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Gluten Free Recipe:
Pumpkin Spice Overnight Oats
- 1/4 cup pumpkin puree
- 1/2 cup old-fashioned or rolled oats
- 1 cup unsweetened vanilla almond milk (any milk works)
- 1/2 teaspoon pumpkin spice
- 1/2 teaspoon cinnamon
- 2 teaspoons maple syrup
- 1/4 cup chopped candied pecans (optional but delicious)
- Mix all the ingredients in a jar. Stir to combine and cover.
- Place in the fridge overnight.
- The next morning, remove and eat in the jar or place in a pot over medium high heat to reheat the oatmeal, or in the microwave to reheat if a microwave safe jar for about 45 seconds. Top with candied pecans, raisins, coconut flakes and more maple syrup (or anything else you want!). Enjoy!
- This recipe is vegan and gluten free. You can adjust the quantities of pumpkin if you'd like less pumpkin to just 2 tablespoons.
- You can also adjust sweetness levels after it's set up in the fridge and add more maple syrup if you desire. You can also use agave nectar or honey instead.
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Seven steps to keep your brain healthy from childhood to old age
- September 7, 2017
- American Heart Association
|A healthy lifestyle benefits your brain as much as the rest of your body -- and may lessen the risk of cognitive decline (a loss of the ability to think well) as you age, according to a new advisory from the American Heart Association/American Stroke Association.|
Both the heart and brain need adequate blood flow, but in many people, blood vessels slowly become narrowed or blocked over the course of their life, a disease process known as atherosclerosis, the cause of many heart attacks and strokes. Many risk factors for atherosclerosis can be modified by following a healthy diet, getting enough physical activity, avoiding tobacco products and other strategies.
"Research summarized in the advisory convincingly demonstrates that the same risk factors that cause atherosclerosis, are also major contributors to late-life cognitive impairment and Alzheimer's disease. By following seven simple steps -- Life's Simple 7 -- not only can we prevent heart attack and stroke, we may also be able to prevent cognitive impairment," said vascular neurologist Philip Gorelick, M.D., M.P.H., the chair of the advisory's writing group and executive medical director of Mercy Health Hauenstein Neurosciences in Grand Rapids, Michigan.
Life's Simple 7 outlines a set of health factors developed by the American Heart Association to define and promote cardiovascular wellness. Studies show that these seven factors may also help foster ideal brain health in adults.
The Life's Simple 7 program urges individuals to:
A healthy brain is defined as one that can pay attention, receive and recognize information from our senses; learn and remember; communicate; solve problems and make decisions; support mobility and regulate emotions. Cognitive impairment can affect any or all of those functions.
The advisory, which is published in the American Heart Association's journal Stroke, stresses the importance of taking steps to keep your brain healthy as early as possible, because atherosclerosis -- the narrowing of the arteries that causes many heart attacks, heart failure and strokes -- can begin in childhood. "Studies are ongoing to learn how heart-healthy strategies can impact brain health even early in life," Gorelick said. Although more research is needed, he said, "the outlook is promising."
Elevations of blood pressure, cholesterol and blood sugar can cause impairment of the large and smaller blood vessels, launching a cascade of complications that reduce brain blood flow. For example, high blood pressure -- which affects about 1 in 3 U.S. adults -- is known to damage blood vessels that supply oxygen and nutrients to the heart and the brain, Gorelick noted. The damage can lead to a buildup of fatty deposits, or atherosclerosis as well as associated clotting. This narrows the vessels, can reduce blood flow to the brain, and can cause stroke or "mini-strokes." The resulting mental decline is called vascular cognitive impairment, or vascular dementia.
Previously, experts believed problems with thinking caused by Alzheimer's disease and other, similar conditions were entirely separate from stroke, but "over time we have learned that the same risk factors for stroke that are referred to in Life's Simple 7 are also risk factors for Alzheimer's disease and possibly for some of the other neurodegenerative disorders," Gorelick said.
The advisory also recognizes that it is important to follow previously published guidance from the American Heart Association, Institute of Medicine and Alzheimer's Association, which include controlling cardiovascular risks and suggest social engagement and other related strategies for maintaining brain health.
The action items from Life's Simple 7, which are based on findings from multiple scientific studies, meet three practical rules the panel developed in pinpointing ways to improve brain health -- that they could be measured, modified and monitored, Gorelick said. Those three criteria make it possible to translate knowledge into action because healthcare providers can assess Life's Simple 7 elements -- like blood pressure -- easily; they can encourage proven, health-promoting steps and they can gauge changes over time.
The AHA advisory provides a foundation on which to build a broader definition of brain health that includes other influential factors, Gorelick said, such as the presence of atrial fibrillation, a type of irregular heartbeat that has been linked to cognitive problems; education and literacy; social and economic status; the geographic region where a person lives; other brain diseases and head injuries.
It is also a starting point for expanding research into areas such as whether there might be detectable markers, like genetic or brain imaging findings, that represent a susceptibiity for cardiovascular or brain illness, Gorelick said. "At some point in our lives, a 'switch' may be getting ready to 'flip,' or activate, that sets us in a future direction whereby we become at-risk for cognitive impairment and dementia."
Dementia is costly to treat. Direct care expenses are higher than for cancer and about the same for heart disease, estimates show. Plus, the value of unpaid caregiving for dementia patients may exceed $200 billion a year.
As lives stretch longer in the U.S. and elsewhere, about 75 million people worldwide could have dementia by 2030, according to the advisory. "Policy makers will need to allocate healthcare resources for this," Gorelick said. Monitoring rates of dementia in places where public health efforts are improving heart health "could provide important information about the success of such an approach and the future need for healthcare resources for the elderly," he said.
The authors of the advisory reviewed 182 published scientific studies to formulate their conclusions that following Life's Simple 7 has the potential to help people maintain a healthy brain throughout life.
American Heart Association. "Seven steps to keep your brain healthy from childhood to old age." ScienceDaily. ScienceDaily, 7 September 2017. <www.sciencedaily.com/releases/2017/09/170907142642.htm>.
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Clinic Seeks Answers to Concussions
Players believe they have CTE,
but can’t be sure
October 8, 2017
By A.J. Perez
USA Today Sports
The announcement last month that Aaron Hernandez had chronic traumatic encephalopathy (CTE) when he committed suicide while in prison did not come as a surprise to many former NFL players.
That’s because they suspect they have the degenerative brain disease too.
Former Kansas City Chiefs running back Larry Johnson said on Twitter he’s “certain” he has CTE, which has been diagnosed posthumously in 111 former NFL players. Pro Football Hall of Fame receiver Cris Carter said he lives in “fear of the unknown.” Husain Abdullah, who retired at 30 last year after suffering his fifth concussion, told USA TODAY Sports that former players know “things can get bad and get bad in a hurry.”
Worst of all for these players and other athletes is there is no reliable way to test for CTE in the living. And there is also no treatment for anybody with symptoms of the disease.
However, several former NFL, college and high school football players and other athletes say they are finding success at a recovery center in Southern California that claims to help rehabilitate brains suffering from the effects of repeated and severe trauma.
“I didn’t think it was something that could be fixed,” Jermichael Finley told USA TODAY Sports. He retired from the Green Bay Packers in 2015 after he says he suffered five concussions in his football career.
“I noticed irritability began to set in and really didn’t know what to do. When I heard about the place, my first thought was, ‘Man, this is not my kind of deal.’ I was told to think outside the box and see what’s going on with my brain.”
Pure Recovery California Center, located in this beach town about 60 miles north of Los Angeles, was founded in 2014 by Deborah Whitney, a former executive for health care companies that developed and sold medical devices. According to Whitney, the clinic has treated two active NFL players, 12 former NFL players and six current college football players in 2017.
The current NFL players sought treatment on their own, either as free agents or while they were suspended. Citing patient privacy laws, Whitney said she’s unable to provide the names of the players without consent.
“I think this is going to be huge,” Finley said after six weeks of treatment.
Whitney said the athletes who have come to the facility have shown the telltale signs of brain injury: impulsive behavior, depression, suicidal thoughts, irritability, sleep disorders and shortterm memory loss.
Those are the symptoms associated with the early stages of CTE, something Boston University’s CTE Center — the outfit that diagnosed CTE in Hernandez and 110 former NFL players — reported last month could soon be diagnosed in living patients through blood testing. When it opened, Pure Recovery first focused on treating substance abuse.
“What struck me is that they had so many things wrong with them related to their brains,” Whitney said. “I didn’t understand why all these people, who we all enjoyed watching when they were players, weren’t getting the support many so desperately needed. That’s when I started to reach out to the top experts in the field to see what was medically available.”
Treatment at Pure Recovery begins with a quantitative electroencephalogram (qEEG), which measures electrical activity in the brain. The results are compared to those taken from people of the same age and gender and then used to generate a three-dimensional map of the brain that highlights areas that might not be functioning normally.
Pure Recovery incorporates pulsed magnetic field stimulation (PMFS), a non-invasive technique in which magnetic fields are used to help spur the brain’s electrical activity. While not used as much as PMFS, the clinic can use pulse electrical stimulation, in which small electrical currents stimulate nerve cells within targeted areas of the brain. That therapy is derived from the controversial electroshock therapy.
“It’s not One Flew Over the Cuckoo’s Nest ,” said Harry Kerasidis, a neurologist who has helped develop Pure Recovery’s program. “We have come a long way since then. One of the nice things about stimulation therapy is that it does not take a lot of energy. You don’t have to induce a shock that even results in a twitch and definitely not convulsions.”
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How Anxiety Leads to Disruptive Behavior
By Caroline Miller
|A 10-year-old boy named James has an outburst in school. Upset by something a classmate says to him, he pushes the other boy, and a shoving-match ensues. When the teacher steps in to break it up, James goes ballistic, throwing papers and books around the classroom and bolting out of the room and down the hall. He is finally contained in the vice principal’s office, where staff members try to calm him down. Instead, he kicks the vice principal in a frenzied effort to escape. The staff calls 911, and James ends up in the Emergency Room.|
To the uninitiated, James looks like a boy with serious anger issues. It’s not the first time he’s flown out of control. The school insists that his parents pick him up and take him home for lunch every day because he’s been banned from the cafeteria.
But what’s really going on? “It turns out, after an evaluation, that he is off the charts for social anxiety,” reports Dr. Jerry Bubrick, director of the Anxiety & Mood Disorders Center at the Child Mind Institute. “He can’t tolerate any—even constructive—criticism. He just will shut down altogether. James is terrified of being embarrassed, so when a boy says something that makes him uncomfortable, he has no skills to deal with it, and he freaks out. Flight or fight.”
James’s story illustrates something that parents and teachers may not realize—that disruptive behavior is often generated by unrecognized anxiety. A child who appears to be oppositional or aggressive may be reacting to anxiety—anxiety he may, depending on his age, not be able to articulate effectively, or not even fully recognize that he’s feeling.
“Especially in younger kids with anxiety you might see freezing and clinging kind of behavior,” says Dr. Rachel Busman, a clinical psychologist at the Child Mind Institute, “but you can also see tantrums and complete meltdowns.”
A great masquerader
Anxiety manifests in a surprising variety of ways in part because it is based on a physiological response to a threat in the environment, a response that maximizes the body’s ability to either face danger or escape danger. So while some children exhibit anxiety by shrinking from situations or objects that trigger fears, some react with overwhelming need to break out of an uncomfortable situation. That behavior, which can be unmanageable, is often misread as anger or opposition.
“Anxiety is one of those diagnoses that is a great masquerader,” explains Dr. Laura Prager, director of the Child Psychiatry Emergency Service at Massachusetts General Hospital. “It can look like a lot of things. Particularly with kids who may not have words to express their feelings, or because no one is listening to them, they might manifest their anxiety with behavioral dysregulation.”
The more commonly recognized symptoms of anxiety in a child are things like trouble sleeping in his own room or separating from his parents, avoidance of certain activities, a behaviorally inhibited temperament. “Anyone would recognize those symptoms,” notes Dr. Prager, co-author of Suicide by Security Blanket, and Other Stories from the Child Psychiatry Emergency Service. But in other cases the anxiety can be hidden.
“When the chief complaint is temper tantrums, or disruption in school, or throwing themselves on the floor while shopping at the mall, it’s hard to know what it means,” she explains. “But it’s not uncommon, when kids like that come in to the ER, for the diagnosis to end up being a pretty profound anxiety disorder.”
To demonstrate the surprising range of ways young children express anxiety, Dr. Prager mentions a case she had just seen of a young child who presented with hallucinations, but whose diagnosis she predicted will end up being somewhere on the anxiety spectrum. “Little kids who say they’re hearing things or seeing things, for example, may or may not be doing that. These may not be the frank hallucinations we see in older patients who are schizophrenic, for example. They might be a manifestation of anxiety and this is the way the child expresses it.”
Problems at school
It’s not uncommon for children with serious undiagnosed anxiety to be disruptive at school, where demands and expectations put pressure on them that they can’t handle. And it can be very confusing to teachers and other staff members to “read” that behavior, which can seem to come out of nowhere.
Dr. Nancy Rappaport, a Harvard Medical School professor who specializes in mental health care in school settings, sees anxiety as one of the causes of disruptive behavior that makes classroom teaching so challenging. “The trouble is that when kids who are anxious become disruptive they push away the very adults who they need to help them feel secure,” notes Dr. Rappaport. “And instead of learning to manage their anxiety, they end up spending half the day in the principal’s office.”
Dr. Rappaport sees a lot of acting out in school as the result of trauma at home. “Kids who are struggling, not feeling safe at home,” she notes, “can act like terrorists at school, with fairly intimidating kinds of behavior.” Most at risk, she says, are kids with ADHD who’ve also experienced trauma. “They’re hyper-vigilant, they have no executive functioning, they misread cues and go into combat.”
Giving kids tools to handle anxiety
When a teacher is able to build a relationship with a child, to find out what’s really going on with him, what’s provoking the behavior, she can often give him tools to handle anxiety and prevent meltdowns. In her book, The Behavior Code: A Practical Guide to Understanding and Teaching the Most Challenging Students, Dr. Rappaport offers strategies kids can be taught to use to calm themselves down, from breathing exercises to techniques for distracting themselves.
“When a teacher understands the anxiety underlying the opposition, rather than making the assumption that the child is actively trying to make her miserable, it changes her approach,” says Dr. Rappaport, “The teacher is able to join forces with the child himself and the school counselor, to come up with strategies for preventing these situations.”
If it sounds labor-intensive for the teacher, it is, she notes, but so is dealing with the aftermath of the same child having a meltdown.
Anxiety confused with ADHD
Anxiety also drives a lot of symptoms in a school setting that are easily misconstrued as ADHD or defiant behavior.
“I’ll see a child who’s having difficulty in school: not paying attention, getting up out of his seat all the time, asking a lot of questions, going to the bathroom a lot, getting in other kids’ spaces,” explains Dr. Busman. “His behavior is disrupting other kids, and is frustrating to the teacher, who’s wondering why she has to answer so many questions, and why he’s so wrapped up in what other kids are doing, whether they’re following the rules.”
People tend to assume what’s happening with this child is ADHD inattentive type, but it’s commonly anxiety. Kids with OCD, mislabeled as inattentive, are actually not asking all those questions because they’re not listening, but rather because they need a lot of reassurance.
How to identify anxiety
“It probably occurs more than we think, either anxiety that looks disruptive or anxiety coexisting with disruptive behaviors,” Dr. Busman adds. “It all goes back to the fact that kids are complicated and symptoms can overlap diagnostic categories, which is why we need to have really comprehensive and good diagnostic assessment.”
First of all, good assessment needs to gather data from multiple sources, not just parents. “We want to talk to teachers and other people involved with the kid’s life,” she adds, “because sometimes kids that we see are exactly the same at home and at school, sometimes they are like two different children.”
And it needs to use rating scales on a full spectrum of behaviors, not just the area that looks the most obvious, to avoid missing things.
Dr. Busman also notes that a child with severe anxiety who’s struggling in school might also have attentional or learning issues, but she might need to be treated for the anxiety before she can really be evaluated for those. She uses the example of a teenager with OCD who she’s “doing terribly” in school. “She’s ritualizing three to four hours a day, and having constant intrusive thoughts—so we need to treat that, to get the anxiety under control before we ask, how is she learning?”
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Handheld Screen Time Linked to Delayed Speech Development
The ASHA Leader
Children who use handheld screens—smartphones, tablets and electronic games—before they begin to talk may be at higher risk for speech delays, according to research presented at the 2017 Pediatric Academic Societies Meeting.
A team led by Catherine Birken, the study’s principal investigator and a staff pediatrician and scientist at The Hospital for Sick Children (SickKids) in Toronto, examined 894 children (ages 6 months to 2 years) participating in TARGet Kids!, a Toronto practice-based research network, between 2011 and 2015.
By their 18-month check-ups, 20 percent of the children had daily average handheld device use of 28 minutes, as reported by their parents. Using a screening tool for language delay, researchers found that the more handheld screen time a child’s parent reported, the more likely the child was to have expressive speech delays.
Each 30-minute increase in handheld screen time translated into a 49 percent increased risk of expressive speech delay. Researchers found no apparent link between handheld screen time and other communication delays, such as social interactions, body language or gestures.
The results support a recent American Academy of Pediatrics recommendation to discourage any type of screen media in children younger than 18 months.