OREGON STATE UNIVERSITY

heath and nutrition

New protein could be key in fighting debilitating parasitic disease

CORVALLIS, Ore. – A naturally occurring protein has been discovered that shows promise as a biocontrol weapon against schistosomiasis, one of the world’s most prevalent parasitic diseases, Oregon State University researchers reported today in a new study.

Schistosomiasis is transmitted via flatworms shed by the freshwater snails that serve as the parasite’s non-human host. It’s a potentially life-threatening illness that affects more than 250 million people annually in tropical and subtropical countries, according to the World Health Organization.

The disease can cause frequent, painful or bloody urine; abdominal pain and bloody diarrhea; anemia; fever, chills and muscle aches; inflammation and scarring of the bladder; and enlargement of lymph nodes, the liver and the spleen.

While a drug called praziquantel is an effective treatment, there is no vaccination for schistosomiasis, and those who’ve had it develop no immunity.

But researchers in OSU’s College of Science have discovered a key new protein in a snail, Biomphalaria glabrata, that hosts and releases Schistosoma mansoni parasites that infect humans. Findings were published today in the journal PLOS Neglected Tropical Diseases.

Known as Grctm6, the protein seems to prevent the snails from shedding at least some of the parasites that could go on to infect people working or playing in the water where the snails live.

“Shedding none would be great, but shedding fewer could still feasibly make a difference,” said the study’s corresponding author, Euan Allan, a postdoctoral scholar in the college’s Department of Integrative Biology. “If snails are releasing a smaller number of parasites into the environment, people are less likely to be infected.”

Three variants of Grctm6 naturally occur, Allan said, and one of them confers more resistance to Schistosoma than the others.

“What’s interesting about that, from kind of an eye in the sky look, is that in the future we might be able to increase prevalence of the more resistant version and create a new population of more resistant snails without actually interfering with their biological function,” Allan said. “That’s the next step.”

Attempts to control schistosomiasis by focusing on the snail hosts date to the 1950s, but earlier efforts involved either molluscicides – poisons – or the introduction of non-host snail species to eat or compete with the hosts.

 “Those approaches bring their own slew of problems,” Allan said. “We’d anticipate far fewer ecological consequences from gene-driving one of these naturally occurring proteins into a population of snails, because they’d remain natural in pretty much every other way – just instead of being more susceptible to Schistosoma, they’d be more resistant.”

Allan says it’s not yet clear if the protein makes snails less likely to pick up the parasite in the first place, more likely to have their immune system kill it, or less likely to shed it.

“It’s speculative, but our best guess is the protein helps a snail’s immune system better recognize the parasite,” he said.

“The real take-home of the work is that we’ve discovered a completely new protein that’s never been discovered in any other species. And this protein is involved in the extent of infection in an intermediate species, and potentially involved in the extent of human infection.” 

Media Contact: 

Steve Lundeberg, 541-737-4039

Source: 

Euan Allan, 541-737-2993

Multimedia Downloads
Multimedia: 

Schistosome mansoni Schistosome mansoni, center

Air pollution and lack of physical activity pose competing threats to children in China

CORVALLIS, Ore. – Children and adolescents in mainland China are facing two serious and conflicting public health threats: ongoing exposure to air pollution and an increasingly sedentary lifestyle with little regular physical activity outside school.

Health workers and policymakers need to find ways to address both of these issues so that

children can be more physically active without suffering the health risks caused by exposure to air pollution, an Oregon State University researcher suggests in a new commentary published this month in The Journal of Pediatrics

“The question is how do we balance the virtues of physical activity with the hazards of air pollution?” said Brad Cardinal, a kinesiology professor in the College of Public Health and Human Sciences at Oregon State University and a national expert on the benefits of physical activity. “Ultimately, we have to find ways for people to stay active despite the air pollution.”

Many cities and countries around the world grapple with air pollution issues, but there is particular concern for children growing up in China in part because they tend to commute more on foot or bike and their playgrounds and sports fields are often found near busy streets or highways, Cardinal said. The impacts of air pollution contributed to 1.2 million deaths in 2010. 

At the same time, very few Chinese children today are participating in moderate or vigorous physical activity outside of school, and the number of overweight and obese children in China has more than doubled in the last 25 years.

Children are particularly susceptible to adverse health impacts from both short- and long-term exposure to air pollution, in part because they have higher rates of respiration and tend to take shallower breaths. Air pollution has been associated with increases in asthma, chronic cough and other respiratory problems in children that are likely to be exacerbated by heavy breathing from vigorous exercise, Cardinal said. 

So how do public health officials approach these competing challenges? Cardinal and his co-author, Qi Si of Zhejiang University in China and a former visiting scholar at OSU, suggest the two problems should be addressed together.

They recommend four urgent steps for health officials and policymakers who are grappling with these issues: 

  • Increase awareness among parents, children, health workers, educators, and policymakers on the causes and impacts of air pollution on children and adolescents, as well as the potential harm when coupled with outdoor physical activity
  • Add air quality systems at school sites, so pollution can be measured when and where children are engaging in physical activity
  • Adjust the intensity of outdoor physical activity during the school day on the basis of air pollution monitoring results
  • Educate children about exercising in polluted environments, including instruction to stop activity when they notice problems such as coughing, chest tightness or wheezing

Since schools are the base for much of the physical activity of today’s children, they are a critical piece in addressing both issues, Cardinal said. Monitoring the micro-climate at a school would provide better, more localized information for school officials making decisions about whether children should be outside exercising or at what level of intensity. 

“Doing some kind of physical activity, even if it is not as vigorous, is still better than having no physical activity for the children,” he said.

Clothing accessories or fitness equipment could also be designed to help protect children from pollution during outdoor play activities on days when air quality levels were low, he said.

“The goal is to get people thinking about these complex problems and real-world solutions,” Cardinal said. “The hope is that someone will innovate appropriate solutions for addressing both of these problems.” 

The National Health and Fitness Technology Research Key Laboratory of Zhejiang Province provided support for this project.

Story By: 
Source: 

Brad Cardinal, 541-737-2506, brad.cardinal@oregonstate.edu

Multimedia Downloads
Multimedia: 

Brad Cardinal

brad_cardinal

Chronically ill women underusing online self-care resources, study shows

CORVALLIS, Ore. – Barriers to internet use may be preventing chronically ill middle-aged and older women from being as healthy as they otherwise could be, new research from Oregon State University suggests.

The study conducted by researchers from the OSU College of Public Health and Human Sciences and the University of Georgia analyzed data from hundreds of women age 44 and older with at least one chronic condition and found that 35 percent of them didn’t use the internet at all. Among those who did, fewer than half used it to learn from the experiences of other chronic-disease patients; fewer than 20 percent took part in online discussions regarding their conditions.

Self-care, including the use of online resources, is an important component in managing chronic illnesses such as heart disease, cancer, stroke, diabetes, arthritis, asthma, high blood pressure, emphysema, chronic bronchitis, depression and anxiety. Effective management of these types of conditions delays or prevents them from becoming debilitating, maintaining quality of life for the patient and saving health care dollars.

The research showed the potential for improved condition management by getting online resources into the hands of more patients.

“We want people to be able to optimize their health,” said researcher Carolyn Mendez-Luck, an assistant professor in the School of Social and Behavioral Health Sciences at OSU.

Among the 418 women participating in the study, internet use for self-care varied depending on factors that included age, the specific condition or conditions a patient had, education level and ethnic background.

“It really seemed to be the lower-resourced individuals who weren’t using the internet and thus online resources,” Mendez-Luck said. “If you’re older, if you’re a member of a minority group, if you’re less educated, if you’re not working, all of those things work against you and impede your use of the internet; that’s what this research suggests.”

The women in the study all completed, via telephone, the National Council on Aging Chronic Care Survey and all had one or more chronic conditions. Support for the research also came from Atlantic Philanthropies, the California Healthcare Foundation, and the Center for Community Health Development. Results were recently published in the Journal of Women’s Health.

The study featured two parts. The first analyzed data in terms of sociodemographics, disease types and healthcare management associated with internet use, and the second focused on the 251 internet-using women to identify the online self- care resources they use and for what purposes.

About 31 percent of the women in the study were 65 and older; 30 percent had three or more chronic conditions; and 65 percent said they used the internet.

“A significantly larger proportion of older women reported multiple chronic conditions, and a significantly smaller proportion of older women reported using the internet or relying on it for help or support,” Mendez-Luck said. “A significantly larger proportion of non-internet users reported needing help learning what to do to manage their health conditions and needing help learning how to care for their health conditions.”

Mendez-Luck says understanding how women with chronic conditions use the internet, or why they don’t, can inform targeted efforts to increase internet availability, to educate patients about online resources, and to tailor internet-based materials to self-care needs. Women tend to live longer than men and also tend to be particularly affected by chronic diseases.

“The number of people living with chronic conditions for longer durations is growing,” Mendez-Luck said. “Complex patients, especially individuals with multiple chronic conditions, present enormous challenges to healthcare providers and a significant financial burden to the healthcare system. This situation is likely to become more critical as the number of Americans living to advanced ages increases in the next few decades.”

Self-care behaviors are important in managing chronic disease, Mendez-Luck noted. Without effective management, chronic conditions can diminish individuals’ capacity to care for themselves as well as thwart caregivers’ efforts.

“We discovered that a significantly larger proportion of internet-using women with diabetes and depression reported needing help in both learning what to do to manage their health conditions and how to better care for their health, compared with women with other health conditions,” Mendez-Luck said. “This finding highlights the notion that internet resources are not a one size fits all situation; it really does depend on the condition.”

Older women represent the chronic-conditions group with the most potential for gains in using online resources for disease self-management.

“There’s an opportunity for sure,” Mendez-Luck said, noting that one method for improvement might be as simple as a physician, nurse or dietitian taking a moment to talk to patients about using the internet and how it can benefit them.

“The fact that older women in general use the internet at lower rates, I think that’s not surprising,” Mendez-Luck said. “We need to give them a chance to get connected to community resources like libraries and senior centers that try to do education to dispel that fear or discomfort older women might have regarding technology. And more research needs to be done to determine how to tailor that online information in a way that meets their needs.”

Media Contact: 

Steve Lundeberg, 541-737-4039

Multimedia Downloads
Multimedia: 

Carolyn Mendez-Luck

Carolyn Mendez-Luck

Repeatedly thinking about work-family conflict linked to health problems

CORVALLIS, Ore. – Thinking over and over again about conflicts between your job and personal life is likely to damage both your mental and physical health, research from Oregon State University suggests.

The study included more than 200 people, with results showing that “repetitive thought” was a pathway between work-family conflict and negative outcomes in six different health categories.

As the term suggests, repetitive thought regarding work-family conflict refers to thinking repeatedly and attentively about the parts of your job and your personal life that clash with each other: for example, that late-afternoon meeting that prevents you from attending your son’s baseball game. It’s a maladaptive coping strategy that impedes daily recovery from stress.

Kelly D. Davis of OSU’s College of Public Health and Human Sciences was the lead author on the project funded by Pennsylvania State University’s Social Science Research Institute and Penn State’s Center for Healthy Aging.

The journal Stress & Health recently published the results.

Davis, an assistant professor in the CPHHS School of Social and Behavioral Health Sciences, says repetitive thought over work-family conflict keeps the stressor active and thus gets in the way of recovery.

The study involved 203 adults ages 24 to 76. Each was in a romantic relationship, and roughly two-thirds had at least one child at home.

Results showed a link between repetitive thought and negative outcomes in the health categories of life satisfaction, positive affect, negative affect, fatigue, perceived health, and health conditions.

Positive affect is the extent to which a person subjectively experiences positive moods, and negative affect is the extent to which someone experiences negative moods. In this study, health conditions referred to a list of 22 conditions or problems, such as stroke or diabetes. Participants were scored based on how many times they answered yes.

In the category of perceived health, participants were asked to rate their health on a five-point scale. 

“The main objective of this study was to test a conceptual model in which repetitive thought explained the association between work-family conflict and health,” Davis said. “There was support for repetitive thought as a mediator in the association between work-family conflict and all six health outcomes.”

Repetitive thought is related to two other types of cognition that also can have adverse effects on health: rumination and worry. Rumination is persistent, redundant thinking that usually looks backward and is associated with depression; worry is also persistent, redundant thinking but tends to look forward and is typically more associated with anxious apprehension.

“Practitioners can assist individuals facing the dual demands of work and family by reducing repetitive thought, and the related issues of worry and rumination,” Davis said.

One technique that can help is mindfulness: intentionally paying attention to the present-moment experience, such as physical sensations, perceptions, affective states, thoughts and imagery, in a nonjudgmental way.

“You stay in the moment and acknowledge what you are feeling, recognize that those are real feelings, and process them, putting things in perspective,” Davis said. “In the hypothetical baseball game example, the person could acknowledge the disappointment and frustration he was feeling as legitimate, honest feelings, and then also think in terms of ‘these meeting conflicts don’t happen that often, there are lots of games left for me to watch my child play, etc.’”

Davis also points out that the burden for coping with work-family conflict shouldn’t fall solely on the employee.

“There needs to be strategies at the organizational level as well as the individual level,” she said. “For example, a business could implement mindfulness training or other strategies in the workplace that make it a more supportive culture, one that recognizes employees have a life outside of work and that sometimes there’s conflict. There can be a good return on investment for businesses for managing work-family stress, because positive experiences and feelings at home can carry over to work and vice versa.”

Work-family conflict is not just a women’s issue or even just a parent’s issue, Davis notes, given the number of workers who are caring for their own mother and/or father.

“Planning ahead and having a backup plan, having a network to support one another, those things make you better able to reduce work-family conflict,” Davis said. “But it shouldn’t just rest on the shoulders of the individual. We need changes in the ways in which organizations treat their employees. We can’t deny the fact that work and family influence one another, so by improving the lives of employees, you get that return on investment with positive work and family lives spilling over onto one another.”

Policy changes are particularly important to lower-income workers, Davis says.

“Not all of us are so fortunate to have backup plans for our family responsibilities to stop us from repetitively thinking about work-family conflict,” she said. “It’s the organizational support and culture that matter most. Knowing there’s a policy you can use without backlash maybe is almost as beneficial as actually using the policy. It’s also important for managers and executives to be modeling that too, going to family events and scheduling time to fit all of their roles.”

Media Contact: 

Steve Lundeberg, 541-737-4039

Multimedia Downloads
Multimedia: 

Kelly Davis

Kelly D. Davis

Boosting levels of known antioxidant may help resist age-related decline

CORVALLIS, Ore. – Researchers at Oregon State University have found that a specific detoxification compound, glutathione, helps resist the toxic stresses of everyday life – but its levels decline with age and this sets the stage for a wide range of age-related health problems.

A new study, published in the journal Redox Biology, also highlighted a compound – N-acetyl-cysteine, or NAC – that is already used in high doses in medical detoxification emergencies. But the researchers said that at much lower levels NAC might help maintain glutathione levels and prevent the routine metabolic declines associated with aging.

In that context, the research not only offers some profound insights into why the health of animals declines with age, but specifically points to a compound that might help prevent some of the toxic processes involved.

Decline of these detoxification pathways, scientists say, are causally linked to cardiovascular disease, diabetes and cancer, some of the primary causes of death in the developed world.

“We’ve known for some time of the importance of glutathione as a strong antioxidant,” said Tory Hagen, lead author on the research and the Helen P. Rumbel Professor for Health Aging Research in the Linus Pauling Institute at OSU.

“What this study pointed out was the way that cells from younger animals are far more resistant to stress than those from older animals,” said Hagen, also a professor of biochemistry in the OSU College of Science. “In young animal cells, stress doesn’t cause such a rapid loss of glutathione. The cells from older animals, on the other hand, were quickly depleted of glutathione and died twice as fast when subjected to stress.

“But pretreatment with NAC increased glutathione levels in the older cells and largely helped offset that level of cell death.”

Glutathione, Hagen said, is such an important antioxidant that its existence appears to date back as far as oxygen-dependent, or aerobic life itself – about 1.5 billion years. It’s a principal compound to detoxify environmental stresses, air pollutants, heavy metals, pharmaceuticals and many other toxic insults.

In this study, scientists tried to identify the resistance to toxins of young cells, compared to those of older cells. They used a toxic compound called menadione to stress the cells, and in the face of that stress the younger cells lost significantly less of their glutathione than older cells did. The glutathione levels of young rat cells never decreased to less than 35 percent of its initial level, whereas in older rat cells glutathione levels plummeted to 10 percent of their original level.

NAC, the researchers said, is known to boost the metabolic function of glutathione and increase its rate of synthesis. It’s already used in emergency medicine to help patients in a toxic crisis, such as ingestion of poisonous levels of heavy metals. It’s believed to be a very safe compound to use even at extremely high levels – and the scientists are hypothesizing that it might have significant value at much lower doses to maintain glutathione levels and improve health.

“I’m optimistic there could be a role for this compound in preventing the increased toxicity we face with aging, as our abilities to deal with toxins decline,” Hagen said. “We might be able to improve the metabolic resilience that we’re naturally losing with age.”

Also of interest, Hagen said, is the wide range of apparent detoxification potential offered by glutathione. Higher levels of it – boosted by NAC – might help reduce the toxicity of some prescription drugs, cancer chemotherapies, and treat other health issues.

“Using NAC as a prophylactic, instead of an intervention, may allow glutathione levels to be maintained for detoxification in older adults,” the researchers wrote in their conclusion.

This research was supported by the National Institutes of Health, the National Science Foundation and the Medical Research Foundation of Oregon.

Story By: 
Source: 

Tory Hagen, 541-737-5083

tory.hagen@oregonstate.edu

Multimedia Downloads
Multimedia: 

Glutathione
Structure of glutathione

System changes improve prenatal care for Oregon Medicaid beneficiaries

CORVALLIS, Ore. – Oregon’s 2012 shift to an incentivized, accountable-care system for Medicaid beneficiaries led to positive changes for expectant mothers and their babies, research at Oregon State University shows.

The research found Oregon’s implementation of “coordinated care organizations” resulted in more expectant moms starting prenatal care on time. It also showed a small narrowing of the gap in prenatal care quality between Medicaid beneficiaries and those with private insurance.

Late-starting or inadequate prenatal care is connected to a number of adverse outcomes, including low birth weight, preterm birth, stillbirth and infant death.

“Improving women’s access to adequate prenatal care — typically defined as initiating prenatal care within the first trimester of pregnancy and adhering to recommended prenatal care visits — can facilitate the identification and subsequent management of high-risk pregnancies,” said Ifeoma Muoto, who was a doctoral student working with Associate Professor Jeff Luck in OSU’s College of Public Health and Human Sciences at the time of the study.

Muoto, now an administrative fellow at Kaiser Permanente Southern California, looked at more than a half-million pregnancies in a six-year period in Oregon and Washington, including 2013, the first year for Oregon’s 16 coordinated care organizations, or CCOs. Washington served as the control group.

The study’s objective was to assess the impact of the CCOs on the quality of prenatal care among Oregon Medicaid beneficiaries. The results were recently published in the journal Health Affairs.

The study also showed a narrowing, albeit a small one, of the gap in prenatal care quality between Medicaid beneficiaries and those with private insurance.

“Prenatal care was one of the performance measures for the new CCOs and you can’t disentangle the measures from the CCO startup, but it’s promising that just in the first year there were significant improvements,” Luck said.

Luck is a member of the Oregon Health Authority’s Metrics and Scoring Committee, which is charged with determining whether CCOs are “effectively and adequately improving care, making quality care accessible, eliminating health disparities, and controlling costs.”

The committee picked which types of care would be incentivized – meaning which types of care would serve as benchmarks that CCOs could meet to earn more funding. Other types of care that are incentivized include chronic diseases, substance abuse and mental health.

“We hypothesized that the CCOs would have the benefit for prenatal care that they did,” Luck said. “This is early evidence that some of the care delivery improvements we hoped for really are occurring.”

The federal Office of Disease Prevention and Health Promotion’s HealthyPeople 2020 initiative includes increasing the percentage of women who initiate prenatal care in the first trimester of pregnancy from 70.8 percent to 77.9 percent.

In Oregon, the rate of pregnant Medicaid beneficiaries starting care in the first trimester climbed from 73.1 percent in the pre-CCO period to 77.3 percent in the first year of the CCOs. In Washington, the rate for women on Medicaid rose from 71.7 to 73.6 percent, a smaller percentage increase than Oregon’s. Although women covered by private insurance in Oregon had higher levels of timely prenatal care initiation and prenatal care adequacy, the rates among that group were stable during the time period studied.

For prenatal care adequacy – initiating care in the first trimester and having at least nine doctor visits during a pregnancy – there was an increase from 65.9 to 70.5 percent for Medicaid-covered women in Oregon. That increase, though, was not statistically significant relative to the increase observed among Medicaid-covered women in Washington, where the improvement was 58.5 to 62.2 percent.

Luck noted the results indicated care adequacy was “going in the right direction but wasn’t yet statistically significant.”

“It’s possible when we have more years of data we’ll be able to make a more precise estimate,” he said. “We also have a parallel project funded by the Centers for Disease Control using a larger pool of data from Oregon – not only birth certificates but Medicaid claims data, claims data from the Oregon Health Plan, which is Oregon’s Medicaid program, and hospital discharge data.”

Luck noted the research is particularly important given the percentage of births to Medicaid beneficiaries. Medicaid births made up roughly 45 percent of total U.S. births even prior to an expansion of the Medicaid program that began in January 2014.

Media Contact: 

Steve Lundeberg, 541-737-4039

Source: 
Multimedia Downloads
Multimedia: 

Prenatal care

Expectant mother

Want to optimize those 10,000 (or fewer) steps? Walk faster, sit less

CORVALLIS, Ore. -- That popular daily target of 10,000 steps is a worthwhile goal, but a new study at Oregon State University suggests that if you find that unattainable, don’t despair - a smaller number, especially at moderate or greater intensity, can lead to health benefits too.

It’s especially helpful if 3,000 of the steps come at a brisk pace, and limiting sedentary time also plays a role in healthy readings for cholesterol and other risk factors.

The average American takes between 5,000 and 7,000 steps per day, researchers say.

“Some physical activity is better than none, and typically more is better than less,” said John Schuna Jr., assistant professor of kinesiology in OSU’s College of Public Health and Human Sciences.

“When it comes to steps, more is better than fewer, and steps at higher cadences for a significant amount of time are beneficial. A good target for healthy adults is 150 minutes per week spent at 100 or more steps per minute. And in terms of time spent sedentary, less is better – you want to spend as little time not moving as possible within reason.”

Schuna, lead author Catrine Tudor-Locke of the University of Massachusetts and six other researchers analyzed data from 3,388 participants age 20 and older in a National Health and Nutrition Examination Survey.

Their findings were recently published in the journal Medicine & Science in Sports & Exercise.

The research builds on earlier studies, many of which relied on self-reported estimates of activity levels, which tend to run high, or accelerometer data using proprietary output measures (e.g., activity counts/minute), and also failed to take cadence – steps per minute – into account. A cadence of 100 steps per minute or greater is widely accepted as the threshold for moderate-intensity activity in adults.

In addition to minute-by-minute step data, the researchers looked at relationships between step-defined physical activity and various cardiometabolic risk factors for the survey participants – such as waist circumference, blood pressure, fasting glucose, insulin, and cholesterol levels, as well as body mass index.

Among male participants, only the highest quintile – the top one-fifth – had a median of more than 10,000 steps per day, checking in at 12,334. Among women, the top quintile’s median was 9,824.

Beyond just total step counts, the research looked at daily “peak 30-minute cadence” – the average number of steps in a participant’s most vigorous 30 minutes, which weren’t necessarily consecutive minutes. To measure sedentary time, researchers used the percentage of accelerometer time per day that showed no step-based movement.

Among all survey participants, only the top quintile had a median peak cadence – 96 steps per minute – that was in line with accepted physical activity guidelines of 30 minutes a day at 100 steps per minute.

Nevertheless, analysis across all quintiles showed a strong relationship between higher cadences – walking more briskly as opposed to less briskly – and favorable numbers in the cardiometabolic risk categories.

The same held true for number of steps, whether above or below the 10,000-step threshold. And higher percentages of sedentary time were linked to less-favorable values in several risk factors.

While FitBit, Garmin and other fitness trackers might be responsible for the current 10,000-step fixation, Schuna notes that the magic number’s roots trace to 1960s Japan. From a fitness craze inspired by the 1964 Tokyo Olympics sprang the first commercial pedometer, the manpo-kei. In Japanese, manpo-kei literally means “10,000 steps meter.”

“One of the questions has always been, what if one person with 10,000 steps per day accumulates nearly all of them in a two-hour time block, and another stretches them over 15 hours – does it matter in terms of health effects?” Schuna said.

“This is a big debate in the field, with a couple of intertwined questions. Current evidence does suggest that moderate to vigorous activity and sedentary time have a certain amount of independence from each other in terms of health effects. But if you’re getting two or three hours of moderate to vigorous activity every day, even if you’re relatively sedentary the rest of the time, it’s hard to imagine the sedentary time would completely ameliorate or wipe out the health benefits associated with that level of activity.”

A person who averages 10,000 or more steps/day typically accumulates at least 150 minutes a week of moderate to vigorous activity, Schuna said.

“Now there is an additional caveat regarding the manner in which physical activity is accumulated to meet current physical activity guidelines, which states that aerobic activity should be accumulated in bouts of at least 10 minutes in duration.,” he said. “If we take this into consideration, it becomes more difficult to determine whether or not someone is meeting the physical activity guidelines using step counts alone. That aside, averaging 10,000 or more steps/day puts you in the top 15 percent of adults in terms of step-defined physical activity.”   

Schuna envisions a future in which wearable fitness trackers will feature apps that make minute-by-minute data available to the user, as research-grade accelerometers now do to scientists.

“That’s along this paradigm of personalized medicine,” he said. “In the future, everyone will have his or her genome sequenced, and from that we’ll be looking for specific markers that predispose people to higher risks for certain conditions. The physical activity and sleep data we collect from wearable devices will be used to track compliance to individualized behavior prescriptions while attempting to optimize each individual’s health.”

Media Contact: 

Steve Lundeberg, 541-737-4039

Source: 

John Schuna, 541-737-1536
john.schuna@oregonstate.edu

Multimedia Downloads
Multimedia: 

Health Extension Run 2014
Walking steps

Lack of pharmacy access sends some patients back to the hospital

PORTLAND, Ore. – Hospital readmissions, a $17 billion annual problem, are higher in rural, remote or smaller communities that sometimes have significantly less access to pharmacies, according to a study published today that was one of the first to examine this issue.

Researchers at Oregon State University and Oregon Health & Science University found that the average number of readmissions from rural areas was 15.3 percent, compared to 14.7 percent for their urban counterparts where the days and hours a person could find an open pharmacy were much higher.

Unplanned hospital readmissions are such a serious national problem that recent changes in federal law are penalizing hospitals that have high readmission rates. It can be a problem with various groups: older adults; people who have several medical conditions; those taking multiple medications; and people who have difficulty adhering to their medication regimen.

The study was done in Oregon with census data of patients over 65, studying 507 pharmacies and 58 hospitals. It was supported by the OHSU Layton Alzheimer Disease Center, which is funded by the National Institutes of Health.

“It’s a huge burden both on a patient and our medical system when they have to be readmitted to a hospital,” said David Lee, an assistant professor in the OSU/OHSU College of Pharmacy, and senior author on a new study in the Journal of the American Pharmacists Association.

“The modern pharmaceutical profession is increasingly being recognized as an important partner in health care, and as its services continue to expand it will help even more. This research shows that pharmacy access can help people from going back to the hospital. For older populations who often find hospital experiences quite exhausting, that’s extremely important to their overall health.

“The sooner a person gets out and stays out of a hospital, the better off they usually will be.”

In some rural areas of Oregon, Lee noted, a person might have to drive 100 miles or more to find a pharmacy. In one of Oregon’s rural communities there is a single pharmacy that’s open 54 hours a week; by comparison, in some major urban areas a person might be able to find multiple pharmacies that collectively are open more than 3,800 hours a week.

These challenges of availability, distance and convenience to professional pharmaceutical products, service and counsel are a problem, researchers said. Another interesting corollary to the issue, they said, is identification of what have been called “pharmacy deserts” even within major urban areas, such as Chicago.

“Large, urban, predominantly white communities usually have a lot of pharmacies and access,” said Sarah Bissonnette, lead author on this study and an OSU postdoctoral fellow. “But in some lower socioeconomic areas even within cities, it’s much more difficult to find an open pharmacy.”

If more conventional pharmacies are not economically viable, the researchers said, a possible remedy to the problem is growth and improvement of what’s called “telepharmacy,” or mail-order services that are carefully backed up by personal advice, monitoring and counsel from professional pharmacists.

Improved hospital discharge medication counseling has been shown to increase adherence to use of new or changed medications, the study indicated. And some hospitals around the country have also taken it upon themselves to open community and 24-hour pharmacies in an attempt to reduce readmission rates.

Nonadherence to medication usage ranges from 25-50 percent in the United States, depending on the disease state, and is associated with increased illness and death, the study noted.  Causes can include adverse side effects, insurance coverage, costs, education levels, cognition and pharmacy access.

Story By: 
Source: 

David Lee, 503-494-2258

Multimedia Downloads
Multimedia: 

Pharmacist consult
Pharmacist consult

Teens who smoke daily are more likely to report health complaints

CORVALLIS, Ore. – As fewer teens overall take up smoking, those who do smoke daily are reporting more health complaints than in years past, a new study indicates.

“Teens who smoke report significantly higher levels of health complaints than nonsmoking teens, and we found that this gap has widened over the years, even as the overall prevalence of teen smoking has dropped,” said Marc Braverman a professor, lead author and Extension specialist in the College of Public Health and Human Sciences at Oregon State University, who worked with collaborators in Norway.

“Some adolescents smoke as an attempt to cope with their health problems, and that subgroup may represent a growing proportion of teen smokers, as fewer teenagers are taking up smoking for social reasons.”

The researchers believe it is the first time that this shifting relationship between daily smoking and health complaints in adolescence has been reported. The results were published recently in the journal Nicotine and Tobacco Research.

Smoking is on the decline among adults and adolescents in most places around the world, which is very welcome news, said Braverman, whose research expertise includes smoking prevention and tobacco control policy.

But as smoking rates decline, reducing them further becomes more challenging. Some tobacco researchers believe that the remaining smokers tend to be more “hard-core” smokers, who have been smoking for long periods and either do not wish to quit or believe they would not be successful if they tried, he said.

“Many public health officials are asking what kinds of new strategies might be needed to reduce smoking prevalence, to say, the low single digits, and what kinds of resources that might require,” Braverman said.  “Some smokers are more addicted to or dependent on cigarettes than others.”

Understanding the links between health and smoking among teens will help public health officials determine better smoking cessation strategies for that age group, particularly those who smoke on a daily basis, Braverman said.

For the study, researchers used data from the Health Behavior in School-Aged Children Study, an international collaborative project sponsored by the World Health Organization that began in the 1980s and currently includes 43 countries. Surveys of 11-, 13- and 15-year-olds are conducted every four years in participating countries.

The researchers examined smoking behavior and health problems among 15-year-olds in Norway over five waves of the survey, from 1993-94 to 2009-10. They focused on Norway in part because that country experienced dramatic declines in smoking rates over that time period, which allows for investigation of how smoking populations have changed, Braverman said.

As part of the survey, the students were asked about their smoking behavior and how often they experienced subjective physical and psychological health complaints such as headache, stomachache, backache, dizziness, irritability, nervousness, feeling “low” and sleep difficulties.

In addition to the changes in health complaints over time, the researchers found important differences in health complaints related to gender. Girls, in general, reported more health complaints than boys, but the difference between the sexes was significantly larger among smoking teens than nonsmoking teens. In particular, girls who smoked daily reported higher levels of health complaints than any other subgroup, Braverman said.

The data collected did not allow for an explanation of the reason for the finding, but the study raises concerns that adolescent girls might be at especially high risk for health problems associated with smoking, he said.

If teens are smoking as a coping mechanism for physical or psychological problems, they may be at greater risk for dependence and addiction than their peers who are smoking because of peer or social influences, Braverman said.

“And for those teens who smoke to cope with health problems, getting them to stop will likely require different strategies and more intensive intervention efforts than those that are commonly used,” Braverman said. “A ‘stop smoking’ media campaign probably won’t be enough.”

Co-authors of the study include Robert Stawski of OSU; Oddrun Samdal of the University of Bergen;    and Leif Edvard Aarø  of the Norwegian Institute of Public Health. Braverman’s work on the study was funded in part by a grant from the OSU Division of International Programs.

Story By: 
Source: 

Marc Braverman, 541-737-1021

marc.braverman@oregonstate.edu

Multimedia Downloads
Multimedia: 

Marc Braverman
Marc Braverman

Vitamin E protects critical nutrient, prevents neurologic damage and death in embryos

CORVALLIS, Ore. – Researchers have discovered that a dietary deficiency of vitamin E in laboratory animals can cause significant neurological impairment in developing embryos, as well as physical abnormalities and embryonic death.

The study suggests that one mechanism leading to this damage may be loss of the role vitamin E plays in protecting levels of DHA, one of the most important of the omega-3 fatty acids that plays a crucial role in brain and cellular development.

The work, by scientists in the Linus Pauling Institute at Oregon State University, was done with zebrafish, a vertebrate that has neurologic development very similar to humans. They also have dietary needs that are more similar to humans than some other animal models.

In these fish, vitamin E-deficient embryos did not respond correctly to visual cues, had severe physical abnormalities as early as two days after fertilization, and many died before the end of five days.

The findings were published in Redox Biology, in work supported by the National Institutes of Health and the National Science Foundation.

They take on special significance, researchers say, because more than 90 percent of the adults in the United States who do not take supplements have diets deficient in vitamin E.

“DHA in a developing embryo is very important for cell signaling and membrane development,” said Melissa McDougall, an OSU graduate research assistant in the Linus Pauling Institute and the College of Public Health and Human Sciences, and lead author on this publication.

“Our research showed that adequate levels of vitamin E are important in preventing depletion of DHA in the embryo.

“Without enough DHA, there was also evidence for disruption of the structural integrity of cell membranes as a whole. It appears that vitamin E protects these critical lipids, such as DHA, from excessive depletion that can cause physical and behavioral damage.”

The study showed loss of locomotor activity in vitamin E-deficient embryos as a measure of impaired behavior. Vitamin E-deficient embryos were 82 percent less responsive to a light/dark stimulus.

Past research done elsewhere with rodents, McDougall said, has correlated low DHA levels with less memory and intelligence, and one study in Bangladesh with vitamin E-deficient pregnant women showed a higher level of miscarriage.

The recommended daily allowance of vitamin E for human adults is 15 milligrams a day, and the typical American diet rarely provides that. Vitamin E is most common in nuts, seeds, some leafy greens like spinach, and a few varieties of vegetable oils like sunflower and canola. Low-fat diets also present a special challenge in getting enough vitamin E.

Not all pre-natal vitamins even include vitamin E, McDougall said, although some of the better ones are now including not only vitamin E but also supplements of DHA, a nutrient most common in fatty fish. It’s worth noting, she said, that vitamin E cannot serve its role in protecting DHA if there is inadequate dietary DHA to begin with.

Most human brain development occurs during pregnancy, and some of the most important neurologic development happens during the first trimester.

The corresponding author on this publication was Maret Traber, the Helen P. Rumbel Professor for Micronutrient Research in the Linus Pauling Institute. Other collaborators were from the OSU College of Pharmacy, the Sinnhuber Aquatic Research Laboratory, the OSU Department of Environmental and Molecular Toxicology, and the OSU Environmental Health Sciences Center.

 

Story By: 
Source: 

Maret Traber, 541-737-7977

maret.traber@oregonstate.edu

Multimedia Downloads
Multimedia: 

Zebrafish
Zebrafish