The first few days after infection, an infected person can spread the virus at a high level and during this time the false negative rate for the COVID test is around 90%.  Even with well established disease, the false negative rate is 32%!!   Many children show no symptoms whatsoever.  This fact plus the limited use of masks proposed for schools and very limited social distancing ensures that COVID will spread widely in the schools and that will result in adults at home being infected.  This approach will kill some parents and grandparents.  I do not believe the schools can be safely opened until we have a vaccine and all students are vaccinated with NO EXCEPTIONS!!

As a Child & Adolescent Psychiatrist, I can tell you that a number of children do better with digital-distance learning.  Children can get up later so they are more rested and do better with the academic material..

Those with ADHD can perform much better because as one explained to me, “if I space out a little in class, I have to think if I should interrupt and ask the teacher to go back.  Then I miss even more.  At home with a digital lecture, I can just back up the video some to get the missed information.”  That covers a larger proportion of the student population than one might think 

The original CDC guidelines for opening businesses included:

NO MASS TRANSIT

NO CAR POOLS

IN AREAS WHERE PEOPLE MAY GATHER (E.G cafeterias) NO SEATING!!!

I.E. NO BUSES, NO SEATS IN CAFETERIAS for schools

People argue that students need to be in school so parents can work BUT from what I’m seeing in my practice, many companies will be VASTLY expanding working from home and it is working despite the inevitable interruptions of work for children.  This is working even for both parents working in a number of families I treat.  For those who really must leave home to work, a group of parents could band together to provide coverage AS LONG AS THEY KEEP THAT GROIUP ISOLATED- I.E. NOT IN THE ACTUAL SCHOOL BUILDING!!!  The school systems could facilitate the formation of such groups. 

Korea which has done a FAR BETTER job than we at containing COVID opened their schools after they thought the virus was contained but had to quickly close them again.

Also note that once a room in a hospital is contaminated, it takes a team several hours to decontaminate it and during parts of the decontamination, no one can be in the room because of the intense UVC exposure. The room is also fogged with aerosols.  I doubt any school system could implement these procedures.  

How many parents and grandparents will have to die before  the schools are closed again? 

BETTER TO NOT OPEN SCHOOLS UNTIL ALL STUDENTS HAVE BEEN VACCINATED.  .

We still have a lot to learn about the immunological response to COVID and that implies we have a lot to assess in potential vaccines.  For example, it appears that the IgG response to COVID disappears in about 6 weeks.  What does that mean for risk of infection?  This question must be addressed in vaccines before we engage in a mass vaccination program.

Also note that children are the primary vectors of respiratory virus infections, e.g. cold and flu.  The best way to protect the elderly population from the flu is to vaccinate the children!!

Donald Rauh M.D., Ph.D., FAPA

Diplomate of the American Board of Psychiatry & Neurology Board Certified in General Psychiatry and in  Child & Adolescent Psychiatry

Source:  https://www.rauhpsychiatry.com

Difficulty walking, blurred vision, slurred speech, slowed reaction times, impaired memory: Clearly, alcohol affects the brain. Some of these impairments are detectable after only one or two drinks and quickly resolve when drinking stops. On the other hand, a person who drinks heavily over a long period of time may have brain deficits that persist well after he or she achieves sobriety. Exactly how alcohol affects the brain and the likelihood of reversing the impact of heavy drinking on the brain remain hot topics in alcohol research today.

We do know that heavy drinking may have extensive and far–reaching effects on the brain, ranging from simple “slips” in memory to permanent and debilitating conditions that require lifetime custodial care. And even moderate drinking leads to short–term impairment, as shown by extensive research on the impact of drinking on driving.

A number of factors influence how and to what extent alcohol affects the brain (1), including

• how much and how often a person drinks;
• the age at which he or she first began drinking, and how long he or she has been drinking;
• the person’s age, level of education, gender, genetic background, and family history of alcoholism;
• whether he or she is at risk as a result of prenatal alcohol exposure; and
• his or her general health status.

This Alcohol Alert reviews some common disorders associated with alcohol–related brain damage and the people at greatest risk for impairment. It looks at traditional as well as emerging therapies for the treatment and prevention of alcohol–related disorders and includes a brief look at the high–tech tools that are helping scientists to better understand the effects of alcohol on the brain.

BLACKOUTS AND MEMORY LAPSES

Alcohol can produce detectable impairments in memory after only a few drinks and, as the amount of alcohol increases, so does the degree of impairment. Large quantities of alcohol, especially when consumed quickly and on an empty stomach, can produce a blackout, or an interval of time for which the intoxicated person cannot recall key details of events, or even entire events.

Blackouts are much more common among social drinkers than previously assumed and should be viewed as a potential consequence of acute intoxication regardless of age or whether the drinker is clinically dependent on alcohol (2). White and colleagues (3) surveyed 772 college undergraduates about their experiences with blackouts and asked, “Have you ever awoken after a night of drinking not able to remember things that you did or places that you went?” Of the students who had ever consumed alcohol, 51 percent reported blacking out at some point in their lives, and 40 percent reported experiencing a blackout in the year before the survey. Of those who reported drinking in the 2 weeks before the survey, 9.4 percent said they blacked out during that time. The students reported learning later that they had participated in a wide range of potentially dangerous events they could not remember, including vandalism, unprotected sex, and driving.

Equal numbers of men and women reported experiencing blackouts, despite the fact that the men drank significantly more often and more heavily than the women. This outcome suggests that regardless of the amount of alcohol consumption, females—a group infrequently studied in the literature on blackouts—are at greater risk than males for experiencing blackouts. A woman’s tendency to black out more easily probably results from differences in how men and women metabolize alcohol. Females also may be more susceptible than males to milder forms of alcohol–induced memory impairments, even when men and women consume comparable amounts of alcohol (4).

ARE WOMEN MORE VULNERABLE TO ALCOHOL’S EFFECTS ON THE BRAIN?

Women are more vulnerable than men to many of the medical consequences of alcohol use. For example, alcoholic women develop cirrhosis (5), alcohol–induced damage of the heart muscle (i.e., cardiomyopathy) (6), and nerve damage (i.e., peripheral neuropathy) (7) after fewer years of heavy drinking than do alcoholic men. Studies comparing men and women’s sensitivity to alcohol–induced brain damage, however, have not been as conclusive.

Using imaging with computerized tomography, two studies (8,9) compared brain shrinkage, a common indicator of brain damage, in alcoholic men and women and reported that male and female alcoholics both showed significantly greater brain shrinkage than control subjects. Studies also showed that both men and women have similar learning and memory problems as a result of heavy drinking (10). The difference is that alcoholic women reported that they had been drinking excessively for only about half as long as the alcoholic men in these studies. This indicates that women’s brains, like their other organs, are more vulnerable to alcohol–induced damage than men’s (11).

Yet other studies have not shown such definitive findings. In fact, two reports appearing side by side in the American Journal of Psychiatrycontradicted each other on the question of gender–related vulnerability to brain shrinkage in alcoholism (12,13). Clearly, more research is needed on this topic, especially because alcoholic women have received less research attention than alcoholic men despite good evidence that women may be particularly vulnerable to alcohol’s effects on many key organ systems.

BRAIN DAMAGE FROM OTHER CAUSES

People who have been drinking large amounts of alcohol for long periods of time run the risk of developing serious and persistent changes in the brain. Damage may be a result of the direct effects of alcohol on the brain or may result indirectly, from a poor general health status or from severe liver disease.

For example, thiamine deficiency is a common occurrence in people with alcoholism and results from poor overall nutrition. Thiamine, also known as vitamin B1, is an essential nutrient required by all tissues, including the brain. Thiamine is found in foods such as meat and poultry; whole grain cereals; nuts; and dried beans, peas, and soybeans. Many foods in the United States commonly are fortified with thiamine, including breads and cereals. As a result, most people consume sufficient amounts of thiamine in their diets. The typical intake for most Americans is 2 mg/day; the Recommended Daily Allowance is 1.2 mg/day for men and 1.1 mg/day for women (14).

Wernicke–Korsakoff Syndrome

Up to 80 percent of alcoholics, however, have a deficiency in thiamine (15), and some of these people will go on to develop serious brain disorders such as Wernicke–Korsakoff syndrome (WKS) (16). WKS is a disease that consists of two separate syndromes, a short–lived and severe condition called Wernicke’s encephalopathy and a long–lasting and debilitating condition known as Korsakoff’s psychosis.

The symptoms of Wernicke’s encephalopathy include mental confusion, paralysis of the nerves that move the eyes (i.e., oculomotor disturbances), and difficulty with muscle coordination. For example, patients with Wernicke’s encephalopathy may be too confused to find their way out of a room or may not even be able to walk. Many Wernicke’s encephalopathy patients, however, do not exhibit all three of these signs and symptoms, and clinicians working with alcoholics must be aware that this disorder may be present even if the patient shows only one or two of them. In fact, studies performed after death indicate that many cases of thiamine deficiency–related encephalopathy may not be diagnosed in life because not all the “classic” signs and symptoms were present or recognized.

Approximately 80 to 90 percent of alcoholics with Wernicke’s encephalopathy also develop Korsakoff’s psychosis, a chronic and debilitating syndrome characterized by persistent learning and memory problems. Patients with Korsakoff’s psychosis are forgetful and quickly frustrated and have difficulty with walking and coordination (17). Although these patients have problems remembering old information (i.e., retrograde amnesia), it is their difficulty in “laying down” new information (i.e., anterograde amnesia) that is the most striking. For example, these patients can discuss in detail an event in their lives, but an hour later might not remember ever having the conversation.

Treatment

The cerebellum, an area of the brain responsible for coordinating movement and perhaps even some forms of learning, appears to be particularly sensitive to the effects of thiamine deficiency and is the region most frequently damaged in association with chronic alcohol consumption. Administering thiamine helps to improve brain function, especially in patients in the early stages of WKS. When damage to the brain is more severe, the course of care shifts from treatment to providing support to the patient and his or her family (18). Custodial care may be necessary for the 25 percent of patients who have permanent brain damage and significant loss of cognitive skills (19).

Scientists believe that a genetic variation could be one explanation for why only some alcoholics with thiamine deficiency go on to develop severe conditions such as WKS, but additional studies are necessary to clarify how genetic variants might cause some people to be more vulnerable to WKS than others.

LIVER DISEASE

Most people realize that heavy, long–term drinking can damage the liver, the organ chiefly responsible for breaking down alcohol into harmless byproducts and clearing it from the body. But people may not be aware that prolonged liver dysfunction, such as liver cirrhosis resulting from excessive alcohol consumption, can harm the brain, leading to a serious and potentially fatal brain disorder known as hepatic encephalopathy (20).

Hepatic encephalopathy can cause changes in sleep patterns, mood, and personality; psychiatric conditions such as anxiety and depression; severe cognitive effects such as shortened attention span; and problems with coordination such as a flapping or shaking of the hands (called asterixis). In the most serious cases, patients may slip into a coma (i.e., hepatic coma), which can be fatal.

New imaging techniques have enabled researchers to study specific brain regions in patients with alcoholic liver disease, giving them a better understanding of how hepatic encephalopathy develops. These studies have confirmed that at least two toxic substances, ammonia and manganese, have a role in the development of hepatic encephalopathy. Alcohol–damaged liver cells allow excess amounts of these harmful byproducts to enter the brain, thus harming brain cells.

Treatment

Physicians typically use the following strategies to prevent or treat the development of hepatic encephalopathy.

• Treatment that lowers blood ammonia concentrations, such as administering L–ornithine L–aspartate.
• Techniques such as liver–assist devices, or “artificial livers,” that clear the patients’ blood of harmful toxins. In initial studies, patients using these devices showed lower amounts of ammonia circulating in their blood, and their encephalopathy became less severe (21).
• Liver transplantation, an approach that is widely used in alcoholic cirrhotic patients with severe (i.e., end–stage) chronic liver failure. In general, implantation of a new liver results in significant improvements in cognitive function in these patients (22) and lowers their levels of ammonia and manganese (23).

ALCOHOL AND THE DEVELOPING BRAIN

Drinking during pregnancy can lead to a range of physical, learning, and behavioral effects in the developing brain, the most serious of which is a collection of symptoms known as fetal alcohol syndrome (FAS). Children with FAS may have distinct facial features (see illustration). FAS infants also are markedly smaller than average. Their brains may have less volume (i.e., microencephaly). And they may have fewer numbers of brain cells (i.e., neurons) or fewer neurons that are able to function correctly, leading to long–term problems in learning and behavior.

Fetal Alcohol Syndrome

Treatment

Scientists are investigating the use of complex motor training and medications to prevent or reverse the alcohol–related brain damage found in people prenatally exposed to alcohol (24). In a study using rats, Klintsova and colleagues (25) used an obstacle course to teach complex motor skills, and this skills training led to a re–organization in the adult rats’ brains (i.e., cerebellum), enabling them to overcome the effects of the prenatal alcohol exposure. These findings have important therapeutic implications, suggesting that complex rehabilitative motor training can improve motor performance of children, or even adults, with FAS.

Scientists also are looking at the possibility of developing medications that can help alleviate or prevent brain damage, such as that associated with FAS. Studies using animals have yielded encouraging results for treatments using antioxidant therapy and vitamin E. Other preventive therapies showing promise in animal studies include 1–octanol, which ironically is an alcohol itself. Treatment with l–octanol significantly reduced the severity of alcohol’s effects on developing mouse embryos (26). Two molecules associated with normal development (i.e., NAP and SAL) have been found to protect nerve cells against a variety of toxins in much the same way that octanol does (27). And a compound (MK–801) that blocks a key brain chemical associated with alcohol withdrawal (i.e., glutamate) also is being studied. MK–801 reversed a specific learning impairment that resulted from early postnatal alcohol exposure (28).

Though these compounds were effective in animals, the positive results cited here may or may not translate to humans. Not drinking during pregnancy is the best form of prevention; FAS remains the leading preventable birth defect in the United States today.

GROWING NEW BRAIN CELLS

For decades scientists believed that the number of nerve cells in the adult brain was fixed early in life. If brain damage occurred, then, the best way to treat it was by strengthening the existing neurons, as new ones could not be added. In the 1960s, however, researchers found that new neurons are indeed generated in adulthood—a process called neurogenesis (29). These new cells originate from stem cells, which are cells that can divide indefinitely, renew themselves, and give rise to a variety of cell types. The discovery of brain stem cells and adult neurogenesis provides a new way of approaching the problem of alcohol–related changes in the brain and may lead to a clearer understanding of how best to treat and cure alcoholism (30).

For example, studies with animals show that high doses of alcohol lead to a disruption in the growth of new brain cells; scientists believe it may be this lack of new growth that results in the long–term deficits found in key areas of the brain (such as hippocampal structure and function) (31,32). Understanding how alcohol interacts with brain stem cells and what happens to these cells in alcoholics is the first step in establishing whether the use of stem cell therapies is an option for treatment (33).

SUMMARY

Alcoholics are not all alike. They experience different degrees of impairment, and the disease has different origins for different people. Consequently, researchers have not found conclusive evidence that any one variable is solely responsible for the brain deficits found in alcoholics. Characterizing what makes some alcoholics vulnerable to brain damage whereas others are not remains the subject of active research (34).

The good news is that most alcoholics with cognitive impairment show at least some improvement in brain structure and functioning within a year of abstinence, though some people take much longer (35–37). Clinicians must consider a variety of treatment methods to help people stop drinking and to recover from alcohol–related brain impairments, and tailor these treatments to the individual patient.

Advanced technology will have an important role in developing these therapies. Clinicians can use brain–imaging techniques to monitor the course and success of treatment, because imaging can reveal structural, functional, and biochemical changes in living patients over time. Promising new medications also are in the early stages of development, as researchers strive to design therapies that can help prevent alcohol’s harmful effects and promote the growth of new brain cells to take the place of those that have been damaged by alcohol.

Source: https://pubs.niaaa.nih.gov/publications/aa63/aa63.htm

References

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Improvement in cognitive functioning of alcoholics following orthotopic liver transplantation. Alcoholism: Clinical and Experimental Research 15(6):956–962, 1991. (23) Pujol, A.; Pujol, J.; Graus, F.; et al. Hyperintense globus pallidus on T1–weighted MRI in cirrhotic patients is associated with severity of liver failure. Neurology 43:65–69, 1993. (24) Chen, W–J.A.; Maier, S.E.; Parnell, S.E.; and West, J.E. Alcohol and the developing brain: Neuroanatomical studies. Alcohol Research & Health 27(2):174–180, 2003. (25) Klintsova, A.Y.; Scamra, C.; Hoffman, M.; et al. Therapeutic effects of complex motor training on motor performance deficits induced by neonatal binge–like alcohol exposure in rats: II. A quantitative stereological study of synaptic plasticity in female rat cerebellum. Brain Research 937:83–93, 2002. (26) Chen, S.Y.; Wilkemeyer, M.F.; Sulik, K.K.; and Charness, M.E. Octanol antagonism of ethanol teratogenesis. FASEB Journal 15:1649–1651, 2001. (27) Spong, C.Y.; Abebe, D.T.; Gozes, I.; et al. Prevention of fetal demise and growth restriction in a mouse model of fetal alcohol syndrome. Journal of Pharmacology and Experimental Therapeutics 297:774–779, 2001. (28) Thomas, J.D.; Fleming, S.L.; and Riley, E.P. Administration of low doses of MK–801 during ethanol withdrawal in the developing rat pup attenuates alcohol’s teratogenic effects. Alcoholism: Clinical and Experimental Research26(8):1307–1313, 2002. (29) Altman, J., and Das, G.D. Autoradiographic and histological evidence of postnatal hippocampal neurogenesis in rats. Journal of Comparative Neurology 124(3):319–335, 1965. (30) Crews, F.T., and Nixon, K. Alcohol, neural stem cells, and adult neurogenesis. Alcohol Research & Health 27(2): 197–204, 2003. (31) Nixon, K., and Crews, F.T. Binge ethanol exposure decreases neurogenesis in adult rat hippocampus. Journal of Neurochemistry 83(5):1087–1093, 2002. (32) Herrera, D.G.; Yague, A.G.; Johnsen–Soriano, S.; et al. Selective impairment of hippocampal neurogenesis by chronic alcoholism: Protective effects of an antioxidant. Proceedings of the National Academy of Science of the U.S.A. 100(13):7919–7924, 2003. (33) Crews, F.T.; Miller, M.W.; Ma, W.; et al. Neural stem cells and alcohol. Alcoholism: Clinical and Experimental Research 27(2):324–335, 2003. (34) Oscar–Berman, M., and Marinkovic, K. Alcoholism and the brain: An overview. Alcohol Research & Health 27(2):125–133, 2003. (35) Bates, M.E.; Bowden, S.C.; and Barry, D. Neurocognitive impairment associated with alcohol use disorders: Implications for treatment. Experimental and Clinical Psychopharmacology 10(3):193–212, 2002. (36) Gansler, D.A.; Harris, G.J.; Oscar–Berman, M.; et al. Hypoperfusion of inferior frontal brain regions in abstinent alcoholics: A pilot SPECT study. Journal of Studies on Alcohol 61:32–37, 2000. (37) Sullivan, E.V.; Rosenbloom, M.J.; Lim, K.O.; and Pfefferbaum, A. Longitudinal changes in cognition, gait, and balance in abstinent and relapsed alcoholic men: Relationships to changes in brain structure. Neuropsychology 14:178–188, 2000. (38) Rosenbloom, M.; Sullivan, E.V.; and Pfefferbaum, A. Using magnetic resonance imaging and diffusion tensor imaging to assess brain damage in alcoholics. Alcohol Research & Health 27(2):146–152, 2003. (39) Kensinger, E.A.; Clarke, R.J.; and Corkin, S. What neural correlates underlie successful encoding and retrieval? A functional magnetic resonance imaging study using a divided attention paradigm. Journal of Neuroscience 23(6):2407–2415, 2003. (40) Wong, D.F.; Maini, A.; Rousset, O.G.; and Brasíc , J.R. 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The Gut Microbiota Mediates the Anti-Seizure Effects of the Ketogenic Diet

Christine A. Olson, Helen E. Vuong, Jessica M. Yano, Qingxing Y. Liang, David J. Nusbaum, Elaine Y. Hsiao2, Correspondence information about the author Elaine Y. HsiaoEmail the author Elaine Y. Hsiao

Highlights

• •Changes in the gut microbiota are required for the anti-seizure effects of the KD
• •Specific KD-associated bacteria mediate and confer the anti-seizure effects of the KD
• •KD microbiota regulate amino acid γ-glutamylation and hippocampal GABA/glutamate

Summary

The ketogenic diet (KD) is used to treat refractory epilepsy, but the mechanisms underlying its neuroprotective effects remain unclear. Here, we show that the gut microbiota is altered by the KD and required for protection against acute electrically induced seizures and spontaneous tonic-clonic seizures in two mouse models. Mice treated with antibiotics or reared germ free are resistant to KD-mediated seizure protection. Enrichment of, and gnotobiotic co-colonization with, KD-associated Akkermansia and Parabacteroides restores seizure protection. Moreover, transplantation of the KD gut microbiota and treatment with Akkermansia and Parabacteroides each confer seizure protection to mice fed a control diet. Alterations in colonic lumenal, serum, and hippocampal metabolomic profiles correlate with seizure protection, including reductions in systemic gamma-glutamylated amino acids and elevated hippocampal GABA/glutamate levels. Bacterial cross-feeding decreases gamma-glutamyltranspeptidase activity, and inhibiting gamma-glutamylation promotes seizure protection in vivo. Overall, this study reveals that the gut microbiota modulates host metabolism and seizure susceptibility in mice.

Living out of sync with the rest of the world may be to blame

by Maggie Fox and Erika Edwards / Apr.12.2018 / 1:10 AM ET

The stress of night owls trying to live against their nature could be a factor in their increased risk of dying over a given period of time.Luciano Lozano / Getty Images/Ikon Images

Are you a night owl? It might be killing you, researchers reported Thursday.

They found people with naturally late body clocks were about 10 percent more likely to die over a given period than early birds who rise with the sun.

It’s probably because living in a world geared for early starts is throwing off the circadian rhythms of the night owls, the researchers said.

Their findings fit in with other reports that show people who stay up later at night have higher risks of diabetes, high blood pressure and some types of cancer.

The researchers looked at surveys of more than 400,000 people taking part in a large British study of genes and health. As part of a detailed questionnaire, they were asked whether they tended to be night owls or morning larks.

There wasn’t much difference among people who fell in the middle. But there was a notable difference between the two extremes, said Kristen Knutson, associate professor of neurology at Northwestern University Feinberg School of Medicine.

“We found that the night owls had a 10 percent increased risk of dying over about a six and a half year period. And that was even after we took into account things like existing health problems,” Knutson told NBC News.

It’s not a lack of sleep — both groups got about the same amount, Knutson and her colleague Malcolm von Schantz, a professor of chronobiology at the University of Surrey, reported in the journal Chronobiology International.

“I think the problem arises because a night owl is trying to live in a morning lark world,” Knutson said. “If the body is expecting you to do something at a certain time like sleep or eat and you’re doing it at the quote ‘wrong’ time, then your body’s physiology may not be working as well.”

Researchers know the body clock is important. Three scientists who study the body’s internal clock won the Nobel Prize in Medicine last year. Their work, done over decades, helps explain how life adapts to the 24-hour cycle of day, and also how diseases such as cancer arise in the cells.

Studies indicate that switches to and from daylight savings time can raise the immediate risk of death over the following days, and others show the health risks of shift work.

The International Agency for Research on Cancer, an arm of the World Health Organization, says shift work probably causes cancer. It’s linked with breast cancer and other types of cancers, as well as diabetes and sleep disruption.

Those studies support the idea that working against the body’s natural inclination can be hazardous to your health.

Knutson and Von Schantz looked at how people answered the early bird question. “Approximately, 27 percent identified as definite morning types, 35 percent as moderate morning types, 28 percent as moderate evening types and 9 percent as definite evening types,” they wrote.

It was the 9 percent of people who said they were “definite” evening types who had the 10 percent increase risk of dying from something over the next six or so years.

“Neither of the two intermediate groups was associated with increased risk of all cause mortality,” they added.

There could be many reasons. People who stay up later eat fattier foods, drink more alcohol and are more likely to use recreational drugs. They have more exposure to artificial light, as well.

“Greater eveningness has also been associated with depression and mood disorders, particularly in those 50 years or older,” the researchers added.

But the stress of trying to live against their natures could be at fault, they proposed.

“The health of evening types could be compromised by misalignment between their endogenous biological clocks and the timing of social activities (e.g. work or meals), termed circadian misalignment,” they wrote.

WHAT CAN PEOPLE DO?

“You can’t just suddenly go to bed three hours earlier tonight because it won’t work,” Knutson said.

Confirmed night owls must make sure to eat a healthy diet and exercise regularly, she said.

But society should also recognize that some people have a genetic tendency to sleep later.

“If we can recognize these chronotypes are, in part, genetically determined and not just a character flaw, jobs and work hours could have more flexibility for owls,” Knutson said.

“This is a public health issue that can no longer be ignored,” von Schantz added.

“We should discuss allowing evening types to start and finish work later, where practical. And we need more research about how we can help evening types cope with the higher effort of keeping their body clock in synchrony with sun time.”

By: Erin Brodwin

Want an all-natural way to lift your mood, improve your memory, and protect your brain against the decline that comes with aging?

Get moving.

Exercises that get your heart pumping and sweat flowing — known as aerobic exercise, or “cardio”— have significant andbeneficial effects on the brain and body, according to a wealth of recent research, including two new studies published this month.

“Aerobic exercise is key for your head, just as it is for your heart,” according to an article in a Harvard Medical School blog.

Here are some of the ways cardio is such a boon for our bodies.

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A study published this week in the journal Neurology suggested that women who were physically fit in middle age were roughly 88% less likely to develop dementia (defined as a decline in memory severe enough to interfere with daily life) than their peers who were only moderately fit.

Neuroscientists from the University of Gothenburg in Sweden studied 191 women whose average age was 50 for 44 years. First, they assessed their cardiovascular health using a cycling test and grouped them into three categories: fit, moderately fit, or unfit.

Over the next four decades, the researchers regularly screened the women for dementia. In that time, 32% of the unfit women were diagnosed with the condition; a quarter of the moderately fit women did. But only 5% of the fit women developed dementia.

Despite that strikingly positive finding, the research only showed a link between fitness and decreased dementia risk; it did not prove that one caused the other. Still, the work builds on several other studies that suggest a powerful tie between exercise and brain health.

Workouts may protect your immune system from some age-related decline as well.

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For a small study published at the beginning of March in the journal Aging Cell, researchers looked at 125 amateur male and female cyclists aged 55 to 79. They compared those individuals with 75 people of a similar age who rarely or never exercised.

The cyclists were found to have more muscle mass and strength, and lower levels of body fat and cholesterol than the sedentary adults. The athletic adults also appeared to have healthier and younger-looking immune systems, at least when it came to a key organ called the thymus.

The thymus is responsible forgenerating key immune cells called T cells. In healthy people, it begins to shrink starting around age 20, and T cell production also starts to drop off around that time.

The study found that the thymus glands of the older cyclists looked like they belonged to younger people — their bodies were producing just as many T cells as would be expected from the thymus of a young person.

“We now have strong evidence that encouraging people to commit to regular exercise throughout their lives is a viable solution to the problem that we are living longer but not healthier,” Janet Lord, the director of the Institute of Inflammation and Aging at the UK’s University of Birmingham, said in a statement.

Cardio tones your muscles.

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It was initially believed that when it comes to building muscle, cardio paled in comparison to exercises like resistance training, which are designed to help you gain strength. But a recent review of 14 studies published in the journal Exercise and Sport Sciences Reviews found that on average, men who did 45 minutes of moderate to intense cardio 4 days a week saw a 5%-6% increase in leg muscle size.

“Aerobic exercise, if done properly, can lead to as much muscle growth as you’d expect with resistance exercise,” Ball State University exercise scientist Matthew Harber, who authored the study, told Men’s Fitness.

It raises your heart rate, improving heart and lung health.

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Aerobic workouts, especially swimming, train your body to use oxygen more efficiently, a practice that gradually reduces your resting heart rate and your breathing rate — two important indicators of cardiovascular health.

A 2008 study compared blood pressure, cholesterol levels, and other heart health metrics across close to 46,000 walkers, runners, swimmers, and sedentary people. The researchers found that the regular swimmers and runners had the best metrics, followed closely by the walkers.

Cardio exercise may even help reverse some heart damage from normal aging.

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Many of us become less active as we get older. Over time, this can lead some muscles in the heart to stiffen. One of those at-risk muscles is in the left chamber of the heart, a section that plays a key role in supplying the body with freshly-oxygenated blood.

A recent study split 53 adults into two groups, one of which did two years of supervised exercise four to five days per week while the other simply did yoga and balance exercises. At the end of the study, published in January in the journal Circulation, the higher-intensity exercisers saw significant improvements in their heart’s performance. Those results suggest that some stiffening in the heart can be prevented or even reversed with regular cardio.

“Based on a series of studies performed by our team over the past 5 years, this ‘dose’ of exercise has become my prescription for life,” Benjamin Levine, the author of the study and a professor of internal medicine at the University of Texas Southwestern, said in a statement.

Aerobic exercise benefits your mind, too — it can lift your mood, for example.

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Aerobic exercise “has a unique capacity to exhilarate and relax, to provide stimulation and calm, to counter depression and dissipate stress,” according to an article in the Harvard Medical School blog “Mind and Mood.”

The reason aerobic workouts lift our spirits seems related to their ability to reduce levels of natural stress hormones, such as adrenaline and cortisol, according to a recent study in the Journal of Physical Therapy Science. Activities like running and swimming also increase overall blood flow and provide our minds fresh energy and oxygen — another factor that could help us feel better

Heart-pumping workouts appear to have a positive impact on your gut.

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A small study published in Novembersuggests that cardio exercise changes the makeup of the microbes in our gut.

Those microbes play a role in inflammation levels, which can be an early warning sign of illness.

The researchers had study participants exercise three to five times per week for six weeks, and observed increases in their concentrations of butyrate, a type of fatty acid that helps keep our guts happy by tamping down on inflammation and producing energy.

“These are the first studies to show that exercise can have an effect on your gut independent of diet or other factors,” Jeffrey Woods, a professor of kinesiology and community health at the University of Illinois who led the research, said in a statement.

Cardio may improve cholesterol levels, too.

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A large recent review of research on how cardio affects cholesterol levels looked at 13 studies on the topic. It found that aerobic exercise was tied with reductions in LDL, which is also known as “bad” cholesterol because it can build up on the walls of your arteries and raise your risk of heart disease.

Cardio exercise was also linked with increases in HDL, also known as “good” cholesterol because it mobilizes the cholesterol in your blood.

“Prolonged moderate-intensity aerobic exercise should be recommended as a starting point for those who have previously been sedentary or are new to exercise,” the authors wrote.

Aerobic exercise helps prevent and manage diabetes by improving the way the body uses blood sugar.

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Several studies have found that cardio exercise helps people both prevent Type 2 diabetes and manage its symptoms — mostly by improving the way the body uses blood sugar.

A large Chinese study found that even modest changes in aerobic exercise (20 minutes of mild or moderate activity, 10 minutes of strenuous activity, or just 5 minutes of very strenuous activity 1-2 times per day) cut participants’ diabetes risk by close to half.

A single session of cardio has been found to increase insulin action and glucose tolerance for more than 24 hours; one week of it can improve whole-body insulin sensitivity.

Cardio workouts may even improve the look and feel of your skin.

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A study from researchers at McMaster University found that people over age 40 who engaged in regular cardio activity tended to have healthier skinthan their sedentary peers. The overall composition of the regular exercisers’ skin was more comparable to that of 20- and 30-year-olds.

It’s not yet clear why our workouts appear to play a role in skin health, but the researchers found elevated levels of a substance critical to cell health called IL-15 in skin samples of participants after exercise. That finding that could shed light on why cardio seems to make our skin look better.

Workouts may reduce the symptoms of depression.

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In addition to boosting the moods of healthy people, aerobic exercise may have a uniquely powerful positive impact on people with depression.

In a pilot study, people with severe depression spent 30 minutes walking on treadmill for 10 consecutive days. The researchers found the activity was “sufficient to produce a clinically relevant and statistically significantreduction in depression.”

Cardio appears to guard against some age-related decline like reduced brain connectivity.

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As we age, the brain — like any other organ — begins to work less efficiently, so normal signs of decline begin to surface. Our memory might not be quite as sharp as it once was, for example.

But older people who develop Alzheimer’s disease often first enter a stage known as mild cognitive impairment (MCI), which involves more serious problems with memory, language, thinking, and judgment.

A study published in May looked at adults with MCI between the ages of 60-88, and had participants walk for 30 minutes four days a week for 12 weeks. The results showed strengthened connectivity in a region of the brain where weakened connections have been linked with memory loss. That development, the researchers noted, “may possibly increase cognitive reserve,” but more studies are needed.

Aerobic exercise may help protect against memory difficulties in people undergoing chemo as well.

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In a July study, researchers examined hundreds of breast cancer survivors to see if activities like walking and swimming have an effect on “chemo brain,” a commonly reported side effect of breast cancer treatment that involves memory loss and difficulties focusing.

They gave nearly 300 breast cancer survivors accelerometers to track their activity, and provided them with an iPad app that featured quizzes designed to measure their attention and memory. At the end of a week, people who’d done aerobic exercise every day were significantly less tired than those who did little to no exercise, and also performed better on the app’s quizzes.

“The message for cancer patients and survivors is, get active!” Diane Ehlers, the lead author on the study and a professor of exercise psychology at the University of Illinois at Urbana Champaign, said in a statement.

Cardio may also be tied to increases in the size of brain areas linked to memory, but more research is needed.

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A study of older women with MCI found that aerobic exercise was tied to an increase in the size of the hippocampus, a brain area involved in learning and memory.

For the study, 86 women with MCI between 70 and 80 years old were randomly assigned to do one of three types of exercise twice a week for six months. Some did aerobic training (like walking and swimming), others focused on resistance training (like weight-lifting), or balance training.

Afterwards, only the women in the aerobic group were found to have significant increases in hippocampal volume, but more studies are needed to determine what effect this has on cognitive performance.

Source: http://www.businessinsider.com/exercise-cardio-brain-body-health-benefits-2017-12#cardio-may-also-be-tied-to-increases-in-the-size-of-brain-areas-linked-to-memory-but-more-research-is-needed-14

When is the best time to exercise or do creative work? Research on the science of timing has answers

By: Daniel H. Pink

You’ve probably made a few New Year’s resolutions, solemn promises to yourself to behave better in 2018. You might have pondered how you’re going to accomplish those goals, who could help you and why you need to change.

But if you’re like most people—and social science suggests that you and I are like most people—you’ve neglected a question that could help you actually stick to those resolutions: “When?”

In fact, timing is really a science. For several decades, researchers in dozens of fields—from economics to anesthesiology to social psychology—have been unearthing the hidden science of timing. In randomized controlled experiments, field studies and the analysis of massive data sets, they are exploring questions that span the human experience. How do beginnings, midpoints and endings alter our actions and memories? How do groups synchronize in time? How do even the verb tenses we use affect our behavior? Time, they have discovered, shapes our productivity, health and well-being in powerful but often invisible ways.

Much of what we consider “natural” units of time—seconds, hours, weeks—are really fences that our ancestors constructed to corral time. But one unit remains beyond our control: We inhabit a planet that turns on its axis at a steady speed in a regular pattern, exposing us to consistent periods of light and dark. The day is perhaps the most important way that we divide, configure and evaluate our time. By understanding the science of the day—and by giving more attention to the question of “when”—we can improve the effectiveness and success of our resolutions.

So how can we harness time to be healthier, happier and more productive?

Resolution: Get a promotion, get a raise or otherwise do well at work. Each year, many of us vow to get more done at work and perhaps even make a few creative breakthroughs. Yet many of us don’t realize how much the time of day matters to our performance.

Scientists began measuring the effect of the time of day on human brain power more than a century ago, when the pioneering German psychologist Hermann Ebbinghaus conducted experiments showing that people learned and remembered strings of nonsense syllables more effectively in the morning than at night. Since then, researchers have continued that investigation for a range of mental pursuits. They’ve drawn three big conclusions.

First, our cognitive abilities don’t remain static over the course of a day. During the 16 or so hours we’re awake, they change—often in a regular, foreseeable manner. We are smarter, faster and more creative in some parts of the day than others.

Second, these daily fluctuations can be extreme. “The performance change between the daily high point and the daily low point can be equivalent to the effect on performance of drinking the legal limit of alcohol,” write Russell Foster, a neuroscientist and chronobiologist at the University of Oxford, and Leon Kreitzman in their book “Rhythms of Life.” Other research has shown that time-of-day effects can explain 20% of the variance in human performance on cognitive undertakings.

Third, how we do depends on what we’re doing. We’re more effective at some tasks early in the day and at other tasks later in the day.

From big-data analyses of 500 million tweets to studies led by Nobel Prize-winning scientists, research has shown that we generally experience the day in three acts: a peak, a trough and a rebound. Most of us experience the pattern in that order. But the roughly one in five of us who have evening “chronotypes”—people who are night owls—tend to proceed in reverse order. (To determine whether you’re an owl, consider a day when you don’t have to awaken to an alarm clock. What is the midpoint between the time you go to sleep and the time you wake up? If it’s 5:30 a.m. or later, you’re probably an owl.)

During the peak, our ability to focus is at its best. When we wake up, our body temperature slowly rises. That rising temperature gradually boosts our energy level and alertness—and that, in turn, enhances our executive functioning, our ability to concentrate and our powers of deduction. For most of us, these sharp-minded analytic capacities crest in the late morning or around noon. This is when we are most vigilant, when we can keep distractions from penetrating our cerebral gates. That makes the peak the best time to tackle work that requires heads-down attention and analysis, such as writing a legal brief or auditing financial statements.

Vigilance, though, has its limits. Alertness and energy levels tend to plummet during the afternoons. And with that drop comes a corresponding fall in our ability to remain focused and constrain our inhibitions. This is the second stage: The trough, which usually occurs in the early to midafternoon.

The effects of the trough can be significant. In a 2016 study, Harvard University’s Francesca Gino and two Danish researchers examined four years of standardized test results for two million students in Denmark and matched scores to the time of day the students took the test. They found that students randomly assigned to take the tests in the afternoon scored considerably lower than those who took the test in the morning—an effect equivalent to missing two weeks of school.

The trough is an especially dangerous time for health-care professionals and their patients. In a study published in 2006 in Quality and Safety in Health Care, researchers at Duke Medical Center reviewed about 90,000 surgeries at the hospital and found that harmful anesthesia errors were three times more likely in procedures that began at 3 p.m. than at 8 a.m.

The afternoon trough is the Bermuda Triangle of our days—the place where effectiveness and good intentions disappear. This is the time to do your mindless administrative work, such as answering email, filing papers and filling out expense reports.

The third stage is the rebound, which for most of us occurs in the late afternoon and early evening. During this stage, we tend to excel at a different type of work. In 2011, two American psychologists, Mareike Weith and Rose Zacks, posed what are called “insight problems”—which require creative, rather than algorithmic, thinking and have nonobvious, surprising solutions—to 428 people, about half of whom were vigilant morning thinkers. These participants fared better on these problems not during their supposedly more optimal mornings but much later in the day—a phenomenon the researchers dubbed “the inspiration paradox.”

In the late afternoons and early evenings, most people are somewhat less vigilant than during the peak, but more alert and in a better mood than during the trough. That combination has advantages. A boosted mood leads to greater openness. A slight reduction in vigilance lets in a few distractions—but those distractions can help us spot connections that we might have missed when our filters were tighter. So we should move brainstorming sessions and other creative pursuits to the rebound stage. (Again, because night owls move through the day in the reverse order, their rebound period is the morning.)

The key is to seek what psychologists call the “synchrony effect”—to bring your own daily rhythms, your task (is it analytical, administrative or insight?) and your time (is it early, midday or later?) into alignment. Doing your analytic work during the rebound or your creative work during the trough is an ideal way to sabotage your resolutions.

Resolution: Get more exercise. It’s the most common New Year’s resolution. But when is the best time to hit the gym? Science has some answers, and most of them depend on the nature of our exercise goals.

Schedule exercise in the morning if you want to:

Lose weight. When we first wake up, having not eaten for at least eight hours, our blood sugar is low. Since we need blood sugar to fuel a run, morning exercise will use the fat stored in our tissues to supply the energy we need. (When we exercise after eating, we use the energy from the food we’ve just consumed.) In many cases, morning exercise may burn 20% more fat than later, post-food workouts.

Boost mood. Cardio workouts—swimming, running, even walking the dog—can elevate mood. When we exercise in the morning, we enjoy these effects all day. If you wait to exercise until the evening, you’ll end up sleeping through some of the good feelings.

Keep a routine. Some studies suggest that we’re more likely to adhere to our workout routine when we do it in the morning. So if you find yourself struggling to stick with a plan, morning exercise, especially if you enlist a regular partner, can help you form a habit.

Exercise in the late afternoon or evening if you want to:

Avoid injury. Studies have found that injuries are less common in workouts later in the day. Our body temperature reaches its high point in the late afternoon and early evening, and when our muscles are warm, they’re more elastic and less prone to injury.

Perform your best. In a 2015 study of 121 athletes, Elise Facer-Childs and Ronald Brandstaetter of the University of Birmingham found that individual performance can vary by as much as 26% based solely on time of day—and that performance typically peaks between 10 and 12 hours after awakening. So working out in the afternoons can help you sprint faster and lift more. Lung function is highest this time of the day, so your circulation system can distribute more oxygen and nutrients. This is also the time of day when strength peaks, reaction time quickens, hand-eye coordination sharpens, and heart rate and blood pressure drop. In fact, a disproportionate number of athletic records, especially in speed events, are set in the late afternoon and early evening.

Enjoy the workout a bit more. People typically perceive that they’re exerting themselves a little less in the afternoon even if they’re doing exactly the same exercise routine as in the morning, according to the American Council on Exercise.

Source site: https://www.wsj.com/articles/how-to-be-healthier-happier-and-more-productive-its-all-in-the-timing-1514560647?emailToken=7ae069394137d491ed5412aaaf681213%2BRe7Y5zm8g33991Ds3vgBmCOdYLT3WVOfUqvMMpBdGPBL7wH%2B%2FZBrdmVLkIV4lcuYlvdmVouh4RFVqsk95vFR%2F5RihJtDP43Ftt2ViXmmDQA8VNqvr9NvLWH3ygDK2pcW5IVNUXXxwZukfDqJ3Op4Q%3D%3D

Having an anxiety disorder can make a major impact in the workplace. People may turn down a promotion or other opportunity because it involves travel or public speaking; make excuses to get out of office parties, staff lunches, and other events or meetings with coworkers; or be unable to meet deadlines.

In a national survey on anxiety in the workplace, people with anxiety disorders commonly cited these as difficult situations: dealing with problems; setting and meeting deadlines; maintaining personal relationships; managing staff; participating in meetings, and making presentations.

Tell Your Employer?

It’s your decision to tell your employer about your anxiety disorder. Some people do so because they need accommodations, others want to educate people about their condition, and some do not want to hide their illness.

If you have a physical or mental disability and are qualified to do a job, the Americans with Disabilities Act of 1990 (ADA) protects you from job discrimination. Being qualified means you must satisfy an employer’s requirements for the job and be able to perform essential functions on your own or with reasonable accommodation. An employer cannot refuse to hire you because your disability prevents you from performing duties that are not essential to the job. Find out more about employment rights.  

Tips to Manage Stress and Anxiety at Work

Getting stressed out at work happens to everyone, and it’s perfectly normal. But stress that is persistent, irrational, and overwhelming and impairs daily functioning may indicate an anxiety disorder. Keep these ideas in mind to keep your work life manageable:

• Work! In addition to financial reasons, working can be important for your self-esteem and it adds to your social identity.
• Tell a trusted coworker.Knowing that someone accepts your condition can be comforting and it may reduce any anticipatory anxiety about having a panic attack at work.
• Educate yourself.Learn to recognize the symptoms of your disorder and how to handle them if you experience any at work.
• Practice time management.Make to-do lists and prioritize your work. Schedule enough time to complete each task or project.
• Plan and prepare.Get started on major projects as early as possible. Set mini-deadlines for yourself. Anticipate problems and work to prevent them.
• Do it right the first time.Spend the extra time at the outset and save yourself a headache later when you have to redo your work.
• Be realistic.Don’t over commit or offer to take on projects if you don’t realistically have enough time.
• Ask for help.If you’re feeling overwhelmed, ask a coworker for help. Later you can return the favor.
• Speak up calmly and diplomatically if you have too much to handle. Your supervisor may not realize you’re overextended.
• Stay organized.Filing and clearing your desk and computer desktop may rank low on your priority list, but they can save you time in the long run and may prevent a crisis later.
• Avoid toxic coworkers.Try to ignore negativity and gossip in your workplace.
• Take breaks.A walk around the block or a few minutes of deep breathing can help clear your head.
• Set boundaries.Try not to bring work home with you. Don’t check your work e-mail or voice mail after hours.
• Savor success.Take a moment to celebrate your
• good work before moving on to the next project. Thank everyone who helped you.
• Plan a vacation.You’ll be rejuvenated and ready to work when you come back.
• Take advantage of employer resources and benefits. Your workplace may offer an Employee Assistance Program (EAP), discounts to gyms, or skill-building courses. Learn what’s available to you.
• Be healthy. Eat healthfully, get enough sleep, exercise regularly, and limit caffeine and alcohol. Try to keep your body and mind in shape to handle challenging situations.

Getting Help

It’s important to find help for anxiety, stress, and related disorders. Find a therapist near you.

With treatment, most people find significant improvement. Several standard approaches have proved effective. Your health care professional will use one or a combination of these treatments:

• Therapy
• Medication
• Complementary and alternative treatment

Source: https://adaa.org/managing-stress-anxiety-in-workplace/anxiety-disorders-in-workplace#