Health and Medical News and Resources

General interest items edited by Janice Flahiff

Self-control may not be a limited resource after all

 

From the 12 September 2012 article at EurekAlert

So many acts in our daily lives – refusing that second slice of cake, walking past the store with the latest gadgets, working on your tax forms when you’d rather watch TV – seem to boil down to one essential ingredient: self-control. Self-control is what enables us to maintain healthy habits, save for a rainy day, and get important things done.

But what is self-control, really? And how does it work?

In a new article in the September 2012 issue of Perspectives on Psychological Science, a journal of the Association for Psychological Science, researchers Michael Inzlicht of the University of Toronto and Brandon Schmeichel of Texas A&M University argue that the prevailing model of self-control may not be as precise as researchers once thought. Rather than being a limited resource, self-control may actually be more like a motivation- and attention-driven process.

Research on self-control has surged in the last decade and much of it has centered on the resource model of self-control. According to this model, originally proposed by Roy Baumeister and colleagues, self-control is a limited resource – if we exercise a lot of self-control by refusing a second slice of cake, we may not have enough self-control later in the day to resist the urge to shop or watch TV.

Over 100 papers have produced findings that support this model. Research has found, for example, that people who are required to manage their emotions show impaired performance on later tasks, such as solving a difficult puzzle, squeezing a handgrip exerciser, and keeping items in working memory.

But Inzlicht and Schmeichel point out that a newer crop of studies are yielding results that don’t fit with this idea of self-control as a depletable resource. Recent studies have shown that incentives, individual perceptions of task difficulty, personal beliefs about willpower, feedback on task performance, and changes in mood all seem to influence our ability to exercise self-control. These results suggest that self-control may not rely on a limited resource after all.

To accommodate these new findings and get at the mechanisms that underlie self-control, Inzlicht and Schmeichel propose an alternative model that describes self-control as a process involving motivation and attention.

“Engaging in self-control by definition, is hard work; it involves deliberation, attention, and vigilance,” the authors write. If we resist that second slice of cake, we may experience a shift in motivation so that we feel justified in indulging ourselves later on. It’s not necessarily the case that we can’t control ourselves because we’re “out” of self-control but rather that we choose not to control ourselves any longer.

At the same time, our attention shifts so that we’re less likely to notice cues that signal the need for self-control (cake = empty calories) and we pay more attention to cues that signal some kind of reward (cake = delicious treat).

In laying out the basic components of this process model, Inzlicht and Schmeichel want to motivate researchers to ask critical questions about how self-control really works. “The idea that self-control is a resource is one possibility, but there are alternative possibilities that can accommodate more of the accumulated data,” Inzlicht says.

Identifying the mechanisms that underlie self-control can help us to understand behaviors related to a wide range of important problems, including obesity, impulsive spending, gambling, and drug abuse. Inzlicht and Schmeichel hope that researchers will ultimately be able to use this knowledge to design effective m..

 

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September 13, 2012 Posted by | Psychiatry, Psychology | , | Leave a comment

Sex Can Cause Genetic Changes In Women

 

From the 12 September 2012 article at Medical News Today

Sensational female responses can be triggered by the activation of a diverse set of genes from sex, including immunity, libido, altered fertility, and eating and sleep patterns.

A team of researchers from the University of East Anglia set out to determine the response female fruit flies (Drosophila melanogaster) have to mating.

The findings, published in Proceedings of the Royal Society B, indicated that semen consists of a single protein which generates a variety of responses in numerous genes in females, which appears evident at different instances and in different areas of their bodies after mating…

..

The discovery in the flies, the authors suggest, may be similar to responses in many animals, where semen is inserted into the female’s body while having sex.

According to research earlier this year in PLoS Biology, neurodegenerative disorders that occur in both fruit flies and humans are caused by mutations in the same gene, showing that it is plausible that humans may experience the same effect during sex that fruit flies do with the activation of genes.

Scientists have been aware that males pass on seminal fluid proteins to their partner while mating, impacting their feeding, sleep patterns, immunity, egg laying, sexual receptivity, and water balance.

Professor Tracey Chapman, from UEA’s school of Biological Sciences and head author, said:

“We tested here the effects of one enigmatic seminal fluid protein, known as the ‘sex peptide’, and found it to change the expression of a remarkable array of many genes in females- both across time and in different parts of the body.”

Researchers identified significant changes to genes linked to:

  • early embryogenesis
  • egg development
  • nutrient sensing
  • behavior
  • phototransduction– the pathways by which they see

This demonstrated that females’ behavior and reproductive system is affected by a direct and global influence of males. In other words, the semen protein is a ‘master regulator’.

These effects could possibly be found across many species, the team pointed out.

Chapman added:

“An additional and intriguing twist is that the effects of semen proteins can favor the interests of males whilst generating costs in females, resulting in sexual conflict.

For example, there can be a tug-of-war, where males employ semen proteins to ensure that females make a large investment in the current brood- even if that doesn’t suit the longer term interests of females.”

 

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September 13, 2012 Posted by | Medical and Health Research News | , , | Leave a comment

Bacteria That Cause Disease In Humans Have ‘Reversible Switching Mechanism’ Allowing Them To Adapt To Environments Lacking Oxygen

 

From the 13 September article at Medical News Today

Bacteria that cause disease in humans have a ‘reversible switching mechanism’ that allows them to adapt to environments lacking oxygen, scientists at the University of East Anglia (UEA) have found.

Published in the journal Proceedings of the National Academy of Sciences USA, the findings provide a new insight into how bacteria sense and adapt to oxygenated atmospheres, and uncover a new ‘antioxidant’ pathway by which certain types of damaged proteins can be repaired. …

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September 13, 2012 Posted by | Medical and Health Research News | , | Leave a comment

Mathematical Model May Lead to Safer Chemotherapy

 

From the 12 September article at ScienceDaily

Cancer chemotherapy can be a life-saver, but it is fraught with severe side effects, among them an increased risk of infection. Until now, the major criterion for assessing this risk has been the blood cell count: if the number of white blood cells falls below a critical threshold, the risk of infection is thought to be high.

A new model built by Weizmann Institute mathematicians in collaboration with physicians from the Meir Medical Center in Kfar Saba and from the Hoffmann-La Roche research center in Basel, Switzerland, suggests that for proper risk assessment, it is essential to evaluate not only the quantity of these blood cells, but also their quality, which varies from one person to another….

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September 13, 2012 Posted by | health care | , , | Leave a comment

When Patients Don’t Take Their Medicine What Role Do Doctors Play in Promoting Prescription Adherence?

 

About 10 years an area health care provider told me she did a study on prescription adherence.
The results included a shocking low percentage of folks taking their prescriptions as prescribed.
She said that no journal would publish the results, because the rates of adherence were so low. (This seemed odd to me, this reasoning).

I’ve been prescribed a cholesterol lowering drug, for being a bit over the HDL threshold. I decided to stop taking it, because after all I have read, I don’t really believe in either the tests, the thresholds, and the efficacy of the drug. No, I haven’t discussed this with my prescribing physician, but I think I’m going to catch hell on the next annual exam. For the past 5 years (age 58) I’ve only seen the doctor about once a year, just for the annual wellness.

 

From the Rand report summary

Analyses indicated that although physicians uniformly felt responsible for assessing and promoting adherence to prescriptions, only a minority of them asked detailed questions about adherence.

 

“Medicine left in the bottle can’t help.”

— Yoruba proverb

Lack of adherence to prescriptions (that is, patients failing to take medicine either as instructed or at all) afflicts medical care in the United States. Nonadherence affects up to 40 percent of older adults, especially those with chronic conditions, and is associated with poor outcomes, more hospitalizations, and higher mortality. The health care cost of nonadherence is estimated at $290 billion per year. Prior RAND research has shown that some nonadherence is cost-related and can be addressed through insurance benefit designs that keep copayments low.[1]

Physicians also play a key role in addressing nonadherence. Yet physician perspectives on their responsibility for nonadherence and strategies for promoting adherence are not well understood. A team from RAND; the University of California, Los Angeles; and the University of California, Davis, examined physicians’ views about their responsibility for medication adherence and explored how physicians and patients discuss nonadherence. The team conducted focus groups with physicians in New Jersey and Washington, D.C., and audiotaped primary care visits in Northern California doctors’ offices.

The results point to a contrast between what physicians believe and what they do:

  • Although physicians uniformly felt responsible for assessing and promoting medication adherence, only a minority of them asked detailed questions about adherence.
  • Although providers often checked which medications a patient was taking, they rarely explicitly assessed adherence to these medications.
  • Many physicians expressed discomfort about intruding on patients’ privacy to detect nonadherence. In the office, they rarely asked about missed medication doses.
  • Most cases of nonadherence detected during office visits were revealed through unprompted patient comments.

Physicians’ reluctance to intrude has important implications for the vast array of new information that is becoming available from pharmacy benefit plans, managed care plans, and other data repositories. In addition, the reluctance to inquire that the physicians described contrasts sharply with the physician role in the increasingly prominent concept of the medical home, where primary care doctors are envisioned as playing a central and active role in managing and coordinating care.

The authors conclude that addressing nonadherence will require a different approach than the one they observed in the study. Given the importance of patients’ shared responsibility, a new paradigm that clarifies joint provider-patient responsibility may be needed to better guide communication about medication adherence. In this context, developing new protocols to guide discussions of adherence is worth exploring.

 

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September 13, 2012 Posted by | health care | , , , , | Leave a comment

   

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