When it comes to preventing Alzheimer's, women respond better than men

April 26, 2022

Science Daily/Florida Atlantic University

A study is the first to examine if sex significantly affects cognitive outcomes in people who follow individually-tailored, multi-domain clinical interventions. The study also determined whether change in risk of developing cardiovascular disease (CVD) and Alzheimer's disease (AD), along with blood markers of AD risk, also were affected by sex. Results showed that while care in an Alzheimer's Prevention Clinic setting is equally effective at improving cognitive function in both women and men, the personally-tailored interventions used by the researchers led to greater improvements in women compared to men across AD and CVD disease risk scales, as well blood biomarkers of risk such as blood sugar, LDL cholesterol, and the diabetes test HbA1C. Findings are important because women are disproportionately affected by AD and population-attributable risk models suggest that managing risk factors can prevent up to one-third of dementia cases.

After increasing age, the most significant risk factor for Alzheimer's disease (AD) is sex -- two-thirds of patients with AD are females. In fact, even when accounting for gender-dependent mortality rates, age at death, and differences in lifespan, women still have twice the risk of incidence.

A study headed by Florida Atlantic University's Richard S. Isaacson, M.D., a leading neurologist and researcher, and collaborators from NewYork-Presbyterian/Weill Cornell Medicine, is the first to examine if sex significantly affects cognitive outcomes in people who follow individually-tailored, multi-domain clinical interventions. The study also determined whether change in risk of developing cardiovascular disease and AD, along with blood markers of AD risk, also were affected by sex. Other studies have focused on the role of hormones and sex-specific risk factors when examining differences in AD risk, but none have explored if these interventions result in differences in real-world clinical practice.

The study is an analysis of the Comparative Effectiveness Dementia & Alzheimer's Registry (CEDAR) trial launched at Weill Medicine in 2015 and spearheaded by Isaacson, which has already demonstrated that individualized, multi-domain interventions improved cognition and reduced the risk of AD in both women and men.

In the sub-group analysis, researchers evaluated the differential effectiveness of the clinical approach itself when considering sex in higher-compliance participants (n=80) from the original study cohort (n=154). Within this cohort, similar to the original study, participants were categorized by baseline diagnoses: normal cognition, subjective cognitive decline, and preclinical AD participants were classified as "Prevention." Mild cognitive impairment due to AD and mild AD were classified as "Early Treatment."

Results of the study, published in the Journal of Prevention of Alzheimer's Disease, showed that risk reduction care in an Alzheimer's Prevention Clinic setting led to improvements in cognition in both women and men without sex-differences. However, in the Prevention group, women demonstrated greater improvements in the Multi-Ethnic Study of Atherosclerosis risk score (MESA) than men. Women in the Early Treatment group also demonstrated greater improvements in CV Risk Factors, Aging and Incidence of Dementia (CAIDE) risk score and the MESA-RS. The CAIDE is a validated risk index that calculates late-life dementia risk based on midlife vascular risk factors such as body mass index, blood pressure, cholesterol and smoking status, while the MESA estimates one's risk of cardiovascular disease incidence over the next ten years using traditional risk factors.

"While care in an Alzheimer's Prevention Clinic setting is equally effective at improving cognitive function in both women and men, our personally-tailored interventions led to greater improvements in women compared to men across Alzheimer's and cardiovascular disease risk scales, as well blood biomarkers of risk such as blood sugar, LDL cholesterol, and the diabetes test HbA1C," said Isaacson, lead author and director of the newly launched FAU Center for Brain Health and the Alzheimer's Prevention Clinic within the Schmidt College of Medicine, who conducted the study while at Weill Cornell Medicine and NewYork-Presbyterian. "Our findings are important because women are disproportionately affected by Alzheimer's disease and population-attributable risk models suggest that managing risk factors can prevent up to one-third of dementia cases, highlighting the immense potential that lies in addressing modifiable risk factors."

After undergoing baseline clinical assessments, which included a detailed clinical history, physical examination, anthropometrics, blood biomarkers, apolipoprotein-?4 (APOE-e4) genotyping, and cognitive assessment, patients in the CEDAR study were given individually-tailored, multi-domain intervention recommendations informed by these clinical and biomarker data. Recommendation categories included patient education/genetic counseling, individualized pharmacological approaches (medications/vitamins/supplements), non-pharmacological approaches (exercise counseling, dietary counseling, vascular risk reduction, sleep hygiene, cognitive engagement, stress reduction, and general medical care) and other evidence-based interventions.

"Our latest results suggest that the individualized management approach used by the CEDAR study in a real-world clinic may offer equal cognitive benefits to both women and men, as well as better mitigation of calculated Alzheimer's disease and cardiovascular disease risk in women compared to men," said Isaacson. "Our work also highlights the need for larger studies focusing on sex differences in AD-related cognitive trajectories, as the existing body of knowledge lacks conclusive evidence on this issue."

Isaacson and collaborators are planning on larger cohorts to further define sex differences in AD risk reduction in clinical practice and hope to launch a multi-site international study soon to draw more definitive conclusions.

https://www.sciencedaily.com/releases/2022/04/220426101641.htm

Stress, anxiety and depression during pregnancy may hinder toddler's cognitive development

April 29, 2022

Science Daily/Children's National Hospital

Women's elevated anxiety, depression and stress during pregnancy altered key features of the fetal brain, which subsequently decreased their offspring's cognitive development at 18 months. These changes also increased internalizing and dysregulation behaviors, according to a new study by Children's National Hospital published in JAMA Network Open. Researchers followed a cohort of 97 pregnant women and their babies. The findings further suggest that persistent psychological distress after the baby is born may influence the parent-child interaction and infant self-regulation.

This is the first study to shed light on an important link between altered in-utero fetal brain development and the long-term cognitive development consequences for fetuses exposed to high levels of toxic stress during pregnancy. While in the womb, the researchers observed changes in the sulcal depth and left hippocampal volume, which could explain the neurodevelopment issues seen after birth. Once they grow into toddlers, these children may experience persistent social-emotional problems and have difficulty establishing positive relationships with others, including their mothers. To further confirm this, future studies with a larger sample size that reflect more regions and populations are needed.

"By identifying the pregnant women with elevated levels of psychological distress, clinicians could recognize those babies who are at risk for later neurodevelopmental impairment and might benefit from early, targeted interventions," said Catherine Limperopoulos, Ph.D., chief and director of the Developing Brain Institute at Children's National and senior author of the study.

Regardless of their socioeconomic status, about one of every four pregnant women suffers from stress-related symptoms, the most common pregnancy complication. The relationship between altered fetal brain development, prenatal maternal psychological distress and long-term neurodevelopmental outcomes remain unknown. Studying in utero fetal brain development poses challenges due to fetal and maternal movements, imaging technology, signal-to-noise ratio issues and changes in brain growth.

All pregnant participants were healthy, most had some level of education and were employed. To quantify prenatal maternal stress, anxiety and depression, the researchers used validated self-reported questionnaires. Fetal brain volumes and cortical folding were measured from three-dimensional reconstructed images derived from MRI scans. Fetal brain creatine and choline were quantified using proton magnetic resonance spectroscopy. The 18-month child neurodevelopment was measured using validated scales and assessments.

This study builds upon previous work from the Developing Brain Institute led by Limperopoulos, which discovered that anxiety in pregnant women appears to affect the brain development of their babies. Her team also found that maternal mental health, even for women with high socioeconomic status, alters the structure and biochemistry of the developing fetal brain. The growing evidence underscores the importance of mental health support for pregnant women.

"We're looking at shifting the health care paradigm and adopting these changes more broadly to better support moms," said Limperopoulos. "What's clear is early interventions could help moms reduce their stress, which can positively impact their symptoms and thereby their baby long after birth."

https://www.sciencedaily.com/releases/2022/04/220429144916.htm

Viruses in the gut may warn of a deadly disease in preterm infants

April 25, 2022

Science Daily/Arizona State University

Immediately after birth, human infants begin to develop a complex, interwoven fabric of microbes in their gut. Known collectively as the gut microbiome, this diverse ecosystem consists of bacteria, archaea, viruses and fungi, numbering in the billions. All have important roles to play in health and disease and researchers are racing to better understand their enigmatic activities.

In a new study published in the journal Nature Microbiology, Efrem Lim and his colleagues explore the galaxy of viruses present in the gut, known as the gut virome. They find that some preterm infants undergo marked alterations in their pattern of gut viruses shortly before developing a serious and often fatal disease known as necrotizing enterocolitis (NEC).

Professor Lim is a researcher in the Biodesign Center for Fundamental and Applied Microbiomics. He is also the principal investigator of the Center for Viral Genomics at ASU and an assistant professor at ASU's School of Life Sciences.

The study was conducted in collaboration with ASU colleagues and researchers from the Washington University School of Medicine.

Although the bacterial component of the gut microbiome has received considerable research attention, viruses inhabiting the gut remain a largely hidden realm. The viral signature highlighted in the study, along with changes in gut bacterial communities, could provide an early warning signal that an infant is at risk of developing NEC, allowing clinicians to take emergency action.

"For many years now, there's been some inkling that the microbiome is implicated in this rapidly developing disease," Lim says. "Studies have shown that changes in the microbiome of the gut in these preterm infants seem to predict the progression to NEC disease."

Yet teasing out the specific microbial changes leading to the disease has been challenging and the precise mechanism causing the affliction is still unknown. The current study is the first to comprehensively investigate changes in the viral microbiome that appear to set the stage for the development of NEC in preterm infants.

A microbial world is born

Microbes begin colonizing the infant gut during birth, when a baby encounters a variety of microorganisms from its mother's vaginal tract. As the baby suckles, it picks up additional microbes from its mother's skin as well as those that have infiltrated her breast milk.

The infant will acquire new microbes from other family and non-family members and even from household pets. These all become incorporated into the developing gut microbiome, composed of some 20-100 billion microbes.

This vast microbial community will go on to shape many aspects of an individual's health, throughout the person's life. Unsurprisingly, abnormal alterations in the gut microbiome can spell serious trouble and premature infants are particularly vulnerable to such disruptions.

Before their time

Preterm birth usually refers to infants born after less than 37 weeks of pregnancy. The condition appears to be on the rise, though the causes of this are not fully understood. In many low-income countries, factors including HIV, infections, malaria, and high adolescent pregnancy rates have all been implicated.

In 2020, preterm birth affected 1 of every 10 infants born in the United States. Babies born too early (particularly before 32 weeks), have higher rates of death and disability. Those that survive may experience lasting health issues, including feeding difficulties; breathing, vision and hearing problems; and abnormalities including developmental delays and cerebral palsy.

Babies born prematurely are also at risk of NEC. The disease often strikes suddenly. When babies are born after fewer than 32 weeks of gestation, the incidence of NEC ranged from 2-7% in high-income countries. Mortality among infants with necrotizing enterocolitis ranges from 22-38%.

A stealthy disease

While rarely occurring in full-term infants, this largely mysterious disease affects 1 in 1,000 premature babies. The condition strikes without warning and can cause an infant to go from appearing healthy to a dire state of illness within hours. The disease usually occurs two to six weeks after birth.

The disease produces severe inflammation of intestinal tissue, causing it to die. Such afflictions are known as necro-inflammatory diseases. A perforation may also form in the intestine, allowing bacteria to leak into the abdomen or bloodstream. The sequence of steps leading to NEC remain unclear, though risk factors are believed to include the prolonged use of antibiotics early in life and formula feeding (in addition to preterm birth).

Although studies have strongly implicated changes in the gut microbiome as contributors to the development of NEC, no single bacterial genus has been consistently associated with the disease.

Babies who survive the affliction often face lifelong health issues, which can include neurodevelopmental disabilities and a condition known as short bowel syndrome.

The role of viruses

In the current study, 138 stool samples were collected over the first 11 weeks of life. The samples were from 23 preterm infants in a neonatal intensive care unit in St. Louis, Missouri. Nine of these infants developed NEC, while 14, matched for weight and gestational age, did not.

The study explored the samples using metagenomics, a sequencing method that allows researchers to comprehensively sample genes from all organisms present in a sample. This allows microbiologists like Lim to evaluate bacterial diversity and detect microbial abundance in various environments. The technique also enables the detailed study of microorganisms that are difficult or impossible to culture in the laboratory. (In early 2020, Lim used metagenomic sequencing to rapidly probe the 30,000 letter code of the SARS CoV-2 virus, identifying a unique mutation.)

The study demonstrates that the NEC infants showed a convergence of viral and bacterial signatures in the gut virome. Notably, babies with NEC showed a reduced diversity in viral composition between communities in the gut, a feature known as ?-diversity. The diminishing viral ?-diversity occurred over a 10-day period preceding the onset of NEC, providing a potential biomarker, alerting clinicians to the looming danger. The findings suggest that the developing virome holds vital clues reflecting on the health of preterm infants.

Microbial horizons

The research could lead not only to faster diagnosis and better therapies for NEC but also for a broad range of diseases mediated by the microbiome. Further, existing therapies directed at modifying the gut microbiome, for example, fecal transplant therapy, could be further improved by taking stock of the viral component.

The study demonstrates that the underexplored viral constituents of the microbiome have much to teach us and almost certainly play an important role not only in the transition to NEC in preterm infants but also in other diseases. With new and rapidly evolving sequencing technologies, researchers can begin to mine the virome for valuable diagnostic signposts of disease and develop more effective therapies.

https://www.sciencedaily.com/releases/2022/04/220425172138.htm

Automated cognitive behavioral therapy for insomnia delivered over the internet shown to be highly effective in Black women

April 20, 2022

Science Daily/Boston University School of Medicine

Black women are disproportionately affected by poor sleep, which is associated with increased risk of adverse outcomes such as cardiovascular disease, depression and worse quality of life. The gold standard treatment for insomnia is cognitive behavioral therapy for insomnia (CBT-I), which specifically targets the individual's problematic sleep behaviors and beliefs.

Internet-delivered CBT-I programs for insomnia have been developed to increase patient access to treatment. While these programs have been shown to be very effective, the vast majority of this research has been conducted among non-Hispanic White participants. This can be an issue for minority groups who understandably may not trust the healthcare system. In particular, Black women were less likely than White women to initiate internet-delivered CBT-I, or to stay engaged with treatment once they began. Now, a study led by researchers from the Slone Epidemiology Center (SEC) at Boston University and the Division of Sleep Medicine at Harvard Medical School shows that internet-delivered CBT-I is highly effective in Black women, and that a version of the program tailored specifically for Black women improves their engagement with treatment.

In a randomized trial, 333 women with insomnia from BU's Black Women's Health Study (BWHS) -- (a large follow-up study of Black women in progress since 1995), were randomized to three internet-delivered treatments: Sleep Healthy Using the Internet (SHUTi); SHUTi-BWHS, a culturally-tailored version of SHUTi developed specifically for Black women, guided by a team of stakeholders including Black women; and patient education about sleep (PE).

The trial participants were unaware of the program to which they had been assigned. The PE group was provided with sleep education materials, such as sleep hygiene recommendations, while the women assigned to SHUTi and SHUTi-BWHS worked their way through the interactive program that contained six "modules" addressing various aspects of sleep. The modules delivered CBT-I using psychoeducational content, customized recommendations based on the participant's reported sleep, videos highlighting common challenges that insomnia patients experience when implementing CBT-I, and advice from experts. The SHUTi-BWHS program addressed key issues that may be more likely to affect a Black woman's sleep, with all of the program's visual content revamped to include only Black patients and sleep physicians.

Participants in both SHUTi and SHUTi-BWHS had greater improvements in their insomnia symptoms compared with the PE group, with these gains sustained at 6 months after program completion. Significantly more women receiving SHUTi-BWHS completed the program than those receiving SHUTi. This is important as women who completed either SHUTi or SHUTi-BWHS were more likely to see their sleep improve.

"While Internet-delivered interventions offer better access to evidence-based care, patient adherence with automated programs that are designed to change health behaviors can be an issue. The development of a culturally tailored intervention may be the key to better engaging minority patients with proven insomnia treatment," explains senior author Lynn Rosenberg, ScD, epidemiologist at the SEC and a principal investigator of the BWHS.

The leaders of the study were encouraged that efforts to address sleep problems facing Black women was successful. "Profound health inequities affect the lives of so many racial/ethnic minority patients. We are proud to have conducted research designed specifically to address sleep health disparities in Black women, and are hopeful that this work spurs further interest and investment into research in this critical domain," said corresponding author Eric Zhou, PhD, clinical psychologist, Dana-Farber Cancer Institute.

https://www.sciencedaily.com/releases/2022/04/220420113004.htm

Fetal exposure to meds may affect infants' brain development

April 20, 2022

Science Daily/University of Helsinki

New study demonstrates that in utero exposure to mother's antiepileptic or antidepressant medication may affect development of the newborn brain networks. In the study, novel mathematical methods were developed to allow future research on how commonly used drugs or other environmental conditions affect the newborn brain.

Pregnant mothers may need treatment for their medical conditions, such as mood disorder or epilepsy. The effects of such drug treatment on newborn brain network functions was examined in a study conducted at the BABA Center, a research unit in University of Helsinki and New Children's Hospital of HUS Helsinki University Hospital. The study used electroencephalography (EEG) to measure electrical brain activity during sleep, and cortical network properties were calculated using advanced mathematical techniques.

"In prior studies, we have shown that changes in cortical activity across sleep states may provide important information on infants' neurological condition," Senior Researcher Anton Tokariev says.

The study demonstrated that exposure to antiepileptics and antidepressants during the fetal period leads to widespread changes in the cortical networks, and these effects may be specific to the type of drug exposure. In the case of antidepressants, the effect was more pronounced in local cortical networks. In contrast, exposure to antiepileptics had drug-specific effects on brain wide networks. Both drug types affected brain networks that are reactive to changes in sleep stages.

"What was clinically significant in the findings was that, some EEG findings linked to children's subsequent neuropsychological development. Stronger changes in neural networks predicted a greater deviation in development at two years of age," says Mari Videman, specialist in paediatric neurology at HUS Helsinki University Hospital.

Shedding new light on early brain development

The studies offer an entirely new way of assessing the effects of pharmaceutical agents on the development of child's brain function.

"The EEG measurement technique developed at the BABA Center and its associated state-of-the-art mathematical assessment of the brain's neural networks constitute breakthroughs in clinical research on early neurodevelopment," Professor Sampsa Vanhatalo says.

Vanhatalo considers it particularly important that these EEG -based measures open a window into mechanisms that operate between neuronal cell. This leads to an opportunitity to compare results observed in human children with research conducted using laboratory-animal models. Such translational work is needed to understand the mechanistic underpinnings of the drug effects. For instance, identical animal work is required to study how the amount or timing of maternal drug treatment would affect brain function of the offspring.

"Our novel methods provide a general analytical framework to support extensive future research on the questions how fetal brain development is affected by changes in intrauterine environment. Such studies may go far beyond maternal drug treatment, including also mother's nutrition and overall physical condition, as well as myriad of further environmental factors," Vanhatalo summarises.

https://www.sciencedaily.com/releases/2022/04/220420092203.htm

Women were less likely to return to work after a severe stroke

April 21, 2022

Science Daily/American Heart Association

According to new research, about one third of people who had a large vessel (severe) ischemic stroke, treated with mechanical clot removal, resumed work three months after stroke treatment. However, women were about half as likely to return to work after a severe stroke compared to men, according to the study published today in Stroke, the peer-reviewed, flagship journal of the American Stroke Association, a division of the American Heart Association.

A stroke due to a blockage in a large blood vessel is an indicator of a severe stroke and the potential for continuing loss of function, which makes it less likely people will return to work. According to the American Heart Association, while ischemic stroke accounts for 87% of strokes in the United States, large vessel occlusions only account for approximately 24% -- 46% of ischemic strokes.

Endovascular therapy (mechanical clot removal) and clot-busting medications are now a standard treatment for select patients with severe stroke. Endovascular therapy involves threading a slim catheter through a vessel in the leg to mechanically remove a clot blocking a brain vessel. In 2018, the American Heart Association stroke treatment guidelines were updated to recommend mechanical clot removal for select stroke patients to improve the odds of functional recovery.

"Returning to work after a severe stroke is a sign of successful rehabilitation. Resuming pre-stroke levels of daily living and activities is highly associated with a better quality of life," said Marianne Hahn, M.D., lead study author and a clinician scientist in the department of neurology at Johannes Gutenberg University in Mainz, Germany. "In contrast to most return-to-work studies, we included a large cohort of only people treated with mechanical clot removal; they are a subgroup of stroke patients at high risk for severe, persisting deficits."

Researchers examined data from the German Stroke Registry -- Endovascular Treatment Study Group. The analysis included more than 600 men and women (28% women), ages 18- to 64-years-old who had a large vessel ischemic stroke between 2015 and 2019.

All study participants were employed prior to their stroke and were treated with mechanical thrombectomy. More than half of the study participants also received intravenous thrombolysis (clot-busting medication).

Researchers compared the people who returned to work 90 days after being treated with mechanical thrombectomy to those who did not resume work. After accounting for age, sex, health conditions, type and severity of stroke, and treatment characteristics, the analysis found:

• About one-third of the stroke survivors resumed work three months later.

• The amount of persistent functional deficits after stroke was the main reason people were not able to return to work.

• Women were 58% less likely to return to work three months after mechanical thrombectomy compared to men.

• Individuals who were treated with both mechanical thrombectomy and intravenous thrombolysis were almost twice as likely to return to work compared to the individuals who had undergone mechanical thrombectomy only.

"After examining the data further, we also found that women in our cohort were younger at the time of their stroke, were more likely to be non-smokers and were more likely to have no existing significant disability when discharged from the hospital compared to the men in our study. Despite having more of these favorable characteristics for return to work, we did not observe a higher re-employment rate among women before considering these differences," Hahn said.

The researchers noted further study is needed to explain the discrepancy between men and women re-entering the workforce after a major stroke. More intensive and supportive vocational rehabilitation programs may be valuable to help women return to work.

"There is more to re-employment after mechanical thrombectomy than functional outcomes," Hahn said. "Targeted vocational and workplace rehabilitation interventions have been shown to improve rates of return to work. And previous studies have also found that returning to work is associated with increased well-being, self-esteem and life satisfaction."

The study authors believe their findings may be transferable to other countries with similar health care and rehabilitation systems. However, confirmation and in-depth analyses of national policies are necessary to explain the observation since there may be differences, such as social services and benefits, which have been shown to influence return to work.

The study was limited in that the data lacked detailed information about types of jobs and available employment opportunities. The German Stroke Registry does not include social determinants of health, and whether an individual was re-employed at the same job or working full- or part-time. Researchers noted these limitations may help explain and play a role in whether people returned to work after a severe stroke.

In the U.S., stroke is the fifth leading cause of death and a leading cause of disability, according to the latest data from the American Heart Association. To recognize stroke symptoms requiring immediate medical attention, the American Stroke Association recommends everyone remember the acronym F.A.S.T. for Face drooping, Arm weakness, Speech difficulty, Time to call 9-1-1.

https://www.sciencedaily.com/releases/2022/04/220421094107.htm

Women's earnings drop after childbirth

April 20, 2022

Science Daily/Cornell University

When U.S. couples have their first child, mothers' earnings still drop substantially relative to fathers', and new Cornell University research demonstrates the stubborn, decades-old pattern isn't changing despite broad increases in other aspects of gender equality.

The research indicates the relative drop in the earnings of mothers cuts across all education levels. The COVID-19 pandemic may lock the income imbalance in place as mothers who pulled back to care for children face worse hiring prospects and wage penalties as they seek to restart their work lives.

An article on the research, "Change and Variation in U.S. Couples' Earnings Equality Following Parenthood," was published March 22 in Population and Development Review. The research was conducted by sociologists Kelly Musick of the Cornell Jeb E. Brooks School of Public Policy, Pilar Gonalons-Pons of the University of Pennsylvania and Christine Schwartz of the University of Wisconsin, Madison.

"The gender revolution has stalled, and women remain economically vulnerable," Musick said, noting the country is an outlier among wealthy nations in offering no mandated paid leave following childbirth, no system of subsidized childcare and scant public support for working families.

The study is one of the first to assess changes over time in within-family earnings inequality, tracking what happened to the incomes of couples over a full 10 years. The researchers used detailed survey results and administrative tax records that provide long-run data on earnings, birth and marriage dates and key characteristics such as education.

The researchers analyzed a period of about 30 years, from the 1980s through the 2000s. They found a brief period in the 1980s when wives became less financially dependent on their husbands after parenthood. Wives' earnings share dropped 13 percentage points following the first birth in the 1980s, relative to 10 percentage points in the 2000s. That modest change held largely true no matter the education or income level of the husband and wife.

Musick said the similarities by education were something of a surprise because disparities -- especially among those with and without a college degree -- have grown in other aspects of family life over this time period. "Across groups, wives become more financially dependent on their husbands after parenthood," the researchers concluded, a worrying sign particularly in the U.S., where divorce remains common and policy support for families is weak.

"The pandemic puts into sharp relief the pitfalls of our fend-for-yourself approach to managing work and family," Musick said. The pandemic also creates an opening for policymakers to build a stronger "infrastructure of care" and the success of that effort will shape gender inequalities in work and family in the decades to come, she said.

https://www.sciencedaily.com/releases/2022/04/220420151611.htm

Babies exposed to cannabis in the womb may be at risk for obesity, high blood sugar

Both CBD and THC put children at risk despite CBD being marketed as having health benefits

March 31, 2022

Science Daily/The Endocrine Society

Cannabis use among pregnant women is on the rise and may be associated with negative health outcomes in children, according to a new study published in the Endocrine Society's Journal of Clinical Endocrinology and Metabolism.

A 2016 study in Colorado revealed that up to 22% of pregnant women had detectable levels of cannabinoids in their body. Women who use cannabis, both tetrahydrocannabinol (THC) and cannabidiol (CBD), during pregnancy could be putting their child at risk for low birth weight and behavioral problems. Exposure to cannabinoids may also increase the child's future risk of obesity and high blood sugar.

Part of CBD's popularity is that it is marketing as being "nonpsychoactive," and that consumers can reap health benefits from the plant without the high. CBD is advertised as providing relief for anxiety, depression and post-traumatic stress disorder. It is also marketed to promote sleep.

"We found that cannabis use during pregnancy was linked to increased fat mass percentage and fasting glucose levels in 5-year-old children," said Brianna Moore, Ph.D., of the Colorado School of Public Health in Aurora, Colo. "We would encourage women to refrain from using any cannabis while pregnant or breastfeeding to minimize adverse health effects in the offspring."

The researchers studied urine samples from 103 pregnant women, 15% of whom had detectable levels of cannabinoids (such as THC and CBD) in their urine. These mothers' 5-year-old children had higher fat mass and fasting glucose levels compared to children who were not exposed to cannabis during pregnancy.

"More studies are needed to understand how exposure to different cannabinoids during pregnancy may impact the offspring," Moore said.

https://www.sciencedaily.com/releases/2022/03/220331101458.htm

Married mothers who earn more than their husbands take on an even greater share of the housework

Married couples may be trying to compensate for deviating from the entrenched gender norm of 'male breadwinner'

March 31, 2022

Science Daily/University of Bath

While new mothers frequently take on a greater share of housework than their spouses, this effect is even more pronounced in mothers who earn more than fathers, new research from the University of Bath shows.

Rational economic theory suggests parenthood and the resulting income and time pressure should lead to a more efficient sharing of household chores. However, the study of more than 6,000 heterosexual North American married households revealed this is not the case.

"Of course, we understand why specialized division of labour exists, but there is no reason for this specialization to be gender-specific. Traditional division has been conventionally explained by men earning more and working longer hours and has a certain logical appeal," said Dr Joanna Syrda of the University's School of Management.

"However, I found that the gender housework gap actually gets bigger for mothers who earned more than their spouses -- the more they earned over their partner, the more housework they did," she said.

Syrda said the findings might indicate that traditional gender identity norms -- the notion of the 'male breadwinner' and its association with masculinity -- are so entrenched that couples may try to compensate for a situation where wives earn more than their husbands. She said she was interested to find the effect was stronger in married couples than in unmarried cohabiting parents.

"Married couples that fail to replicate the traditional division of income may be perceived -- both by themselves and others -- to be deviating from the norm. What may be happening is that, when men earn less than women, couples neutralise this by increasing traditionality through housework -- in other words, wives do more and husbands do less as they try to offset this 'abnormal' situation by leaning into other conventional gender norms," she said.

Syrda noted that the economic argument for mothers taking on a greater share of household chores was to free their higher-earning (male) partner up to focus on work and maximise the household's standards of living.

"We would therefore expect the balance of domestic labour to shift as more women enter the workforce, work longer hours and gain higher salaries -- but that has not been the case! So, we need to look beyond economic theory to this traditionalising effect and couples following traditional gender norms," Syrda said.

Syrda said it was important to recognise that there are some childcare tasks where women have an obvious advantage. However, she noted that the research is about housework defined as 'time spent cooking, cleaning, and doing other work around the house'.

"Therefore, it doesn't necessarily follow that this should lead to gender-specific housework division -- if the wife is the relatively higher earner, transition to parenthood shouldn't result in a more traditional division of domestic labour as this wouldn't improve the household's overall quality of life. But this study suggests this is not the case."

Syrda said the study -- "Gendered Housework: Spousal Relative Income, Parenthood and Traditional Gender Identity Norms" -- is important for the understanding of a prime source of conflict for many married couples. She pointed to research from the U.S. Institute of Family Studies that found the most common area of contention among spouses with children to be chores and responsibilities, highlighting the clash between the traditional division of labour and the modern reality of high-earning, working mothers.

Syrda said that previous research showed that the transition to parenthood brought more of a change to the division of labour in couples than any other event, like getting married or having more children. At the same time, her research showed that this appears to strengthen norms regarding gender-typical behaviour or even shift individual gender role attitudes.

"This is important, because how couples divide the increased domestic workload after becoming parents will be an important determinant of earnings inequalities between women and men over the course of their lives -- a pattern once settled upon is often difficult to renegotiate. And these norms may be passed to their children," she said.

Syrda reflected that one expectation of the 'gender revolution' of the 1960s and 1970s was that women's increased level of employment and earnings would be accompanied by men's greater participation in domestic activities.

"Sadly, however, it looks like married men and women -- especially married parents -- have still not equalised the level of housework they perform, leading many of us to wonder how to restart this 'stalled revolution'?" she said.

https://www.sciencedaily.com/releases/2022/03/220331101532.htm

One in four women experience domestic violence before age 50

Governments are not on track to meet global targets to eliminate violence against women and girls

March 24, 2022

Science Daily/McGill University

Over one in four women (or 27 per cent) experience intimate partner violence before the age of 50, according to a worldwide analysis led by researchers from McGill University and the World Health Organization. The largest of its kind, the analysis covers 366 studies involving more than 2 million women in 161 countries.

"Intimate partner violence against women -- which includes physical and sexual violence by husbands, boyfriends, and other partners -- is highly prevalent globally," says McGill University Professor Mathieu Maheu-Giroux, a Canada Research Chair in Population Health Modeling.

According to the finding published in The Lancet, one in seven women (or 13 per cent) experienced intimate partner violence within the last year of the study period between 2000 and 2018. The analysis also found high levels of violence against young women, estimating that 24 per cent of those between the ages of 15 to 19 experienced domestic violence in their lifetime.

While the numbers are alarming the true scale of violence is likely even higher, the researchers say, noting that the studies were based on self-reported experiences. Given the stigmatized nature of the issue, women can be hesitant to report their experiences, they explain.

High-income countries reported lower rates of domestic violence

The researchers found regional variations, with high-income countries having lower prevalence of both lifetime and past year violence. The lifetime prevalence among women aged 15 to 49 was highest in Africa, South Asia, and parts of South America. The regions with the lowest estimated lifetime domestic violence against women were Central Asia and Central Europe.

The proportion of women who experienced intimate partner violence in the last year was around 5 per cent for North America, Europe, and Asia Pacific. In regions of Africa, this number was as high as 15 per cent to 30 per cent.

Canada among countries with lowest rates of domestic violence

"While Canada is among the top 30 countries with the lowest rates of intimate partner violence, it's still a problem that affects 1 in 25 women," notes Professor Maheu-Giroux. "Some provinces in Canada are looking at different ways to address domestic violence. In Quebec, for example, the government approved a pilot project in 2021 to create a special court for victims of domestic and sexual violence," he adds.

Calls to strengthen response in pandemic rebuilding efforts

"Overall, our research shows that governments are not on track to meet global targets to eliminate violence against women and girls. An important takeaway is that even in some high-income countries the prevalence of intimate partner violence is relatively high, which calls for investment in prevention at local and global levels," says Maheu-Giroux.

"In Québec alone, we witnessed a wave of 17 intimate partner feminicides in 2021 -- the most extreme consequence of intimate partner violence and the highest number in more than a decade," he says.

Globally, the problem is likely to have been further exacerbated by the COVID-19 pandemic, the researchers explain. There's an urgent need to strengthen the public health response to intimate partner violence, and ensure it's addressed in post-COVID-19 rebuilding efforts, they conclude.

https://www.sciencedaily.com/releases/2022/03/220324143806.htm