Why Being a Leader Is Less Stressful than Following

Contrary to the common wisdom that people in positions of power are more stressed than the rest of us, a new study finds that those in higher-ranking roles wield more control and, thus, suffer less stress and anxietyLeadership

While the image of the stressed-out executive or the politician under pressure has been firmly planted in the American mind, research increasingly suggests that it’s actually people lower down on the social scale — not those in leadership positions at the top — who suffer the worst health effects of stress.

Now a new study of military officials and government staffers at a Harvard executive-training program confirms these findings, showing that as people climb the organizational rungs, their stress hormone levels and anxiety typically go down. “Being a leader, especially a high-ranking leader, is associated with lower levels of the stress hormone cortisol,” says study co-author Gary Sherman, a postdoctoral fellow at Harvard’s Kennedy School of Government, noting that chronically high cortisol is a physiological indicator of stress.

Indeed, while everyone needs some amount of cortisol to cope with short-term stress, having consistently high levels of the hormone has been linked to depression, obesity, heart disease, high blood pressure, stroke and other major causes of illness and death. The new study found that cortisol levels were 27% higher, on average, in non-leaders compared with leaders.

(MORE: Study: 1 in 25 Business Leaders May Be Psychopaths)

For the paper, two experiments were conducted. The first involved simply measuring cortisol and anxiety levels in 216 people, including government officials and military officers, and then comparing those levels to those in people recruited from the Boston area who did not hold managerial positions.

The second study included 88 leaders and analyzed whether their sense of social control over their circumstances was linked to how stressed they felt. Previous research has found that even people in low-ranking positions don’t have overly high levels of stress as long as they have a perceived sense of control; but for those who don’t have a sense of power, even being at the top won’t protect them from hazardous stress.

“When we compared leaders of different ranks and levels, we found that higher-ranking leaders reported a greater sense of control in their lives. This helped explain why they had lower levels of stress,” says Sherman. Simply thinking that you have control, whether or not you actually do, changes the way the brain responds to stress and makes it less toxic.

It’s an “interesting and nicely constructed series of studies,” says Scott Lilienfeld, professor of psychology at Emory University, who was not associated with the research.

“Our findings suggest that despite the complexities inherent in human hierarchies, differences in rank do have implications for understanding health. Because cortisol impacts immune function, differences in one’s rank within an organization may have health implications,” says Sherman, adding that this means that increased income inequality could increase health disparities between the rich and the rest.

(MORE: Psychopathic Traits: What Successful Presidents Have in Common)

But, interestingly, while higher rank was generally linked with both lower anxiety and lower stress hormone levels, the study found that anxiety and stress were not related to each other. A person might be extremely anxious and have low stress hormone levels — or be completely nonplussed while having elevated cortisol. In a commentary published along with the study, Stanford’s Robert Sapolsky, a leading researcher on stress and rank, noted that while both stress and anxiety respond to stress, they’re linked with different branches of the stress-response system.

Having low cortisol and low anxiety levels have also been linked with psychopathic traits, which Lilienfeld in turn found to be associated with leadership in a recent study of American presidents. “As the authors themselves acknowledge, their results pose something of a chicken-and-egg conundrum,” he says. “Does leadership produce lower levels of cortisol, or do some of the same personality traits that might be tied to low cortisol, like [the psychopathic trait of] boldness, contribute to leadership?”

Lilienfeld suggests that it’s possible that a certain subset of psychopathic traits, such as physical and social boldness, could predispose a person to have both low cortisol and to be an effective leader — so, low cortisol could be a marker of sorts for both traits. “This hypothesis would be worth pursuing in further research,” he says.

Sherman agrees that it’s “highly plausible” that people with low cortisol levels might tend to become leaders because of their ability to stay cool.

(MORE: Baboon Study Shows Why High Social Status Boosts Health)

Cortisol research is notoriously hard to interpret, however, as Lilienfeld cautions. Some research has found that low cortisol is associated with anxiety and post-traumatic stress disorder, for example, which conflicts with the idea that it is a marker of fearlessness or a psychopathic lack of concern.

In any case, the early scientific evidence that first suggested that higher rank necessarily means higher stress hasn’t held up to scrutiny. Generally, life — and health — are better at the top. As Sapolsky notes in his commentary, “As a final bonus, the work offers an immediate practical benefit for this campaign season: if a politician asserts that his adrenal glands have hypertrophied [i.e., that he's overstressed by the job] but that this is a sacrifice he is willing to bear for the rest of us, consider this a good indicator that anything else he claims should be viewed skeptically.”

The research was published in the Proceedings of the National Academy of Sciences.

New York City Offers Plan B to High School Students

image: Plan B One-Step Pill

In Jan. 2011, New York City quietly launched a pilot program to dispense free prescription contraceptives, including birth control pills and the morning-after pill, Plan B, to students at more than a dozen public high schools in the city.

The program, known as CATCH, for Connecting Adolescents to Comprehensive Healthcare, is an expansion of an existing, privately administered program that has run health centers in about 40 city schools over the past several years, offering students primary health care services as well as contraception, including oral birth control pills and Plan B.

In early 2011, CATCH launched in five New York City schools; this year, the program is in 13 schools. All schools were chosen because they are in neighborhoods that lack nearby clinics or health services or because they have high teen pregnancy rates. While public high schools around the country have offered condoms for students for years, CATCH is thought to be the first to provide contraceptive pills. The program works with city health department doctors and trained school nurses to give students a fuller range of contraceptive services, including pregnancy tests.

(MORE: Plan B: 1 in 5 Pharmacists May Deny Eligible Teens Access to Emergency Contraception)

So far, city officials said, parents have not resisted the program. Parents were notified of the program by letter, and were given the opportunity to opt out by signing a form. Children of parents who don’t opt out can then visit the school nurse and receive contraception, or get a pregnancy test and Plan B after having unprotected sex, without explicitly notifying their parents. About 1% to 2% of parents have opted out, according to the health department.

“We’ve had no negative reaction to the CATCH program,” Deborah Kaplan, assistant commissioner of the health department’s Bureau of Maternal, Infant and Reproductive Health, told NBC News. “We haven’t had one objection. We’ve just had the opt-outs.”

During the 2011-12 school year, 567 students received emergency contraception and 580 received the birth control pill Reclipsen through the program.

(MORE: University Vending Machine Dispenses Morning-After Pill)

Plan B is currently available without a prescription for teens aged 17 and older. Younger users must have a prescription. Last year, the Food and Drug Administration (FDA) was prepared to remove the age restriction, which would have brought Plan B from behind the pharmacist’s counter to store shelves and made it available for all teens. But the move was blocked by Health and Human Services Secretary Kathleen Sebelius, who said she thought there was insufficient evidence that the youngest girls fully understood how to use the drug appropriately.

The FDA’s advice was based on a review of data: one study involving 335 girls aged 12 to 17 showed that 72% to 96% of them understood the package label well enough to use emergency contraception safely and effectively one their own; another study of about 300 girls aged 11 to 16 also found that they could use the drug properly without the help of a doctor. But Sebelius said a significant proportion of American girls start menstruating earlier and could be in need of emergency contraception, yet may not be able to use it safely without consulting a doctor. Critics of Sebelius’s ruling say her decision was based in politics, not science.

(MORE: U.S. Rejects FDA Advice to Sell Plan B One-Step Over the Counter)

Plan B contains a high dose of the progestin hormone levonorgestrel, the same hormone as in birth control pills. It is most effective when taken within 24 hours of unprotected sex, but can prevent pregnancy within 72 hours. Removing barriers to access — like having to get a prescription from a doctor — makes it more likely that girls will take the drug in time, or at all. As Healthland reported last December:

Making access easier is likely to increase use: in the two-year period after the FDA approved emergency contraception for over-the-counter sales, the rate of use more than doubled, compared with the four-to-six year period before that when it was available by prescription only, according to data reported by the Guttmacher Institute in April. Tellingly, the percentage of women who had discussed emergency contraception with a doctor did not change between the two periods, but the overall rate of use remained low, the study found.

As for the question of whether emergency contraception leads to more unsafe sex, at least one study of 15-to-20-year-old women who were provided with emergency contraception shows that preemptive access didn’t reduce pill or condom use — or increase the likelihood of unprotected sex. Abortion and teen birth rates are down as well, although it’s impossible to know how much of this can be attributed to the use of emergency contraception; given how few women use it, the impact is unlikely to be significant.

Overall, the data suggest that making Plan B as easy to get as aspirin will serve to benefit women’s health, without increasing harm. … Indeed, one could argue that it’s safer than aspirin: overdoses of over-the-counter painkillers like aspirin and ibuprofen can lead to serious liver, kidney or gastrointestinal problems, or even death. In contrast, it is impossible to overdose on Plan B. The drug is not used in the manufacture of illegal substances nor is it possible to abuse it like cough medicine. And although combination birth control pills containing both estrogen and progesterone are associated with a very slight elevation in stroke and blood clot risk, the progestin-only emergency contraception is not.

Critics of CATCH cited data suggesting that increased availability of emergency contraception could actually increase risky sex, and faulted schools for not doing enough to promote abstinence education. But many adolescent medicine experts lauded the program for proactively attacking the problem of teen pregnancy. “In New York City, over 7,000 young women become pregnant by age 17 — 90 percent of which are unplanned,” Alexandra Waldhorn, a health department spokeswoman, told reporters. “We are committed to trying new approaches, like this pilot program in place since January 2011, to improve a situation that can have lifelong consequences.”

‘Peace Corps for Doctors’: Solving Shortages of Medical Workers Abroad

A U.S. Senator's daughter launches a nonprofit volunteer program to improve health care both in the developing world and at homeimage: Vanessa Kerry during Women's Leadership Forum of The Democratic National Committee Meeting In New York City, July 11, 2006. Vanessa Kerry speaks at the Women's Leadership Forum of the Democratic National Committee meeting in New York City on July 11, 2006

Dr. Vanessa Kerry, the 35-year-old Massachusetts General Hospital physician and daughter of Senator John Kerry, aims to improve health care, both in developing nations and in the U.S. Her new nonprofit, tentatively called the Global Health Service Partnership, will send doctors and nurses to work in developing countries and in return help pay off their hefty student loans.

The goal of the program, which is partnered with the Peace Corps, is to aid countries with severe shortages of health professionals. But, as NPR reported, Kerry thinks the program will also help bolster health care in America by broadening doctors’ worldviews and teaching them to make the most of the resources they have available. “There’s evidence people come back with better clinical skills, better appreciation of needs, more likely to work in underserved specialties,” Kerry told NPR’s Shots blog.

Kerry partnered with the Peace Corps both for its name recognition and its institutional knowledge — it’s been sending workers abroad “in a sensitive, integrated way,” Kerry said, for 50 years. The Global Health Service Partnership will serve to fill a hole left by the Peace Corps, which doesn’t deploy doctors or nurses: volunteers in Kerry’s program will not only offer medical care but also teach and mentor local health care workers.

(MORE: Got Money? Then You May Lack Compassion)

To make service more enticing to doctors, the program offers school-loan repayment of $30,000 per year of service.

The Global Health Service Partnership launched in March and began accepting applications over the summer for placement in Malawi, Tanzania and Uganda by July 2013. Doctors interested in the program can apply through December, and the first group of volunteers will be announced in February.

Can Caring for Your Aging Parents Hurt Your Career — or Your Paycheck?

Helpful tips on how to be there for your ill and aging parents, while protecting your job and the financial well-being of you and your familyDaughter and Elderly mother checking medicine

When my father was diagnosed with terminal cancer in 1998, I flew from my home in New York City back to my parents’ farm in Iowa one weekend every month for more than a year to help my mother care for him. It was a tough time. I was exhausted from traveling, juggling responsibilities with my own family and worrying about my mother — and, on top of that, I was concerned that the time and energy I was spending to help my parents would have a detrimental effect on my work performance, my career and ultimately, my finances.

Fortunately, I had a flexible job and a supportive boss, but that’s not the case for everyone — and more and more people may be finding themselves in a similar predicament. Studies project that between now and 2050, the 65-and-over population will more than double in the U.S., and as the boomer generation and their parents age, more of their family members will have eldercare responsibilities that will require them to take some time off of work. A new report released by AARP shows that over the last five years, 42% of U.S. workers provided unpaid eldercare for a family member or friend, and 49% expect to do so in the coming five years.

(MORE: 6 Steps for Building a Financial Plan for Aging Parents)

Eldercare may require an afternoon, a day, a week, or much more to be there for loved ones, to arrange for nursing care, to help with recovery or to handle Mom or Dad’s finances and paperwork. Balancing these responsibilities while caring for yourself and your own family can be challenging enough — but what about maintaining your duties at work? Can your commitment to give care to your aging parent(s) actually hurt your career or jeopardize your financial future?

According to new research, the answer is yes — especially if you’re a woman. The same AARP report finds that the average caregiver is a 49-year-old woman who works outside the home and spends nearly 20 hours a week providing unpaid care for a loved one. The financial impact in these situations can be significant: a survey by Working Mother magazine found that more than half of current caregivers reported that they needed to modify their work schedules in order to provide care, and 39% said not being able to accept additional responsibilities at work inhibited their ability to seek or accept promotions.

The financial sacrifices a caregiver makes can come in a variety of forms: the voluntary decision to actually leave a job, job loss due to valid or perceived performance issues, diminished wages due to reduced hours, and raises or bonuses forgone because of an inability to take on new responsibilities. Over time, these financial forfeitures can have a significant impact on how much you can save or contribute to retirement plans and other long-term financial goals. And this just scratches the surface. Other than the possible earning limitations and decreased hours at work, expenses associated with caregiving may add up.

So, in addition to balancing your time and energy to provide care, you must also balance your finances so you can continue to manage your budget and save for your own future. If you are providing eldercare or anticipating that you will in the future, what steps can you take now to ensure that you will stay on track in your career and financially?

(MORE: Is Your Elderly Parent Moving In? It Might Cost You)

Know your rights at work. You have rights and protections at work when it comes to taking time for caregiving for parents or other loved ones. The Federal Family and Medical Leave Act of 1993 (FMLA) allows covered employees up to 12 weeks of unpaid leave to provide care for a family member with a serious health condition. If you are caring for a parent, inform your supervisor and your human resources department about your situation in order to take advantage of this legal protection, if necessary, and create a workable plan within your company’s policies. If you feel that you are experiencing unfair treatment due to your caregiving obligations and choices, be aware that discrimination against caregivers is a serious issue that is receiving increased attention.

Understand the assistance you might be entitled to. Figuring out various government programs, supplements and services will likely take some time, but it’s worth the legwork: your parent may qualify for benefits that can also provide you some relief. Go to the government-hosted benefits site — Govbenefits.gov — for information. Another resource may be found closer to home; each county or city has a federally mandated Area Agency on Aging staffed by professionals who know about elder programs and services in your area.

Proactively adjust and monitor your financial plan. If you have a budget or savings plan based on certain assumptions about your wages or salary, and things have changed, rework the math immediately. If you are earning less — or anticipating a need to take time off — be realistic and identify where you may need to make trade-offs to meet your financial obligations with less money. Do your best to keep saving for your future, even if it’s in small increments. Having a long-term road map and a savings plan in place to achieve your financial goals can be helpful in making informed short-term decisions, especially when there are unexpected expenses and emotions involved.

Keep your retirement in mind. Leaving the workforce, even temporarily, can seem tempting when unexpected family obligations pop up. In some cases, it may be necessary to do so, and of course, you want to be there. But be aware that exiting and re-entering the workforce is about more than just a weekly paycheck. The ability to maintain your earning power and take advantage of an employee sponsored retirement plan such as a 401(k) or 403(b) can each have a significant impact on your finances long-term. Depending on your situation, it may not be possible to remain at work, but consider working with your employer to find a temporary solution that will allow you to remain employed and have access to benefits while you care for your family member.

Being a caregiver for a family member is a rewarding experience that you likely won’t regret, and no amount of money can replace time spent with an ill or aging loved one. But being thoughtful about maintaining your career and adjusting your finances can make all the difference in keeping a sense of normalcy and peace for you and your family.

West Nile Infections Remain High. How Alarmed Should You Be?

West Nile numbers continue to climb, but health officials say people shouldn't worry as long as they're taking precautions to avoid mosquito bitesDr Larry Jernigan / Getty Images

Health officials are calling this year one of the worst West Nile years on record in the U.S. As of Tuesday, 48 states had reported cases of the disease to the Centers for Disease Control and Prevention (CDC), for a total of 3,545 cases nationwide and 47 deaths. Seventy percent of the cases have occurred in eight states: Texas, Mississippi, South Dakota, Michigan, California, Louisiana, Oklahoma and Illinois.

Perhaps somewhat more concerning is that more than half of the reported cases have involved the severe, neuroinvasive form of the virus, which can potentially cause encephalitis or meningitis. Only about 1 in 150 people will come down with the severe form of the disease, however. These symptoms can include high fever, headache, stiffness, disorientation, coma, tremors, convulsions, muscle weakness, vision loss, numbness and paralysis. If you’re experiencing these symptoms, the CDC recommends seeing your doctor and seeking hospital treatment. Severe symptoms can last weeks and occasionally result in permanent neurological effects.

About 80% of people who contract West Nile virus don’t experience any symptoms at all, while 20% of infected people will develop West Nile fever. The fever is characterized by mild symptoms including headache, fatigue, body pain, skin rash and swollen lymph glands, which can last anywhere from a couple of days to a few weeks. There is no specific treatment for West Nile fever, but you can use standard methods to treat its symptoms. Although even healthy people can feel wiped out for a week, it won’t cause any serious health damage.

(MORE: 5 Things You Need to Know About West Nile Virus)

The CDC says it’s hard to predict how many more cases of West Nile virus will be seen this year, especially given the two- to three-week lag time between infection and onset of symptoms. But based on patterns of previous seasonal outbreaks, the mid-August peak season is behind us and infections should decrease in the next several weeks. The outlook may be better for northern state dwellers, however.

“It is quite clear that this seasonal trend we see is much more pronounced in northern states than the southern states,” says Dr. Jorge Parada, infectious disease specialist with Loyola University Medical Center and medical spokesperson for National Pest Management Association (NPMA). “Here, in Chicago, where the temperatures are low, we are not thinking about mosquitoes, but if you’re in the southern states, you will still see them. … As long as the mosquitoes are out and about, we can expect more cases.”

Parada says he sees no reason to expect a large drop-off in cases in areas that remain warm. “There will be some, but not like what we are going to see in the northern states,” he predicts.

Still, Dr. Christopher Perkins, medical director at the Dallas County Health and Human Services noted in an email to Healthland that Dallas County, Texas, has already experienced a significant decline in new cases of human infections in September. Health officials credit the drop to seasonal changes, environmental mosquito control measures and citizens protecting themselves.

(MORE: Everything Is Bigger in Texas, Including the West Nile Virus Outbreak)

Many questions surrounding the outbreak of the disease remain uncertain — like why the nation is seeing such a big spike in the first place (health officials speculate that the mild winter, followed by an early, rainy spring and a long, hot summer allowed more mosquitoes to survive and thrive) and when cases will cease — but  as long as you’re taking precautions to protect yourself, you shouldn’t stress too much about contracting the virus.

“If you’re out at noon in Texas, the odds of getting a mosquito bite are almost nil,” says Parada. ”If it’s sunset and you’re having a BBQ with your friends, maybe wear a long sleeve shirt, get some DEET on or eat in a screened in area.”

According to Perkins, everyone is encouraged to continue using insect repellent, wear long sleeves shirts and pants and minimize outdoor activities when mosquitoes are most active, but there’s no need to change vacation plans to high-risk states. “Come and enjoy your visit in Texas,” she says.

Bizarre, Recurrent Cancer Case May Lead to Custom Care

Janis Christie / Getty Images

It’s a medical nightmare: a 24-year-old man endures 350 surgeries since childhood to remove growths that keep coming back in his throat and have spread to his lungs, threatening his life. Now doctors have found a way to help him by way of a scientific coup that holds promise for millions of cancer patients.

The bizarre case is the first use in a patient of a new discovery: how to keep ordinary and cancerous cells alive indefinitely in the lab.

The discovery allows doctors to grow “mini tumors” from each patient’s cancer in a lab dish, then test various drugs or combinations on them to see which works best. It takes only a few cells from a biopsy and less than two weeks to do, with materials and methods common in most hospitals.

Although the approach needs much more testing against many different types of cancer, researchers think it could offer a cheap, simple way to personalize treatment without having to analyze each patient’s genes.

“We see a lot of potential for it,” said one study leader, Dr. Richard Schlegel, pathology chief at Georgetown Lombardi Comprehensive Cancer Center in Washington. “Almost everyone could do it easily.”

An independent expert agreed.

For infections, it’s routine to grow bacteria from a patient in lab dishes to see which antibiotics work best, Dr. George Q. Daley of Children’s Hospital Boston and the Harvard Stem Cell Institute said in an email. “But this has never been possible with cancer cells because they don’t easily grow in culture,” he said.

The new technique may reveal in advance whether a person would be helped by a specific chemotherapy, without risking side effects and lost time if the drug doesn’t work. “Pretty nifty,” Daley wrote.

In the case of the 24-year-old, described in Thursday’s New England Journal of Medicine, lab-dish tests suggested that a drug used to treat a type of blood cancer and some other unrelated conditions might help.

It’s not a drug that doctors would have thought to try, because the man technically does not have cancer. But his lung tumor shrank after a few months of treatment, and he has been stable for more than a year. He still has to have operations to remove throat growths that keep coming back, but only about once every five months.

The man, an information technology specialist in suburban Washington who asked to remain anonymous to protect his privacy, has recurrent respiratory papillomatosis, or RRP. It’s usually due to infection at birth with certain types of a virus, HPV, that causes genital warts.

The condition causes wartlike growths in the throat, usually around the voice box. These growths usually are noncancerous but can turn malignant, and even benign ones can prove fatal if they spread to the lungs. The main treatment is surgery, usually with lasers to vaporize the growths and keep them from choking off the airway or making it hard to talk.

About 10,000 or more people in the U.S. have the disease, said Jennifer Woo, president of the RRP Foundation. Woo, 29, is a medical student at Georgetown and one of the researchers on the study. She also has the condition but said it is confined to her throat and has required only about 20 surgeries so far.

The man in the study has a much more serious case.

“I was diagnosed when I was 3 or 4. At first, I had to have surgery every 7 to 10 days,” the man said in a phone interview. “I get short of breath and my voice will get more hoarse.”

Two years ago, the growths to his lungs became extensive and life-threatening, and his physician, Dr. Scott Myers, described the condition at a meeting of Georgetown hospital specialists. “It’s crushing the airway,” Myers said.

Doctors suggested that the new lab method pioneered by Schlegel and others might help. It borrows an idea from stem cell researchers: adding mouse cells for nourishment, plus a chemical that prevents cell death to an ordinary lab culture medium. That enabled healthy and cancerous cells to keep growing indefinitely.

Researchers grew “mini tumors” from the man’s lung mass and from healthy tissue and screened various drugs against them. One proved ineffective. Another worked against the tumor but at too high a dose to be safe. The third did the trick.

A similar approach could let doctors screen drugs for cancer patients.

“What could be more personalized than taking this person’s cell, growing it in culture, finding a drug to treat them and then treat them?” said Doug Melton, co-director of the Harvard Stem Cell Institute. The Georgetown method gives an answer quickly enough that it could save lives, he said.

Tyler Jacks, a cancer researcher at the Massachusetts Institute of Technology and former president of the American Association for Cancer Research, said the next step is to show that this could work for many different cancers and that it leads to better outcomes in patients.

“It seems to have worked in this one instance, but other tumors might prove to be more challenging,” he said.

The National Institutes of Health paid for much of this work and has already sent research teams to Georgetown to learn the method. About a dozen other universities have done the same, Schlegel said.

So far, his lab has grown prostate, breast, lung and colon cancer cells.

Georgetown University is seeking a patent on the method.

—By MARILYNN MARCHIONE. AP Science Writer Malcolm Ritter contributed to this report from New York.

View the original article here

Positive Outlook Boosts Likelihood of Healthier Lifestyle

SATURDAY, Sept. 22 (HealthDay News) -- Personality and attitude seem to matter when it comes to living a healthy lifestyle, with a brighter outlook on life leading to healthier choices, Australian researchers say.

In addition, those who believe they are in control of their destiny are more likely to eat a healthier diet, exercise more, and smoke and drink less, according to the researchers. The opposite is true for people who believe their destiny is in the hands of fate or that life is about luck, the investigators found.

In conducting the study, Deborah Cobb-Clark, director of the Melbourne Institute of Applied Economic and Social Research, and colleagues used data from the Household, Income and Labour Dynamics in Australia (HILDA) Survey to examine the diet, exercise and personality type of more than 7,000 people.

"Our research shows a direct link between the type of personality a person has and a healthy lifestyle," Cobb-Clark said in a university news release.

The findings could help shape public health policies on certain conditions, such as obesity, the study authors suggested.

"The main policy response to the obesity epidemic has been the provision of better information, but information alone is insufficient to change people's eating habits," explained Cobb-Clark. "Understanding the psychological underpinning of a person's eating patterns and exercise habits is central to understanding obesity."

Men and women also appear to have different views on the benefits of a healthy lifestyle. Although men seek physical results, women are focused on the daily pleasure they get from living a healthy lifestyle, the results indicated.

"What works well for women may not work well for men," Cobb-Clark noted. "Gender-specific policy initiatives which respond to these objectives may be particularly helpful in promoting healthy lifestyles," she suggested.

The report was published recently by the University of Melbourne in the Melbourne Institute Working Paper Series.

Why Solving Puzzles Is Fun: Q&A with Consciousness Researcher Daniel Bor

The evolutionary link between acquiring good information and survival may have given rise to both consciousness and the pleasure of problem-solvingTony Hutchings / Getty Images

Why do people voluntarily spend time struggling with problems like sudoku or crossword puzzles? According to neuroscientist Daniel Bor, a research fellow at the University of Sussex in England and author of the new book The Ravenous Brain: How the New Science of Consciousness Explains Our Insatiable Search for Meaning, it’s because we take great pleasure in pattern-finding. What’s more, that conclusion has big implications for understanding the brain, consciousness and even neurological disorders like autism. We spoke with Bor recently.

Why do you call the brain “ravenous”?
Human brains have an extreme form of consciousness: they’re ravenous for new innovative solutions to problems in the world, ravenous for optimizing our lives, for building pyramids of knowledge. I was trying to capture [the sense of hunger that] extreme forms of consciousness have about searching for knowledge and for understanding.

You posit that evolution selected for organisms that are good information processors, that are able to acquire accurate information about the world in order to guide their behavior.
One view is that of Richard Dawkins, that it’s all about the selfish gene and that organisms are merely temporary carriers of genes. I was arguing that that [perspective] might miss something crucial about the process of evolution, which is that genes capture something. On some level, they capture something about the world that’s accurate and relevant to [their] own survival: there’s an accumulation of knowledge, of implicit information and representation in organisms, but that doesn’t mean all organisms are conscious. It means that by this stage, 4 billion years after [life first arose], most creatures are sophisticated information-processing devices.

So what does that mean for animal consciousness?
Some animals may well be conscious because they have an extra layer in their brains that processes information online. When you get to great apes and humans, we have an extreme form of information processing, which I closely link with consciousness when it gets very sophisticated and extensive.

How do you define consciousness?
In terms of the mind, consciousness is the product of attention, so we can focus only on a small subset of the world that’s most important to us. It isn’t so much about automatic habits, which we are barely conscious of. Instead, it’s about trying to solve novel or complex problems. We have a mental space dedicated to complex problem solving. What makes human consciousness unique is our ravenous appetite for these innovative lessons that help us solve these novel or complex problems.

Consciousness is generated primarily by our most densely connected brain regions and related to the fastest brain waves. Every moment of our waking lives, there’s a hidden war going on between different populations of neurons [for access to it]. The war involves winning support of active [neurons] and taking over the advanced parts of the cortex, and the victorious neuronal populations control what we attend to — and [that is] what we are conscious of.

Do you think we have any choice in consciousness, any free will?
Choice is a huge separate issue. It can at least appear that we have choice. If I’m in a crowded train station, looking for my wife who is wearing red, I can constrain my attention by looking for red [and the parts of the brain that represent red are more likely to win] than any other bits.

Attention in the standard textbooks is divided into two kinds, one is voluntary, where we set some goal, and the other is extrinsic, where something in the environment takes over what we attend to. A looming animal coming straight at us — we wouldn’t have much choice in attending to that.

What made you decide to study neuroscience, rather than philosophy?
As an undergraduate, I studied both philosophy and psychology, mainly neuroscience, as the equivalent of a double major. It was a question of which one to go for. Philosophy I enjoyed for its apparently crisp logic, but it was frustrating because it didn’t seem like it was particularly progressing at the time; it seemed vague and not in touch with current neuroscience, which was very progressive and cutting edge.

[And] at the time I was doing my final exams, my father unfortunately had a stroke. That made it very clear that things that are very intimate to us like our personality or even our very consciousness itself can be impaired or changed by some relatively small brain injury. … And that made me side [with] neuroscience as well.

Because it showed you that consciousness depends specifically on the brain?
It’s just too obvious. Maybe philosophers would say that I’m missing some subtle points.

You also discuss anesthesia and the question of how we can know when someone is conscious.
There are behavioral measures that you can apply, which have drawbacks. There are experiments done giving varying doses of anesthetics and seeing at what point you stop following commands, at what point do your eyes close, which are reasonably useful. … There are other measures that look at brainwaves and when they take on a certain pattern, it is clear that you are not conscious. That’s currently the best way of knowing whether you are truly unconscious.

What about states like coma and minimal consciousness?
There are some people [with brain injuries] that enter a vegetative state and don’t recover and others that eventually make a reasonable recovery. You can look at which bits are needed for recovery — not just which parts, but also how they communicate with each other. It’s increasingly clear that in order to be able to regain reasonable levels of consciousness, you need at least the thalamus, which is like a relay center in the middle of the brain, and a reasonably intact prefrontal cortex and the back part of the parietal lobe. Those regions map very closely to studies looking at how consciousness changes [under anesthesia]. … It’s the thalamus and prefrontal parietal networks that tend to be activated [during consciousness].

So when those regions are offline, you are unconscious?
It depends on how you define offline. [We don’t know] exactly what mechanism turns [consciousness off, and these regions aren’t simply inactive during unconsciousness]. The prefrontal cortex gets locked into a very tight rhythm with the thalamus, and such tight connection blocks out all communication with the rest of brain; that shuts out long range communication and consciousness as well.

You also write about neurological and psychiatric conditions that can alter consciousness, and suggest that autistic people might actually have more consciousness than others.
Autism is one of those odd-one-out conditions in the literature. The classical assumption was that most severely autistic children are mentally disabled and have low IQs, but that’s partly because they weren’t tested properly. If you test them on nonverbal IQ, they are normal or slightly better than normal. On other tests, they perform better than average for perceptual tasks. Some people are now suggesting that maybe it isn’t a deficit, that they have a different kind of [brain that has certain] advantages. With Asperger’s, which probably many prominent scientists have, whether they are diagnosed or not, it seems almost as if they have extra consciousness: they are better able to process information than normal, which I think is a fascinating idea.

The whole idea that autism is [primarily] a social disorder, I don’t think that theory is going to last into the next decade because there is increasingly successful treatment that centers on socializing that has turned very withdrawn children into very affectionate socially aware children: I don’t see that as fundamental [to autism].

Do you support the “intense world” theory of autism, which suggests that problems result from sensory overload?
I just think [the social issues] are a side effect of the way [people with autism] approach the world. They are searching for patterns and structure in the world — what they obsess over isn’t everything; it’s mainly structures, stuff like calendars and mathematical patterns.

I worked with the prodigy, Daniel Tammet. [Tammet holds the European record for memorizing the 22,514 digits in pi.] He seemed very extremely autistic as kid and has been officially diagnosed with Asperger’s syndrome, but if you meet him, he’s very socially aware. He maintains eye contact. He decided in his teen years to teach himself [to be social and he did].

In what context did you work with Tammet?
We did a brain scan study [where we looked at his brain after he had memorized short sequences of numbers that were either patterned or random]. It was very striking compared to normal people. He completely failed to spot the external structure [in the nonrandom numbers] and his brain activation was very different from those who were aware of the structure. I make the claim that the prefrontal parietal network is important for consciousness; in my study, the prefrontal parietal network was most active when spotting these patterns and maybe that means a lot about what consciousness is for. For Daniel Tammet, his prefrontal parietal network didn’t activate for these sequences because he didn’t spot them, but it was generally raised compared to those of normal people.

So what do you think the purpose of consciousness is?
I think the purpose of it is to draw all the relevant information together in a larger space. It’s almost as if we can’t spot it because we are doing it all the time. Why do we love crossword puzzles and why are people addicted to sudoku? That’s what a huge bit of the cortex is primed to do — to spot [patterns] — and once we spot them we can assimilate them into our pyramid of knowledge and build more layers of strategy, and knowing how to do that makes us incredibly successful at controlling the world.

And that’s why solving puzzles or finding a useful bit of information feels so good?
We get streams of pleasure when we find something that can really help us understand some deep pattern. Sudoku isn’t the most [fun activity], but it sure feels good when you put in that last number. It’s why scientists love doing research. The way I approach my job, it’s like trying to solve a really big fuzzy crossword puzzle and when you do put in that new clue and see the deeper pattern, that’s incredibly pleasurable.

If our brains are hungry for information, then why do we tend to see learning as a chore and fail to recognize it as a huge source of pleasure?
I don’t know. Obviously, more intelligent people get more pleasure from spotting these patterns, but I think almost every normal person does this. I think it’s a pretty pervasive thing but it’s almost as if we can’t notice it because it’s so pervasive.

Cutting Out Soda Curbs Children’s Weight Gain, Studies Show

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Researchers provide the strongest evidence yet that soda and other sugary drinks contribute to the obesity epidemic in children.

The new findings, reported in a trio of studies published online in the New England Journal of Medicine, offer persuasive support for New York City’s first-in-the-nation ban on large-sized soft drinks at restaurants and sports arenas. Critics and the beverage industry immediately cried foul following the passage of the ban, arguing that there was little evidence that such drastic action would change people’s drinking habits — or their waistlines.

But the new research suggests that limiting children’s access to sugary beverages can indeed curb weight gain: one paper found that providing children with water or diet soda as an alternative to full-sugar soft drinks can lead to meaningful drops in children’s fat deposits and weight; another showed that drinking a single no-calorie drink a day, instead of a sugary one, slows weight gain, independent of other behaviors like overeating or failing to exercise. A third study finds that for people who are already genetically predisposed to obesity, drinking sugary sodas can make their weight problem worse.

Taken together, the papers provide the most robust evidence to date that sugary drinks are a significant driver of weight gain.

(MORE: BPA Linked with Obesity in Kids and Teens)

In the first study, led by Janne de Ruyter at the VU University Amsterdam, scientists followed 641 normal weight schoolchildren aged 4 to 11 years for 18 months. The students were randomly assigned to one of two groups: one group received an 8-oz. can of a sugar-sweetened fruit drink to consume every day during recess, while the other group got an identical can of an artificially siweetened, calorie-free drink. On weekends, the children were sent home with two cans to drink on Saturday and Sunday. The trial was double-blinded, meaning that neither the children nor the researchers knew who received which beverage; the scientists went to great lengths to work with a soda manufacturer to formulate beverages that tasted the same and were presented in cans that looked the same.

At the end of the 18-month trial, the children drinking the sugar-free beverage had gained less weight, about 13.9 lbs. on average (6.35 kg) versus 16.2 lbs. (7.37kg) for the sugar-sweetened drink group. What’s more, the sugar-free group also gained 35% less in body fat than the other kids, as measured by an electrical impedance test that gauges fat accumulation.

The 2-lb. difference in weight gain between the groups may seem small, but it “is highly significant, especially since we are talking about an 8-oz. can,” says the study’s senior author Martijn Katan, emeritus professor of nutrition at VU University. “A small amount of soft drink can shift the prevalence of obesity from something parents don’t need to worry about into an entirely different territory. It also means that if you take away sugar, you can shift the curve away from obesity, as we saw with the children in the sugar-free group.”

Because the study involved a large number of children who were followed over a relatively long period of time, and because the it was blinded, Katan says the results provide the clearest evidence of how drinking sugar-sweetened beverages can affect children’s weight gain. Moreover, the researchers purposefully refrained from counseling the children or their families about good nutrition or the risks of obesity, and did not ask them to change their eating or activity habits in any way. All they varied was one beverage a day. Katan acknowledges that some of the children, just by virtue of being in a study, may have altered their eating habits, but given the size of the study, he says that any amendments made by participants in one group were likely balanced out by parallel changes in the other group.

(MORE: Meet Big Soda: As Bad As Big Tobacco)

In the second study, scientists analyzed genetic data on 33,000 health professionals who answered questions about their diet, including their consumption of sugar-sweetened beverages, while participating in three large health surveys over many years. Dr. Lu Qi, assistant professor of nutrition at the Harvard School of Public Health and the senior author of the paper, and his colleagues calculated a score for each participant representing his or her genetic vulnerability to obesity, based on 32 genetic markers known to be involved in weight.

People who had higher genetic scores for obesity were more likely to be obese than those who had fewer such genes, and those who drank a lot of soda were also more likely to be obese than those who drank less — but people who had both a high genetic risk for obesity and drank a lot of soda were at much higher risk of being obese than they would have been given either factor alone. In fact, among people with a high number of obesity genes, the risk of obesity was more than twice as great in those consuming the most sugary drinks (at least one serving a day) as in those who consuming the least (less than one sesrving a month).

(MORE: Study: Obese Kids Have Less Sensitive Taste Buds)

Finally, in the third study, doctors revealed more encouraging evidence that relatively small interventions can alter children’s soda drinking habits and reduce weight gain. In that trial, led by Dr. David Ludwig, director of the New Balance Foundation Obesity Prevention Center at Boston Children’s Hospital and a professor of pediatrics at Harvard Medical School, researchers included 224 overweight or obese teens. For one year, half the group received home deliveries of bottled water and diet drinks and were encouraged to avoid sugar-sweetened beverages. The other teens received $50 gift cards to the local supermarket to purchase whatever they wanted.

Before the intervention began, all of the teens reported drinking at least one sugar-sweetened beverage a day, but after one year, those getting zero-calorie home deliveries had almost completely switched to downing only sugar-free beverages. They had also gained significantly less weight (3.5 lbs.) than those who didn’t receive the deliveries (7.7 lbs.). The control group also ended up consuming fewer sugary beverages by the end of the study, likely because of an overall increase in aggressive public health messaging about the importance of eating well and exercising.

“These results show that sugary beverages can have an effect on body weight quick quickly,” says Ludwig, “perhaps more so than any other single food product. We know of no other study where you eliminated one specific category of food and then show a changed body weight at one year.”

(MORE: Are Cesarean Sections Contributing to Childhood Obesity?)

The trend did not persist, however, when the home deliveries ceased. The researchers continued to observe the teens for additional year during which time none received deliveries of no-calorie drinks. Not surprisingly, these teens began to drink more sugar-sweetened beverages and their weight started to creep back up.

That suggests that changing children’s eating and drinking habits isn’t simply a matter of educating them about nutrition and healthy foods. It also requires changing their environment, so that healthier alternatives become both accessible and convenient. “Children and adolescents will readily change their beverage habits if other products are available,” says Ludwig. “As long as we maintain environments of sugar-sweetened beverages where they are ubiquitous, and heavily marketed, it shouldn’t surprise us that they are drinking a lot of them. But if we create an environment that makes alternatives easy and convenient, they will drink those instead.”

That is essentially the idea driving New York’s controversial ban on large sized-sugary beverages. If jumbo-sized cups aren’t available, then the thinking goes, residents might not consume as many sugary drinks as they currently do.

(MORE: Should Parents Lose Custody of Their Extremely Obese Kids?)

The beverage industry maintains, however, that sugary drinks are only one part of the obesity problem — and that’s certainly true. In a written statement responding to the new studies, the American Beverage Association said, “Studies and opinion pieces that focus solely on sugar-sweetened beverages, or any other single source of calories, do nothing meaningful to help address this serious issue. The fact remains: sugar-sweetened beverages are not driving obesity.” Still, the new results make a strong case that reducing overconsumption of sodas and sugary drinks is a good place to start.

The group further contends that the average American gets about 7% of daily calories from sugar-sweetened beverages, and that consumption of these drinks already dropped by 20% between 2001 and 2010. However, youngsters tend to drink more than adults: some studies show that kids get about 15% of their daily calories in liquid form, largely from sodas and 100% fruit juices.

Public health experts say more should be done to reduce the amount of liquid calories people consume. The new findings suggest that despite criticism about becoming a nanny state, New York City may be on to something with its big-soda ban; experts eagerly await follow-up studies to see if the new policy will have any effect on residents’ waistlines.

The results could reinvigorate efforts to control soda consumption with soda taxes or other restrictions on where the beverages can be sold. “I think we have passed a watershed here,” says Katan about the strength of the data connecting sugar-sweetened beverages and obesity. “The next step will be to see what we can do about it.”

Should Children Be Allowed to Sip Mommy’s Drink?

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Will allowing your child a sip of wine at an early age prevent him from engaging in dangerous drinking later? Probably not, but plenty of parents think so, finds a recent study.

A survey published this week in the journal Archives of Pediatrics & Adolescent Medicine interviewed 1,050 mothers and their third-graders, and found that a substantial proportion of parents — anywhere from 15% to 40% — believe that letting their kids taste alcohol at home will protect them from engaging in risky drinking behaviors with their peers later on. As expected, the children of moms who held such beliefs were more likely to have tried alcohol by about age 9.

For the study, researchers interviewed mothers and their kids for 25 minutes each. Mothers were asked to rate how much they agreed with statements like “If parents don’t let children try alcohol at least once, children will be more tempted by alcohol as a ‘forbidden fruit,’” “Letting children younger than 12 years have sips or tastes of alcohol is a safe way to introduce them to alcohol” and “Children who sip small amounts of alcohol at home with parents will be less likely to experiment with risky drinking in middle school.”

(MORE: Two Questions Can Help Doctors Spot Teen Alcohol Problems)

The third-graders were asked whether they had ever tasted a sip of beer, wine or any other alcohol, and whether an adult in their home had ever allowed them to do so. Approximately a third of the child participants reported sipping alcohol.

Moms were most likely to believe the forbidden-fruit argument — 1 in 3 mothers agreed that keeping alcohol from their kids would only make them want it more and that it would increase its “forbidden fruit” appeal. About 22% of moms thought that children who learn to sip alcohol at home would be better at resisting peer pressure to drink outside the home, and 26% believed that kids who try drinking with their parents will be less likely to experiment with alcohol in middle school. The researchers note, however, that it’s a mistake to think that kids’ drinking behaviors at home, under parental supervision, have any bearing on the way they drink with their friends — recent studies refute that notion.

In fact, there’s little evidence to suggest that early exposure to alcohol curbs drinking in adolescence. Rather, the opposite may be true. The authors cite previous research showing that, for example, fifth-grade children whose parents allowed them to have alcohol were twice as likely to report recent alcohol use in seventh grade. Another study found that sipping or tasting alcohol at age 10 predicted drinking by age 14, even after controlling for other psychological or social factors that could increase the risk of problem drinking.

(MORE: Status: Drunk. Can Facebook Help ID Problem Drinkers?)

Belief in the protective effect of early alcohol sipping was most common in white, college-educated, employed women. The researchers speculate that this could be because drinking is more socially acceptable among this group, so parents are more tolerant of underage drinking. It could also be that women in this group are more concerned than other moms about preventing underage drinking, and thus more likely to try to curb the behavior by introducing alcohol to their kids early.

Lead study author Christine Jackson, a public health analyst at the Research Triangle Institute in North Carolina, notes that parents who hold such pro-sipping beliefs are not only more tolerant of their children tasting alcohol, but they’re also more likely to involve their kids in adult alcohol-related activities, like letting them fetch or pour drinks for adults — all of which could have unintended effects.

“It is possible that an early introduction to alcohol, even when it is limited to sips and even when it is meant to discourage child interest in alcohol, could backfire…leading to more drinking later on,” says Jackson. The authors call for further examination into the effects of parents’ pro-sipping beliefs on children’s alcohol use as they grow older.

“Public health education programs are needed so that more parents know that home drinking norms do not curtail risky drinking in peer contexts,” the authors conclude.

Is Cancer Overtaking Heart Disease as a Leading Killer in the U.S.?

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Cancer is now the leading killer of Hispanics in the U.S. — the latest sign it’s beginning to displace heart disease as the nation’s top cause of death.
The rest of the country may not be far behind, “probably in the next 10 years,” said Rebecca Siegel of the American Cancer Society. She is the lead author of a study reporting the new findings.
That may be a conservative estimate. Government health statisticians think cancer could overtake heart disease as the top U.S. killer as early as this year, or at least in the next two or three.
The change is not exactly cause for alarm. Both cancer and heart disease death rates have been dropping for Hispanics and everyone else. It’s just that heart disease deaths have fallen faster.
(MORE: Regular Exercise Can Help Lower Breast Cancer Risk)
For decades, heart disease has been the nation’s leading cause of death. But cancer has been closing in on it. That’s largely because of better heart disease treatments, including statin drugs that lower cholesterol.
The reason cancer is already the biggest cause of death for Hispanics is likely because that population as a whole in the U.S. is younger than non-Hispanic whites and blacks. Many Hispanics are young immigrants, most of them from Mexico. Cancer tends to kill people at younger ages than heart disease.
The report is being published in the September/October issue of a cancer society publication, CA: A Cancer Journal for Clinicians
Cancer society researchers looked at federal death data for 2009 and found 29,935 U.S. Hispanics died of cancer, slightly more than the 29,611 who died of heart disease. It was the first year in which cancer deaths surpassed heart disease in that ethnic group.
Hispanics are the largest and fastest growing major ethnic group, and include a large number of recent immigrants healthy enough to start a new life in another country.
Most heart disease deaths occur in people 65 and older. The vast majority of Hispanics in the United States are under age 55, so cancer poses a more immediate risk. The story is different in Mexico, which has an older population. There, diabetes is the biggest killer with cancer No. 2, according to 2009 statistics from the Pan American Health Organization.
(MORE: Got Plaque? It May Be Linked with Early Cancer Death)
Cancer is also the leading cause of death for Asian-Americans and Pacific Islanders. And it is now the leading killer in 18 states, according to 2009 numbers from the Centers for Disease Control and Prevention.
Interestingly, none of those states is in the Southwest, where Hispanic populations are more established. Instead, most are in the nation’s northern tier, including Alaska, Washington, Idaho, Montana, Minnesota, Wisconsin and the four states of upper New England.
Aside from statisticians, will it matter to people which disease is taking the most lives each year?
It might, said Robert Anderson who oversees the CDC branch that monitors national death statistics. “We’ve been so focused on heart disease mortality for so long. … This may change the way people look at their risk,” he said.

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Viruses Not to Blame for Chronic Fatigue Syndrome

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A scientific controversy appears to have been put to rest. At the behest of the National Institutes of Health (NIH), researchers conducted a study of 293 people and found no link between chronic fatigue syndrome and retroviruses.
The debate dates back to 2009, when a since-retracted paper in the journal Science
reported a possible connection between the retrovirus XMRV — a common mouse virus — and chronic fatigue, a disabling condition that causes memory impairment, concentration problems, muscle weakness, joint pain and persistent fatigue. A separate study published the following year linked the illness with another mouse retrovirus known as pMLV.
The potential for a viral cause of chronic fatigue caused a stir in the medical community — and offered hope to millions of sufferers who say their symptoms are not taken seriously by doctors — but when numerous other scientists tried to replicate the results of the initial research, they failed. The early findings are now attributed to lab contamination of the blood samples used in the original study. Science
retracted the 2009 paper in December.
(MORE: The Chronic Fatigue Retraction: Good Science Takes Time)
Still, some chronic fatigue researchers and many affected patients did not consider the controversy resolved. So the NIH asked virologist Dr. Ian Lipkin of Columbia University to get conclusive answers. “We went ahead and set up a study to test this thing once and for all and determine whether we could find footprints of these viruses in people with chronic fatigue syndrome or in healthy controls,” Lipkin said in a statement. “The bottom line is we found no evidence of infection with XMRV and pMLV. These results refute any correlation between these agents and disease.”
The researchers examined nearly 300 people in the study, about half of whom had chronic fatigue syndrome and half did not. They drew blood from the participants and tested the samples for genes specific to the XMRV and pMLV viruses. This was similar to how the previously studies were conducted, but unlike the earlier studies, the researchers took care to eliminate contamination of the enzym mixtures and chemicals used during testing, which may have been the source of the contamination in the initial research. The scientists reported that they did not find any trace of the retroviruses in the blood samples.
(MORE: Scientists Back Down From Viral Cause of Chronic Fatigue Syndrome)
Several of the authors of the original research collaborated on the new study, published online in the journal mBio. As the Wall Street Journal

Judy Mikovits, who led the 2009 XMRV study and is an author of the mBio paper, said that although the recent effort found no association of the viruses with chronic fatigue syndrome, it helped develop a collection of CFS samples never before available to investigators, which would advance study of the disease.
“We are not abandoning the patients. We are not abandoning the science. The controversy brought a new focus that will drive efforts to understand [chronic fatigue syndrome] and lead to improvements in diagnosis, prevention and treatment of this syndrome,” said Lipkin in the statement. About 1 to 4 million Americans may suffer from chronic fatigue, according to the Centers for Disease Control and Prevention (CDC), and treating the disease costs the U.S. about $7 billion each year.

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Most Americans May Be Obese by 2030

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We Americans already know how fat we are. Can it get much worse?
Apparently, yes, according to an advocacy group that predicts that by 2030 more than half the people in the vast majority of states will be obese.
Mississippi is expected to retain its crown as the fattest state in the nation for at least two more decades. The report predicts 67 percent of that state’s adults will be obese by 2030; that would be an astounding increase from Mississippi’s current 35 percent obesity rate.
The new projections were released Tuesday by Trust for America’s Health with funding from the Robert Wood Johnson Foundation. Trust for America’s Health regularly reports on obesity to raise awareness, mostly relying on government figures.
The group’s dismal forecast goes beyond the 42 percent national obesity level that federal health officials project by 2030. The group predicts every state would have rates above 44 percent by that time, although it didn’t calculate an overall national average.
(MORE: BPA Linked with Obesity in Kids and Teens)
About two-thirds of Americans are overweight now. That includes those who are obese, a group that accounts for about 36 percent. Obesity rates have been holding steady in recent years. Obesity is defined as having a body-mass index of 30 or more, a measure of weight for height.
Trust for America’s Health officials said their projections are based in part on state-by-state surveys by the Centers for Disease Control and Prevention from 1999 through 2010. The phone surveys ask residents to self-report their height and weight; people aren’t always so accurate about that.
The researchers then looked at other national data tracking residents’ weight and measurements and made adjustments for how much people in each state might fudge the truth about their weight. They also tried to apply recent trends in obesity rates, along with other factors, to make the predictions.
Officials with Trust for America’s Health said they believe their projections are reasonable.
And New York City’s health commissioner agreed. “If we don’t do anything, I think that’s a fair prediction,” said Dr. Thomas Farley whose city banned just supersize sugary drinks to curb obesity.
Trust for America projects that by 2030, 13 states would have adult obesity rates above 60 percent, 39 states might have rates above 50 percent, and every state would have rates above 44 percent.
Even in the thinnest state — Colorado, where about one-fifth of residents are obese — 45 percent would be obese by 2030.
Perhaps more surprising, Delaware is expected to have obesity levels nearly as high as Mississippi. Delaware currently is in the middle of the pack when it comes to self-reported obesity rates.
(MORE: New Diet Pill Qsymia Available Today)
The report didn’t detail why some states’ rates were expected to jump more than others. It also didn’t calculate an average adult obesity rate for the entire nation in 2030, as the CDC did a few months ago. But a researcher who worked on the Trust for America’s Health study acknowledged that report’s numbers point toward a figure close to 50 percent.
CDC officials declined to comment on the new report.
Whichever estimates you trust most, it’s clear that the nation’s weight problem is going to continue, escalating the number of cases of diabetes, heart disease and stroke, said Jeff Levi, executive director of Trust for America’s Health.
By 2030, medical costs from treating obesity-related diseases are likely to increase by $48 billion, to $66 billion per year, his report said.
The focus of so much of the ongoing debate about health care is over controlling costs, Levi said. “…We can only achieve it by addressing obesity. Otherwise, we’re just tinkering around the margins.”

Listed are 2011 obesity levels followed by the Trust for America’s Health projections for 2030. States are listed in order from the highest to lowest projections in 2030:
Mississippi, 35 percent, 67 percent
Oklahoma, 31 percent, 66 percent
Delaware, 29 percent, 65 percent
Tennessee, 29 percent, 63 percent
South Carolina, 31 percent, 63 percent
Alabama, 32 percent, 63 percent
Kansas, 30 percent, 62 percent
Louisiana, 33 percent, 62 percent
Missouri, 30 percent, 62 percent
Arkansas, 31 percent, 61 percent
South Dakota, 28 percent, 60 percent
West Virginia, 32 percent, 60 percent
Kentucky, 30 percent, 60 percent
Ohio, 30 percent, 60 percent
Michigan, 31 percent, 59 percent
Arizona, 25 percent, 59 percent
Maryland, 28 percent, 59 percent
Florida, 27 percent, 59 percent
North Carolina, 29 percent, 58 percent
New Hampshire, 26 percent, 58 percent
Texas, 30 percent, 57 percent
North Dakota, 28 percent, 57 percent
Nebraska, 28 percent, 57 percent
Pennsylvania, 29 percent, 57 percent
Wyoming, 25 percent, 57 percent
Wisconsin, 28 percent, 56 percent
Indiana, 31 percent, 56 percent
Washington, 27 percent, 56 percent
Maine, 28 percent, 55 percent
Minnesota, 26 percent, 55 percent
Iowa, 29 percent, 54 percent
New Mexico, 26 percent, 54 percent
Rhode Island, 25 percent, 54 percent
Illinois, 27 percent, 54 percent
Georgia, 28 percent, 54 percent
Montana, 25 percent, 54 percent
Idaho, 27 percent, 53 percent
Hawaii, 22 percent, 52 percent
New York, 25 percent, 51 percent
Virginia, 29 percent, 50 percent
Nevada, 25 percent, 50 percent
Oregon, 27 percent, 49 percent
Massachusetts, 23 percent, 49 percent
New Jersey, 24 percent, 49 percent
Vermont, 25 percent, 48 percent
California, 24 percent, 47 percent
Connecticut, 25 percent, 47 percent
Utah, 24 percent, 46 percent
Alaska, 27 percent, 46 percent
Colorado, 21 percent, 45 percent
District of Columbia, 24 percent, 33 percent
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Top 10 Drug Company Settlements

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Record-breaking multibillion-dollar settlements against big drug companies have become routine in the U.S. In recent years, pharmaceutical companies seem to have been playing a game of one-upmanship, each surpassing yet a new milestone of wrongdoing — fraudulently marketing their drugs or making misleading claims about their safety — and the threat of massive payouts appears to have offered little deterrent.
(MORE: Breaking Down GlaxoSmithKline’s Billion-Dollar Wrongdoing)
Even the largest of settlements rarely dent the profits associated with the drugs involved: for example, the largest fine ever imposed on a drug company — July’s $3 billion judgment against GlaxoSmithKline (GSK) in part for illegally marketing the antidepressants Paxil and Wellbutrin and withholding data on the health risks of the diabetes medication Avandia — accounted for just 11% of associated revenue. Many other cases resulted in relatively smaller losses even when the fines were imposed as criminal penalties, as in the GSK case, and not just for civil law violations. Contrast such outcomes with those in most individual cases of fraud, in which all profits are typically confiscated as ill-gotten gains and the fraudster goes to prison.
A recent editorial in the New England Journal of Medicine
calls for change: levy large enough fines against drug companies for illegal behavior, so that the payouts can’t be dismissed as merely “the cost of doing business”; offer more protections for whistleblowers; and perhaps most importantly, file criminal charges against drug company executives for misconduct that could put them in prison.
(MORE: A Brief History of Antidepressants)
While the pharmaceutical industry is essential to medicine and has produced crucial drugs that have saved countless lives, eight of the 10 biggest international drug companies have recently agreed to pay millions to billions of dollars to settle charges of wrongdoing, and are currently operating under so-called corporate integrity agreements — essentially, promises not to commit the same crimes again. Some have already violated earlier agreements multiple times, however, to the tune of hundreds of millions dollars.
Following are the 10 biggest pharma settlements since 2007, with details on companies’ illegal acts and the drugs involved, based on both the New England Journal
editorial and other sources.

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Naomi Wolf's Vagina Aside, What Neuroscience Really Says About Female Desire

What Neuroscience Really Says About the Vagina and Female Desire | Healthland | TIME.com /* */ adFactory.getAd(1,1).write(); TIME Magazine Photos Videos Lists Life.com Style Topics Subscribe Follow TIME Facebook TwitterGoogle + Tumblr NewsFeed U.S. Politics World Business Money Tech Health Science Entertainment Opinion   SEARCH TIME.COM Full Archive Covers Videos HomeMedicineInfectious DiseaseLongevityObesityPreventionReproductive HealthSleepDiet & FitnessDietExerciseFood & DrinkFamily & ParentingBreast-FeedingChildhoodFamilyLove & RelationshipsMarriageMen & WomenRelationshipsMental HealthMemoryMental IllnessOverdosePsychologyPolicy & IndustryMedicare & MedicaidPharmaceuticalsPrimary CareRegulationSafetyViewpointMedical Insider ViewpointNaomi Wolf's Vagina Aside, What Neuroscience Really Says About Female DesireBy Maia Szalavitz | @maiasz | September 18, 2012 | +TweetGetty ImagesGetty Images
The controversy surrounding journalist Naomi Wolf’s new book, Vagina: A Cultural History
— an exploration of the brain-vagina connection — has brought fresh attention to the nature and neuroscience of female sexuality. Unfortunately, it’s done so largely because Wolf profoundly misrepresents how the brain works and how neurochemicals like dopamine, oxytocin and serotonin really affect our love lives (as well as conditions like addiction and depression).
Correctly understood, neuroscience offers important insight into how our minds function and how our brains shape our lives: many of my articles on Healthland attempt to explore these questions. But the kind of oversimplification seen in Wolf’s book and, sadly, in many other popular accounts of neuroscience, threatens to perpetuate a psychological myth. Rather than illuminating the complex interplay between mind and brain, it portrays human beings — especially women — as automatons, enslaved by brain chemicals we cannot control.
That’s not what the science shows. The mind-body connection is far more complicated and wonderful, as a quick tour through some of Wolf’s errors will illustrate. There is a new science of female sexual behavior, but it is far more liberating than the book suggests.
(MORE: First 3D Movie of Orgasm in the Female Brain)
Let’s start with Wolf’s understanding of dopamine, a neurotransmitter that rightly fascinates many researchers. Dopamine appears to be critical for motivation and desire: if it’s depleted or blocked (with a medication like an antipsychotic, for example), people may lose the will to strive, even the ability to move. But boost it with a drug like cocaine and people feel capable, excited, empowered.
Here’s how Wolf connects women’s sexuality with the function of dopamine in the brain:

If as a woman, you are frustrated sexually and even worse, aroused but denied release, your dopamine system eventually diminishes in anticipation of sex, you eventually lose access to the positive energy you might otherwise have had both in sex and also subsequently to take elsewhere in your life. … With low dopamine activation, you will suffer from a lack of ambition or drive and your libido will be low.
The theory sounds plausible, but “the fallacy is that she’s saying dopamine is primarily involved in sexual pleasure, and that’s not the case,” says Larry Young, a pioneering researcher on sexual and social bonding and co-author of The Chemistry Between Us: Love, Sex and the Science of Attraction.
“Dopamine is involved in reward and motivation for everything we do in life — whether we’re eating good food, drinking good wine or interacting with our kids and family.”
Sexual frustration, therefore, isn’t likely to turn off your dopamine system. “Taking one [type of pleasure] away isn’t going to change all aspects of your life like that,” Young says. He also points out that dopamine isn’t only associated with joyful experience. “It’s also released under stressful conditions,” he says.
Further, if the dopamine system typically turned itself off when satisfaction wasn’t attained, few people would develop addiction. Indeed, the experience of addiction itself is marked by ongoing
desire in the face of frustration: addiction doesn’t create an overall lack of desire or drive, but rather a very intense, if misdirected, motivational pull toward the drug of choice.
(MORE: The Female Erotic Brain, Mapped)
Wolf further misconstrues how dopamine interacts with serotonin, another neurotransmitter that has multiple functions, including roles in mood and sensation. Arguing that antidepressants that raise serotonin levels (like Prozac and other drugs of its kind) may be used to keep women submissive, she writes:

Dopamine will — if women and their vaginas are not hurt, suppressed, injured or demeaned — make women more euphoric, more creative and more assertive — possibly more than a male-dominated society is comfortable with. … Serotonin literally subdues the female voice, and dopamine literally raises it.
Again, there is no basis in neuroscience for this claim. Although some antidepressants do have the side effect of suppressing sexual desire, this affects both men and women, not women alone. Antidepressants that increase serotonin levels don’t typically deplete desire or motivation in general, however. Quite the opposite in fact: people whose depression has been lifted by these drugs tend to be more motivated, not less.
Women are more likely to be depressed than men, so they’re more likely to take medication for it. And yet while some antidepressants work by elevating dopamine — for example, bupropion (Wellbutrin) — you don’t see women being denied such drugs for fear they’ll overthrow the patriarchy. As with all antidepressants, women are prescribed these drugs more frequently than men are.
We still don’t know which medication will lift depression better — or worsen it, for that matter — in any given individual of either gender, though. The complexity of the condition and the widely varying response to antidepressants illustrate just how subtle and nuanced the interactions are between serotonin, dopamine and other neurotransmitters and our moods and desires. Countless things can go wrong to produce depression or low libido, and innumerable things can go right to alleviate such problems. If the brain were as simple as Wolf presents it, it just wouldn’t work.  It’s not as straightforward as one neurotransmitter, one effect.
“Science, particularly physiology, never works that way,” says Kathryn Clancy, assistant professor of anthropology at the University of Illinois, who studies reproductive behavior and blogs about “ladybusiness” for Scientific American,
noting that, for example, two women with the exact same levels of hormones can have vastly different physiology — either a “lush, thick” uterine lining, say, or a very thin one.
(MORE: What a Workout! Women Report that Exercise Triggers Orgasm)
Wolf includes a similar oversimplification in her discussion of the neurotransmitter and hormone oxytocin, which is best known for its involvement in facilitating bonding between lovers and between parents and children. Wolf calls oxytocin “women’s emotional superpower” and, citing research in prairie voles, concludes that it makes women more likely to become emotionally connected to their sexual partners than men are.
But Young says there’s no data on gender differences in oxytocin in humans. “Based on what we know from animals, it is likely that when women have sex that they are going to experience more of an oxytocin release than men,” he says, adding, “We don’t know.”
Wolf then jumps from this conjecture to the notion that women’s intense oxytocin release makes them more likely to become literally addicted to sex: “Good sex is, in other words, actually addictive for women biochemically in certain ways that are different from the experience of men — meaning that one experiences discomfort when this stimulus is removed and a craving to secure it again.”
From this unscientific claim, the author leaps even further afield, concluding that because of their biochemistry, women are less capable of controlling themselves when it comes to love and therefore, less human. “The tricky part, if you look at the new science, is that women are indeed, in sex, in some ways more like animals than men,” she writes.
Note here that we’ve gone from assuming that an animal finding applies to humans to an assumption (one without any data at all) that the previous conclusion creates an uncontrollable desire for sex in women that is similar to addiction, which characterizes women in love as having little more self-control than animals.
There is a truth buried amongst this nonsense: but it’s not the truth that Wolf is claiming. Love — for both men and women — does rely on the same circuitry that engenders addiction. It’s the same circuitry that fuels the desire to persist in frustrating tasks like parenting as well. Like addiction, both love and parenting involve continuing with behavior despite negative consequences. But that’s a good thing: we need to be a little bit irrational to stay with partners who are far from perfect and to deal with children who can easily drive adults mad.
(MORE: How a Squirt of Oxytocin Can Ease Marital Spats and Boost Social Sensitivity)
This doesn’t mean, however, that we become powerless in the face of our brain chemistry. Even heroin addicts remain human and capable of self-control: you don’t see junkies shooting up in front of the police, for example. Similarly, people maintain control despite the pulls of parenting and love — and women aren’t any more romantically compulsive than men.
That’s because the brain circuitry that drives us to love and to parent — the same region that can be derailed during addiction — isn’t the only part of our brain. Even in the throes of addiction, romantic obsession or the early chaotic days of parenting, we’re still capable of choice, and none of the neuroscience data proves otherwise. “Just because genes or a molecule modulate a behavior, it doesn’t mean that genes or molecules determine that behavior,” says Young. “People who are in love will generally engage in behavior that they wouldn’t normally do, but I don’t think that means they’re less responsible.”
Oddly, one of the few places in her book where Wolf gets the science right — in a discussion about the physiology of a clitoral versus vaginal orgasm — quashes the universalizing claims she makes elsewhere in the book. It was a pinched pelvic nerve in Wolf’s spine that apparently prevented her from experiencing vaginal orgasms and a surgical cure of the problem that inspired the book. She notes that her doctor told her, “Every woman is wired differently; some women’s nerves branch more in the clitoris. Some branch a great deal in the perineum, or at the mouth of the cervix. That accounts for some of the differences in female sexual response.”
Indeed, there is important new research here suggesting that, for example, that the wiring of these nerves affects the types of orgasms women have. Clitoral-focused orgasms seem to rely on one arm of the pudendal nerve, while cervical and some vaginal sensation and related orgasms are linked to the pelvic nerve.  As Wolf rightly notes, this knowledge should bring comfort to women who think themselves different or psychologically immature for having the “wrong” kind of orgasm.
Again, however, there is more complexity to the female orgasm than the author conveys. For one, as she does mention, new anatomical data suggests that the clitoris, far from being located only outside the body, actually wraps around the vagina internally. Which means that it, too, can be stimulated from within. “It’s shaped like a wishbone and the tip of the wishbone is the part that is external,” says Barry Komisaruk, professor of psychology at Rutgers and a leading researcher on sexuality. “The rest of it has these two legs that straddle the vagina and during intercourse the penis can actually stretch the  vagina to the point where the legs of clitoris are stimulated.” While there are distinct vaginal and clitoral orgasms experienced by many women, the two types of stimulation can also intermingle. Neither is inherently superior, nor required for conception.
(MORE: Sharing a Bed Makes Couples Healthier)
Moreover, Komisaruk and his colleagues have found that women with spinal injury, even those who have paralyzing damage, can often still have vaginal orgasms because the spine and pelvic nerve are not the only conductors of sensation from the vagina and cervix. The vagus nerve transmits these impulses, too, outside of the spinal cord. “It’s probably that nerve that carries sensation in [women with] spinal cord injuries [during orgasm],” says Komisaruk. Wolf’s vagus may not have functioned this way, but that doesn’t mean other women have the same problem.The brain and female sexuality are extremely complicated — and reducing them to simplistic formulations that deny women their humanity fails to do justice to either feminism or science. Properly contextualized, neuroscience can add to our knowledge of sexuality, but not if it’s twisted to support sexist ideas about women as “animals” who are so addicted to love that they become zombies.

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Swedish Doctors Claim Pioneering Uterus Transplant

Two Swedish women are carrying the wombs of their mothers after what doctors called the world’s first mother-to-daughter uterus transplants.
Specialists at the University of Goteborg completed the surgery on Sept. 15-16 without complications, but say they won’t consider the procedures successful unless the women achieve pregnancy after their observation period ends a year from now.
“We are not going to call it a complete success until this results in children,” said Michael Olausson, one of the Swedish surgeons told The Associated Press. “That’s the best proof.”
He said the women started in-vitro fertilization before the surgery. Their frozen embryos will be thawed and transferred if the women are in good health after the observation period, Olausson said.
The university said one recipient had her uterus removed many years ago due to cervical cancer and the other was born without a uterus. Both women are in their 30s.
“Both patients that received new uteri are doing fine but are tired after surgery. The donating mothers are up and walking and will be discharged from the hospital within a few days,” team leader Mats Brannstrom said in a statement.
Turkish doctors last year said they performed the first successful uterus transplant, giving a womb from a deceased donor to a young woman. Olausson said that woman was doing fine but wasn’t sure whether she had started undergoing fertility treatment yet.
In 2000, doctors in Saudi Arabia transplanted a uterus from a live donor, but it had to be removed three months later because of a blood clot.

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Ways to make your skin healthy

Ways to make your skin healthy

The primary step to keeping your skin healthy is preventing damage. Pollutants, air, sun as well as by just natural aging can certainly mortify the form of your skin. Frequent grumbles incorporate dry along with itchy skin, sagging, wrinkles, color alterations, together with age spots. Luckily, there are various methods that you can readily apply in order to maintain a healthy skin, feeling and looking at its most excellent appearance. Keeping yourself fit, having enough rest, as well as getting healthy diet can set the basis for fine-looking and vigorous complexion. Moreover, a proper diet is not only the excellent way in attaining good health in general but it as well assists you to guarantee that your skin will get all of the vitamins and minerals, along with the nutrients that it requires to preserve and fix itself.
Another way to keep your skin healthy is to apply the right skin care products to your skin. The best anti aging skincare products that can aid you to hydrate the skin are now available at your favorite skin care product store online. Having a clean skin by using the best skin cleanser is also a great way of preventing skin damages.
One of the most essential ways to protect your skin is to keep it away from the harmful rays of the sun. Ultraviolet radiation harms the skin as well as it can result to wrinkles, premature aging, age spots or even cancer as well. An individual should really get further preventative measures in order to be certain that his or her skin is not totally exposed under the harmful rays of the sun. Do not fail to remember that one should apply a natural sunscreen, or a moisturizer that includes sunscreen (with minimum of SPF 15) every day. Although, it does not mean that you should not go out at all during the day, as if you are like a nocturnal creature. Your skin also needs some sunlight every day. A 10 to 15 exposures at sunrise or sunset will be alright.
In addition to that, a variety of fine skin care products such as an all natural moisturizer is one of the essential components for a vigorous complexity. Keep on moisturizing all through the day to keep your sensitive skin vigorous. Your hands as well as your face is especially vulnerable to everyday dent, and might require it to be moisturized further.

About The Author Skin Care Products are not only witnessed in industrial or professional application since there are as well the likes which are utilized at home or as personal use. One is that I generally utilized is the area of elderly care or in areas where care of people enduring the dilemma of incontinence.

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