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Issue 75
July 2008

Welcome to the 75th edition of Flash, our bi-weekly alert for science, health and medical journalists. Flash is a courtesy service with access to ScienceDirect, Elsevier’s online platform, providing full text access to some 2,000 scientific, technical and medical journals.

If you report a story, we would ask that you credit Elsevier’s journal as the source.

Please use your Flash login and password to access each article’s full text on ScienceDirect. For a new password, forgotten passwords or if you have any feedback, please contact Anna Hogrebe at newsroom@elsevier.com or at +31 20 485 3269.

ARTICLES

1. TARGETING MEN’S WEIGHT IN THE WORKPLACE

It’s estimated that almost 115 million people globally are overweight or obese, and the rate of increase suggests there is no end in sight to the world’s growing waistline. For men in particular, excess weight can lead to fat-related cancers, hypertension, diabetes and a range of other health risks. So what’s the solution? How can we get men to fight the bulge?

In Elsevier’s Journal of Men’s Health, a new study follows a group of men as they participate in a weight loss programme run by a ‘Health of Men’ team within the workplace. A researcher followed ten participants as they took part in the six-week programme.

Four main themes emerged from the analysis. The first related to a desire to improve, and the second related to fear and embarrassment that held some men back. As the course proceeded however, there was a growing feeling of momentum and motivation and a final theme that revolved around the positive association of the programme being run in the workplace.

The authors conclude that the positive results from this workplace weight loss programme build a case for further investigated. All of the interviewees felt that having sessions in the workplace, in work time, was a crucial factor in their decision to attend. Many agreed that if the programme was not available at work, they would have been unlikely to seek help elsewhere.

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2. CONSUMER BEHAVIOUR SHOWS THE PERFECT PRICE IS A NINE

Finding that perfect price is essential when it comes to dealing with consumers. Price too high and no one will give your product a second look. Price too low and your bottom line will take a hit.

To test the effect of prices ending in nine (i.e. €7.99) when it comes to customer behaviour, Elsevier’s International Journal of Hospitality Management features a new study where 1,271 customers were exposed to different pricing at a pizzeria over a six-week period.

During the six-week period, the effect of the price-ending was tested on one pizza. During two weeks, all of the pizzas were proposed with a round 00-ending (i.e. €8.00), whereas for the other two weeks a target-pizza was proposed with a nine-ending price (i.e. €7.99) and the four other pizzas were proposed with a round 00-ending price. In the final two weeks, all pizzas were proposed with a nine-ending price.

In the experiment, it was found that patrons in the restaurant show a greater likelihood of choosing a menu-item that is priced with a nine-ending than with a zero-ending, especially when nine-ending prices are offered alongside items offered with zero-ending prices. The authors also suggest that the preference for the nine-ending price is not only explained by the “.99,” but by the change in the left most digit changing from 8 to 7.

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3. NEW ASSESSMENT TOOL SHINES LIGHT ON MENOPAUSAL SYMPTOMS AND HOW TO COPE

With nearly three-quarters of women seeking advice during their menopause, the health community and women alike are demanding more when it comes to solutions and therapies to cope with the distress.

Growing evidence suggests that hot flushes are triggered by minute elevations in core body temperature, which can be triggered either by changes in ambient temperature or by environmental triggers. The general threshold for hot flushes being triggered is lowered by stress. Recognising this link to stress, researchers believe that a cognitive behavioural model could be beneficial in learning more about the role of psychosocial factors in the experience of hot flushes and night sweats. However, a comprehensive assessment tool has yet to surface … until now. In Elsevier’s latest issue of Maturitas, researchers report on their findings of examining existing cognitive appraisals surrounding menopausal hot flushes and night sweats. A new tool is created and its reliability and validity tested on a group of women.

The result was an all-new Hot Flush Beliefs Scale (HFBS), a questionnaire created to assess women’s appraisals of beliefs about experience of flushes in a social context, and beliefs about coping with hot flushes and night sweats and sleep.

Overall, a total of 103 women completed the HFBS. Ninety-seven percent reported having hot flushes and 88 percent night sweats, but the frequencies and severity varied. The spread of scores were consistent with what is known from existing literature, but the HFBS confirmed that the experience of hot flushes and night sweats activates cognitive, behavioural and affective systems. In other words, certain beliefs and appraisals are associated with more problematic menopausal symptoms.

This new scale can be used to evaluate psychosocial interventions that may improve a woman’s response to hot flushes and night sweats. More research is needed to test the HFBS and further refine it.

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4. ADULTS LIVING WITH COGENITAL HEART DEFECTS ON THE RISE, BUT PATIENT CARE MUST IMPROVE

The good news is that medical advancements and technology have resulted in improved survival rates among children born with heart disease. The challenge though is to improve patient care as these individuals transition into adulthood.

It’s estimated that nearly one million adults in the US are living with a form of congenital heart disease, but as a new paper in Elsevier’s Journal of Pediatric Health Care outlines, the patient care for this group of individuals has evolved, and unique mental and health issues continue to surface.

The paper examines adult patients with single ventrical physiology who underwent the Fontan operation and Fontan conversion surgery. It provides insights into how a congenital heart patient might benefit from these procedures, and the resulting treatments they will then require. Surprisingly, many of these adult patients remain in the pediatric health care system, with only some successfully transitioning to adult centres because of the lack of trained specialists for adults with congenital heart disease.

Research also revealed that these adult patients can experience a gradual decline in quality of life, often having to take extreme precautions when it comes to exercise, and in some cases being limited to the types of jobs they can perform.

The article states that pediatric nurse practitioners with specialities such as critical care, cardiovascular care or electrophysiology, will continue to care for congenital heart patients that have undergone Fontan surgery into adulthood. However, an integrated and multidisciplinary approach is recommended with patients’ mental health given a priority. An adult with congenital heart disease will also be at greater risk if they face diseases such as type II diabetes, coronary heart disease and obesity, so overall health must be closely monitored.

Overall, the paper finds that patients who undergo Fontan conversion to an extracardiac connection with arrhythmia surgery see a great improvement in quality of life. With improved patient care and an integrated approach, these individuals will likely continue to beat the odds.

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5. THE LINK BETWEEN DIABETES AND ALZHEIMER’S DISEASE

With people living longer in many parts of the world, the prevalence of degenerative diseases is on the rise – most notably Alzheimer’s and diabetes. The statistics are staggering, with Alzheimer’s affecting one in 10 Americans over 65 years of age, and nearly 50 percent of those over 85. Similarly, seven percent or approximately 20 million Americans have diabetes, with the vast majority of these cases including individuals over 60.

Sadly, recent studies have shown that diabetic patients with insulin resistant type 2 diabetes have a 30 percent to 65 percent increased risk of developing Alzheimer’s. In an effort to more closely examine this link, a new paper in Elsevier’s Neurobiology of Aging looks at the possible interaction between diabetes and Alzheimer’s by asking if concurrent hyperglycemia and beta amyloid (Aβ) accumulation exposure levels can accelerate and exaggerate the appearance of Alzheimer’s disease-associated disorders.

Using cultured brain microvascular endothelial cells and presymptomatic Alzheimer’s disease transgenic mice, the scientists were able to show that when the cells were exposed to both high glucose and low levels of Aβ, there was a synergistic interaction to cause an increased accumulation of advanced glycation products and reactive oxygen species. In other words, hyperglycemia potentiates Aβ-mediated vascular damage and in turn supports the suggestion that hyperglycemia is a primary pathogenic mechanism when it comes to accelerating central nervous system damage.

These findings at least partially explain the increased frequency of Alzheimer’s in elderly diabetic patients.

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DISCLAIMER:
The summaries of published papers in this email are intended to be read as accessible signposts towards the original abstracts and articles, which of course have been peer-reviewed. However, the summaries in this email have not been peer reviewed, nor have they been approved by the authors of the articles or their editors.

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1. doi:10.1016/j.jomh.2008.03.005
2. doi:10.1016/j.ijhm.2008.03.009
3. doi:10.1016/j.maturitas.2008.05.001
4. doi:10.1016/j.pedhc.2007.08.016
5. doi:10.1016/j.neurobiolaging.2008.02.010