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Newswise — ROCHESTER, Minn. — After highlighting that more than half of American physicians are experiencing burnout, Mayo Clinic researchers now have identified some solutions that are being used to prevent or lessen burnout around the world. The findings show that some of the approaches being used are effective and making a difference. The article appears in the journal The Lancet. The researchers identified more than 2,600 research articles that dealt with outcomes and approaches to physician burnout. They found 15 randomized clinical trials and 37 cohort studies that collectively included more than 3,600 physicians. “We conducted an extensive search and compared the effectiveness of interventions across a range of burnout outcomes,” says lead author Colin West, M.D., Ph.D. “It’s clear that both individual strategies and structured organizational approaches are effective in achieving clinically meaningful reductions in burnout.” Effective individual-focused strategies include mindfulness training, stress management training and small group sessions. Organizational changes that seem to work include limiting physician duty hours and a range of care delivery process changes in hospitals and clinics. Mayo Clinic has been using some of these approaches with noticeable effects, including group interaction sessions in which the institution provides a designated lunch gathering monthly for breakout groups of physicians, so they can talk confidentially about their experiences with each other according to a structured curriculum. The investigators say more research is needed as most published data come from observational studies and that validation of many of the solutions still is needed. In addition, the effect of combinations of interventions and their long-term benefits should be the focus of additional study. Co-authors of the article are Liselotte Dyrbye, M.D., Tait Shanafelt, M.D. and Patricia Erwin, M.L.S. The research was supported by the Arnold P. Gold Foundation Research Institute and Mayo Clinic. ### About Mayo ClinicMayo Clinic is a nonprofit organization committed to clinical practice, education and research, providing expert, whole-person care to everyone who needs healing. For more information, visit http://www.mayoclinic.org/about-mayo-clinic orhttp://newsnetwork.mayoclinic.org/.
Newswise — TALLAHASSEE, Fla. — What can a Thai water bug teach us about our muscles, especially the heart? A lot, says Professor of Biological Science Kenneth Taylor. New research by Taylor published today in Science Advances gives scientists better insight into how the heart muscle works and how sometimes it fails. Taylor and his team used an electron microscope to capture the first three-dimensional image of a tiny filament, or strand, of an essential muscle that the palm-sized water bug Lethocerus indicus uses to fly. This filament is made of chains of a protein called myosin, which produce the power needed to contract muscles. This image shows for the first time the individual molecules in the filament in a relaxed state, which is necessary to re-extend muscles. “After you contract your bicep to see if your muscles look like Arnold Schwarzenegger’s, you need this filament to assume its relaxed structure, so that after contraction your tricep muscle can re-extend your bicep,” Taylor said. Scientists have long examined the flight muscles from Lethocerus indicus as a way to better understand how the human heart works. Both the insect’s flight muscle and a mammal’s heart beat rhythmically. Mutations causing many inherited heart muscle diseases have been identified but are difficult to study in mammals because the heart is essential to life. However, these mutations can be studied in insects, specifically through this filament. Mutations that alter myosin function even slightly can have cumulative effects in a muscle contracting rhythmically. While capturing a clear picture of this exact filament has been difficult, improved technology allowed Taylor and his fellow researchers to record an amazingly detailed image showing the precise filament structure. All muscles have two types of filaments, actin and myosin. The chief difference between actin and myosin is that myosin has two parts, a molecular motor and a very long rod. The rods from many myosin molecules form the filament backbone. When a muscle contracts, molecular motors on the myosin filament grab and pull on the actin filaments causing the muscle to shorten. The packing of the myosin rods within the backbone must be strong enough to sustain this force. With this new image, scientists can see how the molecular motors are arranged to prevent contact with the actin filament facilitating the muscle’s re-extension. At the same time they can see the tight packing of the myosin rods much “like a bamboo forest,” Taylor said. “The image answers a whole lot of questions about myosin filaments that scientists have been wondering about for decades,” Taylor said. The discovery is even more important because mutations in myosin can cause cardiomyopathy — a disease of the heart muscle. About one-third of myosin mutations that cause cardiomyopathies occur in the rod.“Many of these cardiomyopathy mutations may be understandable in terms of flawed muscle relaxation,” Taylor said. This detailed image “shakes up the muscle field,” Taylor said. He hopes this breakthrough leads to novel treatments for cardiomyopathy in the future. Now Taylor and his team will boost the resolution of these images so they can clearly see individual amino acids and accurately determine the key interactions between them.“We study insect flight muscle because it is a simpler route to understanding human disease,” Taylor said. “Ultimately, we must understand human disease from either human filaments or at least mammalian filaments.” Other researchers contributing to the work are FSU molecular biophysics graduate student Zhongjun Hu and Research Associate Dianne Taylor, plus Duke University researchers Michael Reedy and Robert Edwards. The research is funded by the National Institutes of Health and the American Heart Association. ###
Newswise — DALLAS –  When exposed to cold, clusters of cells within the body’s white fat become beige – a color change that reflects the creation of more energy-producing mitochondria, cellular components that enable cells to burn calories and give off heat. But since white fat cells have very few nerves, how do beige fat cells get the message that it’s cold outside?   In research that has implications for diabetes and other metabolic diseases, an international study based at UT Southwestern Medical Center found that the protein connexin 43 (Cx43) forms cell-to-cell communication channels on the surface of emerging beige fat cells that amplify the signals from those few nerve fibers. The channels act like conduits that speed signals across the gaps between clusters of cells – similar to the way a group email reaches several people at once.   The study, recently published in Cell Metabolism, also found that beige fat, unlike the better-known white and brown fat, has interesting anti-diabetic effects on blood sugar metabolism that seem independent of temperature regulation. Impaired glucose metabolism is a hallmark of diabetes.   “The data here show how white fat cells can make maximal use of their limited number of nerves to allow a single nerve fiber to spread the ‘message’ about cold temperatures amongst the connected cells,” explained Dr. Philipp Scherer, lead author of the study and Director of UT Southwestern’s Touchstone Center for Diabetes Research.   “To my knowledge, this is the first time that any fat’s thermal regulatory (warming) and metabolic effects on blood sugar have been observed to work independently. Our findings suggest that activating Cx43 may cause the formation of more beige fat and thus increase the anti-diabetic effects seen in this study,” Dr. Scherer added.   Fat, once considered merely a storage area for excess calories, is now appreciated as a dynamic tissue that comes in several forms with different functions that are still being identified. White fat is used mainly for energy storage. Brown fat, the classic heat-generating fat, helps regulate body temperature, especially in newborns. Some white fat cells are capable of transforming into a third kind of fat, beige. Both brown and beige fat get their color from increased mitochondria that are added in response to cold and other environmental stimuli, he said.   To study the metabolic effects of beige fat, the researchers compared mice with Cx43 that are able to make beige fat normally to mice unable to make Cx43, meaning their white fat seldom got the message to change to beige in response to cold. After three weeks in cold temperatures, the mice were returned to normal temperatures and analyzed for glucose (blood sugar) metabolism.   The mice that produced Cx43 showed greater improvement in glucose metabolism, Dr. Scherer said. Yet, both groups of animals were still able to regulate body temperature, apparently through their brown fat stores, he said.   “This study reaches two conclusions: First, Cx43 is necessary for the propagation of nerve signals that lead to beiging of white fat tissue. Second, beige fat may be more interesting from an anti-diabetic, metabolic standpoint – a finding with significant clinical relevance – than from a body temperature, warming standpoint,” explained Dr. Scherer, who holds the Gifford O. Touchstone, Jr. and Randolph G. Touchstone Distinguished Chair in Diabetes Research.   Study co-authors from the Touchstone Diabetes Center included lead author Dr. Yi Zhu, a postdoctoral fellow and employee of Eli Lilly and Co.; former graduate student Dr. Caroline Tao; postdoctoral researchers Dr. Mengle Shao and Dr. Shangang Zhao; Dr. Olga Gupta, Assistant Professor of Pediatrics and Internal Medicine and a Dedman Family Scholar in Clinical Care; and Dr. William Holland and Dr. Rana Gupta, both Assistant Professors of Internal Medicine. Additional UTSW contributors were Joshua Johnson, a student in UT Southwestern’s Medical Scientist Training Program; Dr. Tiemin Liu, Instructor of Internal Medicine; Dr. Joel Elmquist, Chief of the Division of Hypothalamic Research, Professor of Internal Medicine, Pharmacology and Psychiatry, and holder of the Maclin Family Distinguished Professorship in Medical Science, in Honor of Dr. Roy A. Brinkley, and the Carl H. Westcott Distinguished Chair in Medical Research; and Dr. Kevin Williams, Assistant Professor Internal Medicine in the Division of Hypothalamic Research.   Researchers at the Chinese Academy of Medical Sciences and Peking Union Medical College; The Ohio State University; Xi’an Jiaotong University; the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health (NIH); Albert Einstein College of Medicine; and Joslin Diabetes Center also contributed.   The research was supported by the NIH, the Cancer Prevention and Research Institute of Texas (CPRIT); a Lilly Innovation Fellowship Award; a China Scholarship Council Scholarship, and the American Heart Association.    About UT Southwestern Medical CenterUT Southwestern, one of the premier academic medical centers in the nation, integrates pioneering biomedical research with exceptional clinical care and education. The institution’s faculty includes many distinguished members, including six who have been awarded Nobel Prizes since 1985. The faculty of almost 2,800 is responsible for groundbreaking medical advances and is committed to translating science-driven research quickly to new clinical treatments. UT Southwestern physicians provide medical care in about 80 specialties to more than 100,000 hospitalized patients and oversee approximately 2.2 million outpatient visits a year.   ###
Newswise — (Chicago) – A recently-recognized pathologic protein in the brain may play a larger role in the development of clinical Alzheimer’s disease dementia than previously recognized, according to a study by researchers at Rush University Medical Center. The findings of the study of nearly 1,000 older adults were published in the Sept. 30 issue of the journal, Brain. “This finding could help researchers to understand the cause of memory loss and lead to new ways to approach studying Alzheimer’s disease,” said Bryan James, PhD, study author and epidemiologist with the Rush Alzheimer’s Disease Center. “Our study found that when the main characteristic pathologies of Alzheimer’s disease, plaques and tangles, were mixed with a pathologic protein called TDP-43 in the brain, the combination was more likely to result in diagnosed Alzheimer’s dementia than plaques and tangles alone.” The abnormal protein, TDP-43 (short for ‘hyperphosphorylated transactive response DNA-binding protein 43’), previously has been associated with frontal temporal dementia and amyotrophic lateral sclerosis (ALS, sometimes called Lou Gehrig’s disease). In recent years, TDP-43 also has been found in the brains of persons with other diseases, but most recently in Alzheimer’s disease. Mixed pathologies increase Alzheimer’s risk The hallmark pathologies of Alzheimer’s disease are the accumulation of the protein beta-amyloid (called plaques) and an abnormal form of the protein tau (called tangles). However, research from the Rush Alzheimer’s Disease Center and other groups has shown that the majority of persons with clinical Alzheimer’s dementia also develop other disease pathologies in their brains as well, such as small strokes or protein deposits called Lewy bodies. This combination, called ‘mixed pathologies,’ increases the risk for developing diagnosed Alzheimer’s dementia above and beyond just having plaques and tangles in the brain. “The clinical disease that we call ‘Alzheimer’s disease’ is looking more and more like the result of the accumulation of a number of disease processes in the brain of older persons,” James said. The majority of persons with diagnosed Alzheimer’s dementia actually have mixed pathologies in their brains — not just the plaques and tangles that are the known hallmarks of Alzheimer’s disease. “In particular, mixed Alzheimer’s and TDP-43 pathologies appear to be an under-recognized yet common form of mixed pathologies that contributes to the development of clinical Alzheimer’s dementia,” James said. “This is one of the first studies to examine TDP-43 and Alzheimer’s disease in the context of mixed pathologies.” TDP-43 found in two-thirds of those with Alzheimer’s dementia The Brain paper built on previous research by examining whether TDP-43 was associated with an increased likelihood of a diagnosis of Alzheimer’s dementia in persons both with and without pathologic Alzheimer’s disease. The new study examined brain pathology, drawing on tissue samples from 946 deceased older men and women who had been enrolled in one of two cohort studies by the Rush Alzheimer’s Disease Center, the Rush Memory and Aging Project or the Religious Orders Study. Participants in both studies agree to donate their brains to research after their death. TDP-43 was present in the brains of about half of the participants and in two-thirds of the brains of persons who had been diagnosed with Alzheimer’s dementia while alive. More than a third of the participants had mixed Alzheimer’s (plaques and tangles) and TDP-43 pathologies in their brain. Mixed Alzheimer’s and TDP-43 pathologies were associated with a higher likelihood of diagnosed Alzheimer’s dementia at death than plaques and tangles alone. “These data are exciting, because an improved understanding of the TDP-43 protein has potential to guide alternative treatment strategies for Alzheimer’s disease,” James said.
Newswise — Highly caffeinated energy drinks (EDs) have been of concern to the public-health community for almost a decade. Many young people consume EDs with alcohol to decrease alcohol’s sedative effects and stay awake longer, enabling them to drink more alcohol. Adding to the growing body of research linking ED consumption with risk-taking and alcohol-related problems, this study examined its relationship with drunk driving. Importantly, the researchers differentiated between the different ways in which EDs are consumed: exclusively with alcohol, exclusively without alcohol, or both with and without alcohol depending on the occasion. Researchers looked at data from a longitudinal study of college students assessed annually via personal interviews. In year six, 1,000 participants (550 females, 450 males) self-reported their past-year frequency of drunk driving, ED consumption patterns, alcohol use, and other caffeine consumption. The researchers’ statistical model accounted for several background risk factors for drunk driving in order to isolate whether ED consumption might explain any unique variance in drunk driving behavior. Results indicated that ED consumption was present in 57 percent of students: 9 percent drank EDs exclusively with alcohol, 16 percent drank EDs exclusively without alcohol, and 32 percent drank EDs both with and without alcohol depending on the occasion. More frequent ED consumption was associated with more frequent drunk driving through two distinct pathways. First, echoing prior research, consuming EDs with alcohol was associated with heavier alcohol drinking and, thereby, with more frequent drunk driving. A second separate path was unexpected—namely, consuming EDs without alcohol contributed additional risk for drunk driving, regardless of alcohol drinking patterns. The second path suggests that mechanisms other than the promotion of heavy drinking by EDs are involved in promoting drunk driving. The authors encourage parents, clinicians, and college administrators to regard any style of ED consumption, whether with or without alcohol, as a warning sign that students might be at high risk for alcohol-related consequences such as drunk driving. The authors also reiterate earlier calls to caution students against consuming EDs with alcohol. SEE ORIGINAL STUDY    
Newswise — MINNEAPOLIS/ST. PAUL  — A global genetic interaction map is revolutionizing how genes are being studied. A new study, involving University of Minnesota researchers, is no longer looking at genes as loners, but instead as a social network of the body, interacting in groups. The new approach may ultimately change our understanding of the genetic roots of diseases. The map will help scientists predict how genes function in order to understand, and thwart, the culprits behind diseases, with a potential for developing finely-tuned therapies. The research findings were published today in the journal Science. Prior studies of yeast cells have shown only a fraction of genes, one out of five, was essential for a cell’s survival. This discovery was made by an international consortium of scientists over a decade ago where they targeted each of the yeast cell’s 6,000 genes for deletion. Recent advances in gene editing technology has allowed scientists to tackle the same question in human cells, resulting in the same answer—only a fraction of genes are essential to cell life. Building on this research, University of Minnesota computer science and engineering Associate Professor Chad Myers, along with Professors Brenda Andrews and Charles Boone from the University of Toronto’s Donnelly Centre, have created the first complete genetic interaction network of a yeast cell, one that begins to explain how thousands of genes coordinate with one another to orchestrate cellular life. “Even though many common diseases are thought to be caused by many different loci in the genome, we don't really understand the basic principles for how multiple genes combine to have effects,” Myers said. “Our comprehensive study of double mutant combinations in yeast establishes a set of first principles that we expect to apply in many different species, including humans.” Biking without brakes These findings suggest that most genes within our genomes are “buffered” to protect the cell from mutations and environmental stresses. Cells contain backup systems to ensure the essential functions of life keep working properly, even when one part is damaged. To address this buffering property, scientists had to ask if cells can survive upon losing more than one gene at a time, and they had to test millions of gene pairs. Andrews, Boone, and Myers led the pioneering work in yeast cells by studying cell survival in the context of double mutants. To do so, they automated yeast genetic analysis, and they used robots to construct and examine almost all of the 18 million pairwise double mutant combinations. The global genetic interaction map catalogues the pairs of genes that provide back up for one another—if the gene function of one is lost, the other gene in the genome fills its role. Consider a bicycle analogy: a wheel is akin to an essential gene — a part without which it would be impossible to ride. Front brakes? That depends, because you could ride just fine as long as the back brakes are working. But what if you were to lose both sets of brakes? Without back brakes, the front brakes become essential, and vice versa. Geneticists would call the relationship between front and back brakes as “synthetic lethal," meaning that losing both, but neither by themselves, spells doom. Synthetic lethal double mutant gene pairs are relatively rare, but when they are found, they reveal important information on gene pairs that work together to control essential functions. Guilt by association What’s more, the global map shows that synthetic lethal gene pairs are more likely to control the same biological process in the cell. This way, scientists are able to predict what a gene actually does in the cell simply based on its genetic interaction patterns, a process referred to as “guilt by association”. If most genes in the human genome have one or more backup genes, then instead of searching for single genes underlying diseases, researchers now must look for gene pairs. This poses a huge challenge because they must somehow examine on the order of 200 million (!) possible gene pairs in the human genome that are associated with a disease. Fortunately, with the know-how from the yeast map, researchers can now begin to map genetic interactions in human cells, and even expand it to a number of different cell types. “Technology to manipulate human genomes on a large scale exists now,” Myers said. “Our work in yeast provides a blueprint for how we can learn about the human genome through systematic manipulation in cell lines.” The concept of synthetic lethality is already changing cancer treatment because of its potential to identify drug targets that exist only in tumor cells. Cancer cells differ from normal cells in that they have scrambled genomes, littered with mutations. If scientists could find the highly vulnerable back-up genes in cancer, they could target specific drugs at them to destroy only the cells that are sick, leaving the healthy ones untouched. This work was primarily supported by the National Institutes of Health, Canadian Institutes of Health Research, RIKEN Strategic Programs for R&D, Japan Society for the Promotion of Science Kakeni Grants, and the National Science Foundation.
Newswise — About 20-25 percent of adults have the metabolic syndrome and have increased risk of developing both cardiovascular disease and type 2 diabetes. In this longitudinal study, investigators examined associations between childhood muscular fitness (strength, endurance, and power) and metabolic syndrome – the latter assessed once they reached adulthood. The results suggest that higher levels of childhood muscular fitness might protect against developing metabolic syndrome in adult years. Further, this relationship was found to be independent of the childhood cardiorespiratory fitness levels. For example, those with the highest muscular fitness at ages 9-15 years, had an 80 percent lower risk of developing metabolic syndrome in adulthood – in comparison to those who had low muscular fitness levels during childhood. Supporting the current World Health Organization physical activity guidelines, these results highlight the importance of both muscular strengthening activities and aerobic exercise. Overall, the study supports that a combination of increased muscular fitness, increased cardiorespiratory fitness and decreased adiposity in childhood may reduce future risk metabolic syndrome. Click here to access the abstract.
Newswise — Hatha yoga is an increasingly popular form of physical activity and meditative practice in the U.S. It is important to understand the calorie cost and intensity of yoga in relation to the national physical activity guidelines, such as those recommended by the American College of Sports Medicine (ACSM) and the American Heart Association (AHA). These guidelines encourage 30 minutes of moderate-intensity physical activity on most days of the week. This study was a systematic review that evaluated published research investigations that have directly measured the calorie cost of yoga and calculated the metabolic intensity (METS) of individual yoga poses including a popular sequence called “sun salutations.” Based on ACSM/AHA classification, the intensity of holding most poses and of full yoga sessions ranged from light (less than 3 METS) to moderate-intensity (3-6 METS), with the majority classified as light-intensity. A few sequences/poses, including the sun salutations, met the criteria for moderate-intensity activity. The health benefits of yoga, however, should not be discounted. The regular practice of yoga may also increase strength, balance and flexibility, calm the mind and reduce stress. Click here to access the abstract.
Newswise — Washington, DC— Exposure to bisphenol A (BPA) and other endocrine-disrupting chemicals (EDCs) may reduce levels of vitamin D in the bloodstream, according to a new study published in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism. The study is the first to find an association between EDC exposure and vitamin D levels in a large group of U.S. adults. EDCs are chemicals or mixtures of chemicals that can cause adverse health effects by interfering with hormones in the body. The Society’s Scientific Statement on EDCs examined more than 1,300 studies that found links between chemical exposure and health problems, including infertility, obesity, diabetes, neurological problems and hormone-related cancers. “Nearly every person on the planet is exposed to BPA and another class of endocrine-disrupting chemicals called phthalates, so the possibility that these chemicals may even slightly reduce vitamin D levels has widespread implications for public health,” said the study’s first author, Lauren Johns, MPH, a PhD candidate at the University of Michigan School of Public Health in Ann Arbor, MI. “Vitamin D plays a broad role in maintaining bone and muscle health. In addition, low vitamin D levels have been implicated in outcomes of numerous conditions such as cardiovascular disease, diabetes and cancer.” EDCs are found in everyday products and throughout the environment. There are more than 85,000 manufactured chemicals, of which thousands may be EDCs. BPA, a known EDC, is often found in plastics and other consumer products. Another group of chemicals linked to hormone disruption, phthalates, are found in personal care products such as cosmetics, children’s products, food packaging and medical tubing.The study examined data from 4,667 adults who participated in the National Health and Nutrition Examination Survey (NHANES) between 2005 and 2010. NHANES is a cross-sectional study designed to collect health and nutrition data from a sample of adults from across the United States. The participants provided blood samples so their vitamin D levels could be measured. To measure EDC exposure, the participants had their urine analyzed for substances left behind after the body metabolized phthalates and BPA. The study found people who were exposed to larger amounts of phthalates were more likely to have low levels of vitamin D in the bloodstream than the participants who were exposed to smaller amounts of the EDCs. The link was strongest in women. There also was an association between exposure to higher levels of BPA and reduced vitamin D levels in women, although the relationship was not statistically significant in men. “More research is needed into why an association exists, but it is possible that EDCs alter the active form of vitamin D in the body through some of the same mechanisms that they use to impact similar reproductive and thyroid hormones,” said Professor John D. Meeker, MS, ScD, senior author of the study. “Confirmatory studies are needed to show whether this association exists in other populations.” The study, “Relationships between Phthalate and Bisphenol A Concentrations and Vitamin D Levels in U.S. Adults,” will be published online at http://press.endocrine.org/doi/10.1210/jc.2016-2134, ahead of print. Kelly K. Ferguson of the University of Michigan School of Public Health and the National Institute of Environmental Health Sciences (NIEHS) in Research Triangle Park, NC, co-authored the study with Meeker and Johns. The research was supported in part by the National Institutes of Health’s NIEHS, as well as its intramural research program. For more information on endocrine-disrupting chemicals, visit the Endocrine Society’s centennial website. # # #
Newswise — CHAPEL HILL – An analysis of the quality of life of several thousand breast cancer survivors in North Carolina found differences in how black and white women functioned and felt physically and spiritually during treatment and two years after diagnosis. The study, led by researchers from the University of North Carolina Lineberger Comprehensive Cancer Center, found white women reported higher physical and functional health-related quality of life scores compared with black women during active treatment. The gap in physical quality of life scores narrowed two years after diagnosis, however, and in both physical and functional measures after researchers adjusted the data to account for differences in education, insurance, and marital status. The findings suggest that improved socioeconomic conditions could enhance physical and functional quality of life for breast cancer survivors. Yet, some differences remained. Chiefly, black women had higher spiritual quality of life scores five months and two years after diagnosis than white women, and after adjusting for socioeconomic factors. “Black women generally had poorer physical and functional quality of life after the diagnosis of breast cancer, and socioeconomic and other factors explain some of these differences,” said study co-author Andrew Olshan, PhD, associate director of population sciences at UNC Lineberger and the Barbara Sorenson Hulka Distinguished Professor in Cancer Epidemiology at the UNC Gillings School of Global Public Health. “However, for some domains, black women report better quality of life.” The study, published in the journal Breast Cancer Research and Treatment, drew upon surveys that assessed health-related quality of life issues for women aged 20 to 74 years who lived in North Carolina and had breast cancer. The analysis is part of the third phase of the Carolina Breast Cancer Study, a study first launched at UNC-Chapel Hill in 1993 as part of an effort to better understand why black women have been found to disproportionately die from breast cancer. Olshan is the co-principal investigator of the study. Researchers used surveys to gauge the physical, functional, emotional and spiritual health-related quality of life of more than 2,100 women at five months after their breast cancer diagnosis, and at 25 months, when women have typically stopped active treatment and have entered the survivorship phase.For spiritual quality of life, researchers found that black women scored two points higher than white women at five months, when they were in the midst of active treatment, and two years after diagnosis. Specifically, black women scored an unadjusted average of 41.4 points on spiritual quality of life, while white women scored an average of 39.3 at five months. Two years after diagnosis, black women scored an unadjusted average of 40.5 on spiritual quality of life, while white women had an average score of 38.5. Even after adjusting for socioeconomic factors, black women continued to score higher than white women for spiritual quality of life two years after diagnosis, the study reports. “Black women we surveyed had significantly better spiritual wellbeing than white women, and it was both statistically significant and clinically meaningful,” said the study's first author Laura Pinheiro, a doctoral candidate in the UNC Gillings School of Global Public Health. White women’s average scores for physical and functional quality of life, which track women’s feelings of fatigue, nausea, pain, the woman’s ability to work, sleep, acceptance of her illness and ability to enjoy things in normal life, were two to 2.5 points higher than black women at five months. The unadjusted average score for white women’s physical health at five months was 20.9, compared to 18.4 for black women. For functional health, white women scored an average of 20.1 compared to 18.2 for black women. At 25 months after diagnosis, the researchers found that white women still scored higher for physical, social, and functional health-related quality of life, but the gap between the unadjusted physical scores for white and black women narrowed compared to what they were at five months for physical health-related quality of life. Pinheiro said that the findings, in-line with previous studies, could suggest that the health care system may have had a positive impact on the black women’s overall physical health, helping to narrow those gaps. “As these women are entering the health care system, perhaps some of their other health conditions are better managed,” Pinheiro said. “That is our speculation, and it will merit some additional investigation.”They also report that after adjusting for socioeconomic factors during survivorship, differences in physical health-related quality of life were diminished. “Our research suggests that improved social and economic conditions could improve access to care, reduce co-morbid conditions, and other factors that are associated with both the prognosis of breast cancer, quality of life, and the disparities seen between various groups,” Olshan said. The study demonstrates the importance of the Carolina Breast Cancer Study in understanding how breast cancer and its treatment impacts the lives of North Carolinians, said the study’s senior author Bryce Reeve, PhD, a UNC Lineberger member and professor in the UNC Gillings School of Global Public Health.“We hope to use these findings to find opportunities to improve the quality of life of women with breast cancer,” Reeve said. In addition to Olshan, Pinheiro and Reeve, other authors included: Cleo A. Samuel, Katherine E. Reeder-Hayes, and Stephanie B. Wheeler.The study was supported by the University Cancer Research Fund of North Carolina, the National Cancer Institute Specialized Program of Research Excellence in Breast Cancer at UNC, the Susan G. Komen for the Cure Foundation, and the National Institutes of Health.   SEE ORIGINAL STUDY