Investing in kids’ future pays off

When parents set up long-term savings accounts for college, business start-ups or home ownership, kids feel more financially and emotionally secure, new research shows.

The studies show the importance of families using child development accounts (CDA) as one measure to shift from an overreliance on credit and create a foundation for asset building. In other words, this program encourages households to maintain less debt and more savings.

CDAs can start as early as a child’s birth. Deposits, earnings and incentives help build the account over time, says Trina Shanks, an assistant professor of social work.

The account becomes more of a family affair as the children learn about the importance of savings and achieving education goals, she says.

“As the child grows older, there may be additional opportunities to learn about financial concepts and for the child to become more directly involved in making deposits or monitoring the account,” says Shanks, who co-authored two recently published papers regarding CDA in Children and Youth Services Review.

Shanks has studied how child development accounts and other asset-building programs focused on children impact their short- and long-term outcomes.

Successful parent-child interactions can lead to the child having more self-esteem. This establishes a smoother transition into greater responsibilities and independence as the child grows older, whether in school, relationships or employment, Shanks says.

But for children growing up in disadvantaged circumstances, a child development account alone might not be sufficient, Shanks says. Particularly when early life experiences include persistent economic strain and toxic stress, supplemental interventions might also be necessary to help the child navigate critical milestones.

— Jared Wadley, News Service

Follow-ups prove powerful tool for treating depression in primary care

In the 15 minutes a primary care doctor typically has with a patient, she’s expected to diagnose the current ailment, help manage ongoing health issues and provide preventive care. In this setting, confronting all but the most obvious and immediate mental health needs of patients is an ongoing challenge.

A new study by researchers at the U-M Health System, however, points to an encouraging strategy for improving and sustaining mental health results in chronically depressed patients by providing small amounts of flexible, targeted follow-up care — without overburdening busy doctors’ offices.

The study, published in the September/October issue of Annals of Family Medicine, shows that patients who received interventions that included self-monitoring tools and follow-up phone calls from a care manager were more likely a year and a half later to have symptoms that were in remission and to have fewer reduced-function days than those receiving usual primary care treatment.

“They key is to keep patients engaged in treatment,” says Dr. Michael Klinkman, a professor of family medicine at the Medical School and lead author of the study. “What it’s not is telephone therapy. Patients have a human contact, somebody who can help them become more actively involved in their own care. It’s hard to do that if you’re just spoon feeding information to ‘educate’ a patient or telling them to go to a website.”

With a more traditional approach that depends on a follow-up office visit, it might be months before a primary care doctor learns that his patient’s depression is getting worse. And in many cases patients simply don’t follow up.

Additional U-M authors are Sabrina Bauroth, Stacey Fedewa, Dr. Kevin Kerber, Julie Kuebler, Tanya Adman and Ananda Sen.

— Ian Demsky, UMHS Public Relations

Nature’s backbone of biodiversity at risk

One-fifth of the world’s vertebrate species are threatened with extinction, but the situation would be worse if not for current global conservation efforts, a new study finds.

Biologist Ronald Nussbaum is one of 174 researchers from 115 institutions and 38 countries who authored the study published last week in Science Express.

The study used data for 25,000 species from the International Union for Conservation of Nature’s Red List of Threatened Species to investigate the status of the world’s vertebrates (mammals, birds, amphibians, reptiles and fishes) and how this status has changed over time. The results show that, on average, 50 species of mammal, bird and amphibian move closer to extinction each year due to the impacts of agricultural expansion, logging, over-exploitation and invasive alien species.

“The ‘backbone’ of biodiversity is being eroded,” says the American ecologist and writer Edward Wilson of Harvard University. “One small step up the Red List is one giant leap forward towards extinction. This is just a small window on the global losses currently taking place.”

Southeast Asia has experienced the most dramatic recent losses, largely driven by the planting of export crops like oil palm, commercial hardwood timber operations, agricultural conversion to rice paddies, and unsustainable hunting. Parts of Central America, the tropical Andes of South America, and even Australia, also have all experienced marked losses, in particular due to the impact of the deadly chytrid fungus on amphibians.

While the study confirms previous reports of continued losses in biodiversity, it is the first to present clear evidence of the positive impact of conservation efforts around the globe.

“Our results clearly demonstrate that conservation efforts are having a positive effect on maintaining global biodiversity,” says Nussbaum, a professor of ecology and evolutionary biology and a curator at the Museum of Zoology.

— Nancy Ross-Flanigan, News Service

Sepsis survivors more than three times as likely to have cognitive issues

Older adults who survive severe sepsis are at higher risk for long-term cognitive impairment and physical limitations than those hospitalized for other reasons, according to researchers from the U-M Health System.

Research published Oct. 27 in the Journal of the American Medical Association showed that 60 percent of hospitalizations for severe sepsis were associated with worsened cognitive and physical function among surviving older adults. The odds of acquiring moderate to severe cognitive impairment were 3.3 times higher following an episode of sepsis than for other hospitalizations.

Severe sepsis also was associated with greater risk for the development of new functional limitations following hospitalization, says lead author, Dr. Theodore (Jack) Iwashyna, assistant professor of internal medicine.

Among patients who had no limitations before sepsis, more than 40 percent developed trouble with walking. Nearly 1 in 5 developed new problems with shopping or preparing a meal. Patients often developed new problems with such basic things as bathing and toileting themselves.

“We used to think of sepsis as just a medical emergency, an infection that you get sick with and then recover,” Iwashyna says. “But we discovered a significant number of people face years of problems afterwards.”

Sepsis is an overwhelming infection that can result in failure of multiple organ systems. The initial infections are often common problems, such as pneumonia or a urinary tract infection. About 40 percent of those with severe sepsis die from the infection.

“This research underscores the need for physicians who care for older adults to focus early on preventing infections that can lead to sepsis,” says study co-author Dr. Kenneth Langa, a core investigator for the Ann Arbor Veterans Administration Health Services Research and Development Service’s Center of Excellence and professor of internal medicine.

— Mary Masson, UMHS Public Relations

Climate change: Cultural shift needed similar to smoking, slavery

Despite scientific evidence of climate change, it will take a significant cultural shift in attitudes to address the situation, a U-M researcher says.

The shift would be much like what has happened with recent cigarette smoking bans and even similar to the abolition of slavery in the 19th century.

“The present reality is that we tend to overlook the social dimensions of environmental issues and focus strictly on their technological and economic aspects,” says Andy Hoffman, the Holcim (U.S.) Professor of Sustainable Enterprise at the Stephen M. Ross School of Business and School of Natural Resources and Environment. “To properly address climate change, we must change the way we structure our organizations and the way we think as individuals.

“It requires a shift in our values to reflect what scientists have been telling us for years. The certainty of climate change must shift from that of being a ‘scientific fact’ to that of being a ‘social fact.’”

In an article published in the current issue of the journal Organizational Dynamics, Hoffman compares the current cultural attitudes toward climate change to historical societal views on smoking and slavery.

“Just as few people saw a moral problem with slavery in the 18th century, few people in the 21st century see a moral problem with the burning of fossil fuels,” Hoffman says. “Will people in 100 years look at us with the same incomprehension we feel toward 18th-century defenders of slavery? If we are to address the problem adequately, the answer to that question must be yes.”

But Hoffman says this value shift will require people to come to terms with a new cultural reality: first, that we have grown to such numbers and our technologies have grown to such a capacity that we can, and do, alter the Earth’s ecological systems on a planetary scale; and second, that we share a collective responsibility and require global cooperation to solve it.

— Bernie DeGroat, News Service