Tuesday, 21 February 2012
Health Games
Health games emerge as important new therapeutic tools for physical and mental health and well-beingopen original article
Tue Feb 21, 2012 06:51 from RSS 2.0 by Mary Ann Liebert Inc
Millions of dollars and immeasurable hours of research and development are being invested to develop and employ increasingly sophisticated hardware and software technologies to deliver innovative new personalized health care interventions.
Digital games are rapidly becoming an important tool for improving lifestyle habits, behavior modification, self-management of illness and chronic conditions, and motivating and supporting physical activity, according to a provocative Expert Panel Discussion in the premier issue of Games for Health Journal, a new bimonthly peer-reviewed publication from Mary Ann Liebert, Inc., publishers. The premier issue is available free online at http://www.liebertpub.com/g4h.
The Journal will be the only source for a broad range of hard-to-find and timely information related to health games. For example, the first issue offers a unique Roundtable Discussion, “Health Games Come of Age,” an insightful conversation with leaders in the games for health field. Tom Baranowski, PhD, Baylor College of Medicine; Peter Bingham, MD, University of Vermont; Debra Lieberman, PhD, University of California, Santa Barbara; Ernie Medina, DrPH, Medplay Technologies; Jesse Schell, MS, Carnegie Mellon University; and Sam K. Yohannon, PT, MS, Cornell University Medical Center share their unique approaches and the creative evidenced-based outcomes research that has brought health games to the forefront of innovative patient care.
The Journal breaks new ground as the first to address this emerging and increasingly important area of health care and will provide a bimonthly forum in print and online for academic and clinical researchers, game designers and developers, health care providers, insurers, and information technology leaders. Articles in the Journal explore the use of game technology in a wide variety of clinical applications in disease prevention, promotion, and monitoring, including nutrition, weight management, medication adherence, diabetes monitoring, post-traumatic stress disorder, Alzheimer’s, and cognitive, mental, emotional, and behavioral health.
The Journal is under the leadership of Bill Ferguson, PhD and a distinguished editorial board (http://www.liebertpub.com/editorialboard/games-for-health-journal/588/) including leaders from academia, health care, information technology, and government.
Other key contributions in this issue include an original article on “Use of Nintendo® Wii™ During Physical Therapy of an Adult with Lower Extremity Burns” describing a fascinating intervention using health games to accelerate returning severe burn victims to independent living. “The United Health Group’s Rx for Longer, Healthier Lives” is an informative program profile that examines the huge health provider’s commitment to encouraging and enabling healthier lifestyles through games. Their goal is greater availability and lower cost of health care for people who actively manage their own health and well-being
A clinical brief on “Evaluating Efficacy and Validating Games for Health” suggests the importance and process for objectively assessing the results of games used to improve patients’ health. A fascinating interview with Ben Sawyer, Co-Founder of Digitalmill—”Games? Seriously!”–explores the driving forces in the field and the gamification of health.
“The growing breadth and depth of research in health games will have powerful impacts on all stages of life, from infants with autism to geriatric patients wanting to extend their active lives,” says Editor-in-Chief Bill Ferguson. “These advancements will impact the nature and availability of preventive and remedial care from physicians to therapists to self-management. The Journal will be a powerful voice for the researchers and clinicians, as well as a resource for state-of-the-art developments for everyone concerned with human well-being.”
Saturday, 18 February 2012
Friday, 17 February 2012
Quit Smoking Aide Helps with Alcohol Addiction
A medication commonly used to help people stop smoking may have an unanticipated positive side effect for an entirely different vice: drinking alcohol. A new study by University of Chicago researchers finds that varenicline, sold as Chantix, increases the negative effects of alcohol and therefore could hold promise as a treatment for alcoholism.
A group of heavy-to-moderate social drinkers given a single dose varenicline three hours before an alcoholic beverage reported increased dysphoria and reduced “liking,” even when researchers controlled for the effects of nausea from the drug. Those effects upon the subjective response to alcohol could reduce drinking in people prone to bingeing and other forms of abuse.
“We found that varenicline increased the unpleasant effects of alcohol and decreased drug liking,” said Emma Childs, PhD, research associate at the University of Chicago Medicine and first author of the study published in Alcoholism: Clinical and Experimental Research. “Thus, we think that varenicline may reduce drinking by altering the effects of alcohol.”
Some patients prescribed Chantix to quit smoking have anecdotally reported a reduction in consumption of alcohol as well, and controlled studies in animals and humans have supported the effect. Researchers are now looking for neurobiological mechanisms that connect varenicline, a partial agonist of the brain’s nicotinic receptors, with reduced alcohol craving or consumption.
“Smokers who use varenicline are approximately two to three times more likely to remain abstinent six months or more after their quit date,” said Childs. “After it was approved, several patients treated with varenicline also reported reductions in their drinking, so investigators began to assess if this was an actual effect and how it might be produced.”
The new experiment is the first to look at the acute effects of a single dose of varenicline on the subjective response to a subsequent alcoholic drink. Subjects were recruited based on heavy drinking behavior, not smoking behavior – though the recruits did smoke 4 cigarettes a day on average.
15 subjects (8 men and 7 women) were brought to the laboratory for six different sessions. On each day, the subject received either a varenicline or placebo capsule, and then three hours later was given a drink containing 0, 0.4, or 0.8 mg/kg alcohol. Researchers monitored the effects of the drink on cardiovascular and eye movement measures, and subjects filled out questionnaires to report the subjective effects of the drink.
Compared to sessions where the subjects received a placebo pill, varenicline increased nausea, heart rate, blood pressure. After an alcoholic drink, self-reported dysphoria was increased while alcohol effects on subconscious eye movements (a measure of the drugs’ objective effects) were reduced. Even after controlling for the effect of nausea upon the subsequent response to a drink, the increased dysphoria and reduced “drug liking” after drinking alcohol remained significant.
By increasing the negative effects of alcohol, varenicline might be most effective in people who are unable to stop consuming alcohol after only one drink, Childs said.
“Our findings shed light on the mechanism underlying why people consume less alcohol when they have taken varenicline,” said Childs. “The pleasurable effects of alcohol, for example feeling ‘buzzed’ and talkative, are associated with greater consumption and binge drinking. Some people lose control of their alcohol consumption during a drinking episode, for example they may aim to only have one or two drinks but end up drinking say four or five. If varenicline counteracts these positive effects by producing unpleasant effects, then as a result people may consume less alcohol during a drinking episode.”
The authors cautioned that their study only examined the acute effect of a single dose of varenicline, rather than the sustained exposure experienced with regular use of the drug. But because the effectiveness of varenicline has already been proven as a smoking cessation drug, the unanticipated effects on drinking may make people struggling with both behaviors a logical first target.
“Varenicline may find a nice niche in those individuals who are both nicotine and alcohol dependent, who we know represent a large portion of alcohol-dependent individuals,” added Hugh Myrick, associate professor of psychiatry at the Medical University of South Carolina, who was not involved in the study. “Since there is a high comorbidity between nicotine and alcohol dependence, a single medication that could decrease the use of both substances would be ideal.”
A group of heavy-to-moderate social drinkers given a single dose varenicline three hours before an alcoholic beverage reported increased dysphoria and reduced “liking,” even when researchers controlled for the effects of nausea from the drug. Those effects upon the subjective response to alcohol could reduce drinking in people prone to bingeing and other forms of abuse.
“We found that varenicline increased the unpleasant effects of alcohol and decreased drug liking,” said Emma Childs, PhD, research associate at the University of Chicago Medicine and first author of the study published in Alcoholism: Clinical and Experimental Research. “Thus, we think that varenicline may reduce drinking by altering the effects of alcohol.”
Some patients prescribed Chantix to quit smoking have anecdotally reported a reduction in consumption of alcohol as well, and controlled studies in animals and humans have supported the effect. Researchers are now looking for neurobiological mechanisms that connect varenicline, a partial agonist of the brain’s nicotinic receptors, with reduced alcohol craving or consumption.
“Smokers who use varenicline are approximately two to three times more likely to remain abstinent six months or more after their quit date,” said Childs. “After it was approved, several patients treated with varenicline also reported reductions in their drinking, so investigators began to assess if this was an actual effect and how it might be produced.”
The new experiment is the first to look at the acute effects of a single dose of varenicline on the subjective response to a subsequent alcoholic drink. Subjects were recruited based on heavy drinking behavior, not smoking behavior – though the recruits did smoke 4 cigarettes a day on average.
15 subjects (8 men and 7 women) were brought to the laboratory for six different sessions. On each day, the subject received either a varenicline or placebo capsule, and then three hours later was given a drink containing 0, 0.4, or 0.8 mg/kg alcohol. Researchers monitored the effects of the drink on cardiovascular and eye movement measures, and subjects filled out questionnaires to report the subjective effects of the drink.
Compared to sessions where the subjects received a placebo pill, varenicline increased nausea, heart rate, blood pressure. After an alcoholic drink, self-reported dysphoria was increased while alcohol effects on subconscious eye movements (a measure of the drugs’ objective effects) were reduced. Even after controlling for the effect of nausea upon the subsequent response to a drink, the increased dysphoria and reduced “drug liking” after drinking alcohol remained significant.
By increasing the negative effects of alcohol, varenicline might be most effective in people who are unable to stop consuming alcohol after only one drink, Childs said.
“Our findings shed light on the mechanism underlying why people consume less alcohol when they have taken varenicline,” said Childs. “The pleasurable effects of alcohol, for example feeling ‘buzzed’ and talkative, are associated with greater consumption and binge drinking. Some people lose control of their alcohol consumption during a drinking episode, for example they may aim to only have one or two drinks but end up drinking say four or five. If varenicline counteracts these positive effects by producing unpleasant effects, then as a result people may consume less alcohol during a drinking episode.”
The authors cautioned that their study only examined the acute effect of a single dose of varenicline, rather than the sustained exposure experienced with regular use of the drug. But because the effectiveness of varenicline has already been proven as a smoking cessation drug, the unanticipated effects on drinking may make people struggling with both behaviors a logical first target.
“Varenicline may find a nice niche in those individuals who are both nicotine and alcohol dependent, who we know represent a large portion of alcohol-dependent individuals,” added Hugh Myrick, associate professor of psychiatry at the Medical University of South Carolina, who was not involved in the study. “Since there is a high comorbidity between nicotine and alcohol dependence, a single medication that could decrease the use of both substances would be ideal.”
Thursday, 16 February 2012
Kings Fund Report: Long Term Conditions and Mental Health
http://www.kingsfund.org.uk/publications/mental_health_ltcs.html
Social relationships and physical health
Negative social interactions and body inflammation.open original article
Thu Feb 16, 2012 10:30 from Deric Bownds' MindBlog - Atom by Deric Bownds (mdbownds@wisc.edu)
Many studies have proven that social relationships influence our physical health. People who are more socially integrated live longer, and are less likely to have medical problems such as heart attacks and upper respiratory illness. (Cytokines are small protein molecules - peptides - that regulate our inflammatory immune response. While transient inflammatory response due to tissue insult are adaptive and trigger needed immune responses, chronic increases in proinflammatory cytokines IL-6 and TNF-α are linked hypertension, atherosclerosis, coronary heart disease, depression, diabetes, and some cancers.) Chiang et al. now show that these cytokines promoting tissue inflammation appear when we are in socially stressful situations:
Research has consistently documented that social relationships influence physical health, a link that may implicate systemic inflammation. We examined whether daily social interactions predict levels of proinflammatory cytokines IL-6 and the soluble receptor for tumor necrosis factor-α (sTNFαRII) and their reactivity to a social stressor. One-hundred twenty-two healthy young adults completed daily diaries for 8 d that assessed positive, negative, and competitive social interactions. Participants then engaged in laboratory stress challenges, and IL-6 and sTNFαRII were collected at baseline and at 25- and 80-min poststressor, from oral mucosal transudate. Negative social interactions predicted elevated sTNFαRII at baseline, and IL-6 and sTNFαRII 25-min poststressor, as well as total output of sTNFαRII. Competitive social interactions predicted elevated baseline levels of IL-6 and sTNFαRII and total output of both cytokines. These findings suggest that daily social interactions that are negative and competitive are associated prospectively with heightened proinflammatory cytokine activity.
Thu Feb 16, 2012 10:30 from Deric Bownds' MindBlog - Atom by Deric Bownds (mdbownds@wisc.edu)
Many studies have proven that social relationships influence our physical health. People who are more socially integrated live longer, and are less likely to have medical problems such as heart attacks and upper respiratory illness. (Cytokines are small protein molecules - peptides - that regulate our inflammatory immune response. While transient inflammatory response due to tissue insult are adaptive and trigger needed immune responses, chronic increases in proinflammatory cytokines IL-6 and TNF-α are linked hypertension, atherosclerosis, coronary heart disease, depression, diabetes, and some cancers.) Chiang et al. now show that these cytokines promoting tissue inflammation appear when we are in socially stressful situations:
Research has consistently documented that social relationships influence physical health, a link that may implicate systemic inflammation. We examined whether daily social interactions predict levels of proinflammatory cytokines IL-6 and the soluble receptor for tumor necrosis factor-α (sTNFαRII) and their reactivity to a social stressor. One-hundred twenty-two healthy young adults completed daily diaries for 8 d that assessed positive, negative, and competitive social interactions. Participants then engaged in laboratory stress challenges, and IL-6 and sTNFαRII were collected at baseline and at 25- and 80-min poststressor, from oral mucosal transudate. Negative social interactions predicted elevated sTNFαRII at baseline, and IL-6 and sTNFαRII 25-min poststressor, as well as total output of sTNFαRII. Competitive social interactions predicted elevated baseline levels of IL-6 and sTNFαRII and total output of both cytokines. These findings suggest that daily social interactions that are negative and competitive are associated prospectively with heightened proinflammatory cytokine activity.
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