Culture

People who have greater levels of mindfulness -- or the tendency to maintain attention on and awareness of the present moment -- are better able to cope with the pain of being rejected by others, according to a new study led by a team of Virginia Commonwealth University researchers.

"Social rejection can have a number of negative outcomes both for the rejected person's own health and well-being, as well as their interpersonal relationships," said lead author Alexandra Martelli, a doctoral candidate in the Department of Psychology in the College of Humanities and Sciences. "Therefore it is critical that researchers find adaptive ways at responding to social rejection, and mindfulness may be one effective emotion regulation strategy."

The study, "When Less is More: Mindfulness Predicts Adaptive Affective Responding to Rejection via Reduced Prefrontal Recruitment," will be published in the journal Social Cognitive and Affective Neuroscience.

Researchers from VCU, the University of California, Los Angeles, and the University of Kentucky were curious to discover if mindfulness could be a buffer against the distress and pain of social rejection.

They ran an experiment in which 40 undergraduate students self-reported their levels of mindfulness, and then were placed in an fMRI scanner. The researchers observed live images of the participants' brain activity as they played a virtual ball-tossing game with what they believed to be two other partners.

For the last third of the game, the participants stopped receiving any ball tosses from the other players, mimicking the conditions of social rejection.

After the scanning session, the participants were interviewed about how distressed they were during the game. Participants with higher levels of mindfulness reported less distress from being excluded.

The link between mindfulness and reduced social distress also was seen in the brain imaging, as researchers found there was less activation in the left ventrolateral prefrontal cortex, which is known to assist in the "top-down" inhibitory regulation of both physical and social forms of pain.

The researchers also examined the communication between the ventrolateral prefrontal cortex and other brain areas during social rejection. They found that more mindful individuals showed less functional connectivity between the ventrolateral prefrontal cortex and two brain regions that help generate the experience of social distress, the amygdala and the dorsal anterior cingulate cortex.

"Our findings suggest that mindful people are not as distressed or pained by social rejection," the researchers wrote. "The neural results imply that a reason for mindful individuals' adaptive responses to rejection is that they do not excessively recruit (and therefore tax) 'top-down', inhibitory brain regions to inhibit social distress. Instead, mindful individuals may use more 'bottom-up' emotion-regulation strategies that prevent rejection from being distressing in the first place. Interventions that seek to help socially-isolated and rejected individuals may benefit from this mechanistic and biologically-informed information."

Martelli is a researcher in the Social Psychology and Neuroscience Lab at VCU. The lab, led by David Chester, Ph.D., an assistant professor in the Department of Psychology and a co-author on the study, seeks to understand why people try to harm one another after experiences such as rejection.

"Mindfulness has beneficial effects for many psychological and behavioral maladies," Chester said.

"Yet in many ways, our understanding of how mindfulness achieves these helpful outcomes is not fully understood. Our findings help shed light on the underlying biological and psychological mechanisms through which mindfulness helps people cope with distressing social experiences, such as rejection and exclusion."

Specifically, he said, the study suggests that mindful individuals are not as distressed by social rejection and that mindful individuals appear to successfully regulate such distressing emotions by not using effortful, inhibitory processes that suppress their feelings of social pain.

"This is important because the use of such 'top-down,' suppressive emotion regulation has been shown to backfire and is linked with poor emotion-related outcomes such as impulsivity," he said. "Mindful people are likely using a more 'bottom-up' regulatory approach, which makes sense given these individuals' tendency to focus on the organic origins of their feelings. On a practical level, our findings point to the utility of mindfulness in coping with interpersonal stressors. People dealing with exclusion or rejection may likely benefit from training in mindfulness techniques."

The study's findings are relevant to the Social Psychology and Neuroscience Lab's mission, Martelli said, because they further understanding of the underlying neural mechanisms of aggression and violence within interpersonal relationships.

"An over-reliance on top-down emotion-regulation strategies can result in self-regulatory failure," Martelli said. "Therefore, more bottom-up strategies, such as mindfulness, may be effective at regulating difficult emotions such as anger or frustration that typically result in violent or aggressive acts."

Members of the public are more likely to blame the global marine litter crisis on retailers, industry and government, according to new research led by the University of Plymouth.

However, they have less faith in those agencies' motivation and competence to address the problem, placing greater trust in scientists and environmental groups to develop effective and lasting solutions.

The results were among the findings of a Europe-wide study which asked more than 1,100 members of the general public about their attitudes to marine litter.

It showed more than 95 per cent of people reported having seen litter when they visited the coast, and such experiences were associated with higher concern and a willingness to adapt personal behaviour to address the problem.

There was also growing appreciation and concern about the threat litter poses to wildlife within the marine environment, vastly outweighing other fears such as the impact on tourism and the fishing and shipping industries.

Direct releases into the sea and at the coast were perceived to be more likely routes for waste to enter the marine environment than overflows from water treatment or landfill sites.

And when asked about the key factors contributing to the problem, people attributed it predominantly to the use of plastic in products and packaging, human behaviour when disposing of litter, and the single use nature of plastics.

The research, published in Marine Pollution Bulletin, is the first European public survey to focus solely on marine litter and people's attitudes towards it.

Dr Sabine Pahl, Associate Professor (Reader) in the University of Plymouth's School of Psychology, is the study's corresponding author. She said: "Marine litter is an issue without borders. But human behaviour in its many forms is the sole source of the problem, and changing perceptions and behaviour is key to preventing litter from continuing to escape into the natural environment. This research gives us useful insights so that we can attempt to motivate action on land that makes a positive change to our coastlines and oceans now and in the future."

Professor Richard Thompson OBE, Head of the University's International Marine Litter Research Unit, also contributed to the research. He added: "At a time when there is a broad commitment to address this global crisis, this research presents an interesting conundrum. It is encouraging to see there is growing public awareness of the marine litter problem, but there are clearly challenges to be overcome in convincing people that we all need to be part of the solution. There needs to be an holistic approach which includes governments and industry, scientists and the public, and this research is a useful step in finding ways to communicate that more widely."

Bottom Line: Parents of adolescents believed that the potential to prevent certain types of cancer is the best reason for their children to receive the human papillomavirus (HPV) vaccine, whereas other reasons health care providers often give were far less persuasive.

Journal in Which the Study was Published: Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research.

Author: Melissa B. Gilkey, PhD, assistant professor of Health Behavior at the University of North Carolina Gillings School of Global Public Health in Chapel Hill.

Background: "HPV causes over 40,000 cancers in the U.S. each year, including cancers of the cervix, vagina, vulva, penis, anus, and back of the throat. Most of these cases are potentially preventable through HPV vaccination," Gilkey said.

The Centers for Disease Control and Prevention (CDC) currently recommends that boys and girls receive two doses of the HPV vaccine, beginning at age 11 or 12. As of 2016, about 60 percent of teenagers had received the first dose, but only about 43 percent were up to date on all recommended doses, according to the CDC.

"We still have work to do on improving the timeliness of those doses and on reaching the remaining 40 percent of young people who have not started HPV vaccination," Gilkey said. "To increase uptake, we need to more effectively communicate the value of HPV vaccination to parents."

How the Study Was Conducted: In this study, Gilkey and colleagues developed a best-worst scaling experiment to evaluate 11 reasons health care providers typically give for HPV vaccination. The experiment was administered in 2016 via a national, online survey of 1,177 parents of adolescents ages 11-17. Fifty-seven percent of the parents had initiated HPV vaccination.

Results: Parents said "it can prevent some types of cancer" was the best reason to get the HPV vaccination. Parents also felt that "it can prevent a common infection;" "it has lasting benefits;" and "it is a safe vaccine" were persuasive reasons.

Parents said the worst reasons providers could give included "it is a scientific breakthrough;" "I got it for my own child;" and "your child is due for it."

Messages ranked in the middle were "it works best at this age;" "it should be given before sexual contact;" "getting it on time may mean fewer shots;" and "I think it is important."

The researchers used stratified analyses to evaluate whether the parents' opinions would vary depending on their overall confidence in vaccines. Gilkey said she was surprised to discover that vaccine confidence did not appear to significantly affect parents' perceptions of physicians' messages, and cancer prevention was the most effective message for both groups.

Author's Comments: The study augments previous research that suggested the way in which physicians discuss the HPV vaccine may affect parents' decisions on whether to have their children get the vaccine.

"Our prior research indicates that providers give many different reasons for HPV vaccination, and the findings of this study suggest that they may do better to streamline their communication," Gilkey said. "Cancer prevention is likely to be your best bet no matter who you're talking to."

"Cancer prevention was clearly the most convincing reason for HPV vaccination. Reasons that have to do with sexual activity, scientific novelty, or providers' decisions for their own children may ultimately be distractions that are best avoided," she continued.

Study Limitations: Gilkey pointed out that the study evaluated parents' perceptions about what would motivate them to vaccinate their children, and may not fully reflect real-life conversations during an office visit. Also, because the reasons were ranked, those that were ranked lower may have been less persuasive than the top-ranked messages, but are not objectively "bad" messages to use in discussing HPV vaccination, she said.

Funding & Disclosures: This study was supported by a grant from the National Cancer Institute. The authors declare no conflicts of interest.

Human activity is causing the planet's mammals to flee daylight for the protection of night, according to a new study from the University of California, Berkeley.

The study, published today in the journal Science, and supported in part by the National Science Foundation, represents the first effort to quantify the global effects of human activity on the daily activity patterns of wildlife. Its results highlight the powerful and widespread process by which animals alter their behavior alongside people: human disturbance is creating a more nocturnal natural world.

"Catastrophic losses in wildlife populations and habitats as a result of human activity are well documented, but the subtler ways in which we affect animal behavior are more difficult to detect and quantify," said Berkeley PhD candidate and study lead author Kaitlyn Gaynor.

Gaynor, along with co-authors Justin Brashares and Cheryl Hojnowski of UC Berkeley, and Neil Carter of Boise State University, applied a meta-analysis approach, using data for 62 species across six continents to look for global shifts in the timing of daily activity of mammals in response to humans. These data were collected by various approaches, including remotely triggered cameras, GPS and radio collars, and direct observation. For each species in each study site, the authors quantified the difference in animal nocturnality under low and high human disturbance.

On average, mammals were 1.36 times more nocturnal in response to human disturbance. This means that an animal that naturally split its activity evenly between the day and night increased its nighttime activity to 68% around people. This finding was consistent across carnivore and herbivore species of all body sizes greater than 1 kg (small mammals were not included in the study). The pattern also held across different types of human disturbance, including activities such as hunting, hiking, mountain biking, and infrastructure such as roads, residential settlement, and agriculture.

"While we expected to find a trend towards increased wildlife nocturnality around people, we were surprised by the consistency of the results around the world," said Gaynor. "Animals responded strongly to all types of human disturbance, regardless of whether people actually posed a direct threat, suggesting that our presence alone is enough to disrupt their natural patterns of behavior."

According to Brashares, a professor in the Department of Environmental Science, Policy, and Management and the study's senior author, the consequences of the behavioral shift in wildlife can be seen through contrasting lenses.

"On the positive side, the fact that wildlife is adapting to avoid humans temporally could be viewed as a path for coexistence of humans and wild animals on an increasingly crowded planet," said Brashares. "However, animal activity patterns reflect millions of years of adaptation--it's hard to believe we can simply squeeze nature into the dark half of each day and expect it to function and thrive."

The authors describe a range of potential negative consequences of the shifts they report in wildlife, including mismatches between the environment and an animal's traits, disruption of normal foraging behavior, increased vulnerability to non-human predators, and heightened competition.

They point out, however, that while many of the studies included in their analysis documented a clear increase in nocturnal activity, few examined the consequences for individual animals, populations, or ecosystems.

"We hope our findings will open up new avenues for wildlife research in human-dominated landscapes. We still have a lot to learn about the implications of altered activity patterns for the management of wildlife populations, interactions between species, and even human-induced evolution," said Gaynor.

A new investigation of how children reason about religious rules reveals a remarkable level of acceptance of different religions' rules and practices.

The study, appearing in the June 13 online edition of Child Development, found that both Hindu and Muslim children in India thought that Hindu children should follow Hindu norms and Muslim children should follow Muslim norms.

"Even in a region with a long history of high religious tension, we see impressive levels of religious tolerance among children," said study co-author Audun Dahl, assistant professor of psychology at UC Santa Cruz. "Children think that people in different religions should follow their own norms--and that's a starting point, a reason for optimism."

Very little research has been done on how children reason about religious norms, despite the fact that differences between religious norms underpin conflicts around the globe, including Catholic/Protestant clashes in Europe and differences among Sunni and Shia Muslims, noted Dahl. Religious norms dictate practices from clothing and land ownership to reproduction, he said, with adult adherents frequently wanting others to adhere to their norms.

"Children expressed preferences for their own religion, but we found no evidence of children rejecting the norms of the other religion," said Dahl, adding that such tolerance is the first step toward greater harmony.

Exploring religious tolerance

Dahl and coauthors Mahesh Srinivasan at UC Berkeley and Elizabeth Kaplan at Syracuse University wanted to see if children would extend their thinking about their own religious norms to other groups. In other words, would Hindu children think that all children should follow Hindu norms? And would Muslim children believe that all children should follow Muslim norms?

"As it turned out, both Hindu and Muslim children thought that the norms of a religion applied only to followers of that religion. For instance, almost no participants thought Muslim kids should follow Hindu norms, but at least half thought Muslim kids should follow Muslim norms," said Dahl. Rather than applying their own religious norms to all others, children endorsed the right of each religion to have its own religious norms.

The study took place in Gujarat, India, a region with a history of Hindu-Muslim violence. Investigators worked with 100 children ages 9 to 15, focusing on different Hindu norms, such as the prohibition against eating beef, and Muslim norms, such as the prohibition against worshipping an idol. They also asked the children about hitting people to explore the youngsters' reasoning around moral norms.

"The tendency to restrict the norms of one's own religion only to followers of that religion, and to expect members of another religious group to follow their own customs, may contribute to peaceful coexistence," said Dahl.

Religious norms as distinct from other social norms

The researchers also asked children about moral norms about how to treat others. Fully 95 percent of children--regardless of religion--asserted that it's not okay to hit people. Perhaps more surprisingly, most children thought it was wrong to hit someone even if hitting was permitted by religious authorities or a god. Dahl said this speaks to the difference between religious norms and moral norms.

Yet, children also viewed religious norms as different from social conventions or personal preferences. "Religious beliefs are about truth and falsehood. They are about which god, or gods, exist, and which gods are right," he said. "They don't lend themselves to pluralism as easily as personal preferences or social conventions do."

Most religious people believe their god is the true god, so the researchers thought there was a good chance that Hindu children, for example, would think that Muslim children--as well as Hindu children--should follow Hindu norms.

"In the Hindu religion, the cow is a holy animal, so you could expect Hindu children to say it is wrong for anyone to kill and eat cows," said Dahl. "But that's not what we found. Most Hindu children thought Muslims could eat beef, and should follow Muslim rather than Hindu norms."

Dahl and Srinivasan plan to further explore how children integrate religious norms as distinct from social norms regarding what's right and wrong, including hitting others. "Religions often aren't explicit about the scope of their norms and whether they apply to non-followers, so there's a question about how children apply the fundamental concepts to actual, complicated scenarios of real life," Dahl said. "It's fascinating."

These findings offer hope that exposure to conflicts over religious differences, like those experienced by children in many regions of the world, need not lead children to develop negative attitudes toward the religious practices of other groups. "Rather, perhaps these levels of understanding will play a role in reducing conflict over time," said Dahl.

New Rochelle, NY, June 13, 2018--Integrated approaches that avoid the use of animals to assess the toxicity of inhaled materials may include a computational model to screen for chemical reactivity, a human tissue-based assay to predict the absorption of a chemical into the respiratory tract, and other types of advanced systems based on in vitro and in vivo respiratory biology. A comprehensive review of the progress and ongoing efforts in this fascinating field is the focus of a new special issue on Inhalation Toxicity Testing published in Applied In Vitro Toxicology, a peer-reviewed journal from Mary Ann Liebert, Inc., publishers. The issue is available free on the Applied In Vitro Toxicology website.

The special issue on Inhalation Toxicity Testing is led by Guest Editor Amy Clippinger, PhD, Director of the PETA International Science Consortium Ltd.

"The articles in this special issue describe research to develop and apply human-relevant in silico and in vitro approaches that incorporate cutting-edge science and don't use animals," says Dr. Clippinger.

In the article "Profiling Acute Oral and Inhalation Toxicity Data Using a Computational Workflow to Screen for Facile Chemical Reactivity," Dan Wilson, PhD, and coauthors from The Dow Chemical Company (Midland, MI) describe the computational approaches they are developing to screen for inhalation toxicity based on classes of chemically reactive compounds.

Wiebke Hoffmann, The European Union Reference Laboratory for Alternatives to Animal Testing (Ispra, Italy) and colleagues from University of Vienna (Austria), University of Lausanne (Geneva, Switzerland), Douglas Connect (Basel, Switzerland), and Epithelix Sarl (Geneva) describe their ability to study pulmonary absorption in vitro in the article entitled "Establishment of a Human 3D Tissue-Based Assay for Upper Respiratory Tract Absorption ."

In "Prevalidation of an Acute Inhalation Toxicity Test Using the EpiAirway In Vitro Human Airway Model," George Jackson et al., MatTek Corp. (Ashland, MA) present the results of prevalidation studies using EpiAirway tissues, which are exposed to test chemicals for 3 hours before being assessed for tissue viability.

Also included in the special issue is the Roundtable Discussion "Nonanimal Approaches to Assessing the Toxicity of Inhaled Substances: Current Progress and Future Promise." Dr. Clippinger leads the expert participants from industry, academia, government agencies, and non-profit organizations in a lively discussion on topics including the breadth of nonanimal approaches, their advantages and limitations versus animal inhalation tests, and how to move forward.

"I am pleased with this special issue of Applied In Vitro Toxicology as it focuses on an area of great importance for risk assessment, which has been a challenge to address using in vitro methods. This issue does a wonderful job demonstrating how in vitro methods can be successfully used to understand inhalation toxicology," says Jim McKim, PhD, Editor-in-Chief of Applied In Vitro Toxicology and Founder and CEO, IonTox, LLC.

Minneapolis, June 14, 2018 - Having a prior cesarean section (C-section), smoking, illicit drug use, and obesity increase the likelihood of developing an infection during a C-section delivery, according to new research presented at the 45th Annual Conference of the Association for Professionals in Infection Control and Epidemiology (APIC).

A retrospective chart review of 90 C-section deliveries, (30 cases developed infections and 60 cases did not) identified four pre-delivery risk factors for developing a C-section infection. Women who developed a C-section infection were:

8.41 times more likely to have had a prior C-section

3.8 times more likely to have smoked

25.3 times more likely to have had a history of illicit drug use

More likely to have had a higher body-mass index (BMI) with 42.4 average BMI for all cases and 36.9 BMI for those who did not develop an infection

The majority of the infections were identified by positive wound cultures consisting of both common commensal and enteric organisms, such a Staphylococcus species and Escherichia coli (E. coli) respectively. These are common organisms found in/on the body that normally do not cause harm, but when they invade an open wound, can lead to infection.

A qualitative review of the cases suggested that more patient education was needed following a C-section, as discussed by study co-authors Stefanie Buchanan, RN, BSN, CIC, and Marko Predic, MS. "We found that women leave the hospital with a breadth of information on caring for a newborn and often overlook the education provided on caring for their wound," stated Stefanie Buchanan.

Following the study, the infection prevention team at University of Florida Health Jacksonville updated their standard of care for women pre- and post- C-section, focusing on increasing patient education. Upon discharge, nurses provide patients with additional resources on wound care and perform an assisted shower to demonstrate proper cleaning.

In addition, because a large portion of the infections were attributable to common commensals, nurses now ensure patients are bathed with the disinfectant chlorhexidine gluconate (CHG) prior to surgery.

"The UF Health Jacksonville infection prevention team's work contributes to our understanding of risk factors associated with C-section infections," said 2018 APIC President Janet Haas, PhD, RN, CIC, FSHEA, FAPIC. "They have used this data to design better processes of care for their patients, improving the health and safety of new mothers."

Researchers know that anxiety is a result of repeated stress. William Colmers, a University of Alberta professor in the Department of Pharmacology, is trying to understand why stress affects people differently, and to identify possible new therapeutic approaches to anxiety disorders.

The body is designed to deal with stress thanks to a "fight or flight" response that helps prepare your mind and body to either defend yourself or get away from stressors. Normally, this response reverses once the danger is over, but the over-use of this stress response can also end up causing anxiety.

"Your resources become depleted," said Colmers. "It's like gunning your engine to take off, but if you don't stop, you'll run out of gas at some point."

Anxiety disorders are widespread in today's society. One in four people have an incident in their lifetime, the severity of which can range from manageable to debilitating.

The Colmers lab is interested in the reversal process--turning the stress back down to a level where you can use the resources that you are wasting on the flight or fight response to do other essential things.

The U of A team has identified a new pathway in the brain that might be a good target for a drug to reduce the symptoms of anxiety.

"It's a whole new way of looking at how anxiety can be regulated. It gives us a great deal of hope in terms of finding new avenues for treatment," said Colmers.

Peptide pivot point influences anxiety

To do this, Colmers studied the stress hormone, a peptide called corticotropin-releasing hormone (CRH), and the anti-stress hormone that stops the cycle, called neuropeptide-Y (NPY).

NPY is a brain chemical messenger that the Colmers lab has studied in relation to epilepsy and appetite. He is now investigating how the hormone affects a stress-sensitive part of the brain called the amygdala and its action in reversing stress responses.

It has been shown that NPY causes an animal to become less stressed, acting as an anxiolytic?reducing anxiety. The response to NPY can be observed by testing if the animal is more willing to interact with other animals it does not know, which can be a stressful experience.

While the effect of exposure to NPY lasts just a short while, multiple exposures make the animal resilient to stress for weeks or months.

The Colmers lab identified the exact mechanism that elicits this response:

Activity in the output neurons of the amygdala signals fear or danger. Anything that slows their activity down causes anxiolysis (inhibiting anxiety). The stress hormone CRH increases the activity of these neurons, while NPY does the opposite, slowing down the firing of these neurons.

The same ion channel in the nerve cell's membrane is activated by CRH to excite these neurons, and is shut down by NPY to silence them.

"The same pivot point is being used by the peptides that cause or reduce anxiety," said Colmers.

Colmers observed that over a longer period, the ion channels that NPY shuts down disappear from the membrane, so there are less of those ion channels around.

In a collaboration with Janice Urban's laboratory at Rosalind Franklin University in North Chicago, IL, the U of A team tested to see how important the channel was for behavior.

The lab used a small hairpin RNA (shRNA), which can prevent the protein from being made by the nerve cell. They used a tailored virus to get the nerve cells to produce the shRNA that stops their normal production of the ion channel. It is a very selective method, and can be put in very precise regions of the brain using this viral delivery system.

The group found that within a week of inhibiting the protein, the animals were more likely to interact, and the change lasted for at least eight weeks.

"Knocking down the ion channel protein causes animals to be less anxious," said Colmers. "This gives us a new drug target, and we now have a better understanding of how that area of the brain works."

Middle-to-older aged women who are naturally early to bed and early to rise are significantly less likely to develop depression, according to a new study by researchers at University of Colorado Boulder and the Channing Division of Network Medicine at Brigham and Women's Hospital in Boston.

The study of more than 32,000 female nurses, published in the Journal of Psychiatric Research, is the largest and most detailed observational study yet to explore the link between chronotype, or sleep-wake preference, and mood disorders.

It shows that even after accounting for environmental factors like light exposure and work schedules, chronotype - which is in part determined by genetics - appears to mildly influence depression risk.

"Our results show a modest link between chronotype and depression risk. This could be related to the overlap in genetic pathways associated with chronotype and mood," said lead author Céline Vetter, director of the Circadian and Sleep Epidemiology Laboratory (CASEL) at CU Boulder.

Previous studies have shown that night owls are as much as twice as likely to suffer from depression. But because those studies often used data at a single time-point and didn't account for many other factors that influence depression risk, it has been hard to determine whether depression leads people to stay up later or a late chronotype boosts risk of depression.

To shed light on the question, researchers used data from 32,470 female participants, average age 55, in the Nurses' Health Study, which asks nurses to fill out health questionnaires biennially.

In 2009, all the participants included in the study were free of depression. When asked about their sleep patterns, 37 percent described themselves as early types, 53 percent described themselves as intermediate types, and 10 percent described themselves as evening types.

The women were followed for four years to see who developed depression.

Depression risk factors like body weight, physical activity, chronic disease, sleep duration, or night shift work were also assessed.

The researchers found that late chronotypes, or night owls, are less likely to be married, more likely to live alone and be smokers, and more likely to have erratic sleep patterns.

After accounting for these factors, they found that early risers still had a 12 - 27 percent lower risk of being depressed than intermediate types. Late types had a 6 percent higher risk than intermediate types ( this modest increase was not statistically significant.)

"This tells us that there might be an effect of chronotype on depression risk that is not driven by environmental and lifestyle factors," said Vetter.

Genetics play a role in determining whether you are an early bird, intermediate type, or night owl, with research showing 12-42 percent heritability. And some studies have already shown that certain genes (including PER2 and RORA), which influence when we prefer to rise and sleep, also influence depression risk.

"Alternatively, when and how much light you get also influences chronotype, and light exposure also influences depression risk. Disentangling the contribution of light patterns and genetics on the link between chronotype and depression risk is an important next step" Vetter said.

Vetter stresses that while the study does suggest that chronotype is an independent risk factor for depression, it does not mean night owls are doomed to be depressed.

"Yes, chronotype is relevant when it comes to depression but it is a small effect," she says, noting that her study found a more modest effect than previous ones have.

Her advice to night owls who want to lower their risk?

"Being an early type seems to beneficial, and you can influence how early you are" she said. Try to get enough sleep, exercise, spend time outdoors, dim the lights at night, and try to get as much light by day as possible.

Minneapolis, June 14, 2018 - Neonatal intensive care units increasingly encourage meaningful touch and skin-to-skin care - aka "kangaroo care" - between parents and premature babies to aid the babies' development. But a Michigan children's hospital practicing skin-to-skin care noticed an unwanted side effect in 2016 - a spike in Staphylococcus aureus (SA) infections among newborns.

Hospital staff hypothesized that the two events were connected and implemented a three-part intervention in the small-baby unit that effectively reduced SA infections, according to new research presented at the 45th Annual Conference of the Association for Professionals in Infection Control and Epidemiology (APIC).

The three interventions introduced to curb SA infections were: increased awareness of hand hygiene, mandatory education of staff around SA, and the implementation of parent skin cleansing prior to skin-to-skin care.

In the first-year post-interventions, 20 babies in the small-baby unit developed SA infections, compared to 59 patients in the year prior.
"We know that skin-to-skin care and meaningful touch are good for the baby, but the increase in infections showed how this type of care giving can carry a risk," said Gwen Westerling, BSN, RN, CIC, the study's lead author and infection preventionist at Spectrum Health Helen DeVos Children's Hospital. "The results demonstrate that interventions even as simple as cleaning the skin prior to care can drastically improve infection rates."

Education about SA was also a critical component of this strategy. Following the intervention, 98 percent of staff surveyed knew of the requirements for parental skin cleansing. The mandatory staff education was conducted online. Leadership rounding reinforced the educational content and new cleaning requirements. In turn, nurses educated parents and family about the importance of cleansing before engaging in skin-to-skin care.

"Infection preventionists are uniquely attuned to the impact that process changes may have on the risk of infection," said 2018 APIC President Janet Haas, PhD, RN, CIC, FSHEA, FAPIC. "Increased education around hand hygiene and cleaning procedures may seem straightforward, but we see again and again that they are key components in the reduction of healthcare-associated infections."

PISCATAWAY, NJ - Teenage girls who regularly binge drink may fail to reach their peak bone mass, according to a new study published in the Journal of Studies on Alcohol and Drugs.

The study, of 87 college women, found that those who regularly binge drank in high school had lower bone mass in the spine. That was true even when researchers accounted for other factors that affect bone density--such as exercise, nutrition and smoking habits.

The findings suggest that poorer bone health can be added to the list of binge drinking risks for young women, said lead researcher Joseph LaBrie, Ph.D., a professor of psychology at Loyola Marymount University, in Los Angeles, who conducted the research with health and human sciences professor Hawley Almstedt, Ph.D., R.D.N.

There are well-known short-term risks, LaBrie pointed out--such as alcohol poisoning, car accidents, poor academic performance and sexual assault.

"This study identifies a potential lifetime consequence of binge drinking in young women," he said.

The findings are based on female college students ages 18 to 20--a time when, LaBrie said, bone mass should still be accruing. Women generally reach their peak bone density at the spine between the ages of 20 and 25.

The study participants answered questionnaires about certain lifestyle factors and underwent measurements of their bone density in the lumbar spine. When it came to alcohol, the women were asked to think back to high school and report how often they'd binged--having four or more drinks within two hours.

Overall, LaBrie's team found, women who'd binged frequently since high school had lower bone mass than their peers. "Frequent" meant they'd binged at least 115 times--or nearly twice a month, on average.

The findings expand previous research linking heavy drinking to lower bone mass and higher fracture risk in older adults, suggesting that later in life bone issues may be linked to drinking early in life. Meanwhile, previous animal research has suggested that alcohol hinders healthy development of young bones.

LaBrie noted that anything that keeps a young woman from reaching her peak bone mass will probably raise her odds of developing osteoporosis years down the road.

For now, the findings offer girls and young women one more reason to avoid binge drinking and offers parents further support for seeking to delay onset of children's drinking.

"When we consider bone health," LaBrie said, "we always talk about things like exercise, calcium and vitamin D, and not smoking. We may also need to talk about avoiding binge drinking."

The US Drug Enforcement Administration's decision to restrict prescription drugs containing hydrocodone (a popular opioid painkiller) was associated with a 'significant' increase in illicit trading of opioids through online markets, finds a study published by The BMJ today.

In this study, the term opioids refers to drugs that are usually available by prescription but here are sourced illegally through the dark net and are not prescribed by anyone.

The findings show that the proportion of sales of opioids through illicit markets doubled over the study period and sales of more potent opioids also increased.

Overdose death rates have quadrupled in the US since 1999, and 40% of all deaths involve prescription opioids*, which are primarily used for pain relief.

In October 2014, the US Drug Enforcement Administration decided to move hydrocodone opioids from schedule III to schedule II (a more restrictive category), making it more difficult for patients to access these drugs on prescription and stopping automatic repeat prescriptions.

There is concern that opioid users will source drugs from illegal online markets called 'cryptomarkets' rather than from pharmacies. Users only access these cryptomarkets via the 'darknet', where people can sell and buy drugs anonymously.

Although the legitimate supply of opioids may have decreased, overall consumption will remain unchanged if users decide to source them from illicit markets.

So an international research team set out to investigate whether there was a link between the 2014 reclassification of hydrocodone opioids and an increase in trading of illicit prescription drugs on cryptomarkets.

Using web crawler software, they compared sales for prescription drugs containing hydrocodone with other prescription drugs and illicit opioids from 31 different cryptomarkets operating from September 2013 to July 2016 (before and after reclassification).

They looked at three pieces of information from each product listing placed by a seller: the drug type on offer, the country from where products would be shipped, and the number of reviews the listing had received, to compare usage in relation to the 2014 reclassification.

The researchers found that the sale of opioids through US cryptomarkets increased after the 2014 reclassification, with no significant changes in sales of sedatives, steroids, stimulants, or illicit opioids.

In July 2016, sales of opioids through US cryptomarkets represented 13.7% of all drug sales compared with a modelled estimate of 6.7% of all sales (a 4% yearly increase in market share) had the new schedule not been introduced.

They also report a change in the type of drugs purchased after reclassification. Oxycodone purchases decreased, and fentanyl (a stronger and potent than hydrocodone) moved from being the least sold product to being the second most popular prescription opioid bought from cryptomarket sellers based in the USA. Fentanyl is currently the leading cause of opioid overdose in the USA.*

The researchers outline some study limitations. For example, there may have been a general increase in demand that was unrelated to the 2014 restriction, and the source and destination of the drugs cannot be independently confirmed.

Nevertheless, they say their results "are consistent with the possibility that the scheduled change might have directly contributed to the changes we observed in the supply of illicit opioids."

This possibility "is reinforced by the fact that the increased availability and sales of prescription opioids on cryptomarkets in the US after the schedule change was not replicated for cryptomarkets elsewhere," they add.

By purchasing from cryptomarkets, it becomes more difficult to track individual use of prescription opioids, and to offer treatment and help to users, say the authors, and they suggest strategies to minimise harm, such as dealing with over-prescribing, and making more information available to users about the nature and dangers of prescription opioid use.

"These alternatives are known to have an impact on drug use and could be employed before and after schedule changes to alleviate their negative impacts" they conclude.

In a linked editorial, Scott Hadland from Boston Medical Center's Grayken Center for Addiction and Leo Beletsky from Northeastern University School of Law and Bouvé College of Health Sciences say this analysis illustrates "the predictable consequence of cutting supply without tackling demand."

They point out that the US Department of Justice recently announced it is doubling resources allocated to combatting dark web drug sales, but argue that this approach is unlikely to succeed.

They say demand for opioids in the US will decrease sustainably "only when high-quality evidence-based prevention and treatment programs are broadly implemented, robustly funded, and universally available."

And they warn that the overdose crisis "will likely worsen so long as supply-side interventions are not coupled with evidence-based measures to cut demand and reduce harm."

The UK urgently needs a joined up and strategic approach to the recruitment of international health professionals, argue experts in The BMJ today.

James Buchan and Anita Charlesworth at The Health Foundation say the UK government's decision to review the visa regime for international doctors is "a rare glimmer of common sense in an issue that has been more usually characterized by national policy incoherence."

What remains of concern, however, "is that the underlying problems of the UK approach to international recruitment of health professionals remain to be acknowledged and addressed."

These problems "owe much to a debilitating mix of conflicting policy goals and inadequate national health workforce planning and funding," they explain. "This has led to a long-term 'stop-go' approach to international recruitment of doctors and other health professionals, which has often been misaligned with domestic health workforce and immigration policies."

They point out that ten years ago, the UK Parliament Health Committee report on NHS workforce planning concluded that there had been a "disastrous failure" of planning, in part because of a "clear lack of alignment" between domestic training and active international recruitment.

It recommended that the Department of Health "needs to work more effectively with other departments, notably the Home Office, to ensure that international recruitment is fair and consistent."

Yet little appears to have changed, say Buchan and Charlesworth - except NHS funding is tighter, and staff shortages are now more pronounced.

"While there have been glib statements about the UK achieving "self sufficiency" in doctors and nurses, if this means ending reliance on international recruits "then it is unlikely to happen in the foreseeable future, given current high vacancy rates, the ageing of the NHS domestic workforce, and retention indicators showing no substantial improvement," they argue.

In the meantime, they point out that the UK continues to be heavily reliant on international doctors, while a combination of Brexit and a hardening stance on immigration may leave the UK vulnerable.

The simple truth is there is no overall government policy, published plan, or immediate likelihood of UK self-sufficiency in doctors or nurses, they write.

"What we need is a joined up and strategic approach to international recruitment of health professionals, involving government health departments, the Home Office, regulators and employers, which is embedded in overall national health workforce planning," they conclude.

NEW YORK (June 13, 2018)-- An age-old challenge of determining the right amount of fish to harvest from the sea has finally been overcome with the creation of a new biomass-yield model that captures all the necessary factors for accuracy, according to a new WCS (Wildlife Conservation Society) study.

The study titled "Multicriteria estimate of coral reef fishery sustainability" appears online in the journal Fish and Fisheries.

Knowing the highest volume of fish that can be taken from coral reefs without harming these ecosystems (known as the maximum sustainable yield) has been elusive for many reasons. Among the largest difficulties has been determining accurate estimates of recovery rates of coral reef fish populations that have been fished. Another has been confirming predictions through long-term study of the stability of coral reef catches.

A 20-year study undertaken by WCS (Wildlife Conservation Society) appears to have filled these gaps, capturing information on fishing effort, yields, reef ecology, and the previously missing variables of accurate recovery rate estimates and coral reef catch stability. These new findings have been plugged into a mathematical model that can now accurately predict actual catches, giving confidence to the new numbers.

"It took so long because the missing variables required studying the recovery of fish in reefs where all fishing was banned, as well as measuring fish catches long enough to know if their catches were stable," said Dr. Tim McClanahan, the study's sole author and a Senior Conservation Scientist for WCS. "Both bits of information required 20 years of field studies to be confident in the numbers and their conclusions."

Conserving ecologically functional coral reef systems requires maintaining healthy fish populations and ensuring the ecosystems do not change radically under fishing pressure, and monitoring both fish and changes to their populations due to fishing requires long-term data sets. The newly published study used decades of fishing data gathered from artisanal fisheries in 10 different locations along the heavily but variably fished coastline of Kenya.

Among the many criteria used in this study was information on the state of the ecosystem for different levels of fish biomass, which provides a holistic basis for making recommendations for managing the reefs.

"Fishing sustainably is increasingly becoming critical given the emerging number of ecological challenges facing coral reefs, with climate change, ocean warming and acidification being the best known," said McClanahan. "Sustainably managing fish populations in coral reef systems is one of the few ways to fight the threats that climate pose for coral reefs. And now that we have some clear goals, we can aim for them and limit future damage."

Calibrating the model with the new data, McClanahan found that, in waters where fishable biomass was approximately 20 metric tons per square kilometer, all yields exceeding six metric tons declined at a rate of 2.5 percent annually--a small number that would be hard to detect without a long study. The author concluded that fish biomass would need to be increased to 50 metric tons per square kilometer to achieve the six-metric ton threshold proposed as the maximum sustainable yield.

McClanahan added: "While this took many years of study, I am hopeful that it provides a rigorous benchmark that can be tested and applied to other seascapes in the Indian and Pacific Oceans."

A new study from the University of Waterloo discovered that rising sea levels could be accelerated by vulnerable ice shelves in the Antarctic.

The study, by an international team of polar scientists led by Canada Research Chair Christine Dow of Waterloo's Faculty of Environment, discovered that the process of warmer ocean water destabilizing ice shelves from below, is also cracking them apart from above, increasing the chance they'll break off.

"We are learning that ice shelves are more vulnerable to rising ocean and air temperatures than we thought," said Dow. "There are dual processes going on here. One that is destabilizing from below, and another from above. This information could have an impact on our projected timelines for ice shelf collapse and resulting sea level rise due to climate change."

The study, which was conducted over two years, applied methods similar to forensic science on ice shelves which had already calved. Using radar surveys and Landsat imagery, Dow reports direct evidence that a major 2016 calving event at Nansen Ice Shelf in the Ross Sea was the result of fracture driven by channels melted into the bottom of the ice shelf. The surveys also demonstrated that similar basal channel-driven transverse fractures occur elsewhere in Greenland and Antarctica.

As warmer salt water erodes channels into the ice that attaches glaciers to stable land, it also generates massive vertical fractures splitting glaciers from above and below. Surface water melting on top of the ice shelves then pours into these cracks, accelerating the problem further.

"This study is more evidence that the warming effects of climate change are impacting our planet in ways that are often more dangerous than we perhaps had thought," said Dow. "There are many more vulnerable ice shelves in the Antarctic that, if they break up, will accelerate the processes of sea level rise."