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

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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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

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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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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New study suggests using sedentary behavior counseling in primary care

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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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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Ultraviolet light effective in hospital infection control, study suggests

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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Cancer diagnosis does not make young people religious, research suggests

ScienceDaily (Oct. 18, 2012) — A sociologist of religion from the University of Copenhagen has interviewed 21 young patients diagnosed with a life-threatening cancer about their religious beliefs. She concludes that a cancer diagnosis will not make young people, who are not religious already, turn to religion. But it can confirm already existing beliefs.

"My research shows that young cancer patients' views on existential issues show consistency before and after the diagnosis: Their faith and their religious practices remain the same. However, the beliefs they already had can be confirmed and strengthened -- this applies both to religion and science -- so the patients may feel more strongly for the beliefs they had before they were diagnosed," explains sociologist of religion Nadja Ausker from the University of Copenhagen.

It has been a theoretical staple of sociology of religion that major religious conversions are preceded by personal crises; a person's feelings toward religion are significantly altered when confronted with an existential crisis such as a cancer diagnosis.

But Nadja Ausker challenges this theory with her thesis "Time for a change? Negotiations of religious continuity, change, and consumption among Danish cancer patients." In the thesis, she interviews 21 young cancer patients about the religious consequences of life crises, both shortly after the diagnosis and during treatment.

No hypocrisy

Nadja Ausker explains that a cancer diagnosis does not make young people lose their religion, just as atheists do not become religious:

"The cancer patients do contemplate existential issues, but that does not mean that they suddenly start praying or going to church if these religious practices were not already part of their lives. Several patients said it would be hypocritical of them to change practice and faith because of the diagnosis."

What the patients who already are religious find important, according to Nadja Ausker, is the availability of religious goods to choose from and consume as needed -- just as one takes a pill or other medication. The patients become "consumers" of religious goods, and they pick the goods for immediate consumption, e.g. prayer or attending a church.

The patients therefore consume religious practices, and not new religious beliefs, during their illness. But their post-diagnosis practices are still consistent with their pre-diagnosis practices.

About the study

Nadja Ausker's PhD thesis is a collaboration between the University of Copenhagen and the largest Danish hospital, Rigshospitalet. It is based on 40 interviews with 21 cancer patients under the age of 40 diagnosed with leukemia or lymphoma. The interviews were conducted 1-6 months and 12-18 after the diagnosis.

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

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.

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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

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

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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Children with ADHD find medication frees them to choose between right and wrong, study suggests

ScienceDaily (Oct. 16, 2012) — Children living with ADHD tend to feel they benefit from medication to treat the condition and do not think the medication turns them into 'robots', according to a report published October 17. In fact, they report that medication helps them to control their behaviour and make better decisions. The study, which gives a voice to the children themselves, provides valuable insights into their experiences and the stigma they face.

The ADHD VOICES -- Voices on Identity, Childhood, Ethics and Stimulants -- study has worked with 151 families in the UK and the USA to examine ethical and societal issues surrounding attention deficit hyperactivity disorder (ADHD), particularly the use of treatments such as methylphenidate (Ritalin). The project has been led by biomedical ethicist Dr Ilina Singh from King's College London and was funded by the Wellcome Trust.

Dr Singh and colleagues interviewed children and their families about ADHD, behaviour, medication and identity across four contexts: home, school, the doctor's office and peer groups.

The report is intended not only to highlight ethical and social issues surrounding ADHD but also to help families, doctors, teachers and the children themselves to understand from a child's perspective what it is like to live with ADHD.

"ADHD is a very emotive subject, which inspires passionate debate. Everyone seems to have an opinion about the condition, what causes it, and how to deal with children with ADHD, but the voices of these children are rarely listened to," explains Dr Singh. "Who better to tell us what ADHD is like and how medication affects them than the children themselves?"

Dr Singh points out the controversies that surround providing medication to children with ADHD, which some people argue turns the children into 'robots'. She believes that in many cases and with a correct diagnosis, treatment using stimulants is appropriate and beneficial, particularly if it is complemented by other interventions. The evidence from the children she interviewed suggests that they think medication improves their ability to make their own moral choices.

Glenn (age 10), from the USA, says: "If you're driving in a car, and there's two different ways, and you usually always go this way…and then one day you want to go the other way, but…the ADHD acts as a blocker, so you can't.

"[The medicine] opens the blocker so that you can go [the right] way. But you still have the choice of going the wrong way… It's harder [without medication], that's what's the truth. But it's not like [on medication] you're a robot."

Dr Singh also found that children often did not understand their condition or why they were receiving medication, and many children in the study reported that they had little meaningful contact with their doctors. After the initial evaluation, clinic visits tended to focus on side-effect checks, during which children were weighed and measured. Most children were not asked any questions during these visits.

Roger (age 13), from the UK, says: "I've only just started going to the ADHD clinic, but I haven't actually been to it properly. I've seen the doctor and he's talked about [ADHD] and I get weighed. But...they'll just say parts of what it is but then they'll stop, so they will only say some of it and then change the subject."

Dr Singh argues that children need to be better informed and able to discuss their condition. "Given the ethical concerns that arise from ADHD diagnosis and stimulant drug treatment, it is imperative that children are able to openly discuss the value of diagnosis and different treatments with a trusted professional."

The report concludes with a series of recommendations for how parents, doctors and teachers can help children cope with and better understand the condition, and begin to tackle the stigma that currently exists around it.

Professor Peter Hill, a child and adolescent psychiatrist, says: "We hope that the VOICES Study and the ADHD and Me animations will inspire people to think differently about ADHD, drug treatments and children with behavioural difficulties.

"Behaving differently around these children is the main challenge. We hope that the strategies we have outlined will help improve the interactions with these children and help improve their lives."

Clare Matterson, Director of Medical Humanities and Engagement at the Wellcome Trust, comments: "It is refreshing to hear the voices of children included in the debate about ADHD.

"It is a very emotive subject and despite the fact that these children are at the centre of this debate, they are too often ignored. This report sends a clear message to doctors, teachers and parents about the importance of talking to children about their condition -- and more importantly, listening to what they have to say."

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Vegetable-derived compound effective in treating triple-negative breast cancer, research suggests

ScienceDaily (Oct. 17, 2012) — A new compound created from a rich source in vegetables including broccoli and brussel sprouts has been developed to combat triple-negative breast cancer (TNBC). This research is being presented at the 2012 American Association of Pharmaceutical Scientists (AAPS) Annual Meeting and Exposition, the world's largest pharmaceutical sciences meeting, in Chicago, Ill., on Oct. 14 -- 18, during Breast Cancer Awareness Month.

TNBC accounts for approximately 15-20 percent of all breast cancer cases in the U.S. It is one of the most aggressive forms of breast cancer; it grows faster, spreads to other parts of the body earlier, is harder to detect on a mammogram and recurs more often.

Mandip Sachdeva, Ph.D. and Chandraiah Godugu, P.h.D. from Florida A&M University, in collaboration with Stephen Safe, Ph.D., from Texas A&M University, have evaluated the activity of novel C-substituted diindolylmethane (C-DIM) derivatives and demonstrated that they have superior anticancer activities. Sachdeva's study reveals that these synthetic compounds derived from diindolylmethane (DIM), commonly found in various types of cruciferous vegetables, can be used to treat several types of cancer, including triple-negative breast cancer. C-DIMs are also being investigated for their cancer prevention activity.

"Targeted treatment options for TNBC are limited; current treatments, such as infusions, result in poor patient compliance and increased toxicity," said Sachdeva. "We are confident that the compounds we are currently working with are an effective treatment for triple-negative breast cancer. These compounds are safer for the patient than current treatments available."

In contrast to existing anticancer drugs, the diindolylmethane compounds are orally active, so they could be available to patients in pill form and safe to take daily. When taken in combination with existing anticancer drugs, the diindolylmethane compounds can effectively decrease the number of treatments a patient receives.

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Diet, Exercise May Boost 'Good' Cholesterol, Study Suggests

THURSDAY, Oct. 11 (HealthDay News) -- For overweight people with diabetes, intensive exercise and dieting not only aids weight loss, it can also help train their fat cells to produce a hormone believed to boost production of "good" cholesterol, according to a new study.

And this so-called "good" cholesterol, or HDL cholesterol, has been linked to positive effects for cardiovascular health.

The new study, from researchers at The Methodist Hospital in Houston, included data on overweight and obese people with type 2 diabetes who were taking part in a multicenter clinical trial examining how increased physical activity and reduced calorie intake affected their risk for cardiovascular disease.

The participants were randomly assigned to either an intensive diet and exercise program (the "lifestyle intervention" group) or a program that offered only diabetes support and education and no lifestyle changes (the "control" group).

After one year, the lifestyle intervention group had achieved significant improvements in a measure of total fat called "adiposity," fitness, blood sugar levels and fat levels, the investigators found.

In addition, while levels of "bad" LDL cholesterol did not change, levels of the fat hormone adiponectin and HDL cholesterol did increase: Total adiponectin produced by fat cells increased about 12 percent and HDL cholesterol increased nearly 10 percent in the people who made lifestyle changes, compared to those in the control group, the research showed.

It's well established that adiponectin plays a role in fat burning and sugar storage. This study suggests that the hormone also encourages the liver to produce HDL cholesterol, the study authors pointed out in a hospital news release.

"What we're learning is that even overweight people who are physically active and eating a healthy diet are getting benefits from the lifestyle change," principal investigator Dr. Christie Ballantyne, director of the Center for Cardiovascular Disease Prevention, part of the Methodist DeBakey Heart and Vascular Center at The Methodist Hospital in Houston, said in the news release.

"When you exercise and diet, you're improving the function of your adipose tissue, your heart and vascular systems, and even muscle performance. You're getting a lot of benefits that you may not see by just looking at the weight on a scale," he added.

The study was released online in advance of publication in an upcoming print issue of the Journal of Lipid Research.

-- Robert Preidt Copyright © 2012 HealthDay. All rights reserved. SOURCE: The Methodist Hospital, news release, Oct. 9, 2012

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Social Media Could Boost Condom Use, Study Suggests

THURSDAY, Oct. 11 (HealthDay News) -- Social media can be used to help convince young adults to use condoms to prevent sexually transmitted diseases, a new study finds.

Researchers enrolled online networks of friends who were randomly assigned to an intervention group or a "control" group.

The 942 participants in the intervention group signed up to "like" and receive news from Just/Us, a Facebook community created to promote sexual health. The site featured weekly discussions about topics such as condom use, talking with partners about sexual history, and how to get tested for sexually transmitted diseases. In addition, there were daily updates in the form of video links, quizzes, blogs and discussion threads.

The 636 people in the control group, called 18-24 News, shared general news of interest to 18- to 24-year-olds.

Two months after taking part in the social networking groups, 68 percent of those in the Just/Us group reported using a condom the last time they had sex, compared with 56 percent of those in the 18-24 News group. The rate of condom use during sex in the previous two months was 63 percent in the Just/Us group and 57 percent in the 18-24 News group, the investigators found.

However, the effects seen in the Just/Us group faded over time and there were no differences between the two groups at the six-month follow-up, according to the report published in the November issue of the American Journal of Preventive Medicine.

"The use of social media to influence sexual risk behavior in the short term is novel. It is a first step in considering how to reach the overwhelming numbers of youth online, and how to maximize approaches to technology-based interventions," lead investigator Sheana Bull, of the Colorado School of Public Health's University of Colorado Anschutz Medical Campus, said in a journal news release.

The author of an accompanying commentary, Dr. Nathan Cobb, from the Schroeder Institute for Tobacco Research and Policy Studies at the American Legacy Foundation in Washington D.C., agreed that this use of social media was a step in the right direction. "For health-behavior change intervention designers, Facebook offers something unprecedented -- direct access to an individual's social network, in real time, and without the need for tedious network enumeration by participants," he wrote.

"However, such approaches require multidisciplinary teams that include social media specialists, marketers, and software developers as equal partners in design and intervention development. Building such teams will undoubtedly require changes to traditional funding and development models, but the potential is too large to be ignored or minimized," Cobb added.

-- Robert Preidt Copyright © 2012 HealthDay. All rights reserved. SOURCE: American Journal of Preventive Medicine, news release, Oct. 9, 2012

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