sábado, 27 de mayo de 2017

Hospitals Vary in Moving Stroke Patients to Comfort or Hospice Care: MedlinePlus Health News

Hospitals Vary in Moving Stroke Patients to Comfort or Hospice Care: MedlinePlus Health News

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Hospitals Vary in Moving Stroke Patients to Comfort or Hospice Care

Study found doctors more apt to suggest it sooner for older, white, female and uninsured patients
By Robert Preidt
Thursday, May 25, 2017
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THURSDAY, May 25, 2017 (HealthDay News) -- U.S. hospitals differ greatly in how often they move new stroke patients from treatment to comfort or hospice care, researchers report.
Comfort care refers to medical care designed to ease suffering for a patient near death.
"End-of-life and palliative care plays an important role with stroke, since the death rate is high, yet there has been limited data on the transition from treatment to comfort care," said study author Dr. Shyam Prabhakaran. He is a professor of neurology and medical social sciences at Northwestern University Feinberg School of Medicine in Chicago.
Prabhakaran and his colleagues analyzed data from nearly 1 million people treated for stroke in 1,675 hospitals between 2009 and 2013. About 55,000 had doctor's orders for comfort care only.
Overall, 5.6 percent of the patients were moved to comfort care only. But the rate varied widely among hospitals, from 0.6 percent to 37.6 percent, the study showed.
The percentage of patients who were moved to early comfort care fell over the four-year study period, from 6.1 percent to 5.4 percent, the study found.
Patients with bleeding strokes were more likely to be moved sooner to comfort care than those whose strokes were caused by blocked blood flow to the brain. Patients with bleeding strokes have higher risk of death, the researchers said.
Patients who were older, female, white, unable to walk and uninsured or covered by Medicaid were also more likely to have early comfort orders, as were those who arrived at the hospital during off-hours or by ambulance, the study found.
The findings were published online May 24 in the journal Neurology Clinical Practice.
"The use of early comfort care varies widely between hospitals and is influenced by stroke type as well as the characteristics of both the hospitals and the people who are hospitalized," Prabhakaran said in a journal news release. More study is needed to learn how such decisions are made, he added.
In an accompanying editorial, Dr. Robert Holloway, a neurologist at the University of Rochester Medical Center in New York, noted that severe stroke leads to a series of intense discussions among doctors, patients and families. Those talks center on what health states are acceptable or unacceptable and what makes life worth living, he wrote.
"This study gives us insights into how these transitions are happening and will stimulate discussion about how we can improve this process to help ensure that care is high quality and consistent with the patient's goals," Holloway stated.
SOURCE: Neurology Clinical Practice, news release, May 24, 2017
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News stories are written and provided by HealthDay and do not reflect federal policy, the views of MedlinePlus, the National Library of Medicine, the National Institutes of Health, or the U.S. Department of Health and Human Services.
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Are All Those 'Fidget Spinners' Really Helping Kids?: MedlinePlus Health News

Are All Those 'Fidget Spinners' Really Helping Kids?: MedlinePlus Health News

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Are All Those 'Fidget Spinners' Really Helping Kids?

Hot toy is probably more of a distraction than a help in the classroom, experts say
Thursday, May 25, 2017
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THURSDAY, May 25, 2017 (HealthDay News) -- Fidget spinners may be the latest must-have kids' toy, but claims that the gizmos help students pay attention aren't backed by science, experts say.
Some retailers market the devices as a way to help kids with anxiety, autism or attention deficit hyperactivity disorder (ADHD) keep themselves calm and focused in the classroom.
However, there have been no studies showing that fidget spinners benefit kids struggling to stay still, said Chicago psychiatrist Dr. Louis Kraus.
"To the best of my knowledge, there's no science behind what they're advertising," said Kraus, chief of child and adolescent psychiatry for the Rush University Medical Center.
"Without any research to show it's of benefit, I think it's wrong for them to advertise these things as helpful," he said.
The claims likely are based on small-scale studies that show kids with ADHD pay better attention if they are allowed to fidget, said Dr. Matthew Lorber, a child and adolescent psychiatrist at Lenox Hill Hospital in New York City.
"They actually perform better because it indirectly forces the brain to work harder to focus on the task at hand," Lorber said.
But the lead researcher behind one ADHD/fidgeting study says fidget spinners probably are too interesting and fun to be much help in classrooms.
Fidgeting can help kids pay attention, said Julie Schweitzer, a professor of psychiatry and behavioral sciences at the MIND Institute of the University of California, Davis.
However, "school work is probably a lot less interesting than playing with the toy," Schweitzer said. "You're looking at competing activities here. It seems to me that it would be more distractive than helpful."
In her June 2015 study in the journal Child Neuropsychology, Schweitzer found that kids with ADHD who fidgeted and squirmed more intensely wound up performing better on a test that required their attention.
However, those kids were stirring in their seats, not fiddling with a toy, Schweitzer said.
The palm-size devices whirl much like a fan or helicopter, and they seem to be everywhere these days.
Since they're hand-held, fidget spinners could get in the way of kids completing class work, said Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at Cohen Children's Medical Center in New Hyde Park, N.Y.
"I worry that children will focus on their spinners instead of what they are supposed to be paying attention to," Adesman said. "Moreover, students cannot take notes or other written assignments if they are playing with them."
Fidget spinners might benefit autistic children who use "sensory stimulation behaviors" to calm their anxiety, said Thomas Frazier, chief science officer at Autism Speaks.
These children engage in behaviors such as jumping, flapping their hands or spinning around. "Fidgeting with a fidget spinner as a replacement for that behavior might be a little less stigmatizing," Frazier said. Unfortunately, the toys also could distract the kids from class work.
Fidget spinners might best be used to reward children with autism for good behavior, Frazier said.
"If they pay attention and they complete an assignment and get access to the fidget spinner, it could be really reinforcing for them," he said. "Then they'd be more likely to finish their work next time."
Many schools are banning fidget spinners from the classroom as unnecessary distractions. Lorber recently spoke at a private school in Brooklyn, N.Y., that had taken that step.
"Certainly without question, it becomes a distraction to the class, to the point where teachers and even school systems are not allowing them," Kraus said. "You're going to find that more and more schools aren't going to allow them."
Adesman thinks the fad will be short-lived. "In my view, fidget spinners are just a new craze among children and their appeal will pass with time," he said.
There are other potential methods to help kids fidget in a productive way while in school, Schweitzer said, and these should be explored.
Allowing kids to chew gum might provide enough nonspecific motor activity to keep them focused but not distracted, Schweitzer said. In addition, some schools have tried attaching Velcro strips to desks, to give kids something to stroke and touch during class that doesn't grab their attention.
"If you could find something that doesn't interfere with their learning and attention, that would be best," Schweitzer said.
SOURCES: Louis Kraus, M.D., chief, child and adolescent psychiatry, Rush University Medical Center, Chicago; Matthew Lorber, M.D., child and adolescent psychiatrist, Lenox Hill Hospital, New York City; Julie Schweitzer, Ph.D., professor, psychiatry and behavioral sciences, MIND Institute, University of California, Davis; Andrew Adesman, M.D., chief, developmental and behavioral pediatrics, Cohen Children's Medical Center, New Hyde Park, N.Y.; Thomas Frazier, Ph.D., chief science officer, Autism Speaks
HealthDay
News stories are written and provided by HealthDay and do not reflect federal policy, the views of MedlinePlus, the National Library of Medicine, the National Institutes of Health, or the U.S. Department of Health and Human Services.
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Do Daughters Bring Out a Dad's 'Softer Side'?: MedlinePlus Health News

Do Daughters Bring Out a Dad's 'Softer Side'?: MedlinePlus Health News

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Do Daughters Bring Out a Dad's 'Softer Side'?

Study found men raising toddlers were more responsive, emotional with girls than boys
Thursday, May 25, 2017
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THURSDAY, May 25, 2017 (HealthDay News) -- Mom, it's not all in your head: Dad does respond to toddler daughters and sons differently. Brain scans and random recordings of their times together prove it.
Fathers are not only more attentive to little girls, a new study finds, they're also more accepting of their feelings. Dads sing more to their daughters, play harder with their sons and speak to their little ones in strikingly different -- and important -- ways.
"The really interesting and significant thing to me is these differences are showing up very early," said lead researcher Jennifer Mascaro. She is an assistant professor in family and preventive medicine at Emory School of Medicine in Atlanta. "We really need to think about unintended [gender] biases that we may have in our interactions."
The researchers wanted to learn if different brain responses to boys and girls might affect how dads treat their sons and daughters.
The new study doesn't resolve whether those brain differences mean fathers are hardwired to treat sons and daughters differently or if they are simply trying to behave as they think society expects them to, Mascaro said. But it offers an unfiltered look at how fathers behave with their 1- and 2-year-olds, and some lessons for parents.
For the study, researchers asked 52 dads to clip a small computer to their belts for 48 hours. The device turned on randomly to record their daily interactions with their toddlers -- 30 girls and 22 boys.
The recordings show dads responding swiftly and supportively when their daughters were sad or anxious, but paying less attention to their sons' feelings.
"When a child is expressing emotions -- rather than ignore it or try to distract them or try to undermine some of those really intense feelings -- validating those emotions, naming them and having the child sit with those emotions and identify them on their own is important," Mascaro said. "The idea that fathers and other adults are doing that less with boys is really important."
How dads talked to their toddlers differed, too.
With their sons, they used the language of achievement -- words like "proud," "win" and "top." With their daughters, they coaxed more complex chat with words like "all," "below" and "much" -- analytical language tied to future academic success.
Dads of girls also were more likely to refer to their daughter's body in conversation. That intrigued the researchers, because body stigma takes root in early childhood and girls are more apt than boys to say they are unhappy with the way they look.
In addition to the recordings, dads also had brain scans while viewing photos of their kids.
Although their brains reacted the same to sad-faced photos of their boys and girls, daughters' smiles elicited stronger responses in areas of the brain key to visual processing, reward and emotion control, the study found. That meshes with other studies suggesting fathers are more apt to link happiness with girls.
One finding researchers didn't expect: Dads' brains lit up when they saw pictures of their sons with neutral expressions, ones whose meaning hinges on context. Researchers suspect it's because dads get a kick out of roughhousing. That's a time when their boys' faces probably have just such an expression.
An expert on parent-child communication who was told of the study called it "very exciting work," but cautioned against easy explanations.
Makeba Parramore Wilbourn, an assistant professor of psychology and neuroscience at Duke University in Durham, N.C., said cultural influences rather than biology probably underpin the way fathers behaved.
"Though we might get clear scans of the brain, behavior is complex and it's important for us not to lose sight of that and to remember that there are a lot of factors playing a role," Wilbourn said.
Mascaro agreed, adding further study is needed.
"I think it would be overstepping it to say we can make any predictions about how these differences would play out in the life of a child," she said.
Both suggested, however, that girls develop empathy because they are encouraged to express their emotions, which would also benefit boys. Suppressing their feelings can do lasting harm: It makes grown men feel depressed, isolated and dissatisfied with their marriages, studies have shown.
Fathers, meanwhile, might want to consider more rough-and-tumble play with their little girls -- not only because it's fun, but because it helps kids manage their emotions, according to the study.
Being there for your kids is what matters most, Wilbourn said.
"If I had to pick, I don't care what a dad is saying as long as he's there and saying something," she said. "The most important thing for dads and moms to recognize is that kids need your presence."
The study was published online May 25 in the journal Behavioral Neuroscience.
More information
The American Psychological Association has tips for building healthy parent-child relationships.
SOURCES: Jennifer Mascaro, Ph.D., assistant professor, family and preventive medicine, Emory School of Medicine, Atlanta; Makeba Parramore Wilbourn, Ph.D., assistant professor, psychology and neuroscience, Duke University, Durham, N.C.; May 25, 2017, Behavioral Neuroscience, online
HealthDay
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Teasing Teens About Weight May Do Lasting Harm: MedlinePlus Health News

Teasing Teens About Weight May Do Lasting Harm: MedlinePlus Health News

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Teasing Teens About Weight May Do Lasting Harm

They're more likely to be obese and struggle with emotional eating as adults, research finds
By Mary Elizabeth Dallas
Thursday, May 25, 2017
THURSDAY, May 25, 2017 (HealthDay News) -- Teens who are taunted about their weight may be more likely to become obese adults who struggle with poor body image, a new study finds.
Researchers also found that teens who are bullied about their weight are more likely to become emotional eaters. Teen bullies often target peers' weight, but weight-based teasing can also occur at home.
"Our findings suggest the need for broader anti-bullying initiatives that include both the school and family/home environments as targets for intervention," lead author Rebecca Puhl said in a University of Connecticut news release.
Puhl is a professor and deputy director of the university's Rudd Center for Food Policy & Obesity.
The researchers found that teens who face insults about their weight not only may be upset at the time, they may face serious long-term consequences, including obesity as well as unhealthy dieting and eating habits.
The study involved nearly 1,800 adults. They were tracked for 15 years, from their teens into their early 30s. Men and women who were teased about their weight as teens were both about twice as likely to be obese in adulthood.
Women who were teased as teens were more likely to eat in response to stress and engage in other unhealthy weight-control measures as adults, the study found. They were also more likely to have a poor body image and were more likely to diet.
Men who had been teased about their weight as teens were also less satisfied with their bodies and were more likely to engage in emotional eating.
Over the long term, women were more affected than men by weight-based teasing from family members, the researchers said.
The researchers stressed that children and teens who may be teased need support.
"Health professionals working with youth and families may have unique opportunities to assess youth for their experiences of weight-based teasing, educate parents about the damaging health consequences of teasing, and offer families resources to support children and help them cope with weight-based teasing using healthy, effective strategies," said study co-author Dianne Neumark-Sztainer.
She is head of the University of Minnesota School of Public Health's Division of Epidemiology and Community Health.
The study was published recently in the journal Preventive Medicine.
SOURCE: University of Connecticut, news release, May 2017
HealthDay
News stories are written and provided by HealthDay and do not reflect federal policy, the views of MedlinePlus, the National Library of Medicine, the National Institutes of Health, or the U.S. Department of Health and Human Services.
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Haywire Immune Cells May Help Cause Baldness: MedlinePlus Health News

Haywire Immune Cells May Help Cause Baldness: MedlinePlus Health News

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Haywire Immune Cells May Help Cause Baldness

Cells that fight inflammation also play role in hair growth, mice study finds
By Robert Preidt
Thursday, May 25, 2017
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THURSDAY, May 25, 2017 (HealthDay News) -- Faulty immune cells may play a role in hair loss, a new study suggests.
In experiments with mice, researchers found that regulatory T-cells ("Tregs") -- a type of immune cell that helps control inflammation -- trigger stem cells in the skin to promote hair growth.
If Tregs are missing, those stem cells can't regenerate hair follicles, the University of California, San Francisco team found.
"Our hair follicles are constantly recycling: when a hair falls out, the whole hair follicle has to grow back," study senior author Dr. Michael Rosenblum said in a university news release.
"This has been thought to be an entirely stem cell-dependent process, but it turns out Tregs are essential. If you knock out this one immune cell type, hair just doesn't grow," he explained.
Rosenblum is an assistant professor of dermatology and is also an immunologist.
The findings suggest that defects in Tregs could cause alopecia areata, a common autoimmune disorder that leads to hair loss, and may also be a factor in other forms of baldness, including male pattern baldness, according to Rosenblum.
While research with animals often doesn't produce similar results in humans, the study authors suggested that better understanding of Tregs' role in hair growth could one day lead to improved treatments for hair loss in people.
In addition, the study adds to a growing sense that immune cells play a bigger role than once thought. The same follicle stem cells are involved in regenerating injured skin, and Rosenblum plans to investigate whether Tregs in the skin may also have a big part in wound repair.
"We think of immune cells as coming into a tissue to fight infection, while stem cells are there to regenerate the tissue after it's damaged," he said. "But what we found here is that stem cells and immune cells have to work together to make regeneration possible."
The study appears online May 26 in the journal Cell.
SOURCE: University of California, San Francisco, news release, May 25, 2017
HealthDay
News stories are written and provided by HealthDay and do not reflect federal policy, the views of MedlinePlus, the National Library of Medicine, the National Institutes of Health, or the U.S. Department of Health and Human Services.