Tuesday, February 25, 2014
Why Does School Start So Darn Early, and Should it? Wed at 10 PM...Dr. Rotenberg and Terra Ziporyn Snyder on KPFT
Monday, February 24, 2014
High school students get 7 hours of sleep per night while they need about 9.2.
What happens if school start times are delayed?
Article about start times here
Certain long-term physical disorders, such as asthma and migraine, may boost the risk of self- harm, indicates a comparative study of hospital admissions after an episode of deliberate injury in England, and published in the Journal of the Royal Society of Medicine.
Over 200,000 people are admitted to hospital every year in England as a result of self-harm, and people who self-harm have a substantially increased risk of suicide.
The new National Suicide Prevention Strategy for England includes several priority groups including people with a history of self-harm, young people, and those living with long-term physical health conditions.
The peak age for self-harm is 15–24 years, and suicide is the third leading cause of death in this age group.
While it’s well known that psychiatric illness greatly increases the risk of self-harm, it’s less clear whether physical disorders have a similar impact.
The researchers therefore looked at risk of hospital admission for self-harm among people with different long-term psychiatric and physical disorders across England, using a linked dataset of Hospital Episode Statistics (HES) for 1999–2011.
The psychiatric illnesses studied included depression, bipolar disorder, alcohol abuse, anxiety disorders, eating disorders, schizophrenia and substance abuse.
Unsurprisingly, the analysis showed that patients with these conditions were at much greater risk. They were more than five times as likely to self-harm as those without these conditions, the findings showed.
But certain physical ailments also seemed to be linked to an increased risk of self-harm. Among the physical illnesses studied, patients with epilepsy were around three times more likely to self-harm, while those with asthma or migraine were almost twice as likely to do so.
Patients with psoriasis and diabetes also had a moderately increased risk of self-harm of around 60%, while those with eczema and inflammatory polyarthropathies were around 40% more likely to do so.
Patients with cancers under the age of 65, congenital heart disease, ulcerative colitis, sickle cell anaemia and Down’s syndrome were less likely to self-harm.
“It is important for physicians, general practitioners and mental health workers to be aware of the physical disorders that are associated with an increased risk of self-harm so that at-risk individuals may be better identified and can be monitored for any psychiatric symptoms and mental distress,” write the authors.
Much greater integration of medical and mental health services is needed, they say.
With busy schedules, it’s inevitable to feel sleepy once in a while. But habitually falling asleep during the day while watching TV, reading a book, or in the middle of having a conversation could be a sign of a serious sleep disorder known as narcolepsy.
An underdiagnosed medical condition
Narcolepsy is a sleep disorder that involves the brain’s inability to regulate sleep-wake cycles normally. It affects an estimated one in 2,000 people in the United States, with symptoms typically appearing in early adulthood. Yet it is estimated that 50 percent or more patients with narcolepsy have not been diagnosed. According to a recent survey conducted by Harris Interactive on behalf of Jazz Pharmaceuticals, awareness of narcolepsy is low. One thousand members of the general public and 400 practicing physicians were surveyed about their knowledge of narcolepsy and its symptoms. Only 7 percent of members of the general public who had heard of the condition reported being “very” or “extremely” knowledgeable about it relative to other chronic diseases. That number only increased to 24 percent among primary care physicians. The majority of people surveyed could not identify all five major symptoms of narcolepsy. In fact, studies have shown it may take 10 years or more for people with narcolepsy to receive a correct diagnosis.
“The symptoms of narcolepsy are not well-recognized, which can lead to misdiagnosis,” says Dr. Aatif M. Husain, professor of neurology at Duke University Medical Center. “By becoming aware of the symptoms of narcolepsy, individuals can have more informed conversations with their doctors, which may help lead to quicker diagnosis.”
The symptoms of narcolepsy: more than daytime sleepiness
A recent study, in which researchers evaluated health care data of more than 9,000 narcolepsy patients compared to 46,000 controls, shows that people with narcolepsy are more likely to suffer from depression, anxiety and other conditions including sleep apnea, stroke and heart failure compared to the general population. There are five major symptoms of narcolepsy. Talk to a doctor if one or more sound familiar.
* Excessive daytime sleepiness (EDS) – EDS, the primary symptom of narcolepsy, is characterized by the inability to stay awake and alert during the day resulting in unplanned lapses into sleep or drowsiness; EDS is present in all people with narcolepsy.
* Cataplexy (muscle weakness with emotions) – A sudden, brief loss of muscle strength triggered by strong emotions like happiness, laughter, surprise, or anger.
* Sleep disruption – Frequent periods of waking up during sleep.
* Sleep paralysis – A brief inability to move or speak while falling asleep or waking up.
* Hypnogogic hallucinations – Vivid, dream-like events that occur when falling asleep or waking up.
These symptoms vary from person to person and not all five symptoms must be present for a narcolepsy diagnosis. It is also important that family and friends understand these symptoms, as they may observe them and encourage their loved ones to seek medical advice sooner.
Read more here
For a productive day at work tomorrow, give the smartphone a rest tonight.
Reading and sending work email on a smartphone late into the evening doesn’t just make it harder to get a decent night’s sleep. New research findings show it also exhausts workers by morning and leaves them disengaged by the next afternoon.
That means the way most knowledge workers do their jobs—monitoring their iPhones for notes from the boss long after the office day is done and responding to colleagues at all hours—ultimately makes them less effective, posit researchers from University of Florida, Michigan State University and University of Washington.
The scholars conducted two studies of workers’ nighttime technology habits, sleep duration and quality, energy and workplace engagement. In the first study, 82 mid- to high-level managers were asked every morning how many minutes they used their smartphone after 9:00 pm the night before and how many hours they slept. Then, they were asked to rate their agreement with statements like “I feel drained” and “Right now, it would take a lot of effort for me to concentrate on something.”
In the afternoon, they had to assess statements about work engagement, such as “Today while working, I forgot everything else around me.”
Prior studies have shown that staying focused and resisting distractions takes a lot of effort, so when smartphone use interferes with sleep, it takes a toll the next day.
“The benefit of smartphone use may…be offset by the inability of employees to fully recover from work activities while away from the office,” the researchers write.
After accounting for sleep quality, the researchers found that work-related smartphone use in the evening was associated with fewer hours of sleep. The subjects who recorded shorter nights also reported depleted reserves of self-control, and those who felt morning exhaustion also indicated they were less engaged during the day, a domino effect that shows how an unending workday ultimately leads to poorer work.
The second study, which involved 161 workers, measured how late-night tech use—on smartphones, laptops, tablets and TV—can disrupt sleep and next-day work engagement.
In her book, “Sleeping With Your Smartphone,” Harvard Business School professor Leslie Perlow studied executives at Boston Consulting Group who were given a chance to disconnect on a regular basis. The executives became more excited about their work, felt more satisfied about their professional and personal lives and even became more collaborative and efficient.
Using any kind of electronic device affects sleep quantity and focus the following day, but smartphones are especially draining. That’s partly because the always-on, always-handy phone the first device we turn to, says Christopher M. Barnes, an assistant professor of management at University of Washington’s Michael G. Foster School of Business and a co-author of the paper. Having a screen so close to our faces probably doesn’t help us prepare for sleep, he adds.
The researchers don’t yet know if there’s a particular threshold at which smartphone use begins to affect sleep habits, but even 30 minutes before bedtime can take a toll, Barnes says.
The fix, researchers say, is to put down the phone and enjoy the evening. But that’s easier said than done, so long as managers send emails at 10:30 p.m. and expect responses by 10:31 pm. Barnes says real change will have to come from the top, with managers setting an example by not sending those messages in the first place, or at least toning down expectations on response time.
Autism may result from a faulty chemical switch that doesn't get flipped in time to help the brain develop normally, a new research study suggests.
Building on what they hope will be an important insight into the cause of autism, French researchers are testing a high blood pressure medication on dozens of European children with autism.
The team, which has a financial stake in the drug, has tried it on 30 children with autism; now they are testing it in more, hoping to improve core characteristics of autism for the first time.
There are drugs to treat some of autism's symptoms, but none that address the underlying social and communication difficulties and repetitive behaviors, which define the condition. Previous attempts to develop an effective drug against the condition, which affects at least one in 88 U.S. schoolchildren, have either failed or are also still experimental.
In a study out today in the journal Science, the researchers offer an explanation for the promise of their drug, bumetanide, a generic diuretic long used to treat the fluid retention of high blood pressure.
The researchers found that the drug, given during pregnancy, could reverse autism symptoms in newborn mice bred with a genetic condition that often causes autism in people, and in rats exposed to the epilepsy drug valproic acid, which is known to trigger autism.
They suspect that bumetanide is flipping a chemical switch in the brain — changing the chemical GABA from stimulating electrical activity in the brain to tamping it down. This switch needs to be flipped during or near birth for the brain to develop normally, says lead researcher Yehezkel Ben-Ari of the French Institut National de la Santé et de la Recherche Médicale, in Marseilles, France.
Because this switch fails to flip in rodents with two very different triggers of autism, the researchers say they may have found an underlying cause of the condition.
That is a "pretty incredible finding and really great," says Andrew Zimmerman, a pediatric neurologist and autism expert at the University of Massachusetts Medical School in Worcester, Mass.
He and other researchers note that it's too early for people to try the drug outside of carefully watched clinical trials. There are just so many unknowns, from what the drug will do to the developing brain to how much of the drug to give and when.
"So many things cure cancer in mice and rats, and so many things cure all kinds of things and then when we give them to humans they have adverse affects and don't fix the problems we thought they could fix," says Gary Goldstein, president and CEO of the Kennedy Krieger Institute, a Baltimore-based clinic and research center. "I wouldn't give it to my child, I can tell you that."
Ben-Ari and his colleagues have patented a version of bumetanide and formed a company, Neurochlore, in Marseilles, to test the drug in children. He says bumetanide should not be given to pregnant women — despite his success with rodents — because it is impossible to determine which children will go on to develop autism and unethical to test on healthy ones.
It should be used as early in childhood as possible, Ben-Ari says, and his team is testing the drug in children as young as 2. Autism is typically diagnosed around age 4, but experts are working to push that diagnosis earlier. It is widely believed that the sooner treatment begins, the more effective it is likely to be.
Ben-Ari says he is hopeful that the drug will show benefits across a broad spectrum of children with autism, but behavioral therapy and possibly other pharmaceutical treatments will likely still be needed, too, he says.
"It's important for people to understand there is no drug to cure a medical disease as complicated as autism," he says.
Read more here
Sunday, February 23, 2014
A study shows that seizures caused by fevers in children can be alleviated by antiepileptic drugs.
Early treatment with antiepileptic drugs reduces the length of fever-related seizures in children, according to a new study.
Published Feb. 6 in the journal Epilepsia, the study also found that a standard emergency medical services treatment guideline for prolonged fever-related seizures is needed in the United States.
Most fever-related seizures, also called febrile seizures, are brief, but up to 10 percent can last more than 30 minutes. These prolonged seizures can put children at risk for short- and long-term complications, including developing epilepsy, according to a journal news release.
The new study included nearly 200 children, aged 1 month to 6 years, who had one seizure or a group of seizures that lasted more than 30 minutes. The researchers examined the connection between time to treatment and length of the seizure.
About 90 percent of the children were given at least one antiepileptic drug, and the first dose was given by EMS crews or emergency-room staff an average of 30 minutes after the seizure began, the study found.
The average length of seizure was 81 minutes among children who received an antiepileptic drug before they arrived at the emergency room and 95 minutes for those who did not. On average, seizures ended about 38 minutes after a child received the first dose of an antiepileptic drug.
"The time from the start of the seizure to treatment is crucial to improving patient outcomes," study lead author Dr. Syndi Seinfeld, an assistant professor in the division of child neurology at Children's Hospital of Richmond, at Virginia Commonwealth University, said in the news release.
"Our study is the first to examine the treatment of [febrile seizures] by EMS, which currently does not have a standard therapy protocol for prolonged seizures," Seinfeld said.
"Our findings clearly show that early [antiepileptic drug] initiation results in shorter seizure duration," she said. "A standard [prolonged seizure] treatment protocol prior to arrival at the hospital, along with training for EMS staff, is needed across the United States to help improve outcomes for children with prolonged seizures."