medicine and health

ScienceDaily (Oct. 11, 2012) — Domestic violence rates rose by an average of 30 percent each time England won or lost their games during the 2010 World Cup, but draws had little impact on the statistics.
Those are the key findings of research carried out by statistician Professor Allan Brimicombe and BBC News journalist Rebecca Cafe and published in the October issue of Significance
, the magazine of The Royal Statistical Society and the American Statistical Association.
As a consequence of this and previous research, Professor Brimicombe believes there is a strong case for schools to educate pupils of the dangers of domestic violence, event organisers should promote initiatives that tackle domestic violence and that police forces should prepare themselves for peaks in domestic violence around major sporting events.
"Domestic violence is widespread, accounting for 15 percent of all violent crimes and 35 percent of murders in the UK," explains Professor Brimicombe, from the Centre for Geo-Information Studies at the University of East London.
"It is a crime that is estimated to affect some 30 percent of women and 17 percent of men at some point in their lives."
The researchers based their findings on statistics provided by 33 of the 39 police forces in England, which between them cover 77 percent of the country's population.
The data, for the period covering the 2010 World Cup and the same period in 2009, was obtained under the Freedom of Information Act 2000, which enables members of the public to request official information from public bodies.
The figures showed that when England drew 1-1 against the USA, domestic violence fell by 1.9 percent and when England drew 0-0 against Algeria it rose by 0.1 percent.
However when England won its game against Slovenia 1-0, domestic violence rose by 27.7 percent. And England's exit from the World Cup, after losing 4-1 to Germany, was accompanied by a 31.5 percent rise in domestic violence.
The research aimed to test the validity of an analysis carried out by the Home Office that showed that domestic violence had risen during the 2006 World Cup. "Major sporting events do not cause domestic violence, as perpetrators are responsible for their actions," said the analysis, "but the levels of alcohol consumption linked to the highly charged emotional nature of those events seems to increase the prevalence of such incidents."
Professor Brimicombe concludes that the Home Office findings were right in some respects but fell short in their analysis in other respects.
Professor Brimicombe explains: "Our research shows that increased levels of domestic violence are associated with national football matches, but only if there is a definite win or lose result. The failing of the earlier Home Office analysis was that it ignored the outcome of the match, which as we have seen is crucial.
"The percentage differences that we found are so great that we believe we have established a strong case for linking wins and losses, but not draws, to increased domestic violence.
"I hope that the findings will encourage improved education around the links between major sporting events and peaks in domestic violence and greater awareness of the risk.
"And I would applaud initiatives like the recent beer mat campaign highlighting the dangers of domestic violence, run by the London Borough of Newham and Metropolitan Police during the 2012 Olympics."
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The above story is reprinted from materials provided by Wiley.
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Journal Reference:
Allan Brimicombe, Rebecca Cafe. Beware, win or lose: Domestic violence and the World Cup. Significance, 2012; 9 (5): 32 DOI: 10.1111/j.1740-9713.2012.00606.x
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Nurture trumps nature in study of oral bacteria in human twins, study finds

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ScienceDaily (Oct. 11, 2012) — A new long-term study of human twins by University of Colorado Boulder researchers indicates the makeup of the population of bacteria bathing in their saliva is driven more by environmental factors than heritability.
The study compares saliva samples from identical and fraternal twins to see how much "bacterial communities" in saliva vary from mouth to mouth at different points in time, said study leader and CU-Boulder Professor Kenneth Krauter. The twin studies show that the environment, rather than a person's genetic background, is more important in determining the types of microbes that live in the mouth.
For the new study, doctoral student Simone Stahringer sequenced the microbial DNA present in the saliva samples of twins. She and the research team then determined the microbes' identities through comparison with a microbe sequence database. Saliva samples were gathered from twins over the course of a decade beginning in adolescence to see how salivary microbes change with time.
After determining the oral "microbiomes" of identical twins, who share the same environment and genes, and the microbiomes of fraternal twins who share only half their genes, the researchers found the salivary microbes of the identical twins were not significantly more similar to each other than to those of fraternal twins. "We concluded the human genome does not significantly affect which bacteria are living in a person's mouth," said Krauter of CU-Boulder's molecular, cellular and developmental biology department. "It appears to be more of an environmental effect."
Krauter said while the twin data from the oral microbiome study indicates that genetics plays a more minor role, it's possible the genes still affect the oral microbiome in more subtle ways -- an effect he plans to further explore.
A paper on the subject was published online Oct. 12 in the journal Genome Research
. Other co-authors included doctoral student William Walters of MCD Biology, Jose Clemente and Rob Knight of the chemistry and biochemistry department, Robin Corley and John Hewitt of the Institute for Behavioral Genetics and Dan Knights, a former doctoral student in the computer science department.
The researchers also found that the salivary microbiome changed the most during early adolescence, between the ages of 12 and 17. This discovery suggests that hormones or lifestyle changes at this age might be important, according to the team.
Stahringer said that when several pairs of identical twins moved out of their homes and, for example, went off to college, the oral microbes they carried changed, which is consistent with the idea that the environment contributes to the types of microbes in the saliva. "We were intrigued to see that the microbiota of twin pairs became less similar once they moved apart from each other," Stahringer said.
Krauter said there appears to be a core community of oral bacteria that is present in nearly all humans studied. "Though there are definitely differences among different people, there is a relatively high degree of sharing similar microbial species in all human mouths," he said.
The authors say the new study has established a framework for future studies of the factors that influence oral microbial communities. "With broad knowledge of the organisms we expect to find in mouths, we can now better understand how oral hygiene and environmental exposure to substances like alcohol, methamphetamines and even foods we eat affect the balance of microbes," said Krauter.
The saliva samples used in the new study came from the university's Longitudinal Twin Study and Colorado Adoption Project, which have involved hundreds of identical and fraternal twin pairs. Researchers also are analyzing additional frozen saliva samples collected during their studies for another project assessing possible relationships of oral bacteria to drug addiction, he said.
CU has a strong research focus on the human microbiome. In a 2011 study led by the Washington University School of Medicine and involving CU-Boulder, researchers found the diversity and abundance of gut microbes in animals varied depending on whether they were carnivores, omnivores or vegetarians. Knight is a member of a national research team funded by the Bill & Melinda Gates Foundation to look at the gut microbes of normal and malnourished infants and children around the world in search of novel microbial therapeutics.
In 2012, some 200 researchers from the NIH-funded Human Microbiome Project, including eight CU-Boulder researchers, mapped the microbial makeup of healthy humans for the first time. The study involved nearly 250 healthy U.S. volunteers and targeted 15 to 18 individual sites on the body harboring microbial communities.
Other recent studies involving CU researchers included one that found the delivery methods of babies have a big effect on their individual microbiomes, and second that showed women have a greater diversity of hand bacteria than men. Another showed personal bacterial communities living on the fingers and palms of individual computer users can be matched up with bacterial signatures on the computers and computer mice they recently used, a potential new tool for forensic scientists in the future.
According to scientists, about 100 trillion microorganisms inhabit surfaces and cavities of our bodies, which amounts to roughly 10 microbes per human cell.
Genome Research is an international, peer-reviewed journal that focuses on research that provides new insights into the genome biology of all organisms, including advances in genome medicine.
Funding for the study was provided by National Institutes of Health grants HD-010333 and DA-011015.
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Journal Reference:
Stahringer SS, Clemente JC, Corley RP, Hewitt J, Knights D, Walters WA, Knight R, Krauter KS. Nurture trumps nature in a longitudinal survey of salivary bacterial communities in twins from early adolescence to early adulthood. Genome Research, 2012; DOI: 10.1101/gr.140608.112
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All healthcare professionals need training to deal with the sexual needs of patients, study finds

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ScienceDaily (Oct. 11, 2012) — Providing healthcare staff with a one-day training course on dealing with the sexual needs of people with an acquired physical disability gave them greater understanding of the issues patients faced and enabled them to address intimate questions more comfortably and proactively.
The findings were so encouraging that the authors of the study, published in the November issue of the Journal of Advanced Nursing
, are calling for all healthcare practitioners to receive sexuality training, regardless of their role or the area of healthcare they work in.
Researchers surveyed 29 nurses, allied health professionals and care staff, before and after the course, on their ability and confidence to address sexual issues with patients. They also held in-depth interviews with 12 of them. All age ranges were represented (20 to 55 plus), the majority were female (79 per cent) and most had been working at their current hospital for one to five years (41 per cent).
"Changes associated with an acquired physical disability can diminish a person's self-esteem, sense of attractiveness, relationships and sexual functioning" explains lead author Agnes Higgins, Professor of Mental Health at the School of Nursing and Midwifery, Trinity College Dublin, Ireland.
"Previous research suggests that people with physical disability are dissatisfied with the quality of information and support around sexuality during their rehabilitation."
Subjects addressed during the course included the impact of disability on sexual expression, how to deal with patients' sexual behaviour in the hospital setting and responding to questions such as whether they will be able to have sex in the future.
Key findings included:
Participants rated their knowledge of 13 key areas related to patients' sexuality, including rights, aging, communication and help with specific medical conditions. The mean score was 1.9 out of four before the course and 2.5 after the course -- the equivalent of a 31.5 per cent increase in knowledge.The biggest rises in knowledge were in sexual rights and disability and brain injury and sexuality (both up 0.8 out of four). Other top increases included the impact of a stroke on sexuality and managing 'inappropriate' sexual behaviour (both up 0.7).Participants also rated their ability to deal with 15 situations, ranging from seeing a patient engaging in sexual behaviour to seeking advice on their future sexual ability. The mean score was 2.1 out of four before the course and 2.6 after the course -- the equivalent of a 23.5 per cent increase in ability.The biggest rises in ability were how to deal with walking in on a patient who was masturbating or engaged in sexual foreplay with their partner (both up 0.8). Other top increases included how to respond to a patient who asked if it was OK for them to have sex and advising young and old patients who wonder if they will ever have an erection or orgasm again (all up 0.7).
Staff reported finding the course very helpful.
One participant said it made them more able to respond to difficult issues in a sensitive manner. "I'm less uncomfortable and if they [patients] raise an issue, even in a joking manner, I'm kind of happy to say 'Well is that an issue for you… would you like to talk about that a little bit more?' rather than just kind of laughing and then moving onto the next subject, which is easy to do."
Another said it made them think of more than a patient's medical needs, citing the example of a woman who was incontinent and keen to return home and to work. Normally they would have suggested a urinary catheter, without further exploring the impact of this on the person's life, but the staff member said: "Because I'd done the sexuality course it made me think well actually one of the person's goals is she's got a fiancé, and relationships are important, and that [catheter] would be a huge barrier."
This was reinforced by other staff members. "I like to think I see the patient as a person, but you don't always, you honestly don't" said one. "That [course] made me very, very aware that there is a person here."
It also made it easier for them to deal with sexual comments from patients as one participant illustrated with a pre-course experience. "We are in a room and a young nurse is passing by and she is good looking but he [patient] expresses that in a way that is not exactly inappropriate. He's a young guy… I feel a little bit embarrassed and do not know how to react."
"Patient sexuality is an area that many healthcare practitioners may be reluctant to address or discuss because of embarrassment, particularly when patients have a disability" says Professor Higgins.
"Our study suggests that systematic education and training in sexuality leads to statistically significant changes in health care practitioners' knowledge, skills and comfort. Participants also reported numerous incidents where they were more willing to raise issues for discussion and create a supportive listening space for patients.
"This course provided an effective learning experience for the healthcare practitioners and could easily be replicated elsewhere. We believe that practitioners require education in patient sexuality, regardless of their discipline."
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The above story is reprinted from materials provided by Wiley, via AlphaGalileo.
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Journal Reference:
Agnes Higgins, Danika Sharek, Maeve Nolan, Barbara Sheerin, Paul Flanagan, Sniguole Slaicuinaite, Sinead Mc Donnell, Heather Walsh. Mixed methods evaluation of an interdisciplinary sexuality education programme for staff working with people who have an acquired physical disability. Journal of Advanced Nursing, 2012; 68 (11): 2559 DOI: 10.1111/j.1365-2648.2012.05959.x
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A Detailed Urinary Excretion Time Course Study of Captan and Folpet Biomarkers in Workers for the Estimation of Dose, Main Route-of-Entry and Most Appropriate Sampling and Analysis Strategies

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Tuesday, October 23, 2012

Cyberbullying Rarely Single Factor in Teen Suicides: Study

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SATURDAY, Oct. 20 (HealthDay News) -- Cyberbullying is rarely the only factor behind teen suicides, according to a small study.

The researchers found that most teen suicide victims are bullied both online and in school, and that many also suffer from depression.

For the study, the investigators analyzed 41 suicide cases in Australia, Canada, the United Kingdom and the United States. There were 24 female and 17 male victims, ages 13 to 18.

Twenty-four percent of the teens were the victims of homophobic bullying. Of those, half were identified as homosexual and the other half were identified as heterosexual or of unknown sexual preference.

Seventy-eight percent of the teens were bullied both at school and online. Just 17 percent were targeted online only. Thirty-two percent of the victims had been diagnosed with a mood disorder and 15 percent with depression symptoms.

The study was scheduled for presentation Saturday at the American Academy of Pediatrics' national conference in New Orleans.

"Cyberbullying is a factor in some suicides, but almost always there are other factors such as mental illness or face-to-face bullying," study author Dr. John LeBlanc said in an academy news release. "Cyberbullying usually occurs in the context of regular bullying."

He and his colleagues found that cyberbullying occurred through various media, with Formspring and Facebook specifically mentioned in 21 cases, and text or video messaging noted in 14 cases.

"Certain social media, by virtue of allowing anonymity, may encourage cyberbullying," LeBlanc said. "It is difficult to prove a cause-and-effect relationship, but I believe there is little justification for anonymity."

Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

Electronic Records Do Aid Patient Care, Study Finds

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FRIDAY, Oct. 19 (HealthDay News) -- Electronic health records improve the quality of patient care, according to a new study.

Weill Cornell Medical College researchers looked at 2008 data from 75,000 patients treated by nearly 500 doctors in the Hudson Valley region of New York. The data, which came from five different health plans, was used to assess patient care on nine measures.

The study found that 56 percent of doctors who used commercially available electronic health records provided significantly better quality of care on four measures than those who used paper records. Those four measures were hemoglobin A1c testing in people with diabetes, breast cancer screening, chlamydia screening and colon cancer screening.

In addition, the combined score across all measures indicated that the use of electronic health records resulted in better patient care than paper records, according to the study, which was recently published online in the Journal of General Internal Medicine.

Electronic health records "may improve the quality of care by making information more accessible to physicians, providing medical decision-making support in real time and allowing patients and providers to communicate regularly and securely," study senior investigator Dr. Rainu Kaushal, director of the Center for Healthcare Informatics and Policy and a professor of medical informatics, said in a Weill Cornell news release.

"However, the real value of these systems is their ability to organize data and to allow transformative models of health care delivery, such as the patient-centered medical home, to be layered on top," Kaushal added. The 'medical home' concept involves a team approach that coordinates and tracks patient care over time.

Use of electronic health records in the United States is on the rise, but previous studies have provided conflicting evidence about their impact. It hasn't been clear if they improve the quality of patient care.

Previous studies on the effects of electronic health records for outpatients have had mixed results, study lead investigator Dr. Lisa Kern, associate professor of public health and medicine, said in the news release.

"This is one of the first studies to find a positive association between the use of [electronic health records] and quality of care in a typical community-based setting, using an off-the-shelf electronic health record that has not been extensively tailored and refined," she said. "This increases the [ability to generalize] these findings."

Kids With Autism Find It Hard to Describe Poor Behavior, Study Finds

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FRIDAY, Oct. 19 (HealthDay News) -- It's difficult for children with autism to recognize improper social behavior and, even if they do, they are often unable to use spoken language to explain why the behavior was inappropriate, a small new study reveals.

The findings from brain scans of children with autism support the results of previous behavior studies that reached similar conclusions about language impairment in children with autism, the researchers said.

The study included 12 children with autism and 13 children without autism who were asked to identify in which of two pictures a boy was being bad -- a social judgment -- or which of the pictures was outdoors -- a physical judgment. As the children did this, their brain activity was monitored using functional MRI.

Both groups of children were successful at the task, but the children with autism showed activity in fewer brain regions involving social and language networks, according to the study published Oct. 17 in the journal PLoS One.

Although language was not needed for the task, the children without autism used language areas of the brain while making their decisions about the pictures, noted researcher Elizabeth Carter, of Carnegie Mellon University, and colleagues.

"These results indicate that it is important to work with these children on translating their knowledge into language," Carter said in a journal news release.

Gastric bypass surgery just as effective in teenagers as in adults, study suggests

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ScienceDaily (Oct. 22, 2012) — Teenagers with severe obesity can benefit from gastric bypass surgery just as much as adults. A study by Sahlgrenska Academy, University of Gothenburg, Sweden and Karolinska Institutet, Sweden found that 81 teenagers lost an average of 96.8 pounds following surgery, significantly improving their health and quality of life.

The study, published by the International Journal of Obesity, involved eighty-one 13-18 year-olds who had gastric bypass surgery, which had previously been performed on people younger than 18 in exceptional cases only.

The new study found that gastric bypass surgery is just as effective in teenagers as in adults. At two-year follow-up, the teenagers had averaged weight loss from 292.6 to 195.8 pounds, their self-rated quality of life had increased and a number of risk factors for cardiovascular disease -- primarily insulin levels -- had greatly improved.

"The teenagers who participated in the study represent a highly vulnerable group, with a history of psychosocial problems related to obesity, including bullying and underlying mental disease," says Torsten Olbers, a researcher at Sahlgrenska Academy, Senior Surgeon at Sahlgrenska University Hospital and the leader of the study.

"With that in mind, the results are surprisingly good. We will certainly want to carefully examine potential adverse effects of gastric bypass surgery in teenagers. But no other treatment is currently available for this group. Moreover, we know from earlier studies that teenagers with severe obesity are at risk of developing other diseases and poorer quality of life as adults. For that reason, we hope that the method can eventually be offered to more teenagers" Torsten Olbers concludes.

"Given that these teenagers have tried all other weight control options and are extremely difficult to treat, pediatricians are very receptive to a new treatment method," says Professor Claude Marcus at Karolinska Institutet, who was the pediatrician in charge.

The researchers stress that gastric bypass surgery does not automatically have an effect on psychological problems: some of the teenagers continued to experience them despite having lost weight. Furthermore, surgical complications such as volvulus and gallstones required follow-up surgery in some cases.

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The above story is reprinted from materials provided by University of Gothenburg, via AlphaGalileo.
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Journal Reference:

T Olbers, E Gronowitz, M Werling, S Mårlid, C-E Flodmark, M Peltonen, G Göthberg, J Karlsson, K Ekbom, L V Sjöström, J Dahlgren, H Lönroth, P Friberg, C Marcus. Two-year outcome of laparoscopic Roux-en-Y gastric bypass in adolescents with severe obesity: results from a Swedish Nationwide Study (AMOS). International Journal of Obesity, 2012; DOI: 10.1038/ijo.2012.160

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Exercise the body to keep the brain healthy, study suggests

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ScienceDaily (Oct. 22, 2012) — People who exercise later in life may better protect their brain from age-related changes than those who do not, a study suggests.

Researchers found that people over 70 who took regular exercise showed less brain shrinkage over a three-year period than those who did little exercise.

Psychologists and Neuroimaging experts, based at the University of Edinburgh, did not find there to be any benefit to brain health for older people from participation in social or mentally stimulating activities.

Greater brain shrinkage is linked to problems with memory and thinking and the researchers say their findings suggest that exercise is potentially one important pathway to maintaining a healthy brain both in terms of size and reducing damage.

The researchers also examined the brain's white matter - the wiring that transmits messages round the brain. They found that people over 70 who were more physically active had fewer 'damaged' areas - visible as abnormal areas on scanning - in the white matter than those who did little exercise.

Additionally, the researchers from the University of Edinburgh found that the over-70s taking regular exercise had more grey matter - the parts of the brain with nerve cell bodies.

The Edinburgh team used MRI scans to measure the volume of brain tissue and the volume and health of the brain's white matter in almost 700 people.

They studied levels of physical activity which ranged from moving only for necessary housework to more strenuous forms of exercise such as keep-fit or taking part in competitive sports.

Scientists also recorded whether or not the participants - all aged over 70 - took part in mentally stimulating activities such reading and participating in social groups.

Dr Alan Gow of the University of Edinburgh's Centre for Cognitive Ageing and Cognitive Epidemiology who led the research, said: "Our results suggest that to maintain brain health, physical activity may be more beneficial than choosing more sedentary activities. We are excited by the next stages of this research as we seek to understand more about what might underlie the effect, but in the meantime, increasing physical activity - even a short walk each day - can only be encouraged."

Professor James Goodwin, Head of Research at Age UK who fund the Disconnected Mind research project, said: "This research is exciting as it provides vital clues as to what impacts the way our brain ages and how we could tackle mental decline. If we can establish definitively that exercise provides protection against mental decline, it could open the door to exercise programmes tailored to the needs of people as they age.

"We already know that exercise is important in reducing our risk of some illnesses that come with ageing, such as cardiovascular disease and cancer. This research reemphasises that it really is never too late to benefit from exercise, so whether it's a brisk walk to the shops, gardening or competing in a fun run it is crucial that, those of us who can, get active as we grow older."

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The above story is reprinted from materials provided by University of Edinburgh, via EurekAlert!, a service of AAAS.
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Journal Reference:

A. J. Gow, M. E. Bastin, S. Munoz Maniega, M. C. Valdes Hernandez, Z. Morris, C. Murray, N. A. Royle, J. M. Starr, I. J. Deary, J. M. Wardlaw. Neuroprotective lifestyles and the aging brain: Activity, atrophy, and white matter integrity. Neurology, 2012; 79 (17): 1802 DOI: 10.1212/WNL.0b013e3182703fd2

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Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Many Lesbians Not Screened for Cervical Cancer, Study Finds

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FRIDAY, Oct. 19 (HealthDay News) -- The rate of routine screening for cervical cancer is low among lesbians, according to a new study.

More awareness about screening for this type of cancer among the lesbian community is needed to reduce the risk for the disease in these patients, the researchers said. Specifically, improved communication between patients and their doctors is the key to raising awareness about cancer screenings.

"Despite our knowledge of the value of Pap testing for early detection of treatable cervical abnormalities, lesbians are one subset of women who are not getting screened at recommended rates," said J. Kathleen Tracy, associate professor in the department of epidemiology and public health at the University of Maryland School of Medicine.

"In fact, nearly 38 percent of lesbians in our study had not been screened according to recommended guidelines," Tracy said in a news release from the American Association for Cancer Research.

Often called a Pap smear, the test examines cells scraped from the cervix to look for precancerous abnormalities.

For the study, the researchers sent online surveys on cervical cancer screening to 3,000 women who identified themselves as lesbians. An analysis of more than 1,000 responses revealed that 62 percent of the women had routine screenings. The investigators also found that 17.5 percent of the women said they did not undergo routine screenings because they did not have a physician referral. Meanwhile, just over 17 percent were not regularly screened for cervical cancer because they didn't have a doctor.

After taking into account the women's age, level of education, relationship and employment status, and whether or not the women had health insurance, the study found that women who told their primary care doctor or gynecologist that they were a lesbian were more than twice as likely to be routinely screened for cervical cancer.

"When this finding is coupled with that of the potency of provider recommendation, it underscores how critical effective communication between patient and provider is for optimal health and disease prevention," Tracy said.

The researchers said the women who knew that not having a Pap test is a risk factor for cervical cancer were nearly two times more likely to undergo routine screening for the disease.

"This study highlights an often overlooked cancer disparity," Tracy concluded. "We know that human papillomavirus can be transmitted during same-sex sexual activity, so lesbians are at risk for developing cervical cancer. If this group of women doesn't participate in screening, they are at elevated risk for developing cervical cancer via missed opportunities to identify and treat precursor abnormalities."

The study was scheduled for presentation this week at the annual cancer prevention conference of the American Association for Cancer Research in Anaheim, Calif.

Women should start having Pap tests by age 21, according to the American College of Obstetricians and Gynecologists. How often the screening is performed after that depends on a woman's age and health history.

The data and conclusions of research presented at meetings are typically considered preliminary until published in a peer-reviewed medical journal.

New study suggests using sedentary behavior counseling in primary care

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ScienceDaily (Oct. 22, 2012) — Although primary care physicians take care of many aspects of health and disease, little is known about how they can change sedentary behavior through counseling, according to researchers at The University of Texas Health Science Center at Houston (UTHealth). Results from a new study suggest encouraging patients to decrease the time they spend sitting each day may be feasible in the primary care setting.

"Reducing sedentary time can be done by virtually everyone and requires smaller changes in energy expenditure than meeting physical activity guidelines, which usually entails a complex behavior change particularly for inactive patients," said Kerem Shuval, Ph.D., principal investigator and assistant professor of epidemiology at The University of Texas School of Public Health Dallas Regional Campus, part of UTHealth. "Reducing sedentary time helps promote health and primary care physicians can play a major role in modifying their patients' sedentary behavior, particularly because adults spend many of their waking hours each day sitting or in passive leisure activities."

Results were recently published online in the British Journal of Sports Medicine.

Unlike physical activity counseling, which has been investigated over the years, sedentary behavior counseling is a new term used in this study to describe a dialogue with a patient about the harmful effects of prolonged uninterrupted sitting. The average amount of time spent sitting or reclining during waking hours in the United States is almost 8hours per day, according to data from the National Health and Nutrition Examination Survey.

In this study, Shuval and his colleagues asked adult primary care patients whether their providers asked, advised and encouraged them to modify their physical activity and sedentary behavior in the past year. The "5A" (ask, advise, agree, assist and arrange) framework was used to examine these questions.

Study results indicated that within the last year, only 10 percent of patients received sedentary behavior counseling compared to 53 percent who received physical activity counseling. No patients received a plan pertaining to decreasing sedentary behavior; however, 14 percent were provided with a written plan for increasing physical activity. More social support and specific strategies for behavior change were provided as it relates to increasing physical activity than decreasing sedentary behavior. Obese patients were more likely to receive counseling to decrease their sitting time.

"Accumulating evidence has found prolonged sitting to be associated with increased risk for chronic diseases such as obesity and type 2 diabetes as well as premature death," said Shuval, who is also an adjunct professor at The University of Texas Southwestern Medical Center (UT Southwestern) and a member of the Harold C. Simmons Cancer Center at UT Southwestern.

Sedentary behavior has emerged as a new field of scientific investigation due to the detrimental health effects of prolonged sitting, according to Shuval. A number of studies have begun to explore the impact of interventions specifically focused on reducing and breaking up sedentary time.

"Our study provides initial insight into sedentary behavior counseling practices in the primary care setting," said Shuval. "Additional research is needed prior to developing programs to change patients' sedentary behavior." Several countries have already begun to provide general recommendations to decrease sedentary time.

Co-authors on the paper include Harold W. Kohl, III, Ph.D., professor of epidemiology at the UT School of Public Health; Loretta DiPietro, Ph.D., M.P.H., professor and chair of the Department of Exercise Science at George Washington University; Celette Sugg Skinner, Ph.D., chief of the Division of Behavioral & Communication Sciences, and associate director of population research and cancer control for the Harold C. Simmons Cancer Center at UT Southwestern; Carolyn Barlow, doctoral candidate at the UT School of Public Health and director of knowledge management at the Cooper Institute; Jay Morrow, D.V.M., M.P.H, faculty associate at UT Southwestern; and Robert Goldsteen, D.O., professor of internal medicine at UT Southwestern.

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The above story is reprinted from materials provided by University of Texas Health Science Center at Houston.
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Journal Reference:

K. Shuval, L. DiPietro, C. S. Skinner, C. E. Barlow, J. Morrow, R. Goldsteen, H. W. Kohl. 'Sedentary behaviour counselling': the next step in lifestyle counselling in primary care; pilot findings from the Rapid Assessment Disuse Index (RADI) study. British Journal of Sports Medicine, 2012; DOI: 10.1136/bjsports-2012-091357

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Many Grandparents Lack Latest Child Safety Info: Study

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SUNDAY, Oct. 21 (HealthDay News) -- A new study finds that many grandparent caregivers don't know about newer safety guidelines for children, such as appropriate sleep position, crib safety and car seat use.

The number of grandparents in the United States who are the primary caregivers to their grandchildren has risen nearly 20 percent since 2000 and is now estimated at 2.8 million, according to the 2011 American Community Survey.

In this study, 49 grandparent caregivers completed a 15-question survey designed to assess their knowledge of child care safety guidelines.

When asked about the best sleep position for a baby, 33 percent of the participants said on the stomach, 23 percent said on the side and about 44 percent said on the back. When sleeping, infants should be placed on their backs to prevent sudden infant death syndrome, according to the American Academy of Pediatrics (AAP).

Another question addressed correct car seat positioning, and 24.5 percent of the participants said that a 9-month-old, 22-pound child should be facing forward. The AAP recommends, however, that children remain in rear-facing car seats until age 2 years.

Among the other findings:

Forty-nine percent of respondents thought it was OK to have bumpers, stuffed animals and blankets in cribs, even though the AAP recommends against it.Nearly 74 percent of respondents believed that a walker is a good device to help babies learn to walk, but the AAP advises against their use and urges caregivers to get rid of them because of serious safety concerns.

The study was scheduled for presentation Sunday at the American Academy of Pediatrics' national conference in New Orleans.

"Pediatric health and safety recommendations are constantly evolving," study author Dr. Kathryn Hines, a University of Alabama at Birmingham physician who sees patients at Children's of Alabama, said in an AAP news release. "Many recommendations are likely to have changed since these grandparent caregivers parented their own children."

Primary study author Dr. Amanda Soong, also of UAB, added: "Discussion of health and safety recommendations is an essential part of routine child care, and pediatricians must recognize knowledge deficits that may exist in grandparent caregivers and be comfortable addressing these deficits."

Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

An Inter-Laboratory Study to Determine the Effectiveness of Procedures for Discriminating Amphibole Asbestos Fibers from Amphibole Cleavage Fragments in Fiber Counting by Phase-Contrast Microscopy

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A Detailed Urinary Excretion Time Course Study of Captan and Folpet Biomarkers in Workers for the Estimation of Dose, Main Route-of-Entry and Most Appropriate Sampling and Analysis Strategies

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Sunday, October 21, 2012

Ultraviolet light effective in hospital infection control, study suggests

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ScienceDaily (Oct. 18, 2012) — Research being presented at IDWeek 2012™ shows that a specific spectrum of ultraviolet light killed certain drug-resistant bacteria on the door handles, bedside tables and other surfaces of hospital rooms, suggesting a possible future weapon in the battle to reduce hospital-associated infections.

Researchers at Duke University Medical Center and the University of North Carolina Hospital System used short-wave ultraviolet radiation (UV-C) to nearly eliminate Acinetobacter, Clostridium difficile or vancomycin-resistant enterococci (VRE) in more than 50 patient rooms at the two medical facilities.

"We're learning more and more about how much the hospital environment contributes to the spread of these organisms," said lead researcher Deverick J. Anderson, MD, an assistant professor of medicine at Duke and co-director of the Duke Infection Control Outreach Network. Given previous findings by the University of North Carolina team that UV-C is effective at decreasing methicillin-resistant Staphylococcus aureus (MRSA) in hospital rooms, he believes that the new study lays critical groundwork.

"We have a solid foundation to show that this approach succeeds in both experimental and real-world conditions," Anderson said. "Now it's time to see if we can demonstrate that it indeed decreases the rate of infections among patients."

His group's work is among the significant research being discussed at the inaugural IDWeek meeting, taking place through October 21 in San Diego. With the theme Advancing Science, Improving Care, IDWeek features the latest science and bench-to-bedside approaches in prevention, diagnosis, treatment, and epidemiology of infectious diseases, including HIV, across the lifespan. More than 1,500 abstracts from scientists in this country and internationally will be highlighted over the conference's five days.

"Healthcare-associated infections are linked with significant morbidity and mortality," said Liise-anne Pirofski, MD, an IDWeek chair for the Infectious Diseases Society of America. "Although there are multiple sources for these infections, the hospital environment itself can play an important role. The findings of this study suggest that UV light could hold promise for eliminating bacteria from hospital rooms and reducing the risk of infection with these difficult bacterial pathogens in the healthcare environment. That would be a result to benefit us all."

UV-C, which is harmful to microorganisms, has been used for decades in food, air and water purification and to sterilize equipment in laboratory settings. This study demonstrates that its medical application may offer new strategies for reducing the estimated 1.7 million hospital-associated infections that occur annually in the United States. The cost of treating these infections, often involving increasingly antibiotic-resistant bacteria, ranges from an estimated $4.5 billion to as much as $11 billion.

In their study, the Duke and University of North Carolina researchers questioned whether UV-C could be utilized to eliminate three of the most problematic germs and improve the cleanliness of patient rooms. Given the tough economics of healthcare today, hospitals' environmental services are under pressure to turn rooms over quickly, and many surfaces can get missed by even the most diligent crews.

The study focused on general-medical and intensive-care units of the two medical centers and identified patients with infections from the targeted bacteria. Clostridium difficile, or C. diff as it is commonly known, can trigger serious intestinal conditions. Acinetobacter can cause pneumonia and serious blood, wound and urinary tract infections. VRE most frequently infects the urinary tract, bloodstream, wounds or catheter sites. Each bacterium can survive for prolonged periods on surfaces.

After the patients were discharged, the researchers obtained multiple cultures from each of five specific locations in the hospital rooms and bathrooms -- "high-touch" areas that included bed rails, remote controls and toilets. A special machine with eight UV bulbs mounted on a central column was then positioned strategically in each room and turned on for as long as 45 minutes to eradicate both vegetative bacteria and bacterial spores. Fifteen more cultures were taken from the same locations in every room, and the pre- and post-treatment bacteria counts were compared.

The numbers of bacterial CFUs, or colony-forming units, fell precipitously. Fifty-two CFUs of Acinetobacter were seen before irradiation, but only 1 CFU afterward -- down 98.1 percent. As for VRE, the proportion decrease was nearly the same -- 719 CFUs before and 15 after, a 97.9 percent drop.

The culturing initially was not sensitive enough to isolate C. diff, but improved techniques allowed the researchers to do further testing and the results in the UV-C treated rooms were just as dramatic.

"We would never propose that UV light be the only form of room cleaning, but in an era of increasing antibiotic resistance, it could become an important addition to hospitals' arsenal," Anderson said.

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Foster kids do equally well when adopted by gay, lesbian or heterosexual parents, study suggests

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ScienceDaily (Oct. 18, 2012) — High-risk children adopted from foster care do equally well when placed with gay, lesbian or heterosexual parents, UCLA psychologists report in the first multi-year study of children adopted by these three groups of parents.

The psychologists looked at 82 high-risk children adopted from foster care in Los Angeles County. Of those children, 60 were placed with heterosexual parents and 22 were placed with gay or lesbian parents (15 with gay male parents and seven with lesbian parents).

The age of the children ranged from 4 months to 8 years, with an average age of 4, while the adoptive parents ranged in age from 30 to 56, with an average age of 41. Sixty-eight percent of the parents were married or living with a partner.

The psychologists studied the children two months, one year and two years after they were placed with a family. The children underwent a cognitive assessment by a clinical psychologist three times during the course of the study, and the parents completed standard questionnaires about the children's behavior at each of the three assessment periods.

The psychologists found very few differences among the children at any of the assessments over the two-year period following placement. On average, children in heterosexual, gay and lesbian households achieved significant gains in their cognitive development, and their levels of behavior problems remained stable. Their IQ scores increased by an average of 10 points, from about 85 to 95 -- a large increase, from low-average to average functioning.

"The children showed meaningful gains in heterosexual, gay and lesbian families," said Justin Lavner, a UCLA doctoral candidate in psychology and lead author of the study. "Their cognitive development improved substantially, while their behavior problems and social development were stable."

The study is published in the October issue of the American Journal of Orthopsychiatry.

The children had multiple risk factors at the time of adoption, including premature birth, prenatal substance exposure, abuse or neglect, and multiple prior placements. The psychologists acquired information regarding these biological and environmental risk factors from birth records, court reports and Los Angeles County Department of Children and Family Services records.

The children adopted by gay and lesbian families had more risk factors at the time of their placement; out of nine risk factors, they averaged one additional risk factor, compared with the children adopted by heterosexual parents.

"The children adopted by gay and lesbian parents had more challenges before they were adopted and yet they end up in the same place, which is impressive," said Letitia Anne Peplau, a distinguished research professor of psychology at UCLA and co-author of the study.

At a time when tens of thousands of foster children lack stable homes and concerns about the suitability of gay and lesbian adoptive parents limit the pool of potential parents, the study indicates that gay and lesbian parents can provide nurturing homes for these children in a manner similar to that of heterosexual parents.

"There is no scientific basis to discriminate against gay and lesbian parents," Peplau said.

Asked whether children need a mother and father, senior author Jill Waterman, a UCLA adjunct professor of psychology, said, "Children need people who love them, regardless of the gender of their parents."

The study participants were recruited from UCLA TIES (Training, Intervention, Education, and Services) for Families as part of a broader study on the development of children adopted from foster care. UCLA TIES for Families promotes the successful adoption of high-risk children from foster care to nurturing homes.

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The above story is reprinted from materials provided by University of California - Los Angeles. The original article was written by Stuart Wolpert.
Note: Materials may be edited for content and length. For further information, please contact the source cited above.

Journal Reference:

Justin A. Lavner, Jill Waterman, Letitia Anne Peplau. Can Gay and Lesbian Parents Promote Healthy Development in High-Risk Children Adopted From Foster Care? American Journal of Orthopsychiatry, 2012; 82 (4): 465 DOI: 10.1111/j.1939-0025.2012.01176.x

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No survival advantage with peripheral blood stem cells versus bone marrow, study suggests

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ScienceDaily (Oct. 19, 2012) — Claudio Anasetti, M.D., chair of the Department of Blood & Marrow Transplant at Moffitt Cancer Center, and colleagues from 47 research sites in the Blood and Marrow Transplant Clinical Trials Network conducted a two-year clinical trial comparing two-year survival probabilities for patients transplanted with peripheral blood stem cells or bone marrow stem cells from unrelated donors. The goal was to determine whether graft source, peripheral blood stem cells or bone marrow, affects outcomes in unrelated donor transplants for patients with leukemia or other hematologic malignancies.

Fifty transplant centers in the United States and Canada participated in this phase III study, which randomized 278 patients to receive bone marrow and 273 patients to receive peripheral blood stem cells as the graft source for transplant. The results of the study are in the Oct. 18 issue of The New England Journal of Medicine.

According to the trial analyses, there were no observed differences in overall survival, relapse, non-relapse mortality, or acute graft-versus-host disease (GHVD) between the patients receiving peripheral blood stem cells or bone marrow stem cells from unrelated donors. GVHD is a serious and often deadly post-transplant complication that occurs when the newly transplanted donor cells attack the transplant recipient's body. While engraftment was faster in patients receiving peripheral blood stem cells, there was a higher incidence of overall chronic GVHD in these patients (53 percent) than in those transplanted with bone marrow stem cells (40 percent). Patients receiving transplants of peripheral blood stem cells from unrelated donors also had a higher incidence of chronic GVHD affecting multiple organs (46 percent) than patients who received bone marrow stem cells (31 percent).

"Although peripheral blood stem cells from related donors have demonstrated clinical benefits, our trial demonstrates that when these stem cells originate from unrelated donors, they are not superior to bone marrow stem cells in terms of patient survival, and they increase the risk for chronic GVHD," said Anasetti, lead study author. "More effective strategies to prevent GVHD are needed to improve outcomes for all patients receiving unrelated donor transplants."

Peripheral blood stem cells are stem cells originally found in the bone marrow that have been moved into the blood stream by a special regimen of drugs. Unlike bone marrow stem cells, which must be extracted from the bones in an operating room, peripheral blood stem cells are more easily obtained through apheresis, a process similar to regular blood donation, which collects the peripheral blood stem cells through a tube inserted in a vein. A critical step before the transplant involves finding a donor that is tissue matched to the recipient.

About one-third of patients who need a peripheral blood stem cell or bone marrow transplant for treatment of leukemia or another blood disease are able to secure a related donor. According to the National Marrow Donor Program, for the 70 percent who cannot find a donor within their family, most will be able to find an unrelated donor. Because the majority of transplant patients need cells from unrelated donors, it's necessary to better understand the risks associated with transplants of unrelated donor cells.

Clinical trials on related donor transplants have demonstrated that peripheral blood stem cell transplants in patients with leukemia and other blood diseases result in better engraftment, lower relapse rates, and increased survival compared with transplants with bone marrow stem cells. However, those trials also found that peripheral blood stem cell transplants carry an increased risk of GVHD. Patients who survive early post-transplant may develop chronic GVHD, a disabling condition managed with long-term immunosuppressant therapy.

Many transplant centers are increasingly using peripheral blood stem cells as a source for adult stem cells because of their superiority in clinical trials that have directly compared outcomes between peripheral blood stem cells and bone marrow stem cells from related donors. However, there has not been a comparative study of the two transplant sources that has prospectively analyzed patient outcomes in unrelated donor transplants.

The study was funded by the National Heart, Lung and Blood Institute (U10HL069294), the National Cancer Institute and the National Marrow Donor Program.

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The above story is reprinted from materials provided by H. Lee Moffitt Cancer Center & Research Institute.
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Journal Reference:

Claudio Anasetti, Brent R. Logan, Stephanie J. Lee, Edmund K. Waller, Daniel J. Weisdorf, John R. Wingard, Corey S. Cutler, Peter Westervelt, Ann Woolfrey, Stephen Couban, Gerhard Ehninger, Laura Johnston, Richard T. Maziarz, Michael A. Pulsipher, David L. Porter, Shin Mineishi, John M. McCarty, Shakila P. Khan, Paolo Anderlini, William I. Bensinger, Susan F. Leitman, Scott D. Rowley, Christopher Bredeson, Shelly L. Carter, Mary M. Horowitz, Dennis L. Confer. Peripheral-Blood Stem Cells versus Bone Marrow from Unrelated Donors. New England Journal of Medicine, 2012; 367 (16): 1487 DOI: 10.1056/NEJMoa1203517

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Living in ethnically homogenous area boosts health of minority seniors, study finds

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ScienceDaily (Oct. 18, 2012) — An African-American or Mexican-American senior living in a community where many neighbors share their background is less likely to have cancer or heart disease than their counterpart in a more mixed neighborhood.

Results of the new study by Kimberly Alvarez, a PhD student at Columbia University's Mailman School of Public Health, and Becca Levy, PhD, associate professor of Epidemiology and Psychology at the Yale School of Public Health, appear in the December issue of the American Journal of Public Health and online.

Counter to prevailing notions, researchers found that "living in the barrio or ethnically dense communities isn't always bad for your health," says Alvarez. "For older minority adults, it's actually the reverse: living in an ethnically dense neighborhood is beneficial when it comes to heart disease and cancer," adding that these are the two most common chronic conditions and causes of death among minority older adults.

The researchers used survey data to look at health outcomes of 2,367 Mexican-American and 2,790 African-Americans over age 65 living in communities with high percentages of African-Americans (New Haven, Conn. and north-central North Carolina) and Mexican-Americans (Arizona, California, Colorado, New Mexico, and Texas). Among African-Americans, those living in a county with an ethnic density of 50% or more (that is, where half or more of the population shared the same background) were 46% less likely to report doctor-diagnosed heart disease and 77% less likely to report cancer than those who lived in an ethnic density of less than 25%. Mexican Americans living in a county with an ethnic density of 50% or more were 33% and 62% less likely to report heart disease and cancer, respectively, than those who lived in an ethnic density of less than 25%. Ethnic density was significantly more protective for heart disease in African-Americans than Mexican-Americans; the association between ethnic density and cancer was equally strong for both groups.

Cultural factors could help to explain the phenomenon. "Communities with high ethnic density may be more likely to share values like respect for elders and have close-knit family structures," says Dr. Levy. Earlier studies showed high levels of social support within communities of Hispanic immigrants. "These networks may facilitate better health behaviors and, in turn, better health outcomes," adds Alvarez. "For example, information about free health clinics may be more freely exchanged in these communities."

Past studies showed a health benefit of ethnic density for Hispanics, but the reverse for African-Americans; these results were in keeping with what is known as the Hispanic Paradox: that even with similar levels of socioeconomic status, Hispanics have comparable, or in some cases better, health outcomes than White Americans. Adding a wrinkle to this rule, Alvarez and Dr. Levy are the first to find a positive effect for ethnic-density among African-Americans. The difference, Alvarez explains, may owe to the fact that past studies have looked at African-American children and young adults rather than seniors and measured ethnic density in relation to whites rather than within subsets of other minority populations.

"Having this information is important given the rapidly growing population of older adult minorities," says Alvarez.

Support for the study was provided by grants from the National Institute on Aging (R01AG032284), the National Heart, Lung, and Blood Institute (R01HL089314), and the Patrick and Catherine Wildon Donaghue Medical Research Foundation (to Dr. Levy).

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The above story is reprinted from materials provided by Columbia University's Mailman School of Public Health, via EurekAlert!, a service of AAAS.
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Kimberly J. Alvarez and Becca R. Levy. Health Advantages of Ethnic Density for African American and Mexican American Elderly Individuals. American Journal of Public Health, 2012; DOI: 10.2105/AJPH.2012.300787

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Weight loss does not lower heart disease risk from type 2 diabetes, study suggests

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ScienceDaily (Oct. 19, 2012) — An intensive diet and exercise program resulting in weight loss does not reduce cardiovascular events such as heart attack and stroke in people with longstanding type 2 diabetes, according to a study supported by the National Institutes of Health.

The Look AHEAD (Action for Health in Diabetes) study tested whether a lifestyle intervention resulting in weight loss would reduce rates of heart disease, stroke, and cardiovascular-related deaths in overweight and obese people with type 2 diabetes, a group at increased risk for these events.

Researchers at 16 centers across the United States worked with 5,145 people, with half randomly assigned to receive an intensive lifestyle intervention and the other half to a general program of diabetes support and education. Both groups received routine medical care from their own health care providers.

Although the intervention did not reduce cardiovascular events, Look AHEAD has shown other important health benefits of the lifestyle intervention, including decreasing sleep apnea, reducing the need for diabetes medications, helping to maintain physical mobility, and improving quality of life.

"Look AHEAD found that people who are obese and have type 2 diabetes can lose weight and maintain their weight loss with a lifestyle intervention," said Dr. Rena Wing, chair of the Look AHEAD study and professor of psychiatry and human behavior at Brown University. "Although the study found weight loss had many positive health benefits for people with type 2 diabetes, the weight loss did not reduce the number of cardiovascular events."

Data are currently being analyzed to fully understand the cardiovascular disease results. Investigators are preparing a report of the findings for a peer-reviewed publication.

Few, if any, studies of this size and duration have had comparable success in achieving and maintaining weight loss. Participants in the intervention group lost an average of more than 8 percent of their initial body weight after one year of intervention. They maintained an average weight loss of nearly 5 percent at four years, an amount of weight loss that experts recommend to improve health. Participants in the diabetes support and education group lost about 1 percent of their initial weight after one and four years.

In September 2012, the NIH stopped the intervention arm, acting on the recommendation of the study's data and safety monitoring board. The independent advisory board, charged with monitoring the study data and safety of participants, found that the intensive lifestyle did no harm but did not decrease occurrence of cardiovascular events, the primary study goal. At the time, participants had been in the intervention for up to 11 years.

Because there was little chance of finding a difference in cardiovascular events between the groups with further intervention, the board recommended stopping the intensive lifestyle intervention, but encouraged the study to continue following all Look AHEAD participants to identify longer-term effects of the intervention.

"The intervention group did not have fewer cardiovascular events than the group receiving general diabetes support and education, but one positive factor we saw was that both groups had a low number of cardiovascular events compared to previous studies of people with diabetes," said Dr. Mary Evans, director of Special Projects in Nutrition, Obesity, and Digestive Diseases within the NIH's National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), the study's primary sponsor.

Type 2 diabetes -- affecting nearly 24 million people in the United States alone -- has increased in prevalence along with the country's epidemic of overweight and obesity. Cardiovascular diseases are the most common cause of death among people with type 2 diabetes. Look AHEAD is the first study to examine the long-term effects of a lifestyle intervention on major cardiovascular disease events and death in adults with type 2 diabetes.

"Look AHEAD provides important, definitive information about the long-term health effects of weight loss in people with type 2 diabetes," said NIDDK Director Dr. Griffin P. Rodgers. "Beyond cardiovascular disease, this study and others have shown many other health benefits of weight loss through improved diet and increased physical activity. For example, for overweight and obese adults at high risk for diabetes, modest weight loss has been shown to prevent or delay developing type 2 diabetes."

Participants were 45 to 76 years old when they enrolled in the study. Sixty percent of enrollees were women. More than 37 percent were from racial and ethnic minority groups. Researchers are now analyzing data to measure effects of the lifestyle intervention on subgroups, including racial and ethnic groups and people with a history of cardiovascular disease.

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Nationwide Study Examines Common Heart Procedures

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THURSDAY, Oct. 18 (HealthDay News) -- Risk factors for heart disease -- such as being overweight, having high cholesterol levels and smoking -- are common in patients who undergo angioplasty and stent procedures to open blocked coronary arteries, a large new study finds.

Researchers looked at data from nearly 2 million patients who underwent heart catheterization procedures at nearly 1,500 facilities in the United States between Jan. 1, 2010, and June 30, 2011.

In cardiac catheterization, a long, thin, flexible tube (catheter) is inserted into a blood vessel and threaded to the heart. Through the catheter, doctors can conduct diagnostic tests and treatments on the heart.

About 1.1 million patients in the study underwent diagnostic cardiac catheterization and more than 940,000 underwent angioplasty and stenting, known as percutaneous coronary intervention.

Of the patients who had such intervention, nearly 80 percent were overweight, including 43 percent who were obese. Other risk factors for heart disease also were common. Eighty percent of patients had high blood cholesterol levels and 82 percent had high blood pressure. Nearly 28 percent of patients were current or recent smokers.

The study also found that 70 percent of patients who underwent procedures had heart attacks or other acute symptoms. About 18 percent had stable angina and 12 percent had either atypical symptoms or no angina.

Among patients who were suffering a severe heart attack and arrived at a hospital capable of performing angioplasty, the average time from arrival to treatment was 64.5 minutes. For patients who had to be transferred to another hospital, the average time from arrival at the first hospital to treatment was 121 minutes.

Cardiac catheterization was conducted through an artery in the thigh in just over 90 percent of procedures, rather than through an artery in the wrist.

Low-volume facilities (those that conduct fewer than 200 of these procedures per year) accounted for only 4 percent of the total number of percutaneous coronary interventions during the study period.

The findings appear online and in the Nov. 13 print issue of the Journal of the American College of Cardiology.

"These data will be of interest to the cardiovascular community because they show us where we are and where we can find opportunities for quality improvement," lead author Dr. Gregory Dehmer said in a journal news release.