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Low-Glycemic Diets May Not Improve Cardiovascular Outcomes When Compared to High-Glycemic Diets

A study comparing low- and high-glycemic index diets found no significant difference between the two plans in reducing cardiovascular risk or reversing insulin resistance. A number of widely followed diets have been based on the idea that focusing on foods with a low-glycemic index might improve cardiovascular risk factors and lower the risk of developing diabetes. But a National Institutes of Health (NIH)-funded study suggests that using the glycemic index to select foods may not improve insulin sensitivity, lower high-density lipoprotein or low-density lipoprotein lipid levels, or reduce blood pressure levels. Results of the study appeared online in the Journal of the American Medical Association. The study, funded by the NIH's National Heart, Lung and Blood Institute, included 163 overweight adults in a controlled feeding study. Participants had systolic blood pressure levels of between 120 and 159 mmHg, which means participants at the higher end of this range were considered to have high blood pressure. Participants spent 5 weeks eating each of the four diets being tested. All foods and calorie-containing drinks were provided to participants for the duration of each 5-week period on the test diets. Each diet used the Dietary Approaches to Stop Hypertension (DASH) eating plan with variations in carbohydrate and glycemic index levels. The DASH eating plan emphasizes vegetables, fruits, and whole grains; includes fat-free or low-fat dairy products, fish, poultry, beans, nuts, and vegetable oils; and limits sweets, sugary beverages, and red meats.

  
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Teen Prescription Opioid Abuse, Cigarette, and Alcohol Use Trends Down

Use of cigarettes, alcohol, and abuse of prescription pain relievers among teens has declined since 2013, whereas marijuana use rates were stable, according to the 2014 Monitoring the Future (MTF) survey, released by the National Institute on Drug Abuse (NIDA). However, use of e-cigarettes, measured in the report for the first time, is high. These 2014 results are part of an overall 2-decade trend among the nation's youth. The MTF survey measures drug use and attitudes among 8th, 10th, and 12th graders, is funded by NIDA, and is conducted by researchers at the University of Michigan at Ann Arbor. NIDA is part of the NIH. "With the rates of many drugs decreasing, and the rates of marijuana use appearing to level off, it is possible that prevention efforts are having an effect," said NIDA Director Nora D. Volkow, MD. "It is now more important than ever for the public health community to continue to educate teens, parents, teachers, community leaders, the media and health care providers about the specific harms of drug use among teens, whose brains are still developing."

 

April 1-30 Autism Awareness Month (National)

To highlight the growing need for concern and awareness about autism, the Autism Society has celebrated National Autism Awareness Month since the 1970s. The nation recognizes April as a special opportunity for everyone to educate the public about autism and issues within the autism community. For more information, contact:

 

Autism Society | 301.657.0881 |mailto:info@autism-society.orghttp://www.autism-society.org

 

Older Nurses Push Retirement Envelope

For Growing Number of Nurses, 65 No Longer Represents the Ideal Age to Retire

To be sure, some nurses have always worked past the traditional age of retirement. Nursing education, in particular, is well known for its older demographics. But the number of older nurses in clinical practice is growing, according to a recent study by Peter Buerhaus, PhD, RN, a professor of nursing at Vanderbilt University and Director of the university's Center for Interdisciplinary Health Workforce Studies. Between 1991 and 2012, about three in four nurses (74%) were working at age 62 and about one in four (24%) were working at age 69. That's a considerable jump from earlier decades, the study found. Between 1969 and 1990, about half of nurses (47%) were working at age 62, but only 1 in 10 (9%) were in the workforce at age 69. Advanced practice registered nurses (APRNs) are especially likely to work past 65, according to a national workforce survey conducted in 2013 by the National Council of State Boards of Nursing and the National Forum of State Nursing Workforce Centers. Eight percent of registered nurses (RNs)-but 17% of APRNs-are 65 or older, it found. About one in four clinical nurse specialists (25%) and certified nurse-midwives (23%) are 65 or older, and about 1 in 10 nurse practitioners and nurse anesthetists are 65 or older. Read more at http://rwjf.org

  
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Celebrating Occupational Therapy

April is Occupational Therapy month. Time to recognize this group of professionals who play such a vital role in the health, well-being, and independence of home healthcare patients throughout the year. Occupational therapy practitioners help people across the lifespan participate in the things they want and need to do through the therapeutic use of everyday activities (occupations). Common occupational therapy interventions include helping children with disabilities to participate fully in school and social situations, helping people recovering from injury to regain skills, and providing supports for older adults experiencing physical and cognitive changes.

 

To learn about 46 unique ways Occupational Therapists intervene to improve health, go to: http://aota.org and click on "About Occupational Therapy."

 

In the Media: New Exhibits Shine Light on the History of Nursing

On television and in other media, nurses are often portrayed as gendered stereotypes: the angel, the handmaiden, the battle-axe, or the sex object. Turns out, these portrayals aren't new. That is evident in a new postcard exhibit at the National Library of Medicine in Bethesda, MD, that illustrates cultural perceptions of nursing over the last century. The exhibit, entitled Pictures of Nursing, hails from a collection of more than 2,500 postcards that were donated by Michael Zwerdling, RN. The collection includes postcards that date to the late 1800s, and features images of nurses portrayed as everything from Greek goddesses to Amazon princesses to the Virgin Mary. It also includes rare images of male nurses. Some of the exhibit's more contemporary postcards depict nurses in modern uniforms and as skilled members of healthcare teams-images that counteract sexist and gendered notions of nursing that come through in other postcards. Read more at http://rwjf.org

  
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Drug Improves Function in Rats with Spinal Cord Injuries

Every year, tens of thousands of people nationwide are paralyzed by spinal cord injuries. These injuries crush and sever the long axons of spinal nerve cells, cutting off communication between the brain and the body and leading to paralysis. After a spinal cord injury, axons are unable to regenerate, or sprout. The barrier to their regrowth is largely due to chemicals called chondroitin sulphate proteoglycans (CSPGs). CSPGs are known to play a role in stabilizing connections between nerve cells. After spinal cord injury, nervous system support cells called glia produce higher levels of CSPGs both in the injury region and throughout the spinal cord. Recent studies have revealed that CSPGs stop axon growth by interacting with a receptor protein found in axons called protein tyrosine phosphatase sigma (PTP[sigma]). Dr. Bradley Lang at Case Western Reserve University School of Medicine came up with the idea of designing a drug that would help axons regenerate by inhibiting PTP[sigma]. The research, led by Dr. Jerry Silver and published online on December 3, 2014, in Nature, was partially funded by NIH's National Institute of Neurological Disorders and Stroke. The team first identified a part of the PTP[sigma] protein called a wedge domain. Wedge domains have been shown to regulate the activity of receptor phosphatases. The scientists developed a molecule that mimicked the shape of the PTP[sigma] wedge domain but that could easily cross cell membranes to spread through nervous system cells.

 

The drug, which they call intracellular sigma peptide (ISP), successfully bound both human and rodent PTP[sigma]. Neurons grown in a Petri dish with CSPGs were able to extend axons to a much greater extent when treated with ISP. Next, the researchers tested the drug in rats with spinal cord injuries. After confirming that the drug was able to enter the rat nervous system, they tested it in injured animals. The scientists injected ISP or a placebo under the skin near the site of injury once daily for 7 weeks. After several weeks, the rats given ISP showed significant improvement in movement and/or bladder function, whereas the placebo treatment had no effect.

 

ISP caused sprouting of new axons that use the neurochemical serotonin to communicate. Blocking serotonin communication with a drug partially reversed the beneficial effects of the ISP injections, suggesting that those new axons-and, by extension, the ISP compound-were responsible for the rats' recovery. "Our goal is to progress this treatment forward for use as a therapeutic following spinal cord injury," Lang says. The team is now planning to test the drug in preclinical trials as well as in rodent models of heart attack, peripheral nerve injury, and multiple sclerosis.

 

Despite Risks, Benzodiazepine Use Highest in Older People

Prescription use of benzodiazepines-a widely used class of sedative and antianxiety medications-increases steadily with age, despite the known risks for older people, according to a comprehensive analysis of benzodiazepine prescribing in the United States. Given existing guidelines cautioning healthcare providers about benzodiazepine use among older adults, findings from the NIH-funded study raise questions about why so many prescriptions-many for long-term use-are being written for this age group. The study appears online December 18 in JAMA Psychiatry.

  
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Among the findings:

 

* Use of benzodiazepines increased steadily with age: 5.2% of adults 18 to 80 years old received one or more benzodiazepine prescriptions in 2008; 2.6% of those 18 to 35, 5.4% of those 36 to 50, 7.4% of those 51 to 64, and 8.4% of those 65 to 80.

 

* Overall, about one quarter of prescriptions involve long-acting formulations of benzodiazepines.

 

* Most prescriptions for benzodiazepines are written by nonpsychiatrists. For adults 18 to 80 years old, about two thirds of prescriptions for long-term use are written by nonpsychiatrists; for adults 65 to 80, the figure is 9 out of 10.