Palliative Care Study Exposes Stigma, Calls for Rebranding to Improve Support for Patients, Caregivers

Newswise, April 21, 2016 – An ingrained stigma attached to the label “palliative care” among cancer patients, families and healthcare providers impedes earlier access to supportive care that improves quality of life, shows new research from Princess Margaret Cancer Centre published today in the Canadian Medical Association Journal (CMAJ).

The findings signal the need to rebrand palliative care, says principal investigator Dr. Camilla Zimmermann, to ensure the full spectrum of supportive care is offered to improve quality of life from the moment of diagnosis through the course of illness.

Dr. Zimmermann, Head, Palliative Care Program, UHN and Medical Director, Al Hertz Centre for Supportive and Palliative Care at the Princess Margaret, is a clinician-scientist who also holds the Rose Family Chair in Supportive Care, University of Toronto. She talks about her research at https://www.youtu.be/DerR61coVbc .

The researchers performed and analysed qualitative interviews with 48 patients with advanced cancers and 23 caregivers who had participated in an earlier randomized controlled study of 461 patients.

In that study, half the participants received early palliative care intervention in the outpatient clinic setting in addition to standard cancer care.

The other half received standard cancer care. Participants had advanced cancers (lung, gastrointestinal, genitourinary, breast and gynecological) and estimated survival of between 6-24 months. The published findings showed improved quality of life for the group that received early palliative care intervention (The Lancet, Feb. 19, 2014).

In the follow-up study, says Dr. Zimmermann, “initially, both groups perceived palliative care as synonymous with death; as care at the end of life in a setting where they would die, and in general as a frightening, anxiety-provoking thing they wanted to avoid.”

For the intervention group, however, the perception changed. “They began to see palliative care as relevant early in the course of their illness and as being beneficial to them by supporting them and improving their quality of life. “

But, she says, despite a positive experience, participants in the intervention group still felt stigmatized by the label palliative care. “Patients told us if palliative care were called something else, they wouldn’t feel so stigmatized.”

Dr. Zimmermann adds: “Importantly, the source of this stigma was mainly in the medical system because doctors and nurses had given the impression that palliative care was only end-of-life care. Another source of stigma was media. So I think those are two powerful institutions where we could effect change and give a different perception to families and caregivers about what palliative care really is.”

Although the World Health Organization broadened its definition of palliative care in 2002 to state “palliative care is applicable early in the course of illness, in conjunction with other therapies that are intended to prolong life”, definitions are inconsistent and confusing, says Dr. Zimmermann.

“Until there is a consistent definition of palliative care that is promoted by those referring patients and collaborating in their treatment, it is unreasonable to expect that patients and families will embrace a broadened conceptualisation of palliative care.”

And exactly what is palliative care? Dr. Zimmermann explains: “Palliative care improves quality of life in many different domains. Symptom control is an important domain; and this means managing pain, nausea, shortness of breath, sleep, depression and anxiety.

“Palliative care improves support for the family at home; it gives practical support for planning for the future, and also for how to get through every day. And it provides spiritual support.”

Dr. Zimmermann says: “So we have a branding issue and that’s the central message of this research. Although the definition has changed, we are not promoting it in the right way in the health care system.

“We need to do is promote the message and do so in actions as well as words that palliative care is supportive care that improves quality of life throughout the course of illness. It is not something to be afraid of or that is stigmatizing, but is helpful even while patients are receiving life-prolonging therapies.”

Senior Adults Can See Health Benefits from Dog Ownership

 Study also shows that seniors who form strong bonds with their pets tend to exercise longer and more often

Newswise, April 21, 2016  – The Centers for Disease Control and Prevention recommends that adults of all ages should engage in 150 or more minutes of moderate physical activity per week. 

Among adults 60 years of age or more, walking is the most common form of leisure-time physical activity because it is self-paced, low impact and does not require equipment.

 Researchers at the University of Missouri have determined that older adults who also are pet owners benefit from the bonds they form with their canine companions. 

Dog walking is associated with lower body mass index, fewer doctor visits, more frequent exercise and an increase in social benefits for seniors.

“Our study explored the associations between dog ownership and pet bonding with walking behavior and health outcomes in older adults,” said Rebecca Johnson, a professor at the MU College of Veterinary Medicine, and the Millsap Professor of Gerontological Nursing in the Sinclair School of Nursing.

“This study provides evidence for the association between dog walking and physical health using a large, nationally representative sample.”

The study analyzed 2012 data from the Health and Retirement study sponsored by the National Institute on Aging and the Social Security Administration.

The study included data about human-animal interactions, physical activity, frequency of doctor visits and health outcomes of the participants.

“Our results showed that dog ownership and walking were related to increases in physical health among older adults,” said Johnson, who also serves as director of the Research Center for Human-Animal Interaction at MU.

“These results can provide the basis for medical professionals to recommend pet ownership for older adults and can be translated into reduced health care expenditures for the aging population.”

Results from the study also indicated that people with higher degrees of pet bonding were more likely to walk their dogs and to spend more time walking their dogs each time than those who reported weaker bonds.

 Additionally, the study showed that pet walking offers a means to socialize with pet owners and others.

Retirement communities also could be encouraged to incorporate more pet-friendly policies such as including dog walking trails and dog exercise areas so that their residents could have access to the health benefits, Johnson said.

The study, “Dog Walking, the Human-Animal Bond and Older Adults’ Physical Health,” recently was published by The Gerontologist. Angela L. Curl, assistant professor in the Department of Family Studies and Social Work at Miami University, and Jessica Bibbo, a graduate student at MU, contributed to the study.

Derailed Train of Thought? Brain’s Stopping System May Be at Fault

Newswise, April 21, 2016 — Have you had the experience of being just on the verge of saying something when the phone rang? Did you then forget what it is you were going to say? A study of the brain’s electrical activity offers a new explanation of how that happens.

Published in Nature Communications, the study comes from the lab of neuroscientist Adam Aron at the University of California San Diego, together with collaborators at Oxford University in the UK, and was led by first author Jan Wessel, while a post-doctoral scholar in the Aron Lab.

The researchers suggest that the same brain system that is involved in interrupting, or stopping, movement in our bodies also interrupts cognition – which, in the example of the phone ringing, derails your train of thought.

The findings may give insights into Parkinson’s disease, said Aron, a professor of psychology in the UC San Diego Division of Social Sciences, and Wessel, now an assistant professor of psychology and neurology at the University of Iowa.

The disease can cause muscle tremors as well as slowed-down movement and facial expression. Parkinson’s patients may also present as the “opposite of distractible,” often with a thought stream so stable that it can seem hard to interrupt. The same brain system that is implicated in “over-stopping” motor activity in these patients, Aron said, might also be keeping them over-focused. 

The current study focuses particularly on one part of the brain’s stopping system – the subthalamic nucleus (STN). This is a small lens-shaped cluster of densely packed neurons in the midbrain and is part of the basal ganglia system.

Earlier research by Aron and colleagues had shown that the STN is engaged when action stopping is required. Specifically, it may be important, Aron said, for a “broad stop.”

 A broad stop is the sort of whole-body jolt we experience when, for example, we’re just about to exit an elevator and suddenly see that there’s another person standing right there on the other side of the doors.

The study analyzes signals from the scalp in 20 healthy subjects as well as signals from electrode implants in the STN of seven people with Parkinson’s disease. (The STN is the main target for therapeutic deep brain stimulation in Parkinson’s disease.)

All the volunteers were given a working memory task. On each trial, they were asked to hold in mind a string of letters, and then tested for recall. Most of the time, while they were maintaining the letters in mind, and before the recall test, they were played a simple, single-frequency tone.

On a minority of trials, this sound was replaced by a birdsong segment – which is not startling like a “bang!” but is unexpected and surprising, like a cell phone chirping suddenly. The volunteers’ brain activity was recorded, as well as their accuracy in recalling the letters they’d been shown.

The results show, the researchers write, that unexpected events manifest the same brain signature as outright stopping of the body.

They also recruit the STN. And the more the STN was engaged – or the more that part of the brain responded to the unexpected sound – the more it affected the subjects’ working memory and the more they lost hold of what they were trying to keep in mind.

“For now,” said Wessel, “we’ve shown that unexpected, or surprising, events recruit the same brain system we use to actively stop our actions, which, in turn, appears to influence the degree to which such surprising events affect our ongoing trains of thought.”

A role for the STN in stopping the body and interrupting working memory does fit anatomical models of how the nucleus is situated within circuitry in the brain.

Yet more research is needed, the researchers write, to determine if there’s a causal link between the activity observed in the STN and the loss in working memory.

“An unexpected event appears to clear out what you were thinking,” Aron said. “The radically new idea is that just as the brain’s stopping mechanism is involved in stopping what we’re doing with our bodies it might also be responsible for interrupting and flushing out our thoughts.”

A possible future line of investigation, Aron said, is to see if the STN and associated circuitry plays a role in conditions characterized by distractibility, like Attention Deficit Hyperactivity Disorder. “This is highly speculative,” he said, “but it could be fruitful to explore if the STN is more readily triggered in ADHD.”

Wessel added: “It might also be potentially interesting to see if this system could be engaged deliberately – and actively used to interrupt intrusive thoughts or unwanted memories.”

If further research bears out the connection suggested by the current study, between the STN and losing your train of thought following an unexpected event, the researchers say it might be that it is an adaptive feature of the brain, something we evolved long ago as a way to clear our cognition and re-focus on something new.

Aron suggests this example: You’re walking along one morning on the African Savannah, going to gather firewood. You’re daydreaming about the meal you’re going to prepare when you hear a rustle in the grass. You make a sudden stop – and all thoughts of dinner are gone as you shift your focus to figure out what might be in the grass. In this case, it’s a good thing to forget what you had been thinking about.

Aron and Wessel’s co-authors on the paper are: Ned Jenkinson of John Radcliffe Hospital at the University of Oxford, as well as the University of Birmingham (UK) and John-Stuart Brittain, Sarah H.E.M. Voets and Tipu Z. Aziz, also of Radcliffe Hospital at Oxford.

The study was supported by funding from the National Institutes of Health, grant nos.
R21NS085543 and DA026452, and the James S McDonnell Foundation, grant no. 220020375.

Strength Training Helps Older Adults Live Longer

Newswise, April 21, 2016 — Older adults who met twice-weekly strength training guidelines had lower odds of dying in a new analysis by researchers at Penn State College of Medicine, Penn State Health Milton S. Hershey Medical Center and Columbia University.

The study is the first to demonstrate the association in a large, nationally representative sample over an extended time period, particularly in an older population.

Many studies have previously found that older adults who are physically active have better quality of life and a lower risk of mortality. Regular exercise is associated with health benefits, including preventing early death, cardiovascular disease, diabetes and some cancers.

But although the health rewards of physical activity and aerobic exercise are well established, less data has been collected on strength training.

Over the past decade, researchers have begun to demonstrate benefits of strength training on strength, muscle mass and physical function, as well as improvements in chronic conditions such as diabetes, osteoporosis, low back pain and obesity. Small studies have observed that greater amounts of muscle strength are associated with lower risks of death.

One reason for this lack of data could be that strength training guidelines are newer than recommendations for aerobic activity. Although the American College of Sports Medicine first issued aerobic exercise guidelines decades ago, it was not until 2007 that the organization and the American Heart Association released a joint guideline recommending that all adults strength train at least twice a week.

"This doesn't mean that strength training wasn't a part of what people had been doing for a long time as exercise, but it wasn't until recently that it was solidified in this way as a recommendation," said Dr. Jennifer L. Kraschnewski, assistant professor of medicine and public health sciences, Penn State College of Medicine.

To examine the mortality effects on older adults who meet strength training guidelines, Kraschnewski examined data from the 1997-2001 National Health Interview Survey (NHIS) linked to death certificate data through 2011. Researchers published their results in Preventive Medicine.

The NHIS collects overall health, disease and disability data of the U.S. population from a nationally representative sampling of all 50 states and the District of Columbia. The 1997-2001 survey included more than 30,000 adults age 65 and older.

During the survey period, more than 9 percent of older adults reported strength training at least twice a week.

"That's only a small fraction of the population, but it's actually higher than we had anticipated," Kraschnewski said.

The researchers followed the respondents for 15 years through death certificate data from the National Center for Health Statistics National Death Index. About a third of respondents had died by 2011.

Older adults who strength trained at least twice a week had 46 percent lower odds of death for any reason than those who did not. They also had 41 percent lower odds of cardiac death and 19 percent lower odds of dying from cancer.

Older adults who met strength training guidelines were, on average, slightly younger, and were more likely to be married white males with higher levels of education. They were also more likely to have normal body weight, to engage in aerobic exercise and to abstain from alcohol and tobacco.

When the researchers adjusted for demographic variables, health behaviors and health conditions, a statistically significant effect on mortality remained. Although the effects on cardiac and cancer mortality were no longer statistically significant, the data still pointed to a benefit.

Importantly, after the researchers controlled for physical activity level, people who reported strength exercises appeared to see a greater mortality benefit than those who reported physical activity alone.

The study is strong evidence that strength training in older adults is beneficial beyond improving muscle strength and physical function, the researchers said.

"We need to identify more ways that we can help get people engaged in strength training so we can increase the number from just under 10 percent to a much higher percentage of our older adults who are engaged in these activities," Kraschnewski said.

Other researchers on this project were Christopher N. Sciamanna and Lisa S. Rovniak, Department of Medicine and Department of Public Health Sciences; Jennifer M. Poger, Amanda B. Cooper and Noel H. Ballentine, Department of Medicine; and Erik B. Lehman, Department of Public Health Sciences, all of Penn State College of Medicine/Penn State Health Milton S. Hershey Medical Center; and Joseph T. Ciccolo, Columbia University.

About Penn State College of Medicine
Located on the campus of Penn State Health Milton S. Hershey Medical Center in Hershey, Pa., Penn State College of Medicine boasts a portfolio of nearly $82 million in funded research. Projects range from the development of artificial organs and advanced diagnostics to groundbreaking cancer treatments and understanding the fundamental causes of disease. Enrolling its first students in 1967, the College of Medicine has more than 1,600 students and trainees in medicine, nursing, the health professions and biomedical research on its campus.

Researchers Pinpoint Part of the Brain That Recognizes Facial Expressions

New machine learning algorithm can identify the facial expression a person is looking at based on neural activity

Newswise, April 21, 2016—Researchers at The Ohio State University have pinpointed the area of the brain responsible for recognizing human facial expressions.

It’s on the right side of the brain behind the ear, in a region called the posterior superior temporal sulcus (pSTS).

In a paper published today in the Journal of Neuroscience, the researchers report that they used functional magnetic resonance imaging (fMRI) to identify a region of pSTS as the part of the brain activated when test subjects looked at images of people making different facial expressions.

Further, the researchers have discovered that neural patterns within the pSTS are specialized for recognizing movement in specific parts of the face. One pattern is tuned to detect a furrowed brow, another is tuned to detect the upturn of lips into a smile, and so on.

“That suggests that our brains decode facial expressions by adding up sets of key muscle movements in the face of the person we are looking at,” said Aleix Martinez, a cognitive scientist and professor of electrical and computer engineering at Ohio State.

Martinez said that he and his team were able to create a machine learning algorithm that uses this brain activity to identify what facial expression a person is looking at based solely on the fMRI signal.

“Humans use a very large number of facial expressions to convey emotion, other non-verbal communication signals and language,” Martinez said.

“Yet, when we see someone make a face, we recognize it instantly, seemingly without conscious awareness. In computational terms, a facial expression can encode information, and we’ve long wondered how the brain is able to decode this information so efficiently.

“Now we know that there is a small part of the brain devoted to this task.”

Using this fMRI data, the researchers developed a machine learning algorithm that has about a 60 percent success rate in decoding human facial expressions, regardless of the facial expression and regardless of the person viewing it.

“That’s a very powerful development, because it suggests that the coding of facial expressions is very similar in your brain and my brain and most everyone else’s brain,” Martinez said.

The study doesn’t say anything about people who exhibit atypical neural functioning, but it could give researchers new insights, said study co-author Julie Golomb, assistant professor of psychology and director of the Vision and Cognitive Neuroscience Lab at Ohio State.

“This work could have a variety of applications, helping us not only understand how the brain processes facial expressions, but ultimately how this process may differ in people with autism, for example,” she said.

Doctoral student Ramprakash Srinivasan, Golomb and Martinez placed 10 college students into an fMRI machine and showed them more than 1,000 photographs of people making facial expressions.

The expressions corresponded to seven different emotional categories: disgusted, happily surprised, happily disgusted, angrily surprised, fearfully surprised, sadly fearful and fearfully disgusted.

While some of the expressions were positive and others negative, they all had some commonalities among them.

For instance, “happily surprised,” “angrily surprised” and “fearfully surprised” all include raised eyebrows, though other parts of the face differ when we express these three emotions.

fMRI detects increased blood flow in the brain, so the research group was able to obtain images of the part of the brain that was activated when the students recognized different expressions. Regardless of the expression they were looking at, all the students showed increased activity in the same region—the pSTS.

Then the research group used a computer to cross-reference the fMRI images with the different facial muscle movements shown in the test photographs.

They were able to create a map of regions within the pSTS that activated for different facial muscle groups, such as the muscles of the eyebrows or lips.

First, they constructed maps using the fMRIs of 9 of the participants. Then, they fed the algorithm the fMRI images from the 10th student, and asked it to identify the expressions that student was looking at. Then they repeated the experiment, creating the map from scratch with data from nine of the students, but using a different student as the 10th subject.

About 60 percent of the time, the algorithm was able to accurately identify the facial expression that the 10th person was looking at, based solely on that person’s fMRI image.

Martinez called the results “very positive,” and said that they indicate that the algorithm is making strides toward an understanding of what happens in that region of the brain.

The researchers will continue the work, which was funded by the National Institutes of Health and the Alfred P. Sloan Foundation

Researchers Seeking Ways to Help Older Adults Preserve Their Mobility

Newswise, April 14, 2016-- There’s no getting around it: Simply getting around is a major issue for older adults.

“People are in nursing homes for two reasons, either they can’t think or they can’t walk,” said Stephen Kritchevsky, Ph.D., director of the Sticht Center on Aging at Wake Forest Baptist Medical Center. North Carolina.

“We’re working very hard on the thinking part, and the walking part is equally important.

“The older people who report the highest life satisfaction, and who also seem to live longer, are those with intact and robust social networks. The ability to walk is fundamental to maintaining one’s social contacts and remaining independent. Mobility is critical to quality of life in addition to physical health.”

Kritchevsky is among the Wake Forest Baptist researchers collaborating with colleagues across the country to find ways to keep older adults on their feet.

Backed by a $5.3 million National Institutes of Health (NIH) grant, Wake Forest Baptist and five other institutions are launching a multi-site study to determine if reducing the chronic, low-grade inflammation that is common in the elderly can help avert mobility problems.

“The levels of inflammation we are studying are way below the levels that you can observe when there’s an acute infection,” said Marco Pahor, M.D., director of the Institute on Aging at the University of Florida and co-principal investigator of the study with Walter T. Ambrosius, Ph.D., professor and chair of biostatistical sciences at Wake Forest Baptist. “We are talking about inflammation that’s associated with aging, not disease.”

The researchers will enlist 300 older adults who either have or are at risk for mobility limitations and see whether omega-3 fish oil and the blood pressure drug losartan – both of which have proven effective in lessening inflammation – can improve their physical function and help prevent mobility loss.

Wake Forest Baptist is the data coordinating center for the study – responsible for overall data management, monitoring and communication among all sites and general oversight of the project – and also a field site.

The other participating institutions, in addition to the University of Florida, are Tufts University, Northwestern University, the University of Pittsburgh and the University of Vermont.

“This is looking at reducing inflammation in the hopes that we might be able to design a larger study that would target inflammation in order to preserve the ability of people to walk,” Ambrosius said.

“But the ultimate goal is to develop therapies that can preserve people’s ability to walk unassisted and live independently.”

Kritchevsky said the inflammation project has essentially the “same infrastructure” as a 2014 study that was the first to demonstrate that exercise can help prevent mobility loss in older adults.

In that NIH-funded trial, which included 1,635 sedentary men and women ages 70 to 89, the participants who followed a structured, moderate-intensity exercise program for an average of 2.6 years were 18 percent less likely to suffer mobility disability than those who took part in a program of health education workshops and stretching exercises.

That study also was led by Pahor and coordinated by Wake Forest Baptist. It was conducted at eight field sites: five that are involved in the current inflammation study – Wake Forest Baptist, Florida, Tufts, Northwestern and Pittsburgh – plus Stanford, Yale and Louisiana State universities.

Taking yet another approach to promoting mobility in seniors is Denise Houston, Ph.D., associate professor of geriatrics and gerontology at Wake Forest Baptist. Her focus is on vitamin D, which is essential to bone strength and can have positive effects on other parts of the anatomy, including muscle.

Most of the vitamin D the body needs is produced through exposure to sunlight, but it also can be obtained by consuming fatty fish such as salmon, tuna and mackerel; “fortified” products such as milk, juices and cereals; and supplements.

“Unfortunately, for a variety of reasons a lot of older adults have inadequate intakes of vitamin D,” Houston said.

“The current recommendations for vitamin D are based on bone health, and we’re trying to see if those numbers are the same or need to be adjusted for muscle health.”

In a 2012 study that examined data from more than 2,000 older adults, Houston found that over a six-year period those who had low vitamin D levels were 30 percent more likely to develop mobility limitations and 90 percent more likely to develop mobility disability than those with higher levels.

In a 2015 study of 68 homebound seniors with low vitamin D levels, she found that those who received a monthly vitamin D supplement with a Meals on Wheels delivery reported half as many falls as their counterparts who received a placebo.

In an NIH-supported clinical trial currently under way at Wake Forest Baptist, Houston is testing vitamin D’s effects on muscle function in older adults.

The study will eventually include 200 people ages 65 to 89 with low-normal vitamin D levels and some difficulty performing tasks such as getting in and out of a chair or walking up stairs. Half the participants get a year’s supply of vitamin D pills to be taken once daily while the others receive placebo pills.

All participants are tested for vitamin D levels, muscle qualities and physical capabilities at three intervals over a 12-month period.

“What we’re trying to find out in this study is how vitamin D affects risk factors for falls such as balance and muscle strength,” Houston said, “and whether increasing vitamin D levels in people at risk for mobility problems can improve their balance, muscle strength and function, leading to better mobility and a lower risk of falling.”

Is a Popular Painkiller Hampering Our Ability to Notice Errors?

Newswise, April 14, 2016 — It's been known for more than a century that acetaminophen is an effective painkiller, but according to a new U of T study it could also be impeding error-detection in the brain.

The research, authored by a team including postdoctoral fellow Dan Randles and researchers from the University of British Columbia, is the first neurological study to look at how acetaminophen could be inhibiting the brain response associated with making errors.

"Past research tells us physical pain and social rejection share a neural process that we experience as distress, and both have been traced to same part of the brain," says Randles.

Recent research has begun to show how exactly acetaminophen inhibits pain, while behavioural studies suggest it may also inhibit evaluative responses more generally. Randles own past research has found that people are less reactive to uncertain situations when under the effect of acetaminophen.

"The core idea of our study is that we don't fully understand how acetaminophen affects the brain," says Randles. "While there's been recent behavioural research on the effects of acetaminophen, we wanted to have a sense of what's happening neurologically."

To test the idea two groups of 30 were given a target-detection task called the Go or No Go. Participants were asked to hit a Go button every time the letter F flashed on a screen but refrain from hitting the button if an E flashed on the screen.

"The trick is you're supposed to move very quickly capturing all the GOs, but hold back when you see a No Go," says Randles.

Each participant was hooked up to an electroencephalogram (EEG), which measures electrical activity in the brain. The researchers were looking for a particular wave called Error Related Negativity (ERN) and Error Related Positivity (Pe). Essentially what happens is that when people are hooked up to an EEG and make an error in the task there is a robust increase in ERN and Pe.

One group, which was given 1,000 mg of acetaminophen - the equivalent of a normal maximum dose - showed a smaller Pe when making mistakes than those who didn't receive a dose, suggesting that acetaminophen inhibits our conscious awareness of the error.

"It looks like acetaminophen makes it harder to recognize an error, which may have implications for cognitive control in daily life," says Randles.

Cognitive control is an important neurological function because people are constantly doing cognitive tasks that flow automatically like reading, walking or talking. These tasks require very little cognitive control because they are well mapped out neurological processes, notes Randles.

"Sometimes you need to interrupt your normal processes or they'll lead to a mistake, like when you're talking to a friend while crossing the street, you should still be ready to react to an erratic driver," explains Randles.

"The task we designed is meant to capture that since most of the stimuli were Go, so you end up getting into a routine of automatically hitting the Go button. When you see a No Go, that requires cognitive control because you need to interrupt the process."

The study was double blind, so neither the researcher running the study nor the participant knew whether they had been given a placebo or acetaminophen.

An unexpected and surprise finding that Randles plans to explore more closely is that those who received an acetaminophen dose appeared to miss more of the Go stimuli than they should have.

He plans on expanding on the error detection aspect of the research to see whether acetaminophen is possibly causing people to "mind wander" and become distracted.

"An obvious question is if people aren't detecting these errors, are they also making errors more often when taking acetaminophen? This is the first study to address this question, so we need more work and ideally with tasks more closely related to normal daily behaviour."

The research is published in the current edition of the journal Social Cognitive and Affective Neuroscience.