Roxanna Guilford-Blake

SAVANNAH, GA. – Regular use of a brain fitness program appears to produce slight memory improvements in elderly participants at 2 months and significant gains at 6 months, compared with an active control group.

Extended exposure is correlated with enhanced visual and verbal memory in the elderly, Karen Miller, Ph.D., of the University of California, Los Angeles reported at the annual meeting of the American Association for Geriatric Psychiatry.

The program, Dakim BrainFitness, uses games to exercise long- and short-term memory, critical thinking, visuo-spatial skills, calculation, and language. Dakim sponsored the research, and Dr. Miller serves as a consultant.

The trial included 38 elderly subjects, 22 in the intervention group (average age, 82.4 years), and 16 subjects in the control group (average age, 83.1 years). The program offers 300–400 activities and five levels of difficulty, allowing participants to engage in different activities each session. Although the program is computer-based, it is designed to be used by those with no computer experience.

Patients with Alzheimer's disease were excluded; those with mild cognitive impairment and age-consistent memory impairment were not.

Significant differences were observed at 6 months after randomization between the intervention group, which was enrolled in the program for the duration of the study (an average of 93.3 sessions per participant) and the control group, which, after a 2-month testing phase, also was enrolled (for an average of 45.2 sessions).

Neuropsychological testing was conducted at baseline, at 2 months, and at 6 months.

After 2 months, preliminary analysis of intervention group subjects revealed better delayed recall for list learning. The intervention group improved by recalling 8.3 words, compared with their initial recall of 7.6 words during baseline testing.

The control group's recall declined to on average 5.3 words during the posttesting period from the initial recall of 6.8 words.

At 6 months, participants in the intervention vs. control groups were significantly different in their delayed memory domain score. In the intervention group, which had played for the full 6 months, scores rose from 10.4 at baseline to 12.1.

In the control group, which played from month 2 to month 6, the same memory scores fell slightly, from 10.2 at baseline to 10.1 at follow-up.

The key finding at this point, Miller said, is the importance of exposure. The longer a person uses the program, the more likely he or she is to improve in verbal and visual memory. The results at 2 months were “mild,” while those at 6 months were “most overwhelmingly positive,” she said in a follow-up interview.

She added that 2- and 6-month analyses of a larger study of 100 subjects, which will include data on perception of memory functioning and mood, should be available by the summer. If she secures additional funding, she plans to do a follow-up at years 1 and 5.

Numerous brain fitness products are on the market, and that prompted a question from the audience about how to separate the legitimate programs from the “Elmer Gantries.” Another session panelist, Dr. Gary Smallchso of the University of California, Los Angeles, fielded the question and suggested that the program should be viewed with the same kind of skepticism that should taken toward nutritional supplements. “We need more evidence before we get all excited about it,” he said.

Dr. Small is a Dakim shareholder.

SAVANNAH, GA. – Regular use of a brain fitness program appears to produce slight memory improvements in elderly participants at 2 months and significant gains at 6 months, compared with an active control group.

Extended exposure is correlated with enhanced visual and verbal memory in the elderly, Karen Miller, Ph.D., of the University of California, Los Angeles reported at the annual meeting of the American Association for Geriatric Psychiatry.

The program, Dakim BrainFitness, uses games to exercise long- and short-term memory, critical thinking, visuo-spatial skills, calculation, and language. Dakim sponsored the research, and Dr. Miller serves as a consultant.

The trial included 38 elderly subjects, 22 in the intervention group (average age, 82.4 years), and 16 subjects in the control group (average age, 83.1 years). The program offers 300–400 activities and five levels of difficulty, allowing participants to engage in different activities each session. Although the program is computer-based, it is designed to be used by those with no computer experience.

Patients with Alzheimer's disease were excluded; those with mild cognitive impairment and age-consistent memory impairment were not.

Significant differences were observed at 6 months after randomization between the intervention group, which was enrolled in the program for the duration of the study (an average of 93.3 sessions per participant) and the control group, which, after a 2-month testing phase, also was enrolled (for an average of 45.2 sessions).

Neuropsychological testing was conducted at baseline, at 2 months, and at 6 months.

After 2 months, preliminary analysis of intervention group subjects revealed better delayed recall for list learning. The intervention group improved by recalling 8.3 words, compared with their initial recall of 7.6 words during baseline testing.

The control group's recall declined to on average 5.3 words during the posttesting period from the initial recall of 6.8 words.

At 6 months, participants in the intervention vs. control groups were significantly different in their delayed memory domain score. In the intervention group, which had played for the full 6 months, scores rose from 10.4 at baseline to 12.1.

In the control group, which played from month 2 to month 6, the same memory scores fell slightly, from 10.2 at baseline to 10.1 at follow-up.

The key finding at this point, Miller said, is the importance of exposure. The longer a person uses the program, the more likely he or she is to improve in verbal and visual memory. The results at 2 months were “mild,” while those at 6 months were “most overwhelmingly positive,” she said in a follow-up interview.

She added that 2- and 6-month analyses of a larger study of 100 subjects, which will include data on perception of memory functioning and mood, should be available by the summer. If she secures additional funding, she plans to do a follow-up at years 1 and 5.

Numerous brain fitness products are on the market, and that prompted a question from the audience about how to separate the legitimate programs from the “Elmer Gantries.” Another session panelist, Dr. Gary Smallchso of the University of California, Los Angeles, fielded the question and suggested that the program should be viewed with the same kind of skepticism that should taken toward nutritional supplements. “We need more evidence before we get all excited about it,” he said.

Dr. Small is a Dakim shareholder.

SAVANNAH, GA. – Regular use of a brain fitness program appears to produce slight memory improvements in elderly participants at 2 months and significant gains at 6 months, compared with an active control group.

Extended exposure is correlated with enhanced visual and verbal memory in the elderly, Karen Miller, Ph.D., of the University of California, Los Angeles reported at the annual meeting of the American Association for Geriatric Psychiatry.

The program, Dakim BrainFitness, uses games to exercise long- and short-term memory, critical thinking, visuo-spatial skills, calculation, and language. Dakim sponsored the research, and Dr. Miller serves as a consultant.

The trial included 38 elderly subjects, 22 in the intervention group (average age, 82.4 years), and 16 subjects in the control group (average age, 83.1 years). The program offers 300–400 activities and five levels of difficulty, allowing participants to engage in different activities each session. Although the program is computer-based, it is designed to be used by those with no computer experience.

Patients with Alzheimer's disease were excluded; those with mild cognitive impairment and age-consistent memory impairment were not.

Significant differences were observed at 6 months after randomization between the intervention group, which was enrolled in the program for the duration of the study (an average of 93.3 sessions per participant) and the control group, which, after a 2-month testing phase, also was enrolled (for an average of 45.2 sessions).

Neuropsychological testing was conducted at baseline, at 2 months, and at 6 months.

After 2 months, preliminary analysis of intervention group subjects revealed better delayed recall for list learning. The intervention group improved by recalling 8.3 words, compared with their initial recall of 7.6 words during baseline testing.

The control group's recall declined to on average 5.3 words during the posttesting period from the initial recall of 6.8 words.

At 6 months, participants in the intervention vs. control groups were significantly different in their delayed memory domain score. In the intervention group, which had played for the full 6 months, scores rose from 10.4 at baseline to 12.1.

In the control group, which played from month 2 to month 6, the same memory scores fell slightly, from 10.2 at baseline to 10.1 at follow-up.

The key finding at this point, Miller said, is the importance of exposure. The longer a person uses the program, the more likely he or she is to improve in verbal and visual memory. The results at 2 months were “mild,” while those at 6 months were “most overwhelmingly positive,” she said in a follow-up interview.

She added that 2- and 6-month analyses of a larger study of 100 subjects, which will include data on perception of memory functioning and mood, should be available by the summer. If she secures additional funding, she plans to do a follow-up at years 1 and 5.

Numerous brain fitness products are on the market, and that prompted a question from the audience about how to separate the legitimate programs from the “Elmer Gantries.” Another session panelist, Dr. Gary Smallchso of the University of California, Los Angeles, fielded the question and suggested that the program should be viewed with the same kind of skepticism that should taken toward nutritional supplements. “We need more evidence before we get all excited about it,” he said.

Dr. Small is a Dakim shareholder.

SAVANNAH, GA. – Older Mexican American and white non-Hispanic men are undertreated for depression, possibly because they talk about the depression experience differently from the way in which women do, preliminary findings from the Men's Health and Aging Study show.

MeHAS, funded by the National Institute for Mental Health (NIMH), examines barriers and facilitators to depression care for Mexican American and white non-Hispanic men aged 60 years and older in primary care. It explores how those men experience depression and considers the factors that impede or facilitate care.

Principal investigator Dr. Ladson Hinton of the University of California, Davis, and his colleagues presented preliminary findings at the annual meeting of the American Association for Geriatric Psychiatry.

The cross-sectional, mixed-method study, when complete, will comprise 96 Mexican American and white non-Hispanic subjects with recent depression. It also will include 48 of their primary care physicians.

Previous research has established that men are less likely than women to seek treatment. Depression is more prevalent in women, but men are less likely to seek treatment. “Women are more likely to be treated for depression; men are more likely to kill themselves,” Dr. Hinton said. Older age and its attendant comorbidities can make identification of depression more challenging, he noted.

The four-part presentation drew on screening data from more than 190 men, 74 of whom were eligible for the study. Results from analyses of the first 36 qualitative interviews with eligible men also were presented. The study sample was drawn from a public hospital outpatient clinic and a university outpatient clinic. Future participants will be drawn from other settings.

All of the candidates undergo a brief screening. Eligible participants complete a quantitative interview, then undergo a qualitative interview that includes discussions about childhood, occupational history, migration, family, the experience of depression, health, views of aging, family and social responses to depression, suicide, formal care, and help-seeking attitudes.

Dr. Jrgen Untzer of the University of Washington, Seattle, and the University of California, Los Angeles, reviewed the data from the initial two-stage screening.

Nearly half (48%) of the eligible participants had suicidal thoughts in the previous year; 23% reported such thoughts in the previous month. A third (33%) reported the loss of a loved one in the previous year. Of the eligible participants, 72% rated their health as fair or poor. Nearly three-quarters (74%) received prescriptions for pain. In contrast, 46% received a prescription for depression; 15% received counseling or psychotherapy.

“We're confirming earlier research about particularly low rates of treatment among older men from ethic minority groups,” he reported. Mexican Americans, especially those speaking Spanish, have the lowest rates of treatment.

Judith C. Barker, Ph.D., University of California, San Francisco, then discussed the extended interviews vis–vis notions of male roles and masculinity. Of the 74 men who were eligible for the study, 52 have participated in the qualitative interview. Dr. Barker presented on the first 36 interviews that have been transcribed and analyzed.

What emerges is a picture of men whose sense of manhood is tied into being productive; depression appears to be communicated in the language of lost productivity.

These men perceived loss of productivity as a threat to identity–especially in terms of masculinity and male roles. The interviewees did not want to be a burden. She noted that the issue has come up in research related to other chronic conditions, but not to the same extent as when older men talk about depression.

She quoted one of the interviews: “A man's got to take care of the responsibilities, no matter what they are. You know what I mean? He can't be a burden on anybody. I started right away [after my marriage] taking care of me and my wife.”

In the interviews, the men don't use “red flag” words, such as “blue” or “sad,” Dr. Barker reported. They talk about productivity. She cites an interview in which a 60-year-old white non-Hispanic male said: “I never used to, but lately I have to ask for help sometimes. Physically, there's things you can't do. I used to do everything by myself. … It don't make me feel bad, but I don't like it. … You're not supposed to do that. You are supposed to do it on your own.”

Because older men talk about depression differently from the way women do, clinicians might be less adept at recognizing depression–and its expressions–in them, she said. “Health care professionals need to expand their repertoires for detecting depression.”

They should encourage older men to report and discuss changes in work, health, and family contexts and “assess the reported emotional impact of these changes for possible depression,” said Dr. Barker. “Overall, the degree of distress wrought by these losses that the men were talking about was expressed similarly for both groups of men in a general sense.”

Dr. Barker did identify some differences. Mexican American men linked these losses with impacts on the family more than white non-Hispanic men did. “Mexican men's concerns about the family versus [white non-Hispanic] men's more individualized issues are definitely consistent with a large and diverse literature on these population groups,” indicating they are more familistic, she said.

Lack of productivity was linked to an inability to provide for or take care of family members. White non-Hispanic men, however, were more likely to directly link it to physical disability that affected them as individuals.

Ester Carolina Apesoa-Varano, Ph.D., of the University of California, Davis, then addressed family issues that emerged from the interviews.

Families play a dual role, both facilitating and serving as barriers to the treatment of depression. Drawing from the participants' accounts, she observed that men often perceive a lack of support for their depression.

“Families tend to normalize depression as a part of aging,” she said. That can inhibit care seeking. They also can stigmatize depression, making men less willing to disclose their feelings and less likely to seek formal care, she added.

None of the presenters disclosed any conflicts. MeHAS is funded by the NIMH.

SAVANNAH, GA. – Older Mexican American and white non-Hispanic men are undertreated for depression, possibly because they talk about the depression experience differently from the way in which women do, preliminary findings from the Men's Health and Aging Study show.

MeHAS, funded by the National Institute for Mental Health (NIMH), examines barriers and facilitators to depression care for Mexican American and white non-Hispanic men aged 60 years and older in primary care. It explores how those men experience depression and considers the factors that impede or facilitate care.

Principal investigator Dr. Ladson Hinton of the University of California, Davis, and his colleagues presented preliminary findings at the annual meeting of the American Association for Geriatric Psychiatry.

The cross-sectional, mixed-method study, when complete, will comprise 96 Mexican American and white non-Hispanic subjects with recent depression. It also will include 48 of their primary care physicians.

Previous research has established that men are less likely than women to seek treatment. Depression is more prevalent in women, but men are less likely to seek treatment. “Women are more likely to be treated for depression; men are more likely to kill themselves,” Dr. Hinton said. Older age and its attendant comorbidities can make identification of depression more challenging, he noted.

The four-part presentation drew on screening data from more than 190 men, 74 of whom were eligible for the study. Results from analyses of the first 36 qualitative interviews with eligible men also were presented. The study sample was drawn from a public hospital outpatient clinic and a university outpatient clinic. Future participants will be drawn from other settings.

All of the candidates undergo a brief screening. Eligible participants complete a quantitative interview, then undergo a qualitative interview that includes discussions about childhood, occupational history, migration, family, the experience of depression, health, views of aging, family and social responses to depression, suicide, formal care, and help-seeking attitudes.

Dr. Jrgen Untzer of the University of Washington, Seattle, and the University of California, Los Angeles, reviewed the data from the initial two-stage screening.

Nearly half (48%) of the eligible participants had suicidal thoughts in the previous year; 23% reported such thoughts in the previous month. A third (33%) reported the loss of a loved one in the previous year. Of the eligible participants, 72% rated their health as fair or poor. Nearly three-quarters (74%) received prescriptions for pain. In contrast, 46% received a prescription for depression; 15% received counseling or psychotherapy.

“We're confirming earlier research about particularly low rates of treatment among older men from ethic minority groups,” he reported. Mexican Americans, especially those speaking Spanish, have the lowest rates of treatment.

Judith C. Barker, Ph.D., University of California, San Francisco, then discussed the extended interviews vis–vis notions of male roles and masculinity. Of the 74 men who were eligible for the study, 52 have participated in the qualitative interview. Dr. Barker presented on the first 36 interviews that have been transcribed and analyzed.

What emerges is a picture of men whose sense of manhood is tied into being productive; depression appears to be communicated in the language of lost productivity.

These men perceived loss of productivity as a threat to identity–especially in terms of masculinity and male roles. The interviewees did not want to be a burden. She noted that the issue has come up in research related to other chronic conditions, but not to the same extent as when older men talk about depression.

She quoted one of the interviews: “A man's got to take care of the responsibilities, no matter what they are. You know what I mean? He can't be a burden on anybody. I started right away [after my marriage] taking care of me and my wife.”

In the interviews, the men don't use “red flag” words, such as “blue” or “sad,” Dr. Barker reported. They talk about productivity. She cites an interview in which a 60-year-old white non-Hispanic male said: “I never used to, but lately I have to ask for help sometimes. Physically, there's things you can't do. I used to do everything by myself. … It don't make me feel bad, but I don't like it. … You're not supposed to do that. You are supposed to do it on your own.”

Because older men talk about depression differently from the way women do, clinicians might be less adept at recognizing depression–and its expressions–in them, she said. “Health care professionals need to expand their repertoires for detecting depression.”

They should encourage older men to report and discuss changes in work, health, and family contexts and “assess the reported emotional impact of these changes for possible depression,” said Dr. Barker. “Overall, the degree of distress wrought by these losses that the men were talking about was expressed similarly for both groups of men in a general sense.”

Dr. Barker did identify some differences. Mexican American men linked these losses with impacts on the family more than white non-Hispanic men did. “Mexican men's concerns about the family versus [white non-Hispanic] men's more individualized issues are definitely consistent with a large and diverse literature on these population groups,” indicating they are more familistic, she said.

Lack of productivity was linked to an inability to provide for or take care of family members. White non-Hispanic men, however, were more likely to directly link it to physical disability that affected them as individuals.

Ester Carolina Apesoa-Varano, Ph.D., of the University of California, Davis, then addressed family issues that emerged from the interviews.

Families play a dual role, both facilitating and serving as barriers to the treatment of depression. Drawing from the participants' accounts, she observed that men often perceive a lack of support for their depression.

“Families tend to normalize depression as a part of aging,” she said. That can inhibit care seeking. They also can stigmatize depression, making men less willing to disclose their feelings and less likely to seek formal care, she added.

None of the presenters disclosed any conflicts. MeHAS is funded by the NIMH.

SAVANNAH, GA. – Older Mexican American and white non-Hispanic men are undertreated for depression, possibly because they talk about the depression experience differently from the way in which women do, preliminary findings from the Men's Health and Aging Study show.

MeHAS, funded by the National Institute for Mental Health (NIMH), examines barriers and facilitators to depression care for Mexican American and white non-Hispanic men aged 60 years and older in primary care. It explores how those men experience depression and considers the factors that impede or facilitate care.

Principal investigator Dr. Ladson Hinton of the University of California, Davis, and his colleagues presented preliminary findings at the annual meeting of the American Association for Geriatric Psychiatry.

The cross-sectional, mixed-method study, when complete, will comprise 96 Mexican American and white non-Hispanic subjects with recent depression. It also will include 48 of their primary care physicians.

Previous research has established that men are less likely than women to seek treatment. Depression is more prevalent in women, but men are less likely to seek treatment. “Women are more likely to be treated for depression; men are more likely to kill themselves,” Dr. Hinton said. Older age and its attendant comorbidities can make identification of depression more challenging, he noted.

The four-part presentation drew on screening data from more than 190 men, 74 of whom were eligible for the study. Results from analyses of the first 36 qualitative interviews with eligible men also were presented. The study sample was drawn from a public hospital outpatient clinic and a university outpatient clinic. Future participants will be drawn from other settings.

All of the candidates undergo a brief screening. Eligible participants complete a quantitative interview, then undergo a qualitative interview that includes discussions about childhood, occupational history, migration, family, the experience of depression, health, views of aging, family and social responses to depression, suicide, formal care, and help-seeking attitudes.

Dr. Jrgen Untzer of the University of Washington, Seattle, and the University of California, Los Angeles, reviewed the data from the initial two-stage screening.

Nearly half (48%) of the eligible participants had suicidal thoughts in the previous year; 23% reported such thoughts in the previous month. A third (33%) reported the loss of a loved one in the previous year. Of the eligible participants, 72% rated their health as fair or poor. Nearly three-quarters (74%) received prescriptions for pain. In contrast, 46% received a prescription for depression; 15% received counseling or psychotherapy.

“We're confirming earlier research about particularly low rates of treatment among older men from ethic minority groups,” he reported. Mexican Americans, especially those speaking Spanish, have the lowest rates of treatment.

Judith C. Barker, Ph.D., University of California, San Francisco, then discussed the extended interviews vis–vis notions of male roles and masculinity. Of the 74 men who were eligible for the study, 52 have participated in the qualitative interview. Dr. Barker presented on the first 36 interviews that have been transcribed and analyzed.

What emerges is a picture of men whose sense of manhood is tied into being productive; depression appears to be communicated in the language of lost productivity.

These men perceived loss of productivity as a threat to identity–especially in terms of masculinity and male roles. The interviewees did not want to be a burden. She noted that the issue has come up in research related to other chronic conditions, but not to the same extent as when older men talk about depression.

She quoted one of the interviews: “A man's got to take care of the responsibilities, no matter what they are. You know what I mean? He can't be a burden on anybody. I started right away [after my marriage] taking care of me and my wife.”

In the interviews, the men don't use “red flag” words, such as “blue” or “sad,” Dr. Barker reported. They talk about productivity. She cites an interview in which a 60-year-old white non-Hispanic male said: “I never used to, but lately I have to ask for help sometimes. Physically, there's things you can't do. I used to do everything by myself. … It don't make me feel bad, but I don't like it. … You're not supposed to do that. You are supposed to do it on your own.”

Because older men talk about depression differently from the way women do, clinicians might be less adept at recognizing depression–and its expressions–in them, she said. “Health care professionals need to expand their repertoires for detecting depression.”

They should encourage older men to report and discuss changes in work, health, and family contexts and “assess the reported emotional impact of these changes for possible depression,” said Dr. Barker. “Overall, the degree of distress wrought by these losses that the men were talking about was expressed similarly for both groups of men in a general sense.”

Dr. Barker did identify some differences. Mexican American men linked these losses with impacts on the family more than white non-Hispanic men did. “Mexican men's concerns about the family versus [white non-Hispanic] men's more individualized issues are definitely consistent with a large and diverse literature on these population groups,” indicating they are more familistic, she said.

Lack of productivity was linked to an inability to provide for or take care of family members. White non-Hispanic men, however, were more likely to directly link it to physical disability that affected them as individuals.

Ester Carolina Apesoa-Varano, Ph.D., of the University of California, Davis, then addressed family issues that emerged from the interviews.

Families play a dual role, both facilitating and serving as barriers to the treatment of depression. Drawing from the participants' accounts, she observed that men often perceive a lack of support for their depression.

“Families tend to normalize depression as a part of aging,” she said. That can inhibit care seeking. They also can stigmatize depression, making men less willing to disclose their feelings and less likely to seek formal care, she added.

None of the presenters disclosed any conflicts. MeHAS is funded by the NIMH.

Increased time spent watching television is associated with higher mortality in general and increased cardiovascular disease–related death in particular, according to findings from an Australian population-based cohort study.

Each hour spent in front of the television daily was associated with an 18% increased risk of cardiovascular disease–related death and an 11% increase of death from all causes, wrote David Dunstan, Ph.D., of the Baker IDI Heart and Diabetes Institute in Melbourne, Australia, and colleagues.

Participants who watched television 4 or more hours daily had an 80% increased risk for cardiovascular disease–related death and a 46% higher risk of death from all causes when compared with those who watched less than 2 hours a day (DOI:10.1161/CirculationAHA.109.894824

The risks “were independent of traditional risk factors such as smoking, blood pressure, cholesterol, and diet, as well as leisure-time exercise and waist circumference,” Dr. Dunstan and his colleagues noted.

Investigators examined the relationship between television viewing time and mortality in a national population-based cohort from the Australian Diabetes, Obesity and Lifestyle Study. The participants were enrolled during 1999–2000 and followed through 2006.

A total of 8,800 participants (3,846 men and 4,954 women, a mean age of 50 years) met all inclusion criteria for the analysis. Everyone had undergone testing for glucose levels, fasting serum triglycerides, total cholesterol, and HDL cholesterol. Those with a history of cardiovascular disease or stroke were excluded.

At enrollment, participants reported television-viewing habits for the previous 7 days and were grouped into one of three categories: less than 2 hours daily, between 2 and 4 hours, and more than 4 hours daily. Timeframes when the television was on, but participants were otherwise engaged, did not count.

During the median follow-up of 6.6 years, 284 deaths occurred; 87 were due to cardiovascular disease.

The study was limited by the fact that it assessed a single behavior. However, time spent watching television “has been shown to be a reasonable proxy measure of an overall sedentary behavior pattern,” the authors stated.

The study was funded by the National Health and Medical Research Council and received in-kind support from the Australian Institute of Health and Welfare. The authors reported having no conflicts of interest.

Each hour spent watching TV was linked to an 18% higher risk of cardiovascular disease–related death.

Source ©AlShadsky/Fotolia.com

Increased time spent watching television is associated with higher mortality in general and increased cardiovascular disease–related death in particular, according to findings from an Australian population-based cohort study.

Each hour spent in front of the television daily was associated with an 18% increased risk of cardiovascular disease–related death and an 11% increase of death from all causes, wrote David Dunstan, Ph.D., of the Baker IDI Heart and Diabetes Institute in Melbourne, Australia, and colleagues.

Participants who watched television 4 or more hours daily had an 80% increased risk for cardiovascular disease–related death and a 46% higher risk of death from all causes when compared with those who watched less than 2 hours a day (DOI:10.1161/CirculationAHA.109.894824

The risks “were independent of traditional risk factors such as smoking, blood pressure, cholesterol, and diet, as well as leisure-time exercise and waist circumference,” Dr. Dunstan and his colleagues noted.

Investigators examined the relationship between television viewing time and mortality in a national population-based cohort from the Australian Diabetes, Obesity and Lifestyle Study. The participants were enrolled during 1999–2000 and followed through 2006.

A total of 8,800 participants (3,846 men and 4,954 women, a mean age of 50 years) met all inclusion criteria for the analysis. Everyone had undergone testing for glucose levels, fasting serum triglycerides, total cholesterol, and HDL cholesterol. Those with a history of cardiovascular disease or stroke were excluded.

At enrollment, participants reported television-viewing habits for the previous 7 days and were grouped into one of three categories: less than 2 hours daily, between 2 and 4 hours, and more than 4 hours daily. Timeframes when the television was on, but participants were otherwise engaged, did not count.

During the median follow-up of 6.6 years, 284 deaths occurred; 87 were due to cardiovascular disease.

The study was limited by the fact that it assessed a single behavior. However, time spent watching television “has been shown to be a reasonable proxy measure of an overall sedentary behavior pattern,” the authors stated.

The study was funded by the National Health and Medical Research Council and received in-kind support from the Australian Institute of Health and Welfare. The authors reported having no conflicts of interest.

Each hour spent watching TV was linked to an 18% higher risk of cardiovascular disease–related death.

Source ©AlShadsky/Fotolia.com

Increased time spent watching television is associated with higher mortality in general and increased cardiovascular disease–related death in particular, according to findings from an Australian population-based cohort study.

Each hour spent in front of the television daily was associated with an 18% increased risk of cardiovascular disease–related death and an 11% increase of death from all causes, wrote David Dunstan, Ph.D., of the Baker IDI Heart and Diabetes Institute in Melbourne, Australia, and colleagues.

Participants who watched television 4 or more hours daily had an 80% increased risk for cardiovascular disease–related death and a 46% higher risk of death from all causes when compared with those who watched less than 2 hours a day (DOI:10.1161/CirculationAHA.109.894824

The risks “were independent of traditional risk factors such as smoking, blood pressure, cholesterol, and diet, as well as leisure-time exercise and waist circumference,” Dr. Dunstan and his colleagues noted.

Investigators examined the relationship between television viewing time and mortality in a national population-based cohort from the Australian Diabetes, Obesity and Lifestyle Study. The participants were enrolled during 1999–2000 and followed through 2006.

A total of 8,800 participants (3,846 men and 4,954 women, a mean age of 50 years) met all inclusion criteria for the analysis. Everyone had undergone testing for glucose levels, fasting serum triglycerides, total cholesterol, and HDL cholesterol. Those with a history of cardiovascular disease or stroke were excluded.

At enrollment, participants reported television-viewing habits for the previous 7 days and were grouped into one of three categories: less than 2 hours daily, between 2 and 4 hours, and more than 4 hours daily. Timeframes when the television was on, but participants were otherwise engaged, did not count.

During the median follow-up of 6.6 years, 284 deaths occurred; 87 were due to cardiovascular disease.

The study was limited by the fact that it assessed a single behavior. However, time spent watching television “has been shown to be a reasonable proxy measure of an overall sedentary behavior pattern,” the authors stated.

The study was funded by the National Health and Medical Research Council and received in-kind support from the Australian Institute of Health and Welfare. The authors reported having no conflicts of interest.

Each hour spent watching TV was linked to an 18% higher risk of cardiovascular disease–related death.

Source ©AlShadsky/Fotolia.com

A training program modeled on airline industry initiatives can change behavior and cultivate a culture of safety in the operating room, based on data from a survey and follow-up study.

Such training increased acceptance of perioperative checklists, led to more self-reporting of “unsafe conditions and near misses,” and enhanced empowerment in two medical facilities.

“The introduction of CRM [crew resource management] training, combined with other initiatives, enhances personal commitment to patient safety and appears to alter behaviors relative to checklist use and self-reporting,” reported Dr. Harry C. Sax of the department of surgery at Brown University and the Miriam Hospital, both in Providence, R.I., and his colleagues (Arch. Surg. 2009;144:1133–7).

They reported the results of a CRM program begun at the University of Rochester (N.Y.) Strong Medical Center in 2003, and at Brown University's Miriam Hospital in 2005. Of the 858 participants, half were nurses, 28% ancillary personnel, and 22% physicians.

A 10-item perioperative checklist “modeled on preflight aviation checklists,” was posted in each operating room. It listed all participants and required signoffs from two team members regarding items such as surgical site and side verifications, use of perioperative antibiotics, deep vein thrombosis prophylaxis, and beta-blockade, Dr. Sax and his colleagues wrote. A survey that measured attitudes toward safety was given immediately before and after training, and again at least 2 months later.

The study found that “consistent checklist use rose from 75% in 2002 to 100% in 2007 and beyond,” and “self-reporting of incidents rose from 709 per quarter in 2002 to 1,481 per quarter in 2008.”

Disclosures: Dr. Sax serves as a medical consultant to Indelta Learning Systems Inc., which codeveloped the CRM training; one coauthor is an Indelta employee.

A training program modeled on airline industry initiatives can change behavior and cultivate a culture of safety in the operating room, based on data from a survey and follow-up study.

Such training increased acceptance of perioperative checklists, led to more self-reporting of “unsafe conditions and near misses,” and enhanced empowerment in two medical facilities.

“The introduction of CRM [crew resource management] training, combined with other initiatives, enhances personal commitment to patient safety and appears to alter behaviors relative to checklist use and self-reporting,” reported Dr. Harry C. Sax of the department of surgery at Brown University and the Miriam Hospital, both in Providence, R.I., and his colleagues (Arch. Surg. 2009;144:1133–7).

They reported the results of a CRM program begun at the University of Rochester (N.Y.) Strong Medical Center in 2003, and at Brown University's Miriam Hospital in 2005. Of the 858 participants, half were nurses, 28% ancillary personnel, and 22% physicians.

A 10-item perioperative checklist “modeled on preflight aviation checklists,” was posted in each operating room. It listed all participants and required signoffs from two team members regarding items such as surgical site and side verifications, use of perioperative antibiotics, deep vein thrombosis prophylaxis, and beta-blockade, Dr. Sax and his colleagues wrote. A survey that measured attitudes toward safety was given immediately before and after training, and again at least 2 months later.

The study found that “consistent checklist use rose from 75% in 2002 to 100% in 2007 and beyond,” and “self-reporting of incidents rose from 709 per quarter in 2002 to 1,481 per quarter in 2008.”

Disclosures: Dr. Sax serves as a medical consultant to Indelta Learning Systems Inc., which codeveloped the CRM training; one coauthor is an Indelta employee.

A training program modeled on airline industry initiatives can change behavior and cultivate a culture of safety in the operating room, based on data from a survey and follow-up study.

Such training increased acceptance of perioperative checklists, led to more self-reporting of “unsafe conditions and near misses,” and enhanced empowerment in two medical facilities.

“The introduction of CRM [crew resource management] training, combined with other initiatives, enhances personal commitment to patient safety and appears to alter behaviors relative to checklist use and self-reporting,” reported Dr. Harry C. Sax of the department of surgery at Brown University and the Miriam Hospital, both in Providence, R.I., and his colleagues (Arch. Surg. 2009;144:1133–7).

They reported the results of a CRM program begun at the University of Rochester (N.Y.) Strong Medical Center in 2003, and at Brown University's Miriam Hospital in 2005. Of the 858 participants, half were nurses, 28% ancillary personnel, and 22% physicians.

A 10-item perioperative checklist “modeled on preflight aviation checklists,” was posted in each operating room. It listed all participants and required signoffs from two team members regarding items such as surgical site and side verifications, use of perioperative antibiotics, deep vein thrombosis prophylaxis, and beta-blockade, Dr. Sax and his colleagues wrote. A survey that measured attitudes toward safety was given immediately before and after training, and again at least 2 months later.

The study found that “consistent checklist use rose from 75% in 2002 to 100% in 2007 and beyond,” and “self-reporting of incidents rose from 709 per quarter in 2002 to 1,481 per quarter in 2008.”

Disclosures: Dr. Sax serves as a medical consultant to Indelta Learning Systems Inc., which codeveloped the CRM training; one coauthor is an Indelta employee.