RUSSIA
Our efforts to gain information regarding our Neonatal Womb community in the Russian Federation was difficult, as gaining information in general outside of the US currently seems to be. Our 
’s and yours beat together within the rhythms of the universe, the water that touches your shores falls as rain on our garden flowers, the air we breathe is ours to share.
We cherish you, our family.
Russia or the Russian Federation is a transcontinental country in Eastern Europe and North Asia. At 17,125,200 square kilometres (6,612,100 sq mi), Russia is by a considerable margin the largest country in the world by area, covering more than one-eighth of the Earth’s inhabited land area, and the ninth most populous, with about 146.79 million people as of 2019[update], including Crimea. About 77% of the population live in the western, European part of the country. Russia’s capital, Moscow, is one of the largest cities in the world and the second largest city in Europe; other major cities include Saint Petersburg, Novosibirsk, Yekaterinburg and Nizhny Novgorod.
The Russian Constitution guarantees free, universal health care for all its citizens. In practice, however, free health care is partially restricted because of mandatory registration. While Russia has more physicians, hospitals, and health care workers than almost any other country in the world on a per capita basis, since the dissolution of the Soviet Union the health of the Russian population has declined considerably as a result of social, economic, and lifestyle changes; the trend has been reversed only in the recent years, with average life expectancy having increased 5.2 years for males and 3.1 years for females between 2006 and 2014.
Source: https://en.wikipedia.org/wiki/Russia
Estimated number of preterm births per 100 live births Rate: 7% RANK: 155
(US Rate: USA – 12% Rank: 54)
Source: https://www.marchofdimes.org/mission/global-preterm.aspx#tabs-2
COMMUNITY
The changes in preemie care that may have helped the world’s smallest babies survive
By Dr. Shailja Mehta – Jun 3, 2019
What is believed to be the world’s smallest newborn baby to survive entered the world nearly four months earlier than planned, weighing 8.6 ounces – about the size of a juice box.
Baby Saybie was born at the Sharp Mary Birch Hospital in San Diego. She was transferred to the Neonatal Intensive Care Unit (NICU), where care is given to newborns who need special attention, and finally sent home after 5 months of treatment.
Premature babies like Saybie, who were unlikely to survive if they were born just a few decades ago, are thriving thanks to advances in modern medicine.
Dr. Jonathan Blau, a neonatologist at Staten Island University Hospital, told ABC News that the NICU usually handles the monitoring and treatment of newborns who are at risk for survival. A NICU team usually consists of a neonatologist, a specialized nurse, and a respiratory specialist who arrive and prepare a baby warmer even before the baby is delivered. When the baby is born it is taken to a warmer where heat and oxygen are provided.
Very small premature babies like Saybie are usually hooked up to a tube connected to a breathing machine, and a team constantly monitors their heart rate and blood pressure. “They also get medicines, hydration through IVs, x-rays, and antibiotics,” said Dr. Blau.
All babies undergo dramatic body system changes after birth. Some of these include breathing on their own, changes in the heart structure and direction of blood flow in large vessels. Healthy babies born after 9 months of gestation typically do not need medical help to go through these changes. But premature babies or those with health problems can have difficulty making that transition into the world.
Survival rates for premature babies vary based on the length of pregnancy, weight and sex of the baby, and whether they received a specific medication to help quicken their lung maturity before birth.
A developing fetus goes through important growth throughout pregnancy, including in the final months and weeks, according to the CDC. For example, the brain, lungs, and liver develop during the final weeks of pregnancy. Babies born too early, especially before 32 weeks, have higher rates of death and disability. In 2015, preterm birth and low birth weight accounted for about 17% of infant deaths.
According to Dr. Blau, preemies born at 24 weeks now have a 50% chance of survival. That chance goes up with increasing gestational age. Once the fetus reaches 28 weeks, over 90% of preterm babies survive.
It has been standard to provide lifesaving treatment to a baby born at 24 weeks, according to Dr. Blau, but now doctors are using new technology to try to save babies born ever earlier in some cases.
Care for premature babies has developed immensely over the last few decades, and it’s hard to believe less than a century ago, preemies were sent home with their parents, often with no medical intervention.
The first American NICUs providing specialized newborn care were designed in 1960s by Dr. Louis Gluck, around the same time doctors were learning more about the spread of infection.
Dr. Gluck’s research showed that bathing babies and washing hands reduced the number of bacterial infections. His discovery transformed the NICU layout from babies isolated in cubicles to one large room filled with newborns in their incubators.
In the 1970s, doctors discovered the benefits of mothers holding their babies after giving birth. Dr. Heidelise Als, a specialist in newborn infant behavior, created the Newborn Individualized Developmental Care and Assessment Program (NIDCAP), and encouraged family involvement and individualized care plans for each baby.
Families began staying overnight in the hospital, and were encouraged to participate in “skin to skin” bonding, sometimes also called “kangaroo care,” where the baby is held closely or placed on the mother’s chest to maximize skin contact. Increased skin contact in the NICU has many benefits for the baby including reducing stress levels, helping with growth, controlling the heart rate and regulating breathing.
Technology to better treat premature babies continues to be developed today. Earlier this year, a team of scientists at Northwestern created and are testing soft, flexible wireless sensors for babies to monitor their vital functions, replacing long cords, and found that they were just as accurate and allowed better parent-child interaction.
“We have more sophisticated ventilators that have allowed some of the smallest babies to survive,” Dr. Blau said.
With a growing base of professional knowledge about neonatal care and constant improvements in technology, Dr. Blau thinks the future is bright.
“In addition to lifesaving care for our youngest newborns, we will strive to maximize developmental outcomes so these children can live happy and healthy childhoods.”
*** Dr. Shailja Mehta is a Female Pelvic Reconstructive Medicine and Surgery Fellow at Yale University, working with the ABC News Medical Unit
Source: https://abcnews.go.com/Health/lifesaving-innovations-vulnerable-newborns/story?id=63439120
Universal Health Coverage Day 2019
On 12 December 2012, the United Nations General Assembly endorsed a resolution urging countries to accelerate progress toward universal health coverage (UHC) – the idea that everyone, everywhere should have access to quality, affordable health care – as an essential priority for international development. In 2017, the international community celebrated 12 December as the first International Universal Health Coverage Day.
International Universal Health Coverage Day aims to raise awareness of the need for strong and resilient health systems and universal health coverage with multi-stakeholder partners. Each year on 12 December, UHC advocates raise their voices to share the stories of the millions of people still waiting for health, champion what we have achieved so far, call on leaders to make bigger and smarter investments in health, and encourage diverse groups to make commitments to help move the world closer to UHC by 2030.
Source: https://www.healthynewbornnetwork.org/event/universal-health-coverage-day-2019/
HEALTH CARE PARTNERS
Neonatology Considerations for the Pediatric Surgeon
Updated: Mar 11, 2019 Author: Ibrahim SI Mohamed, MB, BCh, DISP(Fr); Chief Editor: Robert K Minkes, MD, PhD
Neonatal Gestational Age and Birth Weight
As a prerequisite to determine whether neonates fall into reference ranges, all infants are classified on the basis of gestational age (GA) and birth weight (BW).
Early ultrasonography (US) improved the accuracy of pregnancy dating, but discrepancies in dates, physical examination findings, and size necessitate further evaluation. If antenatal care has been lacking, physical assessment remains the primary clinical determinant of GA. GA is noted in completed weeks after the onset of the last menstrual period (LMP).
A term infant is an infant who is born after 37 completed weeks (i.e., ≥37 0/7 weeks’ gestation). A preterm infant is born before 37 completed weeks (i.e., < 37 weeks’ gestation). A post term infant is born after 42 0/7 weeks’ gestation.
Several terms are used to classify neonates according to BW, as follows:
- Low birth weight (LBW) neonates weigh less than 2500 g, either because of prematurity, because they are small for their gestational age, or both
- Very low birth weight (VLBW) neonates weigh less than 1500 g (3 lb 5 oz) at birth [1]
- Extremely low birth weight (ELBW) neonates weigh less than 1000 g (2 lb 3 oz) at birth
These classifications aid the clinician in predicting clinical courses and outcomes.
Small for gestational age (SGA) neonates are those whose BW is less than the 10th percentile for their gestational age. These infants are more prone to hypoxemia and meconium aspiration during labor. They are also at higher risk for polycythemia and require special attention to prevent hypothermia [2] and hypoglycemia. The placenta should be carefully examined by pathologists. These infants are at increased risk for developing necrotizing enterocolitis (NEC). They often have higher than normal caloric requirements for growth.
Intrauterine growth retardation or restriction (IUGR) is used to describe neonates whose growth is not at the 10th percentile for their gestational age in utero or in neonates in whom the weight percentile is decreasing in relation to GA (ie, crossing the 10th percentile lines); these neonates may be SGA.
Considerable evidence has shown that IUGR and smallness for gestational age can increase the risk of non-insulin-dependent diabetes mellitus (NIDDM), coronary heart disease, hypertension, and stroke. This has led to a rapidly growing field: study of the fetal origins of adult diseases.
Large for gestational age (LGA) infants are those whose weight is greater than 90th percentile for their gestational age. These infants are at increased risk for perinatal asphyxia, birth injury, hypoglycemia, hypocalcemia, polycythemia, and thrombocytopenia. Infants of mothers with diabetes are often large for gestational age.
These classifications aid the clinician in predicting clinical courses and outcomes.
Small for gestational age (SGA) neonates are those whose BW is less than the 10th percentile for their gestational age. These infants are more prone to hypoxemia and meconium aspiration during labor. They are also at higher risk for polycythemia and require special attention to prevent hypothermia [2] and hypoglycemia. The placenta should be carefully examined by pathologists. These infants are at increased risk for developing necrotizing enterocolitis (NEC). They often have higher than normal caloric requirements for growth.
Intrauterine growth retardation or restriction (IUGR) is used to describe neonates whose growth is not at the 10th percentile for their gestational age in utero or in neonates in whom the weight percentile is decreasing in relation to GA (ie, crossing the 10th percentile lines); these neonates may be SGA.
Considerable evidence has shown that IUGR and smallness for gestational age can increase the risk of non-insulin-dependent diabetes mellitus (NIDDM), coronary heart disease, hypertension, and stroke. This has led to a rapidly growing field: study of the fetal origins of adult diseases.
Large for gestational age (LGA) infants are those whose weight is greater than 90th percentile for their gestational age. These infants are at increased risk for perinatal asphyxia, birth injury, hypoglycemia, hypocalcemia, polycythemia, and thrombocytopenia. Infants of mothers with diabetes are often large for gestational age.
Source: https://emedicine.medscape.com/article/938854-overview
New doctors’ DNA ages six times faster than normal in first year
Long work hours of intern year associated with accelerated shortening of telomere regions of chromosomes
Date: May 15, 2019 Source: Michigan Medicine – University of Michigan
Summary:
Every summer, tens of thousands of newly minted doctors start the most intense year of their training: the first year of residency, also called the intern year. A new study suggests that the experience will make their DNA age six times faster than normal. And the effect will be largest among those whose training programs demand the longest hours.
In just a few short weeks, tens of thousands of newly minted doctors will start the most intense year of their training: the first year of residency, also called the intern year.
A new study suggests that between now and next summer, that experience will make their DNA age six times faster than normal. And the effect will be largest among those whose training programs demand the longest hours.
The findings about the effect of residency focus on the stretch of DNA called telomeres — which keep the ends of chromosomes intact like the plastic end of shoelaces. The discovery that telomeres shrink in an accelerated way among interns suggest the importance of ongoing efforts to reduce the strain of medical training.
But the researchers say their study also holds implications for other professions and situations that expose people to prolonged stress and months of long hours.
Published online in the journal Biological Psychiatry, the new study is the first to measure telomere length before and after individuals faced a common prolonged intense experience. It involved 250 interns from around the country who volunteered for the Intern Health Study, based at the University of Michigan, and a comparison group of college students from U-M.
“Research has implicated telomeres as an indicator of aging and disease risk, but these longitudinal findings advance the possibility that telomere length can serve as a biomarker that tracks effects of stress, and helps us understand how stress gets ‘under the skin’ and increases our risk for disease,” says Srijan Sen, M.D., Ph.D., the U-M neuroscientist and psychiatrist who is the study’s senior author and heads the Intern Health Study.
He adds, “It will be important to study how telomere changes play out in larger groups of medical trainees, and in other groups of people subjected to specific prolonged stresses such as military training, graduate studies in the sciences and law, working for startup companies, or pregnancy and the first months of parenting.”
Sen’s team worked with Kathryn Ridout, M.D., Ph.D., the new study’s first author, during the research portion of her residency at Brown University. She is now a psychiatrist at Kaiser Permanente in California as well as having an appointment at Brown.
“The current model of intern year training during residency increases trainee stress, which impacts their mental health and wellbeing. These results extend this work and are the first to show that this stress reaches down to the biological level, impacting the well accepted marker of aging and disease risk, telomere length,” says Ridout. “I was particularly surprised to see the relation of number of hours worked to telomere shortening.”
Sen notes that after the discovery that telomeres protect the DNA in chromosomes from damage — a discovery that earned the 2009 Nobel Prize — research on them in humans has focused on taking snapshots of telomere length, mainly in older adults. This has yielded important discoveries about the links between shrunken telomeres and disease.
Ridout analyzed data from dozens of telomere studies for a meta analysis published in 2016 that showed clear links between telomere length and the risk and severity of depression.
In the new study, Sen and his colleagues asked recently graduated medical students to contribute a sample of their DNA before they began their intern year, and then followed up to get another sample at the end of that year. The interns also took a lengthy questionnaire before their training began, and again at several points during and at the end of the intense year.
The results show that some new doctors went into residency with telomeres that were already shorter than their peers. This included those who said their family environment early in life was especially stressful — which echoes previous findings about the impacts of such an upbringing on telomere length.
Those who scored high on personality traits that together are classed as “neuroticism” — being quick to react and slow to relax, and a tendency to respond with negativity — also had shorter telomeres at the start of intern year.
But when the team looked at the results of the DNA tests taken after intern year ended, only one factor that they studied emerged with a clear link to telomere shrinkage: the number of hours the interns worked each week.
On average, all the interns in the study said they worked an average of 64.5 hours a week. But the more the interns worked, and therefore the more days they put in that were at or above the national limit of 16 hours in effect at the time, the faster their telomeres shrank.
“The responses given by some of the interns in these surveys indicated that some were averaging more than 80 hours of work a week, and we found that those who routinely worked that many hours had most telomere attrition,” says Sen. “Those whose hours were at the lower end of the range had less telomere attrition.”
By contrast, the comparison group of 84 first-year U-M undergraduate students experienced no telomere shrinkage, despite also being in a stressful year-long situation of coping with life at an elite institution of higher education. These students were taking part in a study led by Sen’s colleague at the U-M Molecular and Behavioral Neuroscience Institute, Huda Akil, Ph.D.
Sen’s Intern Health Study has begun collecting DNA samples from many more interns, and is now monitoring their mood, sleep and activity using smartphone apps and commercial activity trackers. He hopes to study the telomeres of future groups of interns to gather more data about how they change over the intern year and how those changes match up with their experiences during the year.
For instance, the frequent changes in shift time — from day to night and back again — during residency has already emerged in Sen’s work as an important factor in mood and circadian disruption. Future studies will explore if this sort of shiftwork increases telomere attrition.
He also hopes that researchers can evaluate whether any practices can protect telomeres from shrinkage or even spur repair and lengthening of these protective stretches of DNA. For now, he says, “Residency directors should do as much as they can to keep their interns’ work hours and workload towards the lower end of the current range.”
And as new doctors prepare to graduate and head into their intern years, he advises them to focus on their mood, sleep and stress-relieving activities as much as they can.
Ridout says she hopes the results will be heeded by the Accreditation Council for Graduate Medical Education and others. “Having completed residency myself and understanding the stress that can come with this training and extended work hours, I am hopeful these data can help inform the decisions of governing bodies that have been debating the importance of regulating resident work hours,” she says. “Our results suggest that reforms in intern training and work hours with a renewed focus on wellbeing is necessary to protect the health and viability of our physician workforce.”
Story Source: Materials provided by Michigan Medicine – University of Michigan. Note: Content may be edited for style and length. Journal Reference: Kathryn K. Ridout, Samuel J. Ridout, Constance Guille, Douglas A. Mata, Huda Akil, Srijan Sen. Physician Training Stress and Accelerated Cellular Aging. Biological Psychiatry, 2019; DOI: 10.1016/j.biopsych.2019.04.030
Source:https://emedicine.medscape.com/article/938854-overview
PREEMIE FAMILY PARTNERS
7 Behaviors Common Among Adults Who Went Through Trauma At A Young Age
The Minds Journal- Published on Dec 1, 2018
The intensity of a traumatic incident varies from person to person. Trauma from when one was a child can range from a crippling fear of abandonment to physical abuse and anything between the two. Many adults are forced to deal with the trauma they experienced as children throughout their lives. This article will hold true for whoever has had to face something traumatic as a child. Sometimes, we just hide things because that’s easier than actually dealing with them. We even do this unconsciously in order to protect ourselves at the time. But it is important to deal with these issues so that we can finally be free of that burden. 7 characteristics shared by people who went through trauma at a young age.
Helping Parents Chart Their Path Through Their NICU Journey:
The Peekaboo ICU Parent App Hitting It’s Mark – Deb Discenza
In just two and a half years since its official debut at the October 2018 National Neonatal Nurses Conference (NANN) in Palm Springs, CA, the Peekaboo ICU free parent app has become an essential “go-to” for preemie parents faced with navigating the uncharted journey of the Neonatal Intensive Care Unit (NICU). Available on apple and android devices, its goal is to reduce anxiety for parents by equipping them to understand, document, record, and celebrate their preemie’s story. And indeed, this comprehensive resource is working.
“The app is exceeding our expectations of growth and utility,” said Mark Dolezel, co-founder, producer, and husband of the app’s clinical author, Jodi Dolezel. With over 13,500 downloads and 9,600-page views per month, Jodi’s dream of providing a credible one-stop resource for NICU has become a reality, primarily in the US, but is also in Canada, the United Kingdom, Australia, and South America. No Wi-Fi needed and conveniently accessed at the bedside. A tutorial is available at https://m.youtube.com/ watch?v=2H5WsjxCjIw.
Jodi was determined to find a way to support and prepare parents to feel comfortable and confident while caring for their child as essential partners with the NICU healthcare team. In her many years of NICU bedside practice as a nurse, she has seen this is not always the case. “Parents feel alienated,” she said, “out of control and vulnerable at a time when they themselves are physically and emotionally drained. We decided to try to change this.”
So, the app’s first feature was a tool for parents to customize and track their individual preemie’s growth and development, and to journal their preemie’s unique experience. However, because so many parents are having multiples, that additional capacity was soon added.
Next, the Dolezels researched each critical area of knowledge for preemie parents, and organized them into sequential sections.
Navigating the NICU is the essential first step in helping parents understand unfamiliar medical terminology, staff roles, medical equipment, and the intense clinical environment. The Weekly Developmental Guide provides what every parent wants to know what to expect week to week. They want to know what is considered “normal” and how is my baby progressing towards those norms? Anatomy presents a system-by-system look at each body function relevant to pre-term infants with the option of diving deeper into content regarding complications if they should arise. Growth Tracker allows parents to record and graph ongoing progress of their baby’s head circumference, weight, and length.
This area also promotes strong interaction and discussion points between parents and the healthcare team. With Milestones, parents can capture the moments and achievements they experience with their baby throughout their journey together, all of which can be downloaded and saved as a lifelong keepsake. Steps to Discharge offers a thorough explanation of the achievements required for taking your baby home, which is always a priority for preemie parents. Feeding & Nutrition has tips for successful breastfeeding, a feeding tracker, and pumping logs are essential resources and very helpful for encouraging collaboration with staff. There is a thorough education about the options available to parents, including pasteurized human donor milk and human milk-based fortifiers to ensure optimal nutrition, according to gestational weight. Journaling allows parents to import photos and document their thoughts, experiences, and feelings as often as they’d like. If desired, they can share these with friends and family through e-mail and social media, setting up a “caring network” while decreasing the burden of endless phone calls. And finally, the Support section provides a guide to parent support organizations all over the country that moms and dads can tap into both before and after discharge.
But Peekaboo ICU is not resting on its laurels. With the success of the app comes “an obligation to continue to find new ways of making it even better and more accessible,” said Jodi.
This will include an After the NICU Section for parents to document appointments, medications, nutrition, procedures, a daily schedule, and notes with HIPPA-compliant server integration for capturing real-time data. Server integration will also afford synchronization between multiple apps and provide safety backups. Lastly, there will be an option to create a lasting “baby book” with the ability to download the entire content recorded in the app. “We estimate the app is now available in at least 40 hospitals and the number is growing every day,” said Mark. “The number is very likely much higher as individuals using the app are not required to register their location.”
Jodi feels gratified. She says, “We are receiving amazing feedback from nurses, lactations specialists, hospitals and, of course, parents. Nurses tell us the app makes their job easier. Lactation specialists say it encourages moms to track pumping, which often leads to better outcomes. Hospitals call it an invaluable tool they can use because it is non-branded, without advertisement. And parents simply say, ‘thank you.’ “That’s all we need!
Source: https://neonatologytoday.net/newsletters/nt-jun19.pdf
Health
Preemies and early arrivals have higher risk of heart disease as adults
June 3, 2019 – by admin – SOURCE: bit.ly/2Z7ZFhL and bit.ly/2Z66Dny JAMA Pediatrics, online June 3, 2019.
Babies who are born too soon may be more likely to develop heart disease as adults than full-term infants, a new study suggests.
Adults who were born before 37 weeks gestation were 53 percent more likely to develop heart disease than people who were full-term babies, researchers found. And people who’d been born just a little bit early – at 37 to 38 weeks gestation – were 19 percent more likely to develop heart disease.
Pregnancy normally lasts about 40 weeks, and babies born after 37 weeks of gestation are considered full-term. Babies born prematurely – earlier than 37 weeks – often have difficulty breathing and digesting food in the weeks after birth. Preemies can also encounter longer-term challenges such as impaired vision, hearing and cognitive skills, as well as social and behavioral problems.
Preterm birth has also been linked to an increased risk of high blood pressure and diabetes decades later. But research to date hasn’t conclusively linked an early delivery to an increased risk of so-called ischemic heart disease, which happens with the arteries narrow and limit how much blood and oxygen reach the heart.
For the current study, researchers examined data on more than 2.1 million babies born in Sweden between 1973 and 1994, following them through 2015 to see how many developed heart disease. Only 1,921 of these babies, or less than one percent, went on to be diagnosed with heart disease by ages 30 to 43.
“Preterm birth interrupts the development of the cardiovascular system and other organs, leading to abnormal structure or function of blood vessels and other disorders such as diabetes that can lead to heart disease,” said lead study author Dr. Casey Crump of the Icahn School of Medicine at Mount Sinai in New York City.
“Our findings were not explained by maternal factors that might contribute to both preterm birth and future heart disease, such as obesity, hypertension, diabetes, and smoking,” Crump said by email. “In addition, we also compared persons born preterm with their siblings who were not, which suggested that the findings were not explained by other risk factors shared within families, but were more likely from direct effects of preterm birth.”
For every 100,000 babies born at full term each year, about 5.9 would develop heart disease as adults, researchers calculated. That compares to about 6.5 of every 100,000 babies born slightly early and 8.8 of every 100,000 preemies.
One limitation of the study is that researchers lacked more detailed clinical data needed to verify the heart disease diagnoses, the study authors note. They also had too few extremely preterm babies to draw firm conclusions about the heart risks associated with delivery earlier than 34 weeks gestation.
Another drawback is that the follow-up period was too brief to detect differences in heart disease rates later in adulthood, when the condition is more commonly diagnosed.
Even so, the results suggest that adults born even a little bit early should take extra precautions to protect the heart, said Dr. Thuy Mai Luu of the University of Montreal and CHU Sainte-Justine in Canada, who co-authored an editorial published with the report.
“Some risk factors associated with cardiovascular diseases can be prevented through healthy lifestyle habits including a diet rich in fruits and vegetables, reduced sedentary time, regular physical activity and avoidance of primary and secondary smoke exposure,” Luu said by email.
“This is important to all, but maybe more so for children and adults born preterm,” Luu added. “Given that it is hard to change behaviors, adopting a healthy lifestyle early in childhood is crucial; parents are central to this.”
INNOVATIONS
Study could lead to ‘cognitive therapy in your pocket’
CBM-I via smartphone app could help patients with depression, anxiety, and other mental health conditions
May 29, 2019 McLean Hospital
Summary:
People living with anxiety, depression, and other mental health conditions may soon be able to use a smartphone app to deliver on-demand cognitive bias modification for interpretation (CBM-I), a way to change mental habits without visiting a therapist.
Based on a study by McLean Hospital researchers, individuals with anxiety, depression, and other mental health conditions may soon be able to use a smartphone app to deliver on-demand cognitive bias modification for interpretation (CBM-I), a way to change mental habits without visiting a therapist.
The study, “Translating CBM-I Into Real-World Settings: Augmenting a CBT-Based Psychiatric Hospital Program,” was published in the journal Behavior Therapy. It shows the potential effectiveness of CBM-I when combined with cognitive behavior therapy (CBT) in an acute psychiatric setting. It also points the way for adapting this therapeutic approach for use outside the hospital.
The lead researcher of the study is Courtney Beard, PhD, director of McLean’s Cognition and Affect Research and Education (CARE) Laboratory.
Beard described CBM-I as a “class of interventions designed to shift people’s interpretations of ambiguous situations in either a more positive or more negative way.” She explained that “CBM-I tries to address interpretation bias, a mental habit that is implicated in many mental disorders.”
To do this, individuals undergoing CBM-I treatment can be presented with a series of word association questions that address everyday situations.
For example, the CBM-I task may show a patient a situation about a person yawning during their conversation. Then the patient is asked whether that person is “tired” or “bored.” The individual who answers “tired” is told the response is “correct,” and “bored” is incorrect. Through repetition, this type of CBM-I therapy helps the person reframe or reassess these daily ambiguous situations.
“People face countless interactions like this every day in their lives,” Beard said. “If you have a tendency to jump to a threatening or negative conclusion, it can have a huge impact on how you’re feeling and on what you do and how you react. You can get stuck in a cycle that can maintain anxiety or depression.”
For their study, Beard and her colleagues developed and implemented CBM-I to augment CBT-based treatment in a partial hospital setting. They presented patients with word-sentence associations that encouraged patients to endorse positive interpretations and reject negative interpretations.
Study results showed that CBM-I was practical and acceptable to acute psychiatric patients. Many stated that CBM-I bolstered their primary CBT-based care. The study also found that that the word association exercises were successful in helping reframe potentially negative situations.
Based on these results, Beard and her team are moving forward with a National Institute of Mental Health-backed study to develop a smartphone version of CBM-I.
“With the smartphone app, we can offer CBM-I to many more people at one time,” Beard said. “With the app, they can practice new skills, create healthy mental habits, and stop automatically jumping to negative conclusions. And they can do it on demand.”
Beard stated that the app could be particularly helpful for individuals who have just been discharged from a treatment program. “They can use it during the month transition period after they leave the hospital, which is a risky and challenging time for them,” she said.
Beard sees great promise for app-based CBM-I therapy. “It quickly shows people what their brain is doing,” she explained. “The patient sees hundreds of situations in a short amount of time. So, they see how often they jumped to a negative conclusion, and that can be very powerful. It’s kind of like cognitive therapy in your pocket — but a little different and a lot faster.”
Journal Reference: Courtney Beard, Lara S. Rifkin, Alexandra L. Silverman, Thröstur Björgvinsson. Translating CBM-I Into Real-World Settings: Augmenting a CBT-Based Psychiatric Hospital Program. Behavior Therapy, 2019; 50 (3): 515 DOI: 10.1016/j.beth.2018.09.002 McLean Hospital. “Study could lead to ‘cognitive therapy in your pocket’: CBM-I via smartphone app could help patients with depression, anxiety, and other mental health conditions.” ScienceDaily. ScienceDaily, 29 May 2019. <www.sciencedaily.com/releases/2019/05/190529180230.htm>.
Source: https://www.sciencedaily.com/releases/2019/05/190529180230.htm
Elvie Pump: Silent & Wearable Breast Pump Review | Channel Mum
Channel Mum Published on Nov 2, 2018
The Elvie Pump has completely revolutionised expressing breast milk! The pump is wireless and completely silent, the only sound you will hear is the milk trickling into the empty bottle and even that stops once the bottle starts to fill up.
Kat Chat-
A brief update on my healing journey to treat my preverbal PTSD! I have engaged in a few sessions of hypnotherapy, which I found to be a gentle start. My PTSD-related issues frankly seemed to intimidate the therapist. I realized I wanted to go deeper in a safe environment, and decided to explore additional modalities moving forward. Hypnotherapy may be something I return to in the future as a tool for exploring my internal landscape in relationship to other issues.
Seeking talk-free therapy alternatives appropriate to treat preverbal trauma I identified options that may work well and provide a supportive safe setting for a person with preverbal PTSD. Rolfing, EMDR and Shamanism are three options I may engage in. The first will be Rolfing, and I have identified and connected with a therapist to work with. When she returns to my area, appointments will be set and the adventure will unfold.
Research related to preverbal trauma is sparse and slow to develop. This, like many medical issues for Warriors, will be impacted by the choices we make. I suggest we explore our challenges with Spiritual Guidance, Critical Thinking, and a commitment to Manifesting Wellness as we embrace our days, years and lifetime challenges and opportunities. Let’s share our stories…….
WARRIORS:
Preterm Birth a Key Risk Factor for Development of Childhood Depression
October 4, 2018
The study investigators observed that low level of urbanization was associated with a lower risk for depression.
Children born preterm may have an increased risk for depression compared with children born full-term, according to study results published in the Journal of Affective Disorders.
Researchers analyzed data from 21,478 preterm children and 85,903 full-term children born between 2000 and 2010 who were included in the Taiwan National Health Insurance Research Database. The mean ages of the preterm children and full-term children were 9.72 and 9.88 years, respectively.
Evaluation of the study population found that preterm birth was the key risk factor for depression.
The risk of depression among preterm children was 2.75 times higher than that seen in full-term children (95% CI, 1.58–4.79; P <.001). Depression rates in full-term children were 0.37, compared with 1.01 in preterm children, per 10,000 person-years. In female preterm children, incidence of depression was 3 times higher compared with full-term children. Preterm children whose parents had blue-collar occupations had a risk for depression 3.4 times higher than full-term children in the same demographic. Preterm children whose parents had occupations other than blue-collar positions had a 6.06-fold higher risk for depression compared with full-term children in the same demographic (blue-collar occupations: 95% CI, 1.04–11.15; P <.05; other occupations: 95% CI, 1.71–21.49; P <.01).
Researchers conclude that “findings of the present study suggest that preterm infants have a significantly higher risk of depression in adolescence compared with full-term infants.” They note that limitations of the study include lack of maternal demographic data and emphasize the need for healthcare providers to recognize the potential for depression in children born prematurely.
Reference: Chiu TF, Yu TM, Chuang YW. Sequential risk of depression in children born prematurely: A nationwide population-based analysis J Affect Disord. 2018; 243:42-47. doi: 10.1016/j.jad.2018.09.019
Seattle’s Greenlake – an urban woodland walk paradise; a community of trees from all over the world, living together in harmonious beauty. Our spiritual retreat!
Doctors urged to prescribe
woodland-walks for mental health problems
By Sally Robertson B. Sc. – 06/10/19 Reviewed by Kate Anderson, B.Sc. (Editor)
The Woodland Trust says the Japanese practice of “forest bathing” should be prescribed on the NHS to tackle stress and other mental health problems. According to the charity, hugging trees, listening to bird song and kicking through leaves are all activities that can boost mental health.
The Trust is urging GPs to prescribe forest bathing for mental health conditions and direct patients to their nearest woodland.
Head of innovation at the Woodland Trust, Stuart Dainton, say all family doctors should have the knowledge to point patients towards the nearest suitable woodland where they can absorb nature, informally or as part of a structured program. He is appealing to GPs to make use of the more than 1,000 sites covered by the Trust in the UK.
Stemming from the Japanese art Shinrin-yoku, the practice was devised 40 years ago by the Japanese Ministry of Agriculture, Forestry, and Fisheries as part of an initiative to tackle stress among men. The activity involves breathing deeply and absorbing the atmosphere of the forest as a way of yielding calming, rejuvenating and restorative effects.
Participants are encouraged to immerse themselves in the environment and take in the sights, sounds, touch and smells of the forest.
It’s about invigorating the senses by walking in the woods, smelling, listening to the sounds of the woods, touching the ground. We’re almost losing that as a society.” Stuart Dainton. He adds that forest bathing should also be encouraged for children to help fight the “always on” culture prompted by social media.
BBC presenter Kate Humble is calling for schools to conduct lessons outside, referring to how difficult she found education whilst surrounded by four walls: “I find it stultifying and boring and I spent probably more of my school career going ‘How can five minutes feel like five hours?’ There is no reason why math, English literature or any subject cannot be taught outside.” Kate Humble
Forest bathing is now practiced by more than five million Japanese people and has quietly been gaining popularity in the UK. The therapy, which has become a cornerstone of preventative health care in Japanese medicine, has prompted a number of scientific studies that seem to prove its beneficial effects.
Research mainly conducted in Japan and South Korea, has shown that two hours of time spent mindfully exploring a forest can lower blood pressure, reduce the stress hormone cortisol and improve memory and concentration. Studies have also found that trees release substances called phytoncides, which have anti-microbial properties and can boost the immune system.
As a result of these findings, the Japanese government decided to introduce shinrin-yoku as a national health program and now forest therapy is an established practice throughout the world.
An increasing number of companies are now offering structured forest bathing programs that last anything from between a couple of days through to week-long residential stays.
The Forestry Commission, which is the largest proprietor of wooded land, has also announced that it plans to launch nationwide programs. In addition, it provides printable recommendations on how to practice the activity, including tips on how to breathe correctly.
Health benefits of forest bathing
Beneficial effects of forest bathing (that have been scientifically proven) include:
- Increased natural killer cell count and improved immune system function
- Reduced blood pressure
- Improved sleep
- Higher energy levels
- Improved mood
- Increased concentration, particularly among children with ADHD
- Faster recovery from illness or surgery
- Decreased stress
Helen Stokes-Lampard from the Royal College of GPs advises that getting outside can have a “really positive impact” on health: We do know that patients often benefit from non-medical interventions such as an exercise class, learning a skill or joining a community group. This is now referred to as ‘social prescribing,’ and ‘forest bathing’ is one of many activities that people might find beneficial for their overall wellbeing.” Helen Stokes-Lampard
Dainton says that social prescribing through aspects of Shinrin-yoku, forest bathing, is a route to helping the nation destress: “One in four of us are potentially going to suffer from mental health problems. Part of the solution is just getting outside and enjoying nature.”
Forest bathing “practitioner” Faith Douglas points out that forest bathing has been out there for years: “This is something our ancestors did, this is something that cultures do all over the planet — it’s simply being mindful in a natural environment.”
How many people could benefit from forest bathing?
Millions of people are affected by mental health problems every year in the U.S. Statistics on the prevalence and impact of these conditions in the U.S. include the following:
- Around one-fifth (46.6 million) of adults experience a mental health condition every year
- Each year, an estimated one in 25 (11.2 million) adults develop a serious mental health problem that significantly limits or disrupts day-today activities
- Around one in five (21.4%) individuals aged 13 to 18 years develop a severe mental health condition
- Around 13% of those aged 8 to 15 years develop a severe mental health condition
- The percentage of adults living with schizophrenia is 1.1%
- For bipolar disorder, the figure is 2.6%
- Almost 7% (16 million) adults experienced at least one major depressive episode in the past year
- About 18% of adults developed an anxiety disorder such as phobia, post-traumatic stress disorder and obsessive-compulsive disorder.
- Of 20.2 million adults who had a substance abuse problem, 10.2 million also had a mental health illness
Want to give it a go? The National Trust has put together a beginner’s guide to forest bathing: Link- https://www.nationaltrust.org.uk/lists/a-beginners-guide-to-forest-bathing
KAMCHATKA – KAMCHATKA PENINSULA- Uri Magnus
Published on Feb 17, 2018 – A 4 mints film about kamchatka – surfing in kamchatka & wildlife and adventure.
The Neonatal Womb Warriors 