|
|
|
|
|
| ||
|
March 1, 2010 — Embargoed ContentJAMA news releases are made available to the public after 3 pm US Central time on the first 4 Tuesdays of each month. The Archives of Journals news releases are made available to the public after 3 pm Central time on Mondays. We also provide a list of previous news releases. ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE NEWS RELEASES
Complete Table of Contents
(Embargoed Until: 3 P.M. (CT), Monday, March 1, 2010)
ARCHIVES OF GENERAL PSYCHIATRY NEWS RELEASES
Complete Table of Contents
(Embargoed Until: 3 P.M. (CT), Monday, March 1, 2010)
INFORMATION CONTAINED IN THESE NEWS RELEASES IS PROTECTED BY COPYRIGHT. JOURNAL ATTRIBUTION IS REQUIRED. JOURNALISTS CAN NOW ACCESS EMBARGOED JAMA/ARCHIVES STUDIES ON-LINE. Go to www.jamamedia.org for more information and to apply for access. Please Note: The FOR THE MEDIA website now has a search feature to enable media to find previous JAMA/Archives news releases on specific medical topics. This search feature link is located on the home page at www.jamamedia.org EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, March 1, 2010
Infants Do Not Appear to Learn Words from Educational DVDs
CHICAGO—Among 12- to 24-month old children who view educational baby videos, there does not appear to be evidence that overall general language learning improves or that words featured in the programming are learned, according to a report posted online today that will appear in the May print issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals. Children age 2 and younger spend an estimated two hours per day exposed to media on a screen, and the average age at which infants begin watching programming designed for their age group is five months, according to background information in the article. Manufacturers' claims that these infant-directed media can teach children specific vocabulary words have not been substantiated. Rebekah A. Richert, Ph.D., and colleagues at the University of California, Riverside, studied vocabulary acquisition among 96 children age 12 to 24 months. Participants were tested on measures of vocabulary and general development, and their primary caregivers (77 mothers, seven fathers and four others) answered a series of questions about their children's development and previous exposure to educational media. Half of the children were then given an educational DVD to watch in their homes. When additional tests were conducted after six weeks, there was no evidence children learned the words specifically highlighted in the DVDs, and watching the DVDs was unrelated to measures of general language learning. However, children whose parents reported that they began watching infant DVDs at an early age scored lower on a test of vocabulary knowledge. The association between early DVD viewing and delays in language development could have several explanations, the authors note: "Parents who are concerned about their children's poor language abilities may use baby DVDs to try to teach their children, parents who use baby DVDs early may be less likely to engage in behaviors that promote language development or early viewing of baby DVDs may actually impair language development," they write.
"We conclude by encouraging researchers, parents, practitioners and programmers to consider the variety of cognitive factors related to whether very young viewers should be expected to learn from a DVD, regardless of DVD intent. Many cognitive factors play a role in learning from screens at this age, including children's developing perceptual systems, their understanding of symbols and analogy and their developing abilities to discriminate how much they should trust different sources of information," the authors continue. "Given that infant-directed media have become nearly ubiquitous aspects of many infants' lives, future research should continue to examine whether and how parents can use these DVDs effectively to teach their young children."
Editor's Note: This research was funded by a grant from the National Science Foundation. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc. For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org. EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, March 1, 2010
Teens With More Screen Time Have Lower-Quality Relationships
CHICAGO—Teens who spend more time watching television or using computers appear to have poorer relationships with their parents and peers, according to a report in the March issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals. Over the past 20 years, teens have used an ever-expanding array of screen-based tools for communication and entertainment, according to background information in the article. "The availability and attractiveness of screen time activities has provoked excitement about the opportunities afforded by these options, as well as concern about whether these displace other activities that are important for health and development," the authors write. "One area of interest is how screen time may affect the quality of relationships with family and friends." Rosalina Richards, Ph.D., of the University of Otago, Dunedin, New Zealand, and colleagues studied 3,043 adolescents age 14 to 15 in 2004. The teens completed a confidential questionnaire about their free-time habits, as well as an assessment of their attachment to parents and peers. Overall, the more time teens spent watching television or playing on a computer, the more likely they were to report low attachment to parents (in other words, difficulty forming a relationship or emotional bond). The risk of having low attachment to parents increased 4 percent for every hour spent viewing television and 5 percent for every hour spent playing on a computer. Conversely, teens who spend more time reading and doing homework reported a higher level of attachment to parents. The researchers also assessed interview responses from 976 individuals who were age 15 years in 1987 to 1988. Among these teens, more time spent viewing television was associated with lower attachment to both parents and peers. For every additional hour of television, teens had a 13 percent increased risk of low attachment to their parents and a 24 percent increased risk of low attachment to peers. "Recommendations that children watch less television are sometimes met with the concern that being unable to discuss popular shows or characters may inhibit peer relationships," the authors write. "The findings herein do not suggest that less television viewing is detrimental to adolescent friendships." There are several potential mechanisms underlying the relationship between increased screen time and poorer relationships, they note. For instance, teens who have televisions in their bedroom not only spent more time watching but also may share fewer meals with family members. "However, it is also possible that adolescents with poor attachment relationships with immediate friends and family use screen-based activities to facilitate new attachment figures such as online friendships or parasocial relationships with television characters or personalities," the authors write.
"Given the importance of attachment to parents and peers in adolescent health and development, concern about high levels of screen time among adolescents is warranted," they conclude. "With the rapid advance of screen-based options for entertainment, communication and education, ongoing research is needed to monitor the effect that these technologies have on social development and psychological and physical well-being among adolescents."
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc. For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org. EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, March 1, 2010
Parents Whose Children Are Dying of Cancer May Consider Hastening the Process
Additional articles in Archives of Pediatrics & Adolescent Medicine examine treatments, outcomes among children with cancer CHICAGO—In a study of 141 parents whose children have died of cancer, more than 10 percent reported that they considered hastening their child's death, especially if the child was in pain, according to a report in the March issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals. The article is one of several in the issue focusing on childhood cancers, and is being published in conjunction with a JAMA theme issue on cancer. The March issues of Archives of Neurology, Archives of Internal Medicine, Archives of Ophthalmology, Archives of Dermatology, Archives of Surgery, Archives of Facial Plastic Surgery and Archives of Otolaryngology—Head & Neck Surgery will also publish articles on this theme. In one article, Veronica Dussel, M.D., M.P.H., of the Dana Farber Cancer Institute and Children's Hospital, Boston, and colleagues interviewed 141 parents of children who had died of cancer between 1990 and 1999. In addition to discussing their own child's life and death, the parents were asked to respond to a series of vignettes portraying children with end-stage cancer. A total of 19 of 141 parents (13 percent) reported that they had considered requesting that their children's death be hastened and 9 percent had discussed it. Consideration of hastening death appeared to increase as the child's reported pain increased; about one-third (34 percent) of parents said that they would have considered hastening death had their child been in uncontrollable pain. In response to vignettes, half of parents endorsed hastening death, whereas 94 percent endorsed intensive pain management.
"If physical suffering is identified, our results suggest that parents are willing to have an open discussion about existing options including effective and legal alternatives such as proportionately intensive symptom management and palliative sedation. Desires for hastened death may represent an exit plan to be used if no other alternatives are recognized," the authors conclude. "Attention to pain and suffering and education about intensive symptom management may mitigate consideration of hastening death among parents of children with cancer."
Other studies featured in this issue include the following: Clinical Trial Participation Alone May Not Be Associated With Improved Outcomes for Childhood Cancer Patients
Children with the most common childhood cancer did not experience improved outcomes from participating in a clinical trial between 1997 and 2005. Carl Koschmann, M.D., and colleagues at the University of Washington and Seattle Children's Hospital studied 322 patients with newly diagnosed acute lymphoblastic leukemia (a cancer involving the white blood cells), approximately half of whom participated in one of several available clinical trial protocols for the disease. Overall, 79 percent of the patients survived five years without recurrence of their leukemia, with no significant difference between study participants and non-participants (80 percent vs. 77 percent). "Clinical trial participation does not, by itself, lead to improved outcome for pediatric patients with acute lymphoblastic leukemia in the current era," the authors conclude. "Discussions about participation in a clinical trial should focus on improvement of future therapy, not the direct benefit of the research participant."
"Considerable evidence indicates that clinical trials are associated with substantial benefits as measured by both public health and economic gains," writes Steven Joffe, M.D., M.P.H., of the Dana-Farber Cancer Institute, Boston, in an accompanying editorial. "In the modern era, five-year survival rates for children with acute lymphoblastic leukemia are 80 percent to 90 percent. It is likely that these remarkable outcomes owe much not only to the legacy of treatment insights derived from past trials, but also to the happy side effect of improved quality attributable to the existence of a cooperative clinical trials program and infrastructure in the settings in which most children with cancer receive their care."
Children and Teens Less Likely Than Young Adults to Die of Non-Hodgkin's Lymphoma
Young adults diagnosed with non-Hodgkin's lymphoma appear to have a higher risk of dying from the disease than do children and teens. Eric Tai, M.D., and colleagues at the Centers for Disease Control and Prevention, Atlanta, assessed survival information from cancer registries from 1992 to 2001 for 2,442 cases of non-Hodgkin's lymphoma (one of the most common cancers among young adults, affecting the white blood cells). This included 987 children and teens age 19 or younger and 1,455 young adults age 20 to 29. Even after accounting for the subtype of the disease and the stage at diagnosis, young adults were more likely to die compared with children and adolescents. A total of 87 percent of children and teens survived 24 months compared with 79 percent of young adults, and five-year survival rates were 85 percent for children and teens and 75 percent for young adults.
Overall, "our study showed that non-Hodgkin's lymphoma survival has increased over time, with smaller gains made by young adults compared with children and adolescents," the authors conclude. "Increased survival among patients with non-Hodgkin's lymphoma is dependent on timely and appropriate cancer therapy. Therefore, efforts to address survival should include increasing the number of clinical trials for young adults, encouraging them to enroll in these trials and promoting improved access to care for this population."
Study Explores End-of-Life Experiences of Children With Brain Tumors
Parents and clinicians caring for children with brain tumors may experience significant challenges near the end of life due to the neurologic deterioration that often occurs in these patients. Shayna Zelcer, M.D., F.R.C.P.C., of Children's Hospital, London Health Sciences Center, Ontario, Canada, and colleagues conducted a qualitative analysis of focus group interviews involving 25 parents of 17 children who had died of brain tumors. The analysis identified three primary themes. The first was that parents described their child's dying path as characterized by progressive neurologic deterioration. Loss of communication ability was a key turning point, and parents coped by striving to maintain normality and finding strength through hope and the resilience of their child. The second theme identified common parental struggles: balancing competing responsibilities and talking with their children about death. The third theme was that parents who wanted their child to die at home faced barriers, including inadequate symptom control, financial and practical hardships and a lack of community support.
"We hope this report will increase the awareness of health care professionals concerning the challenges these families face and the need for anticipatory guidance and education of patients and families early in the course of illness," the authors conclude.
Editor's Note: Please see the articles for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, March 1, 2010
Having Greater Purpose in Life Associated With a Reduced Risk of Alzheimer's Disease
CHICAGO—Individuals who report having greater purpose in their lives appear less likely to develop Alzheimer's disease or its precursor, mild cognitive impairment, according to a report in the March issue of Archives of General Psychiatry, one of the JAMA/Archives journals. "Alzheimer's disease is one of the most dreaded consequences of aging, and the identification of modifiable factors associated with the risk of Alzheimer's disease is a top public health priority for the 21st century, particularly given the large and rapidly increasing aging population," the authors write as background information in the article. Relatively few of these risk factors have been identified, but data suggest that some psychological factors—including conscientiousness, extraversion and neuroticism—may be associated with Alzheimer's disease risk. "Purpose in life, the psychological tendency to derive meaning from life's experiences and to possess a sense of intentionality and goal directedness that guides behavior, has long been hypothesized to protect against adverse health outcomes," write Patricia A. Boyle, Ph.D., and colleagues at Rush University Medical Center, Chicago. The researchers assessed this quality in more than 900 community-dwelling older adults without dementia who were participating in the Rush Memory and Aging Project. Participants' purpose in life was measured by their level of agreement with statements such as, "I feel good when I think of what I have done in the past and what I hope to do in the future" and "I have a sense of direction and purpose in life." After an average of four years and a maximum of seven years of annual follow-up clinical evaluations, 155 of 951 participants (16.3 percent) developed Alzheimer's disease. After controlling for other related variables, greater purpose in life was associated with a substantially reduced risk of developing Alzheimer's disease, as well as a reduced risk of mild cognitive impairment and a slower rate of cognitive decline. Specifically, individuals with a score of 4.2 out of 5 (90th percentile) on the purpose in life measure were approximately 2.4 times more likely to remain free of Alzheimer's disease than individuals with a score of 3.0 (10th percentile). The biological basis of the association is unknown, but may result from the positive effects purpose of life is reported to have on immune function and blood vessel health, the authors suggest.
The result may have public health implications. "In particular, these findings may provide a new treatment target for interventions aimed at enhancing health and well-being in older adults. Purpose in life is a potentially modifiable factor that may be increased via specific behavioral strategies that help older persons identify personally meaningful activities and engage in goal-directed behaviors," the authors continue. "Even small behavioral modifications ultimately may translate into an increased sense of intentionality, usefulness and relevance."
Editor's Note: This work was supported by grants from the National Institute on Aging, by the Illinois Department of Public Health and by the Robert C. Borwell Endowment Fund. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc. For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, March 1, 2010
Long-Time Cannabis Use Associated With Psychosis
CHICAGO—Young adults who have used cannabis or marijuana for a longer period of time appear more likely to have hallucinations or delusions or to meet criteria for psychosis, according to a report posted online today that will appear in the May print issue of Archives of General Psychiatry, one of the JAMA/Archives journals. Previous studies have identified an association between cannabis use and psychosis, according to background information in the article. However, concerns remain that this research has not adequately accounted for confounding variables. John McGrath, M.D., Ph.D., F.R.A.N.Z.C.P., of the Queensland Centre for Mental Health Research, Park Centre for Mental Health, Wacol, Australia, and colleagues studied 3,801 young adults born between 1981 and 1984. At a 21-year follow-up, when participants were an average age of 20.1, they were asked about cannabis use in recent years and assessed using several measures of psychotic outcomes (including a diagnostic interview, an inventory of delusions and items identifying the presence of hallucinations). At the 21-year follow-up, 17.7 percent reported using cannabis for three or fewer years, 16.2 percent for four to five years and 14.3 percent for six or more years. Overall, 65 study participants received a diagnosis of "non-affective psychosis," such as schizophrenia, and 233 had at least one positive item for hallucination on the diagnostic interview. Among all the participants, a longer duration since the first time they used cannabis was associated with multiple psychosis-related outcomes. "Compared with those who had never used cannabis, young adults who had six or more years since first use of cannabis (i.e., who commenced use when around 15 years or younger) were twice as likely to develop a non-affective psychosis and were four times as likely to have high scores on the Peters et al Delusions Inventory [a measure of delusion]," the authors write. "There was a 'dose-response' relationship between the variables of interest: the longer the duration since first cannabis use, the higher the risk of psychosis-related outcomes." In addition, the researchers assessed the association between cannabis use and psychotic symptoms among a subgroup of 228 sibling pairs. The association persisted in this subgroup, "thus reducing the likelihood that the association was due to unmeasured shared genetic and/or environmental influences," the authors continue. "The nature of the relationship between psychosis and cannabis use is by no means simple," they write. Individuals who had experienced hallucinations early in life were more likely to have used cannabis longer and to use it more frequently. "This demonstrates the complexity of the relationship: those individuals who were vulnerable to psychosis (i.e., those who had isolated psychotic symptoms) were more likely to commence cannabis use, which could then subsequently contribute to an increased risk of conversion to a non-affective psychotic disorder."
The findings should encourage further research to elucidate the mechanisms underlying the relationship between psychosis and cannabis use, the authors conclude.
Editor's Note: This work was funded by the National Health and Medical Research Council of Australia. Co-author Dr. Alati is funded by a National Health and Medical Research Council Career Development Award in Population Health. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc. For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, March 1, 2010
Obesity Associated With Depression and Vice Versa
CHICAGO—Obesity appears to be associated with an increased risk of depression, and depression also appears associated with an increased risk of developing obesity, according to a meta-analysis of previously published studies in the March issue of Archives of General Psychiatry, one of the JAMA/Archives journals. "Both depression and obesity are widely spread problems with major public health implications," the authors write as background information in the article. "Because of the high prevalence of both depression and obesity, and the fact that they both carry an increased risk for cardiovascular disease, a potential association between depression and obesity has been presumed and repeatedly been examined." Understanding the relationship between the two conditions over time could help improve prevention and intervention strategies. Floriana S. Luppino, M.D., of Leiden University Medical Center and GGZ Rivierduinen, Leiden, the Netherlands, and colleagues analyzed the results of 15 previously published studies involving 58,745 participants that examined the longitudinal (over time) relationship between depression and overweight or obesity. "We found bidirectional associations between depression and obesity: obese persons had a 55 percent increased risk of developing depression over time, whereas depressed persons had a 58 percent increased risk of becoming obese," the authors write. "The association between depression and obesity was stronger than the association between depression and overweight, which reflects a dose-response gradient." Sub-analyses demonstrated that the association between obesity and later depression was more pronounced among Americans than among Europeans, and stronger for diagnosed depressive disorder compared with depressive symptoms. Evidence of a biological link between overweight, obesity and depression remains uncertain and complex, but several theories have been proposed, the authors note. Obesity may be considered an inflammatory state, and inflammation is associated with the risk of depression. Because thinness is considered a beauty ideal in both the United States and Europe, being overweight or obese may contribute to body dissatisfaction and low self-esteem that places individuals at risk for depression. Conversely, depression may increase weight over time through interference with the endocrine system or the adverse effects of antidepressant medication.
The findings are important for clinical practice, the authors note. "Because weight gain appears to be a late consequence of depression, care providers should be aware that within depressive patients weight should be monitored. In overweight or obese patients, mood should be monitored. This awareness could lead to prevention, early detection and co-treatment for the ones at risk, which could ultimately reduce the burden of both conditions," they conclude.
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc. For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, March 1, 2010
Offspring of Parent Couples Who Both Have Psychiatric Illness Have Increased Risk of Developing Mental Disorders
CHICAGO—Offspring of two parents with schizophrenia or bipolar disorder appear more likely to develop the same illness or another psychiatric condition than those with only one parent with psychiatric illness, according to a report in the March issue of Archives of General Psychiatry, one of the JAMA/Archives journals. The offspring of two parents with psychiatric illness represent an extremely high-risk group, according to background information in the article. Studying these children permits researchers to assess the risk associated with two sources of genetic predisposition to mental disorders. "Such risks will be of use to genetic counselors to inform personal decisions with regard to marriage, family formation, adoption and health insurance planning," the authors write. Irving I. Gottesman, Ph.D., Hon.F.R.C.Psych., of the University of Minnesota Medical School, Minneapolis, and colleagues studied a population-based cohort of 2.7 million individuals born in Denmark. The researchers matched records in a general registry of the population with a database of psychiatric admissions. They identified individuals whose parents had both been admitted to psychiatric facilities for schizophrenia and bipolar disorder, and compared the rate of psychiatric admissions for these individuals to those of offspring with one or no parents admitted to psychiatric facilities. Rates of schizophrenia were highest among offspring of two parents with schizophrenia. Of the 196 couples who both had schizophrenia, 27.3 percent of their 270 children were admitted to a psychiatric facility, increasing to 39.2 percent when schizophrenia-related disorders were included. This compared with a rate of 7 percent among 13,878 offspring of 8,006 couples in which one parent had schizophrenia and 0.86 percent in 2.2 million offspring of 1 million couples in which neither parent was admitted for schizophrenia. Similarly, the risk of bipolar disorder was 24.9 percent in 146 offspring of 83 parent couples who were both admitted for bipolar disorder (increasing to 36 percent when unipolar depressive disorder was also included). This compared to a risk of 4.4 percent among 23,152 offspring of 11,995 couples with only one parent ever admitted for bipolar disorder and 0.48 percent in 2.2 million children of 1 million couples with neither parent ever admitted. When one parent had bipolar disorder and the other had schizophrenia, offspring had a 15.6 percent risk of schizophrenia and an 11.7 percent risk of bipolar disorder. The risks in this population "are of such a magnitude that they command clinical and national public health attention in countries with health care roughly similar to Denmark's," the authors write.
"It is important to keep in mind that the yields from genetic epidemiology and the strategies implemented are applicable to groups of people, not to the individuals themselves," they conclude. "However, by joining advances in molecular genetics that are adapted for use in epidemiological genetic screening, our kinds of data with the risk groups described might lead to a large and rapid step forward in the understanding of the etiologies of major mental disorders."
Editor's Note: This study was supported by the Scottish Rite Schizophrenia Research Program, the Drs. Irving and Dorothy Bernstein Professorship in Adult Psychiatry, University of Minnesota Medical School, the NARSAD Lieber Prize for Schizophrenia Research and the Stanley Medical Research Institute. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc. For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org. |
|
|
