Originally posted on Health Services Authors:
The dilemma is pretty well addressed in this article:
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[News item] Religion, spirituality influence health in different but complementary ways — ScienceDaily
March 28, 2014
Oregon State University
Religion and spirituality have distinct but complementary influences on health, new research indicates. A new theoretical model defines the two distinct pathways. “Religion helps regulate behavior and health habits, while spirituality regulates your emotions, how you feel,” explains one of the authors.
Disclaimer: My husband’s cousin developed diabetes after serving in Afghanistan. Diabetes did not run in the family nor did he have a lifestyle that predisposed him to this disease (in our opinion, of course). The VA did pay for his treatment, no questions asked.
Am thankful that research is being done to show just how war related chemicals, and even preventive agents are very harmful and deadly.
March 27, 2014
University of California, San Diego Health Sciences
Veterans of the 1990-91 Persian Gulf War who suffer from “Gulf War illness” have impaired function of mitochondria – the energy powerhouses of cells, researchers have demonstrated for the first time. The findings could help lead to new treatments benefitting affected individuals — and to new ways of protecting servicepersons (and civilians) from similar problems in the future.
Golomb noted that impaired mitochondrial function accounts for numerous features of Gulf War illness, including symptoms that have been viewed as perplexing or paradoxical.
“The classic presentation for mitochondrial illness involves multiple symptoms spanning many domains, similar to what we see in Gulf War illness. These classically include fatigue, cognitive and other brain-related challenges, muscle problems and exercise intolerance, with neurological and gastrointestinal problems also common.”
There are other similarities between patients with mitochondrial dysfunction and those suffering from Gulf War illness: Additional symptoms appear in smaller subsets of patients; varying patterns of symptoms and severity among individuals; different latency periods across symptoms, or times when symptoms first appear; routine blood tests that appear normal.
“Some have sought to ascribe Gulf War illness to stress,” said Golomb, “but stress has proven not to be an independent predictor of the condition. On the other hand, Gulf veterans are known to have been widely exposed to acetylcholinesterase inhibitors, a chemical class found in organophosphate and carbamate pesticides, nerve gas and nerve gas pre-treatment pills given to troops.
“These inhibitors have known mitochondrial toxicity and generally show the strongest and most consistent relationship to predicting Gulf War illness. Mitochondrial problems account for which exposures relate to Gulf War illness, which symptoms predominate, how Gulf War illness symptoms manifest themselves, what objective tests have been altered, and why routine blood tests have not been useful.”
Tel Aviv University research shows fat mass in cells expands with disuse
Over 35 percent of American adults and 17 percent of American children are considered obese, according to the latest survey conducted by the Centers for Disease Control and Prevention. Associated with diabetes, heart disease, stroke, and even certain types of cancer, obesity places a major burden on the health care system and economy. It’s usually treated through a combination of diet, nutrition, exercise, and other techniques.
To understand how obesity develops, Prof. Amit Gefen, Dr. Natan Shaked and Ms. Naama Shoham of Tel Aviv University’s Department of Biomedical Engineering, together with Prof. Dafna Benayahu of TAU’s Department of Cell and Developmental Biology, used state-of-the-art technology to analyze the accumulation of fat in the body at the cellular level. According to their findings, nutrition is not the only factor driving obesity. The mechanics of “cellular expansion” plays a primary role in fat production, they discovered.
By exposing the mechanics of fat production at a cellular level, the researchers offer insight into the development of obesity. And with a better understanding of the process, the team is now creating a platform to develop new therapies and technologies to prevent or even reverse fat gain. The research was published this week in the Biophysical Journal.
Getting to the bottom of obesity
“Two years ago, Dafna and I were awarded a grant from the Israel Science Foundation to investigate how mechanical forces increase the fat content within fat cells. We wanted to find out why a sedentary lifestyle results in obesity, other than making time to eat more hamburgers,” said Prof. Gefen. “We found that fat cells exposed to sustained, chronic pressure — such as what happens to the buttocks when you’re sitting down — experienced accelerated growth of lipid droplets, which are molecules that carry fats.
“Contrary to muscle and bone tissue, which get mechanically weaker with disuse, fat depots in fat cells expanded when they experienced sustained loading by as much as 50%. This was a substantial discovery.”
The researchers discovered that, once it accumulated lipid droplets, the structure of a cell and its mechanics changed dramatically. Using a cutting-edge atomic force microscope and other microscopy technologies, they were able to observe the material composition of the transforming fat cell, which became stiffer as it expanded. This stiffness alters the environment of surrounding cells by physically deforming them, pushing them to change their own shape and composition.
“When they gain mass and change their composition, expanding cells deform neighboring cells, forcing them to differentiate and expand,” said Prof. Gefen. “This proves that you’re not just what you eat. You’re also what you feel — and what you’re feeling is the pressure of increased weight and the sustained loading in the tissues of the buttocks of the couch potato.”
The more you know …
“If we understand the etiology of getting fatter, of how cells in fat tissues synthesize nutritional components under a given mechanical loading environment, then we can think about different practical solutions to obesity,” Prof. Gefen says. “If you can learn to control the mechanical environment of cells, you can then determine how to modulate the fat cells to produce less fat.”
The team hopes that its observations can serve as a point of departure for further research into the changing cellular environment and different stimulations that lead to increased fat production.
HUNTSVILLE, TX (3/20/14) — Parents who use alcohol, marijuana, and drugs have higher frequencies of children who pick up their habits, according to a study from Sam Houston State University.
The study, “Intergenerational Continuity of Substance Use,” found that when compared to parents who did not use substances, parents who used alcohol, marijuana, and other illicit drugs were significantly more likely to have children who used those same drugs. Specifically, the odds of children’s alcohol use were five times higher if their parents used alcohol; the odds of children’s marijuana use were two times higher if their parents used marijuana; and the odds of children’s other drug use were two times higher if their parent used other drugs. Age and other demographic factors also were important predictors of substance use.
“The study is rare in that it assesses the extent to which parent’s substance use predicts use by their children within age-equivalent and developmentally-specific stages of the life course,” said Dr. Kelly Knight of the College Criminal Justice’s Department of Criminal Justice and Criminology. “If a parent uses drugs, will their children grow up and use drugs? When did the parent use and when did their children use? There appears to be an intergenerational relationship. The effect is not as strong as one might believe from popular discourse, but when you measure it by developmental stage, it can provide important information on its impact in adolescence and early adulthood, specifically.”
The study examined the patterns of substance use by families over a 27-year period. It documents substance use over time, giving a more complete understanding of when substance use occurs, when it declines, and the influence of parents in the process.
According to the National Survey on Drug Use and Health in 2011, about 22.6 million Americans age 12 years and older said they used illicit drugs in the last month. Other studies show that drug use is associated with reduced academic achievement, lower employment rates, poorer health, dependency on public assistance, neighborhood disorganization, and an increase in the likelihood of involvement in crime, criminal victimization and incarceration. The cost of drug use in this country from lost productivity, healthcare, and criminal justice is nearly $600 billion.
By plotting the life course of substance use within families, the study may be a valuable tool for the development of intervention programs. The study suggests that if substance use can be curtailed in adolescence, it may help to curb its prevalence in future generations.
The study also helps pinpoint the use of different illicit substances over the span of a lifetime, including its emergence in adolescence and when that use may decline. For example, marijuana and other drug use is most prevalent in adolescence and generally declines before or at age 24. Alcohol use continues to increase throughout adolescence and young adulthood, and then remains relatively steady over the lifetime.
These findings come from the National Youth Survey Family Study, which has collected data from three generations over a 27-year period. The analysis is based on 655 parents and 1,227 offspring from 1977 to 2004.
Addictive behavior such as drug and alcohol abuse could be associated with poor development of the so-called “love hormone” system in our bodies during early childhood, according to researchers at the University of Adelaide. The groundbreaking idea has resulted from a review of worldwide research into oxytocin, known as the “love hormone” or “bonding drug” because of its important role in enhancing social interactions, maternal behavior and partnership. This month’s special edition of the international journal Pharmacology, Biochemistry and Behavior deals with the current state of research linking oxytocin and addiction, and has been guest edited by Dr Femke Buisman-Pijlman from the University of Adelaide’s School of Medical Sciences. Dr Buisman-Pijlman, who has a background in both addiction studies and family studies, says some people’s lack of resilience to addictive behaviors may be linked to poor development of their oxytocin systems.
“We know that newborn babies already have levels of oxytocin in their bodies, and this helps to create the all-important bond between a mother and her child. But our oxytocin systems aren’t fully developed when we’re born – they don’t finish developing until the age of three, which means our systems are potentially subject to a range of influences both external and internal,” Dr Buisman-Pijlman says. She says the oxytocin system develops mainly based on experiences. “The main factors that affect our oxytocin systems are genetics, gender and environment. You can’t change the genes you’re born with, but environmental factors play a substantial role in the development of the oxytocin system until our systems are fully developed,” Dr Buisman-Pijlman says. IMAGE: This photo shows Dr. Femke Buisman-Pijlman from the University of Adelaide. She is the guest editor of the April 2014 edition of Pharmacology, Biochemistry and Behavior, which is focused on… Click here for more information. “Previous research has shown that there is a high degree of variability in people’s oxytocin levels. We’re interested in how and why people have such differences in oxytocin, and what we can do about it to have a beneficial impact on people’s health and wellbeing,” she says. She says studies show that some risk factors for drug addiction already exist at four years of age. “And because the hardware of the oxytocin system finishes developing in our bodies at around age three, this could be a critical window to study. Oxytocin can reduce the pleasure of drugs and feeling of stress, but only if the system develops well.” Her theory is that adversity in early life is key to the impaired development of the oxytocin system. “This adversity could take the form of a difficult birth, disturbed bonding or abuse, deprivation, or severe infection, to name just a few factors,” Dr Buisman-Pijlman says. “Understanding what occurs with the oxytocin system during the first few years of life could help us to unravel this aspect of addictive behavior and use that knowledge for treatment and prevention.”
DALLAS, March 16, 2014 — Honey, that delectable condiment for breads and fruits, could be one sweet solution to the serious, ever-growing problem of bacterial resistance to antibiotics, researchers said here today.
Medical professionals sometimes use honey successfully as a topical dressing, but it could play a larger role in fighting infections, the researchers predicted. Their study was part of the 247th National Meeting of the American Chemical Society (ACS), the world’s largest scientific society.
The meeting, attended by thousands of scientists, features more than 10,000 reports on new advances in science and other topics. It is being held at the Dallas Convention Center and area hotels through Thursday.
“The unique property of honey lies in its ability to fight infection on multiple levels, making it more difficult for bacteria to develop resistance,” said study leader Susan M. Meschwitz, Ph.D. That is, it uses a combination of weapons, including hydrogen peroxide, acidity, osmotic effect, high sugar concentration and polyphenols — all of which actively kill bacterial cells, she explained. The osmotic effect, which is the result of the high sugar concentration in honey, draws water from the bacterial cells, dehydrating and killing them.
In addition, several studies have shown that honey inhibits the formation of biofilms, or communities of slimy disease-causing bacteria, she said. “Honey may also disrupt quorum sensing, which weakens bacterial virulence, rendering the bacteria more susceptible to conventional antibiotics,” Meschwitz said. Quorum sensing is the way bacteria communicate with one another, and may be involved in the formation of biofilms. In certain bacteria, this communication system also controls the release of toxins, which affects the bacteria’s pathogenicity, or their ability to cause disease.
Meschwitz, who is with Salve Regina University in Newport, R.I., said another advantage of honey is that unlike conventional antibiotics, it doesn’t target the essential growth processes of bacteria. The problem with this type of targeting, which is the basis of conventional antibiotics, is that it results in the bacteria building up resistance to the drugs.
Honey is effective because it is filled with healthful polyphenols, or antioxidants, she said. These include the phenolic acids, caffeic acid, p-coumaric acid and ellagic acid, as well as many flavonoids. “Several studies have demonstrated a correlation between the non-peroxide antimicrobial and antioxidant activities of honey and the presence of honey phenolics,” she added. A large number of laboratory and limited clinical studies have confirmed the broad-spectrum antibacterial, antifungal and antiviral properties of honey, according to Meschwitz.
She said that her team also is finding that honey has antioxidant properties and is an effective antibacterial. “We have run standard antioxidant tests on honey to measure the level of antioxidant activity,” she explained. “We have separated and identified the various antioxidant polyphenol compounds. In our antibacterial studies, we have been testing honey’s activity against E. coli, Staphylococcus aureus and Pseudomonas aeruginosa, among others.”
March 19, 2014
American Heart Association
Kids whose parents are demanding but not emotionally responsive are about one-third more likely to be obese than kids whose parents set healthy boundaries, are affectionate and discuss behavior. Researchers compared kids whose parents are generally affectionate, have reasonable discussions about behavior with their child and set healthy boundaries (authoritative) with those whose parents were strict about limits without much dialogue or affection (authoritarian).
[News story] Commonly used pain relievers have added benefit of fighting bacterial infection — ScienceDaily
Some commonly used drugs that combat aches and pains, fever, and inflammation are also thought to have the ability to kill bacteria. New research reveals that these drugs, better known as nonsteroidal anti-inflammatory drugs, act on bacteria in a way that is fundamentally different from current antibiotics. The discovery could open up new strategies for fighting drug-resistant infections and ‘superbugs.’
“We discovered that some anti-inflammatory drugs used in human and veterinary medicine have weak antibiotic activity and that they exert this secondary activity by preventing bacteria from copying their DNA, which they need to do in order to multiply,” explains senior author Dr. Aaron Oakley of the University of Wollongong, in Australia. The researchers analyzed three NSAIDs: bromofenac, carprofen, and vedaprofen. The more commonly known NSAIDs, which include aspirin, ibuprofen, and naproxen, were not tested.
Originally posted on robertbyron22:
I remember when the BRCA genes were discovered and first used in screening for cancer. Estimates were that approximately 10 times the number of the women who could possibly have developed breast cancer chose to have mastectomies. Many of these were undoubtedly prophylactic surgeries, but still … Now the test is recommended to be used in the context of family histories, rather than in testing the general population. Here is a current factsheet from the National Cancer Institute:
Who should consider genetic testing for BRCA1 and BRCA2 mutations?
Because harmful BRCA1 and BRCA2 gene mutations are relatively rare in the general population, most experts agree that mutation testing of individuals…
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Originally posted on Public Health View:
The study, which included over 6,000 participants aged 50 and above, found that those aged 50-65 reporting high-protein diets had a 75% higher risk of death and 4 times the risk of cancer death than those who did not. Conversely, it found that this risk turned into a protective effect for those who were 65 and older. These older individuals had a lower risk of death overall and death from cancer if they consumed more proteins.
Both adult groups, however, were 5 times more at risk of death from diabetes if their lifestyle included a high-protein diet.
Also, when animal-based…
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Excerpts from the 21 February 2014 article
The bacteria in our guts can influence the working of the mind, says Frank Swain. So could they be upgraded to enhance brainpower?
I have some startling news: you are not human. At least, by some counts. While you are indeed made up of billions of human cells working in remarkable concert, these are easily outnumbered by the bacterial cells that live on and in you – your microbiome. There are ten of them for every one of your own cells, and they add an extra two kilograms (4.4lbs) to your body.
Far from being freeloading passengers, many of these microbes actively help digest food and prevent infection. And now evidence is emerging that these tiny organisms may also have a profound impact on the brain too. They are a living augmentation of your body – and like any enhancement, this means they could, in principle, be upgraded. So, could you hack your microbiome to make yourself healthier, happier, and smarter too?
“Diet is perhaps the biggest factor in shaping the composition of the microbiome,” he says. A study by University College Cork researcherspublished in Nature in 2012 followed 200 elderly people over the course of two years, as they transitioned into different environments such as nursing homes. The researchers found that their subjects’ health – frailty, cognition, and immune system – all correlated with their microbiome. From bacterial population alone, researchers could tell if a patient was a long-stay patient in a nursing home, or short-stay, or living in the general community. These changes were a direct reflection of their diet in these different environments. “A diverse diet gives you a diverse microbiome that gives you a better health outcome,” says Cryan.
Beyond a healthy and varied diet, though, it still remains to be discovered whether certain food combinations could alter the microbiome to produce a cognitive boost. In fact, Cryan recommends that claims from probiotic supplements of brain-boosting ought to be taken with a pinch of salt for now. “Unless the studies have been done, one can assume they’re not going to have any effect on mental health,” he says. Still, he’s optimistic about the future. “The field right now is evolving very strongly and quickly. There’s a lot of important research to be done. It’s still early days.”
Review article highlights lack of strong research about addictive nature of viewing sexual images
Journalists and psychologists are quick to describe someone as being a porn “addict,” yet there’s no strong scientific research that shows such addictions actually exists. Slapping such labels onto the habit of frequently viewing images of a sexual nature only describes it as a form of pathology. These labels ignore the positive benefits it holds. So says David Ley, PhD, a clinical psychologist in practice in Albuquerque, NM, and Executive Director of New Mexico Solutions, a large behavioral health program. Dr. Ley is the author of a review article about the so-called “pornography addiction model,” which is published in Springer’s journal Current Sexual Health Reports.
“Pornography addiction” was not included in the recently revised Diagnostic and Statistical Manual because of a lack of scientific data. Fewer than two in every five research articles (37 percent) about high frequency sexual behavior describe it as being an addiction. Only 27 percent (13 of 49) of articles on the subject contained actual data, while only one related psychophysiological study appeared in 2013. Ley’s review article highlights the poor experimental designs, methodological rigor and lack of model specification of most studies surrounding it.
The research actually found very little evidence – if any at all – to support some of the purported negative side effects of porn “addiction.” There was no sign that use of pornography is connected to erectile dysfunction, or that it causes any changes to the brains of users. Also, despite great furor over the effects of childhood exposure to pornography, the use of sexually explicit material explains very little of the variance in adolescents’ behaviors. These are better explained and predicted by other individual and family variables.
Instead, Ley and his team believe that the positive benefits attached to viewing such images do not make it problematic de facto. It can improve attitudes towards sexuality, increase the quality of life and variety of sexual behaviors and increase pleasure in long-term relationships. It provides a legal outlet for illegal sexual behaviors or desires, and its consumption or availability has been associated with a decrease in sex offenses, especially child molestation.
Clinicians should be aware that people reporting “addiction” are likely to be male, have a non-heterosexual orientation, have a high libido, tend towards sensation seeking and have religious values that conflict with their sexual behavior and desires. They may be using visually stimulating images to cope with negative emotional states or decreased life satisfaction.
“We need better methods to help people who struggle with the high frequency use of visual sexual stimuli, without pathologizing them or their use thereof,” writes Ley, who is critical about the pseudoscientific yet lucrative practices surrounding the treatment of so-called porn addiction. “Rather than helping patients who may struggle to control viewing images of a sexual nature, the ‘porn addiction’ concept instead seems to feed an industry with secondary gain from the acceptance of the idea.”###
Reference: Ley, D. et al. (2014). The Emperor Has No Clothes: A Review of the “Pornography Addiction” Model, Current Sexual Health Reports. DOI 10.1007/s11930-014-0016-8.
The full text article and interviews are available to journalists upon request.
Contact: Alexander Brown | Springer | tel.: +1 212.620.8063 | firstname.lastname@example.org
Biologists have shown in rats that chronic stress makes stem cells in the brain produce more myelin-producing cells and fewer neurons, possibly affecting the speed of connections between cells as well as memory and learning. This could explain why stress leads to mental illness, such as PTSD, anxiety and mood disorders, later in life.…
Does stress affect brain connectivity?
Kaufer’s findings suggest a mechanism that may explain some changes in brain connectivity in people with PTSD, for example. One can imagine, she said, that PTSD patients could develop a stronger connectivity between the hippocampus and the amygdala — the seat of the brain’s fight or flight response — and lower than normal connectivity between the hippocampus and prefrontal cortex, which moderates our responses.
“You can imagine that if your amygdala and hippocampus are better connected, that could mean that your fear responses are much quicker, which is something you see in stress survivors,” she said. “On the other hand, if your connections are not so good to the prefrontal cortex, your ability to shut down responses is impaired. So, when you are in a stressful situation, the inhibitory pathways from the prefrontal cortex telling you not to get stressed don’t work as well as the amygdala shouting to the hippocampus, ‘This is terrible!’ You have a much bigger response than you should.”
Stress tweaks stem cells
Kaufer’s lab, which conducts research on the molecular and cellular effects of acute and chronic stress, focused in this study on neural stem cells in the hippocampus of the brains of adult rats. These stem cells were previously thought to mature only into neurons or a type of glial cell called an astrocyte. The researchers found, however, that chronic stress also made stem cells in the hippocampus mature into another type of glial cell called an oligodendrocyte, which produces the myelin that sheaths nerve cells.
The fact that chronic stress also decreases the number of stem cells that mature into neurons could provide an explanation for how chronic stress also affects learning and memory, she said.
Kaufer is now conducting experiments to determine how stress in infancy affects the brain’s white matter, and whether chronic early-life stress decreases resilience later in life. She also is looking at the effects of therapies, ranging from exercise to antidepressant drugs, that reduce the impact of stress and stress hormones.
[Press release] NIH to partner with biopharmaceutical companies and nonprofits to diagnose/treat diseases
The Accelerating Medicines Partnership (AMP) is a bold new venture between the NIH, 10 biopharmaceutical companies and several non-profit organizations to transform the current model for developing new diagnostics and treatments by jointly identifying and validating promising biological targets of disease. The ultimate goal is to increase the number of new diagnostics and therapies for patients and reduce the time and cost of developing them.
[At the risk of breaking copyright, this came via Twitter]
AMP will begin with three to five year pilot projects in three disease areas:
- Alzheimer’s disease
- type 2 diabetes
- autoimmune disorders of rheumatoid arthritis and systemic lupus erythematosus (lupus)
For each pilot, scientists from NIH and industry have developed research plans aimed at characterizing effective molecular indicators of disease called biomarkers and distinguishing biological targets most likely to respond to new therapies.
Through this cross-sector partnership, which will be managed through the Foundation for the NIH (FNIH), NIH and industry partners are sharing expertise and resources — $230 million — in an integrated governance structure that enables the best informed contributions to science from all participants. A critical component of the partnership is that industry partners have agreed to make the AMP data and analyses publicly accessible to the broad biomedical community. These pilot projects will set the stage for broadening AMP to other diseases and conditions.
Government Industry Non-Profit Organizations FDANIH AbbVieBiogen Idec
Johnson & Johnson
Alzheimer’s AssociationAmerican Diabetes Association
Lupus Foundation of America
Foundation for the NIH
Geoffrey Beene Foundation
Rheumatology Research Foundation
Budget: 5 years [$230 Million (Rounded) Total Project Funding]
($Millions) Total Project Total NIH Total Industry Alzheimer’s Disease 129.5 67.6 61.9 Type 2 Diabetes 58.4 30.4 28 Rheumatoid Arthritis and Lupus 41.6 20.9 20.7 Total 229.5 118.9 110.6
Major implications in concepts as free will, sin, justice, mental illness, government/medical “intervention”…..
AUSTIN, Texas — A new study correlating brain activity with how people make decisions suggests that when individuals engage in risky behavior, such as drunk driving or unsafe sex, it’s probably not because their brains’ desire systems are too active, but because their self-control systems are not active enough.
This might have implications for how health experts treat mental illness and addiction or how the legal system assesses a criminal’s likelihood of committing another crime.
Researchers from The University of Texas at Austin, UCLA and elsewhere analyzed data from 108 subjects who sat in a magnetic resonance imaging (MRI) scanner — a machine that allows researchers to pinpoint brain activity in vivid, three-dimensional images — while playing a video game that simulates risk-taking.
The researchers used specialized software to look for patterns of activity across the whole brain that preceded a person’s making a risky choice or a safe choice in one set of subjects. Then they asked the software to predict what other subjects would choose during the game based solely on their brain activity. The software accurately predicted people’s choices 71 percent of the time.
“These patterns are reliable enough that not only can we predict what will happen in an additional test on the same person, but on people we haven’t seen before,” said Russell Poldrack, director of UT Austin’s Imaging Research Center and professor of psychology and neuroscience.
One way to address the growing heroin epidemic? Address lifestyle and environment components.
Certainly would be a public health way to stem folks dependence on substances that can often diminish quality of life and death.
From the 4 January 2014 Science Daily article (read the entire article at this link)
Researchers have discovered that sensitivity to pain could be altered by a person’s lifestyle and environment throughout their lifetime. The study is the first to find that pain sensitivity, previously thought to be relatively inflexible, can change as a result of genes being switched on or off by lifestyle and environmental factors — a process called epigenetics, which chemically alters the expression of genes.
This news release is available in German.
IMAGE: A biopsy punch arranges the biopolymer substrate into the appropriate shape (left). Cells then colonize these circular discs in cell culture vessels (right).
It all began with the pancreas. Prof. Charli Kruse, head of the Fraunhofer Research Institution for Marine Biotechnology EMB in Lübeck, still remembers it well. The researchers had isolated some cells taken from the organ in a petri dish as part of their research – their aim was to investigate the function of the protein Vigilin, which is produced in the gland cells. “Suddenly we realized that these cells were reproducing in an unusual way, since the microscope showed not only gland cells in the dish but nerve and muscle cells, too.” Stem cells had formed out of the gland tissue and multiplied to form a variety of different cells. It quickly became apparent that other gland cells shared the same capability: “We slowly worked our way outward from the internal organs until we got to the skin – and the sweat glands. Again, this yielded the same result: a petri dish full of stem cells.” Up to now the sweat glands haven’t really received much attention since laboratory animals such as mice or rats have them only on their paws. A human being, on the other hand, possesses up to three million – predominantly on the soles of the feet, palms of the hand, armpits and forehead.
Healing stem cells obtained from the armpit
Biologists and medics use stem cells to obtain new tissue to replace cells that are damaged or diseased. They play a particularly important role in healing wounds. Stem cells taken from the patient’s own body are ideal because there is no chance of the body rejecting them. Getting at them, however, requires a cumbersome operation to extract the stem cells either from bone marrow or from the blood. “The sweat glands are significantly easier to get to. All that is required is a short walk-in walk-out visit to your dermatologist. We can obtain stem cells from less than 3 millimeters of underarm skin,” explains Kruse. When grafted to a skin injury, these stem cells can have a very beneficial effect on the healing process. Whether it is the cells themselves that build new skin cells and blood vessels or whether their role is to manage healing processes by releasing growth hormones that in turn activate immune cells is currently undergoing investigation.
Tests conducted by the scientists on animals and on human skin in the petri dish have demonstrated the beneficial effect of stem cells in healing injuries.
From the 25 October 2013 blog item by James Coyne, PhD at PLoS Blogs (Public Library of Medicine)
Is advertising a psychotherapy as “evidence supported,” any less vacuous than “Pepsi’s the one”? A lot of us would hope so, having campaigned for rigorous scientific evaluation of psychotherapies in randomized controlled trials (RCTs), just as is routinely done with drugs and medical devices in Evidence-based Medicine (EBM). We have also insisted on valid procedures for generating, integrating, and evaluating evidence and have exposed efforts that fall short. We have been fully expecting that some therapies would emerge as strongly supported by evidence, while others would be found less so, and some even harmful.
Some of us now despair about the value of this labeling or worry that the process of identifying therapies as evidence supported has been subverted into something very different than we envisioned. Disappointments and embarrassments in the branding of psychotherapies as evidence supported are mounting. A pair of what could be construed as embarrassments will be discussed in this blog.
Websites such as those at American Psychological Association Division 12 Clinical Psychology and SAMHSA’s National Registry of Evidence-based Programs and Practices offer labeling of specific psychotherapies as evidence supported. These websites are careful to indicate that a listing does not constitute an endorsement. For instance, the APA division 12 website declares
This website is for informational and educational purposes. It does not represent the official policy of Division 12 or the American Psychological Association, nor does it render individual professional advice or endorse any particular treatment.
Readers can be forgiven for thinking otherwise, particularly when such websites provide links to commercial sites that unabashedly promote the therapies with commercial products such as books, training videos, and workshops. There is lots of money to be made, and the appearance of an endorsement is coveted. Proponents of particular therapies are quick to send studies claiming positive findings to the committees deciding on listings with the intent of getting them acknowledged on these websites.
But now may be the time to begin some overdue reflection on how the label of evidence supported practice gets applied and whether there is something fundamentally wrong with the criteria.
Now you see it, now, you don’t: “Strong evidence” for the efficacy of acceptance and commitment therapy for psychosis
On September 3, 2012 the APA Division 12 website announced a rating of “strong evidence” for the efficacy of acceptance and commitment therapy for psychosis. I was quite skeptical. I posted links on Facebook and Twitter to a series of blog posts (1, 2, 3) in which I had previously debunked the study claiming to demonstrate that a few sessions of ACT significantly reduced rehospitalization of psychotic patients.
From the 27 January 2014 ScienceDaily article
“These studies have revealed that single gene mutations can alter the ability of an organism to utilize a specific diet. In humans, small differences in a person’s genetic makeup that change how well these genes function, could explain why certain diets work for some but not others,” said Curran, corresponding author of the study and assistant professor with joint appointments in the USC Davis School of Gerontology, the USC Dornsife College of Letters, Arts and Sciences, and the Keck School of Medicine of USC.
Curran and Pang studied Caenorhabditis elegans, a one-milimeter-long worm that scientists have used as a model organism since the ’70s. Decades of tests have shown that genes in C. elegans are likely to be mirrored in humans while its short lifespan allows scientists to do aging studies on it.
In this study, Curran and Pang identified a gene called alh-6, which delayed the effects of aging depending on what type of diet the worm was fed by protecting it against diet-induced mitochondrial defects.
“This gene is remarkably well-conserved from single celled yeast all the way up to mammals, which suggests that what we have learned in the worm could translate to a better understanding of the factors that alter diet success in humans,” Curran said.
Future work will focus on identifying what contributes to dietary success or failure, and whether these factors explain why specific diets don’t work for everyone. This could be the start of personalized dieting based on an individual’s genetic makeup, according to Curran.
“We hope to uncover ways to enhance the use of any dietary program and perhaps even figure out ways of overriding the system(s) that prevent the use of one diet in certain individuals,” he said.
From the 27 January 2014 article at ScienceDaily
Source:University of California – San FranciscoSummary:A new analysis of animal studies on cholesterol-lowering statins found that non-industry studies had results that favored the drugs even more than studies funded by industry.new analysis of animal studies on cholesterol-lowering statins by UC San Francisco researchers found that non-industry studies had results that favored the drugs even more than studies funded by industry.
The analysis of 63 animal studies of statins, led by Lisa Bero, PhD, UCSF professor clinical pharmacy, was published online January 21, 2014, in the scientific journal PLoS Biology.
In previous studies, Bero determined that drug-company-sponsored clinical trials were associated with publication of outcomes that favor the sponsor. Bero’s work has been cited as part of policy reform efforts that have led many journal publishers, agencies and institutions to require researchers to disclose funding sources and possible conflicts of interest when presenting their research.
The impetus for the current study, Bero said, was to explore whether or not industry-funded animal studies also would be likely to yield more positive outcomes for the companies’ drug candidates.
But in their analysis the researchers found the opposite: Results of animal studies that had industry sponsorship were less likely to measure a benefit for statins in slowing or preventing arterial disease. Of the studies that disclosed funding, 9 of 19 industry-sponsored studies had results that favored statins, in comparison to 18 out of 28 studies that favored statins among studies not funded by industry.
The explanation may be, said Bero, that “the interests of the pharmaceutical industry might be best served by underestimating efficacy prior to clinical trials, and overestimating efficacy in clinical trials. By underestimating efficacy in preclinical studies, the pharmaceutical industry could reduce the money spent on clinical trials that did not lead to marketable products.”
“Because demonstrating drug efficacy in human studies is linked to drug company profits, drug companies may have more incentive to publish favorable efficacy findings of human drug studies than animal studies.”
However, the reason for the opposite findings obtained in analyzing animal and human studies merits additional investigation, Bero said. Selective reporting of study outcomes might play a role, she suggested.
Conclusions of all the studies tended to be favorable in Bero’s PLoS Biology analysis. While the industry-sponsored animal studies had somewhat less favorable results, they nonetheless were more likely to present conclusions that favored the statin even when data were less favorable. This result highlights the role of “spin” in communicating research findings, Bero said.
The UCSF researchers also found methodological problems to be common, both in non-industry and industry-sponsored studies. Furthermore, Bero found that harmful side effects were not investigated.
“Not a single animal study we looked at assessed adverse events following the statin intervention,” Bero said. “As toxicity data from animal studies must be submitted to drug regulatory authorities before a compound can proceed to testing in humans, it is surprising that so little data on harm appear in the published scientific literature.”
In about half the studies analyzed, it appeared that animals were not assigned to treatment or placebo arms of the study randomly, a requirement of high-quality clinical trials. Furthermore, in about half the animal studies analyzed animals were identifiable to the person assigning treatment, a violation of the practice of “blinding.”
Criteria for including or excluding animals from studies often were not included in published reports, the UCSF researchers found, and many studies also failed to account properly for changes in the assigned treatment arm that occurred during the course of treatment.
Most of the industry and non industry studies analyzed in Bero’s PLoS Biology report were done using rabbits and mice. To gauge atherosclerosis, targeted by statins, researchers quantified blood vessel qualities such as number of damaged blood vessels, blood-vessel diameter, plaque severity, blockage to coronary and other arteries, and plaque rupture.
From the 27 January 2014 Karolinski Institute press release
IMAGE: Professor Tibor Harkany has shown that the use of Cannabis during pregnancy endangers fetal brain development. The findings are presented online in the EMBO Journal in January 2014….
Click here for more information.An increasing number of children suffer from the consequences of maternal drug exposure during pregnancy, and Cannabis is one of the most frequently used substances. This motivated the study, published in the EMBO Journal, cunducted in mice and human brain tissue, to decipher the molecular basis of how the major psychoactive component from Cannabis called delta-9-tetrahydrocannabinol or THC affects brain development of the unborn foetus.
The study highlights that consuming Cannabis during pregnancy clearly results in defective development of nerve cells of the cerebral cortex, the part of the brain that orchestrates higher cognitive functions and drives memory formation. In particular, THC negatively impacts if and how the structural platform and conduit for communication between nerve cells, the synapses and axons, will develop and function. Researchers also identified Stathmin-2 as a key protein target for THC action, and its loss is characterized as a reason for erroneous nerve growth. It is stressed that Cannabis exposure in experimental models precisely coincided with the fetal period when nerve cells form connections amongst each other.
According to study leader Professor Tibor Harkany, who shares his time between Karolinska Institutet and the Medical University Vienna in Austria, these developmental deficits may evoke life-long modifications to the brain function of those affected. Even though not all children who have been exposed to Cannabis will suffer immediate and obvious deficits, Professor Harkany warns that relatively subtle damage can significantly increase the risk of delayed neuropsychiatric diseases.
“Even if THC only would cause small changes its effect may well be sufficient to sensitize the brain to later stressors or diseases to provoke neuropsychiatric illnesses in those affected in the future”, says Professor Harkany. “This concerns also the medical use of Cannabis, which should be avoided during pregnancy.”
From the January 22/29 2014 issue
The phrase evidence-based medicine (EBM) was coined by Gordon Guyatt1 and then appeared in an article in The Rational Clinical Examination series in JAMA in 1992,2 but the roots of EBM go much further back. The personal stories of the origins of EBM were recently explored in a filmed oral history of some of the individuals most strongly associated with the birth of the movement (see Video, Evidence-Based Medicine: An Oral History).
JAMA and the BMJ invited 6 individuals (including us, with one of us as host, R.S.) who have played a prominent part in the development of EBM to participate in an oral history event and filming. Videos of this event and of interviews with 3 other EBM leaders (Box) have been woven together and may be accessed athttp://ebm.jamanetwork.com. Just 20 years after the term EBM began to be used, an early and informal history has emerged.
Evidence-based medicine grew out of critical appraisal. When Gordon Guyatt, currently a professor of epidemiology and biostatistics and medicine at McMaster University, took over as director of the internal medicine residency program at McMaster in 1990, he wanted to change the program so that physicians managed patients based not on what authorities told them to do but on what the evidence showed worked. He needed a name, and the first was “scientific medicine.” The faculty reacted against this name with rage, arguing that basic scientists did scientific medicine. The next name was “evidence-based medicine” (Evidence-Based Medicine: An Oral History Video).
In the Oral History Video, Sackett distinguishes EBM from critical appraisal because it combines research evidence with clinical skills and patient values and preferences.
[Oral history video here --> http://jama.jamanetwork.com/multimediaPlayer.aspx?mediaid=6391356]
Guyatt acknowledges that in the 1992 JAMA article there was little about patient values.2 It was over the next 5 years that patient values and preferences became much more central, and since then strongly emphasized (Evidence-Based Medicine: An Oral History Video).
Evidence-based medicine quickly became popular, Sackett believes, for 2 main reasons: it was supported by senior clinicians who were secure in their practice and happy to be challenged and it empowered young physicians—and subsequently nurses and other clinicians. Evidence-based medicine did, however, produce a backlash, particularly, says Sackett, “among middle-level guys who were used to making pronouncements,”
Related articles (varying viewpoints)
Posted by Gary Schwitzer in FDA
“Clinical Trial Evidence Supporting FDA Approval of Novel Therapeutic Agents, 2005-2012,” by Dr. Joseph Ross and colleagues, concluded that the quality of clinical trial evidence used by the FDA as the basis of approving new drugs varies widely. A couple of interesting data points:
- in the seven-year period of analysis, 37% of drugs were approved on the basis of a single pivotal trial.
- trials using surrogate end points as their primary outcome formed the exclusive basis of approval for 45% of drugs approved. (See our primer, “Surrogate markers may not tell the whole story.”)
In an opinion piece, “Opening the FDA Black Box,” Drs. Steven Goodman and Rita Redberg said the study:
“…raises a host of questions needing further exploration. Despite the FDA requirement for evidence from a minimum of 2 randomized clinical trials supporting an effect on health outcomes, 37% of product approvals were based on only 1 trial, 53% of cancer trials were nonrandomized, and an active comparator was used in only 27% of non–infectious disease trials. Surrogate end points were used in almost all approvals via the accelerated approval process and in 44% of nonaccelerated approvals. Trials were comparatively short, with most lasting less than 6 months, even those assessing chronic treatments for chronic diseases. Cancer drugs, perhaps predictably, were more often approved via the accelerated process and with weaker designs.”
Another paper looked at the reasons that FDA marketing approval for new drugs was delayed or denied.
And a fourth paper looked at FDA regulation of medical devices, “a process that has received relatively little attention,” according to Goodman and Redberg, who continued:
In USA Today, Liz Szabo wrote a good summary of the JAMA papers under the headline, “Not all FDA-approved drugs get same level of testing: Evidence behind FDA-approved drugs and devices often has major limitations.”
ClinicalTrials.gov is a registry and results database of publicly and privately supported clinical studies of human participants conducted around the world.
When available, study results information is included in the study record under the Study Results tab. See How to Find Results of Studies for more information on finding results entered in the results database.
Results (after 2008, only those required by US federal requirements) include
–Participant data (how many started the trial, dropped out, etc)
– Information about participants (age, gender, blood pressure readings, etc)
[Speaking of gender…]
Good to know, most drugs can affect women and men differently
— Outcome (results of taking the drug plus any placebo), with statistics
–Adverse effects , serious and other (this was not required before 2008)
Evaluating Health Information (from my personal Google site)
Another take on the “relaxation of standards”
[Reblog] Misleading BMJ news releases may be one reason journalists report on more observational studies
[At least 16 comments on this post, click on the link above to read them]
Just a few days ago, a paper in the journal PLoS One, “Media Coverage of Medical Journals: Do the Best Articles Make the News?” showed how journalists are more likely to report on observational studies than on randomized clinical trials. The authors suggest this shows a systematic bias to report on weaker evidence.
And here’s one reason why that may happen.
This week the BMJ sent out a news release on a paper from the Annals of the Rheumatic Diseases, one of the specialist journals it publishes. And I’ve been waiting for days to address it – waiting for the journal’s embargo time to pass so that I’m not violating that sacred trust.
The headline of the news release: HRT cuts risk of repeat knee/hip replacement surgery by 40%.
Nope. Sorry, BMJ news release writers. That’s an overstatement, to be kind. An inaccuracy, to be accurate. That’s not what the study showed, because it wasn’t equipped to show that anything “cut risk.” Proof of cutting risk would be proof of cause and effect. And the observational study in question can’t do that.
Don’t blame the authors of the journal article. They didn’t use cause-and-effect language. They concluded: “HRT is associated with an almost 40% reduction.” (My emphasis added.) That’s the way you describe the results of an observational study. That’s what we try to teach journalists and the public with a primer that’s been on our site for years. Maybe the BMJ should have its news release writers read it.
The researchers went even further, for any writer – journal news release writers included – who bothered to read the study. The research team wrote: “The main limitation of this study is its observational nature.”
To be clear, this was a large study with long followup. This could be a head-turner in medical circles.
But it still is what it is – a study that can only show statistical association.
And association ≠ causation.
We’ve written about this problem with BMJ news releases in the past, and will continue to do so until they get it right. Past examples:
- Unwrapping today’s chocolate story: troublesome BMJ news release
- The BMJ news release that keeps on giving the gift of chocolate hype
- BMJ news releases, observational studies, overstatement
- BMJ news release on alcohol & arthritis may have contributed to misleading coverage
As I wrote in one of these posts: Journals could help lift all ships – or they can (and sometimes do) help us all drown in a daily tsunami of global miscommunication about health news.
Humans are able to smell sickness in someone whose immune system is highly active within just a few hours of exposure to a toxin, according to new research published in Psychological Science, a journal of theAssociation for Psychological Science.
According to researcher Mats Olsson of Karolinska Institutet in Sweden, there is anecdotal and scientific evidence suggesting that diseases have particular smells. People with diabetes, for example, are sometimes reported to have breath that smells like rotten apples or acetone.
Being able to detect these smells would represent a critical adaptation that would allow us to avoid potentially dangerous illnesses. Olsson wondered whether such an adaptation might exist already at an early stage of the disease.
“There may be early, possibly generic, biomarkers for illness in the form of volatile substances coming from the body,” explains Olsson.
To test this hypothesis, Olsson and his team had eight healthy people visit the laboratory to be injected with either lipopolysaccharide (LPS) — a toxin known to ramp up an immune response — or a saline solution. The volunteers wore tight t-shirts to absorb sweat over the course of 4 hours.
Importantly, participants injected with LPS did produce a noticeable immune response, as evidenced by elevated body temperatures and increased levels of a group of immune system molecules known as cytokines.
A separate group of 40 participants were instructed to smell the sweat samples. Overall, they rated t-shirts from the LPS group as having a more intense and unpleasant smell than the other t-shirts; they also rated the LPS shirt as having an unhealthier smell.
The association between immune activation and smell was accounted for, at least in part, by the level of cytokines present in the LPS-exposed blood. That is, the greater a participant’s immune response, the more unpleasant their sweat smelled.
Interestingly, in a chemical assay the researchers found no difference in the overall amount of odorous compounds between the LPS and control group. This suggests that there must have been a detectable difference in the composition of those compounds instead.
While the precise chemical compounds have yet to be identified, the fact we give off some kind of aversive signal shortly after the immune system has been activated is an important finding, the researchers argue. It grants us a better understanding of the social cues of sickness, and might also open up doors for understanding how infectious diseases can be contained.
From the 21 January 2014 press release at EurekAlert
What happens to our cognitive abilities as we age? Traditionally it is thought that age leads to a steady deterioration of brain function, but new research in Topics in Cognitive Science argues that older brains may take longer to process ever increasing amounts of knowledge, and this has often been misidentified as declining capacity.
The study, led by Dr. Michael Ramscar of the University of Tuebingen, takes a critical look at the measures that are usually thought to show that our cognitive abilities decline across adulthood. Instead of finding evidence of decline, the team discovered that most standard cognitive measures are flawed, confusing increased knowledge for declining capacity.
Dr. Ramscar’s team used computers, programmed to act as though they were humans, to read a certain amount each day, learning new things along the way. When the researchers let a computer ‘read’ a limited amount, its performance on cognitive tests resembled that of a young adult.
However, if the same computer was exposed data which represented a lifetime of experiences its performance looked like that of an older adult. Often it was slower, not because its processing capacity had declined, but because increased “experience” had caused the computer’s database to grow, giving it more data to process, and that processing takes time.
“What does this finding mean for our understanding of our ageing minds, for example older adults’ increased difficulties with word recall? These are traditionally thought to reveal how our memory for words deteriorates with age, but Big Data adds a twist to this idea,” said Dr. Ramscar. “Technology now allows researchers to make quantitative estimates about the number of words an adult can be expected to learn across a lifetime, enabling the team to separate the challenge that increasing knowledge poses to memory from the actual performance of memory itself.”
“Imagine someone who knows two people’s birthdays and can recall them almost perfectly. Would you really want to say that person has a better memory than a person who knows the birthdays of 2000 people, but can ‘only’ match the right person to the right birthday nine times out of ten?” asks Ramscar.
“It is time we rethink what we mean by the aging mind before our false assumptions result in decisions and policies that marginalize the old or waste precious public resources to remediate problems that do not exist,” said Topics in Cognitive Science, Editors Wayne Gray and Thomas Hills.
New types of drug intended for use in place of antibiotics have been given a cautious welcome by scientists.
University researchers have been probing the long-term effectiveness of drugs currently being developed by the pharmaceutical industry.
These work by limiting the symptoms caused by a bug or virus in the body, rather than killing it outright.
These treatments are designed to avoid the problem of infections becoming resistant to treatment, which has become widespread with antibiotics.
This approach is intended to enable the patient to tolerate disease, and buy the immune system valuable time to get rid of the infection naturally.
Researchers at the Universities of Edinburgh and Liverpool created a mathematical model to look at how at how drugs that limit the damage caused by disease could affect how infections spread and evolve.
They found that for certain infections, where the symptoms are not linked to the spread of disease, these drugs may prevent disease from evolving too quickly.
They will be useful over longer periods of time.
However, scientists caution that people given damage limitation treatments may appear healthy, but carry high levels of infection and so may be more likely to pass on disease.
In addition, people with lesser symptoms could remain undiagnosed and add to the spread of disease.
In treating infections with drugs, we change their environment, but bacteria and other infectious agents are incredibly good at adapting to their environment. Damage limitation therapies may be a useful alternative to antibiotics, but we should be cautious, and investigate their potential long-term consequences. Limiting damage may work for the individual, but could, in some cases, increase disease spread.
Dr Pedro Vale
School of Biological Sciences
From the 14th January 2014 ScienceDaily article
Contrary to a common belief, researchers have shown that genetic regions associated with increased risk of type 2 diabetes were unlikely to have been beneficial to people at stages through human evolution.
Type 2 diabetes is responsible for more than three million deaths each year and this number is increasing steadily. The harmful genetic variants associated with this common disease have not yet been eliminated by natural selection.
To try to explain why this is, geneticists have previously hypothesized that during times of ‘feast or famine’ throughout human evolution, people who had advantageous or ‘thrifty’ genes processed food more efficiently. But in the modern developed world with too much food, these same people would be more susceptible to type 2 diabetes.
“This thrifty gene theory is an attractive hypothesis to explain why natural selection hasn’t protected us against these harmful variants,” says Dr. Yali Xue, lead author of the study from the Wellcome Trust Sanger Institute. “But we find little or no evidence to corroborate this theory.”
From the 15 January 2014 Mayo Clinic NewsNetwork article by Shelly Plutowski (@rwp01)
ROCHESTER, Minn. — Jan. 15, 2014 — A study published in the January issue of Mayo Clinic Proceedings shows that most clinical practice guidelines for interventional procedures (e.g., bronchoscopy, angioplasty) are based on lower-quality medical evidence and fail to disclose authors’ conflicts of interest.
“Guidelines are meant to create a succinct roadmap for the diagnosis and treatment of medical conditions by analyzing and summarizing the increasingly abundant medical research,” write Joseph Feuerstein, M.D., and colleagues from Beth Israel Deaconess Medical Center. “Guidelines are used as a means to establish a standard of care … However, a guideline’s validity is rooted in its development process.”
Journalists: Sound bites with Dr. Talwalkar are available in the downloads.
In an accompanying editorial, Jayant Talwalkar, M.D., associate medical director of theValue Analysis Program in the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, says that the study further illustrates that existing guidelines are highly variable with respect to evidence quality and transparency.
“Most of the current practice guidelines in circulation do not meet criteria that represent trustworthiness as defined by the Institute of Medicine,” Dr. Talwalkar says.
Dr. Talwalkar also points out that more attention needs to be paid to potential conflicts of interest among guideline authors and guideline development panels.
“There is a growing body of literature documenting the existence of one or more potential conflicts of interest reported for authors or members of guideline development panels,” he says. “As a result, the influence of external activities such as consulting or speaking fees, research grant funding and stock ownership has the potential to create significant bias and uncertainty for issued recommendations.”
Dr. Talwalkar notes that up to 80 percent of recommendations from most guidelines are supported by evidence from non-randomized studies or expert consensus opinion, making conflict of interest disclosure crucial.
Dr. Talwalkar says that, in the future, the guideline-writing process must evolve to include more concise and up-to-date recommendations as well as more transparency about the management of potential conflicts of interest.
MD-led study is first to link racism-related factors and cellular age
COLLEGE PARK, Md. – A new University of Maryland-led study reveals that racism may impact aging at the cellular level. Researchers found signs of accelerated aging in African American men who reported high levels of racial discrimination and who had internalized anti-Black attitudes. Findings from the study, which is the first to link racism-related factors and biological aging, are published in the American Journal of Preventive Medicine.
Racial disparities in health are well-documented, with African Americans having shorter life expectancy, and a greater likelihood of suffering from aging-related illnesses at younger ages compared to whites. Accelerated aging at the biological level may be one mechanism linking racism and disease risk.
“We examined a biomarker of systemic aging, known as leukocyte telomere length,” explained Dr. David H. Chae, assistant professor of epidemiology at UMD’s School of Public Health and the study’s lead investigator. Shorter telomere length is associated with increased risk of premature death and chronic disease such as diabetes, dementia, stroke and heart disease. “We found that the African American men who experienced greater racial discrimination and who displayed a stronger bias against their own racial group had the shortest telomeres of those studied,” Chae explained.
Even after adjusting for participants’ chronological age, socioeconomic factors, and health-related characteristics, investigators found that the combination of high racial discrimination and anti-black bias was associated with shorter telomeres. On the other hand, the data revealed that racial discrimination had little relationship with telomere length among those holding pro-black attitudes. “African American men who have more positive views of their racial group may be buffered from the negative impact of racial discrimination,” explained Chae. “In contrast, those who have internalized an anti-black bias may be less able to cope with racist experiences, which may result in greater stress and shorter telomeres.”
The findings from this study are timely in light of regular mediareports of racism facing African American men. “Stop-and-friskpolicies, and other forms of criminal profiling such as ‘driving orshopping while black’ are inherently stressful and have a real impact on the health of African Americans,” said Chae. Researchers found that racial discrimination by police was most commonly reported by participants in the study, followed by discrimination in employment. In addition, African American men are more routinely treated with less courtesy or respect, and experience other daily hassles related to racism.
Chae indicated the need for additional research to replicate findings, including larger studies that follow participants over time. “Despite the limitations of our study, we contribute to a growing body of research showing that social toxins disproportionately impacting African American men are harmful to health,” Chae explained. “Our findings suggest that racism literally makes people old.”
Scientists at the Buck Institute for Research on Aging have promoted health and increased lifespan in Drosophila by altering the symbiotic, or commensal, relationship between bacteria and the absorptive cells lining the intestine. The research, appearing in the January 16, 2014 edition of Cell, provides a model for studying many of the dysfunctions that are characteristic of the aging gut and gives credence to the growing supposition that having the right balance of gut bacteria may be key to enjoying a long healthy life.
Even though recent research in humans has linked the composition of gut flora with diet and health in the elderly and the list of age-related diseases associated with changes in gut bacteria include cancer, diabetes, and inflammatory bowel disease, lead author and Buck faculty Heinrich Jasper, PhD, says there is no systematic understanding of how we go from having a young, healthy gut to one that is old and decrepit. “Our study explores age-related changes in the gut that include increased oxidative stress, inflammation, impaired efficiency of the immune response, and the over-proliferation of stem cells,” said Jasper. “It puts these changes into a hierarchical, causal relationship and highlights the points where we can intervene to rescue the negative results of microbial imbalance.”
Research involving scientists at the University of York has provided important new information about transmission of human leishmaniasis, a group of infectious diseases which kills more than 100,000 people a year.
rofessor Deborah Smith of the Centre for Immunology and Infection at York, working with colleagues at the Wellcome Trust Sanger Institute and Charles University in Prague, has shown that “Leishmania” parasites reproduce sexually in the wild.
The research, published in PLOS Genetics, is a significant step forward in understanding how leishmaniasis is spread in endemic regions. Caused by “Leishmania”parasites, human leishmaniasis is a serious public health problem in more than 90 countries worldwide. There are high fatality rates among children and young people and those with suppressed immune systems. Pharmaceutical treatments are limited and there is no vaccine.
These microscopic organisms infect humans through the bite of a female blood-feeding sand fly carrying infective parasites in its gut. People only become infected, therefore, in geographical regions that are well-suited to support sand fly populations — those with suitable habitats, humidity and temperature. But the biology of the parasite in the sandfly is also critically important in determining the outcome of infection in man.
The new research uses DNA sequencing to investigate genetic variation at the highest level of resolution in “Leishmania “parasites isolated from sand flies caught in a defined focus of human leishmaniasis in south-east Turkey. This analysis provides evidence that “Leishmania “parasites can reproduce sexually in wild-caught sand flies, an event only detected previously under specialised laboratory conditions.. It also establishes, for the first time, quantitative estimates of the relative rates of sexual and asexual reproduction during the parasite life cycle.
From the 14 January 2014 ScienceDaily article
Exposing skin to sunlight may help to reduce blood pressure and thus cut the risk of heart attack and stroke, a study published in theJournal of Investigative Dermatology suggests.
Research carried out at the Universities of Southampton and Edinburgh shows that sunlight alters levels of the small messenger molecule, nitric oxide (NO) in the skin and blood, reducing blood pressure.
Martin Feelisch, Professor of Experimental Medicine and Integrative Biology at the University of Southampton, comments: “NO along with its breakdown products, known to be abundant in skin, is involved in the regulation of blood pressure. When exposed to sunlight, small amounts of NO are transferred from the skin to the circulation, lowering blood vessel tone; as blood pressure drops, so does the risk of heart attack and stroke.”
From the 17 December 2013 ScienceDaily article
The fact that smoking means a considerable health risk is nowadays commonly accepted. New research findings from Uppsala University and Uppsala Clinical Research Center show that smoking alters several genes that can be associated with health problems for smokers, such as increased risk for cancer and diabetes.
We inherit our genes from our parents at birth. Later in life the genetic material can be changed by epigenetic modifications, i.e. chemical alterations of the DNA the affect the activity of the genes. Such alterations are normally caused by aging but can also result from environmental factors and lifestyle.
In a study recently published in the journal Human Molecular Genetics the researchers have examined how the genes are changed in smokers and users of non-smoke tobacco. They could identify a large number of genes that were altered in smokers but found no such effect of non-smoke tobacco.
t has been previously known that smokers have an increased risk of developing diabetes and many types of cancer, and have a reduced immune defence and lower sperm quality. The results from the study also showed that genes that increase the risk for cancer and diabetes, or are important for the immune response or sperm quality, are affected by smoking.
From the 30 December 2013 EurkAlert
According to new study of normal-weight and overweight or obese individuals published in the Journal of the Academy of Nutrition and Dietetics
Philadelphia, PA, December 30, 2013 – Obesity rates in the United States increased from 14.5% of the population in 1971-1974 to 35.9% of the population in 2009-2010. It’s believed that one contributing factor to expanding waistlines is the reported increase in energy intake. Research suggests that the ability to control energy intake may be affected by the speed at which we eat, and a high eating rate may impair the relationship between the sensory signals and processes that regulate how much we eat.
In order to learn more about the relationship between eating speed and energy intake, a team of researchers in the Department of Kinesiology at Texas Christian University took a look at how eating speed affects calories consumed during a meal in both normal weight subjects as well as overweight or obese subjects. The investigators also collected data on feelings of hunger and fullness before and after the fast-paced and slow-paced meals and water consumption during the meals. Their results are published in the Journal of the Academy of Nutrition and Dietetics.
While previous studies have reviewed the relationship between eating speed and body weight, most of those studies were conducted with normal-weight individuals. In this new study, investigators asked a group of normal-weight subjects and a group of overweight or obese subjects to consume two meals in a controlled environment. All subjects ate one meal at a slow speed, for which they were instructed to imagine that they had no time constraints, take small bites, chew thoroughly, and pause and put the spoon down between bites, and a second meal at a fast speed, for which they were instructed to imagine that they had a time constraint, take large bites, chew quickly, and not pause and put the spoon down.
At the conclusion of the study, researchers found that only normal-weight subjects had a statistically significant reduction in caloric consumption during the slow compared to the fast meal: 88 kcal less for the normal weight group, versus only 58 kcal less for the overweight or obese group.
“Slowing the speed of eating led to a significant reduction in energy intake in the normal-weight group, but not in the overweight or obese group. A lack of statistical significance in the overweight and obese group may be partly due to the fact that they consumed less food during both eating conditions compared to the normal-weight subjects,” explained lead author Meena Shah, PhD, professor in the Department of Kinesiology at Texas Christian University. “It is possible that the overweight and obese subjects felt more self-conscious, and thus ate less during the study.”
Despite the differences in caloric consumption between the normal-weight and overweight and obese subjects, the study found some similarities. Both groups felt less hungry later on after the slow meal than after the fast meal. “In both groups, ratings of hunger were significantly lower at 60 minutes from when the meal began during the slow compared to the fast eating condition,” added Dr. Shah. “These results indicate that greater hunger suppression among both groups could be expected from a meal that is consumed more slowly.”
Also, both the normal weight and overweight or obese groups consumed more water during the slow meal. During the fast condition, participants across the study only consumed 9 ounces of water, but during the slow condition, that amount rose to 12 ounces. “Water consumption was higher during the slow compared to the fast eating condition by 27% in the normal weight and 33% in the overweight or obese group. The higher water intake during the slow eating condition probably caused stomach distention and may have affected food consumption,” said Dr. Shah.
With obesity rates continuing to rise among the adult population in the United States, information about how different weight groups approach and consume food will be helpful in crafting strategies to lower energy intake, but for now, Dr. Shah suggested, “Slowing the speed of eating may help to lower energy intake and suppress hunger levels and may even enhance the enjoyment of a meal.”
The editors of the journal Science have chosen cancer immunotherapy — using the body’s immune system to attack tumors instead of targeting the tumor itself — as the biggest breakthrough of 2013.
“Cancer immunotherapy clinched the #1 spot because it’s causing such a paradigm shift among researchers in how they tackle cancer,” the journal’s editorial team wrote in a statement.
The technique involves training immune cells to recognize the characteristics of cancer cells, and then fight back. There’s still a lot of work ahead since the treatment has only worked for a few patients and some types of cancers so far, but the results from clinical trials offer hope for a new weapon against cancer.
Nine other groundbreaking achievements that were chosen from this year are detailed below.
Scientists discover the first real reason we need sleep
By studying a newfound pathway in mice, scientists identified the first major mechanical reason we need to sleep: to clean the brain. When the brain is sleeping, channels between cells grow. This allows cerebrospinal fluid into the depths of the brain tissues to flush out toxic proteins that build up during the day, including the kind that are responsible for neurodegenerative diseases like Alzheimer’s.
MAYWOOD, Ill. – A newly improved Internet research tool is helping cancer researchers and physicians make sense out of a deluge of genetic data from nearly 100,000 patients and more than 50,000 mice.
The tool, called the Gene Expression Barcode 3.0, is proving to be a vital resource in the new era of personalized medicine, in which cancer treatments are tailored to the genetic makeup of an individual patient’s tumor.
Significant new improvements in the Gene Expression Barcode 3.0 are reported in the January issue of the journal Nucleic Acids Research, published online ahead of print.
Senior author is Michael J. Zilliox of Loyola University Chicago Stritch School of Medicine. Zilliox is co-inventor of the Gene Expression Barcode.
“The tool has two main advantages,” Zilliox said. “It’s fast and it’s free.”
The Gene Expression Barcode is available at a website designed and hosted by Loyola University Chicago Stritch School of Medicine. The website is receiving 1,600 unique visitors per month.
Knowing how a patient’s cancer genes are expressed can help a physician devise an individualized treatment. In a tumor cell, for example, certain genes are turned on (expressed) while other genes are turned off (unexpressed). Also, different types of cancer cells have different patterns of gene expression. Genes are expressed through RNA, a nucleic acid that acts as a messenger to carry out instructions from DNA for making proteins.
Research institutions have made public the genetic data from nearly 100,000 patients, most of whom had cancer, and more than 50,000 laboratory mice. In raw form, however, these data are too unwieldy to be of much practical use for most researchers. The Gene Expression Barcode applies advanced statistical techniques to make this mass of data much more user-friendly to researchers.
The barcode algorithm is designed to estimate which genes are expressed and which are unexpressed. Like a supermarket barcode, the Gene Expression Barcode is binary, meaning it consists of ones and zeros – the expressed genes are ones and the unexpressed genes are zeros.
Zilliox co-invented the Gene Expression Barcode, along with Rafael Irizarry, PhD. (At the time, Zilliox and Irizarry were at Johns Hopkins University.) Zilliox joined Loyola in 2012, and Irizarry now is at the Dana-Farber Cancer Institute. Zilliox and Irizarry first reported the Gene Expression Barcode in 2007. In 2011, they reported an improved 2.0 version. The Barcode already has been cited in more than 120 scientific papers, and the new 3.0 version will make it even easier and faster for researchers to use, Zilliox said.
The Gene Expression Barcode is supported by funding from the National Institutes of Health and Loyola institutional funds.
In addition to Zilliox and Irizarry, co-authors of the article describing the Barcode 3.0 version are Matthew McCall of the University of Rochester, Harris Jaffee of Johns Hopkins University, Susan Zelisko of Loyola University Chicago Stritch School of Medicine and Neeraj Sinha and Guido Hooiveld of Wageningen University.
In the paper, the authors thank Joseph Koral, Baimei Guo, Corey Sartin and Ron Price of Loyola’s Informatics and Systems Development for their computational support.
The article is titled “The Gene Expression Barcode 3.0: Improved Data Processing and Mining Tools.”
The Loyola University Chicago Health Sciences Division (HSD) advances interprofessional, multidisciplinary, and transformative education and research while promoting service to others through stewardship of scientific knowledge and preparation of tomorrow’s leaders. The HSD is located on the Health Sciences Campus in Maywood, Illinois. It includes the Marcella Niehoff School of Nursing, the Stritch School of Medicine, the biomedical research programs of the Graduate School, and several other institutes and centers encouraging new research and interprofessional education opportunities across all of Loyola University Chicago. The faculty and staff of the HSD bring a wealth of knowledge, experience, and a strong commitment to seeing that Loyola’s health sciences continue to excel and exceed the standard for academic and research excellence. For more on the HSD, visit LUC.edu/hsd.
- Helping cancer researchers make sense of the deluge of genetic data (eurekalert.org)
Negative studies are just as important to consumers as positive studies. They are essential blocks in the evidence base. They help everyone—consumers and health care providers—avoid interventions that don’t help.
A recent study in the New England Journal of Medicine, authored by six researchers at the National Heart, Lung, and Blood Institute (NHLBI), prompts some thoughts about studies with negative outcomes—and their importance in the entire research process.
In this report Dr. David Gordon, Dr. Michael Lauer, and their colleagues analyzed the 244 extramural, randomized clinical trials supported by NHLBI and completed between the years 2000 and 2011. The primary outcome was the time between completion of trials and publication of the main results in a peer-reviewed journal; the secondary outcome was the annual citation rates for these articles—i.e., how many times each article was cited in a given time period. The team also examined a number of trial characteristics that related to these questions, such as budget, number of participants, and whether the result was positive or negative.
Among the many interesting findings are that more than half of the studies analyzed (58 percent) yielded negative results. And intriguingly, of the 31 trials having the highest citation rates, only 8 (26 percent) had positive results. Studies supported by NHLBI, and indeed, studies supported by NCCAM, generally start with enthusiasm of the investigators, peer reviewers, and NIH. They generally start with the expectation (and indeed preliminary data) that the intervention being studied has the potential to improve patient outcomes. By and large, when no benefit is demonstrated, research teams are understandably disappointed. And Gordon and co-authors found that investigators completing negative studies are indeed significantly slower to publish.
Nevertheless, we do the research because we don’t know the answer! Negative studies are just as important to consumers as positive studies. They are essential blocks in the evidence base. They help everyone—consumers and health care providers—avoid interventions that don’t help.
There is an additional “silver lining.” Negative studies are extremely important in the research process. And the high-quality data produced during our well-performed, carefully monitored studies are of enormous value in deciding on follow-on questions and in the design of subsequent studies.
We learn from surprises—from discovering that we don’t always know what we think we know.
- The National Center for Complementary and Alternative Medicine incorporates negative study findings in
many of its products, including Herbs At A Glance
Protein Folding (http://helpfromthedoctor.com/blog/2010/07/27/what-is-a-protein/)
A team led by a longtime Oregon Health & Science University researcher has demonstrated in mice what could be a revolutionary new technique to cure a wide range of human diseases — from cystic fibrosis to cataracts to Alzheimer’s disease — that are caused by “misfolded” protein molecules
Misfolded protein molecules, caused by gene mutation, are capable of maintaining their function but are misrouted within the cell and can’t work normally, thus causing disease. The OHSU team discovered a way to use small molecules that enter cells, fix the misfolded proteins and allow the proteins to move to the correct place and function normally again.
The researchers were led by P. Michael Conn, Ph.D., who was a senior scientist in reproductive sciences and neuroscience at OHSU’s Oregon National Primate Research Center and professor of physiology and pharmacology, cell biology and development and obstetrics and gynecology at OHSU for the past 19 years. This month, Conn joined Texas Tech University Health Sciences Center as senior vice president for research and associate provost.
The team’s work will be published this week in the early online edition of the Proceedings of the National Academy of Sciences. The work was the culmination of 13 years of work on the process by Conn and Jo Ann Janovick, former senior research associate at the ONPRC who is now also at TTUHSC. Richard R. Behringer, Ph.D., from the University of Texas MD Anderson Cancer Center, M. David Stewart, Ph.D., from the University of Houston, and Douglas Stocco, Ph.D., and Pulak Manna, Ph.D., from the department of biochemistry/microbiology at TTUHSC, also contributed to the work.
Conn and his team perfected the process in mice, curing them of a form of disease that causes males to be unable to father offspring. The identical disease occurs in humans and Conn believes the same concept can work to cure human disease as well.
“The opportunity here is going to be enormous,” said Conn, “because so many human diseases are caused by misfolded proteins. The ability of these drugs — called ‘pharmacoperones’ — to rescue misfolded proteins and return them to normalcy could someday be an underlying cure to a number of diseases. Drugs that act by regulating the trafficking of molecules within cells are a whole new way of thinking about treating disease.”
A wide range of diseases are caused by an accumulation of misfolded proteins. Among the diseases are neurodegenerative diseases like Alzheimer’s disease, Parkinson’s disease and Huntington’s disease. Other diseases include certain types of diabetes, inherited cataracts and cystic fibrosis.
Conn said the next steps will be clinical trials to see whether the same technique can work in humans.
- OHSU researchers develop new drug approach that could lead to cures for wide range of diseases (eurekalert.org)
- Drugs to fix “misfolded” proteins could cure a range of diseases (gizmag.com)
- Misfolded proteins are capable of forming tree-like aggregates in Alzheimer’s disease (medicalnewstoday.com)
- Inhibiting IGF1 Signaling Reduces Misfolded Protein Aggregation in Aging (fightaging.org)
- Bad proteins branch out (news.rice.edu)
- Could arthritis drug combat Alzheimer’s? (theguardian.com)
- Session 10A Protein processing and degradation (reccob.wordpress.com)
- New survival mechanism found for stressed mitochondria (medicalnewstoday.com)
- New startup looking to cure genetic diseases by editing genes in new way (medicalxpress.com)
- Dementia: Five priorities for research (bbc.co.uk)
The Association of Health Care Journalists offers a wide range of resources – many of which are available exclusively to members.
AHCJ publications include our newsletter, HealthBeat, as well as several guides to covering specific aspects of health and health care.
Members share ideas and ask questions of fellow members on the AHCJ electronic mailing list. Tip sheets are prepared for our conferences and workshops, often offering sources and information about covering specific stories.
Contest entries are from the Awards for Excellence in Health Care Journalism, recognizing the best health reporting in print, broadcast and online media. We have links to past winners and information culled from questionnaires submitted with the entries about how each story was researched and written.
We include links to some recent reports and studies of interest to our membership, as well as links to Web sites relevant to health care.
Members and other journalists write articles specifically for AHCJ about how they have reported a story, issues that our members are likely to cover and other important topics.
- AHCJ Articles
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- Journalists Doubt Obama Administration’s Dedication to Transparency (pogoblog.typepad.com)
- Charles Ornstein: Six Questions About HealthCare.gov’s Future (guernicamag.com)
- There Once was a Responsible Journalist (find links at the bottom) (scottbest.wordpress.com)
- Donor Dilemma receives national recognition (andrewcconte.wordpress.com)
On a personal note. Back in 1972 the religion classes for juniors and seniors at my high school were composed of electives. I took the marriage class. One week was spent on contraceptives. The material on the different types was fact based. Since it was a Catholic school abstinence was emphasized! Still, I was a bit taken aback that we were given all the facts in order to make our own decisions. Didn’t tell my parents about this! But the week’s focus on contraception did reinforce what we were taught at home – responsibilities for our actions.
On a somewhat related note – my heart goes out to all who are sexually abused and feel that a sexual relationship (and/or a relationship that is disproportionally based on the needs of others) is the only way out of a bad (often home) environment.
Qualitative Study Explores Women’s Perceptions of Pregnancy Risk
In-depth interviews with 49 women obtaining abortions in the United States found that most of the study participants perceived themselves to be at low risk of becoming pregnant at the time that it happened. According to “Perceptions of Susceptibility to Pregnancy Among U.S. Women Obtaining Abortions,” by Lori Frohwirth of the Guttmacher Institute et al., the most common reasons women gave for thinking they were at low risk of pregnancy included a perception of invulnerability, a belief that they were infertile, self-described inattention to the possibility of pregnancy and a belief that they were protected by their (often incorrect) use of a contraceptive method. Most participants gave more than one response.
The most common reason women gave for their perceived low risk of pregnancy was perceived invulnerability to pregnancy. Study participants understood that pregnancy could happen, but for reasons they couldn’t explain, thought they were immune or safe from pregnancy at the time they engaged in unprotected sex. One reported that she “always had good luck,” while another said, “…It’s like you believe something so much, like ‘I just really don’t want children,’ [and] for some reason, I thought that would prevent me from getting pregnant.” This type of magical thinking—that pregnancy somehow would not happen despite acknowledged exposure—suggests a disconnect between the actual risk of pregnancy incurred by an average couple who does not use contraceptives (85% risk of pregnancy over the course of a year) and a woman’s efforts to protect herself from unintended pregnancy.
Equal proportions (one-third) of respondents thought they or their partners were sterile, said the possibility of pregnancy “never crossed my mind” and reported that (often incorrect) contraceptive use was the reason they thought they were at low risk. Perceptions of infertility were not based on medical advice, but rather on past experiences (e.g., the respondent had unprotected sex and didn’t get pregnant) or family history. Among those who thought they were protected by their contraceptive method, most women reported inconsistent or incorrect method use. For example, one woman felt a few missed pills did not put her at risk: “I just thought…they were like magic. If I missed it one day, it wouldn’t really matter.”
The authors suggest that further research is needed to quantify the proportion of women at risk of pregnancy who believe they are not at risk, and reasons why they hold that belief, in order to better address misconceptions around pregnancy risk with the goal of preventing unintended pregnancy. Additionally, they suggest that health care providers should seek to better understand patients’ beliefs regarding their ability to get pregnant and the efficacy of contraception so as to address these topics, and that public health campaigns should dispel myths, address magical thinking, and call attention to the general problem of low health literacy.
“Perceptions of Susceptibility to Pregnancy Among U.S. Women Obtaining Abortions” is currently available online and will appear in a forthcoming issue of Social Science & Medicine.
- Statistics on Abortion from Abort73.com (whyyoushouldbeprochoice.wordpress.com)
- Why young women are going off the pill and on to contraception voodoo | Hadley Freeman (theguardian.com)
- [Brookings Institute report] Isabel V. Sawhill and Quentin Karpilow – Three Facts about Birth Control and Social Mobility (jflahiff.wordpress.com)
- A Major Cause of Unplanned Pregnancies (vitalisticvixen.com)
- Pope Francis sends out survey to ask Catholics about gay sex, abortion and contraception (independent.co.uk)
- Theory post about Abortion (violetlightning.wordpress.com)
Non-Specialist Health Workers Play Important Role in Improving Mental Health in Developing Countries
Non-specialist health workers are beneficial in providing treatment for people with mental, neurological and substance-abuse (MNS) problems in developing countries — where there is often a lack of mental health professionals — according to a new Cochrane review.
Researchers, led by the London School of Hygiene & Tropical Medicine, say non-specialist health workers (such as doctors, nurses or lay health workers) not formally trained in mental health or neurology, and other professionals with health roles, such as teachers, may have an important role to play in delivering MNS health care. The study is the first systematic review of non-specialist health workers providing MNS care in low- and middle-income countries.
After examining 38 relevant studies from 22 developing countries, researchers found that non-specialist health workers were able to alleviate some depression or anxiety. For patients with dementia, non-specialists seemed to help in reducing symptoms and in improving their carers’ coping skills. Non-specialists may also have benefits in treating maternal depression, post traumatic stress disorder as well as alcohol abuse, though the improvements may be smaller.
Lead author Dr Nadja van Ginneken, who completed the research at the London School of Hygiene & Tropical Medicine’s Centre for Global Mental Health with funding from the Wellcome Trust Clinical PhD programme, said: “Many low- and middle-income countries have started to train primary care staff, and in particular lay and other community-based health workers, to deliver mental health care. This review shows that, for some mental health problems, the use of non-specialist health workers has some benefits compared to usual care.”
Cochrane Abstract is here
Check with a local academic, health/medical, or public library for free or low cost access to full text.
Professor of Genetics Scott Williams, PhD, of the Institute for Quantitative Biomedical Sciences (iQBS) at Dartmouth’s Geisel School of Medicine, has made two novel discoveries: first, a person can have several DNA mutations in parts of their body, with their original DNA in the rest — resulting in several different genotypes in one individual — and second, some of the same genetic mutations occur in unrelated people. We think of each person’s DNA as unique, so if an individual can have more than one genotype, this may alter our very concept of what it means to be a human, and impact how we think about using forensic or criminal DNA analysis, paternity testing, prenatal testing, or genetic screening for breast cancer risk, for example. Williams’ surprising results indicate that genetic mutations do not always happen purely at random, as scientists have previously thought.
His work, done in collaboration with Professor of Genetics Jason Moore, PhD, and colleagues at Vanderbilt University, was published in PLOS Genetics journal on November 7, 2013.
Genetic mutations can occur in the cells that are passed on from parent to child and may cause birth defects. Other genetic mutations occur after an egg is fertilized, throughout childhood or adult life, after people are exposed to sunlight, radiation, carcinogenic chemicals, viruses, or other items that can damage DNA. These later or “somatic” mutations do not affect sperm or egg cells, so they are not inherited from parents or passed down to children. Somatic mutations can cause cancer or other diseases, but do not always do so. However, if the mutated cell continues to divide, the person can develop tissue, or a part thereof, with a different DNA sequence from the rest of his or her body.
f our human DNA changes, or mutates, in patterns, rather than randomly; if such mutations “match” among unrelated people; or if genetic changes happen only in part of the body of one individual, what does this mean for our understanding of what it means to be human? How may it impact our medical care, cancer screening, or treatment of disease? We don’t yet know, but ongoing research may help reveal the answers.
Christopher Amos, PhD, Director of the Center for Genomic Medicine and Associate Director for Population Sciences at the Cancer Center, says, “This paper identifies mutations that develop in multiple tissues, and provides novel insights that are relevant to aging. Mutations are noticed in several tissues in common across individuals, and the aging process is the most likely contributor. The theory would be that selected mutations confer a selective advantage to mitochondria, and these accumulate as we age.” Amos, who is also a Professor of Community and Family Medicine at Geisel, says, “To confirm whether aging is to blame, we would need to study tissues from multiple individuals at different ages.” Williams concurs, saying, “Clearly these do accumulate with age, but how and why is unknown — and needs to be determined.”
Just as our bodies’ immune systems have evolved to fight disease, interestingly, they can also stave off the effects of some genetic mutations. Williams states that, “Most genetic changes don’t cause disease, and if they did, we’d be in big trouble. Fortunately, it appears our systems filter a lot of that out.”
Mark Israel, MD, Director of Norris Cotton Cancer Center and Professor of Pediatrics and Genetics at Geisel, says, “The fact that somatic mutation occurs in mitochondrial DNA apparently non-randomly provides a new working hypothesis for the rest of the genome. If this non-randomness is general, it may affect cancer risks in ways we could not have previously predicted. This can have real impact in understanding and changing disease susceptibility.”
- Study finds novel genetic patterns that make us rethink biology and individuality (medicalxpress.com)
- Novel genetic patterns may make us rethink biology and individuality (scooprocket.com)
- A patchwork of genetic variation found in the brain: Surprising degree of variation among genomes of individual neurons from same brain (sciencedaily.com)
- New Technique to Determine Whether DNA is from Mom or Dad (medindia.net)
PUBLIC RELEASE DATE:5-Nov-2013
Ethical research with minorities
Johns Hopkins bioethicist Nancy Kass is a guest editor of the AJPH special issue taking a comprehensive look at the current ethical landscape of human subjects research with minority populations
Remarkable improvements in the quality of life, prevention and treatment of disease have been made possible through advancements in biomedical research, including clinical trials involving human subjects. Future progress will depend in large measure on the inclusion of women and racial and ethnic minority populations into the research enterprise. Unfortunately, research abuses in the past have contributed to fear and mistrust among these populations resulting in regulatory measures designed to protect them due to their real or perceived “vulnerability.”
Increasingly groups seen as vulnerable are demanding access to the benefits of research and investigators are making progress in successful inclusion of women and minorities. This question of vulnerability is just one of many ethically relevant concepts raised in the current theme issue of the American Journal of Public Health, titled “The Ethics of Human Subjects Research on Minorities”.
“While there is growing attention to the participation of minority populations in research, there has been far less attention on the ethical issues raised through research recruitment, enrollment and engagement; our goal was to shine a spotlight on those issues in particular,” says Nancy E. Kass, ScD, one of three guest editors of the issue and the Deputy Director for Public Health at the Johns Hopkins Berman Institute of Bioethics.
The theme issue opens with an editorial by Kass and her co-guest editors Sandra C. Quinn, PhD, and Stephen B. Thomas, PhD, of the Maryland Center for Health Equity (M-CHE) at the University of Maryland School of Public Health. In their editorial, “Building Trust for Engagement of Minorities in Human Subjects Research: Is the Glass Half Full, Half Empty or the Wrong Size?” The editors contextualize the history of human subjects protections for “vulnerable persons,” recognizing that the protections themselves, while critically important and very successful, may also have limited the benefits of research among the populations that were “protected”. They discuss the progress we’ve made, the challenges still to be tackled, and propose a shift in the way researchers approach minority communities.
Other topics explored in the issue include recruitment of minority populations, community engagement, and training of researchers and health professionals in ethics and working with minority populations. Articles in the volume focus on specific populations including Native American and Alaskan Native populations, persons with disabilities, populations at risk of contracting HIV, and racial and ethnic minority populations.
The theme issue is one of the scholarly products made possible by the National Bioethics Research Infrastructure Initiative grant from the NIH-NIMHD, “Building Trust Between Minorities and Researchers ” awarded to the University of Maryland Center for Health Equity. The issue assembles a collection of peer-reviewed papers that explore the complexities involved in the ethical inclusion of minority populations in research and the challenges facing the nation in having a research enterprise that is both protective and inclusive of vulnerable groups. Additionally, contemporary research operates in the long shadow cast by the abuse of human subjects in research, Kass says.
Drs. Quinn, Kass, and Thomas are uniquely suited to guest editing this theme issue. Kass holds a joint appointment in Johns Hopkins’ Berman Institute of Bioethics and Bloomberg School of Public Health as the Phoebe R. Berman Professor of Bioethics and Public Health; she is a globally recognized public health expert and has served on international and national ethics committees, in addition to leading the Johns Hopkins-Fogarty African Bioethics Training Program for the last 13 years.
Quinn has extensive experience investigating the impact of disasters on preparedness of minority communities and the willingness of these groups to accept seasonal flu and other vaccines. Thomas is Professor and Founding Director of the Maryland Center for Health Equity at the University of Maryland School of Public Health and a recognized national expert on community engaged research. His work with Quinn on the legacy of the US Public Health Service Syphilis Study done at Tuskegee contributed to the 1997 Presidential Apology to survivors. Together Thomas and Quinn are principal investigators of the Building Trust project at M-CHE.
According to Dr. Thomas, “It is impressive how several of the articles call for the re-imagination of human subjects protections for vulnerable populations and a reengineering of the research enterprise to elevate the ‘community’ to be as important as the ‘individual’ when it comes to improving the informed consent process” he said.
The full theme issue is available online now at http://ajph.aphapublications.org/
The print version will be available December 2013.
Funding for the theme issue was provided the by Award Number 7RC2MD004766 (Quinn & Thomas, Principal Investigators) from the National Institute on Minority Health and Health Disparities (NIMHD) and the Office of the Director, National Institutes of Health (NIH).
- PEBS Neuroethics Roundup (JHU) (kolber.typepad.com)
- Minorities Underrepresented in Federal Regulations on Human Subject Research (hofstrabioethics.wordpress.com)
PUBLIC RELEASE DATE:5-Nov-2013
Torture permanently damages normal perception of pain
Tel Aviv University researchers study the long-term effects of torture on the human pain system
Israeli soldiers captured during the 1973 Yom Kippur War were subjected to brutal torture in Egypt and Syria. Held alone in tiny, filthy spaces for weeks or months, sometimes handcuffed and blindfolded, they suffered severe beatings, burns, electric shocks, starvation, and worse. And rather than receiving treatment, additional torture was inflicted on existing wounds.
Forty years later, research by Prof. Ruth Defrin of the Department of Physical Therapy in the Sackler Faculty of Medicine at Tel Aviv University shows that the ex-prisoners of war (POWs), continue to suffer from dysfunctional pain perception and regulation, likely as a result of their torture. The study — conducted in collaboration with Prof. Zahava Solomon and Prof. Karni Ginzburg of TAU’s Bob Shapell School of Social Work and Prof. Mario Mikulincer of the School of Psychology at the Interdisciplinary Center, Herzliya — was published in the European Journal of Pain.
“The human body’s pain system can either inhibit or excite pain. It’s two sides of the same coin,” says Prof. Defrin. “Usually, when it does more of one, it does less of the other. But in Israeli ex-POWs, torture appears to have caused dysfunction in both directions. Our findings emphasize that tissue damage can have long-term systemic effects and needs to be treated immediately.”
A painful legacy
The study focused on 104 combat veterans of the Yom Kippur War. Sixty of the men were taken prisoner during the war, and 44 of them were not. In the study, all were put through a battery of psychophysical pain tests — applying a heating device to one arm, submerging the other arm in a hot water bath, and pressing a nylon fiber into a middle finger. They also filled out psychological questionnaires.
The ex-POWs exhibited diminished pain inhibition (the degree to which the body eases one pain in response to another) and heightened pain excitation (the degree to which repeated exposure to the same sensation heightens the resulting pain). Based on these novel findings, the researchers conclude that the torture survivors’ bodies now regulate pain in a dysfunctional way.
It is not entirely clear whether the dysfunction is the result of years of chronic pain or of the original torture itself. But the ex-POWs exhibited worse pain regulation than the non-POW chronic pain sufferers in the study. And a statistical analysis of the test data also suggested that being tortured had a direct effect on their ability to regulate pain.
The researchers say non-physical torture may have also contributed to the ex-POWs’ chronic pain. Among other forms of oppression and humiliation, the ex-POWs were not allowed to use the toilet, cursed at and threatened, told demoralizing misinformation about their loved ones, and exposed to mock executions. In the later stages of captivity, most of the POWs were transferred to a group cell, where social isolation was replaced by intense friction, crowding, and loss of privacy.
“We think psychological torture also affects the physiological pain system,” says Prof. Defrin. “We still have to fully analyze the data, but preliminary analysis suggests there is a connection.”
American Friends of Tel Aviv University supports Israel’s leading, most comprehensive and most sought-after center of higher learning, Tel Aviv University (TAU). Rooted in a pan-disciplinary approach to education, TAU is internationally recognized for the scope and groundbreaking nature of its research and scholarship — attracting world-class faculty and consistently producing cutting-edge work with profound implications for the future. TAU is independently ranked 116th among the world’s top universities and #1 in Israel. It joins a handful of elite international universities that rank among the best producers of successful startups.
- Torture permanently damages normal perception of pain (scienceblog.com)
- Torture permanently damages normal perception of pain (sciencedaily.com)
- Torture permanently damages normal perception of pain (medicalxpress.com)
- Chilean Exile Tortured During Pinochet Dictatorship Wins Compensation (eurasiareview.com)
- Former bodyguards allege torture by Kazakh exile Rakhat Aliyev (timesofmalta.com)
- The pain didn’t end (1trueme.wordpress.com)
- How Doctors Became Torturers (shaneomara.wordpress.com)