilities. The experience stayed with him through college and during his master of public health (MPH) degree program at the University of South Carolina. When he decided to get his Ph.D. degree in behavioral and community health sciences at the University of Pittsburgh Graduate School of Public Health, he did some soul-searching. “I asked myself what was the most rewarding thing I’d done so far, what would I like to do for a living, and it was working with older people,” he says. “I decided to try to see what was important about the social lives of older adults. Could we use [an understanding of that] to either prevent or help people compensate when they’re having challenges due to dementia?”

An invitation to join the faculty at UCSF offered him an opportunity to hone his focus. “I thought about what was unique about San Francisco and where there were opportunities to contribute,” he says. As he began volunteering with organizations serving the city’s LGBTQ community, he recognized that there was a paucity of research on the challenges of dementia in this population and decided he could help change that.

Investigating Dementia Risk in LGBTQ Elders

To that end, Flatt is using a career development award from the National Institute on Aging to jump-start his investigation of the epidemiology of dementia among LGBTQ elders. His study is the first to address the issue, investigating whether there are unique risk or protective factors in this group.

He and his collaborators – including Associate Dean for Research Julene Johnson – are using medical records from a large data set held at Kaiser Permanente Northern California’s Research Program on Genes, Environment and Health (RPGEH). The records allow him to follow more than 4,000 participants identifying as lesbian, gay or bisexual from the time they enter the health system and compare them with other participants to investigate the factors that affect dementia risk. (Transgender individuals aren’t part of the study at this point.) The data set offers a unique opportunity to get longitudinal data on this group, Flatt says, because RPGEH began recording data on the cohort in 1996 and started asking participants about sexual orientation in 2007, making it one of the earliest large research programs to do so.

Flatt is primarily pursuing two overlapping research questions: Are sexual minorities at higher or lower risk for developing dementia? And how does sexual minority status affect outcomes for elders living with dementia?

“We know that [sexual minorities] are at higher risk for health conditions like depression, heart disease and risky health behaviors like tobacco use, which are potential risk factors for dementia,” says Flatt. “What’s unique about [the LGBTQ community] is that, in some ways, they can’t rely on the same social support structures that other elders do. They’re often not married or partnered, they’re less likely to have children, and they’re more likely to live alone. We know that those are risk factors for [poor outcomes for people with] dementia.”

Flatt and his co-investigators’ first paper, published in the Journal of Alzheimer’s Disease, has begun to tease out answers to the first question, but Flatt hopes to publish many more papers that emerge from this data set. “It’s very basic descriptive data,” he says. “Our first step is to describe and look at the strengths and weaknesses for this community, and how they relate to the risks related to Alzheimer’s.” As associations between those strengths and weaknesses and Alzheimer’s risk emerge from the research, Flatt says, the next step is to develop programs and interventions both to help people reduce their risk for developing dementia and to help those who do develop it better cope with their condition.

In a separate but related project, Flatt is a collaborator on the UCSF PRIDE Study, a landmark investigation of LGBTQ health that uses mobile phone technology to connect with LGBTQ adults across the U.S. to study factors related to health over time. Flatt is specifically looking at the over-50 cohort in the study group to examine health disparities and to quantify strengths and weaknesses related to aging in the LGBTQ community.

Inclusive and Affordable Housing’s Effect on Health

Another of Flatt’s research projects looks at the impact of inclusive and affordable housing on the health of LGBT older adults. With funding from UCSF’s Resource Allocation Program (RAP), Flatt and his co-investigators – Leslie Dubbin, of the School of Nursing, Meredith Greene and Madeline Deutsch, of the School of Medicine, and Karyn Skultety, executive director of San Francisco’s Openhouse, a nonprofit organization that provides housing and a range of supportive services and community programs for LGBTQ seniors – are following LGBTQ participants in San Francisco’s affordable housing lottery for the next year to see how receiving or not receiving housing affects their health and quality of life. He was also recently contacted by SAGE, a national organization that advocates for services for LGBT seniors, to include two new housing sites in New York City in his study. This will result in evaluating the impact of 307 new LGBT-inclusive and affordable apartments on the health of LGBT seniors in San Francisco and New York.

Research suggests that housing status is linked to health outcomes, and LGBTQ seniors face increased challenges finding stable housing due to a number of factors, including discrimination, lack of social and family support and chronic health problems like testing positive for human immunodeficiency virus (HIV). A related concern is that LGBT seniors who can’t find welcoming, age-appropriate housing will be forced into long-term care facilities, where they may face discrimination, leading to adverse health outcomes and poor quality of life.

A 2010 report from Justice in Aging, a national organization that fights poverty among older adults, found that a majority of LGBT seniors surveyed were afraid it would be unsafe for them to be “out” in a long-term care facility. The report also recorded 853 incidences of mistreatment, including harassment and neglect by long-term care facility staff, reported by LGBT seniors or their family, friends or other advocates.

Flatt’s study will look at whether receiving affordable, LGBTQ-friendly housing is associated with decreased health care utilization among seniors, which would suggest improved health. Because some of the lottery units are designated for people who have been chronically homeless or are living with HIV, Flatt says, he would not be surprised to see initial utilization go up as those individuals transition to stable housing and can begin to focus on health issues. He hopes his study will show whether, over time, emergency department visits and inpatient hospital stays will decrease as these issues are addressed and stably housed participants are better able to manage chronic health conditions.

Flatt’s work with Openhouse has led to another project he’s excited about – one that takes him back to his roots working with seniors in assisted living. Openhouse and its partner On Lok, a nonprofit senior care organization, have invited Flatt and his research team to do a needs assessment for a new “LGBT-welcoming” high-rise building for low-income seniors in San Francisco. The team is working with community members to look at the need for all-inclusive health care for the building’s residents.

The project appeals to Flatt’s passion for working directly with members of the community and giving back to the people who have inspired and fueled his research career. “I’m interested in more participatory approaches [to research], and this is true community-participatory work,” he says.

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Construction worker suicide rates are highest in the US, CDC study says

Males working in construction have the highest suicide rates in the country, according to a recent analysis by the Center for Disease Control and Prevention (CDC).

Males working in construction have the highest suicide rates in the country, according to a recent analysis by the Center for Disease Control and Prevention (CDC).

Comparing the suicides of more than 22,000 people across 17 states in 2012 and 2015, researchers found males working in construction and extraction took their lives the most often, a rate of roughly 44 per 100,000 “civilian noninstitutionalized working persons” for construction workers and 53 per 100,000 for extraction workers.


Men working in the arts, design, entertainment, sports, and media came in second — an increase of 47 percent during the years studied, according to the CDC. Installation, maintenance and repair rounded out the top three for males in 2015.

Comparatively, in 2015, women working in arts, design, entertainment, sports, and media had the highest suicide rates for females, while women in protective services came in second. The third were women who worked in health care support, according to the study.

“Among both males and females, the lowest suicide rate in 2015 was observed in Education, Training, and Library occupations,” the CDC reported.

The research comes adjacent to the rising suicide rates in the U.S. overall. The health agency announced in June the rates have been rising in “nearly every state,” with 25 states reporting a more than 30 percent increase during the study period.


“Increasing suicide rates in the U.S. are a concerning trend that represent a tragedy for families and communities and impact the American workforce,” Deb Houry, the director of the CDC National Center for Injury Prevention and Control, said in an online statement. “Knowing who is at greater risk for suicide can help save lives through focused prevention efforts.”

The study Thursday is a correction to a similar 2016 study, which mistakenly included the misclassification of some workers as farmers instead of managers.

The Associated Press contributed to this report.

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Meditation helps conflict veterans with PTSD, study finds

Transcendental meditation—the practice of effortless thinking—may be as effective at treating PTSD in conflict veterans as traditional therapy, US researchers said Friday, in findings that could help tens of thousands deal with their trauma.

Post traumatic stress disorder, a debilitating condition that can lead to psychosis, bipolar disorder or suicidal and homicidal thoughts, affects an estimated 14 percent of US veterans who serve in Iraq or Afghanistan.

The most common treatment for PTSD is a process known as prolonged exposure psychotherapy, which forces sufferers to re-experience traumatic events by confronting their memories of the conflict.

Researchers from three US universities decided to look into whether more everyday techniques, which help civilians lower their stress levels and increase focus and productivity, would work on traumatised veterans.

They trialed 203 former servicemen and women with PTSD, most of whom were receiving medication for their symptoms, and randomly assigned them courses of transcendental meditation, prolonged exposure therapy or a specialised PTSD health education class.

They found that 60 percent of veterans who did 20 minutes of quiet meditation every day showed significant improvement in their symptoms, and more completed the study than those given exposure therapy.

“Over the past 50 years, PTSD has expanded to become a significant public health problem,” Sanford Nidich, of the Maharishi University of Management Research Institute, told AFP.

“Due to the increasing need to address the PTSD public health care problem in the US, UK and worldwide, there is a compelling need to implement governmental policy to include alternative therapies such as transcendental meditation as an option for treating veterans with PTSD.”

Transcendental meditation involves effortlessly thinking of an idea or mantra to produce a settled, calmer state of mind—scientists call it “restful alertness”.

Unlike exposure therapy, meditation can be practised at home, takes up relatively little time, and researchers say it would be significantly cheaper than current treatment techniques.

It also avoids forcing combat veterans to relive their trauma in a bid to get better.

“Transcendental meditation is self-empowering, and can be practised just about anywhere at any time, without the need for specialised equipment or ongoing personnel support,” said Nidich, who was the lead author of the study published in The Lancet Psychiatry journal.

‘Gave me my life back’

The main problem with existing PTSD treatment, according to Nidich, is that forcing veterans to relive their trauma means many never finish the courses.

Exposure therapy, although officially approved as a treatment by the US Veterans’ Association, is ineffective in up to 50 percent of patients and drop-out rates range from 30-45 percent.

“New treatments, including options not involving exposure to the traumatic experience, are needed for veterans who do not respond to treatment or drop-out due to discomfort,” said Nidich.

One study participant, a 32-year-old navy veteran whom authors identified only as Ms. K, said learning the meditation technique had “given me my life back.”

After being diagnosed as having suffered sexual trauma while on military service, her symptoms worsened until she drank to excess every night and sought to avoid human interaction.

After the transcendental meditation course, “I began to come out of my nightmares and face the battle I had ahead,” she said.

She added she had since applied for a job in a hospital.

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Study finds alcohol advertising rules may fail to protect Australian kids

Regulations introduced to restrict the placement of alcohol advertising are unlikely to reduce young people’s exposure to alcohol marketing in Australia, new research led by Curtin University has found.

The research, published in the Drug and Alcohol Review journal, critically reviewed the placement rules added to the industry-run Alcohol Beverages Advertising Code (ABAC) Scheme in November 2017 and evaluated their ability to effectively regulate the placement of alcohol marketing in Australia.

Co-author Ms Julia Stafford, from the Alcohol Programs Team at the Public Health Advocacy Institute of WA (PHAIWA) based at Curtin University, said the placement rules do not meet the criteria for effective self-regulation and do not appear to have introduced any additional safeguards for young people.

“The placement rules were introduced to put some restrictions on where alcohol companies could market their products. The rules include requiring advertisers meet other industry codes that apply to the placement of alcohol advertising, market their products to audiences that are at least 75 per cent adults, and ensure alcohol advertising is not placed within programs aimed at minors,” Ms Stafford said.

“We found that they are unlikely to reduce young people’s exposure to alcohol marketing as they are very narrow in scope, exclude key forms of promotion, and place minimal restrictions on marketers. All but one of the 24 placement-related determinations published in the first six months of the placement rules were either dismissed or found to be ‘no fault’ breaches.

“The rules allow alcohol advertising to be broadcast during televised sport on weekends and public holidays, and do little to limit outdoor advertising. Alcohol ads placed in shopping centres, at sports stadiums, on public transport vehicles, and at bus stops or train stations outside of a 150m radius of a school are all consistent with the placement rules.”

First author Ms Hannah Pierce, also from the Alcohol Programs Team at PHAIWA, said the review also identified substantial flaws in the regulatory processes of the placement rules.

“The alcohol and advertising industries were heavily involved in the development of the rules, but there was no evidence of consultation with other stakeholders. There are also no penalties for marketers who breach the rules,” Ms Pierce said.

“Our findings support existing evidence that industry-managed systems fail to effectively regulate alcohol marketing and government intervention is needed if young people’s wellbeing is to be a priority.

“It has now been 12 months since the placement rules were introduced and our research shows that a comprehensive, independent review of the ABAC Scheme is needed.”

The research was also co-authored by researchers from the Public Health Advocacy Institute of WA and the School of Psychology at Curtin University and Cancer Council WA.

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