Category: Health & Medicine

Research could change course of treatment for cancer that spreads to bones

Post author By Margaret Allen
Post date August 11, 2010

New research holds promise for the thousands of people whose cancer has spread to their bones.

A common treatment for such patients is radiation surgery &#8212 even though very little is known about radiosurgery’s impact on bone strength, says Edmond Richer, associate professor of engineering at Southern Methodist University in Dallas.

Researchers now hope to conclusively establish the effects of radiation on human bone under a $596,000 grant from the National Institutes of Health. The 15-month grant will look at cervical fractures that sometimes occur six to eight months after stereotactic radiosurgery, called SRS, in patients with vertebral metastases.

SMU and UT Southwestern partnership
The researchers include Richer, the Robert C. Womack Endowed Chair of mechanical engineering and founder of the Biomedical Instrumentation and Robotics Laboratory in SMU’s Bobby B. Lyle School of Engineering, and Paul Medin, John Anderson and Joseph Zerwekh, professors at UT Southwestern Medical Center at Dallas.

The grant from NIH’s Neurological Disorders and Stroke Institute could transform treatment for patients with cancer metastases in the bone, as well as for millions with other bone diseases, such as osteoporosis, Richer says. According to the American Osteoporosis Foundation, an estimated 10 million Americans have the disease and 34 million more are at risk of developing it.

High fracture rate post-radiosurgery
Vertebral metastases occur in approximately 100,000 cancer patients annually, most of whom have major lung, breast, prostate, renal and myeloma malignancies, Richer says. SRS, considered a noninvasive procedure for treating spinal tumors, requires highly sophisticated instruments that deliver a precise amount of radiation to the targeted lesion.

A fracture rate of up to 39 percent has been reported in post-radiosurgery patients who receive high doses of radiation. The potentially devastating consequences of fractures include disabling pain, limited mobility and incontinence, Richer says.

“It’s a growing concern for radiology oncologists because there’s not much that can be done medically to reverse those problems,” he says, noting that advances in SRS technology outpace the research on its complex effects on bone.

“We began looking at the history of radiosurgery, and as algorithms and instruments have become more refined in the computation of doses and the delivery of radiation, the number of required treatments has decreased to a single procedure,” he says. “The issue of what happens to bone strength when the treatment goes from six lower-grade doses, each a month apart, to a single high-grade dose is an area practically void of research over the past 30 years.”

Gauging mechanical strength of bone
Richer’s focus for the project is on gauging the mechanical strength of bone and how it is affected. Assisting him is Julie Pollard, an SMU engineering graduate student, and Jessica Steinmann-Hermsen, a senior majoring in mechanical engineering and math.

“We’re looking at nondestructive modalities to determine bone strength,” specifically ultrasound technology, says Richer. While a bone mineral density test provides an accurate picture of calcium and other minerals in a segment of bone, it doesn’t measure the actual strength of the bone, he says.

Builds on earlier ultrasound instrument research
The project builds on Richer’s previous research to develop an ultrasound instrument that determines the elasticity of human bone. The instrument is under review by the U.S. Food and Drug Administration.

An abstract of the research by Richer and his collaborators has been accepted by the Acoustical Society of America, an international scientific society for sound-related fields, including biomedical ultrasound, for presentation at its biannual meeting in November. “Reduction of Ultrasound Propagation Velocity in Porcine Vertebrae Following Stereotactic Radiosurgery” was also selected for oral presentation at the meeting.

Richer supports interdisciplinary collaboration on research in medical robotics and advanced imaging techniques.

“Successful research is the result of free communication and thinking,” he says. “When engineers and physicians come together to discuss seemingly crazy ideas, frequently it turns out they’re not. And bringing them to fruition can help people in ways that neither the engineers nor the physicians imagined by themselves.” &#8212 Patricia Ward

Tags Edmond Richer, Jessica Steinmann-Hermsen, Julie Pollard, Lyle School of Engineering

Culture, Society & Family Health & Medicine Researcher news SMU In The News

UPI: Abusive mothers can improve parenting

Post author By Margaret Allen
Post date August 6, 2010

UPI covered the research of SMU psychologists Ernest Jouriles, Renee McDonald, David Rosenfield and Deborah Corbitt-Shindler in a July 30 story “Abusive mothers can improve parenting.”

EXCERPT:

DALLAS, July 30 (UPI) — Abusive mothers, who are taught parenting skills and given emotional support, can improve their parenting skills, two U.S. researchers say.

Ernest Jouriles and Renee McDonald of Southern Methodist University in Dallas say parenting improved in impoverished, neglectful, abusive mothers after home visits, classes and emotional support from therapists.

The study, published in the Journal of Family Psychology, says large improvements in mothers’ parenting were observed in families given instruction and emotional support compared to families that did not receive the services.

Jouriles is professor and chairman of the SMU Psychology Department. McDonald and Rosenfield are associate professors. Corbitt-Shindler is a psychology department doctoral candidate.

Read the full story: “Abusive mothers can improve parenting”

Tags David Rosenfield, Deborah Corbitt-Shindler, Dedman College, Ernest Jouriles, Renee McDonald, SMU Department of Psychology, SMU Family Research Center

Culture, Society & Family Health & Medicine Mind & Brain

Mad? Sad? Glad? People with severe mental illness can’t easily “read” their partner’s feelings; but there may be help

Post author By Margaret Allen
Post date June 28, 2010

For a healthy couple in a romantic relationship, getting along can be hard enough. But what if one person has been diagnosed with schizophrenia, bipolar disorder or major depression?

Adding severe mental illness into the mix can make it even harder to keep a relationship healthy, happy and satisfying, say psychologists Amy Pinkham and Lorelei Simpson, both assistant professors in the Department of Psychology at Southern Methodist University, Dallas.

A new research project by Pinkham and Simpson aims to understand how relationships function where one person has been diagnosed with a severe mental illness. Their study takes a close look at how couple relationships function when one partner has difficulties with the important social ability called “social cognition.”

Failure to understand emotional cues

Social cognition is the ability to understand social information and accurately read and interpret another person’s feelings, to understand their perspective, and then respond appropriately.

Social cognition is commonly lacking or deficient in people with severe mental illness, say Pinkham and Simpson. For example, an ill individual may think their partner is angry when in fact the person is unhappy.

Understanding these deficits could lead to treatments to address social cognition deficits within relationships, say Pinkham and Simpson.

Pinkham and Simpson hope to develop programs for people with severe mental illness to help them improve the social skills critical for them to maintain a happy relationship.

“Understanding a partner’s viewpoint and emotions is key to many relationship skills,” says Simpson. “The social cognition deficits among people with severe mental illness may help explain their greater risk for relationship distress.”

More episodes of domestic abuse
People with severe mental illness tend to have more episodes of intimate partner violence and greater relationship discord, say Pinkham and Simpson. It’s possible that deficits in social cognition may play a role in these negative outcomes, they say.

Over the next few months, the researchers will recruit 60 couples from ethnically diverse backgrounds between the ages of 18 and 65. They will compare social cognition deficits and relationship functioning in couples in which one partner has a severe mental illness to couples in which neither partner has severe mental illness.

The researchers will assess the couples and analyze the data over the next 12 months. The Texas-based Hogg Foundation for Mental Health has awarded the psychologists a one-year, $15,000 grant to fund the study.

Study may provide treatment roadmap

Pinkham and Simpson say they expect to find that impairments in social cognition do detract from a couple’s efforts at a happy relationship.

They hope this initial study will improve understanding of the problems leading to relationship distress that are commonly seen in these couples.

They also expect that the study will lead to longitudinal and treatment studies that will enable them to develop recommendations for treatment and therapy that can help people with severe mental illness overcome the deficit.

“In the last five years, several treatment programs have been developed that show considerable promise for improving social cognitive abilities in individuals with a severe mental illness. If we find that social cognition does contribute to relationship satisfaction, we may be able to extend these same treatments to couples therapy,” says Pinkham.

Pinkham has expertise in social cognition and has investigated social cognitive impairments in people with severe mental illness for the past 10 years. Simpson’s expertise is with couple relationship functioning, couples therapy and couples facing severe mental illness.

About 6 percent of people in the United States suffer from serious mental illness, according to the National Institute of Mental Health.

Due to newer, more effective medications, as well as advances in behavioral therapy, more people with severe mental illness are able to function at higher levels, including maintaining long-term relationships like marriage, say the psychologists.

First study of its kind
However, the illness still takes a toll on people with severe mental illness and their relationships with others. Improving their ability to function is essential for better quality of life, say Pinkham and Simpson.

Over the past 20 years, researchers have studied severe mental illness and social cognitive impairment. But this will be the first study to examine the role of social cognition in how couple relationships function when one person has severe mental illness, say Pinkham and Simpson.

Much of the research on severe mental illness has focused on treating symptoms. But treating symptoms doesn’t necessarily give them skills by which to improve their relationships, say Pinkham and Simpson.

The Pinkham-Simpson study is one of 12 Texas research projects to receive funding from the Hogg Foundation, which was founded to promote improved mental health for Texans.

“Academic research is an important tool in our quest to understand the complexities of mental health,” said Octavio N. Martinez Jr., executive director of the foundation in announcing the awards. “The Hogg Foundation selected these projects because they address issues that profoundly affect people’s lives.”

Tags Amy Pinkham, Lorelei Simpson, Lorelei Simpson Rowe, SMU Department of Psychology

Health & Medicine Mind & Brain Researcher news SMU In The News

TIME magazine: SMU’s Jasper Smits says exercise can help alleviate anxiety, depression

Post author By Margaret Allen
Post date June 21, 2010

Exercise is a great way to alleviate anxiety and depression, according to a new article in TIME magazine that features the research of SMU psychologist Jasper Smits.

Exercise is free and has no side effects, says the June 19 article “Is Exercise the Best Drug for Depression?” by Laura Blue. “Compare that with antidepressant drugs, which cost Americans $10 billion each year and have many common side effects: sleep disturbances, nausea, tremors, changes in body weight,” writes Blue.

Smits has said that more therapists should prescribe exercise as an effective treatment. He co-authored a book detailing how exercise can provide relief for people who struggle with depression and anxiety disorders.

Smits and Michael Otto, psychology professor at Boston University, analyzed numerous studies and determined exercise should be more widely prescribed by mental health care providers.

They presented their findings to researchers and mental health care providers March 6 at the Anxiety Disorder Association of America’s annual conference in Baltimore. Their workshop was based on their therapist guide “Exercise for Mood and Anxiety Disorders,” with accompanying patient workbook (Oxford University Press, September 2009).

The guide draws on dozens of population-based studies, clinical studies and meta-analytic reviews that demonstrate the efficacy of exercise programs, including the authors’ meta-analysis of exercise interventions for mental health and study on reducing anxiety sensitivity with exercise.

EXCERPT:
By Laura Blue
TIME magazine
At his research clinic in Dallas, psychologist Jasper Smits is working on an unorthodox treatment for anxiety and mood disorders, including depression. It is not yet widely accepted, but his treatment is free and has no side effects. Compare that with antidepressant drugs, which cost Americans $10 billion each year and have many common side effects: sleep disturbances, nausea, tremors, changes in body weight.

This intriguing new treatment? It’s nothing more than exercise.

That physical activity is crucial to good health — both mental and physical — is nothing new. As early as the 1970s and ’80s, observational studies showed that Americans who exercised were not only less likely to be depressed than those who did not, but were also less likely become depressed in the future.

In 1999, Duke University researchers demonstrated in a randomized controlled trial that depressed adults who participated in an aerobic exercise plan improved as much as those treated with sertraline, the drug that was marketed as Zoloft, and was earning Pfizer more than $3 billion annually before its patent expired in 2006.

Subsequent trials have repeated these results, showing again and again that patients who undergo aerobic exercise regimens see comparable improvement in their depression as those treated with medication, and that both groups do better than patients given only a placebo. But exercise trials on the whole have been small and most have run only for a few weeks; some are plagued by methodological problems.

Still, despite limited data, the trials all seem to point in the same direction: Exercise boosts mood. It not only relieves depressive symptoms, but appears to prevent them from recurring.

“I was really surprised that more people weren’t working in this area when I got into it,” says Smits, an associate professor of psychology at Southern Methodist University.

Read the full article

Tags Dedman College, Jasper Smits, SMU Department of Psychology

Culture, Society & Family Health & Medicine Mind & Brain Researcher news

SMU anthropologist to study mental health care needs of abused Mexican women immigrants

Post author By Margaret Allen
Post date June 9, 2010

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An abused woman who seeks medical help may recover more quickly if health care providers understand her culture, and her social and economic background, says Nia Parson, a medical anthropologist in SMU’s Department of Anthropology.

How can mental health providers best help an abused woman who is a Mexican immigrant?

Scant research has been done to answer that question, Parson says, even though in Texas 39 percent of Hispanic women report experiencing severe abuse. For that reason, the Hogg Foundation for Mental Health in Austin has awarded Parson a one-year, $15,000 grant to examine the mental health care needs of Mexican immigrant women who have sought help after abuse by a boyfriend or a husband.

Abused suffer depression, PTSD, chronic ailments

Abused women suffer not only physical injuries, but often develop other ailments as well, such as depression, anxiety, post-traumatic stress disorder and chronic headaches and backaches. They may seek treatment for those problems in emergency rooms, or public or private clinics.

Delivering care in a way that takes into account a person’s cultural and socio-economic background is termed “cultural competency.” However, medical anthropologists have pointed to the need to move beyond notions of culture that are static, stereotypical, and politically and economically without context.

“It is important to recognize the particular situations of abused women who are immigrants and the specific kind of challenges to their recoveries from the abuse, such as a lack of social and family networks, unfamiliarity with social service systems, language barriers and fear of deportation. It is also crucial to examine diversity of experiences within groups, which this research will also do. Not all Mexican immigrants come from the same backgrounds and share the same experiences,” Parson says.

Minorities get lower quality care

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Racial and ethnic minorities are less likely to receive needed mental health services and are more likely to receive lower quality care, according to research cited by the Office of Women’s Health, U.S. Department of Health and Human Services, in its report “Action Steps for Improving Women’s Mental Health.” The report — based on the landmark “Mental Health: A Report of the Surgeon General in 1999” — calls for expanding cultural competence across mental health research, training and services. The report also calls for more gender and cultural diversity in mental health academic research and medicine.

Cultural competency could benefit Hispanics and other minorities, according to the 2009 “National Healthcare Disparities Report” by the U.S. Department of Health and Human Services. According to the report: “Culturally and linguistically appropriate services can decrease the prevalence, incidence, severity, and duration of certain mental disorders.”

The Hogg Foundation in 2005 declared cultural competence one if its priority funding areas. Stating that more than half the population of Texas is ethnic and racial minorities, the foundation says its goal is to increase the availability of effective mental health services for people of color.

Parson already has done some research on cultural competency. In a 2006-07 study of Spanish-speaking immigrant women in New Jersey, Parson found that health care and social services suited for these women were detrimentally lacking.

She also has published research on the struggle for abused women to find adequate and appropriate treatment in Santiago, Chile.

Culturally competent care is beneficial

Hogg Foundation: Providing Evidence-Based Practices to Populations of Color

Texas Council on Family Violence Report: Family Violence in Texas

For some immigrant women, Parson speculates, the proper response might include a public health clinic embedded in the community, or social networks that keep women from feeling isolated. Or it could be that immigrant women need more help finding legal services, getting help with language and computer skills, or connecting with their children’s schools.

“Ultimately, from this research I’d like to broaden our conceptualizations of cultural competency in health care and to have something of value to say to policymakers,” Parson says.

Parson will begin the research this summer. Aided by anthropology graduate student Carina Heckert, Parson will interview 100 women who immigrated to Dallas from Mexico. She and Heckert, along with select undergraduates, will recruit women through The Family Place, a Dallas-based agency that helps victims of family violence by providing intervention, shelter and counseling.

Research to address immigrant women
“Domestic violence research has been conducted over the last 40 years, since the early 1970s,” Parson says. “However, we don’t have much specialized knowledge about how to address the mental health impacts in immigrant women. Recognition of domestic violence as a health issue emerged in the 1990s. And there’s very little research on domestic violence and cultural competency in health care, especially from an anthropological perspective. Medical anthropologists have a lot to contribute to knowledge about how to address mental health problems in diverse populations.”

Parson is one of 12 Texas researchers to receive a research grant from the Hogg Foundation, which promotes improved mental health for Texans.

“Academic research is an important tool in our quest to understand the complexities of mental health,” said Octavio N. Martinez Jr., executive director of the foundation, in announcing the awards. “The Hogg Foundation selected these projects because they address issues that profoundly affect people’s lives.” — Margaret Allen

Tags Dedman College, Nia Parson, SMU Department of Anthropology

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