Improving Quality of Life for the Seriously Ill

Newswise, February 13, 2016— Being diagnosed with a potentially life-threatening illness is distressing enough but a dearth of cohesive services often compounds the difficulty, according to an NAU researcher.

Mary Anne Hale Reynolds, an associate professor in the School of Nursing, focuses on adults, ages 20-59, and the physical, psychosocial, emotional and spiritual impacts following a life-threatening disease diagnosis.

Reynolds’ area of expertise is palliative care, which she described as an array of services geared toward people with serious illnesses.

“The interesting thing about palliative care teams is they are almost always based in acute-care settings in hospitals,” Reynolds said. “But for people who are discharged home, then community resources become very important.”

Most people Reynolds has surveyed are unable to accurately describe palliative care, which she describes as similar to hospice services but provided on an outpatient basis through community partners over a longer period of time.

Palliative care includes spiritual counseling, pharmaceutical assistance and health care services. Unlike patients in hospitals, hospice and assisted-living facilities, many people in Reynolds’ research live at home, continue to work and often care for family members despite a potentially life-threatening diagnosis.

As the health care system in the United States continues to evolve, Reynolds has witnessed a move toward more palliative care, yet research on the topic is sparse.

With more people living longer with life-threatening illnesses, there is an imperative to improve the quality of their lives, Reynolds said, which could be accomplished through a robust model of palliative care.

Services could include managing symptoms and pain, transportation to and from treatments, navigating insurance and referring people to a lawyer if advanced directives are needed.

In a recent northern Arizona study, Reynolds learned about inadequacies of services for people with cancer. She discovered recurring themes among the afflicted, including difficulty maintaining employment, financial burdens and the challenge of commuting to Flagstaff for health care.

Most of the people in Reynolds’ study, which was funded by the American Nurses Association and Hospice and Palliative Nurses Association, were slow in being correctly diagnosed, postponing their cancer treatments.

After a diagnosis, palliative care services could have improved their lives, she said.

\
"Palliative care models are all about improving people's quality of life, not the quantity," said Reynolds, noting that in many cases patients receiving palliative care early do actually live a couple of months longer than expected.

In addition to enhancing the quality of life following a diagnosis, Reynolds said, palliative care research shows an economic benefit from fewer hospital readmissions.

Reynolds wants to expand her recent research to include cardiac patients and people with other types of life-limiting illnesses. Educating primary care providers, including those in rural communities, would be a big step toward improving the quality of life for patients.

"With palliative care, it is about identifying services we have an what we need," Reynolds said. Nurses, including Reynolds' students, will play significant roles on future interdisciplinary teams if the healthcare system moves to a more encompassing palliative care model.

Reynolds received word this week that two of her grant applications were accepted and funding will be awarded for additional palliative care research.

Past Experiences Affect Recognition, Memory

Newswise, February 10, 2016 — New research from the University of Guelph on the brain and memory could help in developing therapies for people with schizophrenia and Alzheimer’s disease.

The study by psychology professor Boyer Winters and his research team was published recently in the Journal of Neuroscience.

Their work sheds new light on the internal workings of the brain, specifically regions involved in recognizing and remembering objects.

“Our study suggests that past experience with an object alters the brain circuitry responsible for object recognition,” said Winters.

“It has significant implications for our understanding of multisensory information processing.”

Multisensory integration is an important part of memory, Winters said. For example, if you hold something while blindfolded, chances are you can recognize it by touch if you have seen it before. But how?

Specialized areas of the brain mediate information for sight and touch, Winters said. Some researchers say those regions “talk” to each other, enabling better recognition of an object.

Others believe that the brain integrates information from the senses and stores it in a separate place entirely, and then taps into that area to aid object recognition.

Winters and his team from U of G’s Collaborative Neuroscience Program set out to test which model is correct using rats.

They let some rats briefly explore an object’s tactile and visual characteristics. 

The next day, the researchers showed the object to the same animals, and compared their responses to rats seeing the object for the first time.

Rats exploring the objects for the first time appeared to use multiple specialized brain regions to recognize the object, while rats with previous exposure tapped into a separate part of their brains to perform the same memory task.

“Knowing what an object looks like enables them to assimilate information in a way that doesn’t happen when there is no pre-exposure,” Winters said.

“Our study suggests there is an assigned region of the brain for memory based on previous experience with objects.”

The more exposure to an object, the more information about it is stored in dedicated parts of the brain, leading to more efficient behavioural responses, Winters said.

The research may help in developing therapies for people with dementia and other brain disorders who cannot recognize highly familiar objects or people, he said.

Study Shows Promising Safety Results for Anti-Aging Drug

First rapamycin metabolic study results in nonhuman primates results in new grant

Newswise, February 10, 2016– The search for the fountain of youth led to a 2009 discovery that a drug called rapamycin was shown to extend the lifespan of mice.

Since that time, studies on the metabolic side effects of rapamycin have made it unclear whether the drug is safe as a long-term treatment. A recent study published in the November issue of the journal Aging showed minimal metabolic side effects after continuous, long-term treatment with encapsulated rapamycin in a marmoset (monkey) model.

The study, completed by researchers with the Barshop Institute for Longevity and Aging Studies at The University of Texas Health Science Center at San Antonio and the Southwest National Primate Research Center (SNPRC) at Texas Biomedical Research Institute, is the first to examine the metabolic consequences of rapamycin dosing in healthy, non-human primates.

In addition to metabolic function, the researchers found that the encapsulated rapamycin was well tolerated by the marmosets.

“This initial study with marmosets as a model for human aging has allowed us to evaluate the efficacy of a new intervention treatment that looked promising in other animal model species for both healthspan and lifespan extension,” said Dr. Corinna Ross, lead author of the study and Assistant Professor Biology, Texas A&M University San Antonio.

“The results are encouraging,” said Dr. Suzette Tardif, Associate Director of SNPRC and co-investigator on the study. “Marmosets also offer a unique non-human primate model that will allow us to further evaluate not just the safety but the effectiveness of treatment with rapamycin.”
Due to results from this study, a grant for $2.7 million was awarded to the Barshop Institute and SNPRC by the National Institute on Aging to fund a new study to determine the effects of rapamycin lifespan and markers of healthy aging for a cohort of marmosets that have already reached middle age.

Dr. Adam Salmon, principal investigator of the new study and Assistant Professor/Research Department of Molecular Medicine at the Barshop Institute, said, “These studies will provide an important step towards translational approaches to delay age-related disease and improve healthy aging in humans by means of pharmaceutical inhibition of mTOR (mechanistic target of rapamycin).”
The new study begins this month.

###

The University of Texas Health Science Center at San Antonio, with missions of teaching, research and healing, is one of the country’s leading health sciences universities. Its schools of medicine, nursing, dentistry, health professions and graduate biomedical sciences have more than 32,200 alumni who are advancing their fields throughout the world. With six campuses in San Antonio and Laredo, the university has a FY 16 revenue operating budget of $801.8 million and is the primary driver of its community’s $30.6 billion biomedical and health care industry. For more information on the many ways “We make lives better®,” visit www.uthscsa.edu.

Texas Biomed is one of the world's leading independent biomedical research institutions dedicated to advancing health worldwide through innovative biomedical research. Texas Biomed partners with hundreds of researchers and institutions around the world to develop vaccines and therapeutics against viral pathogens causing AIDS, hepatitis, herpes, hemorrhagic fevers and parasitic diseases responsible for malaria, schistosomiasis and Chagas disease. The Institute also has programs in the genetics of cardiovascular disease, diabetes, obesity, psychiatric disorders and other diseases. For more information on Texas Biomed, go to www.TxBiomed.org.

Money and Influence in 2016 Presidential Campaign Tracked by New Index at Chicago Booth

Newswise, February 5, 2016 — As the 2016 presidential campaign attracts more money and bigger political donations than any campaign in U.S. history, the University of Chicago Booth School of Business has created a financial index to capture the influence that corporations and special interest groups have on politics and the economy.

The George J. Stigler Center for the Study of the Economy and the State at Chicago Booth launched the Campaign Financing Capture Index to measure the concentration of campaign funding in the 2016 U.S. presidential election.

The index ranks the concentration of funding for each candidate with an eye toward predicting how political donations could influence policy decisions under a new president.

The creation of the index comes as the U.S. courts have lifted limits on the size of political donations, and special interest groups, in the form of super PACS, are playing a bigger role in how campaigns are financed.

“The more concentrated the sources of funding to a political campaign, the higher the risk a politician will be influenced by special interests,” said Professor Luigi Zingales, director of the Stigler Center.

“Candidates receiving large donations from few donors may be less willing and able to lead reforms in markets where powerful special interest groups benefit from the status quo.”

The Campaign Financing Capture Index, published quarterly, will track when and how big-money political donations shift during the course of the campaign. Researchers at the Stigler Center expect there to be significant changes in the concentration of donations as the race progresses.

The index measures “concentration” by the number of donors and the amount of each donation. Candidates with highly concentrated funding have the fewest donors giving the most amount of money.

 Candidates with low concentration of funding have the largest number of donors giving the smallest amounts of money. The Stigler Center defines large donations as contribution of $5,000 or more.

“We think that when donations start to exceed $5,000, donors are not just expressing a political preference, they are trying to influence future policies,” said Zingales.

First Round of Results

Republican candidate and former Florida governor Jeb Bush ranked as the candidate with the highest concentration of big donors at 77 percent of total campaign contributions above $5,000.

Republican Senator Marco Rubio of Florida ranked second at 59 percent, closely followed by Republican Senator Ted Cruz of Texas at 58 percent.

Democratic candidate Hillary Clinton fell in the middle of the pack with 32 percent of political contributions above $5,000, followed by Democratic former Maryland governor Martin O’Malley at 17 percent, Republican Ben Carson at 12 percent, Republican billionaire Donald Trump at 2.9 percent, and Democratic Senator Bernie Sanders of Vermont at 0.1 percent.

The candidates ranked in the same order when tracking donations of $100,000 or more. Bush had the highest concentration of $100,000-plus donors at 58 percent, followed by Rubio at 47 percent, Cruz at 45 percent, Clinton at 29 percent, and O’Malley at 4.3 percent. Figures for Carson were inconclusive.

Sanders and Trump are the only candidates to have received no political contributions over $100,000. Sanders’ campaign is dominated by individual donations of $200 or less. Trump is in a category of his own, digging into his own pockets to fund much of his campaign.

The funding results are for the campaigns are through Dec. 31, 2015.

Analysis is based on Federal Election Commission data collected by the Center for Responsive Politics, a nonprofit, nonpartisan research group.

The Stigler Center is a nonpartisan, academic research institution that is focused on the creation and dissemination of research on competitive markets, regulatory capture and the ways in which special interest groups distort markets.

The Campaign Financing Capture Index is led by Professor Luigi Zingales, along with the University of Chicago’s Milena Ang and Chicago Booth’s Eran Lewis.

Mature Drivers Favour Checks on Over 70s, New Study Finds

Publisher’s Note:  Although this survey was taken outside the US, we publish it here as the US faces challenges of an Aging Population—including driving and transportation for older persons

Newswise, February 5, 2016 — The majority of older drivers are in favour of tighter rules on checking the health and suitability of over-70s to drive – even if those checks could take them off the road themselves – according to a new report. T

he Institute of Advanced Motorists (IAM) worked with Dr Carol Hawley at Warwick Medical School, the University of Warwick, to survey more than 2,600 drivers and former drivers on their opinions, habits and motoring history.

The first major survey of its kind for two decades, Keeping Older Drivers Safe and Mobile, found more than half of over 70s demonstrate that they self-regulate to stay safe, by avoiding driving in challenging situations like busy traffic, after dark, in rush hour or bad weather.

While mature drivers travel significantly fewer miles than other age groups, 84% of them rated their driving ability as ‘good to excellent’ and only 6% had ever considered giving up driving.

Despite that a very high proportion of respondents were in favour of measures to increase their safety on the roads. Dr Hawley said: “Almost 60% of those questioned said drivers should retake the driving test every five years after age 70, 85% said drivers should pass an eyesight test every five years once they have reached 70, and more than half said that drivers aged around 70 should be required to have a medical examination.”

Dr Hawley worked with Professor Elizabeth Maylor in the University’s Psychology Department who provided access to the Warwick University research volunteer panel which provided nearly all of the respondents. Of those questioned 94% agreed that GPs should be required to inform patients if their medical condition may affect their fitness to drive and half agreed that a flexible licensing system should be introduced which could restrict types of roads and conditions for some older drivers.

The IAM’s survey found respondents wanted some rules to extend further than older drivers – 84% agreed that all drivers should pass an eyesight test every 10 years after first passing, regardless of their age.

The report also found just how important driving is to this group. Some 82% said that driving was very or extremely important to them, a figure that increases for women. Independence and convenience were cited as the main reasons for wanting to continue driving.

The number of drivers over the age of 70 is set to double over the next 20 years and with more than one million licence holders over the age of 80, there is a pressing need for enlightened policies and practical actions to help them keep safe and competently mobile for as long as possible.

Sarah Sillars, IAM chief executive officer, said: “Driving is about so much more than getting from A to B and nowhere is this more apparent than in this age group. It helps maintain self-esteem and freedom and is essential for combatting social isolation.

“There are certain issues that affect mature drivers more so than other groups however, such as reductions in mobility and a slowdown in reaction times. The great news from this survey is that mature drivers themselves are aware of the risks and support action to review their safety.

“Voluntary self-assessment and better education via GPs are important techniques for helping drivers understand how long they can continue to drive safely for. And for those needing a confidence boost or a little extra reassurance on today’s busy roads, the IAM’s Mature Driver Assessment could be something to think about.”

Yoga for Heart Health

Yoga practitioners have been touting yoga’s psychological and physical benefits for more than 5,000 years. Increasingly, yoga is being recommended for some patients with heart disease

Newswise, February 5, 2016— Yoga practitioners have been touting yoga’s psychological and physical benefits for more than 5,000 years. Increasingly, yoga is being recommended for some patients with heart disease.

Valley Medical Group’s Center for Integrative Medicine, located in Ridgewood, NJ recently introduced a free cardiac yoga program designed to help patients deal with the stress of a diagnosis of heart disease on all levels: physical, mental, emotional, and spiritual. 

The program takes a gentle approach to cardiac rehabilitation and each class includes adaptive yoga poses and sequences, restorative yoga poses, gentle breathing techniques, relaxation and guided meditation.

“Participants in the class experience numerous physical and psychological benefits, which can include decreased levels of stress, reduction in blood pressure, lowering of cholesterol levels and lessening of harmful inflammation,” says cardiologist Benita Burke, M.D. 

In addition to serving as Medical Director of Valley Medical Group’s Heart Care for Women practice, Dr. Burke is a board-certified integrative medicine practitioner.

Valley’s cardiac yoga program is being offered in conjunction with Kula for Karma, a not-for-profit organization that offers therapeutic yoga, meditation and stress management. Loretta Turner, a Senior Program Director with Kula for Karma, explains that their “yoga instructors are specifically trained to work with cardiac patients. 

Each instructor must complete an advanced teacher training that outlines the physiological considerations when working with this population. The instructors meet each participant at his or her own level and provide self-care tools that often become invaluable both in class and throughout life.”

Allendale resident Linda Parise says that “This is not something I would have considered because I was embarrassed about my level, but there is no judgment here. The instructors are wonderful and concerned about me. I feel a physical change.”

Adds Fair Lawn resident Beth Goldberg, “There is a sense of community in this class—whatever the path was that brought us here—we have a common purpose. The class is not intimidating and it is a welcoming group.”

Valley’s Center for Integrative Medicine also offers specialty yoga classes for patients who are recovering from spinal surgery and patients and survivors of cancer. A physician’s prescription is required to participate.

Valley Medical Group is part of Ridgewood, NJ-based Valley Health System, which also includes The Valley Hospital and Valley Home Care.

Small business owners: U.S. is facing a retirement crisis Workers have help on the way thanks to sales, economic outlook

COLUMBUS, Ohio, Feb. 5, 2016 /PRNewswire/ -- A recent survey of U.S. small business owners (SBOs) reveals contradictory views on the retirement preparedness of the country's workers – yet offers an optimistic economic outlook for the next two years.

An overwhelming majority of SBOs believe that the country is in the midst of a retirement crisis. The online study, commissioned by Nationwide and conducted by Harris Poll, found that 84 percent of small business owners believe American workers are facing a retirement readiness crisis.

However, 60 percent of SBOs believe that their own employees are on track to retire.

Nearly two-thirds (63 percent) of small business owners say it's important for a business owner to provide retirement benefits, but, in reality, only a third (34 percent) of small business owners offer these benefits to their employees.

Small businesses play an outsized role in helping workers prepare for retirement.

Consider this: According to the U.S. Small Business Administration, small businesses make up 99.7 percent of all employers, employ nearly 50 percent of all private-sector workers (48.5 percent) and create 63 percent of the net new private-sector jobs in the country.¹

"Small businesses are the lifeblood of our economy and keep our communities moving forward," said Joe Frustaglio, vice president and leader of private sector retirement plan sales at Nationwide. "All workers deserve access to retirement savings options, and it is evident that we've reached a point in this country where people are starting to pay attention to the fact that a retirement savings problem exists. Employers need to provide access and education, and workers need to take advantage of what's available to them."

Help is on the way

Workers should have hope that their retirement-readiness outlook will improve. Of the SBOs who offer retirement benefits, including 401(k) plans, to their employees, 67 percent say they plan to increase their company contribution to employees' 401(k) plan.

Of the SBOs who do not currently offer retirement benefits, 30 percent say they plan to offer these benefits in the future. If that happens, then more than half (54 percent) of SBOs will offer their employees retirement benefits.

A positive economic outlook is a driving force behind this. Half of SBOs who plan to start offering retirement benefits say they will do so because they expect sales or revenue to increase in the next 12 to 24 months (50 percent), and 32 percent believe the U.S. economy will improve in the same timeframe.

Small business owners who currently offer 401(k) plans and say they will increase contributions have an even more positive outlook: 56 percent expect company sales or revenue to increase in the next 12 to 24 months, and 53 percent believe the U.S. economy will improve in that same period.

"In spite of recent market volatility, economic indicators are pointing toward continued growth for the U.S. economy in 2016," said David Berson, senior vice president and chief economist at Nationwide. "Small business owners should see Main Street benefit from the economic stability that we've enjoyed during the last few years."

Affordable Care Act: making its impact

The Affordable Care Act (ACA) is indirectly affecting workers' retirement preparedness.

Of SBOs who plan to offer retirement benefits in the future, 25 percent say the ACA has made health benefits less attractive to employees, and 18 percent say the ACA has decreased company health care costs.

Of SBOs who currently offer retirement benefits and plan to increase company contributions to their employees' 401(k) plans, 33 percent say the ACA has made health care benefits less attractive to employees, and 30 percent say the ACA has decreased the company's health care costs.

"Lower health care costs means small business owners have the option of contributing more to their employees' retirement," said Frustaglio.

As the ACA makes health care benefits less relevant to small business employees, business owners have to find a new way to recruit and retain employees. There is mounting evidence that 401(k) plans are filling that role.

Among small business owners, 59 percent disagree that retirement benefits are not important for attracting and retaining employees.

More than two in five (42 percent) of small business owners who said they plan to increase contributions agree their company's 401(k) plan is now more important for attracting and retaining employees as a result of the ACA. Similarly, about one-quarter (24 percent) of small business owners who will offer retirement benefits in the future say their company's 401(k) plan is now more important for attracting and retaining employees because of the ACA.

"As the health care insurance marketplace becomes more commoditized, employers are looking for new tools to attract and retain key employees," said Frustaglio. "Employers who are using 401(k) plans as a recruitment tool are ahead of the game because we're seeing more company owners asking how they can do this."

Access to 401(k) plans

Small business owners who are not currently offering a 401(k) plan to their employees should talk to a financial advisor about finding a plan that's right for their employees and business.

A vast majority, 80 percent, of small business owners say they cannot compete with a Fortune 500 company's benefits, and nearly half, 48 percent, feel they could afford a customized 401(k) plan to meet their small business needs.

"Small companies not being competitive with large corporations in terms of employee benefits is just not true in today's world," said Frustaglio. "No matter the size of the business, from one with 33,000 associates like Nationwide to the corner grocery store, today's 401(k) plans allow for customization and access to the same options with the same tools for all employees."

Frustaglio recommends that small business owners who already offer retirement benefits to their employees should do a plan review every year with their advisor. The review should include an analysis of the plan's components and investment options for their employees.

Methodology:
The 2015 Small Business Owner Study was conducted online by Harris Poll on behalf of Nationwide between June 8 and June 19, 2015, among 500 U.S. small business owners, defined as companies with less than 300 employees. Results were weighted to be representative of small business owners in the U.S. Research participants were drawn from the Harris Poll Online (HPOL) research panel and partner sample. Because the sample is based on those who were invited to participate in the HPOL panel, estimates of theoretical sampling error cannot be calculated. Percentages were rounded to the nearest whole percent. Differences in the sums of combined categories/answers were due to rounding.

About Nationwide
Nationwide, a Fortune 100 company based in Columbus, Ohio, is one of the largest and strongest diversified insurance and financial services organizations in the U.S. and is rated A+ by both A.M. Best and Standard & Poor's. The company provides a full range of insurance and financial services, including auto, commercial, homeowners, farm and life insurance; public and private sector retirement plans, annuities and mutual funds; banking and mortgages; pet, motorcycle and boat insurance. For more information, visit www.nationwide.com.

Nationwide, Nationwide is on your side, Join the Nation and the Nationwide N and Eagle are service marks of Nationwide Mutual Insurance Company. ©2015