A new UCSF analysis of tobacco industry documents shows that Philip Morris USA manipulated data on the effects of additives in cigarettes, including menthol, obscuring actual toxicity levels and increasing the risk of heart, cancer and other diseases for smokers. Tobacco industry information can't be taken at face value, the researchers conclude. They say their work provides evidence that hundreds of additives, including menthol, should be eliminated from cigarettes on public health grounds. The article is published in PLoS Medicine.

In the new, independent study, the scientists reassessed data from Philip Morris' "Project MIX," which detailed chemical analyses of smoke and animal toxicology studies of 333 cigarette additives. Philip Morris, the nation's largest tobacco company, published its findings in 2002. By investigating the origins and design of Project MIX, the UCSF researchers conducted their own inquiry into the Philip Morris results. They stressed that many of the toxins in cigarette smoke substantially increased after additives were added to cigarettes. They also found, after obtaining evidence that additives increased toxicity, that tobacco scientists adjusted the protocol for presenting their results in a way that obscured these increases. "We discovered these post-hoc changes in analytical protocols after the industry scientists found that the additives increased cigarette toxicity by increasing the number of fine particles in the cigarette smoke that cause heart and other diseases," said senior author Stanton A. Glantz, PhD, UCSF professor of medicine and director of the Center for Tobacco Control Research and Education at UCSF. "When we conducted our own analysis by studying additives per cigarette – following Philip Morris' original protocol -- we found that 15 carcinogenic chemicals increased by 20 percent or more," he said.

Additionally, in the independent study, the researchers discovered the reason behind Philip Morris' failure to identify many toxic effects in animal studies: its studies were too small. "The experiment was too small in terms of the number of rats analyzed to statistically detect important changes in biological effects," Glantz said. "Philip Morris underpowered its own studies."

The results of "Project MIX" were first published as four papers in a 2002 edition of Food and Chemical Toxicology, a journal whose editor and many members of its editorial board had financial ties to the tobacco industry. While Philip Morris was trying to get the papers published, the company scientist who led Project Mix sent an email (.pdf) to a colleague describing the peer review process as "an inside job."

In the new study, the researchers used documents made public as a result of litigation against the tobacco industry. The documents are available to the public through UCSF's Legacy Tobacco Documents Library.

New analysis casts doubt on results of tobacco industry studies into safety of cigarette additives

Published tobacco industry scientific research on the safety of cigarette additives cannot be taken at face value, according to an analysis led by Stanton Glantz from the Center for Tobacco Control Research and Education at the University of California in San Francisco, and published in this week's PLoS Medicine. In the PLoS Medicine study, the authors reanalyzed data from "Project MIX" in which chemical analyses of smoke, and the potential toxicity of 333 cigarette additives were conducted by scientists from the tobacco company Philip Morris. The results of these analyses were published in Food and Chemical Toxicology in 2002.

The authors of the independent analysis used documents made public as a result of litigation against the tobacco industry to investigate the origins and design of Project MIX, and to conduct their own analyses of the results. Internal documents revealed post-hoc changes in analytical protocols after the industry scientists found that the additives increased cigarette toxicity by increasing the number of particles in the cigarette smoke. Crucially, the authors also found that in the original Project MIX analysis, the published papers obscured findings of toxicity by adjusting the data by Total Particulate Matter concentration: when the authors conducted their own analysis by studying additives per cigarette, they found that 15 carcinogenic chemicals increased by 20% or more. The authors also found that the failure to identify many toxic biological effects was because the studies Philip Morris carried out were too small to reliably detect toxic effects.

The authors conclude that their independent analysis provides evidence for the elimination of the use of the studied additives (including menthol) from cigarettes on public health grounds. The authors say: "The results demonstrate that toxins in cigarette smoke increase substantially when additives are put in cigarettes, including the level of [Total Particulate Matter]. In particular, regulatory authorities, including the [Food and Drug Administration] and similar agencies elsewhere, could use the Project MIX data to eliminate the use of these 333 additives (including menthol) from cigarettes."

Americans are no strangers to antidepressants. During the last 20 years the use of antidepressants has grown significantly making them one of the most costly and the third most commonly prescribed class of medications in the U. S. According to the Centers for Disease Control and Prevention, from 2005-2008 nearly 8.9 percent of the U.S. population had at least one prescription in this drug class during any given month. A new study led by researchers at the Johns Hopkins Bloomberg School of Public Health examines national trends in antidepressant prescribing and finds much of this growth was driven by a substantial increase in antidepressant prescriptions by non-psychiatrist providers without any accompanying psychiatric diagnosis. The results are featured in the August 2011 issue of Health Affairs.

"We've seen a marked increase in antidepressant use among individuals with no psychiatric diagnosis. Nearly four out of every five antidepressant prescriptions are written by non-psychiatrist providers," said Ramin Mojtabai, MD, PhD, MPH, lead author of the study and an associate professor with the Bloomberg School's Department of Mental Health. "Between 1996 and 2007, the number of visits where individuals were prescribed antidepressants with no psychiatric diagnoses increased from 59.5 percent to 72.7 percent and the share of providers who prescribed antidepressants without a concurrent psychiatric diagnosis increased from 30 percent of all non-psychiatrist physicians in 1996 to 55.4 percent in 2007."

Using data from the 1996-2007 National Ambulatory Medical Care Surveys, researchers reviewed a national sample of office-based physician visits by patients ages 18 years and older during a one-week period. They conducted two sets of logistic regression analyses, comparing antidepressant visits lacking psychiatric diagnoses with antidepressant visits including psychiatric diagnoses and visits lacking both prescriptions for antidepressants and psychiatric diagnoses. In addition, Mojtabai and colleagues assessed physician practice-level trends in antidepressant visits without psychiatric diagnosis and found that in the general medicine practice, antidepressant use was concentrated among people with less severe and poorly defined mental health conditions.

An earlier study led by Mojtabai and published in the Journal of Affective Disorders examined the impact of expansion of antidepressant use on the prevalence and characteristics of depression and suicidal ideations. That study found that antidepressant use significantly reduced the prevalence of more severe depression and suicidal ideations among individuals with sever depressive episodes. The findings lead researchers to recommend that antidepressants be prescribed primarily to individuals with severe depression or a confirmed psychiatric diagnosis.

"With non-specialists playing a growing role in the pharmacological treatment of common mental disorders, practice patterns of these providers are becoming increasingly relevant for mental health policy," adds Mojtabai. "To the extent that antidepressants are being prescribed for uses not supported by clinical evidence, there may be a need to improve providers' prescribing practices, revamp drug formularies or undertake broad reforms of the health care system that will increase communication between primary care providers and mental health specialists."

Newly published research in the journal Science confirms that institutionalized orphans placed into foster care have much better intellectual development than those who remain behind. The authors say the results have implications for countries "grappling with how best to care for abandoned, orphaned and maltreated young children."

A team of researchers including Nathan Fox, a professor of human development (College of Education) at the University of Maryland, has been studying a randomly chosen group of 136 abandoned children from six institutions in Bucharest, Romania for a number of years. The Bucharest Early Intervention Project (BEIP) tracked the children out to 54 months of age. Also involved in the study are Charles Nelson of Harvard University; Dr. Charles Zeanah and Anna Smyke of Tulane University, and Peter Marshall of Temple University. The research was supported by the MacArthur Foundation Research Network on "Early Experience and Brain Development."

The Importance of Early Intervention
Earlier evidence from the intervention project showed that young children who remain institutionalized suffered intellectual, emotional, psychiatric and brain development problems. Prof. Fox says, "They are deprived of typical social and emotional stimulation and interaction, as well as typical cognitive and language stimulation." Knowing this, the primary question researchers had was, is there a "best time" when intervention can help prevent these children from becoming psychologically deprived - when damage can be prevented. The Bucharest Early Intervention Project was designed to look at this issue of timing as it related to early deprivation.

The study accomplished this by randomly assigning children into two groups of children that were abandoned at or shortly after birth. "Children at the time of entry into the study ranged in age from 6-29 months of age," says Fox. Half the children remained in the institution, the other half were placed into foster care. All children were the subject of follow-up assessments that included not only cognitive development, but also standardized intelligence tests. Timing related to the intervention was looked at closely. A third group of children - who were being reared by their biological families in Bucharest - served as a base group.

The study was conducted with the full approval of the Government of Romania and was conducted as a way to help guide that nation's child welfare policy. Before this study, there was a bias in the child welfare community towards institutionalized care. In fact, the BEIP had to create its own foster care program as part of the study because the government of Romania's foster care program was limited to "about one family." As part of the study's ethical guidelines, no child placed into foster care was returned to an institution.

Methodology and Results
Fox and the other American researchers wanted to see if they could show there was improvement through specific tests of these institutionalized children.

After random assignment, the average age of children placed into foster care was 21 months of age. Testing was conducted prior to placement, at 30 months and 42 months using the Bayley Scales of Infant Development (BSID II), and at 54 months with the Weschsler Preschool Primary Scale of Intelligence (WPPSI-R) test. The BSID II test looks at a wide range of abilities, while the WPPSI-R test is more focused assessment of a child's cognitive abilities. Romanian psychologists administered these tests.

The main findings from the study confirmed earlier results that "children reared in institutions showed greatly diminished intellectual performance relative to children reared in their families of origin." Further, children who were randomly assigned to foster care experienced "significant gains in cognitive function." Finally, on the importance of timing when pursuing intervention, Prof. Fox says, "the results show that the age point where things mattered was 24 months of age." The report adds that "there was a continuing 'cost' to children who remained in the institution over the course of the study. The findings say it would take a larger study to really determine if there is a true "sensitive period" for intervention.

Media presentations of terrorism contribute to posttraumatic stress disorder

20 December 2007 – A new report published in Clinical Psychology: Science and Practice reveals that children exposed to terrorist attacks show elevated symptoms of mental health problems, including posttraumatic stress disorder, separation anxiety disorder, and general anxiety disorder.

Statistically speaking, it is unlikely that the majority of youth will ever experience direct exposure to a terrorist attack. Following a terrorist attack, however, youth are exposed to a substantial amount of attack-related media coverage. Within this present climate of heightened awareness about terrorism, many children are exposed to what the authors termed “second-hand terrorism,” in which media disproportionately focus on the possibility of being a direct victim of future terrorism. This sets the stage for insecurity, countless false alarms, and persistent anxiety. Technological advances provide a stage from which terrorist acts can reach a truly vast audience, and news networks further afford unprecedented coverage of terrorism on a global scale. Media-based contact with terrorism can result in substantial amounts of distress in exposed youth.

“Researching youth in the aftermath of terrorist attacks, as well as youth exposed to media presentations about terrorism, is critical to inform service delivery and public policy, and to ensure that the mental health needs of youth are afforded ample resources,” the authors note.

The combination of extended wakefulness [[e.g., lack of sleep]] and low-dose alcohol has significant adverse effects on a person’s ability to drive, and elevates the risk of getting into a vehicular accident, according to a study published in the October 1 issue of the journal SLEEP.

The study, authored by Mark E. Howard, PhD, of the Institute for Breathing and Sleep in Heidelberg, Victoria, Australia, focused on 19 volunteer professional drivers, who participated in a driving simulation and the Psychomotor Vigilance Task. The subjects were measured in a rested state (12-15 hours awake) and after extended wakefulness (18-21 hours awake) during two sessions. Alcohol was administered during one session, with performance measured at blood alcohol concentrations (BAC) of 0.00 percent, 0.03 percent and 0.05 percent in a non-sleep deprived state, and at 0.03 percent after extended wakefulness (at 1 a.m. and at 3 a.m.). During the second session, tests were performed at the same times without alcohol.

According to the results, extended wakefulness, combined with low-dose alcohol (0.03 percent BAC), resulted in more lapses and greater variation in lane position and speed than did a BAC of 0.05 percent in a rested state.

“In addition to alcohol, sleepiness also increases the risk of road crashes. It is estimated that 15 to 30 percent of traffic accidents are directly related to driver sleepiness, as determined by crash circumstances. Although there are conclusive data regarding the separate effects of alcohol and sleepiness on driving, in real-life situations it is common for these two conditions to occur simultaneously (alcohol-related accidents occur more commonly in the early hours of the morning). The combination of legal low-dose alcohol and extended wakefulness results in impairment worse than that at an alcohol level known to increase accident risk. Avoiding alcohol when driving after extended wakefulness may reduce accident risk,” said Dr. Howard.

Those who think they might have a sleep disorder are urged to discuss their problem with their primary care physician, who will issue a referral to a sleep specialist.

The presence of guns in homes is strongly associated with higher suicide rates, a new U.S. study found.

PHILADELPHIA (UPI) — A University of Pennsylvania psychologist says a number of studies have found negative psychological effects associated with adolescent acne.

David Sarwer, an associate professor at the Center for Human Appearance at the University of Pennsylvania School of Medicine in Philadelphia, said up to 50 percent of teenage acne sufferers also experience increased body image dissatisfaction, social anxiety, low self-esteem and symptoms of depression, USA Today reported Monday.

"Some become so upset they may think about or actually attempt suicide," Sarwer said.

Researchers say drugs and treatments developed in recent years offer new hope to sufferers of acne, which is caused when sebaceous glands in the skin create too much sebum oil, which can clog pores and mix with bacteria, causing inflammation.

Mild acne can be treated with over-the-counter medications containing benzoyl peroxide, salicylic acid and sulfur, but unresponsive outbreaks and acne characterized by larger cysts may require the prescription drug isotretinoin. The drug derived from vitamin A is an effective treatment, but scares away some consumers due to its extensive list of side effects, including liver changes and birth defects in pregnant women.

Copyright © 2007 by United Press International

Up to one in three mental health patients are being over-prescribed drugs, says the Healthcare Commission [in Great Britain]. Read the article.

Ditto for the U.S.

New Survey: Insecurity, Xenophobia Extremely High in Iraq

29 September 2006
APSA Press Release

CARDIFF, Wales, Sept. 28 (UPI) -- University of Cardiff researchers studied drinking habits in children aged 11 to 16 in England and found a link between alcohol and violence.

The researchers found not only a link between drink and aggression but also that children who drank were more likely to be hit, even if they weren't violent themselves.

More than 4,000 children were surveyed at 13 schools in four areas of England. The study found that 25 percent of 11-year-olds were drinking monthly and 3.6 percent daily, with 12.8 percent admitting to getting drunk three to five times a year.

By the age of 16, 40 percent were drinking weekly and 6.2 percent were drinking every day. The research also showed 22.6 percent of 16-year-olds getting drunk more than 21 times a year, according to the study published in the Journal of Adolescence.

"This new study seems to be the first to show a direct link between alcohol misuse and vulnerability to injury, independent of any link between drinking and fighting. There now needs to be much more effort put into reducing alcohol misuse in order to reduce injury," the study said.

People who drink alcohol are up to four times more likely than non-drinkers to be hurt from physical injuries such as a fall or punch, new research shows.

The University of Queensland study found any alcohol consumption quadrupled the risk of injury for the first six hours after drinking alcohol and this risk remained at 2.5 times that of a non drinker for the next 24 hours.

Quantity and specific drinks such as beer or spirits did not increase injury risk but mixing drinks increased injury risk five-fold.

Binge drinkers were more at risk of being injured than regular drinkers.

And people who sustained serious injuries were more likely to have consumed beer and have been drinking in a licensed premises. [read more]

EurekAlert
20 July 2006

In the latest issue of Psychology of Women Quarterly (June 2006), researchers find that men rate themselves and the women they just interacted with higher on sexual traits, such as flirtatiousness, than women rate men. The authors find that after a five-minute conversation with a stranger of the opposite gender, men were more likely to interpret ambiguous or friendly behavior as indicating sexual interest. "The findings suggest that men generally think in more sexual terms than women," the authors explain.

Within their brief conversation, partners introduced themselves and talked about college experiences. There was no significant difference in how men, compared to women, rated their conversation partners on agreeableness or extroversion. Nor was their evidence of sexual chemistry, as partners did not share a tendency to find each other attractive or desire a future interaction.

If women found their male partner as more partner physically attractive and saw him as more agreeable, they rated the partner higher on sexual traits. Men's ratings of women were also associated with physical attractiveness but unrelated to whether he saw her as agreeable or felt the conversation was enjoyable.

EurekAlert!
8 June 2006