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In the News, Mental Health, Public Safety

Will a steel net under the Golden Gate Bridge deter would-be jumpers?

Will a steel net under the Golden Gate Bridge deter would-be jumpers?

Golden Gate BridgeThe Bridge Rail Foundation estimates that there have been almost 1,600 suicide deaths from the Golden Gate Bridge since it opened in 1937, and the San Francisco’s Golden Gate Bridge Board of Directors recently approved $76 million in funding to install a 20-foot-wide steel net to deter suicide jumpers.

In a piece on the Washington Post’s Wonkblog, Stanford’s Keith Humphreys, PhD, examined the effectiveness of bridge barriers on suicide prevention, writing that “a half century of experience and evidence supports an optimistic view.” He highlights several small studies before writing:

Because suicide by jumping is a mercifully rare event, most studies of barriers have small samples, making findings unstable and the difference between the Toronto study and other research unsurprising. Statistically, a more reliable result would come from combining the findings across all prior studies.  When Dr. Jane Pirkis of the University of Melbourne led such a “meta-analysis” in 2013, she and her colleagues found that on average barriers reduce suicides by 86% at the barrier site, and that jumping suicides at other nearby sites rise by 44%.  The net benefit is a 28% decrease in suicides by jumping per year.

Dr. Pirkis’ findings bode well for the success of San Francisco’s suicide barrier, which is expected to be installed in about three years.  Even if the net has only the average level of effectiveness, it would have saved a life a month in 2013 alone, as well as sparing the families of the deceased years of mental and emotional anguish.

Jen Baxter is a freelance writer and photographer. After spending eight years working for Kaiser Permanente Health plan she took a self-imposed sabbatical to travel around South East Asia and become a blogger. She enjoys writing about nutrition, meditation, and mental health, and finding personal stories that inspire people to take responsibility for their own well-being. Her website and blog can be found at www.jenbaxter.com.

Previously: Stanford researcher examines link between sleep troubles and suicide in older adults and Stanford’s Keith Humphreys on Golden Gate Bridge suicide prevention: Get the nets

Behavioral Science, Chronic Disease, Mental Health, Neuroscience, Research, Stanford News

Can Alzheimer’s damage to the brain be repaired?

Can Alzheimer's damage to the brain be repaired?

repair jobIn my recent Stanford Medicine article about Alzheimer’s research, called “Rethinking Alzheimer’s,” I chronicled a variety of new approaches by Stanford scientists to nipping Alzheimer’s in the bud by discovering what’s gone wrong at the molecular level long before more obvious symptoms of the disorder emerge.

But Stanford neuroscientist Frank Longo, MD, PhD, a practicing clinician as well as a researcher, has another concern. In my article, I quoted him as saying:

Even if we could stop new Alzheimer’s cases in their tracks, there will always be patients walking in who already have severe symptoms. And I don’t think they should be forgotten.

A study by Longo and his colleagues, which just went into print in the Journal of Alzheimer’s Disease, addresses this concern. Longo has pioneered the development of small-molecule drugs that might be able to restore nerve cells frayed by conditions such as Alzheimer’s.

Nerve cells in distress can often be saved from going down the tubes if they get the right medicine. Fortunately, the brain (like many other organs in the body) makes a number of its own medicines, including ones called growth factors. Unfortunately, these growth factors are so huge that they won’t easily cross the blood-brain barrier. So, the medical/scientific establishment can’t simply synthesize them, stick them into an artery in a patient’s arm and let them migrate to the site of brain injury or degeneration and repair the damage. Plus, growth factors can affect damaged nerve cells in multiple ways, and not always benign ones.

The Longo group’s study showed that – in mice, at least -  a growth-factor-mimicking small-molecule drug (at the moment, alluded to merely by the unromantic alphanumeric LM11A-31) could counteract a number of key Alzheimer degenerative mechanisms, notably the loss of all-important contacts (called synapses) via which nerve cells transmit signals to one another.

Synapses are the soldier joints that wire together the brain’s nerve circuitry. In response to our experience, synapses are constantly springing forth, enlarging and strengthening, diminishing and weakening, and disappearing.They are crucial to memory, thought, learning and daydreaming, not to mention emotion and, for that matter, motion. So their massive loss — which in the case of Alzheimer’s disease is a defining feature – is devastating.

In addition to repairing nerve-cells, the compound also appeared to exert a calming effect on angry astrocytes and  microglia, two additional kinds of cells in the brain that, when angered, can produce inflammation and tissue damage in that organ. Perhaps most promising of all, LM11A-31 appeared to help the mice remember where things are and what nasty things to avoid.

Previously: Stanford’s brightest lights reveal new insights into early underpinnings of Alzheimer’s, Stanford neuroscientist discusses the coming dementia epidemic and Drug found effective in two mouse models of Huntington’s disease
Photo by Bruce Turner

Mental Health, Nutrition, Obesity, Research, Women's Health

Stressed? You could be burning fewer calories

Stressed? You could be burning fewer calories

cupcakesBad news, ladies: Findings (subscription required) recently published in Biological Psychiatry show that women who consumed comfort food while feeling stressed burned fewer calories than their zen-like counterparts.

In the study, Ohio State University researchers quizzed a group of women about what was causing stress in their lives before they ate a caloric meal consisting of eggs, turkey sausage, biscuits and gravy. Scientific American reports:

Turns out that the most stressed women had higher levels of insulin. Which slows down metabolism and causes the body to store fat. And that fat, if not burned off, accumulates in the body.

The women who had reported feeling stressed or depressed in the day before eating the meal burned 104 fewer calories during the seven hours following the meal than women who felt more mellow.

If eating high-calorie comfort food to alleviate stress becomes habitual, the result could be an average weight gain of 11 pounds per year.

So next time you’re feeling overwhelmed and exhausted, you might want to reconsider reaching for a cupcake.

Previously: Learning tools for mindful eating, Mindful eating tips for the desk-bound and Want to curb junk food cravings? Get more sleep
Photo by Class V

Aging, Complementary Medicine, Health and Fitness, Mental Health, Neuroscience, Research

Mindfulness training may ease depression and improve sleep for both caregivers and patients

Mindfulness training may ease depression and improve sleep for both caregivers and patients

meditatingDepression and poor sleep often affect both dementia patients and their caregivers. Now new research shows that caregivers and patients who undergo mindfulness training together experience an improvement in mood, sleep and overall quality of life.

While past studies have shown that yoga and simple meditations can relieve caregivers’ stress, researchers at Northwestern University wanted to determine if patients and caregivers could be trained together.

In the small study (subscription required), pairs of patients and caregiver participated in an eight-week mindfulness program. Patients were diagnosed with dementia due to Alzheimer’s disease or mild cognitive impairment, often a precursor to dementia. Caregivers included spouses, adult children or other relatives. The training was designed specifically to meet the needs of  individuals with memory loss due to terminal neurodegenerative illness and their caregivers. Researchers evaluated participants within two weeks of starting the program and two weeks of completing it.  Lead author Ken Paller, PhD, explained the results in a release:

We saw lower depression scores and improved ratings on sleep quality and quality of life for both groups… After eight sessions of this training we observed a positive difference in their lives.

Mindfulness involves attentive awareness with acceptance for events in the present moment… You don’t have to be drawn into wishing things were different. Mindfulness training in this way takes advantage of people’s abilities rather than focusing on their difficulties

Since caregivers often have limited personal time, mindfulness programs that accommodate them as well as patients could be an effective approach to helping both groups regularly attend sessions, said researchers.

The findings were published Monday in the American Journal of Alzheimer’s Disease and Other Dementias.

Previously: Regularly practicing hatha yoga may improve brain function for older adults, Study suggests yoga may help caregivers of dementia patients manage stress and How mindfulness-based therapies can improve attention and health
Photo by Alex

Aging, Mental Health, Research, Sleep, Stanford News

Stanford researcher examines link between sleep troubles and suicide in older adults

Stanford researcher examines link between sleep troubles and suicide in older adults

Chassériau painting - smallAfter nights spent tossing and turning, I’m grumpy. The world becomes darker, slower and smaller.

That’s why I wasn’t terribly surprised to learn that sleep-deprived older adults are more likely to kill themselves, the results of a study published Aug. 13 in JAMA Psychiatry. Lead author Rebecca Bernert, PhD, instructor of psychiatry and behavioral science and her team examined data from a pool of 14,456 adults older than 65 between 1981 and 1991. They then probed the sleep patterns of 20 people who died by suicide with those of 400 similar individuals.

They found that participants with impaired sleep had a 1.4 percent greater chance of death by suicide than participants who slept well. “This is important because sleep disturbances are highly treatable and arguably less stigmatizing than other suicide risk factors,” Bernert commented in a press release.

Bernert and her team plan to work to develop potential interventions through two ongoing clinical trials.

What did surprise me about the findings was the prevalence of suicide deaths in older adults, particularly among older men: In fact, white men over 65 have a rate of 31 deaths by suicide per 100,000, much higher than the general population rate of 13 or so per 100,000.

Regardless, any number of suicides is too high, a belief Bernert reiterates emphatically.

“Suicide is preventable,” Bernert said. “But the interventions for suicide prevention are alarmingly scarce.”

That’s why for Bernert, the suicide net recently approved for the Golden Gate Bridge is a no-brainer. She recently joined the board of directors of the Bridge Rail Foundation, the nonprofit formed to advocate for the net. “This is a very effective way to prevent suicides,” she said.

More than 1,600 people have died by suicide at the bridge; a similar number of deaths due to any other reason would have necessitated public intervention decades ago, she said.  She attributed the delay, in part, to the powerful stigma that surrounds suicide.

Bernert urged others to learn about suicide by visiting the American Foundation for Suicide Prevention, or, if in crisis, to call 1-800-273-TALK to reach a 24-hour help line.

Becky Bach is a former park ranger who now spends her time writing, exploring, or practicing yoga. She’s currently a science writing intern in the medical school’s Office of Communication & Public Affairs.

Previously: Stanford’s Keith Humphreys on Golden Gate Bridge suicide prevention: Get the nets, CDC report highlights the dangers of sleep deprivation and Sleep deprivation may increase young adults’ risk of mental distress, obesity
Painting by Théodore Chassériau via Wikipedia Commons

From August 11-25, Scope will be on a limited publishing schedule. During that time, you may also notice a delay in comment moderation. We’ll return to our regular schedule on August 25.

Behavioral Science, Mental Health, Research

Pump up the bass, not the volume, to feel more powerful

Pump up the bass, not the volume, to feel more powerful

runner_iPodAs any seasoned athlete or fitness fanatic knows, a meticulously curated playlist is key when staying focused before a big game or getting through a tough workout. But what is it about music that transforms our psychological state and make us feel more powerful?

To answer this question, researchers at the Kellogg School of Management at Northwestern University identified so-called “highest power” songs (such as Queen’s “We Will Rock You“) and “lowest power” tunes (such as Fatboy Slim’s “Because We Can“) and then performed a series of experiments designed to ascertain how the music affected individuals’ sense of power, perceived sense of control, competitiveness and abstract thinking. According to a release, their findings showed “that the high-power music not only evoked a sense of power unconsciously, but also systematically generated the three downstream consequences of power.”

Since participants didn’t report increased feelings of empowerment after reading the lyrics of the songs, researchers turned their attention to how manipulation of bass levels impacted listeners. More from the release:

In the bass experiments, the researchers asked participants to listen to novel instrumental music pieces in which bass levels were digitally varied. In one experiment, they surveyed participants about their self-reported feelings of power, and in another, they asked them to perform a word-completion task designed to test implicit, or unconscious, feelings of power. They found that those who listened to the heavy-bass music reported more feelings of power and generated more power-related words in the implicit task than those listening to the low-bass music.

The effects of the bass levels support one possible explanation for why music makes people feel more powerful: the “contagion hypothesis.” The idea is that when people hear specific music components that express a sense of power, they mimic these feelings internally. “Importantly, because we used novel, never-before-heard music pieces in these experiments, it suggests that the effect may sometimes arise purely out of contagion,” [Dennis Hsu, PhD,] says. “Of course, this does not preclude the possibility that music could induce a sense of power through other processes, such as conditioning.”

The “conditioning hypothesis” suggests that certain pieces of music might trigger powerful experiences because these experiences are often paired with that particular music. For example, music used frequently at sports events may elicit powerful feelings because of the association with power, rewards, and winning (e.g., “We Are the Champions” is often played to celebrate victory).

Previously: Why listening to music boosts fitness performance, Can music benefit cancer patients? and Prescription playlists for treating pain and depression?
Photo by Bert Heird

Aging, Genetics, Imaging, Immunology, Mental Health, Neuroscience, Research, Women's Health

Stanford’s brightest lights reveal new insights into early underpinnings of Alzheimer’s

Stanford's brightest lights reveal new insights into early underpinnings of Alzheimer's

manAlzheimer’s disease, whose course ends inexorably in the destruction of memory and reason, is in many respects America’s most debilitating disease.  As I wrote in my article, “Rethinking Alzheimer’s,” just published in our flagship magazine Stanford Medicine:

Barring substantial progress in curing or preventing it, Alzheimer’s will affect 16 million U.S. residents by 2050, according to the Alzheimer’s Association. The group also reports that the disease is now the nation’s most expensive, costing over $200 billion a year. Recent analyses suggest it may be as great a killer as cancer or heart disease.

Alarming as this may be, it isn’t the only news about Alzheimer’s. Some of the news is good.

Serendipity and solid science are prying open the door to a new outlook on what is arguably the primary scourge of old age in the developed world. Researchers have been taking a new tack – actually, more like six or seven new tacks – resulting in surprising discoveries and potentially leading to novel diagnostic and therapeutic approaches.

As my article noted, several Stanford investigators have taken significant steps toward unraveling the tangle of molecular and biochemical threads that underpin Alzheimer’s disease. The challenge: weaving those diverse strands into the coherent fabric we call understanding.

In a sidebar, “Sex and the Single Gene,” I described some new work showing differential effects of a well-known Alzheimer’s-predisposing gene on men versus women – and findings about the possibly divergent impacts of different estrogen-replacement  formulations on the likelihood of contracting dementia.

Coming at it from so many angles, and at such high power, is bound to score a direct hit on this menace eventually. Until then, the word is to stay active, sleep enough and see a lot of your friends.

Previously: The reefer connection: Brain’s “internal marijuana” signaling implicated in very earliest stages of Alzheimer’s pathology, The rechargeable brain: Blood plasma from young mice improves old mice’s memory and learning, Protein known for initiating immune response may set up our brains for neurodegenerative disease, Estradiol – but not Premain – prevents neurodegeneration in woman at heightened dementia risk and Having a copy of ApoE4 gene variant doubles Alzheimer’s risk for women, but not for men
Illustration by Gérard DuBois

Events, Medicine X, Mental Health, Stanford News, Technology

Medicine X spotlights mental health, medical team of the future and the “no-smartphone” patient

Medicine X spotlights mental health, medical team of the future and the “no-smartphone” patient

Larry_ChuInnovative thinkers and thought leaders engaged in using emerging technologies to enhance health-care delivery and advance the practice of medicine will gather here in early September for Stanford Medicine X.

As Lloyd Minor, MD, dean of the School of Medicine, comments in a release today, Larry Chu, MD, associate professor of anesthesia at Stanford and executive director of the conference, “has made this the go-to event for e-patients, physicians and innovators who want to get together to map out the future of health care.” Chu also notes that the conference  “has distinguished itself through a singular commitment to inclusivity and by finding new ways to bring every voice and perspective into important conversations about health care.”

Now in its third year, Medicine X is building on this inclusive spirit by exploring a variety of new themes during its 2014 program. More from our release:

This year’s program will spotlight the relationship between physical and mental well-being with three breakout panels. Psychologist Ann Becker-Shutte, PhD, will moderate a session on how mental health affects overall health. A conversation about emerging technologies in mental health will be led by Malay Gandhi, managing director of Rock Health, a business accelerator for health-care technology startup companies. Additionally, patient advocate Sarah Kucharski will direct a discussion about depression caused by chronic disease and about coping through online communities.

“Mental health is imperative to address in the overall conversation about the future of health care,” said Chu. “We need to be thinking about the health of the whole person, not just a patient’s individual symptoms or disease.”

The three-day event will also feature panels on what the medical team of the future may look like; how patients with chronic diseases can use self-tracking tools to improve their health and support one another; ways for the pharmaceutical industry to partner with patients in the drug discovery and clinical trial process; and opportunities to connect with “no-smartphone” patients — those who don’t have the access or resources to fully engage with health-enhancing technologies.

Keynote speakers for this year’s conference, being held Sept. 5-7, include Daniel Siegel, MD, clinical professor of psychiatry at the University of California-Los Angeles; Barron Lerner, MD, PhD, professor of medicine and population health at New York University School of Medicine; and Charles Ornstein, a Pulitzer Prize-winning journalist and senior reporter at ProPublica.

For information about the program or to  register the Medicine X website. Last year’s conference sold out, and space is limited for this year’s event.

More news about Stanford Medicine X is available in the Medicine X category.

Previously: Medicine X Live! to host Hangout on design thinking for patient engagement, Quite the reach: Stanford Medicine X set record for most number of tweets at a health-care conference, Videos from Medicine X now available and “You belong here”: A recap of Stanford Medicine X
Photo of Larry Chu by StanfordMedicineX

In the News, Mental Health, Research

How are flight attendants affected by plane disasters?

How are flight attendants affected by plane disasters?

airplaneA few nights after the recent plane crash in Ukraine, I ran into an acquaintance who was heading to Europe later in the week. “It feels weird to fly,” she told me, comparing it to how she felt about boarding a plane for the first time after the 9/11 attacks 13 years ago. I could relate: During my first post-9/11 flight, I was jittery and uneasy the entire way from San Francisco to Minneapolis. (It didn’t help that I was flying alone, in the darkened cabin of a red-eye.)

If plane crashes and tragedies like the one in Ukraine can leave passengers feeling unsettled (or worse), how might they affect people who take to the skies on an almost daily basis? In a piece on The Atlantic yesterday, writer Rebecca Rosen reported on the work of Jeffrey M. Lating, PhD, a professor of psychology at Loyola University Maryland who has studied this issue. Rosen writes:

For flight attendants who worked at American Airlines on 9/11, the rates [of PTSD] were… just over 18 percent. This number is so high, Lating says, it is comparable to the rates seen among people living south of Canal Street in Manhattan, the neighborhoods closest to Ground Zero.

Lating and his colleagues found no statistical difference in probable PTSD rates between West Coast flight attendants and East Coasters, who were much more likely to have known the flight attendants killed on 9/11. For flight attendants, it seems that the trauma they experience following a crash comes not only from the loss and tragedy itself, but also from a deep sense of vulnerability. A follow-up study in 2006 found similarly high rates of probable PTSD at another airline, further suggesting that “it didn’t matter what airline you worked for,” says Lating. “The virulent factor in this was, ‘I wonder if I could possibly be next.’ ”

Those fears can make just doing one’s job as a flight attendant incredibly challenging. Many suffering from PTSD try to avoid sights and triggers that recall the initial trauma. But for flight attendants, those reminders are unavoidable, part of the work itself. To have to work through that anxiety, all the while servicing others and maintaining a sense of calm on a flight— “you could imagine how uncomfortable that would be,” Lating say

Previously: 9/11: Grieving in the age of social media and What 9/11 has taught us about PTSD
Photo by epsos.de

Behavioral Science, Health and Fitness, Mental Health, Research

Exercise and relaxation techniques may help ease social anxiety, study finds

Exercise and relaxation techniques may help ease social anxiety, study finds

TrishWardMeditationPicPhysical exercise and relaxation techniques are common forms of stress-relief. Now, a new study has found that both may help people with social anxiety perceive their surroundings as less threatening environments.

Researchers from Queen’s University in the U.K. conducted two experiments measuring anxiety in participants. In both experiments, the participants were shown point-of-light displays describing a human but not indicating which way the stick figure was facing or whether it appeared to be approaching or receding. Facing-the-viewer bias, a possible biological protective mechanism, may lead people to assume the figure is approaching and posing a threat. And, according to the study, people who are more anxious may place their attention on more threatening stimuli, thereby increasing anxiety.

The researchers tested two means of altering participants’ perception of threat when looking at the stick-figure displays. From a release:

“We wanted to examine whether people would perceive their environment as less threatening after engaging in physical exercise or after doing a relaxation technique that is similar to the breathing exercises in yoga (called progressive muscle relaxation),” researcher [Adam Heenan, a PhD candidate,] said in a statement. “We found that people who either walked or jogged on a treadmill for 10 minutes perceived these ambiguous figures as facing towards them (the observer) less often than those who simply stood on the treadmill. The same was true when people performed progressive muscle relaxation.”

“This is a big development because it helps to explain why exercising and relaxation techniques have been successful in treating and mood and anxiety disorders in the past,” Heenan said.

The research was published in PLOS ONE.

Previously: Research brings meditation’s health benefits into focusAh…OM: Study shows prenatal yoga may relieve anxiety in pregnant womenStudy reveals initial findings on health of most extreme runners and The remarkable impact of yoga breathing for trauma
Photo courtesy of Trish Ward-Torres

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