Is gender equality achievable in the Russian family?

Nizhny Novgorod scientists have studied the responsibilities Russian men (fathers) are ready to assume in the family

CONSIDERING THE OLD USSR WAS SUPPOSED TO BE ALL ABOUT EQUALITY WHICH IS WHY THAT HAD PROGRESSIVE DAY CARE FOR WOMEN WORKERS

LOBACHEVSKY UNIVERSITY

Distribution of rights and obligations in the family, opportunities and responsibilities in performing the main family functions is one of the most controversial, but at the same time one of the most important issues in the modern context.

Scientists from the Department of General Sociology and Social Work of the Faculty of Social Sciences at Lobachevsky University have been engaged in research on parenthood and the distribution of parental functions for many years.

According to Nadezhda Egorova, Associate Professor at the Department of General Sociology and Social Work of the UNN Faculty of Social Sciences, the so-called traditional or patriarchal family role structure is increasingly subject to criticism and revision in the views of various social groups.

"The formula proposed by the famous American sociologist of the 20th century, Tolcott Parsons, that was very popular until the end of the century, according to which "the role of women is primarily in the performance of their family functions as wives, mothers and housewives, while the role of men is carried out in the professional world, at work..." is increasingly less acceptable in modern conditions that require women's active involvement in the field of labor relations," comments Nadezhda Egorova.

An egalitarian model based on equality and partnership in marriage and parenthood is becoming a more popular alternative to this distribution of roles and power in the family. At the same time, the movement towards equality is not an easy process. It requires finding the answers to the main questions of the study: what do women and men want to do and what are they ready to change? Is gender equality achievable in Russian realities?

UNN scientists' conclusions are based on their research: a questionnaire survey of third and fourth year students of Nizhny Novgorod universities ("Students' ideas regarding a father's role", N=472) and in-depth interviews with men aged 24 to 57 years old who have children ("Social practices of fatherhood in a modern Russian family", N=46) conducted by the authors in 2017-2019.

Research results show that most students are of the same opinion: parenting is the responsibility of both partners. Both young men (78%) and girls (89%) generally support this idea.

"However, the democratization of family relations is taking place at different rates; the need to share parental responsibility is more pronounced in the views of girls than in those of young men. The latter are more oriented towards traditional values, for example, they more often believe that the father does not have to be involved in the daily care of the child, he should bring up the child by his own example (the degree of agreement with this judgment is 40% for young men and 23% for girls). In the girls' opinion, on the contrary, men should share the responsibility for taking care of their children with women (86% vs. 74%)," comments Elena Ryabinskaya, sociologist at the Department of General Sociology and Social Work.

In the family practices of the fathers who have been interviewed, most follow the traditional model of distribution of parental and family responsibilities in general. At the same time, modern men have to adapt to women's active role in the labour market and have to be more frequently involved in family processes, including the upbringing of children.

Studies conducted by Lobachevsky University researchers show that the role of the father involves a wide range of responsibilities that imply men's full participation in the life of their children at various stages of their growing up.

"Fulfilled fathers are aware of the importance and value of paternal involvement in raising their children. In addition to the traditional patriarchal roles of a breadwinner, a disciplinarian, an 'image maker' and a family defender in public settings, today's fathers focus on parental responsibility, direct contribution to looking after their children, hygienic care, playing games, sharing their life experience, and the practice of active involvement of men in parenting becomes quite significant," says Alina Yanak, Assistant at the Department of General Sociology and Social Work.

Lobachevsky University scientists have proved that all young people are willing to be involved in the process of raising and caring for children, but there are certain differences in their approach to this matter.

"Activities related to the organization of children's leisure time throughout the whole stage of their growing up are more attractive for young men than the routine, daily work of providing constant care for young and growing children. This work should probably remain the woman's responsibility. Here, young people's views on parenthood are affected by the continuity of their families' traditions," Elena Ryabinskaya comments on the study's findings.

Thus, the area of competence of the surveyed students' mothers comprised only everyday responsibilities for the care and upbringing of the child, and the area of competence of their fathers mainly included responsibilities related to the organization of the child's leisure time.

Studies have shown that girls are more demanding with respect to men's parenting role, often believing that all these actions should be an integral part of the father's role set.

In their research, scientists from Lobachevsky University have also demonstrated another important aspect of the upbringing process: building relationships with children of different sexes. Most students believe that the amount of attention given to a child should not depend on whether it is a boy or a girl. However, when it comes to specific actions, views on the extent to which a man is involved in raising a daughter and a son can differ. In the actual practices of fathers, this difference becomes both more significant and more understandable.

In general, it is easier for men to adapt to the parenting role in interaction with boys, they can better understand how to structure their behavior with them. Men believe that they will be able to self-realize and self-identify in the role of the father, primarily in the process of raising their son, because they want to be self-projected on their child, want to be an example to him, to develop "male" skills and interests, to communicate 'on equal terms'. "It's easier with a son... A boy is a boy. There are a lot of common interests: some technical stuff, sports, and other things. Can Daddy do that? Yes, he can. Can Daddy teach? He will," one of the fathers says.

Fathers speak of their daughters with some trepidation, they believe that there are more complex nuances in dealing with girls, they need a more attentive, flexible and gentle approach. A father of four had this to say: "I'm very strict... And... it was very difficult for me, when we had a daughter, to change my ways after raising three boys... With boys, it's like in the army: "Attention!", "At ease!" "Dismissed!" But with a girl, it's different. So, at the beginning my wife even offered me to read psychological articles on how I should love my daughter and how I should talk to her...".

"They consciously put themselves on secondary positions with regard to girls, imposing the duty of caring for them on mothers," continues Alina Yanak. Nizhny Novgorod scientists have shown that the movement towards egalitarianism in the sphere of parenthood is becoming more and more visible both at the level of perceptions and in real family practices. But the process is controversial and nonuniform.

"We are witnessing a gradual inclusion of men in parenting rather than a conscious readiness for equality in this sphere," Nadezhda Yegorova says in conclusion.

The difference in goals and in the process of socialization of boys and girls proved by the studies of Nizhny Novgorod scientists is likely to contribute to the reproduction of the traditional/patriarchal model of family and parenthood.

###

Mom and baby share 'good bacteria' through breast milk

The process of pumping, storing and bottle-feeding breast milk may reduce the transfer of bacteria from mom to baby

UNIVERSITY OF BRITISH COLUMBIA

 

IMAGE: A NEW STUDY HAS FOUND THAT BACTERIA ARE SHARED AND POSSIBLY TRANSFERRED FROM A MOTHER'S MILK TO HER INFANT'S GUT, AND THAT BREASTFEEDING DIRECTLY AT THE BREAST BEST SUPPORTS THIS... view more 

CREDIT: KEVIN LIANG/UNSPLASH

A new study by researchers at the University of British Columbia and the University of Manitoba has found that bacteria are shared and possibly transferred from a mother's milk to her infant's gut, and that breastfeeding directly at the breast best supports this process.

The research, published today in Cell Host & Microbe, found that certain bacteria, including Streptococcus and Veillonella, co-occur in mothers' milk and their infants' stool, and this co-occurrence is higher when infants nurse directly at the breast.

"Our study confirms that breast milk is a major driver of infant gut microbiota development," said the study's senior co-author Dr. Stuart Turvey, a professor in UBC's department of pediatrics and investigator at BC Children's Hospital. "We found that breastfeeding exclusivity and duration was strongly associated with a baby's overall gut microbiota composition and that breast milk bacteria shape a baby's gut microbiome to a similar degree as other known modifiers of the gut microbiota such as birth mode--meaning a cesarean-section or vaginal delivery."

According to the researchers, this is the first study to evaluate the association of multiple breast milk feeding practices (mode, exclusivity, and duration), milk bacteria, and milk components with infant gut microbiota composition at multiple time points in a baby's first year.

The researchers analyzed the microbiome of infants' stool and their mothers' breastmilk using 16S rRNA sequencing, a technique used to identify, classify and determine the abundance of microbes.

The 1,249 mother-baby pairs involved in the research are participating in the CHILD Cohort Study (CHILD), a world-leading birth cohort study in maternal, newborn and child health research. The findings build upon previous CHILD research that showed pumping breast milk is associated with differences in both milk microbiota composition and infant health.

"Uniquely, our study showed that while breast milk and the infant gut have distinct microbiota compositions, there are a few commonly shared bacteria that were more prevalent and abundant in breast milk of mothers who only nursed directly at the breast, while other bacteria showed dose-dependent associations with exclusive breastfeeding," said the study's senior co-author Brett Finlay, professor in the departments of biochemistry and molecular biology, and microbiology and immunology at UBC.

"These results advance the hypothesis that breast milk may act as an incubator that enriches, protects and transports certain bacteria to a baby's intestinal tract and this may give us clues about which bacteria could make good probiotics since they appear to withstand the trip to the baby's gut," Finlay added.

###

The collaborative study was co-led by Turvey, Finlay and Meghan Azad, Canada Research Chair in Developmental Origins of Chronic Disease at the University of Manitoba, and co-director of the Manitoba Interdisciplinary Lactation Centre at the Children's Hospital Research Institute of Manitoba. Trainees Rozlyn Boutin and Hind Sbihi at UBC, and Kelsey Fehr and Dr. Shirin Moossavi at the University of Manitoba were the study's co-first authors.

Disclaimer: 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.

Commentary in Pediatrics: Children don't transmit Covid-19, schools should reopen in fall

Rising cases in Texas childcare facilities could be misinterpreted, says commentary author

UNIVERSITY OF VERMONT

    SHARE

 PRINT  E-MAIL

IMAGE: BASED ON ONE NEW AND THREE RECENT STUDIES, THE AUTHORS OF A COMMENTARY IN PEDIATRICS CONCLUDE THAT CHILDREN RARELY TRANSMIT COVID-19, EITHER AMONG THEMSELVES OR TO ADULTS. BASED ON THE... view more 

CREDIT: WWW.VPEREMEN.COM / CC BY-SA

A commentary published in the journal Pediatrics, the official peer-reviewed journal of the American Academy of Pediatrics, concludes that children infrequently transmit Covid-19 to each other or to adults and that many schools, provided they follow appropriate social distancing guidelines and take into account rates of transmission in their community, can and should reopen in the fall.

The authors, Benjamin Lee, M.D. and William V. Raszka, Jr., M.D., are both pediatric infectious disease specialists on the faculty of the University of Vermont's Larner College of Medicine. Dr. Raszka is an associate editor of Pediatrics.

The authors of the commentary, titled "COVID-19 Transmission and Children: The Child Is Not to Blame," base their conclusions on a new study published in the current issue of Pediatrics, "COVID-19 in Children and the Dynamics of Infection in Families," and four other recent studies that examine Covid-19 transmission by and among children.

--In the new Pediatrics study, Klara M. Posfay-Barbe, M.D., a faculty member at University of Geneva's medical school, and her colleagues studied the households of 39 Swiss children infected with Covid-19. Contact tracing revealed that in only three (8%) was a child the suspected index case, with symptom onset preceding illness in adult household contacts.

--In a recent study in China, contact tracing demonstrated that, of the 68 children with Covid-19 admitted to Qingdao Women's and Children's Hospital from January 20 to February 27, 2020, 96% were household contacts of previously infected adults. In another study of Chinese children, nine of 10 children admitted to several provincial hospitals outside Wuhan contracted Covid-19 from an adult, with only one possible child-to-child transmission, based on the timing of disease onset.

--In a French study, a boy with Covid-19 exposed over 80 classmates at three schools to the disease. None contracted it. Transmission of other respiratory diseases, including influenza transmission, was common at the schools.

--In a study in New South Wales, nine infected students and nine staff across 15 schools exposed a total of 735 students and 128 staff to Covid-19. Only two secondary infections resulted, one transmitted by an adult to a child.

"The data are striking," said Dr. Raszka. "The key takeaway is that children are not driving the pandemic. After six months, we have a wealth of accumulating data showing that children are less likely to become infected and seem less infectious; it is congregating adults who aren't following safety protocols who are responsible for driving the upward curve."

Rising cases among adults and children in Texas childcare facilities, which have seen 894 Covid-19 cases among staff members and 441 among children in 883 child care facilities across the state, have the potential to be misinterpreted, Dr. Raszka said. He has not studied the details of the outbreak.

"There is widespread transmission of Covid-19 in Texas today, with many adults congregating without observing social distancing or wearing masks," he said. "While we don't yet know the dynamics of the outbreak, it is unlikely that infants and children in daycare are driving the surge. Based on the evidence, it's more plausible that adults are passing the infection to the children in the vast majority of cases."

Additional support for the notion that children are not significant vectors of the disease comes from mathematical modeling, the authors say. Models show that community-wide social distancing and widespread adoption of facial cloth coverings are far better strategies for curtailing disease spread, and that closing schools adds little. The fact that schools have reopened in many Western European countries and in Japan without seeing a rise in community transmissions bears out the accuracy of the modeling.

Reopening schools in a safe manner this fall is important for the healthy development of children, the authors say. "By doing so, we could minimize the potentially profound adverse social, developmental, and health costs that our children will continue to suffer until an effective treatment or vaccine can be developed and distributed, or failing that, until we reach herd immunity," the paper concludes.

###

Columbia physicians give first comprehensive review of COVID-19's effects outside the lung

COLUMBIA UNIVERSITY IRVING MEDICAL CENTER

NEW YORK, NY (July 10, 2020) -- After only a few days caring for critically ill COVID-19 patients at the start of the outbreak in New York City, Aakriti Gupta, MD, realized that this was much more than a respiratory disease.

"I was on the front lines right from the beginning. I observed that patients were clotting a lot, they had high blood sugars even if they did not have diabetes, and many were experiencing injury to their hearts and kidneys," says Gupta, one of the first Columbia cardiology fellows to be deployed to the COVID intensive care units at Columbia University Irving Medical Center.

In early March, there wasn't much clinical guidance on the non-respiratory effects of COVID-19, so Gupta decided to coalesce findings from studies that were just beginning to appear in the literature with what the physicians were learning from experience.

Gupta, along with senior author Donald Landry, MD, PhD, chair of medicine at Columbia University Vagelos College of Physicians and Surgeons, organized senior co-authors, and Gupta, along with two other colleagues, Mahesh Madhavan, MD, a cardiology fellow at CUIMC, and Kartik Sehgal, MD, a hematology/oncology fellow at Beth Israel Deaconess Medical Center/Harvard Medical School, mobilized clinicians at Columbia, Harvard, Yale, and Mount Sinai Hospital, among other institutions, to review the latest findings on COVID-19's effect on organ systems outside the lungs and provide clinical guidance for physicians.

Their review--the first extensive review of COVID-19's effects on all affected organs outside the lungs--was published today in Nature Medicine.

"Physicians need to think of COVID-19 as a multisystem disease," Gupta says. "There's a lot of news about clotting but it's also important to understand that a substantial proportion of these patients suffer kidney, heart, and brain damage, and physicians need to treat those conditions along with the respiratory disease."

Blood Clots, Inflammation, and an Immune System in Overdrive

"In just the first few weeks of the pandemic, we were seeing a lot of thrombotic complications, more than what we would have anticipated from experience with other viral illnesses," says Sehgal, "and they can have profound consequences on the patient."

Scientists think these clotting complications may stem from the virus's attack on cells that line the blood vessels. When the virus attacks blood vessel cells, inflammation increases, and blood begins to form clots, big and small. These blood clots can travel all over the body and wreak havoc on organs, perpetuating a vicious cycle of thromboinflammation.

To combat clotting and its damaging effects, clinicians at Columbia, many of whom are co-authors on this review, are conducting a randomized clinical trial to investigate the optimal dose and timing of anticoagulation drugs in critically ill patients with COVID-19.

The untempered inflammation can also overstimulate the immune system, and though doctors initially shied away from using steroids to globally suppress the immune system, a recent clinical trial has found that at least one steroid, dexamethasone, reduced deaths in ventilated patients by one-third. Randomized clinical trials are underway to target specific components of thromboinflammation and the immune system, such as interleukin-6 signaling.

"Scientists all over the world are working at an unprecedented rate towards understanding how this virus specifically hijacks the normally protective biological mechanisms. We hope that this would help in the development of more effective, precise, and safer treatments for COVID-19 in the near future," says Sehgal.

Straight to the Heart

Clots can cause heart attacks, but the virus attacks the heart in other ways, one author says.

"The mechanism of heart damage is currently unclear, as the virus has not been frequently isolated from the heart tissue in autopsy cases," says Gupta.

The heart muscle may be damaged by systemic inflammation and the accompanying cytokine release, a flood of immune cells that normally clears up infected cells but can spiral out of control in severe COVID-19 cases.

Despite the degree of heart damage, physicians were not able to utilize the diagnostic and therapeutic strategies, including heart biopsies and cardiac catheterizations, that they would normally use during the early stages of the pandemic given the need to protect personnel and patients from viral transmission. This has changed as the disease prevalence has gone down in New York CIty.

Kidney Failure

Another surprising finding was the high proportion of COVID-19 patients in the ICU with acute kidney damage.

The ACE2 receptor used by the virus to gain entry into the cells is found in high concentrations in the kidney and could likely be responsible for the renal damage. Studies in China reported renal complications, but in New York City, clinicians saw renal failure in up to 50% of patients in the ICU.

"About 5 to 10% of patients needed dialysis. That's a very high number," Gupta says.

Data regarding long-term renal damage are currently lacking, but a significant proportion of patients will likely go on to require permanent dialysis.

"Future studies following patients who experienced complications during hospitalizations for COVID-19 will be crucial," notes Madhavan.

Neurological Effects

Neurological symptoms, including headache, dizziness, fatigue, and loss of smell, may occur in about a third of patients.

More concerning, strokes caused by blood clots occur in up to 6% of severe cases and delirium in 8% to 9%.

"COVID-19 patients can be intubated for two to three weeks; a quarter require ventilators for 30 or more days," Gupta says.

"These are very prolonged intubations, and patients need a lot of sedation. 'ICU delirium' was a well known condition before COVID, and the hallucinations may be less an effect of the virus and more an effect of the prolonged sedation."

"This virus is unusual and it's hard not to take a step back and not be impressed by how many manifestations it has on the human body," says Madhavan.

"Despite subspecialty training as internists, it's our job to keep all organ systems in mind when caring for the patients in front of us. We hope that our review, observations, and recommendations can help other clinicians where cases are now surging."

###

The paper is titled, "Extrapulmonary manifestations of COVID-19."

Other authors are: Nandini Nair (Columbia), Shiwani Mahajan (Yale University School of Medicine, New Haven, CT), Tejasav S. Sehrawat (Mayo Clinic, Rochester, MN), Behnood Bikdeli (Columbia), Neha Ahluwalia (Icahn School of Medicine at Mount Sinai, New York, NY), John C. Ausiello (Columbia), Elaine Y. Wan (Columbia), Daniel E. Freedburg (Columbia), Ajay J. Kirtane (Columbia), Sahil A. Parikh (Columbia), Mathew S. Maurer (Columbia), Anna S. Nordvig (Columbia), Domenico Accili (Columbia), Joan M. Bathon (Columbia), Sumit Mohan (Columbia), Kenneth A. Bauer (Harvard Medical School, Boston, MA), Martin B. Leon (Columbia), Harlan M. Krumholz (Yale), Nir Uriel (Columbia), Mandeep R. Mehra (Harvard), Mitchell S.V. Elkind (Columbia), Gregg W. Stone (Columbia), Allan Schwartz (Columbia), David D. Ho (Columbia), and John P. Bilezikian (Columbia).

The authors received support from the National Institutes of Health (T32 HL007854, K08HL122526, R01HL152236, and R03HL146881, K23 DK111847, 5T32 NS007153, R01 AR050026, U01AR068043, R01-DK114893, R01-MD014161, and U01-DK116066) and the Department of Defense.

Financial disclosures are detailed in the paper.

Study: Medicaid expansion meant better health for the most vulnerable low-income adults

New research and report show the impact of Michigan's safety-net health coverage, and could inform states that are now considering or preparing for expansion

MICHIGAN MEDICINE - UNIVERSITY OF MICHIGAN

 

The most vulnerable residents of the nation's 10th most populous state say their health improved significantly after they enrolled in Michigan's expanded Medicaid program, a new study finds.

Michiganders with extremely low incomes, those who live with multiple chronic health problems, and those who are Black, got the biggest health boosts year over year among all those enrolled in the safety-net health coverage program, the study shows.

But participants of almost all ages, backgrounds and in all geographic regions reported improvements in health over time.

Writing in the new issue of JAMA Network Open, a team from the University of Michigan reports the results of a survey that asked more than 3,000 enrollees in the Healthy Michigan Plan about their health, at two time points a year apart.

The new paper adds to a growing body of evidence about the impacts of Michigan's Medicaid expansion, compiled by a team from the U-M Institute for Healthcare Policy and Innovation with funding from the Michigan Department of Health and Human Services.

The IHPI team just unveiled a summary of findings based on the final report from the first five years of their evaluation of the Healthy Michigan Plan. The new paper is the latest in a series of peer-reviewed, data-driven articles that the team has published in academic journals based on their evaluation work.

Michigan's experience might inform states where Medicaid has not yet been expanded, or is about to be - including Missouri which has a ballot proposal up for a vote in early August, Oklahoma, whose voters just approved expansion last week, and Nebraska, which is preparing to start its program this fall. Twelve other states have not expanded their Medicaid programs.

Reductions in poor health

The new paper's lead author is Minal Patel, Ph.D., M.P.H., an associate professor at the U-M School of Public Health who analyzed data from the longitudinal survey of participants who had been enrolled in the Healthy Michigan Plan for at least a year before the first time they were surveyed.

The percentage of respondents who called their health fair or poor dropped from nearly 31% in 2016 to 27% in 2017. Larger decreases were seen among those with the very lowest incomes, those who were Black, those who had two or more chronic conditions, and those who live in the Detroit metropolitan area.

Additional survey data contained in a new report showed that the percentage who said their health was fair or poor dropped further, to 25.6% by 2018.

The average number of days in the past month when the respondents said they had been in poor physical health dropped by more than a day in many groups, including those with two or more chronic health conditions. But there was no significant change in days of poor mental health or days when respondents said their health interfered with their usual activities.

Nearly one quarter of respondents who answered in 2016 were no longer enrolled in the program when surveyed in 2017.

Enrollees had incomes below or just above the federal poverty line, but 57% said they were employed or self-employed. Just over half had incomes less than 35% of the federal poverty level, which was $11,880 for a single adult in 2016.

"Our study showed that sub-groups who would benefit the most from greater access to care through Michigan's Medicaid expansion reported improved health over time," says Patel. "Better access is indeed translating to better health."

The emphasis that the Healthy Michigan Plan places on primary care and prevention, as well as the inclusion of dental and vision care that can address long-unmet needs, likely played a role, she adds.

"It is rare to find a change in health policy that actually improves health of a target population in merely one year," says Susan D. Goold, M.D., MHSA, M.A., study co-author and professor of internal medicine at U-M. "The Healthy Michigan Plan model of expansion, which emphasized both insurance coverage and primary care, built on what we have learned from health systems around the globe."

Five years in, some key findings

The economic effects of COVID-19 have likely led more Michiganders to seek coverage from the safety net of the Healthy Michigan Plan. As of this week, more than 751,000 people are enrolled in the plan, up from 675,000 in February before COVID-19 struck Michigan.

"This new study adds to the large body of evidence on Medicaid expansion that our team at the University of Michigan has developed over the past five years," says IHPI director and study co-author John Z. Ayanian, M.D., M.P.P.

Some other key findings documented in the five-year summary brief:

• Before enrolling in the Healthy Michigan Plan, half of those surveyed said they had a doctor or clinic they could see for regular care. By 2018, that had climbed to 83%.
• The percentage who said that emergency rooms were their usual source of care dropped from 12% to 3%.
• 85% of enrollees had seen a primary care provider in the last year, 84% had received a preventive medical service such as a cancer screening, and nearly half had seen a dentist.
• 40% of enrollees surveyed said their dental health had improved since enrolling
• 85% of enrollees said they had fewer problems paying medical bills since they enrolled
• The percentage of enrollees who said they were employed or enrolled as a student grew to 61% in 2018, up from 55% in 2016.
• 43% of enrollees said they had completed a Health Risk Assessment, a special feature of the Healthy Michigan Plan. Of these, 91% said it motivated them to be more responsible for their health.
• Enrollees with incomes above the poverty level pay a contribution of 2% of their household income for their Healthy Michigan Plan coverage. Some services have co-pays. 88% of enrollees said that the amount they pay for their coverage seems fair. Among those who were billed for contributions or copays, the average quarterly statement amount was $16.85.

The IHPI team continues to study the impacts of Medicaid expansion on Michigan's enrollees. Learn more about IHPI's Healthy Michigan Plan evaluation: https://ihpi.umich.edu/featured-work/healthy-michigan-plan-evaluation

F 4 FAKE

New study warns of misinformation about opt-out organ donation

UNIVERSITY OF NOTTINGHAM

 

A new study has warned of the power of a type of behaviour dubbed the 'lone wolf' effect which could result in people 'opting out' of supporting organ donation.

A behavioural study led by researchers from the University of Nottingham's School of Psychology and Nanyang Technological University's Department of Economics found that initial co-operation, encouraged by an opt-out policy, can be undermined by members of the public observing the actions of 'lone wolves'.

The study revealed that lone wolves unilaterally defect and publicly display their decision to opt out leading others to follow suit and do the same. This effect of lone wolves is a stronger social force for change than people following 'good shepherds' who are observed to register under an opt-in policy. Their findings have been published in Scientific Reports.

It has long been recognised that when it comes to making an organ donation decision, not everyone wishes to or can donate. People also may wish to donate, but don't, simply because they never got around to signing up. To help overcome this inertia, and redress the shortage in organs, some countries, including Wales and most recently, England, have introduced a change in law, to move from an opt-in system (where everyone is assumed to be a non-donor and registers to be a donors) to an opt-out system (where everyone is assumed to be a donor, unless they opt out.)

The policy in England is a so-called "soft opt-out" policy. This means that all adults in England (unless they are in one of the excluded groups), will be considered to have agreed to be an organ donor when they die unless they have recorded a decision not to donate (either by registering their decision on the NHS Organ Donor Register or telling their family and friends.) The system is a "soft opt-out" as relatives will still be consulted, before organ donation goes ahead.

Professor Eamonn Ferguson from the University of Nottingham said: "The opt-out system relies on people accepting the default of their organs being donated, unless they take action to confirm their decision not to donate. However, our research uncovered a disruptor to this called the 'lone wolf'.

If people know that others have decided to opt out, they are very likely also to do the same. In a world dominated by social media and instant messaging, this can sets up a negative cascade that quickly spreads.

This is important as much of the evidence for moving to opt-out is derived from population studies that cover time periods prior to the social media explosion."

The researchers devised economic games to model the organ donor decision. 213 people participated in games where they indicated their decision to register as a donor under opt-in, or opt-out. They examined the effect the feedback from others (akin to social media updates) had on people's decisions.

Associate Professor Jonathan Tan of Nanyang explains: "In theory, under an opt-out system where feedback is available, people are better off cooperating if they cannot get away with free-riding since others can observe them and opt out too. In practice, however, so long as there are lone wolves who unconditionally free-ride, this default system will lose its strategic power."

Professor Ferguson adds: "The results showed that when people decide not to follow an opt-out default or request, the effect on causing others to follow suit is very strong and much stronger than following people who are acting in accordance with an opt-in policy and registering.

We know that people follow others behaviour, but it is interesting that when everyone is requested to cooperate and help, people has a strong tendency to follow the example of a negative uncooperative influence (or lone wolf). Many people may decide to opt-out simply because others do. This may be because they think that others know something they don't or they don't want to be left behind.

This also raises a very real risk that incorrect information about organ donation and the law change could lead large numbers of people to opt out. This is something that has not been documented before in academic research and we feel is important for the public to be aware, so they can be alert and on their guard for the influence of such information.

While we examined these effects in organ donation they have implications for other public health policies where defaults may be considered such as vaccinations, energy conservation and social distancing."

We would recommend harnessing the 'good shepherd' effect to help encourage registration as exemplified by recent evidence that posting about signing up to be a donor increased registration: the so called 'Facebook' effect.

If moving to an opt-out policy then strategies to ameliorate the 'lone wolf 'effect need to be considered. This could involve the use of moral norms to ameliorate the 'lone wolf 'as well as strategies to monitor social media and 'fake news' or negative stories about organ donation and ask people to question the validity of any information they see."

###

Scientists may have found one path to a longer life 

Research in lab models shows the drug mifepristone may counter negative effects experienced by females after mating. The results could lead to extending lifespan in humans.

UNIVERSITY OF SOUTHERN CALIFORNIA

Scientists at USC Dornsife College of Letters, Arts and Sciences may have found the beginnings of a path toward increasing human lifespan.

The research, published July 10 by the Journal of Gerontology: Biological Sciences, shows the drug mifepristone can extend the lives of two very different species used in laboratory studies, suggesting the findings may apply to other species, including human beings.

Countering wear and tear inflicted by males

Studying one of the most common laboratory models used in genetic research -- the fruit fly Drosophila -- John Tower, professor of biological sciences, and his team found that the drug mifepristone extends the lives of female flies that have mated.

Mifepristone, also known as RU-486, is used by clinicians to end early pregnancies as well as to treat cancer and Cushing disease.

During mating, female fruit flies receive a molecule called sex peptide from the male. Previous research has shown that sex peptide causes inflammation and reduces the health and lifespan of female flies.

Tower and his team, including Senior Research Associate Gary Landis, lead researcher on the study, found that feeding mifepristone to the fruit flies that have mated blocks the effects of sex peptide, reducing inflammation and keeping the female flies healthier, leading to longer lifespans than their counterparts who did not receive the drug.

The drug's effects in Drosophila appear similar to those seen in women who take it.

"In the fly, mifepristone decreases reproduction, alters innate immune response and increases life span," Tower explained. "In the human, we know that mifepristone decreases reproduction and alters innate immune response, so might it also increase life span?"

Overcoming juvenile hormone effects

Seeking a better understanding of how mifepristone works to increase lifespan, Tower and his team looked at the genes, molecules and metabolic processes that changed when flies consumed the drug. They found that a molecule called juvenile hormone plays a central role.

Juvenile hormone regulates the development of fruit flies throughout their life, from egg to larvae to adult.

Sex peptide appears to escalate the effects of juvenile hormone, shifting the mated flies' metabolism from healthier processes to metabolic pathways that require more energy to maintain. Further, the metabolic shift promotes harmful inflammation, and it appears to make the flies more sensitive to toxic molecules produced by bacteria in their microbiome. Mifepristone changes all of that.

When the mated flies ate the drug, their metabolism stuck with the healthier pathways, and they lived longer than their mated sisters who did not get mifepristone. Notably, these metabolic pathways are conserved in humans, and are associated with health and longevity, said Tower.

Hope for humans?

In a scientific first, Tower and collaborators Chia-An Yen, who obtained her Ph.D. last spring from USC Dornsife College, and Sean Curran, associate professor of gerontology and biological sciences at USC Leonard Davis School of Gerontology and USC Dornsife College, also gave mifepristone to another common laboratory model, a small roundworm called C. elegans. They found the drug had the same life-extending effect on the mated worm.

Because Drosophila fruit flies and C. elegans worms sit on relatively distant branches of the evolutionary tree, Tower believes the similar results in such different species suggest other organisms, including humans, might see comparable benefits to lifespan.

"In terms of evolution, Drosophila and C. elegans are equally as distant from each other as either one is distant from humans," he said, and the fact that mifepristone can increase lifespan in both species suggests the mechanism is important to many species.

Tower emphasizes that a clearer understanding of the intricacies of mifepristone's actions is needed before drawing any firm conclusions.

"Our data show that in Drosophila, mifepristone either directly or indirectly counteracts juvenile hormone signaling, but the exact target of mifepristone remains elusive."

Revealing that target may give scientists critical insight needed to extend lifespan in people.

###

About the study

In addition to Tower, Landis, Yen and Curran, authors on the study include Devon Doherty, Yang Fan, Ina Wang, Jimmy Wu, Palak Patel, Shinwoo Lee, and Mina Abdelmesieh at USC Dornsife; Lu Wang and Daniel Promislow of the University of Washington, Seattle; and Jie Shen of Hangzhou Dianzi University in China.

The study was supported by National Institute on Aging of the National Institutes of Health (NIH) grant R01 AG057741 and NIH grants P30 AG013280, R01 AG049494 and R01 AG063371.

Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases

Study finds fatty acid that kills cancer cells

WASHINGTON STATE UNIVERSITY

 

PULLMAN, Wash. - Researchers have demonstrated that a fatty acid called dihomogamma-linolenic acid, or DGLA, can kill human cancer cells.

The study, published in Developmental Cell on July 10, found that DGLA can induce ferroptosis in an animal model and in actual human cancer cells. Ferroptosis is an iron-dependent type of cell death that was discovered in recent years and has become a focal point for disease research as it is closely related to many disease processes.

Jennifer Watts, a Washington State University associate professor and corresponding author on the paper, said this discovery has many implications, including a step toward a potential treatment for cancer.

"If you could deliver DGLA precisely to a cancer cell, it could promote ferroptosis and lead to tumor cell death," Watts said. "Also, just knowing that this fat promotes ferroptosis might also affect how we think about conditions such as kidney disease and neurodegeneration where we want to prevent this type of cell death."

DGLA is a polyunsaturated fatty acid found in small amounts in the human body, though rarely in the human diet. Compared to other fatty acids, such as those found in fish oil, DGLA is relatively understudied.

Watts has been researching dietary fats including DGLA for nearly twenty years, using the nematode Caenorhabditis elegans as an animal model. A microscopic worm, C. elegans is often used in molecular research because it is transparent and allows scientists to easily study cell-level activity in a whole animal over its relatively short lifespan. Results found in the C. elegans cells are also often transferable to human cells.

Watts' research team discovered that feeding nematodes a diet of DGLA-laden bacteria killed all the germ cells in the worms as well as the stem cells that make the germ cells. The way the cells died carried many signs of ferroptosis.

"Many of the mechanisms we saw in the nematodes were consistent with the hallmarks of ferroptosis in mammalian systems, including the presence of redox-active iron and the inability to repair oxidized lipids, which are like molecular executioners," said Marcos Perez, a WSU doctoral student and first author on the paper.

To see if the results would translate to human cells, Watts and Perez collaborated with Scott Dixon of Stanford University, who has been studying ferroptosis and its potential for battling cancer for many years.

Taking what they had learned from the nematode work, the researchers showed that DGLA could induce ferroptosis in human cancer cells. They also found an interaction with another fatty acid class, called an ether lipid, that had a protective effect against DGLA. When they took out the ether lipids, the cells died faster in the presence of DGLA.

In addition to this new knowledge, the study also demonstrated that C. elegans can be a useful animal research model in the study of ferroptosis, a field that has had to rely mostly on cell cultures.

To take this research further, Watts' team recently received a $1.4 million grant from the National Institutes of Health to investigate what makes the nematode germ cells so susceptible to DGLA and explore the role of mitochondria, the cell organelles involved in burning fat and regulating metabolism, in ferroptosis.

###

This study was supported by National Institutes of Health, the Farrell Memorial Fund, the Stanley Adler Research Fund and the Donald R. Weldin research fund.

Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news

Collective behavior research reveals secrets of successful football (SOCCER) teams

Research team with participation of the University of Konstanz analyses movement profiles and teamwork of football teams

UNIVERSITY OF KONSTANZ

 

The scientists analysed five full matches played by nine teams from a German Bundesliga season. They employed a tool borrowed from statistical physics, the directional correlation techniques, that describes how similar the motion of the players is to each other in terms of their directions. From this the scientists created a metric - the HCS (highly correlated segments) - which reveals how players perform together within their group and against the opponent players. So rather than analysing only individual performance metrics, for example how much or how fast a player runs in a game, the study examined cooperation and coordination among players in order to reveal collective strategies associated with team performance.

Published by an interdisciplinary research team, from the Research Center in Sports Sciences, Health Sciences and Human Development in Portugal, the Cluster of Excellence "Centre for the Advanced Study of Collective Behaviour" at the University of Konstanz and the co-located Max Planck Institute of Animal Behaviour in Germany, the study can aid football teams in identifying talent and can give extra value for assessment for coaching staff.

###

Read the full article in campus.kn, the online-magazine of the University of Konstanz: https://www.campus.uni-konstanz.de/en/science/collective-behaviour-research-reveals-secrets-of-successful-football-teams

Facts:

- Collective behaviour researchers have applied a new tool for analysing the movement of football players that goes beyond looking at individual athletes to capturing how the team operates as a whole.

- The tool - directional correlation techniques - comes from statistical physics but has never been used for sports analysis.

- By analysing full matches played by teams from the German Bundesliga, the study finds clear differences in collective dynamics between winning and losing teams and can even predict the market value of players.

- Researchers include scientists from the Research Center in Sports Sciences, Health Sciences and Human Development in Portugal, the Cluster of Excellence "Centre for the Advanced Study of Collective Behaviour" at the University of Konstanz and the co-located Max Planck Institute of Animal Behavior in Germany.

- Funded by the Portuguese Foundation for Science and Technology, the DFG Cluster of Excellence 2117 "Centre for the Advanced Study of Collective Behaviour" (ID: 422037984), the Hungarian Academy of Sciences.

- Original paper: Marcelino R, Sampaio J, Amichay G, Gonçalves B, Couzin ID, Nagy M (2020) Collective movement analysis reveals coordination tactics of team players in football matches. Chaos, Solitons & Fractals. URL: https://doi.org/10.1016/j.chaos.2020.109831

Contact:

University of Konstanz
Communications and Marketing
Phone: +49 7531 88-3603
Email: kum@uni-konstanz.de

Study shows that aerosol box used to protect healthcare workers during COVID

intubation increases, rather than decreases, exposure to airborne particles

AAGBI

 

A new study shows that certain aerosol boxes of a similar type to those that have been manufactured and used in hospitals in the UK and around the world in order to protect healthcare workers from COVID-19 can actually increase exposure to airborne particles that carry the virus, and thus casts doubt on their usefulness.

The authors - who include Drs Peter Chan, Joanna Simpson and colleagues, Intensive Care and Anaesthesia Specialists at Eastern Health, Melbourne, VIC, Australia - say that "the consequences of promotion of such untested devices include either a false sense of security using these devices, or paradoxical increase in healthcare workers exposure to COVID-19". The study is published in Anaesthesia (a journal of the Association of Anaesthetists).

The danger posed to frontline health workers exposed to infectious COVID-19 is significant. The sickest COVID-19 patients often need to be placed onto a ventilator, which is also when the risk to the health worker of exposure to virus is potentially at its greatest. This has created a race to manufacture aerosol containment devices including improvised protection strategies and devices for use during tracheal intubation. This has taken on even greater urgency in the last week, with a global "second wave" becoming more likely, and a recent open letter to the World Health Organization from 239 global scientists in 32 countries warning that we have probably been severely underestimating the amount of COVID-19 spread through fine aerosol droplets over large distances. On Wednesday, July 8, WHO formally acknowledged this emerging evidence regarding potential spread of COVID-19 through these tiny droplets.

Aerosol boxes have been promoted by multiple worldwide news organisations in print, television, online and across social media (see examples below) as not only a quick and simple solution to protecting frontline workers but also an example of private industries stepping up production to support frontline healthcare workers. However, these devices were produced outside the normal regulatory framework, and thus were never clinically tested or validated for effectiveness and safety. They were subsequently heavily promoted in the media and on social media. Yet despite this heavy promotion, no international guideline on personal protective equipment (PPE) has ever endorsed their use.

In recent months there have been increasing concerns from the medical community that these devices might be either not helping, or potentially exposing frontline medical staff to unforeseen harm, but as this could not be proven, the devices continued to be used across the globe. In this new study, Drs Chan and Simpson and colleagues partnered with Ascent Vision Technologies, a Melbourne-based engineering company, to test the effectiveness of varying methods of aerosol containment, including the so-called aerosol box (see links to photos below), which various private companies have offered their services to manufacture.

The study was carried out in a self-contained intensive care unit room at Box Hill Hospital, Melbourne, using seven adult volunteers (four male, three female), who took turns in random order acting as the patient or the doctor (the person performing the intubation). The study simulated exposure of the doctor to airborne particles sized 0.3 - 5.0 microns using five aerosol containment methods (aerosol box; sealed box with and without suction; vertical drape; and horizontal drape) compared with no intervention. As each of the seven volunteers did all six trials (the five interventions plus no intervention), the study generated 42 sets of results.

To simulate aerosolisation, the patient volunteer held a bottle of fluid just under their mouth, and coughed every 30 seconds. Over five minutes particle detection devices were used to count different sized particles and assess particle spread.

Compared with no device use, the aerosol box surprisingly showed an increase in airborne particle exposure of all sizes over 5 minutes. Assuming that COVID-19 particles act in the same way as the fluid used in this simulation, the results of this study suggest that this aerosol box was increasing exposure to COVID-19 particles, in some cases by a factor of 5 times or more.

The authors say: "We were surprised to find airborne particle contamination of the doctor increased substantially using the aerosol box compared with all other devices and with no device use. Spikes of airborne particles were clearly seen, coinciding with patient coughing. We believe that these represent particles escaping from the arm access holes in the aerosol box."

They add: "The race to generate sustainable equipment to protect healthcare workers during intubation procedures in patients with suspected or proven COVID-19, particularly in settings where PPE supply is limited, has flooded the scientific community and social media with a variety of novel devices meant to contain potentially infectious aerosols produced by patients. Evidence for the safety and efficacy of these devices is lacking."

They conclude: "This study demonstrates that devices such as the aerosol box we tested - which is typical of designs used worldwide - confer minimal to no benefit in containing aerosols during an aerosol-generating procedure and may increase rather than decrease airborne particle exposure. The use of any aerosol containment device has been eliminated from our intubation protocols until their safety can be properly established."

Dr Chan adds: "If this box were a sold as a product, and therefore regulated, it would likely need to be immediately recalled due to a potential infection risk to the healthcare worker. Unfortunately, because these devices have been donated and are not regulated in any way, healthcare workers might be continuing to increase their exposure to COVID-19 while thinking they are protecting themselves."

###