School-Wide Prevention Program Lowers Teen Suicide Risk

(This version of the Jan. 23rd story corrects name of the University of South Florida in paragraph 16)

By Madeline Kennedy

(Reuters Health) – After a school-based prevention program, European teenagers were about half as likely to attempt suicide or to feel suicidal, a new study shows.

Danuta Wasserman, a professor of psychiatry at the Karolinska Institute in Sweden, said the program was likely successful because students “felt that the power of mastering their feelings, coping with stress and choosing solutions was in their hands and not decided or forced by adults.”

Suicide is the third leading cause of death between the ages of 10 and 24, according to the U.S. Centers for Disease Control and Prevention (CDC). Suicide attempts are even more common, with some research suggesting that 4 to 8 percent of high school students try to kill themselves each year, the CDC says.

Those most at risk have a history of suicide attempts, mental illness or substance abuse, or a family history of mental illness and access to lethal methods.

In 10 European countries, Wasserman's team randomly assigned 168 high schools - with more than 11,000 students overall - to provide one of three suicide prevention programs, or no program at all.

The three programs took different approaches. One program, called Question, Persuade, and Refer, focused on training teachers and administrators to recognize kids at risk. A second, the Youth Aware of Mental Health Program, targeted all students with lectures, role-playing exercises and education about mental health and suicide risk. A third program used mental health professionals to screen at-risk pupils who were referred to them.

The researchers compared the number of suicide attempts by students as well as reports of suicidal thoughts after three months of having the programs in place, and again after a year.

At three months, none of the programs showed a significant effect. After a year, however, schools with the Youth Aware of Mental Health program had half as many suicide attempts and reports of suicidal ideation as the comparison schools with no intervention. The other two programs showed much smaller differences from the no-intervention schools.

In schools with the Youth Aware of Mental Health program, 14 students attempted suicide over the course of the year, and 15 students reported having suicidal thoughts. In the no-intervention schools, there were 34 suicide attempts and 31 reports of suicidal thoughts.

In schools with the faculty-focused program, there were 22 suicide attempts and 29 reports of suicidal thinking among students. In the program that used screening by professionals, there were 20 suicide attempts and 22 reports of suicidal thoughts.

Dr. David Brent, a child and adolescent psychiatrist at Western Psychiatric Institute and Clinic in Pittsburgh wrote an editorial on the new study in The Lancet. He told Reuters Health that education about suicide, and early detection and treatment, are two important aspects of effective prevention programs, and the Youth Aware of Mental Health program meets both standards.

Wasserman said the universal prevention model used in that program is effective because it offers treatment before students show outward signs of risk, and it does not stigmatize anyone.

Prediction is very difficult because so many suicide attempts are impulsive, Brent said in an email.

He said one weakness of the study is its exclusion of students who had recently attempted suicide, so it is unclear how well the programs would have worked for students at the highest risk.

Despite these reservations, Brent said he has faith in such programs and that “suicidal behavior is preventable in adolescents through a school-based intervention protocol.”

U.S. schools offer several programs that focus on suicide prevention, he said, and the University of South Florida publishes a booklet full of resources on effective school-based suicide prevention called The Guide (http://bit.ly/186FMwO).

Wasserman urges parents to advocate for programs like Youth Aware of Mental Health and to convince school authorities that “the health of young people is important.”

source School-Wide Prevention Program Lowers Teen Suicide Risk

Eating in These 5 Places May Be Making You Fat

It's not always possible to eat your meals and snacks at the dinner table, but when you eat on the run or while doing something else, you're more likely to consume extra calories. To prevent weight gain, avoid munching in these five places.

Standing in the Kitchen

When you meander into the kitchen for a quick bite, you're surrounded by food, so no wonder you end up eating way more than you anticipated. The worst is eating while standing in front of an open fridge or cupboard, or chomping straight out of the package since it's difficult to keep track of just how many chips you've eaten. If you're hungry for a snack or meal, prepare an appropriate portion size in a bowl or on a plate, and sit down at the table to enjoy it.

In the Car

Eating on the run is never a good idea. Quick food that is made to "grab and go" tends to be high in calories; and, when you eat while driving, you often inhale food quickly to avoid having a hand off of the steering wheel. You're also so busy watching the road that you don't watch how much food you're actually eating. If you must eat in the car, pack healthy snacks and meals so you know exactly how many calories you're consuming.

In Front of the TV

Television commercials are brutal when it comes to your appetite. All those ads for cheesy pizzas, hamburgers, nachos, wings, and desserts really do inspire late-night snacks. No wonder you head to the kitchen and bring back bags of chips, pints of ice cream, and chocolate bars. There's nothing wrong with a snack in front of the boob tube, just make sure you're not mindlessly munching on endless calories. Measure out a serving and keep the rest in the kitchen.

At Your Desk

This is such a tough habit to break, especially if you have a demanding nine-to-fiver and need to work through your lunch break. This is similar to eating in the car or in front of the TV. You're busy working and aren't paying attention to what you're eating, and before you know it, you've devoured an entire plate of food within minutes. When you eat quickly and don't pay attention to each bite, your brain doesn't register how much you've actually eaten, so you end up feeling hungry instead of satiated, which translates to reaching for more food. If you can, take at least 15 minutes away from your desk to eat your meal or snack, and be sure not to tempt yourself by keeping packages of food and treats in your desk drawer.

In Bed

There's a few reasons people eat in bed, but, whether you're feeling sick, are being pampered, or are just feeling a little lazy, eating in bed isn't always a good thing. It encourages mindless eating and creates a less-than-hygienic sleep area. Avoid eating in bed by having a satisfying dinner at the table, and if need be, eat a small bowl of fresh fruit a couple hours before you hit the hay to ward off late-night hunger pangs.

source Eating in These 5 Places May Be Making You Fat

Delinquent Kids Have Earlier Sex

(Reuters Health) - Kids with behavior problems became sexually active earlier than their peers, in a recent study.

Having sex early - before age 16 - increases the risk of teen pregnancy, partner violence, sexually transmitted infections and other negative health outcomes, the researchers say.

Other studies have found that behaviors like frequent opposition or rule breaking are associated with earlier age of first sexual intercourse or teenage pregnancy, said lead author S. Rachel Skinner of the University of Sydney in Australia, in email to Reuters Health.

The new study is larger and more robust, she said.

“We were able to disentangle this relationship from many other known risk factors, and demonstrate that (behavior problems are) an independent predictor of earlier age of first sexual intercourse,” Skinner said.

Her team used data from a long-term study beginning in 1989 that followed almost 3,000 Australian children and their families from birth through age 17.

By age 17, 44 percent of boys and 50 percent of girls said they’d had intercourse.

Overall, almost 22 percent of boys and 25 percent of girls said they started before age 16, usually around age 15.

Parents answered questions about their child’s “internalizing” behavior, like withdrawal, physical complaints, anxiety and depression, and “externalizing” behavior, like aggression and criminal behavior.

Kids with total behavioral scores high enough to be considered problematic were more likely than other kids to have sex before age 16.

High scores on externalizing behavior were associated with having sex before age 16 for both boys and girls, but internalizing behavior was related to age at first intercourse only for boys, according to results in Pediatrics.

Bad behavior starting at age five for boys and age 10 for girls increased the likelihood of having sex before age 16 when the authors accounted for other factors like parental age, education attainment and socioeconomic status.

Researchers can only speculate about why externalizing behavior and early sexual activity would be connected, Skinner said.

“We do know that young people who display externalizing behavior are more likely to take risks, and to be sensation seekers,” she said. “They are more likely to take physical risks, for example, while riding motorbikes or skateboarding.”

Having sex earlier could be part of a pattern of risk-taking, she said.

“Delinquent behavior stems from a child not understanding or not caring about the consequences that will result,” said Patricia A. Cavazos-Rehg, assistant professor of psychiatry at Washington University School of Medicine in St. Louis, Missouri.

Cavazos-Rehg, who was not involved in the new research, told Reuters Health by email, “It does not matter what the behavior is, if the child does not understand or care about consequences, then he or she will most certainly engage in a deviant behavior if temptation should arise. An individual with self-regulation problems as a child is on a trajectory to have these problems as a teen unless someone or something intervenes.”

For both genders, younger age of the mother, lower level of maternal education, the father of the child not living with the mother and parents who smoke or use drugs increased the risk for early sexual intercourse.

“Most of these factors are not changeable by any intervention that we know works,” Skinner said. “It is probably better for us to use our understanding of the risk factors of early (first sexual intercourse) to identify those who are vulnerable and make sure they receive support to stay at school, to have goals of a career or work after school, and to ensure they receive well designed sexual health and relationships education from a young age.”

source Delinquent Kids Have Earlier Sex

Working From Home Is Good For You And Your Boss

As a Winter Storm Juno ravages the Northeast, many employees are skipping their daily commutes and office 9-to-5, and instead getting comfortable with their living rooms and laptops.

This remote work may be something we should be doing more of, according to two new studies. Working from home can be good for your health andproductivity. Not only did people who worked from home report greater work satisfaction and less "work exhaustion," they also got better sleep. Separately, researchers found that the highest performing workers were the most likely to cultivate and excel in a "WFH" environment.

Researchers from Stanford University recently conducted a study on 255 employees of a large Chinese travel agency, all of whom had been employed with the agency for at least six months. Half of the employees worked from home for a period of nine months, while the other half of the employees acted as a control group, and continued to work out of the office. Both group worked the same shifts at the same time.

While the performance of the group that stayed in the office remained stable, the performance of the work from home group increased by 13 percent, as measured by their sales rate and interactions with customers. They were also more productive per minute. The researchers cited less noise distraction, fewer breaks and fewer sick days as some possible reasons for the boosts in productivity, Harvard Business Review reported.

But they found something else that was interesting. After the test period was over, the employees were given the choice whether to continue working from home or to return to the office. Roughly half the work-from-homers decided to return the office, and three-quarters of the group who remained in the office decided to stay there -- and typically, it was the highest-performing employees who chose to work from home, likely because they were not worried about getting distracted.

"Our advice is that firms — at the very least — ought to be open to employees working from home occasionally, to allow them to focus on individual projects and tasks," the study's authors wrote in Harvard Business Review.

Another way that working from home may improve employee productivity and satisfaction is by improving sleep quality, according to an unrelated new study. Research conducted on nearly 500 workers found that employees with a more flexible work schedule are less sleep-deficient than those with less control over their time.

The study, recently published in the journal Sleep Health, found that employees who were able to decide when and where they work enjoyed an improved quality and quantity of sleep.

"Work can be a calling and inspirational, as well as a paycheck, but work should not be detrimental to health," one of the study's authors, Orfeu M. Buxton, said in a statement. "It is possible to mitigate some of the deleterious effects of work by reducing work-family conflict and improving sleep."

Some previous research has supported these findings. A 2007 meta-analysis of 46 studies found that working remotely improved productivity by both objective measures and supervisor evaluations. Remote work was also found to reduce stress and increase job satisfaction, but on the negative side, was correlated with a lower quality of relationships with co-workers.

A 2014 University of Calgary study also found that when it comes to work-from-home productivity, personality matters. Workers who were honest, conscientious and satisfied with their jobs were productive at home, while (unsurprisingly), workers who had a tendency to procrastinate were less productive at home.

source Working From Home Is Good For You And Your Boss

6 Reasons Why You Should Sleep Naked

Pack away the flannel pajamas: A handful of studies and surveys show sleeping naked could actually be good for you. Six reasons why you should consider it:

1. You may like your partner more: A 2014 survey of Brits by Cotton USA (which promotes cotton products that likely include both pajamas and sheets) found that 57% of those who slept nude reported being happy in their relationship. That was 9 percentage points more than PJ wearers, followed by 43% of nightie wearers. Onesie wearers—they apparently exist—brought up the rear at 38%, per the Daily Mail.
2. It could help prevent diabetes: It's a bit of a stretch, but here's the logic: Adults have small amounts of brown fat (aka "good fat") in their bodies, and a 2014 study looked at how bedroom temperature affected the fat.
   
   The four-month study was small: just five males who slept in rooms heated to 66-, 75-, or 81-degrees. After four weeks spent at the coldest temp, the men had almost twice as much brown fat, and their insulin sensitivity was better, which a researcher says could lower their diabetes risk.
   
   Four weeks at 81 degrees undid all the benefits. Though the New York Times points out the test subjects slept in hospital scrubs, going naked could help prevent overheating.
3. It's better for your lady health:Cosmopolitan cites advice from Dr. Jennifer Landa, who points out that an overly warm environment could spur too much yeast or bacteria to grow in the vaginal area. By passing on PJs, you'll have a better chance of giving air access to the region, preventing infections.
4. It's how our ancestors did it: If you're a Paleo-dieter who eats like a caveman, why not sleep like one, too? Neurologist Rachel Salas with the Johns Hopkins Center for Sleep in 2013 told the Wall Street Journal that "back in the cave days," people slept naked. It was, in part, a means of protection from predators, and that feeling of safety could be imparted by sleeping similarly in modern day.
5. It could be better for the immune system:Mic reports that when skin-on-skin contact occurs, our adrenal glands get a message: lighten up on the production of the stress hormone cortisol. As one doctor explains, "Cortisol suppresses the immune response." Skin-to-skin contact also increases levels of oxytocin, which can have positive effects on blood pressure and healing, says Salas.
6. Body temp affects sleep: A 2004 study found that for sleep to "initiate normally," core body temp matters. Per a researcher, "Studies of sleep onset insomniacs show that they consistently have a warmer core body temperature immediately before initiating sleep, when compared with normal healthy adults."

source 6 Reasons Why You Should Sleep Naked

Can Astrology Predict a Divorce?

The reasons why people divorce can be as complex and varied as what makes people fall in love in the first place. However, the act of calling it quits may have something to do with a person's sun sign—you and your spouse could be astrologically predisposed to certain habits associated with failed relationships. "Every sign has its own problem spots that can lead to partnering trouble, whether physically, emotionally or intellectually," says astrologer John Townley, author ofComposite Charts: The Astrology of Relationships. "But it's not the individual signs that tell the tale; it's the dynamic interplay of both individuals' total planetary picture." (And of course, factors outside of astrology can also place a strain on your marriage). With this in mind, consider these seven common catalysts for divorce and the sun signs most likely to fall trap to them.

Physical Unfaithfulness

Praise-adoring Aries and Leo might be led astray if "someone is stroking their ego—or another body part," says astrologer Elizabeth Ball, romantic compatibility specialist and founder of astrology company It's in the Stars. Meanwhile Gemini and Sagittarius might turn to a lover for the thrill. If sensual Scorpio doesn't get enough sex, it's possible that they will drift from their marriage to get more, Townley adds.

Emotional Cheating

When Libras, Cancers and Pisces venture outside of their relationships, it's probably in the name of love and connection, which they value over sex, says Ball. If Water signs (Cancer, Scorpio, Pisces) in particular don't get enough emotional attention at home, they may be tempted to find it elsewhere, Townley adds. "You've got to keep their tanks full, or someone else will fill them," he says.

Lacking Commitment

Signs thought to be unpredictable as partners—and as people, for that matter—don't always make model spouses. This can be especially true among signs that have trouble finishing what they start. Geminis can be inconsistent and don't seem to care enough, which can trigger insecurity in their partners, according to Townley. Both Gemini and Sagittarius are prone to being marriage shy or, conversely, could end up marrying more than once. Aries, too, are believed to have a hard time sitting still and following through, which can make them fickle and restless in relationships.

Contrasting Confrontation Styles

Fixed signs (Taurus, Leo, Scorpio, Aquarius) are usually the most argumentative, as they all can be incredibly stubborn and unwilling to admit when they are wrong, Ball says. While Fixed signs are often reluctant to budge in a fight, Mutable signs (Gemini, Virgo, Sagittarius, Pisces) go with the wind and will take any side that's convenient or works for them in the moment, Townley adds. ("Both can be terminally annoying," he says.) On the flip side, some signs have a reputation for being averse to arguing. Specifically, Capricorns, Libras and Pisces may be unwilling to assert themselves or let on when something is wrong. Over time, their reluctance to speak up could drive them to divorce if unresolved relationship issues fester, according to Ball.

Impulsivity

Whether marrying too soon or too young, some signs are more likely than others to make rash decisions. Aries and Sagittarius especially gravitate toward Las Vegas-style weddings, say Townley and Ball. However, Libras (as well as Cancers and Taurus) like having a partner, but they may need "a marriage or two to realize that they don't have to marry for that," Townley says. Libras particularly don't want to be alone, which might lead them to rush into marrying their first love, Ball adds.

Unrealistic Expectations

With the possible exception of grounded Taurus, every sign in the zodiac can set the bar too high when it comes to their marriage expectations. (Perhaps this explains the sky-high divorce rate.) In general, Fire signs (Aries, Leo, Sagittarius) and Air signs (Gemini, Libra, Aquarius) can be the most unrealistic about marriage and may not fully understand the level of commitment required to make a relationship work, Ball says. In addition, she adds, Virgos and Capricorns are prone to having ridiculously lofty standards for how their partners should behave. Yet Water signs come with their own issues, too: Cancers tend to expect marriage to be a repeat of their childhood, and therefore project parental images on a partner, Townley says. Dream-dwelling Pisces are also likely to find that their relationship aspirations don't match reality, and Scorpios sometimes expect the initial passion in a romance to last forever.

source Can Astrology Predict a Divorce?

How Insurance Companies Still Discriminate Against the Sick

One of the most important things the Affordable Care Act (the Obamacare law) was supposed to do was put an end to a practice called pre-existing condition exclusion. Before the law passed, health insurers could refuse to cover any medical services for a health condition a person already had when they joined that insurance plan, or they could prevent the person from joining the plan entirely. So, for example, if you had psoriasis, the company might say that you could be on their plan, but you'd have to pay for all your psoriasis medications out-of-pocket.

For many people with big, expensive health problems, like asthma or diabetes, this part of the law greatly brought down the cost of their treatment. However, a new study published in the New England Journal of Medicine suggests that some insurers are still finding ways to keep sick people off their plans, particularly when it comes to people with HIV.

For the study, Doug Jacobs and Benjamin D. Sommers of Harvard analyzed the co-pays for HIV drugs within 48  "Silver" (mid-range cost) health-insurance exchange plans in 12 states. The drugs they examined were nucleoside reverse-transcriptase inhibitors, or NRTIs, which are one of the most commonly prescribed HIV medications.

Annual Cost of HIV Treatments

They found that in a quarter of the plans, insurers had listed the NRTIs in the highest co-pay tier, meaning that the customers would have to pay 30 percent of the cost or more. About half of these so-called "adverse tiering" plans also had a deductible specific to that drug. People enrolled in these plans would have to pay more than $3,000 more per year for their treatments, even if they used generics.

"If plans place all HIV drugs in the highest cost-sharing tier, enrollees with HIV will incur high costs regardless of which drugs they take," the authors write. "This effect suggests that the goal of this approach—which we call 'adverse tiering'—is not to influence enrollees’ drug utilization but rather to deter certain people from enrolling in the first place."

The authors point out that these adversely-tiered HIV patients will at some point realize they're overpaying and switch plans. However, that creates its own problem. Health insurance markets require a delicate balance to function. Just enough sick people and healthy people need to be enrolled in each plan for the insurer to be able to make a small—yet reliable—profit while still paying for everything they promised to cover.

Once all the HIV patients start clustering in the more generous plans, it may lead to a "race to the bottom in drug-plan design," the authors write. No insurer wants to be saddled with all the most-expensive customers, so they may all rejigger their drug co-pays to be similarly harsh.

"The [Affordable Care Act] has already made major inroads in designing a more equitable health care system for people with chronic conditions," Jacobs and Sommers conclude, "but the struggle is far from over."

source How Insurance Companies Still Discriminate Against the Sick

California Announces Campaign To Combat Use Of E-Cigarettes

LOS ANGELES — Arguing that the rising popularity of electronic cigarettes soon would undermine California's leadership in reducing tobacco use, state health officials Wednesday called for tighter regulation of the devices and announced an educational campaign to combat their use.

Addressing "vaping" by minors and young adults, the fastest-growing group of users in the state, will be a key focus, California's Department of Public Health said in a 21-page report. E-cigarette use among young adults ages 18 to 29 in California tripled between 2012 and 2013, according to the agency.

"I'm advising Californians, including those who currently use tobacco, to avoid using e-cigarettes," state health officer Dr. Ron Chapman said during a conference call following the document's release. "E-cigarettes ... re-normalize smoking behavior and introduce a new generation to nicotine addiction."

Chapman did not provide specifics about the campaign, including its expected cost. In addition to the report, the department issued an advisory recommending health care providers do more to educate parents and the public.

"This is just the beginning of getting the word out," he said.

The battery-operated devices, which often look like traditional cigarettes, work by heating and aerosolizing a nicotine-containing liquid that users then inhale. The vapor does not contain some of the dangerous components of tobacco smoke.

One key question is whether e-cigarettes help smokers quit or simply get more people hooked on nicotine, exposing them to a different set of toxic chemicals. With the health effects not yet comprehensively studied, there is debate over whether vaping devices are in fact a danger.

Citing a number of studies, the state's report concluded that there was "no scientific evidence that e-cigarettes help smokers successfully quit traditional cigarettes or that they reduce their consumption."

Proponents, however, said Wednesday that e-cigarettes can help smokers kick their dangerous tobacco habits and called the state's position "irresponsible."

"It's public health malpractice to tell an adult who is inhaling burning smoke into their lungs on a daily basis that they shouldn't even try to quit smoking (by) using vaping," said Gregory Conley, president of the American Vaping Association.

Stanton Glantz, a professor of medicine at the University of California, San Francisco's Center for Tobacco Control Research and Education, called the report a "fair reading of the evidence" and said he hoped that Californians would press the health department to reveal when its effort might launch.

"It's true that this is a new area (of research) ... but there's a pretty clear picture emerging," he said. "The whole: 'We don't know enough, the research is incomplete, bla bla bla,' that's what the cigarette companies have said since the 1950s."

The report detailed the increase in e-cigarette use among younger Californians.

Asked in 2012 if they had used e-cigarettes in the last 30 days, 2.3 percent of those between 18 and 29 years of age said they had. A year later, that number had more than tripled to 7.6 percent. Young adults were three times more likely to use e-cigarettes than people over 30.

Teen vaping in the U.S. also was on the rise, surpassing traditional cigarette use for the first time in 2014.

Nicotine exposure among teens, the report said, is believed to harm brain development. The aerosols emitted by e-cigarettes, including secondhand aerosols, contain at least 10 chemicals known to cause cancer, birth defects or reproductive harm.

One way companies make e-cigarettes appealing to children, Chapman said, was by offering e-liquid — as the nicotine solution the devices vaporize is sometimes called — in flavors like chocolate, gummy bear and bubble gum. That could make youngsters want to use e-cigarettes or ingest the liquid.

Poisonings among children age 5 and under linked to e-cigarettes grew from seven in 2012 to 154 in 2014, the health department report stated.

Amid the debate over the risks or benefits of electronic cigarettes, local and federal officials have put some regulations in place.

Los Angeles in 2013 adopted rules controlling the sale and use of e-cigarettes. At least one state legislator is pushing a bill that would ban vaping in locations where tobacco is prohibited, although similar attempts to regulate e-cigarettes statewide previously failed.

In April 2014, the U.S. Food and Drug Administration proposed rules for regulating the product; those still are under review.

source California Announces Campaign To Combat Use Of E-Cigarettes