New research from the University of Chicago highlights a third component to that cycle: the millions of microbes that live in the intestines. These organisms respond to the same environmental cues as their host organism; their activity and metabolism is intertwined with the sleep/wake cycles and feeding schedules of the animal.
Members of a panel at Health Journalism 2015 on medical device coverage provided a variety of advice for reporters covering and of the implants, instruments and diagnostic tools common to the modern medical machine.
Moderator of the session was Chad Terhune, aLos Angeles Times reporter who recently found himself chasing an outbreak of carbapenem-resistant enterobacteriaceae (CRE) linked to dirty duodenoscopes. Contributing to the discussion were panelists USA Today investigative reporterPeter Eisler and Scott Lucas, associate director of accident and forensic investigation at the ECRI Institute.
A recent CRE outbreak at Ronald Reagan UCLA Medical Center illustrates the broader issues of medical device approval and oversight. The Olympus scopes used at the Los Angeles hospital, and at other facilities around the nation where the superbug infected patients, did not require any formal study or approval from the FDA before hitting the market because they were considered “substantially equivalent” to a previous models. Equivalency, Eisler explained, allows thousands of devices to move from labs to patients with little more than a short 510K statement that the manufacturer files with the FDA.
Only 10 percent of devices, such as those which “sustain or support life, are implanted, or present potential unreasonable risk of illness or injury” fall into the FDA’s “premarket approval’” category requiring a greater level of regulatory scrutiny, including safety and effectiveness studies, before sale.
Things are not much better once devices hit the market.
It is important to understand that medical devices seldom stand alone, he said. They are usually part of much broader systems used to deliver care safely to patients. When a patient dies after a ventilator fails, for example, it may be that alarms, communications networks or staffing protocols designed to quickly detect and report the failure did not work.
Thus, if reporters want to understand what went wrong in a specific incident, they should ask about more than the device itself. “The system approach to an investigation is key to finding the answer,” Lucas said.
Also be aware that hospitals are supposed to have detailed plans that tell employees what to do when there is a problem with a device. Sequestering machines that malfunction, and downloading data from them before it is purged, are examples of best-practice steps that reporters can ask about.
Handling the pitch
So what should a reporter do when he or she receives a glowing pitch from a local hospital about the latest device?
Terhune suggests starting with Medicare’s open payments database to see if the doctors involved have a financial interest in the device that’s being pitched. While a financial interest is not necessarily a deal breaker for coverage, it is something reporters should know about going in and make sure they can adequately address in their coverage.
When writing about transparency in health care prices and quality, journalists should expose the myths that health care providers promote. That’s the advice Francois de Brantes gave during a session on price and quality transparency at Health Journalism 2015 last month.
Providers promote the false ideas that gathering accurate price and quality data is difficult, if not impossible, and that variations in price result from the severity of illness in populations, de Brantes explained. By debunking these myths, journalists would inform policymakers and the public that there are ways to calculate the prices of medical episodes of care accurately, and that price variation can be controlled. “Price varies because of the way physicians practice,” he said.
Among those myths:
Price is a trade secret
Disclosing prices would impede the ability of health plans, hospitals and physicians to compete effectively
Revealing prices enables collusion and thus violates antitrust law
Publishing prices leads to higher health care costs.
Traits passed between generations are not decided only by DNA, but can be brought about by other materials in cells.
Edinburgh scientists studied proteins found in cells, known as histones, which are not part of the genetic code, but act as spools around which DNA is wound.
Histones are known to control whether or not genes are switched on.
Researchers found that naturally occurring changes to these proteins, which affect how they control genes, can be sustained from one generation to the next and so influence which characteristics are passed on.
The finding demonstrates for the first time that DNA is not solely responsible for how characteristics are inherited.
It paves the way for research into how and when this method of inheritance occurs in nature, and if it is linked to particular traits or health conditions.
It may also inform research into whether changes to the histone proteins that are caused by environmental conditions – such as stress or diet – can influence the function of genes passed on to offspring.
The research confirms a long-held expectation among scientists that genes could be controlled across generations by such changes.
However, it remains to be seen how common the process is, researchers say.
Scientists tested the theory by carrying out experiments in a yeast with similar gene control mechanisms to human cells.
They introduced changes to a histone protein, mimicking those that occur naturally, causing it to switch off nearby genes.
The effect was inherited by subsequent generations of yeast cells.
The study, published in Science, was supported by the Wellcome Trust and the EC EpiGeneSys Network.
We’ve shown without doubt that changes in the histone spools that make up chromosomes can be copied and passed through generations. Our finding settles the idea that inherited traits can be epigenetic, meaning that they are not solely down to changes in a gene’s DNA.
Inderscience news: Unhealthy information remedy.
Liu has developed a simple metric that can be used to analyse a document or website and ascertain just how reliable the medical information in it might be. The metric counts the number of different health or medical terms in the longest passage of a given document
From the 2 April 2015 post
A little health knowledge can be a very dangerous thing, especially if the information comes from the Internet. Now, research published in the International Journal of Intelligent Information and Database Systems, describes a new quality indicator to remedy that situation.
Rey-Long Liu of the Department of Medical Informatics, at Tzu Chi University, in Hualien, Taiwan, explains how the internet has in many cases replaced one’s physician as the primary source of health information, particularly when someone is faced with new symptoms. Unfortunately, there is a lot of misinformation and disinformation readily available on the internet via myriad websites and networking groups that might, at first sight, offer a cure, but may lead to a putative patient following a hazardous route to health.
Liu has developed a simple metric that can be used to analyse a document or website and ascertain just how reliable the medical information in it might be. The metric counts the number of different health or medical terms in the longest passage of a given document. In experiments on thousands of real web pages evaluated manually and with this “health information concentration” metric, Liu has been able to validate with precision those pages that have genuine medical information and revealed the quackery and ill-advised health pages. The approach is much more accurate than conventional web-ranking by search engines and precludes the need for natural-language comprehension by the system.
“High-quality health information should be focused on specific health topics and hence composed of those text areas that are large enough and dedicated to health topics,” explains Liu. “The empirical evaluation reported in the paper justifies the hypothesis. The result also shows that a web page that happens to have many health terms does not necessarily contain quality health information, especially when the health terms are scattered in separate areas with a lot of non-health-related information appearing among them,” he adds. “Quality health information should be written by healthcare professionals who tend to provide both detailed and focused passages to present the information.”
The metric could readily be incorporated into search engine ranking algorithms to help healthcare consumers find high-quality information working alongside more conventional, general quality ranking parameters devised by the search engine companies for detecting relevance, importance, source and author of each webpage.
“Frontiers in Psychology is an open access journal that aims at publishing the best research across the entire field of psychology. Today, psychological science is becoming increasingly important at all levels of society, from the treatment of clinical disorders to our basic understanding of how the mind works. It is highly interdisciplinary, borrowing questions from philosophy, methods from neuroscience and insights from clinical practice – all in the goal of furthering our grasp of human nature and society, as well as our ability to develop new intervention methods. The journal thus welcomes outstanding contributions in any domain of psychological science, from clinical research to cognitive science, from perception to consciousness, from imaging studies to human factors, from animal cognition to social psychology.”
Breast milk seems like a simple nutritious cocktail for feeding babies, but it is so much more than that. It also contains nutrients that feed the beneficial bacteria in a baby’s gut, and it contains substances that can change a baby’s behaviour. So, when a mother breastfeeds her child, she isn’t just feeding it. She is also building a world inside it and simultaneously manipulating it.
To Katie Hinde, an evolutionary biologist at Harvard University who specialises in milk, these acts are all connected. She suspects that substances in milk, by shaping the community of microbes in a baby’s gut, can affect its behaviour in ways that ultimately benefit the mother.
It’s a thought-provoking and thus far untested hypothesis, but it’s not far-fetched. Together with graduate student Cary Allen-Blevins and David Sela, a food scientist at the University of Massachussetts, Hinde has laid out her ideas in a paper that fuses neuroscience, evolutionary biology, and microbiology.
It begins by talking about the many ingredients in breast milk, including complex sugars called oligosaccharides. All mammals make them but humans have an exceptional variety. More than 200 HMOs (human milk oligosaccharides) have been identified, and they are the third most common part of human milk after lactose and fat.
Babies can’t digest them. Instead, the HMOs are food for bacteria, particularly the Bifidobacteria and Bacteroides groups. One strain in particular—Bifidobacterium longum infantis—can outcompete the others because it wields a unique genetic cutlery set that allows it to digest HMOs with incredible efficiency.
Why would mothers bother producing these sugars? Making milk is a costly process—mums quite literally liquefy their own bodies to churn out this fluid. Obviously, it feeds a growing infant, but why not spend all of one’s energy on filling milk with baby-friendly nutrients? Why feed the microbes too? “To me, it seems incredibly evident that when mums are feeding the microbes, they are investing on a greater return on their energetic investment,” says Hinde. By that, she means that setting up the right communities of microbes provides benefits for the baby above and beyond simple nutrition.
TOXMAP® is a Geographic Information System (GIS) that uses maps of the United States and Canada to help users visually explore data primarily from the US Environmental Protection Agency (EPA)’s Toxics Release Inventory (TRI) and Superfund Program.
It’s time to ask uncomfortable questions about the brain mechanisms that allow ‘ordinary’ people to turn violent, says Itzhak Fried.
What happens in the brains of people who go from being peaceable neighbours to slaughtering each other on a mass scale? Back in 1997, neurosurgeon Itzhak Fried at the University of California, Los Angeles, conscious of the recent massacres in Bosnia and Rwanda, described this switch in behaviour in terms of a medical syndrome, which he called ‘Syndrome E’ 2. Nearly 20 years later, Fried brought sociologists, historians, psychologists and neuroscientists together at the Institute of Advanced Studies in Paris to discuss the question anew. At the conference, called ‘The brains that pull the triggers‘, he talked to Nature about the need to consider this type of mass murder in scientific as well as sociological terms, and about the challenge of establishing interdisciplinary dialogue in this sensitive area.
What are the main features of the syndrome?
There was a myth that the primitive brain is held in check by our more-recently evolved prefrontal cortex, which is involved in complex analysis, and that the primitive, subcortical part takes over when we carry out brutal crimes such as repetitive murder. But I saw it the other way around. The signs and symptoms that I gathered in my research indicated that the prefrontal cortex, not the primitive brain, was responsible, because it was no longer heeding the normal controls from subcortical areas. I called it ‘cognitive fracture’ — the normal gut aversions to harming others, the emotional abhorrence of such acts, were disconnected from a hyper-aroused prefrontal cortex. I also proposed a neural circuitry in the brain that could perhaps account for this. In brief, specific parts of the prefrontal cortex become hyperactive and dampen the activity of the amygdala, which regulates emotion.
If mass murder happens because of activity in the brain, what does this say about personal responsibility?
Perpetrators of repeated killings have the capacity to reason and to solve problems — such as how best practically to kill lots of people rapidly. Proposing the existence of a syndrome does not absolve them of responsibility.
From the report (The 2015 World Happiness Report and supplemental files are available for download for free at this link)
The World Happiness Report is a landmark survey of the state of global happiness. The first report was published in 2012, the second in 2013, and the third on April 23, 2015. Leading experts across fields – economics, psychology, survey analysis, national statistics, health, public policy and more – describe how measurements of well-being can be used effectively to assess the progress of nations. The reports review the state of happiness in the world today and show how the new science of happiness explains personal and national variations in happiness. They reflect a new worldwide demand for more attention to happiness as a criteria for government policy.
The world has come a long way since the first World Happiness Report launched in 2012. Increasingly happiness is considered a proper measure of social progress and goal of public policy. A rapidly increasing number of national and local governments are using happiness data and research in their search for policies that could enable people to live better lives. Governments are measuring subjective well-being, and using well-being research as a guide to the design of public spaces and the delivery of public services.
Harnessing Happiness Data and Research to Improve Sustainable Development
The year 2015 is a watershed for humanity, with the pending adoption by UN member states of Sustainable Development Goals (SDGs) in September to help guide the world community towards a more inclusive and sustainable pattern of global development. The concepts of happiness and well-being are very likely to help guide progress towards sustainable development.
Sustainable development is a normative concept, calling for all societies to balance economic, social, and environmental objectives. When countries pursue GDP in a lopsided manner, overriding social and environmental objectives, the results often negatively impact human well- being. The SDGs are designed to help countries to achieve economic, social, and environmental objectives in harmony, thereby leading to higher levels of well-being for the present and future generations.
The SDGs will include goals, targets and quantitative indicators. The Sustainable Development Solutions Network, in its recommendations on the selection of SDG indicators, has strongly recommended the inclusion of indicators of Subjective Well-being and Positive Mood Affect to help guide and measure the progress towards the SDGs. We find considerable support of many governments and experts regarding the inclusion of such happiness indicators for the SDGs. The World Happiness Report 2015 once again underscores the fruitfulness of using happiness measurements for guiding policy making and for helping to assess the overall well-being in each society.
We could stop almost all psychotropic drug use without deleterious effect, says Peter C Gøtzsche, questioning trial designs that underplay harms and overplay benefits. Allan H Young and John Crace disagree, arguing that evidence supports long term use
Yes—Peter C Gøtzsche
Psychiatric drugs are responsible for the deaths of more than half a million people aged 65 and older each year in the Western world, as I show below.1 Their benefits would need to be colossal to justify this, but they are minimal.123456
Overstated benefits and understated deaths
The randomised trials that have been conducted do not properly evaluate the drugs’ effects. Almost all of them are biased because they included patients already taking another psychiatric drug.178910 Patients, who after a short wash-out period are randomised to placebo, go “cold turkey” and often experience withdrawal symptoms. This design exaggerates the benefits of treatment and increases the harms in the placebo group, and it has driven patients taking placebo to suicide in trials in schizophrenia.8
Under-reporting of deaths in industry funded trials is another major flaw.Based on some of the randomised trials that were included in a meta-analysis of 100 000 patients by the US Food and Drug Administration, I have estimated that there are likely to have been 15 times more suicides among people taking antidepressants than reported by the FDA—for example, there were 14 suicides in 9956 patients in trials with fluoxetine and paroxetine, whereas the FDA had only five suicides in 52 960 patients, partly because the FDA only included events up to 24 hours after patients stopped taking the drug.1
No—Allan H Young, John Crace
Psychiatric conditions are common, complex, costly, and often long term illnesses. More than a fifth of all health related disability is caused by mental ill health, studies suggest, and people with poor mental health often have poor physical health and poorer (long term) outcomes in both aspects of health.26
Raised standardised mortality rates and reduced life expectancy have been reported in people with psychiatric disorders such as psychosis and mood and personality disorders.27 These increased death rates are only partly because of suicide and mostly attributable to coexisting physical health disorders. There is thus a clear need for psychiatric disorders to be treated to attempt to reduce the long term harm associated with them. The key question is whether psychiatric drugs do more harm than good.
All therapeutic interventions may potentially do both good and harm, and thorough evaluation of the relative benefits and harms of a treatment should be done for psychiatric drugs no less than for any others.28 These evaluations of benefits and harms are based on group data, which have to be applied to judgments for individual patients and can therefore be advisory only; the individual’s subjective experience is crucially important to consider.
What about harms?
Worldwide, regulatory agencies are responsible for ensuring that drugs work and are acceptably safe. Postmarketing surveillance continues after drugs are licensed. This can further refine, or confirm or deny, the safety of a drug in the general population, which unlike study populations includes people with varied medical conditions. Several approaches are used to monitor the safety of licensed drugs, including spontaneous reporting databases, prescription event monitoring, electronic health records, patient registries, and record linkage between health databases.30 These safeguards work to ensure drugs available do more good than harm.30
Nevertheless, many concerns have been expressed about psychiatric drugs, and for some critics the onus often seems to be on the drug needing to prove innocence from causing harm rather than a balanced approach to evaluating the available evidence.
Whether concerns are genuine or an expression of prejudice is not clear, but over time many concerns have been found to be overinflated. A few examples may be illustrative.
IMAGE: VIOLENCE AND GENDER IS THE ONLY PEER-REVIEWED JOURNAL FOCUSING ON THE UNDERSTANDING, PREDICTION, AND PREVENTION OF ACTS OF VIOLENCE. THROUGH RESEARCH PAPERS, ROUNDTABLE DISCUSSIONS, CASE STUDIES, AND OTHER ORIGINAL CONTENT,… view more
Author Michael Stone, MD, Columbia College of Physicians and Surgeons and Mid-Hudson Forensic Psychiatric Hospital, New York, NY, provides an in-depth look at the scope of mass murders committed in the U.S. during recent decades, describing the crime as “an almost exclusively male phenomenon.” Most mass murderers have a mental illness characterized by a paranoid personality disorder that includes a deep sense of unfairness and a skewed version of reality. Unfortunately, this profile of the men who have committed mass murders has often led to the unwarranted stigmatization of the mentally ill as a group as being inherently dangerous, which is not the case.
Dr. Stone points in particular to the growing availability of semiautomatic weapons as a key factor contributing to the increasing rate of random mass shootings in the U.S. during the past 65 years. The number of events nearly doubles in the 1990s compared to the 1980s, for example.
Around a quarter of people experience depression at some point in their lives, two-thirds of whom are women. Each year more than 11m working days are lost in the UK to stress, depression or anxiety and there are more than 6,000 suicides. The impact of depression on individuals, families, society and the economy is enormous.
Front-line therapies usually include medication. All the commonly prescribed antidepressants are based on “the monoamine hypothesis”. This holds that depression is caused by a shortage of serotonin and noradrenaline in the brain. Existing antidepressants are designed to increase the levels of these chemicals.
The first generation of antidepressants were developed in the 1950s and a second generation came in the 1980s. Products such as Prozac and Seroxat were hailed as “wonder drugs” when they first came onto the market.
In the roughly 30 years since, these kinds of drugs have come to look tired and jaded. Patents have expired and there are doubts about their efficacy. Some scientists even argue the drugs do more harm than good.
There has been no third generation of antidepressants. This is despite there having been moon-landing levels of investment in research. The antidepressant discovery process that gave rise to the earlier drugs is clearly broken. It is also apparent that this process had never worked that well, since the only real improvements over the previous 60 years were a reduction of side-effects.
By the mid-2000s the major pharmaceutical companies started disinvesting in this area. Government funding for basic research into depression and charitable funding followed a similar pattern. In 2010 GSK, AstraZeneca, Pfizer, Merck and Sanofi all announced that they had stopped looking for new antidepressants altogether. Professor David Nutt, the former government drug advisor, declared this to be the “annus horribilis” for psychiatric drug research. The likelihood now is that there will be no new antidepressants for decades.
However, there continues to be an urgent and pressing need for more effective treatments. The question the drug companies now need to ask themselves is, did they fail because the task was impossible, or did they fail simply because they got things wrong? Our view is that there was a systems failure.
Certain meditation techniques can promote behavior to vary adaptively from moment to moment depending on current goals, rather than remaining rigid and inflexible. This is the outcome of a study by Lorenza Colzato and Iliana Samara from the Leiden Institute of Brain and Cognition at Leiden University, published in Consciousness and Cognition.
Different meditation types, different effects
Colzato and her fellow researchers were the first to investigate if meditation has an immediate effect on behavior, even in people who have never meditated before. “There are two fundamental types of meditation that affect us differently,” Colzato says, “open monitor meditation (which involves being receptive to every thought and sensation) and focused attention meditation (which entails focusing on a particular thought or object).”
Today at Sarvodaya’s Early Morning meditation (Photo credit: Wikipedia)
36 people who had never meditated before participated in this experiment. Half of the people practiced open monitor meditation while the other half practiced focused attention meditation for 20 minutes, respectively. After meditating, Samara asked participants to perform a task during which they were required to continuously adjust and adaptively discriminate irrelevant information from relevant information as quickly as possible.
Meditation optimizes adaptive behavior
Compared to participants who performed OMM, people who performed FAM were significantly better in adapting and adjusting their behavior from moment to moment. Colzato: “Even if preliminary, these results provide the first evidence that meditation instantly affects behavior and that this impact does not require practice. As such, our findings shed an interesting new light on the potential of meditation for optimizing adaptive behavior.
If a time machine was available, would it be right to kill Adolf Hitler when he was still a young Austrian artist to prevent World War II and save millions of lives? Should a police officer torture an alleged bomber to find hidden explosives that could kill many people at a local cafe? When faced with such dilemmas, men are typically more willing to accept harmful actions for the sake of the greater good than women. For example, women would be less likely to support the killing of a young Hitler or torturing a bombing suspect, even if doing so would ultimately save more lives.
According to new research published by the Society for Personality and Social Psychology, this gender difference in moral decisions is caused by stronger emotional aversion to harmful action among women; the study found no evidence for gender differences in the rational evaluation of the outcomes of harmful actions.
“Women are more likely to have a gut-level negative reaction to causing harm to an individual, while men experience less emotional responses to doing harm,” says lead research author Rebecca Friesdorf. The finding runs contrary to the common stereotype that women being more emotional means that they are also less rational, Friesdorf says. The journal article was published online in the Personality and Social Psychology Bulletin on April 3, 2015.
“..today we must assume that if our generation is suffering hardship, violence or the like, not only will we struggle to forget these difficult periods ourselves but our genes too will remember them, carrying traces to be passed on to the next generation or even several generations.”
From the 8 May 2015 post at Scilogs
The science behind a rapid paradigm shift
When the first human genome was decoded, popular thinking went: “If we know the genes, we know the person.” Today, barely 15 years later, science is in the middle of an exciting new area of research, which is entertaining interested members of the public with exciting, if not always serious, headlines. The field alleges that traumatic experiences can be passed down through the generations and even significantly affect the lives of grandchildren. As it turns out, the reality is that genes not only control, but are also controlled. And that is what epigenetics is all about – how are genes controlled and what factors can influence them?
Epigenetics refers to the meta-level of genetic regulation. Under the influence of external factors, epigenetic mechanisms regulate which genes are turned on and off. This helps our fixed genetic material to be more flexible. At the biochemical micro level, epigenetic regulators are responsible for how closely packed individual genomic regions are and therefore how accessible or not they are. This works by small adhered or detached chemical groups. The resulting marking of the genome is read by specialised enzymes that then cause the switching on or off of the genes.
As reasonable as this appears, one consequence is that we will have to say goodbye to a long-established dogma: the idea that genes are immutable in the creation of a living being. And, looking back through the history of science: was Lamarck right, after all? The 19th-century French biologist had claimed that organisms acquired traits to pass on to future generations . It is precisely this mechanism that epigeneticists are on the trail of today. Laboratory experiments with mice have demonstrated that a particular, targeted encoding of individual genes results in the changes being passed on to the offspring. Epigenetic changes, however, are so-called soft changes, as they can be undone. And that is medicine’s great hope – to be able to intervene in the control mechanism from the outside in order to be able to work against, for example, senile dementia.
At this point, the level of possible tension around this new field of research becomes clear. On the one hand, the idea that our human condition can be so strongly “manipulated” by environmental influences can be very disturbing. And rightly so. Previously, we may have had the upbeat expectation that although we are experiencing suffering, the next generation will have it better. However, today we must assume that if our generation is suffering hardship, violence or the like, not only will we struggle to forget these difficult periods ourselves but our genes too will remember them, carrying traces to be passed on to the next generation or even several generations.
A study often mentioned in this context is based on the analysis of data collected in the Netherlands over the years of hunger in 1944-45, during which the population there suffered particularly difficult conditions. The children born at this time were not only smaller, but, as adults, had an increased risk of obesity, cardiovascular problems and neuropsychiatric disorders. In turn, their offspring were again smaller than average – despite food being in ready supply and living conditions having greatly improved.
Use of Force against Inmates with Mental Disabilities in US Jails and Prisons
MAY 12, 2015
This 127-page report details incidents in which correctional staff have deluged prisoners with painful chemical sprays, shocked them with powerful electric stun weapons, and strapped them for days in restraining chairs or beds. Staff have broken prisoners’ jaws, noses, ribs; left them with lacerations requiring stitches, second-degree burns, deep bruises, and damaged internal organs. In some cases, the force used has led to their death.
Coffee has gone from dietary foe to friend in recent years, partly due to the revelation that it’s rich in antioxidants. Now even spent coffee-grounds are gaining attention for being chock-full of these compounds, which have potential health benefits. In ACS’ Journal of Agricultural and Food Chemistry, researchers explain how to extract antioxidants from the grounds. They then determined just how concentrated the antioxidants are.
María-Paz de Peña and colleagues note that coffee — one of the most popular drinks in the world — is a rich source of a group of antioxidants called dietary phenolic compounds. Spent grounds, however, often end up in the trash. But recently, scientists have discovered that antioxidants aren’t just in the brewed coffee; they’re also in the used grounds. De Peña wanted to figure out the total phenolic content in extracts from these leftovers.
The researchers used three different methods to release antioxidants from spent grounds and found high levels of phenols in the extracts — sometimes at higher levels than in brewed coffee. Thus, they have the potential to serve as additives to enhance the potential health effects of other food products, the scientists conclude.
EVANSTON, Ill. — Treatments used by traditional healers in Nigeria have inspired scientists at Northwestern University to synthesize four new chemical compounds that could one day lead to better therapies for people with psychiatric disorders.
In a paper published online in the journal Angewandte Chemie International Edition, the scientists detail how they created these natural compounds by completing the first total syntheses of two indole alkaloids — alstonine and serpentine. These alkaloids, found in various plant species used by healers in Nigeria to treat people with conditions such as schizophrenia and bipolar disorder, have antipsychotic properties that have potential to improve mental disorder treatments.
The current drugs used for schizophrenia effectively treat delusions and hallucinations but are only partially effective for cognitive impairment. Early experimental research of these new compounds in animal models shows promise in improving cognitive impairment, the Northwestern scientists said.
Traditional healers boil these special plants and produce an extract that they administer to people with symptoms of mental illness. However, this extract isn’t pure, and it contains other compounds and materials that may not be beneficial to people with mental disorders.
“Nature did not intend this plant to produce an antipsychotic drug on its own,” Meltzer said.
The collaborative work to create the compounds took place in the Center for Molecular Innovation and Drug Discovery (CMIDD) at Northwestern, using high-level purification resources and state-of-the-art research instrumentation and equipment. Scheidt is the director of CMIDD.
Through an efficient and stereo-selective synthesis, Scheidt and his team created four separate but related natural products. Now a template exists to continue making these compounds as needed for future studies and ultimately for use in clinical drug trials.
“We can make multi-gram quantities of any of the compounds we want,” Scheidt said. “We built the assembly line and are now uniquely positioned to explore their potential.”
Meltzer is already using these compounds in animal studies in his lab to better understand how they affect brain biology and chemistry in the schizophrenia disease model. Early results from his lab show that the compounds may increase the ability of other antipsychotic drugs to improve cognitive impairment.
Other study authors are Dr. Ashkaan Younai and Bi-Shun Zeng of Northwestern University. This study was supported the Chemistry of Life Processes Institute at Northwestern in the form of an Innovators Grant and the Weisman Family Foundation.
May 11, 2015 – What are the most influential studies on surgery of the lower (lumbar) spine? The “top 100″ research papers in lumbar spine are counted down in a special review in the May 15 issue of Spine, published by Wolters Kluwer.
Dr. Samuel K. Cho and colleagues of Icahn School of Medicine at Mount Sinai, New York City, performed a literature review to analyze and quantify the most important research papers on lumbar spine surgery. Their results raise some interesting “questions, trends and observations”–including the finding that the two most-cited studies focus on situations when spinal surgery should not be performed.
And the Top 100 Lumbar Spine Papers Are…
The goal of the analysis was to identify the 100 most frequently cited papers relevant to lumbar spine surgery and published in spine-related journals. Citation by subsequent papers is a key measure of the relevance and importance of medical studies.
Out of more than 16,500 papers matching the search criteria, 322 were cited at least 100 times. The top-ranked paper–cited more than 1,000 times–was a classic 1990 study showing that many people have common spinal abnormalities on magnetic resonance imaging (MRI) scans–despite having no back pain or other symptoms. A 1994 study on a similar topic was the second most-cited paper, highlighting the need for a “clear correlation” of patients’ symptoms and imaging findings
The third most-cited paper was a 2000 review of an important survey tool (the Oswestry Disability Index) for assessing the impact of low back pain on patients’ lives. Overall, low back pain was the most common topic, addressed by 23 of the top 100 papers. Other frequent topics included spinal biomechanics and degenerative disc disease.
About half of the papers were published during the 1990s, and most originated in the United States. Overall, 63 of the top 100 lumbar spine papers were published in Spine.
Reflecting the current emphasis on evidence-based practice, the most frequently cited author isn’t even a spinal surgeon. That researcher, Dr. Richard Deyo of Oregon Health and Science University, Portland, is a leading authority on patient outcomes research.
The other two most frequently cited authors were Scott D. Boden of Emory University, Atlanta, and Dr. James Weinstein of the Dartmouth Institute, Lebanon, N.H. All three of these “most prolific” authors contributed to the SPORT study–a pivotal clinical trial comparing the benefits of surgery versus nonsurgical treatment for sciatica from herniated lumbar discs. Dr. Weinstein is Editor-in-Chief of Spine, and Dr. Boden and Dr. Deyo are Deputy Editors.
Over the years, rates of spinal surgery have risen, but with wide regional variations. Meanwhile, there are persistent questions about which patients truly benefit from surgery for the common and costly problem of low back pain. Many of the top-cited studies reflect the current emphasis on evidence-based practice–seeking to define groups of patients and characteristics associated with beneficial effects of spinal surgery.
Within the limitations of the review methods used, Dr. Cho and colleagues believe their study provides unique insights into the development and trends of the “challenging subspecialty” of lumbar spine surgery. The researchers add, “This paper identifies those individuals whose contributions to the ever-growing body of knowledge have provided guidance and suggestions for further investigation.”
From the 14 May 2014 Dartmouth College news release
A Dartmouth research laboratory is working to quantify the effects of playing games. In a study published online last month by the Games for Health Journal, Professor Mary Flanagan and her team found that attitudes toward public health issues shift to be more accepting and understanding after playing a game they developed calledRePlay Health.
“Sales of games have been steadily increasing for several years,” says Flanagan, the Sherman Fairchild Distinguished Professor in Digital Humanities at Dartmouth and the director of the Tiltfactor laboratory. “So economically, we have measured their impact, and now it’s time to measure their ability to change behaviors and attitudes.”
RePlay Health is a role-playing sport that requires players to assume different identities and carry out various activities to improve their health. The backdrop of the game is a fictional health care system, and the players learn how personal behaviors, workplace productivity, insurance (or lack of it), and all related health care costs are woven together within the system. Each player is presented with opportunities to not only improve their own health, but also the health of their community through policy initiatives that they vote on.
“We showed how active engagement with the game’s characters and events was crucial to the game’s ability to shift players’ mindsets and attitudes about health and health policy,” says Geoff Kaufman, a co-author of the study and Tiltfactor’s post-doctoral researcher in psychology.
The researchers asked a group of young adults to complete an online questionnaire two weeks prior to playing RePlay Health and again within a week after playing the game. Flanagan says that the results indicate that the game has the potential to have a lasting impact on the players.
RePlay Health was developed in collaboration with The Dartmouth Center for Healthcare Delivery Science and the Rippel Foundation. The game is part of a broad initiative to promote learning about public health policies and spending priorities. Flanagan and her team envision college students, medical students, doctors, local council leaders, government officials, and any other people interested broadly in public health playing the game to digest the issues and find ideas that resonate. “It’s not just students and public officials who can play this game, or benefit from playing,” says Flanagan.
The very public trials of the Boston Marathon bomber, Dzhokhar Tsarnaev, and the Colorado theater shooting suspect, James Holmes, put images and stories about these traumatic events once again in front of the public.
During both phases of the Boston Marathon bombing trial, testimony from survivors and first responders, as well as graphic images of the bombing, were front and center on television, the internet, and print media. And survivors of the Colorado theater shooting have vividly described in their trial testimony that night in detail and their terror and anguish seeing loved ones next to them dead or dying.
So what are the psychological and health effects of exposure to traumatic events like these?
What is trauma?
Traumatic events are those experiences that are perceived to be threats to one’s safety or stability and that cause physical, emotional and psychological stress or harm. In other words, these are events that fall outside the range of normal human experience and to which reactions vary according to the individual person.
Traumatic events aren’t always violent. They can range from moving somewhere new to a mass disaster or even war.
For most people, trauma is experienced during and immediately after the event. But for many, the trauma may be relived for months or even years, as has been the case, for instance, with the aftereffects of the September 11 attacks.
New trauma can bring back old memories
In addition, people with histories of previous trauma such as combat veterans may be more vulnerable to the effects of new traumatic events.
How can people cope with trauma?
What, then, can people do to alleviate the negative aftereffects of such events in order to return to their normal daily lives? The American Psychological Association recommendsmaking connections with others, accepting change, meeting problems head on and taking care of yourself.
It’s also important to remember that one never completely forgets such events, nor do professionals suggest that is the goal of recovery. Healthy recovery involves acknowledging that the events were terrible but at the same time not allowing them to interfere with daily living. Even if, 10 years later, a sudden noise triggers momentary fear.
A fecal sample analysis of 98 Swedish infants over the first year of life found a connection between the development of a child’s gut microbiome and the way he or she is delivered. Babies born via C-section had gut bacteria that showed significantly less resemblance to their mothers compared to those that were delivered vaginally.
The study, which appears May 11 in Cell Host & Microbe‘s special issue on “The Host-Microbiota Balance,” also found nutrition to be a main driver of infant gut microbiome development–specifically the decision to breast-feed or bottle-feed.
“Our findings surprisingly demonstrated that cessation of breastfeeding, rather than introduction of solid foods, is the major driver in the development of an adult-like microbiota,” says lead study author Fredrik Bäckhed of The University of Gothenburg, Sweden. “However, the effect of an altered microbiome early in life on health and disease in adolescence and adulthood remains to be demonstrated.”
Gut bacteria are suspected to be a source of nutrients and vitamins for a growing infant. Our intestinal tenants are able to interact with normal cellular processes to, for example, produce essential amino acids. Understanding the role individual gut microbes play in metabolism, immunity, and even behavior is an active area of investigation.
From the 15 May 2015 University of Connecticut news release
People’s personalities tend to vary somewhat depending on the season in which they are born, and astrological signs may have developed as a useful system for remembering these patterns, according to an analysis by UConn researcher Mark Hamilton. Such seasonal effects may not be clear in individuals, but can be discerned through averaging personality traits across large cohorts born at the same time of year. Hamilton’s analysis was published in Comprehensive Psychology on May 13.
Psychologists have known that certain personality traits tend to be associated with certain birth months. For example, people born in January and February tend to be more creative, and have a higher chance of being diagnosed with schizophrenia, than people born at any other time of year. And people born in odd-numbered months tend to be more extroverted than those born in even-numbered months.
So it wasn’t unprecedented when a paper appeared in 2013 in the Journal of Social Sciences linking birth month with the likelihood of becoming a celebrity. What was unusual, though, was that one of the authors was an astrophysicist, and the paper’s introduction included an explanation of the physics behind the astrological calendar. The authors argued that astrological ‘signs’ are merely an accident of the sun’s location in the cosmos, but that analysis shows certain zodiac signs have a curious correlation with fame.
The next year, a psychologist published a paper in Comprehensive Psychology purporting to debunk the first paper’s astrological findings. The author claimed that relative age among all the children in the same school grade could explain the zodiac effect, with children who were born earlier in the year, and were comparatively more mature, having more positive experiences overall.
UConn’s Hamilton, a social scientist in the Department of Communication, was unconvinced. He had reviewed the original paper for the Journal of Social Sciences, and considered the data and analysis to be sound. So he set out to debunk the debunking, examine some of the traditional astrological explanations, and see if they could be aligned with known psychological findings.
Traditional Western astrology uses elements (water, earth, air, and fire), sign duality (bright/dark), and sign qualities (cardinal, mutable, and fixed) to describe and categorize seasonal effects on personality. It considers late December through early March as a “wet” time of year, and connects wetness with creativity, for example. “Fixed” signs are said to be more stubborn and persistent than others.
Hamilton looked at the same data from the original paper, a set of 300 celebrities from the fields of politics, science, public service, literature, the arts, and sports. He found that celebrities’ birth dates tended to cluster at certain times of the year. “Wet” signs were associated with a larger number of celebrities, as were signs classified as “bright” and “fixed”.
“Psychologists want to dismiss these astrological correlations,” says Hamilton, “but there are seasonality effects that we have yet to explain.” Hamilton is not arguing that heavenly bodies are the true source of these effects; rather that astrological aspects are just useful tools, or heuristics, that help people remember the timing and patterns of nature.
Hamilton found that relative age of children in a school cohort did have some effect on propensity to become a celebrity. Children who spend their school years slightly older than the average among their peers are somewhat more likely to become famous, perhaps because they have more early success and so have better self-esteem into adulthood.
But Hamilton found that the relative age effect was dwarfed by the effect of being born under a wet astrological sign such as Aquarius or Pisces. Being born under a fixed quality sign – Aquarius, Taurus, Leo, or Scorpio – also increased a person’s chances of achieving celebrity to about the same degree as being older than average in his or her school cohort. In addition, being born under a “bright” sign increased a person’s chances of finding fame.
Hamilton is currently working with other researchers on an analysis of 85,000 celebrities dating from 3000 B.C. to the present era. He says the seasonality effect on celebrity appears to hold true even in this large data set that stretches across millennia and cultures.
New bio-sensing technologies give us cheap, fast and convenient health data
Amsterdam, May 12, 2015
Wearable E-skin that can measure heart rate and blood pressure, and paper diagnostic machines the size of a credit card that can give instant readings on blood and saliva samples are two new bio-sensing technologies presented at Elsevier’s 4th International Conference on Bio-Sensing Technology in Lisbon, Portugal on 12 May 2015.
Bio-sensors can detect and analyze data to give patients information on their heart rate and blood pressure, blood sugar and hormone levels, and even test whether they are infected with antibiotic-resistant bacteria. This detection technology is a step forward in personal medicine, giving patients real-time information about how their bodies are functioning and suggesting the most suitable treatments.
Professor Anthony Turner, Head of the Biosensors & Bioelectronics Centre at Linköping University, Sweden, has developed an instrument the size of a credit card that can analyse blood and saliva samples. It is simple to use: you switch it on by pressing a button, then apply your sample to a circle in the bottom right corner and wait for a digital reading to be displayed and even sent to your mobile phone.
The whole instrument is printed on the card using a screen-printing technique. It could be used to monitor diabetes, kidney disease and heart disease, or to detect cancer. This, says Professor Turner, could turn a 2500-year-old paradigm on its head and put the power in the patient’s hands.
This means they have the potential to provide patients and doctors in developing countries with accessible, affordable medical tests. For example, the printed card could be made part of the packaging of antibiotics, helping determine which antibiotic would be best to treat a patient’s infection.
Such printable devices could also be worn like plasters or contact lenses, transmitting information to mobile phones. Similarly, e-skin devices are also designed to be wearable and portable, and to transmit data about how a patient’s body is functioning.
Professor Ting Zhang, from Suzhou Institute of Nano-Tech and Nano-Bionics, Chinese Academy of Sciences, China, is presenting a new kind of e-skin at the Conference. E-skin is developed based on flexible electronic technology and nanotechnology; because of its unique ability to detect tiny changes in pressure, e-skin can be used to monitor blood pressure, heart rate and wrist pulse.
Bio-sensing technologies are gaining momentum in areas like health, the environment and security. The conference brings together leaders from industry and academia to exchange and share their experiences, present research results, explore collaborations and spark new ideas, with the aim of developing new projects and exploiting new technology for bio-sensing applications.
About the 4th International Conference on Bio-Sensing Technology
Following the success of the first 3 conferences, the 4th International Conference on Bio-Sensing Technology will continue to bring together leaders from industry and academia to exchange and share their experiences, present research results, explore collaborations and to spark new ideas, with the aim of developing new projects and exploiting new technology for bio-sensing applications. www.biosensingconference.com.
Scientists at a U.S. Army research center have modified an assay that tests whether or not a sample of mosquitoes harbors the virus responsible for the disease known as chikungunya (CHIKV), long a problem in the Old World tropics but recently established in the Americas.
…“Chikungunya” is a term used by people of the Makonde Plateau, between Tanzania and Mozambique, where the disease was discovered in 1952. It means, “that which bends up,” referring to the way arthritis caused by the disease crooks posture of the victim’s body. Symptoms of chikungunya can be as brutal as its name is to pronounce, although it is seldom fatal. Victims experience fever and pain and swelling of muscles and joints. Headache and rash may occur. The disabling impact can last for months.
Approximate distribution of Aedes aegypti (left) and Aedes albopictus in the United States, according to the Centers for Disease Control.
The chikungunya virus belongs to a group known as alphaviruses, at least 30 of which can infect humans and other vertebrates, causing diseases such as equine encephalitis and a variety of rash-accompanied fevers. CHIKV is transmitted by mosquitoes of the genus Aedes, chiefly Aedes aegypti, the bane of humans in the tropics because it also carries viruses responsible for yellow fever and dengue fever. Scientists have identified three different lineages — genetically-related groups — of CHIKV linked to geographical areas: Asia, West Africa, and East/Central/South Africa. All of the lineages exist outside the geographical areas after which they are named. A member of the Asian lineage, for example, has infected people in the Americas.
Like many tropical diseases, chikungunya has been rampant in the developing world for many years, but only became the focus of intensive research after it threatened western nations. An outbreak on Reunion Island, a French Department in the Indian Ocean, during 2005 and 2006 attracted attention largely because it’s a hot tourist destination for Europeans. Perhaps not by coincidence, the first transmission from mosquitoes in the Americans occurred in December 2013, on the French half of St. Martin, and island in the Caribbean. Reported cases in the Americas have now passed 1.5 million.
It began to show up in the United States during 2014, with nearly 2,500 cases reported from 46 states. Nearly all, however, were in travelers who picked up the infection in the tropics. Eleven people on the U.S. mainland, all in South Florida, contracted the disease directly from mosquitoes in the U.S.
During 2014, more than 4,500 people in Puerto Rico and the U.S. Virgin Islands were infected by mosquitoes, although the number may have been higher because chikungunya was not officially reportable to the federal Centers for Disease Control and Prevention until this year. There have been 77 chikungunya cases reported this year — as of April 7, from 21 states — but all were contracted out of the country.
To date, tests for CHIKV require expensive equipment in a laboratory setting and technicians who have undergone extensive training. Not so the dipstick test. It can be done on site by a neophyte and, importantly, does not require electricity. The dipstick involved is not the kind used to check oil in an automotive motor. It’s a small strip, usually paper-like nitrocellulose, a compound that is used in gunpowder, nail polish, laboratory filter paper, and other products. On the surface of the stick are reagents that will react to CHIKV antigens if the virus is present in the test sample, which is in a liquid solution.
Ed Ricciuti is a journalist, author, and naturalist who has been writing for more than a half century. His latest book is called Bears in the Backyard: Big Animals, Sprawling Suburbs, and the New Urban Jungle(Countryman Press, June 2014). His assignments have taken him around the world. He specializes in nature, science, conservation issues, and law enforcement. A former curator at the New York Zoological Society, and now at the Wildlife Conservation Society, he
From the 12 May 2015 British Medical Journal editorial
Criticism of the Israeli government does not necessarily equate with antisemitism
In April, Reed Elsevier, publishers of the Lancet, received a complaint written by Professor Mark Pepys and signed by 396 physicians and scientists, including five Nobel Laureates.1 They protested that the Lancet was being used for political purposes and for “publication of deliberately false material which deepens polarization between Israelis and Palestinians.”
The most recent example of what was termed this “political vendetta” was the July publication, during the latest Israeli assault on Gaza, of an “Open letter for the people in Gaza.”2 They wrote that the letter “contains false assertions and unverifiable dishonest ‘facts,’ many of them libellous,” and that its authors had failed to declare possible conflicts of interest. The complaint insisted that the July letter be retracted (disagreeing with the Lancetombudsman’s decision3) and that it contravened the code of the Committee on Publication Ethics (disagreeing with a former chair of the committee4). It asked for the support of all scientists and clinicians “on whom they [Reed Elsevier] depend for their business,” adding “none of us is under any obligation to submit and review material for publication in their journals or to serve on their editorial or advisory boards.”
An email chain soliciting support for this complaint was more explicit.5 In it Pepys accused the July letter of “viciously attacking Israel with blood libels echoing those used for a thousand years to create anti-Semitic pogroms” and being “written by dedicated Jew haters.” He suggested that the letter “would have made Goebbels proud” and that “anybody who was not a committed anti-Semite would firstly not have published Manduca [lead author of the July letter] and secondly would have retracted instantly when her long track record of blatant anti-Semitism were [sic] exposed.” Two days before the complaint, the title of the email chain was modified to read “DO NOT CITE The Lancet in your work—Their content includes fraudulent data.”6
The July letter included a UN estimate of the number of Gazan children killed up to that date during the Israeli bombardment,7 which the Pepys email implied was exaggerated.
Medicine cannot avoid politics
These events raise two issues. The first is the appropriateness of medical journals discussing political issues that have bearing on health, including civilian mortality and morbidity.
The second issue is the similarity between this complaint’s attempt to stifle coverage of the conflict in Gaza and previous examples of writing campaigns provoked by articles in medical journals critical of Israeli policies, including allegations of hyperbole, accusations of antisemitism, and threats of boycott.
The reports published by the UN and others all point to the need for an independent investigation into the conflict by international teams of humanitarian, arms, and legal experts to determine whether and by whom—from either side of the conflict—violations of international human rights and humanitarian law were committed. The effect of this war on civilian mental health, morale, and assets is magnified by the cumulative burden of still destroyed houses and livelihoods dating from previous conflicts. As a deputy editor of The BMJ has pointed out, “Future generations will judge the journal harshly if we avert our gaze from the medical consequences of what is happening to the occupants of the Palestinian territories and to the Israelis next door.
From the 11 May 2015 Indiana University news release
BLOOMINGTON, Ind. — Over nearly 15 years spent studying ticks, Indiana University’s Keith Clay has found southern Indiana to be an oasis free from Lyme disease, the condition most associated with these arachnids that are the second most common parasitic disease vector on Earth.
He has also seen signs that this low-risk environment is changing, both in Indiana and in other regions of the U.S.
A Distinguished Professor in the IU Bloomington College of Arts and Sciences’ Department of Biology, Clay has received support for his research on ticks from over $2.7 million in grants from the National Science Foundation-National Institutes of Health’s Ecology and Evolution of Infectious Diseases Program and others.
Clay’s lab has found relatively few pathogens in southern Indiana ticks that cause common tick-borne diseases compared to the Northeast and states like Wisconsin and Minnesota.
But Lyme disease has been detected just a few hours north of the region around Tippecanoe River State Park and Lake Michigan’s Indiana Dunes, and Clay said the signs are there that new tick species, and possibly the pathogens they carry, are entering the area.
“Just in the past 10 years, we’re seeing things shift considerably,” Clay said. “You used to never see lone star ticks in Indiana; now they’re very common. In 10 years, we’re likely to see the Gulf Coast tick here, too. There are several theories for why this is happening, but the big one is climate change.”
A vector for disease
The conclusions are drawn from years of work spent mapping tick boundaries and disease risks, but the exact cause of the shifting borders is not clear. In addition to changing temperatures, Clay references changes in animal populations, including deer, which provide large, mobile hosts for the parasites.
From the 15 January 2015 article at The Conversation
Many people are aware that low levels of iron in their body can lead anaemia, with symptoms such as fatigue. But few realise that too much iron can result in a potentially fatal condition.
Normally, if we have enough iron in our body, then no further iron is absorbed from the diet, and our iron levels remain relatively constant.
But the body also has no way of excreting excess iron. In a condition called hereditary haemochromatosis, the most common cause of iron overload, the mechanism to detect sufficient iron in the body is impaired and people can go on absorbing iron beyond the normal required amount.
Untreated, haemochromatosis can result in scarring to the liver (cirrhosis), liver cancer, damage to the heart and diabetes. These problems are the result of excess iron being deposited in the liver, heart and pancreas. Haemochromatosis can also cause non-specific symptoms such as fatigue, loss of libido and arthritis. In some, it results in a shortened lifespan.
The most common cause of hereditary haemochromatosis is a mutation received from both parents, in a gene called HFE.
Around one in every 200 Australians of European heritage have a double dose of this gene fault and are at risk of developing the disorder. Haemochromatosis is much less common among people who aren’t of European ancestry.
Approximately 80% of men and 60% of women who have inherited this gene fault from both parents develop high iron levels. And of those who do, up to 40% of men and 10% of women will develop health problems.
Actual blood iron levels are generally normal in those with haemochromatosis, as excess iron in the body is stored in tissues like the liver. So haemochromatosis is diagnosed by testing blood iron indices called transferrin saturation and serum ferritin levels.
FRIDAY, May 8, 2015 (HealthDay News) — Misconceptions about miscarriages are common, and those mistaken beliefs can make the experience even more painful for those who suffer through it, a new survey reveals.
More than half of the 1,000 adults who responded to the survey incorrectly believed miscarriages are rare, and many thought they could occur for reasons that actually don’t affect miscarriage risk at all.
In reality, miscarriages are not that uncommon, yet almost half of those women who have suffered a miscarriage have felt guilt and a sense of isolation about what happened, the researchers said.
“A striking finding from the study is the discrepancy between what medicine and science teach us about miscarriage and what people believe,” said study co-author Dr. Zev Williams, a professor of obstetrics and gynecology at Albert Einstein College of Medicine and Montefiore Medical Center in New York City.
“Miscarriage seems to be unique in medicine in being very common yet rarely discussed, so that you have many women and couples feeling very isolated and alone,” Williams said.
Another expert was also disturbed by the findings.
“I was surprised to learn how much false information our patients have, and how this information led the patients in the study to feelings of guilt and remorse,” said Dr. Iris Dori, medical director at the Center for Women’s Health at Staten Island University Hospital in New York City.
Among the respondents — roughly half women and half men — 15 percent reported that they or their partner had experienced at least one miscarriage.
But over half of the respondents believed miscarriages occur in less than 6 percent of all pregnancies. Men were more than twice as likely as women to think miscarriages were rare, the survey found.
Most of the adults (74 percent) correctly believed that genetic or medical problems most often caused miscarriages, but they also incorrectly believed in other causes, the investigators found.
PULLMAN, Wash. – Washington State University researchers say the popularity of bamboo landscaping could increase the spread of hantavirus, with the plant’s prolific seed production creating a population boom among seed-eating deer mice that carry the disease.
Bamboo plants are growing in popularity, judging by the increased number of species listed by the American Bamboo Society. Some grow in relatively self-contained clumps, while other so-called “running bamboos” can spread rapidly by underground stems called rhizomes, making them difficult to contain.
They have extremely intermittent flowering cycles but when they flower, or mast, they produce huge amounts of seed over as many as 18 months. During that time, deer mice can undergo several reproductive cycles. When the seed is gone, the mice will go looking for new food sources in and around human homes and other dwellings.
More than one in 10 deer mice carry hantavirus, which is spread through contact with their urine, droppings or contaminated dust. People who catch the disease typically have a few days of flu-like symptoms followed by respiratory and pulmonary complications. Roughly one in three cases is fatal, according to the state health department.
Quarantine changes recommended
Mack stresses that a bamboo-mouse-hantavirus outbreak is only a possibility but notes that such a rapid spread and increase in abundance of a non-native plant bears similarities to other biological invasions. Some imported bamboos would do well in the Northwest’s coniferous forests, and deer mice in the bamboos’ naturalized range can breed year-round.
As a precaution, Mack is recommending a change in U.S. and Canadian plant quarantine policies to eradicate aggressively spreading non-native bamboo on public lands, as is already the practice in U.S. national parks. He also suggests that regulators consider evaluating bamboo plants’ flowering intervals and seed palatability before letting them into the U.S.
The National Library of Medicine (NLM) Tox Town Town neighborhood now has a new photo-realistic look. The location and chemical information remains the same, but the new graphics allow users to better identify with real-life locations.
The Town scene is available in HTML5, allowing it to be accessed on a variety of personal electronic devices, including cell phones (iphones and androids), ipads, ipad minis, and tablets.
Tox Town uses color, graphics, sounds and animation to add interest to learning about connections between chemicals, the environment, and the public’s health. Visit the updated Town neighborhood and learn about possible environmental health risks in a typical town.
Image shows increased activity in the brains of ADRA2b deletion carriers.
From the 6 May 2015 University of British Columbia news release
Your genes may influence how sensitive you are to emotional information, according to new research by a UBC neuroscientist. The study, recently published in The Journal of Neuroscience, found that carriers of a certain genetic variation perceived positive and negative images more vividly, and had heightened activity in certain brain regions.
“People really do see the world differently,” says lead author Rebecca Todd, a professor in UBC’s Department of Psychology. “For people with this gene variation, the emotionally relevant things in the world stand out much more.”
The gene in question is ADRA2b, which influences the neurotransmitter norepinephrine. Previous research by Todd found that carriers of a deletion variant of this gene showed greater attention to negative words. Her latest research is the first to use brain imaging to find out how the gene affects how vividly people perceive the world around them, and the results were startling, even to Todd.
“We thought, from our previous research, that people with the deletion variant would probably show this emotionally enhanced vividness, and they did more than we would even have predicted,” says Todd, who scanned the brains of 39 participants, 21 of whom were carriers of the genetic variation.
Carriers of the gene variation showed significantly more activity in a region of the brain responsible for regulating emotions and evaluating both pleasure and threat. Todd believes this may help explain why some people are more susceptible to PTSD and intrusive memories following trauma.
“Emotions are not only about how feel about the world, but how our brains influence our perception of it,” says Adam Anderson, professor of human development at Cornell University and senior author of the study. “As our genes influence how we literally see the positive and negative aspects of our world more clearly, we may come to believe the world has more rewards or threats.”
Todd points out there are also benefits to carrying the gene variant. “People who have the deletion variant are drawing on an additional network in their brains important for calculating the emotional relevance of things in the world,” she says. “In any situation where noticing what’s relevant in the environment is important, this gene variation would be a positive.”
Todd says a prime example of a carrier of this variation was French novelist Marcel Proust: “He bit into the Madeleine cookie and then wrote seven volumes of memoirs,” she says. “He probably was emotionally sensitive too and he was certainly creative. He’s a classic deletion carrier.
From the 28 April 2015 article at The Conversation
Traffic death rates are falling in OECD countries, but generally rising elsewhere as mass car ownership spreads to other countries. For this reason, the WHO forecast traffic fatalities moving up to the fifth leading cause of death globally by 2030.
Paradoxically, fatality rates (deaths per 100,000 people) are far higher in low-income countries, despite their low levels of vehicle ownership. The main reason? Pedestrian and cyclist deaths can be as high as two-thirds of those killed, compared with 16% in Australia.
Tens of millions are also injured each year on the world’s roads. Particularly in low-income countries, this can mean a double catastrophe: loss of earnings and high medical costs for the affected families.
Air pollution also results in millions of premature deaths, especially in Asian megacities, and the rapid rise in vehicular traffic is an important cause. Further, a recent Chinese studyhas found that children’s school performance was adversely affected by living in traffic-polluted areas.
What’s the alternative?
For some time in OECD countries—and even elsewhere, when we consider traffic casualties and air pollution health effects—the societal costs of extra mobility have been rising faster than the benefits obtained. We must now focus on accessibility —the ease with which people can reach various activities — rather than vehicular mobility.
When access replaces mobility, we can finally start designing our cities for humans rather than cars. We’ll need to design our cities and towns to encourage an attachment to place, rather than endlessly trying to be someplace else. Excess mobility can destroy this sense of place.
For readers fascinated by the intricacies and ins and outs of domestic life in 21st century America, the Atlantic has gathered together its articles on family in a handy, easily accessible – and free – webpage. The articles run from serious investigations of How Nurses Can Help Low-Income Mothers and Kids to entertaining ones exploring The Psychological Reason ‘Billie Jean’ Kills at Weddings. Along the way, readers may explore the pros and cons of apps that help parents track their baby’s napping cycles, why it is that pretending to understand what a baby says can help it learn, and the research-confirmed importance of making deliberate choices in love relationships.[CNH]
From the 25 March 2015 University of Adelaide news release
Going for a walk instead of resting after eating could help to save older people from some falls caused by a sudden loss in blood pressure, according to new research.
Post-prandial hypotension is a fall in blood pressure seen within two hours of eating a meal. This health condition commonly affects older people – after a meal (usually breakfast), an older person may feel tired, dizzy or even experience a fall.
“Falls among older people often result in fractures, and those who experience a fall may lose confidence as well as lose their independence. Falls can also be fatal for older people,” she says.
Professor Visvanathan says researchers have been trying to better understand the reasons as to why this condition occurs, in the hopes of developing improved treatments or preventing post-prandial hypotension.
Research by University of Adelaide student Dr Shailaja Nair and University of South Australia student Ms Zoe Kopsaftis, working under the supervision of Professor Visvanathan and Dr Diana Piscitelli from the University of South Australia, has now confirmed that older people with post-prandial hypotension should be encouraged to walk intermittently at a normal pace for at least 120 minutes after a meal, as a means of reducing the fall in bloodpressure.
“This advice, coupled with other practical strategies, such as drinking a glass of water with meals, may help older people avoid the consequences of post-prandial hypotension,” Professor Visvanathan says.
“Much of the research conducted to date has been undertaken in healthy older people, but this new research has involved people with a confirmed diagnosis of the condition,” she says.
Professor Visvanathan says the University of Adelaide is considered a world leader in this field, but much more work is needed. “Simple, practical and cheap lifestyle interventions that older people can implement are highly desirable. The results showing that walking can be an effective strategy are pleasing, and will help in better understanding the overall picture of this common problem,” she says.
That, at least, is the conclusion reached by Yale researchers in “Searching for Explanations: How the Internet Inflates Estimates of Internal Knowledge,” a paper published last week in American Psychological Association’s Journal of Experimental Psychology. Lead by doctoral candidate Matthew Fisher, the research team administered a series of experiments to over a thousand students in order to test the degree to which internet connectivity affects a person’s sense of their own intelligence. According to The Telegraph:
In one test, the internet group were given a website link which gave the answer to the question ‘how does a zip work’ while a control group were given a print-out of the same information.
When they two groups were quizzed later on an unrelated question – ‘why are cloudy nights warmer?’ the group who had searched online believed they were more knowledgeable even though they were not allowed to look up the correct answer.
“We’re coming to recognize that meditation changes people’s brains,” said Wells, an assistant professor of neurology at Wake Forest Baptist Medical Center. “And we’re just beginning to gain understanding of what those changes mean and how they might benefit the meditator.”
In separate clinical studies, Wells has looked into the effectiveness of a meditation and yoga program called mindfulness-based stress reduction (MBSR) as a therapy for mild cognitive impairment – problems with memory or other faculties without yet having dementia – and for migraine headaches.
In the first study, the participants were adults between 55 and 90 with mild cognitive impairment. Those who practiced MBSR for eight weeks had significantly improved functional connectivity in the brain’s network that is active during introspective thought such as retrieving memories, along with trends of less atrophy in the hippocampus (the area of the brain responsible for emotions, learning and memory) compared with the participants who received conventional care. These findings indicate that meditation may positively affect the areas of the brain most impacted by Alzheimer’s and thus may be capable of slowing the progress of the disease.
Wells’ second study found that adults with migraines who practiced MBSR for eight weeks had shorter and less debilitating migraines than those in the control group who received standard medical care. The members of the MBSR group also had trends of less frequent and less severe attacks, and reported having a greater sense of self-control over their migraines.
A new analysis reported in JAMA Psychiatry raises serious questions about the increasingly common use of second-generation antidepressant drugs to treat anxiety disorders.
It concludes that studies supporting the value of these medications for that purpose have been distorted by publication bias, outcome reporting bias and “spin.” Even though they may still play a role in treating these disorders, the effectiveness of the drugs has been overestimated.
In some cases the medications, which are among the most widely prescribed drugs in the world, are not significantly more useful than a placebo.
The findings were made by researchers from Oregon State University, Oregon Health & Science University, and the University of Groningen in The Netherlands. The work was supported by a grant from the Dutch Brain Foundation.
Publication bias was one of the most serious problems, the researchers concluded, as it related to double-blind, placebo-controlled clinical trials that had been reviewed by the U.S. Food and Drug Administration. If the FDA determined the study was positive, it was five times more likely to be published than if it was not determined to be positive.
Bias in “outcome reporting” was also observed, in which the positive outcomes from drug use were emphasized over those found to be negative. And simple spin was also reported. Some investigators concluded that treatments were beneficial, when their own published results for primary outcomes were actually insignificant.
“These findings mirror what we found previously with the same drugs when used to treat major depression, and with antipsychotics,” said Erick Turner, M.D., associate professor of psychiatry in the OHSU School of Medicine, and the study’s senior author. “When their studies don’t turn out well, you usually won’t know it from the peer-reviewed literature.”
This points to a flaw in the way doctors learn about the drugs they prescribe, the researchers said.
“The peer review process of publication allows, perhaps even encourages, this kind of thing to happen,” Turner said. “And this isn’t restricted to psychiatry – reporting bias has been found throughout the medical and scientific literature.”
UNSW biomedical engineer Melissa Knothe Tate is using previously top-secret semiconductor technology to zoom through organs of the human body, down to the level of a single cell.
UNSW Paul Trainor Chair of Biomedical Engineering, Professor Melissa Knothe Tate. Photo: Grant Turner/Mediakoo
A world-first UNSW collaboration that uses previously top-secret technology to zoom through the human body down to the level of a single cell could be a game-changer for medicine, an international research conference in the United States has been told.
The imaging technology, developed by high-tech German optical and industrial measurement manufacturer Zeiss, was originally developed to scan silicon wafers for defects.
Family income is associated with children’s brain structure, reports a new study in Nature Neuroscience coauthored by Teachers College faculty member Kimberly Noble. The association appears to be strongest among children from lower-income families.
“We can’t say if the brain and cognitive differences we observed are causally linked to income disparities,” said Noble, who currently is both a TC Visiting Professor and Director of the Neurocognition, Early Experience and Development Lab of Columbia University Medical Center, but will join TC’s faculty as Associate professor of Neuroscience and Education in July in the Department of Biobehavioral Sciences. “But if so, policies that target poorest families would have the largest impact on brain development.”
1. Always ask “why?” This seems obvious, but even in this modern era, many patients take it as an article of faith that a doctor’s recommendation is thoughtful and well informed. It may well be; but on any given occasion, it could also be a knee-jerk — born of prevailing tendencies, distractions, and want of time. The question “why” is easily addressed by those who have already thought it over; and is a necessary reality check for those of us who have not.
2. Always ask “what else?” In the case of the fluoroquinolone syndrome, it’s bad enough when a fluoroquinolone was a genuinely thoughtful, warranted choice. It’s downright tragic when a much-less-potentially-toxic, narrow spectrum antibiotic would have served at least as well. “What else?” is a reminder that there is generally more than one way to test or treat, and the one we want is the BEST of them: most likely to help, least likely to hurt. It prods our providers to do the extra work of getting us there when we remind them we want to know the options, and comparison shop them.
3. Always ask “then what?” This would certainly defend against a screening colonoscopy in an 85 year old with congestive heart failure. If I have this test, then what? The answer would have to be: We can find potential cancer early, and fix it now so it doesn’t cause you trouble in ten years. That would invite all concerned to revisit the relevance of that “help” ten years in the future of someone exceedingly unlikely to live that long.
Today, the U.S. Food and Drug Administration launched the agency’s first mobile application (app) specifically designed to speed public access to valuable information about drug shortages.
The app identifies current drug shortages, resolved shortages and discontinuations of drug products.
Drugs in short supply can delay or deny needed care for patients. Drug shortages may also lead health care professionals to rely on alternative drug products, which may be less effective or associated with higher risks than the drug in shortage.
“The FDA understands that health care professionals and pharmacists need real-time information about drug shortages to make treatment decisions,” said Valerie Jensen, associate director of the Drug Shortage Staff in the FDA’s Center for Drug Evaluation and Research. “The new mobile app is an innovative tool that will offer easier and faster access to important drug shortage information.”
App users can search or browse by a drug’s generic name or active ingredient, and browse by therapeutic category. The app can also be used to report a suspected drug shortage or supply issue to the FDA.
The FDA, an agency within the U.S. Department of Health and Human Services, protects the public health by assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices. The agency also is responsible for the safety and security of our nation’s food supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products.
Open the medicine cabinet of a senior and you’re likely to find scores of pill bottles. Physicians are often unaware of all the medications a patient is taking, which can result in unnecessary additional prescriptions, non-prescription medications and potential drug-drug interactions that cause unexpected adverse effects. When a cancer diagnosis is thrown into the mix, the drug-drug interactions can become even more complex. A new study evaluates the currently available screening tools for determining if and when seniors with cancer are taking too many medications and finds that a more comprehensive medication assessment and monitoring plan is needed to improve treatment for this population.
Coordinated care refers to the ability for physicians in different specialties to come together and share skills and accountability for a given patient’s care. Treatment models such as the accountable care organization and patient-centered medical home are operational examples of the trend of coordinated care come to life through a team of clinicians, though more hospitals are starting to see the value in combining disparate care settings in one package.
In fact, two hospitals in New York and New Jersey have taken the concepts of coordinated care and translated those into new physical spaces in their facilities that make it easier for physicians to provide prompt and accurate care. While one focused on health literacy and the other preferred to add new technologies to their hospitals, both represent a significant conceptual step in transforming the physical space of hospitals into embodiments of modern medicine.
1. The $8 million operating room
At first glance, constructing a single room in a hospital for $8 million seems like a gross over-expenditure of funds that could better be spent elsewhere, especially in an industry already facing out-of-control costs. However, CNY Central reported that Crouse Hospital in Syracuse, New York added not just one, but two state-of-the-art operating rooms each with similar price tags.
So what makes these operating rooms so expensive? Thanks to the inclusion of both surgical and radiological equipment, physicians can give patients X-rays and perform surgery without wasting time shuttling all over the facility. According to Adham Kamel, M.D., a surgeon at Crouse Hospital, the new rooms will make it much easier to diagnose and treat stroke victims.
2. Engaging patients through design
Within the realm of patient engagement, the hospital has always been a nebulous area for patient education and engagement. Some patients simply do not feel comfortable in these facilities, and physicians are often too busy to sit down with their patients and talk them through their conditions for hours on end.
However, officials at New Jersey’s Morristown Medical Center have taken cues from both the physician’s and the patient’s world to create HealtheConnect, a cafe-style lounge room where patients can get help setting up health management apps on their smartphones, tablets or other mobile devices, PFSK.com reported. HealtheConnect took design cues from Apple’s Genius bars to create a welcoming atmosphere for even the most anxious patients.
…By taking the first detailed look at how one such parasite periodically assumes a new protein disguise during a long-term infection, new research at Rockefeller University challenges many assumptions about one of the best-known examples of this strategy, called antigenic variation, in the parasite that causes African sleeping sickness.
Here’s how it works. Many animals, including humans, have immune systems capable of learning to recognize pathogens based on those pathogens’ antigens, usually proteins on their surface. After encountering an antigen, the immune system generates its own proteins called antibodies to target that antigen. By continually changing antigens, a pathogen evades those antibodies.
The authors discuss how the use of quarantine can unintentionally introduce secondary and tertiary effects. If individuals show symptoms but are not isolated immediately, they will contaminate the quarantine group, and if individuals without symptoms are cohorted with a group already symptomatic, the risk of transmission will increase. The other unintended consequence is to patients admitted to hospitals for other medical reasons, e.g., heart attacks, strokes, trauma, and cancer.
The issue of psychological stress during quarantine is also addressed. These include fear of the disease and possible confinement, and the effects on family, friends and colleagues.
Before civil liberties are suspended, decision-makers must use evidence-based data to support their decisions. Public health officials and political figures should avoid taking unnecessary harsh precautions in their effort to appear on top of the situation. Per Dr. Barbisch, Major General, US Army (ret): “Quarantine should only be used if the inherent restrictions will effectively reduce the spread of the disease.”
he National Center for Medical-Legal Partnership, part of Milken Institute School of Public Health at the George Washington University, will host its tenth annual conference on April 9-10, 2015, in McLean, Virginia to discuss how to better address the social and legal problems negatively impacting the health of 50 million low-income Americans. Leaders from law, health care, public health and government in 38 states will present research and strategies aimed at effectively integrating health and legal care.
With featured remarks from Lauren Taylor, co-author of The American Health Care Paradox, Jeffrey Levi, executive director of Trust for America’s Health, and Phillip Alberti, senior director for health equity research & policy at the Association of American Medical Colleges, participants will explore topics including:
The intersection of health and legal problems for veterans, children and chronically ill individuals;
The ways that providing integrated legal care for patients can help meet community benefit requirements for public hospitals; and
The ability of legal care to strengthen population health interventions.
March 26, 2015 — Researchers atColumbia University’s Mailman School of Public Health analyzed the results of the Oregon Health Experiment, where eligible uninsured individuals were randomly assigned Medicaid or to stay with their current care. Considered controversial because the experiment found no measurable gains for physical health it did reveal benefits for mental health, financial wellbeing, and preventive screening. In terms of quality-adjusted life years, the researchers showed that Medicaid is an excellent value—a $62,000 gain in quality-adjusted life years. Study findings are online in the American Journal of Public Health.
This blog presents a sampling of health and medical news and resources for all. Selected articles and resources will hopefully be of general interest but will also encourage further reading through posted references and other links. Currently I am focusing on public health, basic and applied research and very broadly on disease and healthy lifestyle topics.
Several times a month I will post items on international and global health issues. My Peace Corps Liberia experience (1980-81) has formed me as a global citizen in many ways and has challenged me to think of health and other topics in a more holistic manner. (For those wishing to see pictures of a 2009 Friends of Liberia service trip to this West African country, please visit www.fol.org. My photo album is included).
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My professional work experience and education includes over 10 years experience as a medical librarian and a Master’s in Library Science. In my most recent position I enjoyed contributing to our library’s blog, performing in depth literature searches, and collaborating with faculty, staff, students, and the general public.
While I will never be be able to keep up with the universe of current health/medical news,
I subscribe to the following to glean entries for this blog
Krafty (Medical)Librarian,” a collection of writings from Michelle Kraft on items of interest to medical librarians. She tends to write on technology and medical libraries but she also writes about things in general on librarianship, medicine and health”
Research Buzz, “news about search engines, digital archives, online museums, databases, and other Internet information collections since 1998″
Free Government Information, a “place for initiating dialogue and building consensus among the various players (libraries, government agencies, non-profit organizations, researchers, journalists, etc.) who have a stake in the preservation of and perpetual free access to government information”
Scout Report, a “weekly publication offering a selection of new and newly discovered Internet resources of interest to researchers and educators”