Research Roundup	Print Issue
April 15, 2008, Volume 54, No. 29

More Popular Than American Idol: American Politics

Americans are following the 2008 presidential campaign more closely than they did in 2004, according to data released by the National Annenberg Election Survey of the University of Pennsylvania. More than three-quarters of adults in the United States (78%) report following the 2008 presidential campaign “very closely” or “somewhat closely.” When asked a comparable question in 2004, 57% of adults reported following the Democratic primary “very closely” or “somewhat closely.”

“Political scholars often worry that Americans do not pay enough attention to politics. This campaign season has demonstrated that competitive races with the right candidates can trigger interest,” said Dr. Kate Kenski, senior analyst for the National Annenberg Election Survey and assistant professor of communication at the University of Arizona.

Among demographic groups this year, older respondents were more likely to follow the campaign closely than were younger respondents. Respondents with higher incomes were more likely to report following the campaign closely than were those with lower incomes. Those living in urban areas were more likely to report following the campaign closely than were those in rural areas. Democrats were slightly more likely to report following the campaign very closely than were Republicans and Independents.

Data for this study were collected between December 17, 2007 and March 18, 2008 from 20,225 adults and between December 1, 2003 and March 8, 2004 from 18,007 adults in the United States.

Exploration of Lost Port City in Region of the Trojan War

Along an isolated stretch of the eastern shoreline of Greece, Dr. Thomas Tartaron, assistant professor of classical studies, and his colleagues are unlocking the secrets of a partially submerged harbor town believed to have been built by the Mycenaeans 3,500 years ago.

The settlement, referred to as Korphos-Kalamianos by Dr. Tartaron and Dr. Daniel J. Pullen, of Florida State University, rests on the shores of the Saronic Gulf in the western Aegean Sea about 60 miles southwest of Athens. Drs. Tartaron and Pullen are members of the Saronic Harbors Archaeological Research Project, or SHARP, that promises to shed new light on a wide range of questions about how Mycenaean influence in the region spread so quickly and what forces caused so many Mycenaean centers to be abruptly abandoned just a century later.

Mycenaean Greece is a region known as the center of Homer’s epic tales, including the Trojan War. The site was discovered by the Eastern Korinthia Archaeological Survey project in 2001 using computer modeling and a search of hundreds of miles of coastline.

The structures’ grid-like pattern suggests that the entire community was planned and built rather than pieced together. To researchers, this indicated that the settlement was built with purpose, perhaps as a military or naval outpost.

This spring, the team returns to document the architecture and other remains at Kalamianos with special emphasis on geological work that will reconstruct the contours of the Bronze Age shoreline. In 2009, excavation will begin at selected locations in the port town to learn about the daily lives of the people of Mycenaean Kalamianos.

New Method for Treating Major Depression

Researchers at the University of Pennsylvania School of Medicine and other study sites have found that transcranial magnetic stimulation (TMS)–a non-invasive technique that excites neurons in the brain via magnetic pulses passed through the scalp is a safe and effective, non-drug treatment with minimal side effects for patients with major depression who have tried other treatment options without benefit.

This study–the largest to-date studying TMS as a standalone treatment for major depression–appeared in the December 1, 2007 issue of Biological Psychiatry.

“TMS provides a well-tolerated treatment option to patients whose depression is otherwise treatment resistant,” said Dr. John P. O’Reardon, associate professor of psychiatry, and lead study author.  “Since TMS is administered via the scalp and therefore goes directly to the brain, it allows the patient to avoid bodily side effects such as weight gain, sedation and/or loss of sexual function.”

Dr. O’Reardon further commented, “As indicated by recent large scale, government-sponsored, studies of existing treatment options for major depression conducted by the National Institutes of Health (the STAR-D reports), there is a great need to develop new, effective treatments for patients, especially those not benefiting from first line interventions. The results of this study indicate that TMS offers new hope to patients in this regard.”

Colonoscopy Fears Overcome With Support

Patients who have had a colonoscopy can play a life-saving role by encouraging other patients to follow through with their own colorectal cancer screenings, according to new research from Penn’s School of Medicine. These peer coaches can provide important information to combat myths and fears that serve as barriers to colonoscopy—issues patients say their doctors often fail to address.

In a randomized trial, clinicians in the division of general internal medicine studied patients who were at increased risk of missing their scheduled colon study appointment.  They found that those who received telephone mentoring from a trained “peer coach” were two times more likely to keep their first colonoscopy appointment than those who received an educational brochure about the procedure in the mail or received no peer or literature support.

Colorectal cancer is the second most common cause of cancer-related death in the United States, but less than 60 percent of Americans over the age of 50 have had a screening colonoscopy or sigmoidoscopy in the past ten years. Even when patients schedule appointments for these tests, one-third of patients cancel, in part because they have unanswered questions or unfounded fears about the procedure or the colon-cleansing preparation.

Lead author Dr. Barbara J. Turner, professor of medicine and director of Penn’s General Medicine Physician Scientist Fellowship and her colleague Dr. Kevin Fosnocht, Chief Quality and Patient Safety Officer for Penn Presbyterian Medical Center, ran a training program for the five peer coaches, each of whom had previously had a colonoscopy. During the program, the coaches learned about communication strategies, the biology of colorectal cancer, screening modalities and potential barriers to colonoscopy.

During follow-up phone calls, 80 percent of patients in the peer coach arm of the study rated their coaching as “very helpful,” and most appreciated hearing about another patient’s experience and commented on their need for more information than was provided by their physician.

Those findings mirror previous Penn research, published in the August 2007 issue of the Journal of Family Practice, which identified communications shortfalls among doctors discussing colonoscopy with patients. Although most doctors who were studied explained the value of screening to patients, few touched on issues concerning insurance coverage for the procedure—a barrier for many patients—dietary issues before the procedure, or risks of the procedure.

“Mobile Polling” for Older American Voters

The US Senate Special Committee on Aging held a hearing in January in Washington, DC, on older Americans and the significant barriers they face in exercising their right to vote. Dr. Jason Karlawish, associate professor of medicine and medical ethics in the School of Medicine, testified before the Committee, citing results from a series of his studies examining voting rights for the elderly. Dr. Karlawish, a member of Penn’s Institute on Aging, recommended that to help break down the logistical and geographical voting barriers many older Americans face, the US must develop a model for mobile polling. 

“Elderly voters–especially elderly voters who live in long-term care settings–are at the mercy of others when it comes to exercising their right to vote,” said Dr. Karlawish. Due to geographical distances, the lack of transportation to polling sites, and the lack of assistance to absentee ballot applications, it is other people who decide whether or not older Americans with issues of mobility can vote.

“Mobile polling means election officials or equivalent groups visit long-term facilities in their district prior to registration deadlines to encourage and solicit registrations,” said Dr. Karlawish. “It also means directly distributing ballots to long-term facility residents, assisting with voting, collecting ballots and ensuring their return to a polling site.”

Dr. Karlawish reported on the results of studies of voting in long-term care populations conducted by him and his colleagues.  Twenty-nine states do not have voting guidelines to accommodate residents of long-term care facilities. The convergence of four trends underscores the need to address this issue:

1) The 2000 US presidential election demonstrated how very important elections can be won by remarkably small numbers of votes; 2) Older Americans vote in larger numbers than any other age group; 3) The older American population is growing. It is estimated that between 2000 and 2030, the population over 65 will more than double from 35 million to 71.5 million; 4) A larger number of Americans with cognitive impairments live in long-term care settings such as assisted living facilities and nursing homes.