Category: Medicine

A more expensive placebo works better than a cheaper one.

On By A.P.In Medicine, Neurology, placebo, ScienceLeave a comment

Results of a small study suggest that Parkinson’s patients seem to improve if they think they’re taking a costly medication. The findings have been published online Jan. 28 in Neurology.

In the study, 12 patients had their movement symptoms evaluated hourly, for about four hours after receiving each of the placebos. On average, patients had bigger short-term improvements in symptoms like tremor and muscle stiffness when they were told they were getting the costlier of two drugs. In reality, both “drugs” were nothing more than saline, given by injection. But the study patients were told that one drug was a new medication priced at $1,500 a dose, while the other cost just $100 — though, the researchers assured them, the medications were expected to have similar effects.

Yet, the researchers found that when patients’ movement symptoms were evaluated in the hours after receiving the fake drugs, they showed greater improvements with the pricey placebo. What’s more, magnetic resonance imaging scans showed differences in the patients’ brain activity, depending on which placebo they’d received. The patients in the study didn’t get as much relief from the two placebos as they did from their regular medication, levodopa. But the magnitude of the expensive placebo’s benefit was about halfway between that of the cheap placebo and levodopa. What’s more, patients’ brain activity on the pricey placebo was similar to what was seen with levodopa.

And this effect is “not exclusive to Parkinson’s,” according to Peter LeWitt, M.D., a neurologist at the Henry Ford West Bloomfield Hospital in Michigan, who wrote an editorial published with the study. Research has documented the placebo effect in various medical conditions, he told HealthDay. “The main message here is that medication effects can be modulated by factors that consumers are not aware of — including perceptions of price.”

http://www.empr.com/pricey-placebo-works-better-than-cheaper-one-in-parkinsons-study/article/395255/?DCMP=EMC-MPR_DailyDose_rd&CPN=edgemont14,emp_lathcp&hmSubId=&hmEmail=5JIkN8Id_eWz7RlW__D9F5p_RUD7HzdI0&dl=0&spMailingID=10518237&spUserID=MTQ4MTYyNjcyNzk2S0&spJobID=462545599&spReportId=NDYyNTQ1NTk5S0

The Likely Cause of Addiction Has Been Discovered, and It Is Not What You Think

On By A.P.In Addiction, Da Brayn, Neuropsychiatric DiseaseLeave a comment

by Johann Hari
Author of ‘Chasing The Scream: The First and Last Days of the War on Drugs’

It is now one hundred years since drugs were first banned — and all through this long century of waging war on drugs, we have been told a story about addiction by our teachers and by our governments. This story is so deeply ingrained in our minds that we take it for granted. It seems obvious. It seems manifestly true. Until I set off three and a half years ago on a 30,000-mile journey for my new book, Chasing The Scream: The First And Last Days of the War on Drugs, to figure out what is really driving the drug war, I believed it too. But what I learned on the road is that almost everything we have been told about addiction is wrong — and there is a very different story waiting for us, if only we are ready to hear it.

If we truly absorb this new story, we will have to change a lot more than the drug war. We will have to change ourselves.

I learned it from an extraordinary mixture of people I met on my travels. From the surviving friends of Billie Holiday, who helped me to learn how the founder of the war on drugs stalked and helped to kill her. From a Jewish doctor who was smuggled out of the Budapest ghetto as a baby, only to unlock the secrets of addiction as a grown man. From a transsexual crack dealer in Brooklyn who was conceived when his mother, a crack-addict, was raped by his father, an NYPD officer. From a man who was kept at the bottom of a well for two years by a torturing dictatorship, only to emerge to be elected President of Uruguay and to begin the last days of the war on drugs.

I had a quite personal reason to set out for these answers. One of my earliest memories as a kid is trying to wake up one of my relatives, and not being able to. Ever since then, I have been turning over the essential mystery of addiction in my mind — what causes some people to become fixated on a drug or a behavior until they can’t stop? How do we help those people to come back to us? As I got older, another of my close relatives developed a cocaine addiction, and I fell into a relationship with a heroin addict. I guess addiction felt like home to me.

If you had asked me what causes drug addiction at the start, I would have looked at you as if you were an idiot, and said: “Drugs. Duh.” It’s not difficult to grasp. I thought I had seen it in my own life. We can all explain it. Imagine if you and I and the next twenty people to pass us on the street take a really potent drug for twenty days. There are strong chemical hooks in these drugs, so if we stopped on day twenty-one, our bodies would need the chemical. We would have a ferocious craving. We would be addicted. That’s what addiction means.

One of the ways this theory was first established is through rat experiments — ones that were injected into the American psyche in the 1980s, in a famous advert by the Partnership for a Drug-Free America. You may remember it. The experiment is simple. Put a rat in a cage, alone, with two water bottles. One is just water. The other is water laced with heroin or cocaine. Almost every time you run this experiment, the rat will become obsessed with the drugged water, and keep coming back for more and more, until it kills itself.

The advert explains: “Only one drug is so addictive, nine out of ten laboratory rats will use it. And use it. And use it. Until dead. It’s called cocaine. And it can do the same thing to you.”

But in the 1970s, a professor of Psychology in Vancouver called Bruce Alexander noticed something odd about this experiment. The rat is put in the cage all alone. It has nothing to do but take the drugs. What would happen, he wondered, if we tried this differently? So Professor Alexander built Rat Park. It is a lush cage where the rats would have colored balls and the best rat-food and tunnels to scamper down and plenty of friends: everything a rat about town could want. What, Alexander wanted to know, will happen then?

In Rat Park, all the rats obviously tried both water bottles, because they didn’t know what was in them. But what happened next was startling.

The rats with good lives didn’t like the drugged water. They mostly shunned it, consuming less than a quarter of the drugs the isolated rats used. None of them died. While all the rats who were alone and unhappy became heavy users, none of the rats who had a happy environment did.

At first, I thought this was merely a quirk of rats, until I discovered that there was — at the same time as the Rat Park experiment — a helpful human equivalent taking place. It was called the Vietnam War. Time magazine reported using heroin was “as common as chewing gum” among U.S. soldiers, and there is solid evidence to back this up: some 20 percent of U.S. soldiers had become addicted to heroin there, according to a study published in the Archives of General Psychiatry. Many people were understandably terrified; they believed a huge number of addicts were about to head home when the war ended.

But in fact some 95 percent of the addicted soldiers — according to the same study — simply stopped. Very few had rehab. They shifted from a terrifying cage back to a pleasant one, so didn’t want the drug any more.

Professor Alexander argues this discovery is a profound challenge both to the right-wing view that addiction is a moral failing caused by too much hedonistic partying, and the liberal view that addiction is a disease taking place in a chemically hijacked brain. In fact, he argues, addiction is an adaptation. It’s not you. It’s your cage.

After the first phase of Rat Park, Professor Alexander then took this test further. He reran the early experiments, where the rats were left alone, and became compulsive users of the drug. He let them use for fifty-seven days — if anything can hook you, it’s that. Then he took them out of isolation, and placed them in Rat Park. He wanted to know, if you fall into that state of addiction, is your brain hijacked, so you can’t recover? Do the drugs take you over? What happened is — again — striking. The rats seemed to have a few twitches of withdrawal, but they soon stopped their heavy use, and went back to having a normal life. The good cage saved them. (The full references to all the studies I am discussing are in the book.)

When I first learned about this, I was puzzled. How can this be? This new theory is such a radical assault on what we have been told that it felt like it could not be true. But the more scientists I interviewed, and the more I looked at their studies, the more I discovered things that don’t seem to make sense — unless you take account of this new approach.

Here’s one example of an experiment that is happening all around you, and may well happen to you one day. If you get run over today and you break your hip, you will probably be given diamorphine, the medical name for heroin. In the hospital around you, there will be plenty of people also given heroin for long periods, for pain relief. The heroin you will get from the doctor will have a much higher purity and potency than the heroin being used by street-addicts, who have to buy from criminals who adulterate it. So if the old theory of addiction is right — it’s the drugs that cause it; they make your body need them — then it’s obvious what should happen. Loads of people should leave the hospital and try to score smack on the streets to meet their habit.

But here’s the strange thing: It virtually never happens. As the Canadian doctor Gabor Mate was the first to explain to me, medical users just stop, despite months of use. The same drug, used for the same length of time, turns street-users into desperate addicts and leaves medical patients unaffected.

If you still believe — as I used to — that addiction is caused by chemical hooks, this makes no sense. But if you believe Bruce Alexander’s theory, the picture falls into place. The street-addict is like the rats in the first cage, isolated, alone, with only one source of solace to turn to. The medical patient is like the rats in the second cage. She is going home to a life where she is surrounded by the people she loves. The drug is the same, but the environment is different.

This gives us an insight that goes much deeper than the need to understand addicts. Professor Peter Cohen argues that human beings have a deep need to bond and form connections. It’s how we get our satisfaction. If we can’t connect with each other, we will connect with anything we can find — the whirr of a roulette wheel or the prick of a syringe. He says we should stop talking about ‘addiction’ altogether, and instead call it ‘bonding.’ A heroin addict has bonded with heroin because she couldn’t bond as fully with anything else.

So the opposite of addiction is not sobriety. It is human connection.

When I learned all this, I found it slowly persuading me, but I still couldn’t shake off a nagging doubt. Are these scientists saying chemical hooks make no difference? It was explained to me — you can become addicted to gambling, and nobody thinks you inject a pack of cards into your veins. You can have all the addiction, and none of the chemical hooks. I went to a Gamblers’ Anonymous meeting in Las Vegas (with the permission of everyone present, who knew I was there to observe) and they were as plainly addicted as the cocaine and heroin addicts I have known in my life. Yet there are no chemical hooks on a craps table.

But still, surely, I asked, there is some role for the chemicals? It turns out there is an experiment which gives us the answer to this in quite precise terms, which I learned about in Richard DeGrandpre’s book The Cult of Pharmacology.

Everyone agrees cigarette smoking is one of the most addictive processes around. The chemical hooks in tobacco come from a drug inside it called nicotine. So when nicotine patches were developed in the early 1990s, there was a huge surge of optimism — cigarette smokers could get all of their chemical hooks, without the other filthy (and deadly) effects of cigarette smoking. They would be freed.

But the Office of the Surgeon General has found that just 17.7 percent of cigarette smokers are able to stop using nicotine patches. That’s not nothing. If the chemicals drive 17.7 percent of addiction, as this shows, that’s still millions of lives ruined globally. But what it reveals again is that the story we have been taught about The Cause of Addiction lying with chemical hooks is, in fact, real, but only a minor part of a much bigger picture.

This has huge implications for the one-hundred-year-old war on drugs. This massive war — which, as I saw, kills people from the malls of Mexico to the streets of Liverpool — is based on the claim that we need to physically eradicate a whole array of chemicals because they hijack people’s brains and cause addiction. But if drugs aren’t the driver of addiction — if, in fact, it is disconnection that drives addiction — then this makes no sense.

Ironically, the war on drugs actually increases all those larger drivers of addiction. For example, I went to a prison in Arizona — ‘Tent City’ — where inmates are detained in tiny stone isolation cages (‘The Hole’) for weeks and weeks on end to punish them for drug use. It is as close to a human recreation of the cages that guaranteed deadly addiction in rats as I can imagine. And when those prisoners get out, they will be unemployable because of their criminal record — guaranteeing they with be cut off even more. I watched this playing out in the human stories I met across the world.

There is an alternative. You can build a system that is designed to help drug addicts to reconnect with the world — and so leave behind their addictions.

This isn’t theoretical. It is happening. I have seen it. Nearly fifteen years ago, Portugal had one of the worst drug problems in Europe, with 1 percent of the population addicted to heroin. They had tried a drug war, and the problem just kept getting worse. So they decided to do something radically different. They resolved to decriminalize all drugs, and transfer all the money they used to spend on arresting and jailing drug addicts, and spend it instead on reconnecting them — to their own feelings, and to the wider society. The most crucial step is to get them secure housing, and subsidized jobs so they have a purpose in life, and something to get out of bed for. I watched as they are helped, in warm and welcoming clinics, to learn how to reconnect with their feelings, after years of trauma and stunning them into silence with drugs.

One example I learned about was a group of addicts who were given a loan to set up a removals firm. Suddenly, they were a group, all bonded to each other, and to the society, and responsible for each other’s care.

The results of all this are now in. An independent study by the British Journal of Criminology found that since total decriminalization, addiction has fallen, and injecting drug use is down by 50 percent. I’ll repeat that: injecting drug use is down by 50 percent. Decriminalization has been such a manifest success that very few people in Portugal want to go back to the old system. The main campaigner against the decriminalization back in 2000 was Joao Figueira, the country’s top drug cop. He offered all the dire warnings that we would expect from the Daily Mail or Fox News. But when we sat together in Lisbon, he told me that everything he predicted had not come to pass — and he now hopes the whole world will follow Portugal’s example.

This isn’t only relevant to the addicts I love. It is relevant to all of us, because it forces us to think differently about ourselves. Human beings are bonding animals. We need to connect and love. The wisest sentence of the twentieth century was E.M. Forster’s — “only connect.” But we have created an environment and a culture that cut us off from connection, or offer only the parody of it offered by the Internet. The rise of addiction is a symptom of a deeper sickness in the way we live — constantly directing our gaze towards the next shiny object we should buy, rather than the human beings all around us.

The writer George Monbiot has called this “the age of loneliness.” We have created human societies where it is easier for people to become cut off from all human connections than ever before. Bruce Alexander — the creator of Rat Park — told me that for too long, we have talked exclusively about individual recovery from addiction. We need now to talk about social recovery — how we all recover, together, from the sickness of isolation that is sinking on us like a thick fog.

But this new evidence isn’t just a challenge to us politically. It doesn’t just force us to change our minds. It forces us to change our hearts.

Loving an addict is really hard. When I looked at the addicts I love, it was always tempting to follow the tough love advice doled out by reality shows like Intervention — tell the addict to shape up, or cut them off. Their message is that an addict who won’t stop should be shunned. It’s the logic of the drug war, imported into our private lives. But in fact, I learned, that will only deepen their addiction — and you may lose them altogether. I came home determined to tie the addicts in my life closer to me than ever — to let them know I love them unconditionally, whether they stop, or whether they can’t.

When I returned from my long journey, I looked at my ex-boyfriend, in withdrawal, trembling on my spare bed, and I thought about him differently. For a century now, we have been singing war songs about addicts. It occurred to me as I wiped his brow, we should have been singing love songs to them all along.

The full story of Johann Hari’s journey — told through the stories of the people he met — can be read in Chasing The Scream: The First and Last Days of the War on Drugs, published by Bloomsbury. The book has been praised by everyone from Elton John to Glenn Greenwald to Naomi Klein. You can buy it at all good bookstores and read more at http://www.chasingthescream.com.

Johann Hari will be talking about his book at 7pm at Politics and Prose in Washington DC on the 29th of January, at lunchtime at the 92nd Street Y in New York City on the 30th January, and in the evening at Red Emma’s in Baltimore on the 4th February.

Thanks to Da Brayn for bringing this to the attention of the It’s Interesting community.

http://www.huffingtonpost.com/johann-hari/the-real-cause-of-addicti_b_6506936.html

New death test to predict whether someone will die in the next 30 days of being admitted to the hospital

On By A.P.In death, MedicineLeave a comment

A test to determine if elderly patients will die within 30 days of being admitted to hospital has been developed by doctors to give them the chance to go home or say goodbye to loved ones.

Health experts say the checklist will prevent futile and expensive medical treatments which merely prolong suffering.

The screening test looks at 29 indicators of health, including age, frailty, illness, mental impairment, previous emergency admissions and heart rate and produces a percentage chance of death within one month and 12 weeks.

Researchers say the aim of Critera for Screening and Triaging to Appropriate aLternative care, or CriSTAL for short, is to kick-start frank discussions about end of life care, and minimise the risk of invasive ineffective treatment.

“Delaying unavoidable death contributes to unsustainable and escalating healthcare costs, despite aggressive and expensive interventions,” said lead author Dr Magnolia Cardona-Morrel, a researcher at the University of New South Wales.

“These interventions may not influence patient outcome; often do not improve the patient’s quality of life; may compromise bereavement outcomes for families; and cause frustration for health professionals.”

The new test aims to provide a ‘starting point’ for ‘honest communication with patients and families about recognising that dying is part of the life cycle.’

Researchers looked at 112 peer-reviewed studies to find out which tests and questions were the best predictors of death.

They claim the test will help doctors and nurses who are often under great pressure from family members and society to prolong the life of patients at all costs.

“While there are accepted policies for de-escalating treatment in terminally ill patients, there are also inherent and societal pressures on medicine to continue utilising technological advances to prolong life even in plainly futile situations,” said Dr Cardona-Morrel.

“Training for nurses and doctors in the use of the screening tool and in approaching patients and families with concrete information about inevitability of death and lack of benefit of further intensive treatment are paramount.”

Most patients end up dying in hospital, even though that is not their stated preference, when asked.

Caroline Abrahams, Charity Director at Age UK, said:“The best time to begin discussing end of life issues and an older person’s wishes, is well in advance, when they are fit and well, but we acknowledge that this isn’t always possible.

“The ability to accurately identify people entering hospital who are nearing the end of their lives ought to help ensure they receive high quality care, appropriate to their needs, so we welcome this development. However, in practice, access to good end of life care services remains extremely variable and discussions with older people and their families about this most difficult of subjects are not always handled sensitively and well.

“So as well as improved analysis and triage of people’s needs, better training and support for medical staff in speaking compassionately with older people and their families about end of life care is also required. “

By giving families and patients some options about the preferred place of death, the test could also help terminally ill elderly people choose to go home, the authors said.

The checklist is yet to be tested but the researchers hope it will eventually be used for all hospital admissions.

The research was published in the BMJ Open publication Supportive & Palliative Care.

http://www.telegraph.co.uk/news/science/science-news/11363731/Death-test-could-predict-chance-of-dying-within-30-days.html

Checking emails less often shown to reduce stress

On By A.P.In Neuropsychiatric Disease, stressLeave a comment

New research has found that checking email less reduces stress.

It provides further evidence that stepping away from your inbox is a good idea not just for the sake of productivity, but also for the sake of your health.

In an experiment done by Kostadin Kushlev and Elizabeth Dunn, participants were told to change how they dealt with email in two separate weeks.

In one week, a limit was put on the amount they could check email – they were only allowed to check email three times a day.

The other week, they could check their email as much as they liked.

The researchers – from the University of British Columbia, Vancouver – found that in the week when email use was restricted, participants experienced significantly lower daily stress than when they checked email more often.

http://www.sciencedirect.com/science/article/pii/S0747563214005810

Depression, Behaviour Changes May Start in Alzheimer’s Even Before Memory Changes

On By A.P.In Alzheimer's disease, Dementia, Depression, Medicine, Neuropsychiatric DiseaseLeave a comment

Depression and other behaviour changes may show up in people who will later develop Alzheimer’s disease even before they start having memory problems, according to a study published in the January 14, 2015, online issue of the journal Neurology.

“While earlier studies have shown that an estimated 90% of people with Alzheimer’s experience behavioural or psychological symptoms such as depression, anxiety, and agitation, this study suggests that these changes begin before people even have diagnosable dementia,” said Catherine M. Roe, PhD, Washington University School of Medicine, St. Louis, Missouri.

The study looked at 2,416 people aged 50 years and older who had no cognitive problems at their first visit to one of 34 Alzheimer’s disease centres across the country. The participants were followed for up to 7 years. Of the participants, 1,198 people stayed cognitively normal, with no memory or thinking problems, during the study. They were compared with 1,218 people who were followed for about the same length of time, but who developed dementia.

The people who developed dementia during the study also developed behaviour and mood symptoms such as apathy, appetite changes, irritability, and depression sooner than the people who did not develop dementia. For example, 30% of people who would develop dementia had depression after 4 years in the study, compared with 15% of those who did not develop dementia. Those who developed dementia were more than twice as likely to develop depression sooner than those without dementia and more than 12 times more likely to develop delusions than those without dementia.

Dr. Roe said the study adds to the conflicting evidence on depression and dementia.

“We still don’t know whether depression is a response to the psychological process of Alzheimer’s disease or a result of the same underlying changes in the brain,” she said. “More research is needed to identify the relationship between these two conditions.”

http://dgnews.docguide.com/depression-behaviour-changes-may-start-alzheimer-s-even-memory-changes?overlay=2&nl_ref=newsletter&pk_campaign=newsletter

Man experiencing headaches, seizures, memory flashbacks and strange smells discovered to have had tapeworm living in his brain for 4 years

On By A.P.In MedicineLeave a comment


Parasitic worm normally found in amphibians and crustaceans in China may have scavenged nutrients from patient’s brain

A man who went to see his doctor after suffering headaches and experiencing strange smells was found to have been living for more than four years with a rare parasitic worm in his brain.

In the first case of its kind in Britain, the ribbon-shaped tapeworm was found to have burrowed from one side of the 50-year-old man’s brain to the other.

Doctors were left baffled after spotting strange ring-like patterns moving 5cm through his brain tissue in a series of scans taken over four years.

Surgeons only discovered the 1cm worm while carrying out a biopsy at Addenbrooke’s hospital in Cambridge and took it to parasite experts to be identified.

Geneticists at the Wellcome Trust Sanger Institute in Cambridge found the creature was a rare species of tapeworm known as Spirometra erinaceieuropaei.

Only 300 cases of infection by this parasite in humans have been reported since 1953, with only two previous cases identified in Europe.

The worm is normally found in amphibians and crustaceans in China and as it goes through its life cycle it later infects the guts of cats and dogs, where it can grow into 1.5-metre adult worms. Even in China, where the parasite is normally found, there have only been 1,000 cases reported in humans since 1882.

The unfortunate patient, who was of Chinese descent but lived in East Anglia, is thought to have picked up the parasite while on a visit to China, where he visited regularly. However, exactly how he came to be infected is not known, but he could have picked it up from infected meat or water and the worm then burrowed through his body to his brain.

Now scientists believe they have been able to learn new information about this rare parasite after studying its DNA.

Rather than living on the brain tissue of its unknowing victim, the parasite is thought to have simply absorbed nutrients from the man’s brain through its body as the worm has no mouth.

Dr Hayley Bennett said they hoped to use the result of the study to help diagnose infections in humans more quickly in the future and even find ways of treating it.

She said: “This worm is quite mysterious and we don’t know everything about what species it can infect or how. Humans are a rare and accidental host. for this particular worm. It remains as a larva throughout the infection. We know from the genome that the worm has fatty acid binding proteins that might help it scavenge fatty acids and energy from its environment, which may be one the mechanisms for how it gets its food.

“This genome will act as a reference, so that when new treatments are developed for the more common tapeworms, scientists can cross-check whether they are also likely to be effective against this very rare infection.” The research is published in the journal Genome Biology.

The patient first noticed something was wrong in 2008 when he began suffering headaches, seizures, memory flashbacks and strange smells.

After visiting his doctor, an MRI scan revealed a cluster of rings in the right medial temporal lobe.

He was given tests for a wide range of other diseases including syphilis, HIV and tuberculosis but tested negative for them all. Later scans showed the rings moving through his brain.

After undergoing two biopsies, surgeons found the worm moving around in his brain and removed it in 2012. The man was then given drugs to help treat the infection but he continues to suffer from problems associated with having had the worm living in his brain.

It is not known how he first became infected, but one source of infection is the use of frog poultice, a traditional Chinese remedy where raw frog meat is used to calm sore eyes.

“We did not expect to see an infection of this kind in the UK, but global travel means that unfamiliar parasites do sometimes appear,” said Dr Effrossyni Gkrania-Klotsas, one of the clinicians involved in the man’s treatment at Addenbrooke’s NHS Trust.

“We can now diagnose sparganosis using MRI scans, but this does not give us the information we need to identify the exact tapeworm species and its vulnerabilities.

“Our work shows that, even with only tiny amounts of DNA from clinical samples, we can find out all we need to identify and characterise the parasite.”

http://www.theguardian.com/science/2014/nov/21/tapeworm-parasite-mans-brain-four-years-china

Dyslexie: the chubby-ankled font that makes reading easier for people with dyslexia

On By A.P.In Dr. Lutter, dyslexiaLeave a comment

By weighing down the characters and distorting similar letters, this new typeface pins words firmly to the page.

Watching letters float and twist across a page, flipping and jumbling with gymnastic abandon, can be a daily frustration for readers with dyslexia. But the restless characters might soon be tamed thanks to a new font.

Developed by young Dutch designer Christian Boer, the Dyslexie typeface, currently on show at the Istanbul Design Biennial, has put all 26 letters of the alphabet through a finely-tuned process of adjustment to weigh them down and make it harder for similar letters to be confused.

“When they’re reading, people with dyslexia often unconsciously switch, rotate and mirror letters in their minds,” says Boer, who is dyslexic himself. “Traditional typefaces make this worse, because they base some letter designs on others, inadvertently creating ‘twin letters’ for people with dyslexia.”

To counteract this tendency, Boer has introduced a number of tweaks. First, the letters are weighted towards the bottom, as if the bulk of each character’s body has slumped downwards under accelerated gravitational pressure. This sets a heavy baseline, which makes it harder for the letters to be flipped upside down – and gives the font the look of a chubby-ankled cousin of Comic Sans.

This lowered centre of gravity is joined by specific alterations to differentiate similar letters. In many fonts, the d is the same as a b is the same as a p is the same as a q – a simple hoop on a stick, variously mirrored and rotated to form four different characters. Boer’s typeface distorts each letter, slanting the extenders and descenders and enlarging the openings to make them harder to confuse, in a process of careful anatomical refinement.

http://www.theguardian.com/artanddesign/architecture-design-blog/2014/nov/12/dyslexie-new-font-that-makes-reading-easier-with-dyslexia

Thanks to Dr. Lutter for bringing this to the attention of the It’s Interesting community.

Orthorexia Nervosa – when healthy eating becomes an unhealthy obsession

On By A.P.In eating disorder, Medicine, Neuropsychiatric Disease, orthoxia nervosaLeave a comment

By Sumathi Reddy

The growing interest in eating healthy can at times have unhealthy consequences.

Some doctors and registered dietitians say they are increasingly seeing people whose desire to eat pure or “clean” food—from raw vegans to those who cut out multiple major food sources such as gluten, dairy and sugar—becomes an all-consuming obsession and leads to ill health. In extreme cases, people will end up becoming malnourished.

Some experts refer to the condition as orthorexia nervosa, a little-researched disorder that doesn’t have an official diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, or DSM, considered the bible of psychiatric illnesses. Often, individuals with orthorexia will exhibit symptoms of recognized conditions such as obsessive-compulsive disorder or end up losing unhealthy amounts of weight, similar to someone with anorexia.

Researchers in Colorado recently proposed a series of criteria they say could help clinicians diagnose orthorexia. The guidelines, published online in the journal Psychosomatics earlier this year, also could serve as a standard for future research of the disorder, they say.

Ryan Moroze, a psychiatry fellow at the University of Colorado Denver School of Medicine and senior author of the study, said more research needs to be done to develop a valid screening instrument for orthorexia, determine its prevalence and differentiate it from other more well-known eating disorders.

“There are people who become malnourished, not because they’re restricting how much they eat, it’s what they’re choosing to eat,” said Thomas Dunn, a psychologist and psychology professor at the University of Northern Colorado in Greeley, Colo., and a co-author of the article.

“It’s not that they’re doing it to get thin, they’re doing it to get healthy. It’s just sort of a mind-set where it gets taken to an extreme like what we see with other kinds of mental illness,” Dr. Dunn said.

Among the proposed criteria: an obsession with the quality and composition of meals to the extent that people may spend excessive amounts of time, say three or more hours a day, reading about and preparing specific types of food; and having feelings of guilt after eating unhealthy food. The preoccupation with such eating would have to either lead to nutritional imbalances or interfere with daily functional living to be considered orthorexia.

Some orthorexia patients are receiving treatments similar to those for obsessive-compulsive disorder. “We’re getting the people who aren’t being treated well under an eating-disorder diagnosis and their disorder is better treated under the OCD dial,” said Kimberley Quinlan, clinical director of the OCD Center of Los Angeles, an outpatient clinic.

The condition seems to start with an interest in living healthy and then, over time, people develop an increased anxiety about eating food that is contaminated or that they deem unhealthy, said Ms. Quinlan. Treatment often involves cognitive behavioral therapy, a type of psychotherapy aiming at behavior modification. “We’ve basically taken a model that we use to treat OCD and applied it to this disorder which is so similar,” she said.

Experts say there is a gray area between striving to eat healthy and going to the extreme, which helps to spur skepticism about orthorexia. “People don’t believe how eating healthy can be a disorder,” said Ms. Quinlan.

Sometimes other illnesses can lead to orthorexia. David Rakel, director of integrative medicine at the University of Wisconsin School of Medicine and Public Health, estimated that 10% to 15% of the patients who come in with food allergies and related problems develop an unhealthy fear of particular foods.

Nutritional therapy often involves elimination diets—stopping to eat certain foods to check if they are contributing to an inflammatory condition, Dr. Rakel said. Under the program, the foods are later gradually reintroduced, but some people continue to avoid them. “People are getting so strict with their health choices that they’re not getting the nutrients that they need,” he said.

Some eating-disorder therapists say many of the orthorexia patients they treat also suffer from anorexia. But other experts say orthorexics often aren’t underweight, which can make it difficult to identify them.

“Someone on paper may be perfectly healthy and their blood work is great and their weight is fine but their behavior has become obsessive with food,” said Marjorie Nolan Cohn, a New York City-based dietitian and national spokeswoman for the Academy of Nutrition and Dietetics, a professional organization.

A red flag is when someone’s eating habits are making them avoid social engagements, Ms. Cohn said. “They may not be able to go out to a restaurant with their friends because they don’t know what’s in the food or it’s not cooked in a certain way or what if it’s not organic olive oil?” she said.

Jordan Younger, 24, of Los Angeles, started a popular Instagram and blog last year to post recipes and pictures from her plant-based vegan diet. Then her daily diet became all-consuming.

“I would wake up in a panic thinking, ‘What am I going to eat today?’ ” said Ms. Younger. “I would go to a juice place or Whole Foods or a natural grocery store and would spend so much time in there looking at everything trying to plan out the whole day. It just began to take over my mind in a way that I started to see was unhealthy,” she said.

Ms. Younger, already slim, said she lost 25 pounds on her restrictive diet. Her skin turned orange and she stopped menstruating. In May, she started seeing an eating-disorder specialist and nutritionist who helped her recover.

Now, Ms. Younger said she doesn’t restrict herself from eating anything except for processed food. Her skin has returned to its normal color, her hair has thickened and grown 5 inches and she has put back on her weight.

“With all these different dietary philosophies, there’s a lot more room for orthorexia to develop,” she said. “It makes it really hard to eat if you’re listening to all these theories and it gives eating and food a ton of anxiety when really food should be enjoyable.”

http://online.wsj.com/articles/when-healthy-eating-calls-for-treatment-1415654737

Landmark 20-Year Study Finds Pesticides Linked to Depression In Farmers

On By A.P.In Depression, Kebmodee, Medicine, Neuropsychiatric DiseaseLeave a comment

Earlier this fall, researchers from the National Institute of Health finished up a landmark 20-year study, a study that hasn’t received the amount of coverage it deserves. About 84,000 farmers and spouses of farmers were interviewed since the mid-1990s to investigate the connection between pesticides and depression, a connection that had been suggested through anecdotal evidence for far longer. We called up Dr. Freya Kamel, the lead researcher on the study, to find out what the team learned and what it all means. Spoiler: nothing good.

“There had been scattered reports in the literature that pesticides were associated with depression,” says Kamel. “We wanted to do a new study because we had more detailed data than most people have access to.” That excessive amount of data includes tens of thousands of farmers, with specific information about which pesticides they were using and whether they had sought treatment for a variety of health problems, from pesticide poisoning to depression. Farmers were surveyed multiple times throughout the 20-year period, which gives the researchers an insight into their health over time that no other study has.

Because the data is so excessive, the researchers have mined it three times so far, the most recent time in a study published just this fall. The first one was concerned with suicide, the second with depression amongst the spouses of farmers (Kamel says “pesticide applicators,” but most of the people applying pesticides are farmers), and the most recent with depression amongst the farmers themselves.

There’s a significant correlation between pesticide use and depression, that much is very clear, but not all pesticides. The two types that Kamel says reliably moved the needle on depression are organochlorine insecticides and fumigants, which increase the farmer’s risk of depression by a whopping 90% and 80%, respectively. The study lays out the seven specific pesticides, falling generally into one of those two categories, that demonstrated a categorically reliable correlation to increased risk of depression.

The study doesn’t really deal with exactly how the pesticides are affecting the farmers. Insecticides are designed to disrupt the way nerves work, sometimes inhibiting specific enzymes or the way nerve membranes work, that kind of thing. It’s pretty complicated, and nobody’s quite sure where depression fits in. “How this ultimately leads to depression, I don’t know that anyone can really fill in the dots there,” says Kamel. But essentially, the pesticides are designed to mess with the nerves of insects, and in certain aspects, our own nervous systems are similar enough to those of insects that we could be affected, too. “I don’t think there’s anything surprising about the fact that pesticides would affect neurologic function,” says Kamel, flatly.

Kamel speaks slowly and precisely, and though her voice is naturally a little quavery, she answered questions confidently and at one point made fun of me a little for a mischaracterization I’d made in a question. The one time she hesitated was when I asked what she thought the result of the study should be; it’s a huge deal, finding out that commonly used pesticides, pesticides approved for use by our own government, are wreaking havoc on the neurological systems of farmers. Kamel doesn’t recommend policy; she’s a scientist and would only go so far as to suggest that we should cut down on the use of pesticides in general.

Others are going further. Melanie Forti, of a farmer advocacy group based in DC, told Vice, “There should be more regulations on the type of pesticides being used.” With any luck, this study will lead to a thorough reexamination of the chemical weapons allowed by farmers.

These types aren’t necessarily uncommon, either; one, called malathion, was used by 67% of the tens of thousands of farmers surveyed. Malathion is banned in Europe, for what that’s worth.

I asked whether farmers were likely to simply have higher levels of depression than the norm, given the difficulties of the job — long hours, low wages, a lack of power due to government interference, that kind of thing — and, according to Kamel, that wasn’t a problem at all. “We didn’t have to deal with overreporting [of depression] because we weren’t seeing that,” she says. In fact, only 8% of farmers surveyed sought treatment for depression, lower than the norm, which is somewhere around 10% in this country. That doesn’t mean farmers are less likely to suffer from depression, only that they’re less likely to seek treatment for it, and that makes the findings, if anything, even stronger.

Landmark 20-Year Study Finds Pesticides Linked to Depression In Farmers

Thanks to Kebmodee for bringing this to the attention of the It’s Interesting community.

91 year old Polish woman declared dead and then later wakes up in mortuary

On By A.P.In death, Dementia, Poland, wake-upLeave a comment

A Polish woman who spent 11 hours in cold storage in a mortuary after being declared dead has returned to her family, complaining of feeling cold. Officials say Janina Kolkiewicz, 91, was declared dead after an examination by the family doctor. However, mortuary staff were astonished to notice movement in her body bag while it was in storage. The police have launched an investigation.

Back home, Ms Kolkiewicz warmed up with a bowl of soup and two pancakes. Her family and doctor said they were in shock, according to the website of the Polish newspaper Dziennik Wschodni.

The woman’s niece, in the eastern Polish town of Ostrow Lubelski, summoned the doctor after coming home one morning to find that her aunt did not seem to be breathing or to have a pulse. After examining the woman, the family doctor declared her dead and wrote out her death certificate.

The body was taken to the mortuary and preparations were made for a funeral in two days’ time. “I was sure she was dead,” Dr Wieslawa Czyz told the television channel TVP. “I’m stunned, I don’t understand what happened. Her heart had stopped beating, she was no longer breathing,” Dr Czyz said.

However, the mortuary staff called some hours later to report that the woman was not yet dead, her niece told Dziennik Wschodni. The death certificate has been declared invalid, the newspaper says.

Ms Kolkiewicz told her relatives she felt “normal, fine” after returning home. She is apparently unaware of how near she came to the grave. “My aunt has no inkling of what happened since she has late-stage dementia,” Bogumila Kolkiewicz, her niece, told local media.

http://www.bbc.com/news/world-europe-30048087