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Risk In Developing Asthma May Be Reduced For 40% Of Women With COPD

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More than 4 in 10 women with asthma may go on to develop chronic obstructive pulmonary disease (COPD), according to a study conducted in Ontario, Canada, and published online in the Annals of the American Thoracic Society.

In “Asthma and COPD Overlap in Women: Incidence and Risk Factors,” Teresa To, PhD, and coauthors report that of the 4,051 women with asthma included in their study, 1,701, or 42 percent, developed COPD. On average, the women were followed for about 14 years after being diagnosed with asthma.

The researchers examined risk factors for developing asthma and COPD overlap syndrome, known as ACOS. Those who develop ACOS experience increased exacerbations and hospitalizations and have a lower quality of life, compared to those who have asthma or COPD alone.

“Previous studies have found an alarming rise in ACOS in women in recent years and that the mortality rate from ACOS was higher in women than men,” said Dr. To, a professor in the Graduate School of Public Health at the University of Toronto in Canada.

“We urgently need to identify and quantify risk factors associated with ACOS in women to improve their health and save lives.”

The authors report that individual risk factors played a more significant role in the development of ACOS than exposure to fine particulate matter, a major air pollutant that because of its microscopic size penetrates deep into the lungs.

Women who had a more than five-pack-year smoking history, meaning they had smoked more than the equivalent of a pack of cigarettes a day for five years, were much more likely to develop ACOS than those who smoked fewer cigarettes or never smoked.

However, ACOS did not affect only those who smoke: 38 percent of the women who developed ACOS in the study had never smoked.

In addition to smoking, the study identified obesity, rural residence, lower education levels and unemployment as significant risk factors for ACOS. The authors speculate that these factors indicative of low socioeconomic status may result in suboptimal access to care, under-treatment of asthma and poor compliance to medications, all of which lead to more frequent asthma attacks. These attacks in turn may lead to airway remodeling that increases the chances of developing ACOS.

The researchers noted that they lacked the data to investigate this association directly. Study limitations also include not having information about exposure to second-hand smoke and exposure to air pollution over the entire time the women were followed.

The authors wrote that they were encouraged by the fact that most of the risk factors identified in their study were modifiable.

“The adverse impact of smoking and obesity on health may be even worse in those who are already living with asthma or COPD,” said Dr. To, who is also senior scientist, Child Health Evaluative Sciences, at The Hospital for Sick Children (SickKids).

“Identifying modifiable risk factors in the progression from asthma to COPD is an essential first step in developing prevention strategies that lead to a healthy, active lifestyle.”

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Parents, Kids Spend More Time Discussing How To Use Mobile Technology Than Talking About Content

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ANN ARBOR—Most parents would agree that one of the of the biggest modern parenting challenges is monitoring a child’s online activity.

A new study appearing in the Journal of Child and Family Studies found that parents spend more time talking with kids about the mechanics of using their mobile devices than they do about what their kids watch and download on those devices.

The findings came from a small, recent study of 75 children and their families, led by researcher Sarah Domoff, then a postdoctoral fellow at University of Michigan Center for Human Growth and Development. The children wore recording devices at home, which recorded talking, conversations or other sounds nearby, as well as audible screen media use.

Domoff, now an assistant professor at Central Michigan University, said the findings revealed some concerning trends in how families and children communicate about media today. Specifically, the researchers observed minimal conversation about the content of programming that children were watching.

Additionally, they learned that other family members appear to play an important role when content is discussed. Children––not parents––initiated most conversations about content, and older siblings played a much bigger role than parents in content mediation for younger siblings. Also, the study found that children as young as toddlers were exposed to multiple media sources at one time, or media multitasking.

Other findings include:

  • Negotiations and conflict are common among parents and children.
  • Parallel family media use is common, meaning different family members use their own devices at the same time.

“One of the most challenging aspects of parenting today is being aware of what children are exposed to online, particularly content delivered via mobile devices,” Domoff said.

“Thus, it is critical that parents utilize privacy settings and restrictions to protect children from certain content. Ideally, this would occur before the child received their own mobile device.”

Domoff recommends developing a family media plan. In 2016, The American Academy of Pediatrics released a tool that helps families set different goals and media use rules based on individual needs, she said.

It’s also troubling that some apps downloaded by children include advertising or request in-app purchases, she said. Parents can identify these apps by using Common Sense Media’s app review.

Parents can also recruit older children to help younger siblings make good content choices.

The study aimed to identify themes of parental mediation and family communication around mobile media devices. There’s a dearth of scientific data in this area compared to television and video games, but studies show that parental mediation leads to better outcomes for children.

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Internet Therapy Apps Reduce Depression Symptoms

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BLOOMINGTON, Ind. — In a sweeping new study, Indiana University psychologists have found that a series of self-guided, internet-based therapy platforms effectively reduce depression.

The work, which reviewed 21 pre-existing studies with a total of 4,781 participants, was published in the November issue of the Journal of Medical Internet Research. The study was led by Lorenzo Lorenzo-Luaces, an assistant professor of clinical psychology in the IU Bloomington College of Arts and Sciences’ Department of Psychological and Brain Sciences.

In the past several years, many internet-based apps and websites have made claims to treat depression. The subjects of the IU study were specifically those applications that provide treatment with cognitive behavioral therapy, a form of psychotherapy that focuses on changing thought patterns and behavior to alleviate symptoms of depression and other mental disorders.

Previous studies had examined the effectiveness of individual internet-based cognitive behavioral therapy apps, or iCBT, using a range of methods. Until this study, however, no review had examined whether the effects of these treatments were inflated by excluding patients with more severe depression or additional conditions such as anxiety or alcohol abuse.

“Before this study, I thought past studies were probably focused on people with very mild depression, those who did not have other mental health problems, and were at low risk for suicide,” Lorenzo-Luaces said.

“To my surprise, that was not the case. The science suggests that these apps and platforms can help a large number of people.”

For Lorenzo-Luaces, internet-based cognitive behavioral therapy apps are an important new tool for addressing a major public health issue: that individuals with mental health disorders like depression far outnumber the mental health providers available to treat them.

“Close to one in four people meet the criteria for major depressive disorder,” he said.

“If you include people with minor depression or who have been depressed for a week or a month with a few symptoms, the number grows, exceeding the number of psychologists who can serve them.”

People with depression are also expensive for the health care system, he added.

“They tend to visit primary-care physicians more often than others,” Lorenzo-Luaces said.

“They have more medical problems, and their depression sometimes gets in the way of their taking their medication for other medical problems.”

By conducting a “meta-regression analysis” of 21 studies, Lorenzo-Luaces and collaborators decisively determined that internet-based therapy platforms effectively alleviate depression. A central question was determining whether previous studies distorted the strength of these systems’ effects by excluding people with severe depression.

The conclusion was that the apps worked in cases of mild, moderate and severe depression.

Many of the studies in the analysis compared use of internet-based cognitive behavioral therapy apps to placement on a wait list for therapy or the use of a “fake app” that made weak recommendations to the user. In these cases, the iCBT apps worked significantly better.

“This is not to say that you should stop taking your medication and go to the nearest app store,” added Lorenzo-Luaces, who said both face-to-face therapy and antidepressants may still prove to be more effective than the iCBT apps alone.

“People tend to do better when they have a little bit of guidance,” he said. But he added that a 10- to 15-minute check-in may be sufficient for many people, freeing health care providers to see more patients.

App-based therapy also has an advantage in situations where access to face-to-face therapy is limited due to logistical barriers, such as long distances in rural areas or inflexible work schedules.

“ICBT apps take the methods we have learned and make them available to the many people who could benefit from them,” Lorenzo-Luaces said.

“It’s an exciting development.”

 

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New Study Finds Employee Incentives Can Lead To Unethical Behavior In The Workplace

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Considering end-of-year bonuses for your employees? Supervisors be forewarned, a new study finds that while incentive rewards can help motivate and increase employee performance it can also lead to unethical behavior in the workplace.

“Goal fixation can have a profound impact on employee behavior, and the damaging effects appear to be growing stronger in today’s competitive business landscape,” says Bill Becker, co-author of the study and associate professor of management in the Pamplin College of Business at Virginia Tech.

The study, “The effects of goals and pay structure on managerial reporting dishonesty,” provides valuable insight into the relationship between pay structures and motivation.

Findings suggest that setting compensation goals can increase dishonesty when managers are also paid a bonus for hitting certain targets.

“These unintended negative consequences can lead to dishonesty, unethical behavior, increased risk-taking, escalation of commitment, and depletion of self-control,” says Becker.

The study points to observations of unethical behaviors in the workplace that include employees falsifying or manipulating financial reporting information as well as time and expense reports.

For example, service professionals such as auditors, contractors, lawyers, and consultants who report hours billed against a target budget is often based on a fixed contract price.

“This causes potential for both under-reporting and over-reporting costs, which can undermine organizational objectives and negatively impact the interest of the firm,” says Becker.

“Using purely monetary incentives is almost always a double edged sword.”

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