Friday, November 20, 2009

An intervention that can reduce hostile perceptions in children with prenatal alcohol exposure

  • Prenatal alcohol exposure (PAE) has been linked to significant impairments in social skills.
  • Researchers have found that a social- skills intervention called Children's Friendship Training can lead to a decrease in hostile attributions or perceptions of children with PAE.

Prenatal alcohol exposure (PAE) has been linked to a wide array of developmental deficits, including significant impairments in social skills. An examination of a social- skills intervention called Children's Friendship Training found that it led to a decrease in hostile attributions or perceptions of children with PAE.

Results will be published in the February 2010 issue of Alcoholism: Clinical & Experimental Research.

"Children with PAE have a hard time making and keeping friends," explained the study's corresponding author Vivien Keil, who was a staff research associate in the department of psychiatry and biobehavioral sciences at the David Geffen School of Medicine at UCLA when the research was conducted.

"More specifically, they tend to have difficulty understanding social cues and common social norms," she said. "In order to make and keep friends, we must be able to read social cues such as facial expressions and other body language. If a child makes hostile attributions, this means that s/he is more likely to perceive that the people around them are hostile or negative and, as a result, s/he is likely to respond in a hostile manner, thus undermining successful social relationships."

"These social problems are due, in part, to the neurological and cognitive deficits known to be associated with prenatal exposure to alcohol," said Joseph M. Price, a research scientist in the Children and Adolescent Services Research Center at Rady Children's Hospital in San Diego. "However, children prenatally exposed to alcohol are also more likely to be exposed to negative early-life experiences – such as unresponsive caregivers, maltreatment, disruptions in early parent-child interactions, and out-of-home placements – all of which are known to contribute to behavior and social problems during childhood and adolescence."

Price also said, given that these social problems may eventually lead to school problems, emotional and behavior problems, early school dropout, delinquency, and drug and alcohol use, that children who were prenatally exposed to alcohol will likely benefit from intervention efforts designed to improve their social skills and their relationships with peers and adults.

Researchers assigned 100 children (51 boys, 49 girls) with PAE, between 6 to 12 years of age, to one of two groups: Children's Friendship Training or a Delayed Treatment Control condition.

"The Children's Friendship Training decreased the level of hostile attributions made by children with PAE in group- entry scenarios, or those situations in which they were asked to join a group of similarly aged children in play activities," said Keil. "This means that when the children were asked about other children's intentions, they made fewer hostile attributions after the intervention. These findings are encouraging because hostile attributions were not the focus or target of the intervention. Rather, the intervention sought to improve children's social skills more broadly; decreased hostile attributions were merely a positive side-effect of the intervention and perhaps a mechanism of change."

"In short," added Price, "it appears that children's hostile interpretations of peers' social intentions, which have been found to be associated with aggressive behavior and peer rejection, can be modified by intervention efforts. What will be exciting to see is if the Children's Friendship Training procedure also improves other aspects of children's social information-processing patterns, such as social problem-solving skills or their evaluation of behavior outcomes, and improves the social behavior and peer relationships of children who have been exposed to alcohol during prenatal development."

"There are many reasons to be hopeful that children with PAE can overcome their weaknesses and reach their full potential," said Keil. "It is encouraging that a psychological intervention such as social-skills training seems to have resulted in improvements in more objective measures of child functioning such as social information-processing like hostile attributions rather than relying on more subjective parent reports of child functioning. These findings suggest that although there are neurocognitive deficits associated with prenatal alcohol exposure, children with PAE can make meaningful improvements in their social skills and overall functioning with the use of effective evidence-based treatments."

Source: An intervention that can reduce hostile perceptions in children with prenatal alcohol exposure

Smoking up nationally

Cigarette smoking rose slightly last year for the first time in almost 15 years.

A survey done in 2008 showed that just under 21 percent of Americans were cigarette smokers, according to the U.S. Centers for Disease Control and Prevention. The study was released earlier this month. That’s up slightly from 2007, when 19.8 percent said they were smokers.

In an effort to combat cigarette smoking, the American Lung Association, American Thoracic Society and Congress of Long Association Staff launched the Freedom from Smoking project in 1980.

Somerset Hospital will celebrate the Great American Smokeout from 10:30 a.m. to 2:30 p.m. Nov. 19 in the hospital main lobby.

“Smokers are invited to can their habit,” said Greg Chiappelli, director of corporate communications. “Just toss your cigarettes away in exchange for a cold turkey sub gift card from Subway.”

People may also use a monitor to measure the amount of carbon monoxide in their bodies and a pulse oximeter to measure the amount of oxygen in their blood, try the interactive smoking facts computer, sign paper balloons for the “In Our Hearts” banner for someone affected by tobacco and get tips on how to quit smoking.

Somerset Hospital also offers free smoking cessation classes. To register online for the next classes, which start in January, go to the Web site: stopsmokingsomerset.org.

Jennifer Hostetler, prevention specialist at Twin Lakes Center for Drug and Alcohol Rehabilitation, used to teach that smoking cessation class.

“People who attended all sessions quit smoking, but I don’t know if everyone stuck with it,” she said. “You learn to establish rewards for quitting, learn how to overcome cravings and other ways of dealing with stress.”

Quitting smoking is a learning process, she said. People may have to try several times to become successful. Statistics show that people who use the cessation program are six times more likely to be smoke-free one year later than those who try to quit on their own.

“The Freedom From Smoking cessation classes offer individuals a step-by-step plan for quitting,” Hostetler said. “The program focuses on how to quit and remain abstinent.”

A dietitian also talks about ways to avoid gaining weight after quitting smoking, she said.

“It is extremely important to quit smoking,” she said. “Lung cancer is the leading cause of cancer deaths. Smoking kills more Americans than homicides, suicides, car wrecks, drunk driving accidents, fires, alcohol, drugs and AIDS. More than 4 million people worldwide die of smoking-related diseases each year. The hospital class is free and if you attend the first four, you get free Chantix (a prescription medicine to help people stop smoking) that can cost $120 to $150. Most insurance won’t pay for it. There’s no nicotine in it — it blocks the receptors in the brain. But like any medication, there can be side effects.”

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FDA panel backs stronger benefit claims and safety profile for inhaler drug Spiriva

By Matthew Perrone

FDA panel backs safety, benefits of Spiriva

WASHINGTON — Federal health experts on Thursday brushed off lingering safety questions about a popular inhaler drug and suggested it carry bolder benefit claims.

The Food and Drug Administration’s panel of lung specialists voted 11-1 in favor of new labeling about the benefits of Boehringer Ingelheim’s Spiriva Handihaler, which is approved to treat lung disease.

The FDA is not required to follow the group’s advice though it usually does.

The German company submitted studies to the FDA showing Spiriva reduces specific side effects of chronic obstructive pulmonary disease, such as coughing, wheezing and shortness of breath.

“I thought both trials showed unequivocal evidence of benefit,” said panelist Daren Knoell, a pharmacy professor at Ohio State University.

Boehringer said in a statement it was pleased with the panel’s vote and would continue working with the FDA as it completes its review. A company spokeswoman declined to disclose the expected date for an FDA decision.

Spiriva is co-marketed in the U.S. by Pfizer Inc., the world’s largest drugmaker.

While Thursday’s meeting was prompted by Boehringer’s request for bolstered labeling claims, FDA regulators also asked the panel to examine conflicting evidence about whether Spiriva increases the risk of heart attack, stroke and death.

An analysis of multiple studies published in the Journal of the American Medical Association last year suggested increased risks with the inhaler. But panelists said a more definitive, 6,000-patient trial by the company did not show increased death, and suggested it can actually reduce that risk.

Panelists voted 11-1 that the company’s data “adequately address” concerns about increased stroke. They voted 11-0, with one abstention, that the same study addresses the issue of increased risk of heart attack.

Panel chair Dr. Mark Brantly said the company might eventually be able to win approval for a claim about the drug’s lifesaving powers.

“We encourage this be pursued as an indication in the future as an important outcome,” said Brantly, a professor of lung care at the University of Florida.

source

FDA panel backs stronger benefit claims and safety profile for inhaler drug Spiriva

By Matthew Perrone

FDA panel backs safety, benefits of Spiriva

WASHINGTON — Federal health experts on Thursday brushed off lingering safety questions about a popular inhaler drug and suggested it carry bolder benefit claims.

The Food and Drug Administration’s panel of lung specialists voted 11-1 in favor of new labeling about the benefits of Boehringer Ingelheim’s Spiriva Handihaler, which is approved to treat lung disease.

The FDA is not required to follow the group’s advice though it usually does.

The German company submitted studies to the FDA showing Spiriva reduces specific side effects of chronic obstructive pulmonary disease, such as coughing, wheezing and shortness of breath.

“I thought both trials showed unequivocal evidence of benefit,” said panelist Daren Knoell, a pharmacy professor at Ohio State University.

Boehringer said in a statement it was pleased with the panel’s vote and would continue working with the FDA as it completes its review. A company spokeswoman declined to disclose the expected date for an FDA decision.

Spiriva is co-marketed in the U.S. by Pfizer Inc., the world’s largest drugmaker.

While Thursday’s meeting was prompted by Boehringer’s request for bolstered labeling claims, FDA regulators also asked the panel to examine conflicting evidence about whether Spiriva increases the risk of heart attack, stroke and death.

An analysis of multiple studies published in the Journal of the American Medical Association last year suggested increased risks with the inhaler. But panelists said a more definitive, 6,000-patient trial by the company did not show increased death, and suggested it can actually reduce that risk.

Panelists voted 11-1 that the company’s data “adequately address” concerns about increased stroke. They voted 11-0, with one abstention, that the same study addresses the issue of increased risk of heart attack.

Panel chair Dr. Mark Brantly said the company might eventually be able to win approval for a claim about the drug’s lifesaving powers.

“We encourage this be pursued as an indication in the future as an important outcome,” said Brantly, a professor of lung care at the University of Florida.

source