Syringe exchange programs -- a critical public health strategy without federal funding

[ Back to EurekAlert! ] Public release date: 15-Mar-2012
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Contact: Nancy Jean
njean@lifespan.org
Lifespan

Rhode Island Hospital study finds barriers, difficulty in obtaining funding when available

PROVIDENCE, R.I. A study from Rhode Island Hospital examined the two-year period when the current ban on federal funding for syringe exchange programs (SEPs) was lifted in order to learn whether SEPs received or anticipated pursuing federal funding during that time. Only three of the 187 SEPs that responded had received funding at the time of the survey, and early experiences cited many barriers to accessing the federal funds. With the ban reinstated, the researchers state that the effect of federal SEP funding can therefore not realize its full public health potential. The findings are published in the American Journal of Public Health.

SEPs, which have been controversial since their inception, have been found to be effective and cost-effective interventions that prevent the spread of HIV and hepatitis infections among drug users. Their number and impact in the U.S., however, has been limited by federal, state and local laws as well as law enforcement practices.

In December 2009, the Consolidated Appropriation Act modified the two-decade ban on the use of federal funds to support SEPs. At the time, the law did three things: formalized the federal government's recognition of the role of SEPs in community-based disease prevention; allowed federal public health agencies to research and provide technical assistance to the programs; and provided a new source of funding during 2010 for the more than 180 SEPs in operation in the country. State and local governments provided 79 percent of SEP funding, with the remainder from private sources. In the past, limited funding was cited as a common problem facing SEPs. The lifting of the federal funding ban, however, was not permanent. It was reinstated by Congress in December 2011.

Traci Green, Ph.D., M.Sc., a researcher with Rhode Island Hospital and Lifespan/Tufts/Brown Center for AIDS Research, led a study to determine discrepancies between the promise of the law and its "street-level impact" in the initial stages of implementation. Through a telephone survey of SEPs around the country, Green and her colleagues examined several things: whether SEPs currently received federal funding explicitly for syringe exchange and distribution activities; whether SEPs anticipated pursing federal funding; and the experienced and perceived barriers to acquiring federal funds under the preliminary U.S. Health and Human Services (HHS) guidelines.

Their findings indicate that of the 187 SEPs that responded, 90 percent were legally authorized. While 116 intended to pursue federal funding, only three were receiving federal funding at the time of study.

Green says, "Support for increased access to clean syringes and availability of federal funding for these prevention activities are part of the National HIV/AIDS Strategy. Yet we found that established SEPs rely heavily on state and local public funding, and report ongoing funding concerns. Given this, reinstating federal funding is critical for these life-saving programs. Our findings support calls that future federal funding should not come with strings attached and should be accessible to programs of any size or type that are successfully connecting with people who use drugs, and who are at high risk of acquiring HIV."

The researchers also identified perceived barriers in obtaining federal funding, in particular, the requirement that SEPs obtain annual certifications from local public health or law enforcement agencies to verify the appropriateness and location of their operations. Green says, "Clear guidelines from federal agencies are needed and legal reform is needed in several states to authorize SEP activities."

Green concludes, "It's disappointing to see the SEP funding ban reinstated but there is concerted advocacy to reverse this. If and when the ban is removed again, our findings suggest ways that this legislative action can be done to maximize public health benefit, including removing difficult-to-implement law enforcement requirements or location restrictions, increasing dissemination of guidelines, offering technical assistance to sites, and dedicating federal funding for SEPs. We call upon our legislators to ensure that these important programs receive the legislative and financial support they need to reduce the spread of HIV in the community."

###

The study was funded through a grant from the Lifespan/Tufts/Brown Center for AIDS Research. Green's principal affiliation is Rhode Island Hospital, a member hospital of the Lifespan health system in Rhode Island. Her lab and research is fully supported by Rhode Island Hospital and the Lifespan health system. Green holds an academic appointment at The Warren Alpert Medical School of Brown University and is also an affiliated scientist with the Lifespan/Tufts/Brown Center for AIDS Research in Providence, R.I. The grant for this project was received through the Lifespan Office of Research Administration. Other researchers involved in the study with Green include Sarah Bowman, M.P.H, and Marita Mann, B.S., from the division of internal medicine at Rhode Island Hospital; Erika G. Martin, of Rockefeller College of Public Affairs and Policy at SUNY Albany; and Leo Beletsky, currently with Northeastern University School of Law & Bouv College of Health Sciences.

About Rhode Island Hospital

Founded in 1863, Rhode Island Hospital (www.rhodeislandhospital.org) in Providence, R.I., is a private, not-for-profit hospital, the largest teaching hospital of The Warren Alpert Medical School of Brown University and a founding member of the Lifespan health system. A major trauma center for southeastern New England, the hospital is dedicated to being on the cutting edge of medicine and research. Rhode Island Hospital receives nearly $55 million each year in external research funding. It is home to Hasbro Children's Hospital, the state's only facility dedicated to pediatric care.


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[ Back to EurekAlert! ] Public release date: 15-Mar-2012
[ | E-mail | Share Share ]

Contact: Nancy Jean
njean@lifespan.org
Lifespan

Rhode Island Hospital study finds barriers, difficulty in obtaining funding when available

PROVIDENCE, R.I. A study from Rhode Island Hospital examined the two-year period when the current ban on federal funding for syringe exchange programs (SEPs) was lifted in order to learn whether SEPs received or anticipated pursuing federal funding during that time. Only three of the 187 SEPs that responded had received funding at the time of the survey, and early experiences cited many barriers to accessing the federal funds. With the ban reinstated, the researchers state that the effect of federal SEP funding can therefore not realize its full public health potential. The findings are published in the American Journal of Public Health.

SEPs, which have been controversial since their inception, have been found to be effective and cost-effective interventions that prevent the spread of HIV and hepatitis infections among drug users. Their number and impact in the U.S., however, has been limited by federal, state and local laws as well as law enforcement practices.

In December 2009, the Consolidated Appropriation Act modified the two-decade ban on the use of federal funds to support SEPs. At the time, the law did three things: formalized the federal government's recognition of the role of SEPs in community-based disease prevention; allowed federal public health agencies to research and provide technical assistance to the programs; and provided a new source of funding during 2010 for the more than 180 SEPs in operation in the country. State and local governments provided 79 percent of SEP funding, with the remainder from private sources. In the past, limited funding was cited as a common problem facing SEPs. The lifting of the federal funding ban, however, was not permanent. It was reinstated by Congress in December 2011.

Traci Green, Ph.D., M.Sc., a researcher with Rhode Island Hospital and Lifespan/Tufts/Brown Center for AIDS Research, led a study to determine discrepancies between the promise of the law and its "street-level impact" in the initial stages of implementation. Through a telephone survey of SEPs around the country, Green and her colleagues examined several things: whether SEPs currently received federal funding explicitly for syringe exchange and distribution activities; whether SEPs anticipated pursing federal funding; and the experienced and perceived barriers to acquiring federal funds under the preliminary U.S. Health and Human Services (HHS) guidelines.

Their findings indicate that of the 187 SEPs that responded, 90 percent were legally authorized. While 116 intended to pursue federal funding, only three were receiving federal funding at the time of study.

Green says, "Support for increased access to clean syringes and availability of federal funding for these prevention activities are part of the National HIV/AIDS Strategy. Yet we found that established SEPs rely heavily on state and local public funding, and report ongoing funding concerns. Given this, reinstating federal funding is critical for these life-saving programs. Our findings support calls that future federal funding should not come with strings attached and should be accessible to programs of any size or type that are successfully connecting with people who use drugs, and who are at high risk of acquiring HIV."

The researchers also identified perceived barriers in obtaining federal funding, in particular, the requirement that SEPs obtain annual certifications from local public health or law enforcement agencies to verify the appropriateness and location of their operations. Green says, "Clear guidelines from federal agencies are needed and legal reform is needed in several states to authorize SEP activities."

Green concludes, "It's disappointing to see the SEP funding ban reinstated but there is concerted advocacy to reverse this. If and when the ban is removed again, our findings suggest ways that this legislative action can be done to maximize public health benefit, including removing difficult-to-implement law enforcement requirements or location restrictions, increasing dissemination of guidelines, offering technical assistance to sites, and dedicating federal funding for SEPs. We call upon our legislators to ensure that these important programs receive the legislative and financial support they need to reduce the spread of HIV in the community."

###

The study was funded through a grant from the Lifespan/Tufts/Brown Center for AIDS Research. Green's principal affiliation is Rhode Island Hospital, a member hospital of the Lifespan health system in Rhode Island. Her lab and research is fully supported by Rhode Island Hospital and the Lifespan health system. Green holds an academic appointment at The Warren Alpert Medical School of Brown University and is also an affiliated scientist with the Lifespan/Tufts/Brown Center for AIDS Research in Providence, R.I. The grant for this project was received through the Lifespan Office of Research Administration. Other researchers involved in the study with Green include Sarah Bowman, M.P.H, and Marita Mann, B.S., from the division of internal medicine at Rhode Island Hospital; Erika G. Martin, of Rockefeller College of Public Affairs and Policy at SUNY Albany; and Leo Beletsky, currently with Northeastern University School of Law & Bouv College of Health Sciences.

About Rhode Island Hospital

Founded in 1863, Rhode Island Hospital (www.rhodeislandhospital.org) in Providence, R.I., is a private, not-for-profit hospital, the largest teaching hospital of The Warren Alpert Medical School of Brown University and a founding member of the Lifespan health system. A major trauma center for southeastern New England, the hospital is dedicated to being on the cutting edge of medicine and research. Rhode Island Hospital receives nearly $55 million each year in external research funding. It is home to Hasbro Children's Hospital, the state's only facility dedicated to pediatric care.


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AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.


Source: http://www.eurekalert.org/pub_releases/2012-03/l-sep031412.php

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HPV Testing Recommended for Women Over 30

Women over 30 may need to get a pap smear only once every five years if they undergo testing for the human papillomavirus (HPV) at the same time, according to new cervical cancer screening guidelines.

The guidelines, announced today (March 14) by the U.S. Preventative Task Force, say women between ages 30 and 65 who receive a normal pap test result and negative HPV test can safely wait five years to have their next screening.

An early draft of the guidelines was released in October. At that time, the task force said there was not enough information to judge the risks and benefits of HPV testing. But since then, new information has become available, including a Dutch study published in December that suggested that, for women over 30 with a normal pap test and negative HPV test, the risk of cervical cancer within the next three to five years is very low.

"It's really about time," Dr. Leo Twiggs, a professor of obstetrics and gynecology at the University of Miami School of Medicine, said of the inclusion of HPV testing in the new recommendations. "This is a more precise way of determining whether the disease is really there or not," Twiggs said.

The task force does not recommend HPV testing for women under 30, as HPV infection is common in this group and is often cleared by the immune system.

More recommendations

Other recommendations in the new guidelines are consistent with what the ?U.S. Preventative Task Force has said previously: women should start cervical cancer screening at age 21, and undergo screening every three years until age 65 (unless they choose to lengthen their screening interval by also getting an HPV test after age 30). This recommendation applies to women regardless of their sexual history.

The task force does not recommend cervical cancer screening for women under 21, as cervical cancer is rare in this group and evidence suggests screening does more harm than good. Abnormal results from a pap smear in women and teens under 21 are likely to be due to a temporary condition, the guidelines say.

Women over 65 do not need to be screened for cervical cancer if they have received adequate screening in the past and are not at increased risk for the disease, the guidelines say. And women who've had a hysterectomy, including removal of the cervix, and who do not have a history of cervical cancer or precancerous lesions do not need to be screened.

Screening harms

Screening for cervical cancer screening comes with risks of additional testing and treatments for precancerous lesions that may go away on their own. Some treatments of cervical cancer are associated with a risk of harmful outcomes in pregnancy, such as preterm delivery, the guidelines say.

A positive HPV test is considered a positive screening result, said study research, Dr. Virginia Moyer, professor of pediatrics at Baylor Medical College in Houston and chairwoman of the task force for cervical cancer screening. For this reason, women who chose HPV testing in addition to pap testing should be aware that they may require additional, more frequent tests if their HPV test is positive, Moyer said. About 11 percent of women ages 30 to 34 who have a normal pap test will have a positive HPV test, the guidelines say.

The new recommendations do not specify that screening be done differently for women who've received the HPV vaccine.

"Future evidence may show that less frequent screening will be appropriate in vaccinated women, but given the limitations of current research, and the low vaccination coverage among unexposed U.S. adolescents," screening recommendations for vaccinated women should not differ from those for unvaccinated women at this time, Dr. Nora Kizer and Dr. Jeffrey Peipert of the Washington University in St. Louis School of Medicine, wrote in an editorial accompanying the guidelines.

The guidelines and editorial are published today (March 14) in the journal Annals of Internal Medicine.

Pass it on:? Women over 30 who are screened for cervical cancer with HPV testing and a pap smear may not need another screening for five years.

This story was provided by MyHealthNewsDaily, a sister site to LiveScience. Follow MyHealthNewsDaily staff writer Rachael Rettner on Twitter @RachaelRettner. Find us on Facebook.

Source: http://news.yahoo.com/hpv-testing-recommended-women-over-30-223201980.html

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Killer Joe's NC-17 Sticks

Killer Joe

After walking out of Killer Joe, one of my favorite films of SXSW, the NC-17 rating was one of the first things that hit me. It?s easy to see why the MPAA slapped it with that box-office death rating. When William Friedkin?s film gets nasty, it gets nasty. The film is about the rough and real kind of violence, not the goofy fun type. However, Killer Joe?s violence and sex is still plenty steps down from a handful of R-rated releases. We?ve seen violence of this magnitude done on-screen before, so it?s most likely a tonal issue the MPAA has with Friedkin?s stage adaptation.

LD Entertaiment recently attempted to appeal the NC-17 rating, but it has now been denied. Rumors are that they?ll appeal again soon. David Dinerstein, the president of LD Entertainment, and the film?s screenwriter Tracy Letts?both gave statements to the appeals board, and I happened to have interviewed Letts the other day at SXSW.

Here?s what he had to say on the matter:

?You know, talking about the NC-17 rating, for instance, in some ways it?s because the characters are well-drawn and well-acted. It?s more real, so people identify with it more. There?s a reason that Saw and Hostel get R-ratings: they?re jokes and cardboard characters. They?re clearly very successful as jokes, but they?re jokes? To?tell you the truth, I was really surprised. Billy [Friedkin] was really worried about it. At some point in filming, I said, ?Oh, there?s nothing in here [that'd make it NC-17].? I was taken totally by surprised.?

Killer Joe is currently rated NC-17 for ?graphic aberrant content involving violence and sexuality, and a scene of brutality.?

Source: JoBlo

Source: http://www.rottentomatoes.com/m/1924752/news/1924752/

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Selena Gomez and Vanessa Hudgens: Boozing in Bikinis!


Selena Gomez and Vanessa Hudgens were caught getting totally wasted in Florida this week, but fear not. They aren't going all Lindsay Lohan on us.

The young actresses co-star with Ashley Benson and Rachel Korine in Spring Breakers, an upcoming film in which the quartet portrays college girls who end up in prison after robbing a restaurant in order to finance their vacation.

They then get bailed out by a drug/arms dealer who wants them to do engaged in even more dirty work.

Sounds intriguing, and looks even better. Compare the bikini bodies below of Selena and a blonde-wigged Vanessa and vote now: Who rocks hers the best?

Source: http://www.thehollywoodgossip.com/2012/03/selena-gomez-and-vanessa-hudgens-boozing-in-bikinis/

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5 Ways Guys and Ladies Use Cell Phones Differently and Similarly ...

Guys and girls are diverse in lots of ways, so it is no surprise that they use mobile devices in various ways. We do not live on completely diverse planets however, so we also have similarities in the techniques that we use phones. Right here are some of the top examples of how genders use phones.

Gossip

Two thirds of all human conversation is gossip, so it is no surprise that this is extended to use of cell phones. Guys and girls each admit to using their cell phones as a way to gossip via e-mail, texting and chatting. Gossip is a very good and healthful issue, due to the fact it is the way that we socially groom every single other.

Establishing social abilities

Young females, but particularly young (and even some older) males, use mobile devices as a way to overcome social awkwardness. It is a means to discover to communicate, and a lot more teens communicate now then pre-mobile occasions. Due to mobile phones they communicate with more men and women, more regularly refining their social abilities.

Mobile as a bodyguard

Females will frequently use the mobile phone as a body guard. If they really feel uncomfortable someplace they could even pretend to have a conversation with a person, so that no one will try to bother them or method them. Males do not do this as frequently, but often they will if walking via a rough inner city location.

More of talking and texting

Girls have been show to talk 22% a lot more than the typical man through their telephone. They also text a lot more by texting an typical of 159 much more texts a month. This is since females typically use their phones to preserve their relationships, while men use their phones for more basic communication.

Keeping tabs on the kids

Research have shown that females will keep track of their daughters through cell phones, far more than men will reach out to sons or daughters. This is credited to the importance of matriarchal bonds in society, and the female need for that kind of bond. In much more common terms females will perform on establishing person bonds with females, while males tend to scatter their attention.

Overall cell phones have opened up communication in a excellent way. We communicate similarly to how we did in tiny communities with back-fence chatting via texting and calling. As social creatures, this expansion of communication has been overall wholesome for the human community to be in a position to continue social grooming.

Post by LookupExpert, cell telephone lookup provider.

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Source: http://www.techieaj.com/5-ways-guys-and-ladies-use-cell-phones-differently-and-similarly.html/

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Keynote for iPhone and iPad review

Keynote is all you need to create, edit, and give stunning presentations straight from your iPhone or iPad

Apple's Keynote is the presentation component of their iWork productivity suite of software, and a companion app to Pages for word processing and Numbers for spreadsheets. All three are universal apps that work on iPhone, iPod touch, and iPad, and popular choices for document management on the go. They've also just been updated to support iOS 5.1 and the new iPad's Retina display. If you're a new iPad or iPhone owner and need a way to create, edit, and give presentations on the go, Keynote is Apple's iCloud integrated solution. It was designed for Apple's late co-founder, Steve Jobs, and the desktop version was used to give every one of his presentations, including the original iPhone and iPad introductions. Does it work just as well on iOS?

Source: http://feedproxy.google.com/~r/TheIphoneBlog/~3/megedke432k/story01.htm

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Wisconsin approves recall votes for more Republican senators

MADISON, Wisconsin (Reuters) - Four more Wisconsin Republican state senators, including the Senate leader, will face recall elections this year, bringing the number of state lawmakers forced to campaign in special elections to 40 percent of the entire Senate, officials said.

The state agency that oversees elections agreed unanimously on Monday that enough valid signatures by voters were submitted to require all four senators to face recall votes.

The four lawmakers include Senate President Scott Fitzgerald, a chief architect of a law limiting union powers that was passed last year and that sparked the recall movement.

The date of the votes has not yet been set.

The decision means 13 of the state's 33 senators will have already faced a recall vote or will soon face one since Republican Governor Scott Walker pushed the law through the legislature last March.

Nine state senators faced recall last summer, six Republicans and three Democrats. Two of the Republicans were defeated, leaving the Republicans with a thin 17 to 16 majority in the chamber. The Democrats were challenged because they opposed the union law.

The law championed by Walker stripped unions representing teachers and other state and local government workers of much bargaining power over wages and benefits. It also required public workers to pay more for health insurance and pensions. Republicans said it was needed to restore the financial health of the state.

Outraged union supporters and Democrats vowed to vote the Republicans out of office. They have collected more than one million signatures to recall Walker. They also submitted a recall petition against his lieutenant governor.

The dates for the Senate recall elections have not yet been set in part because the election agency has not completed reviewing the huge volume of signatures seeking Walker's ouster.

The recall movement in Wisconsin has created a toxic partisanship in the state, likely to be a battleground in the 2012 presidential election.

Wisconsin voted for President Barack Obama, a Democrat, in 2008 but then elected Walker and Republican majorities of the legislature in 2010, and ousted a longtime Democratic U.S. senator.

Polls have shown a close vote in any Walker recall vote. If the signatures are verified, Democrats will still have to pick a candidate to face him. So far the best-known Democratic candidate to announce a run for governor is Douglas La Follette, a relative of well-known Wisconsin progressive "Fighting Bob" La Follette who once served at governor and U.S. senator.

(Writing by Greg McCune; Editing by Paul Thomasch and Will Dunham)

Source: http://news.yahoo.com/wisconsin-approves-recall-votes-more-republican-senators-144353547.html

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A simple, low-cost yoga program can enhance coping and quality of life for the caregivers

[ Back to EurekAlert! ] Public release date: 13-Mar-2012
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Contact: Mark Wheeler
mwheeler@mednet.ucla.edu
310-794-2265
University of California - Los Angeles

For every individual who's a victim of Alzheimer's some 5.4 million persons in the United States alone there's a related victim: the caregiver. Spouse, son, daughter, other relative or friend, the loneliness, exhaustion, fear and most of all stress and depression takes a toll

While care for the caregivers is difficult to find, a new study out of UCLA suggests that using yoga to engage in very brief, simple daily meditation can lead to improved cognitive functioning and lower levels of depression for caregivers.

Dr. Helen Lavretsky, professor of psychiatry at the UCLA Semel Institute for Neuroscience and Human Behavior, and colleagues report a further benefit as well: a reduction in stress-induced cellular aging.

The report appears in the current online edition of the International Journal of Geriatric Psychiatry.

As the U.S. population continues to age over the next two decades, the prevalence of dementia and the number of family caregivers who provide support to these loved ones will increase dramatically. Currently, at least five million Americans provide care for someone with dementia. The detrimental burden on them, in terms of their own lives, can be severe.

For example, says Lavretsky, who also directs UCLA's Late-Life Depression, Stress and Wellness Research Program, "We know that chronic stress places caregivers at a higher risk for developing depression. On average, the incidence and prevalence of clinical depression in family dementia caregivers approaches 50 percent. Caregivers are also twice as likely to report high levels of emotional distress." What's more, many caregivers tend to be older themselves, leading to what Lavretsky calls an "impaired resilience" to stress and an increased rate of cardiovascular disease and mortality.

While medication can improve depression, many caregivers may be opposed to the use of medication because of the associated cost and drug side-effects. That consideration motivated Lavretsky and her colleagues to test a brief mind-body intervention for stress reduction.

The researchers recruited 49 family caregivers who were taking care of their relatives with dementia. Their ages ranged from 45 to 91 years old and included 36 adult children and 13 spouses. The participants were randomized into two groups. The meditation group was taught a brief, 12-minute yogic practice that included an ancient chanting meditation, Kirtan Kriya, which was performed every day at the same time for eight weeks. The other group was asked to relax in a quiet place with their eyes closed while listening to instrumental music on a relaxation CD, also for 12 minutes every day at the same time for eight weeks.

At the end of the eight weeks the researchers found that the meditation group showed significantly lower levels of depressive symptoms and greater improvement in mental health and cognitive functioning, compared with the relaxation group. In the meditation group, 65 percent showed a 50 percent improvement on a depression rating scale, and 52 percent of the group showed a 50 percent improvement on a mental health score. This compared to a 31 percent depression improvement and a 19 percent mental health improvement for the relaxation group.

The researchers also found that meditation increased telomerase activity and thus slowed cellular aging. Telomerase is an enzyme that maintains the DNA at the ends of our chromosomes, known as telomeres. Telomeres are associated with a host of health risks and diseases, which may be regulated in part by psychological stress. In the absence of telomerase activity, every time our cells divide, our telomeres get shorter and shorter, until eventually, they become so short the cells die. If high telomerase can be maintained or promoted, though, it will likely promote improvement in telomere maintenance and immune cell longevity.

In the study, the meditation group showed a 43 percent improvement in telomerase activity compared with 3.7 percent in the relaxation group.

"Although the relation between mental and physical health has been previously documented, the mechanistic links are beginning to be understood at the cellular level," said Lavretsky.

"To a varying degree, many psychosocial interventions like this have been shown to enhance mental health for caregivers," she said. "Yet given the magnitude of the caregiver burden, it is surprising that very few interventions translate into clinical practice. The cost of instruction and offering classes may be one factor. Our study suggests a simple, low-cost yoga program can enhance coping and quality of life for the caregivers."

The pilot results were "striking," she said, given the improvements that were shown in mental health, cognition, and telomerase activity over a short eight weeks at a mere 12 minutes a day. "We found that the effects on cognitive and mental functioning and telomerase activity were specific to the Kirtan Kriya. Because Kirtan Kriya had several elements of using chanting, mudras (finger poses) and visualization, there was a 'brain fitness' effect in addition to stress-reduction that contributed to the overall effect of the meditation." Lavretsky plans a follow-up study to provide further confirmation of this potential mechanism in a neuroimaging study of Kirtan Kriya.

Recently, UCLA launched its new Alzheimer's and Dementia Care Program, which provides comprehensive, coordinated care as well as resources and support to patients and their caregivers. Lavretsky has incorporated yoga practice into the caregiver program.

###

Funding for the study was provided by the Alzheimer's Research and Prevention Foundation grant, the National Institutes of Health, the UCLA Cousins Center at the Semel Institute, the UCLA Older Americans Independence Center Inflammatory Biology Core, and the Bernard and Barbro Fund. Other authors of the study included P. Siddarth, N. Nazarian, N. St. Cyr, and M.R. Irwin, UCLA; E.S. Epel, J. Lin, and E. Blackburn, University of California, San Francisco; and D.S. Khalsa, Alzheimer's Research and Prevention Foundation, Tucson, Ariz. The authors report no conflict of interest.

The UCLA Department of Psychiatry and Biobehavioral Sciences is the home within the David Geffen School of Medicine for faculty who are expert in the origins of and treatments for disorders of complex human behavior. It is part of the Semel Institute for Neuroscience and Human Behavior, a world leading, interdisciplinary research and education institute devoted to the understanding of complex human behavior and the causes and consequences of neuropsychiatric disorders.



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AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.


[ Back to EurekAlert! ] Public release date: 13-Mar-2012
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Contact: Mark Wheeler
mwheeler@mednet.ucla.edu
310-794-2265
University of California - Los Angeles

For every individual who's a victim of Alzheimer's some 5.4 million persons in the United States alone there's a related victim: the caregiver. Spouse, son, daughter, other relative or friend, the loneliness, exhaustion, fear and most of all stress and depression takes a toll

While care for the caregivers is difficult to find, a new study out of UCLA suggests that using yoga to engage in very brief, simple daily meditation can lead to improved cognitive functioning and lower levels of depression for caregivers.

Dr. Helen Lavretsky, professor of psychiatry at the UCLA Semel Institute for Neuroscience and Human Behavior, and colleagues report a further benefit as well: a reduction in stress-induced cellular aging.

The report appears in the current online edition of the International Journal of Geriatric Psychiatry.

As the U.S. population continues to age over the next two decades, the prevalence of dementia and the number of family caregivers who provide support to these loved ones will increase dramatically. Currently, at least five million Americans provide care for someone with dementia. The detrimental burden on them, in terms of their own lives, can be severe.

For example, says Lavretsky, who also directs UCLA's Late-Life Depression, Stress and Wellness Research Program, "We know that chronic stress places caregivers at a higher risk for developing depression. On average, the incidence and prevalence of clinical depression in family dementia caregivers approaches 50 percent. Caregivers are also twice as likely to report high levels of emotional distress." What's more, many caregivers tend to be older themselves, leading to what Lavretsky calls an "impaired resilience" to stress and an increased rate of cardiovascular disease and mortality.

While medication can improve depression, many caregivers may be opposed to the use of medication because of the associated cost and drug side-effects. That consideration motivated Lavretsky and her colleagues to test a brief mind-body intervention for stress reduction.

The researchers recruited 49 family caregivers who were taking care of their relatives with dementia. Their ages ranged from 45 to 91 years old and included 36 adult children and 13 spouses. The participants were randomized into two groups. The meditation group was taught a brief, 12-minute yogic practice that included an ancient chanting meditation, Kirtan Kriya, which was performed every day at the same time for eight weeks. The other group was asked to relax in a quiet place with their eyes closed while listening to instrumental music on a relaxation CD, also for 12 minutes every day at the same time for eight weeks.

At the end of the eight weeks the researchers found that the meditation group showed significantly lower levels of depressive symptoms and greater improvement in mental health and cognitive functioning, compared with the relaxation group. In the meditation group, 65 percent showed a 50 percent improvement on a depression rating scale, and 52 percent of the group showed a 50 percent improvement on a mental health score. This compared to a 31 percent depression improvement and a 19 percent mental health improvement for the relaxation group.

The researchers also found that meditation increased telomerase activity and thus slowed cellular aging. Telomerase is an enzyme that maintains the DNA at the ends of our chromosomes, known as telomeres. Telomeres are associated with a host of health risks and diseases, which may be regulated in part by psychological stress. In the absence of telomerase activity, every time our cells divide, our telomeres get shorter and shorter, until eventually, they become so short the cells die. If high telomerase can be maintained or promoted, though, it will likely promote improvement in telomere maintenance and immune cell longevity.

In the study, the meditation group showed a 43 percent improvement in telomerase activity compared with 3.7 percent in the relaxation group.

"Although the relation between mental and physical health has been previously documented, the mechanistic links are beginning to be understood at the cellular level," said Lavretsky.

"To a varying degree, many psychosocial interventions like this have been shown to enhance mental health for caregivers," she said. "Yet given the magnitude of the caregiver burden, it is surprising that very few interventions translate into clinical practice. The cost of instruction and offering classes may be one factor. Our study suggests a simple, low-cost yoga program can enhance coping and quality of life for the caregivers."

The pilot results were "striking," she said, given the improvements that were shown in mental health, cognition, and telomerase activity over a short eight weeks at a mere 12 minutes a day. "We found that the effects on cognitive and mental functioning and telomerase activity were specific to the Kirtan Kriya. Because Kirtan Kriya had several elements of using chanting, mudras (finger poses) and visualization, there was a 'brain fitness' effect in addition to stress-reduction that contributed to the overall effect of the meditation." Lavretsky plans a follow-up study to provide further confirmation of this potential mechanism in a neuroimaging study of Kirtan Kriya.

Recently, UCLA launched its new Alzheimer's and Dementia Care Program, which provides comprehensive, coordinated care as well as resources and support to patients and their caregivers. Lavretsky has incorporated yoga practice into the caregiver program.

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Funding for the study was provided by the Alzheimer's Research and Prevention Foundation grant, the National Institutes of Health, the UCLA Cousins Center at the Semel Institute, the UCLA Older Americans Independence Center Inflammatory Biology Core, and the Bernard and Barbro Fund. Other authors of the study included P. Siddarth, N. Nazarian, N. St. Cyr, and M.R. Irwin, UCLA; E.S. Epel, J. Lin, and E. Blackburn, University of California, San Francisco; and D.S. Khalsa, Alzheimer's Research and Prevention Foundation, Tucson, Ariz. The authors report no conflict of interest.

The UCLA Department of Psychiatry and Biobehavioral Sciences is the home within the David Geffen School of Medicine for faculty who are expert in the origins of and treatments for disorders of complex human behavior. It is part of the Semel Institute for Neuroscience and Human Behavior, a world leading, interdisciplinary research and education institute devoted to the understanding of complex human behavior and the causes and consequences of neuropsychiatric disorders.



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Source: http://www.eurekalert.org/pub_releases/2012-03/uoc--asl031312.php

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