Sunday, August 31, 2014

5 Signs of Sleep Deprivation

This article discusses five signs that a person has sleep deprivation. If you have these, you may want to talk to your doctor.

People all over the country are walking around sleep deprived on a daily basis. Everyone thinks about the harried new mom or the busy executive, or the college kid with finals creeping up when the term “sleep deprived” comes up.
But there are many more Americans who are not getting enough sleep than you might think. About 20 percent of adults in the United States, one in every five, are considered sleep deprived, according to the American Academy of Sleep Medicine.
Sleep deprivation is not just about looking and feeling well rested in the morning. There are some real health risks linked to long-term sleep deprivation.
Anxiety, irritability, forgetfulness and lack of coordination, are just some of the effects lack of sleep can have on a person's life. It can also be associated with medical conditions such as high blood pressure, heart attack, obesity and diabetes.
Getting enough sleep is healthy for everyone. Knowing the signs of sleep deprivation is key for change to take place. Here are five signs that may indicate that you're not getting enough sleep.
Five Signs of Sleep Deprivation:
1) Being able to fall asleep fast 
According to the National Institute of Neurological Disorders and Stroke, people who routinely fall asleep within five minutes of laying down are most likely suffering from severe sleep deprivation or even a sleep disorder. Falling asleep fast does not mean that person is just a “good sleeper”.
2) Being impulsive 
When you're not getting enough sleep, the prefrontal cortex is greatly affected. When you are sleep deprived, its effect on this area of the brain can lead a person to poor judgment or impulsive behaviors like buying expensive items or eating unhealthy foods. It can also create irritability and mood issues.
3) Being forgetful 
Memory is also affected by sleep deprivation. Sleep helps people consolidate memories and leads to emotional processing. When you don't get the proper amount of sleep, you'll have a harder time forming memories and putting those memories into context.This also makes it more difficult to act thoughtfully and rationally.
4) Being hungryYes, sleep deprivation can make you want to eat more. It does so by affecting leptin and ghrelin, two hormones that control appetite and hunger in the body. When you are sleep deprived, ghrelin (the hormone that increases appetite) increases and leptin (the hormone that tells the body to stop eating) decreases.
5) Being clumsy 
Lack of sleep affects everything, even coordination. Motor skills can be affected when you are sleep deprived, causing you to stumble or to just feel unsteady on your feet.
Read more here

Children need to ease into school sleep schedules

This article explains that children need to be eased back into their school sleeping schedules after summer and that the transition cannot happen overnight.
Parents shouldn't wait until the last minute to help children get back into their normal sleep schedules for school, an expert says.
"Getting back on a normal sleep schedule doesn't just happen overnight," Peter Bidey, instructor of family medicine at Philadelphia College of Osteopathic Medicine, said in a college news release.
"A gradual transition back to regular sleep habits is essential. A drastic change in sleep habits can be a shock to your child's system," he explained.
During summer vacation, children tend to stay up later and sleep in longer. Letting them continue that pattern until school starts can lead to trouble that first morning they have to wake up early for class, Bidey pointed out.
Getting children back into a sleep schedule for school "should start at least a week before school begins," Bidey said. "Parents can begin waking their children up earlier each day with an alarm clock, and sending their child to bed a bit earlier each night."
One way to make mornings before school less hectic is to be well-organized, he suggested.
"Parents can pack lunches and lay out school clothes the night before. That will help them stay calm in the mornings, which will in turn keep children calm," Bidey said.
Research shows that adequate sleep benefits children's mental health and school performance, he noted.
Read more here

Why children with ADHD may make poor decisions

A study shows that children with ADHD might make poor decisions due to different learning and decision-making processes.

Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most common psychiatric disorders among school children. Pupils with ADHD often make poorer decisions than their unaffected classmates. Researchers from the University of Zurich now discovered that different learning and decision-making mechanisms are responsible for these behaviors, and localized the underlying impairments in the brain.
Which shirt do we put on in the morning? Do we drive to work or take the train? From which takeaway joint do we want to buy lunch? We make hundreds of different decisions every day. Even if these often only have a minimal impact, it is extremely important for our long-term personal development to make decisions that are as optimal as possible. People with ADHD often find this difficult, however. They are known to make impulsive decisions, often choosing options which bring a prompt but smaller reward instead of making a choice that yields a greater reward later on down the line. Researchers from the University Clinics for Child and Adolescent Psychiatry, University of Zurich, now reveal that different decision-making processes are responsible for such suboptimal choices and that these take place in the middle of the frontal lobe.
Mathematical models help to understand the decision-making processes
In the study, the decision-making processes in 40 young people with and without ADHD were examined. Lying in a functional magnetic resonance imaging scanner to record the brain activity, the participants played a game where they had to learn which of two images carried more frequent rewards. In order to understand the impaired mechanisms of participants with ADHD better, learning algorithms which originally stemmed from the field of artificial intelligence were used to evaluate the data. These mathematical models help to understand the precise learning and decision-making mechanisms better. "We were able to demonstrate that young people with ADHD do not inherently have difficulties in learning new information; instead, they evidently use less differentiated learning patterns, which is presumably why sub-optimal decisions are often made," says first author Tobias Hauser.
Multimodal imaging affords glimpses inside the brain
In order to study the brain processes that triggered these impairments, the authors used multimodal imaging methods, where the participants were examined using a combined measurement of functional magnetic resonance imaging (fMRI) and electroencephalography (EEG) to record the electrical activity and the blood flow in the brain. It became apparent that participants with ADHD exhibit an altered functioning in the medial prefrontal cortex -- a region in the middle of the frontal lobe. This part of the brain is heavily involved in decision-making processes, especially if you have to choose between several options, and in learning from errors. Although a change in activity in this region was already discovered in other contexts for ADHD, the Zurich researchers were now also able to pinpoint the precise moment of this impairment, which already occurred less than half a second after a feedback, i.e. at a very early stage.
Psychologist Tobias Hauser, who is now researching at the Wellcome Trust Centre for Neuroimaging, University College London, is convinced that the results fundamentally improve our understanding of the mechanisms of impaired decision-making behavior in people with ADHD. The next step will be to study the brain messenger substances. "If our findings are confirmed, they will provide key clues as to how we might be able to design therapeutic interventions in future," explains Hauser.
Read more here

Thursday, August 28, 2014

Headaches in children

This article discusses headaches in children, which is becoming more prevalent as the school year begins.

As the school year approaches and begins, many parents may start to hear their children complain about headaches.

According to Nick DeBlasio, MD, a pediatrician in Cincinnati Children's Hospital Medical Center's Pediatric Primary Care Clinic, about 10% of school-aged children and 15-27% of teens experience them from time to time.
Headaches can be triggered by a number of different things. Here are the most common causes of occasional headaches in children:
Inadequate hydration. Not drinking enough fluids is one of the biggest causes of headaches. This is especially true when the weather gets warmer and kids become more active outside and lose fluid through sweating. If this is the case, the cure might be as simple as having your child drink more water.
Diet. Does your child eat regular meals? Skipping one meal, like breakfast, can trigger a headache. It's also important to make sure that your child is eating a well-balanced diet with lots of fruits and vegetables. Too much caffeine and certain foods can cause a headache as well.
Sleep. Kids in middle and high school typically need at least 10-12 hours of sleep a night. Not sleeping enough at night can cause a headache. And getting less than 10 hours isn't enough to feel well-rested.
Stress. We all experience stress from time to time, and children and teens are no exception. If your child is under a lot of pressure from school, or experiencing big changes at home like a divorce or a big move, a headache can result.
Vision problems. If your child is unable to see what's happening at the front of the classroom, he might be straining his eyes to see far away, which can result in a headache. A vision test can give you a better understanding of whether or not your child's headaches are being caused by vision problems.
Family history. Your child is more likely to have headaches if a parent gets them as well.
If your child has a headache, try giving her water and over-the-counter ibuprofen. Follow the instructions on the package for the appropriate dosage and do not give it to your child more than three times in a week. If it persists for a few days or worsens, call your child's pediatrician.
Fortunately the majority of headaches in children are not a cause for alarm. However, there are a few instances which require a little more investigation. If your child's headaches have become more frequent or severe, if he wakes up in the morning of the middle of the night from it, or if the headache causes vomiting, it's best to have your child evaluated by your pediatrician.
He or she will perform a physical exam and decide if any tests need to be done. Brain MRIs and CT scans are rarely needed. If your pediatrician suspects a migraine, she might refer your child to a neurologist who is familiar with medications to help prevent and treat them.
And if your child or teen is suffering from chronic headaches and migraines, recent research by Cincinnati Children's found that adding cognitive behavioral therapy to treatment of pediatric migraines improves relief.
Read more here

Sleep apnea makes high blood pressure difficult to treat

A study shows that sleep apnea could make a person's high blood pressure more difficult to treat.

A new study finds strong links between severe, untreated obstructive sleep apnea (OSA) and high blood pressure even for heart patients on blood pressure medication.
“The current findings suggest that severe OSA may contribute to poor blood pressure control despite aggressive medication use,” says sleep disorder specialist Harneet Walia, MD. She says the study suggests that better strategies to treat sleep apnea can improve blood pressure control. And, in turn, patients’ heart health should improve.
The study results are significant because patients were under the close care of heart specialists, Dr. Walia says. And these doctors were following national guidelines to treat cardiovascular risk.
“The results are of interest as severe levels of obstructive sleep apnea appear to be contributing to uncontrolled blood pressure.” And this leaves the patients more vulnerable to heart problems, she says.
Dr. Walia was the first author of the study, titled “Association of Severe Obstructive Sleep Apnea and Elevated Blood Pressure Despite Antihypertensive Use.” This was a part of the Heart Biomarker Evaluation in Apnea Treatment (HeartBEAT) trial.” The study appears in the American Academy of Sleep Medicine journal.

Apnea patients and poor blood pressure control

Sleep apnea is a serious sleep disorder that occurs when a person’s breathing is interrupted during sleep. People with untreated sleep apnea stop breathing repeatedly during sleep, sometimes hundreds of times during the night. Their upper airways are completely or partially blocked repeatedly during sleep.
During an apnea episode, the diaphragm and chest muscles work harder as the pressure increases to open the airway. Breathing usually resumes with a loud gasp or body jerk. These episodes can interfere with sound sleep, reduce the flow of oxygen to vital organs, and cause heart rhythm irregularities.
Of the 284 study subjects, those with serious apnea were four times more likely to have resistant elevated blood pressure – even though they were taking three or more medications, says Dr. Walia. All these patients either had or were at risk for cardiovascular disease.
Previous research has also linked obstructive sleep apnea to resistant hypertension, Dr. Walia says.
“Our study is different because these are folks who had cardiovascular disease, and who were followed by cardiologists, yet severe apnea may have contributed to suboptimal blood pressure control,” she says.
“This is an important finding from a clinical perspective because patients with poor blood pressure control taking multiple anti-hypertensive medications are particularly vulnerable to increased cardiovascular risk. Strategies to treat obstructive sleep apnea should be strongly considered because the improved control in blood pressure could potentially lead to improvement in cardiovascular morbidity and mortality,” she says.

Should you be evaluated?

Dr. Walia suggests that patients who have high blood pressure, are on anti-hypertensive medication and who have signs of obstructive sleep apnea be evaluated. Snoring, pauses in breathing during sleep, restlessness during sleep, excessive daytime sleepiness and impaired concentration are all signs of OSA, says Dr. Walia.
“It’s an important finding, especially for people who are taking multiple blood pressure medications,” she says. “They may be at risk for cardiovascular disease, anyway. Future research is definitely needed to gain a better understanding of the mechanistic pathways of this link.”
She says more studies are also needed on how sleep apnea treatment relates to blood pressure control and how it impacts people on different types of blood pressure medications.
Read more here

Age and brand of football helmet do not influence concussion risk

A recent study shows that both the brand and age of a football helmet do not change the risk of concussion for high school students.

A University of Wisconsin study suggests there is no difference in concussion risk for high school football players based on different brands or ages of helmets, according to a release.
The study involved 2,081 football players at 34 high schools in Wisconsin during the 2012 and 2013 football seasons, according to the release. Players completed a pre-season demographic and injury questionnaire, and sport-related concussions were recorded throughout the year.
A total of 206 players, about 9 percent, sustained a total of 211 SRCs during the study, officials said. During the study, players wore Riddell, Schutt and Xenith helmets.
The study also found that custom-fitted mouth guards increased SRC risk by 60 percent compared to generic guards; the rate of SRC was nearly seven times higher during competition than practice and four times higher during full-contact practice than no-contact practice; and age, BMI, grade in school or competition level was not associated with an increased risk of SRC.
Another important finding was that players who sustained an SRC during the previous 12 months were almost twice as likely to sustain another one compared to players with a history of SRC, according to the release.
“This was surprising because we found that the increased risk exists even when controlling for the players’ use of protective equipment, years of football experience and player characteristics, such as their grade in school and competition level,” said Tim McGuine, UW sports medicine researcher and co-author of the study. “These results highlight the need for medical providers to document a history of SRC in young football players and for more education among parents, coaches and the players about the increased concussion risk in these individuals.”
The researchers said other than learning appropriate tackling and other on-field techniques, properly maintained and fitted helmets remain one of the most important ways to prevent skull fractures and scalp lacerations in football players.
Read more here

Friday, August 22, 2014

Researchers make functional tissue like a brain

Researchers have made a functional brain-like tissue that could have huge implications for studying neural diseases.

Researchers who created functional 3-D brain-like tissue say it could help scientists find new treatments for brain injuries and diseases and improve knowledge about normal brain function.
The tissue, which can be kept alive in the laboratory for more than two months, is structurally similar to tissue in a rat's brain. It's also functionally like brain tissue.
In early experiments with the tissue, researchers used it to study chemical and electrical changes that occur immediately after brain injury and the changes that occur in response to a drug.
The tissue was developed at Tuft University's Tissue Engineering Resource Center, which is funded by the U.S. National Institute of Biomedical Imaging and Bioengineering (NIBIB). The research is described in an article published online Aug. 11 in the Proceedings of the National Academy of Sciences.
"This work is an exceptional feat," Rosemarie Hunziker, program director of Tissue Engineering at NIBIB, said in an agency news release. "It combines a deep understand of brain physiology with a large and growing suite of bioengineering tools to create an environment that is both necessary and sufficient to mimic brain function."
This tissue offers advantages over using live animals to study brain injury, according to project leader David Kaplan, a professor of engineering at Tufts and director of the Tissue Engineering Resource Center.
In live animals, researchers can't start assessing the effects of a brain injury immediately after it occurs. That's because the animal's brain has to be dissected and prepared for experiments.
With the new 3-D brain-like tissue, "you can essentially track the tissue response to traumatic brain injury in real time," Kaplan said. "Most importantly, you can also start to track repair and what happens over longer periods of time."
The longevity of the tissue also makes it valuable for studying brain diseases and disorders.
"The fact that we can maintain this tissue for months in the lab means we can start to look at neurological diseases in ways that you can't otherwise because you need long timeframes to study some of the key brain diseases," Kaplan said.
He and his colleagues are now trying to find ways to make the tissue model even more brain-like.
Read more here

Suicide risk increased by sleep disorder presence

This article discusses the association seen between presence of a sleep disorder in older adults and increased suicide risk.
Sleep quality influences suicide risks for older adults, according to a research undertaken by scientists from Stanford University School of Medicine. Rebecca Bernert, the study’s author, says this is a highly treatable condition. Bernert, PhD, is the director of the Suicide Prevention Research Laboratory at Stanford. The fact that sleep disorder increases suicide risks for older adults comes after a complex research.
Another research carried earlier this year involvedblood analysis to determine suicide risks.
“Suicide is the outcome of multiple, often interacting biological, psychological and social risk factors,” Bernert said. “Disturbed sleep stands apart as a risk factor and warning sign in that it may be undone, which highlights its importance as a screening tool and potential treatment target in suicide prevention.
To reach the conclusion, the team of scientists from Stanford looked at data from 14.456 adults over 65 years old. Out of this group, they chose 400 individuals who had similar sleeping patterns to 20 people who committed suicide. Scientists followed the sleeping behavior over a 10 years period. In the end, researchers concluded that older people with sleeping disorders have a suicide risk 1.4 times higher than their counterparts with high sleep quality.
The comparison between the two groups was done by looking at a series of data obtained through interviews. The questions addressed topics such as depression signs, and mental and physical functioning. Even after taking out the depression variable, the lack of quality sleep remained an important factor determining an increased risk of committing suicide.
Suicide is associated with stigma, so people suffering suicidal thoughts or attempts have troubles talking about the issue. However, if a disturbed sleeping pattern accounts for such a high influence in determining suicide, there is a ray of hope. If trouble sleeping is not a stigmatized disorder, focusing on improving the older adults’ sleep quality might reduce the suicide rates.
The subjects involved in the study were mostly white males. A group of twenty suicide victims is surely not enough to draw the definitive conclusion that sleep disorder increases suicide risks, but is a start. Further research involving data from cases involving women and minority groups may shed additional light on the issue.
People who are at risk of committing suicide should ask for help by calling the National Suicide Prevention Lifeline (1-800-273-TALK).
Read more here

Adulthood with ADHD Podcast

At the link below, view a podcast about the transition from childhood to adulthood for a person with ADHD.

ADD and ADHD don’t just affect children. More and more adults are being diagnosed with the condition, especially young women. According to a recent report, between 2008 and 2012, the number of women taking ADHD drugs jumped 85 percent. This hour we’ll talk about the disorder, how adults are affected and how they live with it.

Listen to the podcast here

How teens experience concussions

This article explains how teens experience concussions, and the relationship between physical and emotional symptoms that results from them.

With multiple concussions between the two of them, Dan Han and Lisa Koehl's latest research interest isn't surprising.
"I played competitive soccer through high school and continue to play recreationally," says Koehl, a doctoral candidate in the University of Kentucky's Department of Psychology, "so I have firsthand experience with the dynamics that come into play when a teen suffers a concussion."
As a former high school assistant principal in the Chicago public school system, Han was responsible for overseeing student-athletes' return to school after a concussion. Han left educational administration to pursue his doctorate in neuropsychology. Now director of the Multidisciplinary Concussion Program at the UK HealthCare, Han has a reputation for top-notch clinical work and research on concussion.
"There aren't many places in Kentucky where you find a true multidisciplinary concussion program," Han says. "UK HealthCare's Multidisciplinary Concussion Program embraces an interdepartmental group effort -- from Neurology, from Neurosurgery, Sports Medicine, Physical Medicine and Rehabilitation, from the Trauma team -- we all work together to look at how brain injury affects the cognitive, physical and emotional state of our patients."
This group effort puts the athlete's safety first. For that reason, UK HealthCare's concussion program is the go-to for the athletics programs at Fayette County Public Schools, the University of Kentucky, Eastern Kentucky University, and Kentucky State University, who all rely on the UK Multidisciplinary Concussion Program's clinical expertise in sports concussion for state-of-the-art input to help make decisions affecting an athlete's return to play.
Add to Han's clinical skills a lifelong love of full contact martial arts (Han practices kickboxing and Brazilian jujitsu), and it's easy to see how Han and Koehl are well-suited to study the symptoms of sports concussions.
Drawing from a large UK database of patients with brain injury, Koehl and Han used a subset of 37 athletes aged 12 to 17 to explore post-concussion changes in physical, emotional, and cognitive symptoms over time.
According to Koehl, 22 of the 37 study participants demonstrated post-concussive emotional symptoms. Of those, 23 percent were sensitive to light while 14 percent were sensitive to noise. In comparison, of the 15 teens without emotional symptoms, 13 percent were sensitive to light and no teens were sensitive to noise.
There were no differences between the two groups in factors such as what percentage experienced loss of consciousness, amnesia, nausea and/or headaches, indicating that the groups were likely comparable in the level of severity of concussion.
"We discovered a bidirectional relationship between both emotional symptoms developing in conjunction with physical symptoms, and also emotional symptoms developing because of the physical symptoms," said Koehl.
In other words, said Koehl, "This research gives us a better understanding of the interaction between physical and emotional symptoms in concussion and will allow us to explore ways to help adolescents recover in a more timely fashion."
According to Han, teens in the study who reported anxiety were 55 percent more likely to experience attention difficulties than those without anxiety, while teens with irritability/aggression were 35 percent more likely to self-report problems with attention than teens without irritability.
"While these findings are preliminary and require a larger sample size to predict outcomes with more confidence, we are intrigued by the potential these data offer in terms of providing teens with a better treatment plan based on their unique cognitive, physical and emotional response to concussion," Han said.
"Identifying factors that affect a teen's experience after concussion may help in planning for the appropriate treatment and in making decisions about when to return to play and what accommodations are needed at school during recovery."
Read more here

Why does autism occur?

This article explains the factors that influence autism development, such as genetics, brain imaging, and cognition, and describes how they play into autism development.

An analysis of autism research covering genetics, brain imaging, and cognition led by Laurent Mottron of the University of Montreal has overhauled our understanding of why autism potentially occurs, develops and results in a diversity of symptoms. The team of senior academics involved in the project calls it the "Trigger-Threshold-Target'' model.
Brain plasticity refers to the brain's ability to respond and remodel itself, and this model is based on the idea that autism is a genetically induced plastic reaction. The trigger is multiple brain plasticity-enhancing genetic mutations that may or may not combine with a lowered genetic threshold for brain plasticity to produce either intellectual disability alone, autism, or autism without intellectual disability. The model confirms that the autistic brain develops with enhanced processing of certain types of information, which results in the brain searching for materials that possess the qualities it prefers and neglecting materials that don't. "One of the consequences of our new model will be to focus early childhood intervention on developing the particular strengths of the child's brain, rather than exclusively trying to correct missing behaviors, a practice that may be a waste of a once in a lifetime opportunity," Mottron said.
Mottron and his colleagues developed the model by examining the effect of mutations involved in autism together with the brain activity of autistic people as they undertake perceptual tasks. "Geneticists, using animals implanted with the mutations involved in autism, have found that most of them enhance synaptic plasticity -- the capacity of brain cells to create connections when new information is encountered. In parallel, our group and others have established that autism represents an altered balance between the processing of social and non-social information, i.e. the interest, performance and brain activity, in favor of non-social information," Mottron explained. "The Trigger-Threshold-Target model builds a bridge between these two series of facts, using the neuro cognitive effects of sensory deprivation to resolve the missing link between them."
The various superiorities that subgroups of autistic people present in perception or in language indicates that an autistic infant's brain adapts to the information it is given in a strikingly similar way to sensory-deprived people. A blind infant's brain compensate the lack of visual input by developing enhanced auditory processing abilities for example, and a deaf infant readapts to process visual inputs in a more refined fashion. Similarly, cognitive and brain imaging studies of autistic people work reveal enhanced activity, connectivity and structural modifications in the perceptive areas of the brain. Differences in the domain of information "targeted'' by these plastic processes are associated with the particular pattern of strengths and weaknesses of each autistic individual. "Speech and social impairment in some autistic toddlers may not be the result of a primary brain dysfunction of the mechanisms related to these abilities, but the result of their early neglect," Mottron said. "Our model suggests that the autistic superior perceptual processing compete with speech learning because neural resources are oriented towards the perceptual dimensions of language, neglecting its linguistic dimensions. Alternatively, for other subgroups of autistic people, known as Asperger, it's speech that's overdeveloped. In both cases, the overdeveloped function outcompetes social cognition for brain resources, resulting in a late development of social skills."
The model provides insight into the presence or absence of intellectual disability, which when causative mutation alter the function of brain cell networking. Rather than simply triggering a normal but enhanced plastic reaction, these mutations cause neurons to connect in a way that does not exist in non-autistic people. When brain cell networking functions normally, only the allocation of brain resources is changed.
As is the case with all children, environment and stimulation have an effect on the development and organization of an autistic child's brain. "Most early intervention programs adopt a restorative approach by working on aspects like social interest. However this focus may monopolize resources in favor of material that the child process with more difficulties, Mottron said. "We believe that early intervention for autistic children should take inspiration from the experience of congenitally deaf children, whose early exposure to sign language has a hugely positive effect on their language abilities. Interventions should therefore focus on identifying and harnessing the autistic child's strengths, like written language." By indicating that autistic ''restricted interests'' result from cerebral plasticity, this model suggest that they have an adaptive value and should therefore be the focus of intervention strategies for autism.
Read more here

Medications for shift workers show little effectiveness

A review of medications shift workers take both for alertness and to help them sleep have little effectiveness.

Shift workers are taking drugs to help them stay awake or get to sleep despite weak evidence for their benefit, according to a new Cochrane review. The authors of the review found only small numbers of trials testing over-the-counter and prescription drugs used by shift workers, and the results suggest that for some people they might do more harm than good.

In most developed countries, at least 10% of the workforce is involved in some form of shift work. European statistics suggest that as many as three quarters of the population have 'non-standard' working hours. Disturbances to normal sleeping and waking patterns increase the risk of accidents and affect shift workers' health. It is therefore important to avoid shift work where possible and improve shift work schedules to help shift workers achieve more normal sleeping and waking patterns. In jobs where shift work cannot be avoided, such as health care, the police force or the military, drugs can potentially offer short-term benefits.
The review included 15 trials involving a total of 718 people. In nine trials, the over-the- counter hormone drug melatonin helped shift workers sleep for around 24 minutes longer during the night or day, compared to placebos. However, it did not help them get to sleep any quicker. Data from only one trial of the hypnotic drug zoplicone was available. The drug was no more effective than placebos for helping shift workers sleep during the day.
The remaining trials focused on caffeine and two drugs, modafinil and armodafinil, that are prescribed for sleepiness during night shifts. In one trial, caffeine reduced sleepiness during night shifts, when workers also napped before shifts. Modafinil and armodafinil, used by shift workers in one and two trials respectively, increased alertness and reduced sleepiness. However, they also caused headaches, nausea and a rise in blood pressure in a substantial number of people. Due to the limited benefits and frequent side effects, neither of these drugs is approved for shift workers in Europe.
"For lots of people who do shift work, it would be really useful if they could take a pill that would help them go to sleep or stay awake at the right time," said lead author of the review, Juha Liira, who is based at the Finnish Institute of Occupational Health in Helsinki, Finland. "But from what we have seen in our review, there isn't good evidence that these drugs can be considered for more than temporary use and some may have quite serious side effects."
Most of the data reported in the review was from small, low quality trials. In addition, trials tended to be carried out in specific settings, such as health care or oil rigs, so their results may be less relevant for workers in other types of roles.
"It's curious that there's such a clear gap in the research," said Liira. "It may well be that studying the effects of these drugs or others drugs in properly designed trials would be seen as unethical because workers should not need drugs to get along with their work. So the studies just haven't been done or if they have, our review has not been able to identify relevant data."
Read more here

ADHD diagnosis by involuntary eye movements

A study shows that ADHD can accurately be diagnosed by a person's involuntary eye movements.

Attention Deficit Hyperactivity Disorder (ADHD) is the most commonly diagnosed -- and misdiagnosed -- behavioral disorder in children in America, according to the Centers for Disease Control and Prevention. Unfortunately, there are currently no reliable physiological markers to diagnose ADHD. Doctors generally diagnose the disorder by recording a medical and social history of the patient and the family, discussing possible symptoms and observing the patient's behavior. But an incorrect evaluation can lead to overmedication with Ritalin (methylphenidate), which has parents everywhere concerned.
Now a new study from Tel Aviv University researchers may provide the objective tool medical professionals need to accurately diagnose ADHD. According to the research, published in Vision Research, involuntary eye movements accurately reflect the presence of ADHD, as well as the benefits of medical stimulants that are used to treat the disorder.
Keeping an eye on the eyes
Dr. Moshe Fried, Dr. Anna Sterkin, and Prof. Uri Polat of TAU's Sackler Faculty of Medicine, Dr. Tamara Wygnanski-Jaffe, Dr. Eteri Tsitsiashvili, Dr. Tamir Epstein of the Goldschleger Eye Research Institute at Sheba Medical Center, Tel Hashomer, and Dr. Yoram S. Bonneh of the University of Haifa used an eye-tracking system to monitor the involuntary eye movements of two groups of 22 adults taking an ADHD diagnostic computer test called the Test of Variables of Attention (TOVA). The exercise, which lasted 22 minutes, was repeated twice by each participant. The first group of participants, diagnosed with ADHD, initially took the test un-medicated and then took it again under the influence of methylphenidate. A second group, not diagnosed with ADHD, constituted the control group.
"We had two objectives going into this research," said Dr. Fried, who as an adult was himself diagnosed with ADHD. "The first was to provide a new diagnostic tool for ADHD, and the second was to test whether ADHD medication really works -- and we found that it does. There was a significant difference between the two groups, and between the two sets of tests taken by ADHD participants un-medicated and later medicated."
Foolproof, affordable, and accessible diagnosis
The researchers found a direct correlation between ADHD and the inability to suppress eye movement in the anticipation of visual stimuli. The research also reflected improved performance by participants taking methylphenidate, which normalized the suppression of involuntary eye movements to the average level of the control group.
"This test is affordable and accessible, rendering it a practical and foolproof tool for medical professionals," said Dr. Fried. "With other tests, you can slip up, make 'mistakes' -- intentionally or not. But our test cannot be fooled. Eye movements tracked in this test are involuntary, so they constitute a sound physiological marker of ADHD.
"Our study also reflected that methylphenidate does work. It is certainly not a placebo, as some have suggested."
The researchers are currently conducting more extensive trials on larger control groups to further explore applications of the test.
Read more here

Top-of-head concussions are more severe

A study claims that concussions on the top of a person's head have a higher level of severity than other concussions.

As we head into the start of the new school year, many young people will begin signing up for the football team. Though team sports are a great way for kids to boost their self-esteem and increase physical activity, there are certain risks involved with contact sports, including concussions. Now, a recent study from the American Academy of Pediatrics investigates how the location of impact could affect concussion severity.
Prior to this study, published in the journal Pediatrics, very little research had focused on how location of impact on the head could yield differentconcussion outcomes.
According to the Centers for Disease Control and Prevention (CDC), a concussion is a traumatic brain injury(TBI) that is the result of a bump, blow or jolt to the head that can change how the brain normally works.
To investigate further, researchers used data from the National High School Sports-Related Injury Surveillance Study to calculate rates and circumstances of concussions that occurred during football as a result of player-to-player collisions.
The team observed that most concussions of this type (44.7%) occurred on the front of the head, while 22.3% occurred on the side of the head. Based on where the impact occurred, the number and type of symptoms, symptom resolution time, and length of time before returning to play did not vary significantly.
But the data revealed that more football players whose concussions resulted from top-of-head impacts lost consciousness than those whose impacts were located elsewhere on the head.
In detail, 8% of players with top-of-head concussions experienced loss of consciousness, compared with only 3.5% of those with impacts on other areas.
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Thursday, August 21, 2014

Autism and risk of GI issues

This article discusses why children with autism may be at an increased risk of having gastrointestinal issues.

Children with an autism spectrum disorder (ASD) are more likely to deal with gastrointestinal issues, than non-ASD children, according to recent findings published in the journalPediatrics.
Despite lack of attention to the linked health issues, researchers are now more closely examining this possible connection. Findings revealed that children with an ASD were four times more likely to experience general GI complaints and up to three times more likely to experience constipation or diarrhea than their non-ASD counterparts, according to Medical Xpress. In fact, these children complained about abdominal pain twice as often as other peers not dealing with the cognitive health issue.
For the study, researchers at the Marcus Autism Center, Children's Healthcare of Atlanta and Emory University School of Medicine, conducted an analysis to determine the link.
"One was to survey what we know about these issues-and we don't know much," said co-study author William Sharp, director of the Pediatric Feeding Disorders Program at Marcus Autism and assistant professor of pediatrics at the School of Medicine, in a news release. "There have been only fifteen studies published in the past 32 years that have really good experimental controls. "We also hope this study prompts the medical community to increase its focus on the prevalence, cause, and remediation of these issues."
Researchers noted that in the past 32 years, only 15 studies have been published with good experimental control groups to examine any connections between these health issues. 
However, while this new research confirms a connection to these two health issues based on the anecdotal experience of pediatricians and parents, it does not show a casual relationship.
Furthermore, researchers reiterate the need for more research strictly focusing on GI symptoms experienced in ASD populations.
"Clearly, consideration should be given to the high rate of feeding problems and related behavioral issues such as toileting concerns documented in this population," Sharp added.
At this time, researchers do not have enough evidence to suggest a unique GI pathology in children with an ASD. 
Read more here

Monday, August 18, 2014

Blood pressure and cognitive decline

High blood pressure as an adult may indicate a weaker brain with more cognitive decline later in life.

Let your blood pressure get too high in midlife, and you might pay the price in mental decline later on, a new study suggests.

The study of almost 14,000 people found that high blood pressure in those aged 48 to 67 was tied to a late-life drop in mental ability. Over 20 years, people with high blood pressure in midlife experienced a modest but significant 6.5 percent decline in scores on tests of mental function, compared with people with normal blood pressure.
"High blood pressure might be an important risk factor for dementia, since mental decline is a known risk factor," said lead researcher Dr. Rebecca Gottesman, an associate professor of neurology and epidemiology at Johns Hopkins University School of Medicine in Baltimore.
However, she stressed that because "we know how to treat high blood pressure," bringing it under control might also cut a person's risk for dementia.
For the study, Gottesman's team collected data on people taking part in a major U.S. heart disease study. The participants were followed for as long as 23 years and their mental abilities were tested three separate times.
Gottesman's group found that people whose blood pressure was controlled with medication had less mental decline than those with uncontrolled high blood pressure. The effect was stronger among whites than blacks, the researchers noted.
Blood pressure levels in middle age may be especially important to later-life mental acuity, Gottesman said.
"This may be why some clinical trials that have studied the role of blood pressure medications [in older people] have failed to find a benefit in reducing mental decline and dementia," she reasoned. "The trials may simply not be long enough -- it may be most important to start treatment of high blood pressure when people are middle-aged."
However, the jury is still out on whether blood pressure medication given in middle age can help boost late-life thinking and memory.
"In our study, people who were on medications to treat high blood pressure did have less mental decline than did people not on medications," Gottesman said. "But it's possible those people had been on medications for years."
Still, "our data suggest that, overall, being on any medications for high blood pressure may be protective," Gottesman said.
The report was published online Aug. 4 in JAMA Neurology.
Dr. Philip Gorelick is medical director of the Hauenstein Neuroscience Center at Michigan State University College of Human Medicine in Grand Rapids.
He believes that the new study "provides some evidence that those who were observed and treated for high blood pressure were better off in the long run from a mental standpoint than those who were not treated for high blood pressure."
Gorelick, who authored an accompanying journal editorial, said that doctors have long known that treating high blood pressure is key to cutting people's odds for stroke and heart attack.
Now "another, but less well-documented benefit, of blood pressure lowering may be the preservation of mental function as we age," he said. "With additional study, we may be better positioned to tell our patients whether control of blood pressure not only prevents stroke and heart attack, but also helps to preserve their brain."
Read more here