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Almost Alcoholic. Is My or My Loved One’s Drinking a Problem.

Editor — Sun, 04 Mar 2012 16:00:32 +0000

Almost Alcoholic.

Is My (or My Loved One’s) Drinking a Problem
The First Volume in The Almost Effect Series
by Robert Doyle, MD and Joseph Nowinski, PhD

“A stunning achievement. ALMOST ALCOHOLIC shines light on behavior that has thus far largely escaped scrutiny—namely drinking that is definitely causing problems even though it doesn’t rise to a diagnostic level—and not only helps individuals understand the costs of their drinking but goes further, offering practical advice and solutions for those so afflicted.” —J.Wesley Boyd, MD, PhD
Staff Psychiatrist, Cambridge Health Alliance and Children’s Hospital Boston
Assistant Clinical Professor of Psychiatry, Harvard Medical School
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In the United States there are fourteen to eighteen million people who meet the official criteria for alcohol abuse or dependence. Many millions more fit into what the medical profession recognize as a subclinical category—they are definitely experiencing negative effects due to alcohol, but they are not considered full-blown alcoholics.

Last fall Hazelden Publishing and Harvard Medical School announced the publication of a brand new series of books The Almost Effect, which for the first time will address the medical and behavioral issues that are causing problems for average people, but are not currently categorized in the medical literature. The debut title in this collection is ALMOST ALCOHOLIC: Is My (or My Loved One’s) Drinking a Problem? (Hazelden Publishing/Harvard Health Publications; April 2, 2012; $14.95) by Robert Doyle, MD from Harvard Medical School and Joseph Nowinski, PhD. According to Drs. Doyle and Nowinski, the almost alcoholic falls into a gray area between “normal” and the medical definition of “alcoholic”.

In ALMOST ALCOHOLIC Drs. Doyle and Nowinski explain that an “almost alcoholic” is someone who drinks more often than occasionally or socially, and that almost alcoholic behavior is widespread and often goes unrecognized by individuals and health care professionals. If we were to help these people, we could reduce overall risks for many mental health disorders like depression and anxiety as well as health issues that are often not recognized as related to drinking.

The difference between being an alcoholic and an almost alcoholic is a matter of degree. Here are five key signs that you or someone you know is almost alcoholic:
1. You continue drinking despite at least some negative consequences.
2. You look forward to drinking.
3. You drink alone.
4. You sometimes drink in order to control emotional and/or physical symptoms.
5. You and your loved ones are suffering as a result of your drinking.

ALMOST ALCOHOLIC will not only help people identify the problems they are having as they relate to alcohol, it will also provide solutions. A few of these are:
• Taking an assessment of your life as it is today. Are you living the life you envisioned for yourself?
• Building support systems. Are your current friends and activities centered around drinking?
• Changing your habits and routines. Have you built special rituals and routines around drinking?
• Developing refusal skills. Suggestions for ways you can decline invitations to drink and ways to mingle in situations where you choose to remain sober.

ALMOST ALCOHOLIC is the first book with evidence-based research to back up its claims. It will help the millions of people who are distressed because of their unhealthy relationships with alcohol.

ABOUT THE ALMOST EFFECT SERIES:

The Almost Effect Series presents books written by Harvard Medical School faculty and other experts that offer guidance on common behavioral and physical problems falling in the spectrum between normal health and a full-blown medical condition. These are the first publications to help general readers recognize and address these problems.

ABOUT THE AUTHORS:
A nationally recognized expert on alcoholism, Robert Doyle, MD., is a clinical instructor in psychiatry at Harvard Medical School and is on the medical staff at Harvard’s prestigious teaching hospital, Massachusetts General Hospital.
Clinical psychologist Joseph Nowinski, PhD, was assistant professor of psychiatry at the University of California-San Francisco and associate adjunct professor of psychology at the University of Connecticut. He is currently a columnist for the Huffington Post and works in private practice.

ALMOST ALCOHOLIC
Is My (or My Loved One’s) Drinking a Problem
By Robert Doyle, MD, Harvard Medical School
and Joseph Nowinski, PhD
Hazelden Publishing/Harvard Health Publications
Publication Date: April 2, 2012
ISBN: 978-1-61649-159-8
Price: $14.95
250 pp.
www.thealmosteffect.com

More about The Almost Effect™…

Almost Alcoholic. Is My or My Loved One’s Drinking a Problem. is an article review from: Medicinezine.com

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The Almost Effect.

Editor — Sun, 04 Mar 2012 15:39:50 +0000

The Almost Effect

What is The Almost Effect™?

Welcome to The Almost Effect website. The Almost Effect was developed at Harvard Medical School in collaboration with many experts from Harvard Medical School, Hazelden and other institutions.

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Assistant Professor at Harvard Medical School and Chief Editor of Books at Harvard Health Publications, Dr. Julie Silver, talks about The Almost Effect™–a new book series from Harvard Health Publications and Hazelden.
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The Almost Effect was developed at Harvard Medical School in collaboration with many experts from Harvard Medical School, Hazelden and other institutions.

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Associate Professor of Psychology at Harvard Medical School and Director of Law and Psychiatry Services at Massachusetts General Hospital, Ron Schouten talks about his forthcoming book, Almost a Psychopath. Schouten and co-author, James Silver, JD, explain that there is a subclinical syndrome for psychopathy.

…

Q & A With the Authors of The Almost Effect™ Series

Most medical conditions present along a continuum that begins just to the right of “normal” if you were to look at it on a horizontal line. However, usually one doesn’t go from normal to a diagnosable condition right away. At first, there are subtle signs and symptoms that suggest a shift is taking place from normal toward the right side of the horizontal line. Metaphorically, we often think of this as a “grey area”, because it’s more murky than the “white” of normal or the “black” of a confirmed diagnosis. What this means is that instead of two categories—normal and diagnosis—there is a spectrum from normal to a confirmed diagnosis which goes from white to grey to black.

Indeed, very often in medicine categories don’t make as much sense as a spectrum does. Not surprisingly, the grey area between normal and a confirmed diagnosis can be more difficult to identify than the more clearly demarcated white or black. What this means to people who are experiencing problems in the grey area is that they might not be recognized or addressed despite the fact that there is real pain and suffering occurring.

For example, an almost alcoholic doesn’t meet the diagnosis for alcoholism or alcohol dependency, but his drinking habits are not normal. The almost alcoholic may experience negative health effects like trouble sleeping or depressed moods. He or she might have physical problems due to alcohol such as injury to the liver or nervous system. The problems associated with the almost alcoholic may affect not only the individual but also loved ones, co-workers and friends. In this grey area, there is significant unaddressed suffering.

Recognizing The Almost Effect has two primary goals. The goals are to:

1. alleviate pain/suffering now

2. prevent more serious problems later

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The Almost Effect is not about labeling people but rather identifying genuine medical problems that involve emotional and/or physical suffering to the individual and those around him/her. These books are written by Harvard doctors in collaboration with other experts who are well-versed in understanding and recognizing the entire spectrum from normal to a confirmed diagnosis, including grey areas that are often “subclinical” problems which do not meet the criteria for a diagnosis. The Almost Effect books focus on helping readers to better understand the grey areas between normal and a confirmed diagnosis and offer suggestions about appropriate treatment interventions. If you (or a loved one) are currently in a grey area, shifting left may allow you to live a happier, healthier life.

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> ALMOST ALCOHOLIC.

Is My (or My Loved One’s) Drinking a Problem?

Robert Doyle, MD and Joseph Nowinski, PhD

Determine if your drinking is a problem, develop strategies for curbing your intake, and measure your progress with this practical guide to taking care of yourself.

Every day, millions of people drink a beer or two while watching a game, shake a cocktail at a party with friends, or enjoy a glass of wine with a good meal. For more than 30 percent of these drinkers, alcohol has begun to have a negative impact on their everyday lives. Yet, only a small number are true alcoholics—people who have completely lost control over their drinking and who need alcohol to function. The great majority are what Dr. Doyle and Dr. Nowinski call “Almost Alcoholics,” a growing number of people whose excessive drinking contributes to a variety of problems in their lives.

In Almost Alcoholic, Dr. Doyle and Dr. Nowinski provide the tools to:

identify and assess your patterns of alcohol use;
evaluate its impact on your relationships, work, and personal well-being;
develop strategies and goals for changing the amount and frequency of alcohol use;
measure the results of applying these strategies; and
make informed decisions about your next steps.

Excerpt from Almost Alcoholic

I once overheard a mother counseling her grown daughter to avoid dating a man who she thought had a drinking problem. The daughter said, “Mom, he’s not an alcoholic!” The mother quickly responded with, “Well, maybe not, but he almost is.”

ALMOST ALCOHOLIC
Is My (or My Loved One’s) Drinking a Problem
By Robert Doyle, MD, Harvard Medical School
and Joseph Nowinski, PhD
Hazelden Publishing/Harvard Health Publications
Publication Date: April 2, 2012
ISBN: 978-1-61649-159-8
Price: $14.95
250 pp.
www.thealmosteffect.com

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> ALMOST A PSYCHOPATH

Do I (or Does Someone I Know) Have a Problem with Manipulation and Lack of Empathy?

Ron Schouten, MD, JD and James Silver, JD

Praise for ALMOST A PSYCHOPATH

Psychopaths are the predatory and very dangerous few. Those who are “almost a psychopath” create mischief and misery for many. In this marvelous book of knowledge, wisdom, and sound advice, the subclinical–or should we say subcriminal–psychopath is brought to life. He can be dangerous but not lethal, duplicitous but not completely fraudulent. We finally have a book to help us recognize and cope with a personality whose highest praise from others is often, “he could be worse.”

- Reid Meloy, PhD, Forensic Psychologist and author, The Psychopathic Mind

Do you know someone who is too manipulative and full of himself? Does someone you know charm the masses yet lack the ability to deeply connect with those around her?

Grandiosity and exaggerated self-worth. Pathological lying. Manipulation. Lack of remorse. Shallowness. Exploitation for financial gain. These are the qualities of Almost Psychopaths. They are not the deranged criminals or serial killers that might be coined “psychopaths” in the movies or on TV. They are spouses, coworkers, bosses, children, neighbors, and people in the news who exhibit many of the same behaviors as a full-blown psychopath, but with less intensity and consistency.
In Almost a Psychopath, Ronald Schouten, MD, JD, and James Silver, JD, draw on scientific research and their own experiences to help you identify if you are an Almost Psychopath and, if so, guide you to interventions and resources to change your behavior.

If you think you have encountered an Almost Psychopath, they offer practical tools to help you:

recognize the behavior, attitudes, and characteristics of the Almost Psychopath;
make sense of interactions you’ve had with Almost Psychopaths;
devise strategies for dealing with them in the present; and
make informed decisions about your next steps.

Excerpt from Almost a Psychopath

Perhaps you’ve heard someone, referring to a boss or public figure, say (or have said yourself), “I don’t like that guy. He’s almost a psychopath!”

ALMOST A PSYCHOPATH
Do I (or Does Someone I Know) Have a Problem with Manipulation and Lack of Empathy?
By Ron Schouten, MD, JD and James Silver, JD
Hazelden Publishing/Harvard Health Publications
www.thealmosteffect.com

About Harvard Health Publications (HHP)

Harvard Health Publications (HHP) is a division of Harvard Medical School and Harvard University. For over 30 years, Harvard Medical School has been a major publisher of health information for the general public. Through our various publications, we reach more than 90 million consumers each year through a collaboration of print, Web, and video publications—all carrying the unparalleled name and reputation of and expert faculty doctors of Harvard Medical School.

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About Hazelden

Hazelden is the leading publisher of books and multi-media tools for those in recovery from addiction or who are dealing with related life issues. With the publication of Twenty-Four Hours a Day in 1954—the first daily meditation book written expressly for recovering alcoholics—Hazelden began a tradition of bringing readers information and inspiration to strengthen lifelong recovery and personal growth. Today, Millions of people make Hazelden books and electronic resources a part of their day. Hazelden publishes print books, e-books, mobile apps, multimedia tools, and other resources that inform and support prevention, intervention, treatment, and lifelong recovery from addiction. Translating research into practice, Hazelden is also the leading publisher of evidence-based alcohol, drug, and violence prevention and treatment curricula for professionals and organizations.

Learn more about Hazelden at Hazelden.org

From Sid Farrar, Executive Editorial Director

In the fourteen years that I have directed the acquisitions and development of publications for Hazelden I have seen the assessment and treatment of addiction and mental health issues slowly evolve to accommodate the research and theoretical work of the pioneers and original thinkers in the behavioral health field. For example, research had shown over twenty years ago that the integrated treatment of co-occurring addiction and mental illness yielded far superior outcomes to treating the two disorders separately, which had been (and to some degree still is) the common practice. It has only been in the last four or five years that evidence-based integrated treatment models have been widely adopted and recognized as best practice; and we at Hazelden are proud to be a part of furthering that movement through our recovery and self-help product lines for consumers.

So when Dr. Silver came to me with the idea for co-publishing a series of consumer books with Harvard Health Publications addressing the subclinical symptoms and behaviors on the spectrum between “normal” and formal DSM diagnoses, I recognized an opportunity for Hazelden to play a part in moving the field forward and raising the consciousness of both consumers and professionals on a critical and neglected behavioral health issue.

All of us at Hazelden Publishing are very excited to work with Harvard Health Publications, and the stellar group of Harvard Medical School faculty members as well as the other authors and writers who have contributed to The Almost Effect™ series. I believe these books will break new ground in offering help and hope to millions of readers who will now have their problems recognized at last, and be given the long overdue guidance they need in finding solutions.

Sid Farrar
Executive Editorial Director
Hazelden Publishing

The Almost Effect. is an article review from: Medicinezine.com

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A Healthier Muffin for Your Valentine.

Editor — Wed, 08 Feb 2012 18:06:30 +0000

CIA Recipe: A Healthier Muffin for Your Valentine

Muffin Makeovers Dispel the Low-Fat-is-Healthy Myth

One of the most romantic things you can do for your loved ones on Valentine’s Day is to bring them breakfast in bed. But if you’re thinking it’s not healthy to indulge in any sweets for a Valentine’s Day meal this year, think again. The chefs at The Culinary Institute of America (CIA) have teamed up with researchers from the Harvard School of Public Health (HSPH) to dispel the low-fat-is-healthy myth and give you five delicious muffin-makeover recipes to serve to those you love.

HSPH research showed that low-fat diets are no better for health than moderate or high-fat diets—and for many people, may be worse. To support these findings, nutrition experts as HSPH and chefs at the CIA developed five new muffin recipes that incorporate healthy fats and whole grains, and use a lighter hand on the salt and sugar. Their goal? To “make over” the ever-present low-fat muffin, touted as a “better-for-you” choice when in fact it often has reduced amounts of heart-healthy fats, such as liquid plant oils, but boasts plenty of harmful carbohydrates in the form of white flour and sugar.

>>>Read more at: A Muffin Makeover: Dispelling the Low-Fat-Is-Healthy Myth <<<

Take a regular blueberry muffin from a national coffee shop, for example. It has 450 calories on average and most of those calories come from carbohydrates from white flour and sugar. However, now that national chains have eliminated trans fats, a regular muffin does have heart-healthy fat, usually from soybean or canola oil. A low-fat muffin still has about the same amount of calories, but contains more carbohydrates and sugar and about 60% more sodium than a regular muffin.

The new made-over Blueberry Muffin recipe below is less than half the size of a coffee shop muffin and contains just 130 calories. It is made with a mixture of whole wheat and white and almond flour, and uses canola oil, a healthy fat.

“There are so many ingredients available to home bakers who want to offer their families healthful, flavorful baked goods,” says CIA Chef Richard Coppedge, Jr. “The five recipes not only include a wide variety of whole grain and nut flours; they also demonstrate how more unusual ingredients like canned chickpeas and extra virgin olive oil can be used in baking.”

Show the ones you love how much you care. Bake up a batch of delicious “made-over” muffins, sure to become favorites, and let them indulge in a more healthful way.

………………………………………………………………………………………………

Blueberry MuffinsMakes 18 muffins

1 cup whole wheat pastry flour
3/4 cup all-purpose flour
1/4 cup almond flour
1 teaspoon baking powder
1/2 teaspoon baking soda
1/2 teaspoon salt
1 teaspoon orange zest
2 cups fresh blueberries
2 eggs, large
1 1/4 cups low-fat (1%) buttermilk
1/2 cup brown sugar
6 tablespoons canola oil
1 tablespoon orange juice
1/2 teaspoon vanilla

Place the rack in the top third of the oven and preheat the oven to 400 degrees F. Line muffin tins with paper liners.
In a large mixing bowl, combine the flours, baking powder, baking soda, salt, and orange zest. Add the fresh blueberries and toss gently to coat the blueberries in flour. This will help keep the blueberries suspended in the batter instead of falling to the bottom.
In a medium mixing bowl, lightly beat the eggs, then whisk in the buttermilk, brown sugar, canola oil, orange juice, and vanilla. Don’t be concerned if the mixture looks curdled or lumpy.
Pour the wet ingredients into the dry ingredients and stir until most of the flour is incorporated. The mixture can be slightly lumpy; don’t over-mix. Divide the batter among the 18 prepared muffin cups.
Bake 12 to 14 minutes, until the muffins are golden brown around the edges.

Nutrition analysis per muffin: 130 calories, 3g protein, 16g carbohydrate, 1g saturated fat, 2g polyunsaturated fat, 3g monounsaturated fat, 140mg sodium, 21mg cholesterol, 1.5g fiber.

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* Photo Captions: Photo 1: Whole wheat pastry flour and low-fat buttermilk are among the ingredients that make CIA’s Blueberry Muffins healthier. (Photo credit: CIA/Keith Ferris) Photo 2: CIA’s Healthier Muffins: Cranberry Orange, Jalapeño Cheddar Corn, Whole Wheat Banana Nut, Lemon Chickpea Breakfast, and Blueberry. (Photo credit: CIA/Keith Ferris)

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> About Culinary Institute of America (CIA)

Founded in 1946, The Culinary Institute of America is an independent, not-for-profit college offering bachelor’s and associate degrees in culinary arts and baking and pastry arts as well as certificate programs in culinary arts, Latin cuisines, and wine and beverage studies. As the world’s premier culinary college, the CIA provides thought leadership in the areas of health & wellness, sustainability, and world cuisines & cultures through research and conferences. The CIA has a network of more than 44,000 alumni that includes industry leaders such as Grant Achatz, Anthony Bourdain, Cat Cora, Dan Coudreaut, Steve Ells, Roy Choi, Johnny Iuzzini, Charlie Palmer, and Roy Yamaguchi. In addition to its degree programs, the CIA offers courses for professionals and enthusiasts, as well as consulting services in support of innovation for the foodservice and hospitality industry. The college has campuses in Hyde Park, NY; St. Helena, CA; San Antonio, TX; and Singapore.

For more information, visit the CIA online at www.ciachef.edu

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* The above story is adapted from materials provided by Culinary Institute of America (CIA)

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A Healthier Muffin for Your Valentine. is an article review from: Medicinezine.com

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Deciding to go left or right.

Editor — Wed, 08 Feb 2012 16:58:01 +0000

Deciding to go left or right.
Researchers use device to determine that lower animals can navigate too.

Stephanie Mitchell/Harvard Staff Photographer/Physics Professor Aravinthan Samuel and a team of Harvard researchers have shown that the lowly fruit fly maggot is capable of making “left- and right-steering decisions based on sensory input.”

For decades, scientists have associated binary decision making — opting to go left or right — with higher-ranking animals, including humans. A team of Harvard researchers, however, is rewriting that assumption with research showing that the lowly fruit fly maggot is capable of making the same choices.

As described in a recent paper in the journal Nature Methods, the research is aimed at answering one of the most fundamental, long-standing questions about how the brain gives rise to behaviors.

“What we have shown is that the larvae really make left- and right-steering decisions based on sensory input,” said Aravinthan Samuel, professor of physics and co-author of the paper. “We now believe we have a complete algorithmic picture of how those decisions are made, based on the ways in which motor activity is regulated by these inputs. We know smells cause the animal to initiate a navigational decision. And once that navigational decision starts, we know how it’s carried out.”

At the heart of the work was an unusual piece of technology, the Linear and Dynamic Gaseous Gradient Apparatus — or LADY GAGA for short — that allowed researchers to precisely control odors in the air.

“This was the most challenging stimulus-control system we’ve ever built,” Samuel said of the device. “It works by pushing air across a plate to create a very slight breeze — approximately one centimeter per second — while a series of switches injects scents into the airflow.”

Using a computer program to control precisely when, where, and how much scent is injected enables the device to produce a perfectly linear gradient of odor across the plate. At one end, Samuel said, the scent is absent, while it is unavoidable at the other. Unlike similar experiments, which typically used a droplet of an odor-producing chemical, the breeze prevents the odor from diffusing throughout the device. As long as it is renewed by the injector, the scent effectively stays put.

“The problem with earlier experiments is that when you put a scent on one side of the plate, you can’t keep it there,” said Marc Gershow, a postdoctoral fellow in physics and designer of the device. “Over time, it will diffuse.”

In addition to LADY GAGA, Samuel and his team relied on another oddly named piece of technology to unlock navigational behavior, the MAGAT analyzer.

Short for Multiple Animal Gait and Trajectory Analyzer, the technology is a software package that uses a high-resolution camera to track dozens of larvae as they move in reaction to stimuli. Once placed on the plate inside LADY GAGA, the analyzer showed that larvae sweep their heads to the left and right to sample the environment, then made a decision on which way to move based on the input they receive.

Using that data, Samuel said, the next step is to understand “how that algorithm is written in the wiring diagram of the brain.”

Doing so will require another device with a celebrity namesake, CoLBeRT — short for Controlling Locomotion and Behavior in Real Time — a tracking microscope that allows researchers to track individual larva and stimulate specific neurons using pulses of laser light.

“The nice thing about the larva is that it’s optically transparent,” Samuel said. “It also has a small brain, with less than 10,000 neurons, so we should be able to map all the processing of odor information to the increased or decreased activity of a specific circuit in the brain.

“Once we figure out what that circuit is, we can determine how the patterns of activity in that circuit correlate with observable behavior. Using CoLBeRT, we may also be able to ‘push’ the activation into a neuron, even in the absence of a sensory input, and get the animal to behave as if the input was actually there.”

The larvae may seem relatively simple creatures, but Samuel believes that studying them will ultimately uncover the general principles for how the nervous systems of higher animals work.

“If there are general principles for understanding how an entire nervous system orchestrates itself to do purposeful things, those principles will be ferreted out with simple organisms,” he said. “And if that’s true, maybe we don’t give these little organisms enough credit.”

By Peter Reuell
Harvard Staff Writer

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About Harvard Medical School (HMS)

Driving Change. Building Momentum. Making History.

“Since 1872, Harvard Medical School has been the incubator of bold ideas—a place where extraordinary people advance education, science and health care with unrelenting passion.

Whether training tomorrow’s doctors and scientists, decoding the fundamental nature of life, advancing patient care or improving health delivery systems around the world, we are never at rest. Allied with some of the world’s best hospitals, research institutes and a University synonymous with excellence, the School’s mission remains as ambitious as it is honorable: to alleviate human suffering caused by disease.”

More at Harvard Medical School & Harvard Medical School. Generations of Leaders.

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About Harvard School of Public Health (HSPH)

Harvard School of Public Health is dedicated to advancing the public’s health through learning, discovery and communication. More than 400 faculty members are engaged in teaching and training the 1,000-plus student body in a broad spectrum of disciplines crucial to the health and well being of individuals and populations around the world. Programs and projects range from the molecular biology of AIDS vaccines to the epidemiology of cancer; from risk analysis to violence prevention; from maternal and children’s health to quality of care measurement; from health care management to international health and human rights.

More at Harvard School of Public Health (HSPH) & Harvard School of Public Health (HSPH). History.

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About Harvard University.

Established in 1636, Harvard is the oldest institution of higher education in the United States. The University, which is based in Cambridge and Boston, Massachusetts, has an enrollment of over 20,000 degree candidates, including undergraduate, graduate, and professional students. Harvard has more than 360,000 alumni around the world.

Harvard University is devoted to excellence in teaching, learning, and research, and to developing leaders in many disciplines who make a difference globally. Harvard faculty are engaged with teaching and research to push the boundaries of human knowledge. For students who are excited to investigate the biggest issues of the 21st century, Harvard offers an unparalleled student experience and a generous financial aid program, with over $160 million awarded to more than 60% of our undergraduate students. The University has twelve degree-granting Schools in addition to the Radcliffe Institute for Advanced Study, offering a truly global education.

‘Universities nurture the hopes of the world: in solving challenges that cross borders; in unlocking and harnessing new knowledge; in building cultural and political understanding; and in modeling environments that promote dialogue and debate… The ideal and breadth of liberal education that embraces the humanities and arts as well as the social and natural sciences is at the core of Harvard’s philosophy. ’/ Drew Gilpin Faust

More About Harvard University & About Harvard University. Information.

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* The above story is adapted from materials provided by Harvard University

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Deciding to go left or right. is an article review from: Medicinezine.com

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Study finds patients wait longer than they should.

Editor — Wed, 08 Feb 2012 16:52:00 +0000

Right time for ‘end-of-life’ talk.
Study finds patients wait longer than they should.

Amanda Swinhart/ Harvard Staff Photographer/ “Previous studies have shown that patients who discuss their end-of-life care preferences with a physician are more likely to choose palliative, comfort-focused care over aggressive measures, and [to] receive hospice or other care consistent with their wishes. But studies haven’t looked at the timing of these discussions, or where and with whom they occur,” says the study’s lead author, Assistant Professor of Pediatrics Jennifer Mack of Harvard Medical School and Dana-Farber/Children’s Hospital Cancer Center.

The vast majority of patients with incurable lung or colorectal cancer talk with a physician about their options for care at the end of life, but often not until late in the course of their illness, according to a new study by Harvard-affiliated Dana-Farber Cancer Institute investigators published in the Feb. 7 issue of the Annals of Internal Medicine.

The researchers found that such belated conversations tend to occur under particularly stressful conditions — when patients have been admitted to a hospital for acute care. And the doctor who shares in the end-of-life care talk is often a hospital physician rather than an oncologist who has treated the patient for much of his or her illness.

Together, these circumstances may deprive patients of the opportunity for extended reflection and deliberation that would have been possible months earlier, when the conversation also could have occurred under less trying and hectic conditions, the authors suggest.

“Previous studies have shown that patients who discuss their end-of-life care preferences with a physician are more likely to choose palliative, comfort-focused care over aggressive measures, and [to] receive hospice or other care consistent with their wishes. But studies haven’t looked at the timing of these discussions, or where and with whom they occur,” says the study’s lead author, Jennifer Mack of Dana-Farber/Children’s Hospital Cancer Center. Mack is also an assistant professor of pediatrics at Harvard Medical School (HMS).

The new study, which involved 2,155 patients with stage IV (highly advanced) lung or colorectal cancer, found that 73 percent of the patients had a conversation about end-of-life care with a physician, according to medical records or an interview with the patient or a companion. Among the nearly 1,000 patients who passed away and whose records document an end-of-life care discussion with a physician, the median time of those discussions was 33 days before death.

Other findings pertain to the location of those discussions and the type of physician involved. Of the more than 1,000 end-of-life care discussions in medical records, 55 percent occurred in the hospital. Oncologists documented end-of-life care talks with only 27 percent of their terminally ill patients in the study.

Data for the study was provided by the Cancer Outcomes Research and Surveillance Consortium (CanCORS), a multi-region, population- and health system-based study of more than 10,000 patients with lung or colorectal cancer. Researchers interviewed patients at two time points and analyzed their medical records 15 months after diagnosis.

“It’s encouraging to see such a high percentage of patients had end-of-life care conversations with a physician,” Mack says. “There’s a concern, though, that so many of these talks are taking place late in the trajectory of the disease.”

Previous studies had estimated that fewer than 40 percent of patients with advanced cancer had end-of-life care discussions. Mack theorizes that this lower figure may reflect that earlier studies didn’t record end-of-life talks that took place shortly before patients’ death.

Other research has suggested that physicians may delay end-of-life care discussions because of a natural reluctance to broach the subject, or because it conflicts with physicians’ problem-solving, hope-giving image. While such motivations are understandable, Mack says, they may work to patients’ detriment if they postpone the conversations too long.

Mack and her colleagues are planning future studies to examine the quality and content of end-of-life care conversations, and then explore whether having such talks earlier in the course of illness can benefit patients.

The study’s senior author is HMS Professor of Medicine Jane Weeks of Dana-Farber. Co-authors include Angel Cronin and Nathan Taback of Dana-Farber; Haiden Huskamp and Nancy Keating of Harvard Medical School; Jennifer Malin of the University of California, Los Angeles; and Craig Earle of the Ontario Institute for Cancer Research.

The study was funded by grants from the National Cancer Institute, the U.S. Department of Veterans Affairs, the American Cancer Society, and the National Palliative Care Research Center.

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About Harvard Medical School (HMS)

Driving Change. Building Momentum. Making History.

“Since 1872, Harvard Medical School has been the incubator of bold ideas—a place where extraordinary people advance education, science and health care with unrelenting passion.

More at Harvard Medical School & Harvard Medical School. Generations of Leaders.

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About Harvard School of Public Health (HSPH)

More at Harvard School of Public Health (HSPH) & Harvard School of Public Health (HSPH). History.

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About Harvard University.

More About Harvard University & About Harvard University. Information.

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* The above story is adapted from materials provided by Harvard University

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Study finds patients wait longer than they should. is an article review from: Medicinezine.com

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Coffee: The Good News

Editor — Tue, 07 Feb 2012 23:32:32 +0000

Coffee: The Good News

More than half of American adults drink coffee every day. Recent scientific studies suggest moderate consumption may help reduce some disease risks. The interactive graphic below contains information about some of coffee’s possible health benefits. These studies are observational, meaning that researchers draw conclusions based on differences between the number of disease cases in coffee drinkers versus non-drinkers.

You can also learn facts about coffee consumption, view a comparison of the amount of caffeine in common beverages, or learn about some of coffee’s downsides.

Coffee: The Downsides

While recent scientific studies have shown that coffee may have health benefits, data have also been collected that suggest there may be harmful effects associated with the beverage, particularly if not consumed in moderation.

Coffee by the Numbers See the cup below for current statistics on coffee drinking trends in the United States.

> Coffee by the Numbers – Who is drinking?

> Coffee by the Numbers – How much they drink?

> Coffee by the Numbers – When do they drink it?

> Coffee by the Numbers – How much do they spend?

> Coffee by the Numbers – Total U.S. spends on coffee

source: National Coffee Drinking Trends 2010, National Coffee Association Caffeine ComparisonsThe size of the beverage in the image below represents how much or how little caffeine it contains.

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About Harvard Medical School (HMS)

Driving Change. Building Momentum. Making History.

“Since 1872, Harvard Medical School has been the incubator of bold ideas—a place where extraordinary people advance education, science and health care with unrelenting passion.

More at Harvard Medical School & Harvard Medical School. Generations of Leaders.

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About Harvard School of Public Health (HSPH)

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Happiness & Health. The biology of emotion – and what it may teach us about helping people to live longer.

Editor — Tue, 07 Feb 2012 21:38:38 +0000

Happiness & Health. The biology of emotion – and what it may teach us about helping people to live longer.

Could a sunny outlook mean fewer colds and less heart disease?

Do hope and curiosity somehow protect against hypertension, diabetes, and respiratory tract infections?

Do happier people live longer—and, if so, why?

These are the kinds of questions that researchers are asking as they explore a new—and sometimes controversial—avenue of public health: documenting and understanding the link between positive emotions and good health.

A vast scientific literature has detailed how negative emotions harm the body. Serious, sustained stress or fear can alter biological systems in a way that, over time, adds up to “wear and tear” and, eventually, illnesses such as heart disease, stroke, and diabetes. Chronic anger and anxiety can disrupt cardiac function by changing the heart’s electrical stability, hastening atherosclerosis, and increasing systemic inflammation.

Jack P. Shonkoff, Julius B. Richmond FAMRI Professor of Child Health and Development at HSPH and at the Harvard Graduate School of Education, and Professor of Pediatrics at Harvard Medical School, explains that early childhood “toxic stress”—the sustained activation of the body’s stress response system resulting from such early life experiences as chronic neglect, exposure to violence, or living alone with a parent suffering severe mental illness—has harmful effects on the brain and other organ systems. Among these effects is a hair-trigger physiological response to stress, which can lead to a faster heart rate, higher blood pressure, and a jump in stress hormones.

Keys to a happier, healthier life

Research suggests that certain personal attributes—whether inborn or shaped by positive life circumstances—help some people avoid or healthfully manage diseases such as heart attacks, strokes, diabetes, and depression. These include:

Emotional vitality: a sense of enthusiasm, hopefulness, engagement
Optimism: the perspective that good things will happen, and that one’s actions account for the good things that occur in life
Supportive networks of family and friends
Being good at “self-regulation,” i.e. bouncing back from stressful challenges and knowing that things will eventually look up again; choosing healthy behaviors such as physical activity and eating well; and avoiding risky behaviors such as unsafe sex, drinking alcohol to excess, and regular overeating

FOCUSING ON THE POSITIVE

“But negative emotions are only one-half of the equation,” says Laura Kubzansky, HSPH associate professor of society, human development, and health. “It looks like there is a benefit of positive mental health that goes beyond the fact that you’re not depressed. What that is is still a mystery. But when we understand the set of processes involved, we will have much more insight into how health works.”

Kubzansky is at the forefront of such research. In a 2007 study that followed more than 6,000 men and women aged 25 to 74 for 20 years, for example, she found that emotional vitality—a sense of enthusiasm, of hopefulness, of engagement in life, and the ability to face life’s stresses with emotional balance—appears to reduce the risk of coronary heart disease. The protective effect was distinct and measurable, even when taking into account such wholesome behaviors as not smoking and regular exercise.

Among dozens of published papers, Kubzansky has shown that children who are able to stay focused on a task and have a more positive outlook at age 7 report better general health and fewer illnesses 30 years later. She has found that optimism cuts the risk of coronary heart disease by half.

Kubzansky’s methods illustrate the creativity needed to do research at the novel intersection of experimental psychology and public health. In the emotional vitality study, for example, she used information that had originally been collected in the massive National Health and Nutrition Examination Survey, or NHANES, an ongoing program that assesses the health and nutritional status of adults and children in the United States. Starting with the NHANES measure known as the “General Well-Being Schedule,” Kubzansky crafted an adaptation that instead reflected emotional vitality, and then scientifically validated her new measure. Her research has also drawn on preexisting data from the Veterans Administration Normative Aging Study, the National Collaborative Perinatal Project, and other decades-long prospective studies.

In essence, Kubzansky is leveraging gold-standard epidemiological methods to ask new public health questions. “I’m being opportunistic,” she says. “I don’t want to wait 30 years for an answer.”

Laura Kubzansky doesn’t want her research on positive emotions to be used to blame people for getting sick.

STATE OF MIND=STATE OF BODY
Some public health professionals contend that the apparent beneficial effects of positive emotions do not stem from anything intrinsically protective in upbeat mind states, but rather from the fact that positive emotions mark the absence of negative moods and self-destructive habits. Kubzansky and others disagree. They believe that there is more to the phenomenon—and that scientists are only beginning to glean the possible biological, behavioral, and cognitive mechanisms.

Previous work supports this contention. In 1979, Lisa Berkman, director of the Harvard Center for Population and Development Studies, co-authored a seminal study of nearly 7,000 adults in Alameda County, California. Participants who reported fewer social ties at the beginning of the survey were more than twice as likely to die over the nine-year follow-up period, an effect unrelated to behaviors such as smoking, drinking, and physical activity. Social ties included marriage, contact with friends and relatives, organizational and church membership.

A HAPPINESS POLICY?
If scientists proved unequivocally that positive moods improve health, would policymakers act? Some observe that, in the U.S., we define “happiness” in economic terms—the pursuit of material goods. They contend that even an avalanche of research showing that emotional well-being protected health would have no traction in the policy world. Many Americans believe, after all, that people are responsible for their own lives.

But others see direct policy implications. “In public health, it’s important to understand how we can translate guidelines into behavior,” notes Eric Rimm, HSPH associate professor in the Departments of Epidemiology and Nutrition and director of the program in cardiovascular epidemiology. “Seventy to 80 percent of heart attacks in this country occur not because of genetics nor through some mysterious causative factors. It’s through lifestyle choices people make: diet, smoking, exercise. Why are people choosing to do these things? Does mood come into play?”

The toll of toxic stress goes far beyond poorer health for individuals—population-wide, the cost of chronic diseases related to these conditions is enormous. “Imagine if we could enact a policy that would reduce heart disease by just 1 percent,” suggests Shonkoff. “How many billions of dollars and how many lives would that save? Now what if we could also reduce diabetes—which is growing in epidemic proportions—and even stroke?” The point, Shonkoff says, is that society pays a considerable cost for treating chronic diseases in adulthood, and reducing toxic stress early in life may actually get out in front of these diseases to prevent them.

Kubzansky concedes that psychological states such as anxiety or depression—or happiness and optimism—are forged by both nature and nurture. “They are 40–50 percent heritable, which means you may be born with the genetic predisposition. But this also suggests there is a lot of room to maneuver.” Her “dream prevention”: instill emotional and social competence in children—with the help of parents, teachers, pediatricians, sports coaches, school counselors, mental health professionals, and policy makers—that would help confer not only good mental health but also physical resilience for a lifetime.

Even in adulthood, it’s not too late to cultivate these qualities, she says. While psychotherapy or meditation may work for one person, someone else may prefer faith-based activities, sports, or simply spending time with friends. “My guess is that many of the people who are chronically distressed never figured out how to come back from a bad experience, focus on something different, or change their perspective.”

MAPPING HAPPINESS
Drawing on recently compiled data from a nationally representative study of older adults, Kubzansky is beginning to map what she calls “the social distribution of well-being.” She is working with information collected on participants’ sense of meaning and purpose, life satisfaction, and positive mood. By tracking how these measures and health fall out across traditional demographic categories such as race and ethnicity, education, income, gender, and other categories, she hopes to understand in a fine-grained way what it is about certain social environments that confers better frame of mind and better physical health.

The last thing she wants, Kubzansky says, is for her research to be used to blame people for not simply being happier—and therefore healthier. Referring to one of her first major studies, which found a link between worry and heart disease, she said: “My biggest fear was that journalists would pick it up and the headlines would be, ‘Don’t worry, be happy.’ That’s useless. Not everyone lives in an environment where you can turn off worry. When you take this research out of the social context, it has the potential to be a slippery slope for victim blaming.”

BEING IN THE MOMENT
Kubzansky, who is married and has two young children, says her work has made her think a lot more about finding balance in her own life. To that end, she says, she recently signed up for a yoga class. She also plays classical piano—both chamber music with friends and solo hours at the keyboard for her own enjoyment.

“When I’m playing piano,” she explains, “I’m in the moment. I’m not worrying or thinking or trying to work out a problem. I’m just doing this thing that takes all my attention.”

That insight is also at the center of her research. “Everyone needs to find a way to be in the moment,” she says, “to find a restorative state that allows them to put down their burdens.”

A stress test of a different sort

In Laura Kubzansky’s Society and Health Psychophysiology Lab—modest and neutral as the blandest therapy office—volunteers responding to a Craigslist ad for a research study are in for a surprise. First, they are rigged up to a tangle of electrodes, which continuously monitor heart rate, cardiac output, and other measures. A cuff measures blood pressure. Test tube spittoons collect saliva to be tested for stress-related hormones such as cortisol and DHEA.

Then comes the fun. The volunteers must give a five-minute improvised speech on a knotty topic, such as the gasoline tax or welfare reform. Next, they are asked to perform a complicated math exercise, such as counting backward from 2,027 by 13—swiftly, and with a loud buzzer signaling a faulty calculation, after which they must start over. Two lab assistants occasionally toss off challenging remarks. And the nerve-wracking performance is videotaped.

The experiment gauges the potentially beneficial effects on heart health of oxytocin, a natural hormone that acts as a neurotransmitter and is thought to be both a cause and effect of positive social relationships. Kubzansky manipulates three variables: oxytocin levels, stress, and social support. She administers oxytocin—a prescription drug that cannot be purchased in a conventional drug store—through a nasal spray. She induces stress by asking the volunteers to publicly perform. And she creates social support by having some participants bring an encouraging friend with them, while others are instructed to show up alone.

The experiment is designed to answer several questions: How do the stress-reduction benefits of oxytocin compare to those of social support? Does oxytocin offer the same protective effects in women as in men? Most important, does oxytocin tamp down the damage from toxic stress hormones that course through the body under duress, causing corrosive effects over time?

By Sara Rimer – Boston-based journalist and author
& Madeline Drexler is editor of the Harvard Public Health Review.

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* The above story is adapted from materials provided by Harvard University

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In case involving Kenyan abuse, scholarship must fit legal rubric.

Editor — Tue, 07 Feb 2012 18:57:00 +0000

In case involving Kenyan abuse, scholarship must fit legal rubric.

Kris Snibbe/Harvard Staff Photographer/Caroline Elkins, a Harvard history professor who studies colonial rule in East Africa, has spent the past few years as an “expert witness” testifying on the Mau Mau, a nationalist movement that liberated Kenya from British rule.

What can historians learn by being expert witnesses in court? They can learn to cooperate, to state the facts, and to leave their opinions and academic squabbles in the library.

“There’s no room for academic blather,” said Caroline Elkins, a Harvard history professor who studies colonial rule in East Africa. In court, she said in a recent lecture, the judge is the “teacher” and the academics — famous for squabbling — have to give up their “sandbox.”

In 2008, Elkins was named the first of three “expert witnesses,” historians who were called upon to provide evidence to the High Court of Justice in London. (She and the others are advisers to the British law firm Leigh Day.) At issue is a coming trial that gives aging Kenyan Mau Mau insurgents and sympathizers the opportunity to prove claims of rape, torture, murder, and other crimes that they allege happened in the waning days of British colonial rule in the East African country.

The Mau Mau led a 1952-1960 rebellion that British officials at the time called “the Emergency.” In that era, 32 white civilians were killed. At least 11,000 — and perhaps as many as 50,000 — black Kenyans died, half of them children. About 80,000 were imprisoned, and up to 1.5 million were displaced and shuttled into what Elkins called a “pipeline” of prisons and forced settlements.

Elkins is author of the Pulitzer Prize-winning book “Imperial Reckoning: The Untold Story of Britain’s Gulag in Kenya” (2005). This month, she will send the third installment of her testimony to the court, a 75-page document. The two British historians who recently joined her as expert witnesses, are David Anderson, whose book about Kenya, “Histories of the Hanged,” also appeared in 2005, and young defense studies scholar Huw C. Bennett.

Elkins studies the civil side of the conflict: the Mau Mau era’s camps and prisons. Anderson studies capital cases from a time when due process was suspended and 800 insurgents were sent to the gallows. Bennett studies the role of the British Army in putting down the rebellion, including controversial interrogation and intelligence-gathering methods.

“We each have our own specialties,” said Elkins during a Jan. 25 lecture, the first in a weekly spring colloquium series sponsored by the W.E.B. Du Bois Institute. But all of them are “revisionists” who challenge traditional interpretations of the war, including the usual assumption that British colonial abuses in Kenya were the exception and not the rule.

Collectively, said Elkins during her Thompson Room lecture, their scholarship provides what she called in a recent article an “alchemy of evidence,” a portrait of “systematic violence over time” by colonial authorities against the Mau Mau.

On a screen behind her, she showed a chart of how the punitive British pipeline worked, circa 1954. “I had to reconstruct the logic of the pipeline itself,” she said, a task that took her five years in British and Kenyan archives. “This case rests on historical evidence,” said Elkins. Without it, Mau Mau plaintiffs never would have won the right to trial.

Contact with the courtroom offers a cautionary tale, she said. The intellectual tumult of historical debate in journals and in the press reveals fault lines, and scholars consider a little battering the price of doing business. (Elkins called such paper battles “a nerd-off.”) But the particulars of such scholarly debates will be used in court. If a book review criticized one of the historians on methodology, for instance, that contention becomes grist for a defense lawyer and is open to legal scrutiny. That’s what makes this case novel, said Elkins. “History is on trial.”

Her own use of African oral histories in “Imperial Reckoning” led some reviewers to call the book speculative and lightweight, she said, as if it were “some kind of fictive account of Mau Mau memory.” But if you look at the book carefully, Elkins said, there are 600 footnotes and fewer than 300 citations from oral histories.

At the same time, having to send documents to court gave historians lessons in compression. For her first expert testimony, Elkins said, she boiled down her book into a 100-page document. It contained just the facts, without shading, asides, or opinions. After all, objective reasoning is at the core of the legal system, said Elkins. But there can be a culture clash between the law and humanistic scholarship. In the law, she said, “there is none of the kind of indeterminacy that we like.”

From 2006 to 2009, critics waged a war of opinion over revised histories of the Mau Mau era. But in the end, the collective evidence of the case “is overwhelming,” said Elkins, and points to systematized British abuse of Kenyan civilians. “Like most things in the British Empire, this was very well thought out.”

Last year, more evidence came to light, when 300 boxes of British documents from the Mau Mau era (1,500 files) turned up in a secret repository in a village in Southeast England. It was a rare find. (Elkins estimated that from 1958 to 1963, up to 3.5 tons of documents were destroyed by the British in Kenya.)

The new papers are being digitized and assessed by what Elkins called her “Team Mau Mau” at Harvard, as well as by a team at the University of Oxford. The files reveal fresh evidence of torture and cover-up, and detail more than 450 cases of abuse.

Her role in the civil court case has shown that history can be a “complementary knowledge set” useful in litigation. At the same time, her involvement with the law provided a rare sort of satisfaction. “There’s nothing more satisfying,” said Elkins, “than doing this kind of work and having it matter.”

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By Corydon Ireland
Harvard Staff Writer

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In case involving Kenyan abuse, scholarship must fit legal rubric. is an article review from: Medicinezine.com

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In the end, Somali famine preventable.

Editor — Tue, 07 Feb 2012 18:30:10 +0000

In the end, Somali famine preventable.
Panel cites man-made factors in making natural disaster wors.

Photos by Jon Chase/Harvard Staff Photographer/Ken Menkhaus, professor of political science at Davidson College, said it was profoundly disappointing to be discussing another Somali famine, after he worked in the country during the 1991-92 one. Each famine, he said, has distinct characteristics, and this one unfolded in slow motion over the past couple of years.

The United Nations declared last Friday that Somalia’s famine is over. But the official declaration means little to the millions of Somalis who are still hungry and waiting for their crops to grow, according to authorities gathered at Harvard University.

“The difference between famine versus not famine for most Somalis is a distinction without a difference,” said Ken Menkhaus, professor of political science at Davidson College, whose research focuses on Somalia and the Horn of Africa.

Menkhaus said it was profoundly disappointing to be discussing another Somali famine, after he worked in the country during the 1991-92 one. Each famine, he said, has distinct characteristics, and this one unfolded in slow motion over the past couple of years. That’s at least partly because the Somali diaspora sent money home that delayed the worst effects.

Paul Farmer (left) speaks with Caroline Elkins prior to the opening remarks during the “Sound the Horn: Famine in the Horn of Africa” event.

Menkhaus was among four experts on Somalia and famine who spoke at the Radcliffe Gym Monday evening. The event, “Sound the Horn: Famine in the Horn of Africa,” was sponsored by the Committee on African Studies, Harvard Medical School’s Program in Infectious Disease and Social Change, the Weatherhead Center for International Affairs, and the Harvard Undergraduate Council.

The event was introduced by Paul Farmer, Kolokotrones University Professor of Global Health and Social Medicine and co-founder of the nonprofit Partners In Health. It featured opening remarks by Caroline Elkins, history professor and chair of the Committee on African Studies, and Salmaan Keshavjee, assistant professor of medicine and director of the Program on Infectious Disease and Social Change.

Other speakers included Michael Delaney, director of humanitarian response for Oxfam America, William Masters, chair of the Department of Food and Nutrition Policy at Tufts University, and Robert Paarlberg, adjunct professor of public policy at the Harvard Kennedy School and a political science professor at Wellesley College.

Elkins said the event was part of a University-wide effort to respond to the Somali disaster. Harvard President Drew Faust sent a message that Elkins read to the audience. Faust said the crisis deserves the world’s attention in an era when it is easier than ever to be informed about any subject, but perhaps harder to be aware of what’s important.

Farmer drew on his experience treating malnourished people in Haiti, where he has worked for decades, and said the human and social context of hunger need as much attention as the patients do. A malnourished child is typically an indication of poverty at home, and aid to families should be part of treating the child, he said. Similarly, broader agricultural interventions and fair trade policies are needed to boost local agricultural economies.

Though famine is often thought of as a natural disaster, Monday’s speakers said that is a false impression. Though Somalia suffered through a severe drought, with today’s instant communications, transport systems can move massive amounts of food. Given today’s global food markets, famine is too often a failure of local government and international response.

“In today’s 21st-century world, just about everything about famine is man-made,” Paarlberg said. “We’re no longer in a world of man against nature.”

Paarlberg’s assertion echoed that of other speakers, who pointed out that several of the most deadly famines in history occurred because of government action or inaction.

“In today’s 21st-century world, just about everything about famine is man-made. We’re no longer in a world of man against nature,” said Robert Paarlberg, adjunct professor of public policy at the Harvard Kennedy School.

Ethiopia, which was also affected by the recent drought, fared much better this time because of reforms implemented after the 2001 one. Likewise, Paarlberg said, northern and central Somalia, regions that fall outside of the influence of the Al-Shabaab militia, also fared better.

There were several man-made features of this famine, which affected more than 10 million people and killed between 50,000 and 100,000, half of them children under age 5.

The largest man-made feature was the role of the Al-Shabaab militia that rules the region and that kept food aid from reaching those in need. But the international community isn’t blameless. As early as November 2010, an international famine early warning system was predicting the failure of rains in the region, but the international community didn’t respond fully until an official famine was declared in July 2011. On top of that, U.S. anti-terrorism laws cut off food aid because Al-Shabaab, listed as a terrorist group, was taking some of it.

Though the United Nations has declared the famine over, that was based on statistical measures, such as the number of people dying each day and the number of children who are malnourished. Though the official famine may be over, both U.N. officials and Monday’s speakers said the crisis continues for the people of Somalia. Almost a third of the population remains dependent on humanitarian assistance, crops growing from recent rains will take months to reach maturity, and herds of cows, goats, and other animals were greatly reduced during the crisis.

Delaney warned that the world will have another chance to get its response right, because the warning signs are pointing to an impending famine in Africa’s Sahel, the arid, continent-spanning transition zone just below the Sahara Desert.

By Alvin Powell
Harvard Staff Writer

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* The above story is adapted from materials provided by Harvard University

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In the end, Somali famine preventable. is an article review from: Medicinezine.com

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Duncan urges experiments in education.

Editor — Tue, 07 Feb 2012 18:16:45 +0000

Duncan urges experiments in education.
Education secretary offers proposals to aid nation’s students.

Kris Snibbe/Harvard Staff Photographer/ “It’s a stain on our nation that today one in four American students fails to finish high school on time or drops out … that is absolutely morally unacceptable and economically unsustainable,” U.S. Secretary of Education Arne Duncan told his Harvard audience.

U.S. Secretary of Education Arne Duncan would like to see reform of the nation’s public educational system, and he urged administrators, educators, politicians, and parents to work together to overcome the nation’s tough educational challenges.

“It’s a stain on our nation that today one in four American students fails to finish high school on time or drops out … that is absolutely morally unacceptable and economically unsustainable,” Duncan told a crowd Monday at the Harvard Graduate School of Education’s Longfellow Hall.

In an Askwith Forum talk titled “Fighting the Wrong Education Battles,” he said that too often “well-intentioned advocacy goes awry.” Frequently, decision-makers search for an ideal solution to educational reform instead of collaborating and compromising on “imperfect” but important initiatives that could bring lasting change.

“We shouldn’t be asking, ‘Is this the perfect solution?’ We should be asking, ‘Is this a much better solution? Can it help us challenge the status quo and accelerate student achievement?’”

Stakeholders must consider in- and out-of-school influences as part of that overall solution, said Duncan. While poverty greatly affects a child’s performance, great schools and teachers are the “most effective anti-poverty tool of all.” He suggested creating full-service community schools that can offer educational as well as health and social services to disadvantaged children, and pointed to the Obama administration’s Promise Neighborhoods, an initiative that funds organizations that develop similar, inclusive school models.

Reform also involves developing rigorous assessments and college and career-ready academic standards like those created by the Massachusetts educational system, said Duncan. Boosting student achievement is not an “either/or solution,” he said. “Educators and the broader community should be attacking both in-school and out-of-school causes of low academic achievement.”

For Duncan, the argument over whether teacher evaluations should include measures of student achievement is another “false choice.”

Critics of standardized tests are right to complain that such tests are flawed can’t accurately gauge factors like “classroom management, teamwork, collaboration, and individualized instruction,” said Duncan. He acknowledged that teacher evaluations must never be based solely on test scores and should include principal observations, peer reviews, student work, and surveys.

“Still, the shortcomings of today’s tests,” he said, “doesn’t mean we should simply abandon the use of standardized testing.”

Another important part of education reform involves getting managers and labor leaders to work together to engage in “tough-minded collaboration and step outside of their comfort zones,” Duncan said.

He suggested that No Child Left Behind, the 2001 act that includes educational reforms that critics say place too much emphasis on testing and standardized measures, is “fundamentally broken.” Duncan said that states, districts, neighborhoods, and schools need to be held to rigorous standards, but simultaneously be given room to find their own means of meeting high benchmarks.

“In my mind, it’s tight on goals, being absolutely clear about goals, but give folks a lot more room to hit them.”

By Colleen Walsh
Harvard Staff Writer

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New initiative for better teaching.

Editor — Mon, 06 Feb 2012 18:44:44 +0000

New initiative for better teaching.
Scholars, experts explore creative approaches to instructing, learning.

Harvard’s ambitious new initiative to spark innovative teaching and learning kicked off with a daylong conference on Friday that drew together authorities and scholars from the University and beyond to debate, discuss, and share ideas in the field.

The inaugural conference was part of the Harvard Initiative for Learning & Teaching (HILT), a University-wide presidential initiative launched through a $40 million gift from Rita E. and Gustave M. Hauser, aimed at catalyzing innovation in higher learning.

“What we hope to ask and answer with HILT is how can we fully embrace all the possibilities before us as teachers and learners, how can we make constant discovery and renewal a part of every teacher’s life, and, as we experiment, how can we best evaluate what is successful and then sustain and scale it?” said Harvard President Drew Faust during opening remarks for the conference at the Northwest Science Building.

Other early initiative-supported projects include developing a consortium of staff from across Harvard that will provide instructional and technological support, as well as an infrastructure for capturing and archiving video for teaching and other purposes, in collaboration with Harvard’s Academic Technology Group.

The initiative also has established the 2012-13 Hauser Fund Grants program that issues awards between $5,000 and $50,000 for innovative proposals in teaching and learning. Currently, 255 letters of intent, submitted from faculty, staff, and students at every Harvard School, are being considered for final proposals.

A professor of psychology from Washington University in St. Louis surprised some attendees of a morning session. Less studying and more testing enhances learning, suggested memory expert Roddy Roediger during a discussion on the science of learning. Roediger showed the audience how students who were frequently tested on a subject on the first day of an experiment in his lab performed better on the same tests two days later, compared with those who studied more but had fewer tests on the first day.

“What you really need to practice to be able to retrieve something two days later … [is] retrieving it.”

For Steven Pinker, Harvard’s Johnstone Family Professor of Psychology, teaching students to write well is a fundamental charge of a good university. But, he lamented, “we are not succeeding.” To write effectively, an author must remember that he or she likely knows much more about a particular subject than readers do, said Pinker. Placing yourself in the shoes of your audience, he argued, “might be the most important cognitive process in the crafting of clear prose.”

“You should never underestimate the power of trying to do big, collective things as an organization,” said Youngme Moon (second from left), senior associate dean at Harvard Business School. Moon was joined in an afternoon panel by Harvard Provost Alan Garber (far left), Harvard Corporation member Lawrence S. Bacow, and Michael Sandel, the Anne T. and Robert M. Bass Professor of Government. Photo by Stephanie Mitchell/Harvard Staff Photographer

A series of interactive afternoon sessions gave a group of Harvard professors the chance to show their colleagues and contemporaries what goes on in their own classrooms.

Proving that the lecture format remains an effective teaching tool, Tom Kelly delivered a lively talk based on his popular General Education course, “First Nights,” in which he explores the performance premieres of five seminal works through a cultural, musical, and historical lens.

Waving his hands emphatically to the beat of accompanying audio and video clips, Kelly, Harvard’s Morton B. Knafel Professor of Music, carefully deconstructed Igor Stravinsky’s “The Rite of Spring.” Kelly’s presentation style, which during class often involves running to a piano to play an important chord or passage, offers students a new way of listening, and hopefully fosters in them a love for the subject matter.

I want them to know “how lucky they are to be alive on a planet like this that has music on it,” he said.

Eric Mazur was in his seventh year of teaching when he realized “my students were not learning; they were simple regurgitating back to me what I delivered to them, and then promptly forgetting it a few months later.” Effective teaching requires the assimilation or “sense-making” of that information, he said. And for that, the students themselves hold the key. In his classes, Mazur, the Balkanski Professor of Physics and Applied Physics, uses his popular and effective peer-instruction method, in which he asks questions of students and then has them try to convince each other of their own reasoning during class.

“It is absolutely essential,” Mazur said, “that we engage them.”

But developing sustainable methods of teaching and learning also requires an infrastructure and a culture of innovation, said Youngme Moon, Donald K. David Professor of Business Administration and senior associate dean at Harvard Business School (HBS), during an afternoon panel that included Harvard Provost Alan Garber. She pointed to the School’s new experiential learning program as an example of innovative pedagogy. In January, 900 HBS students took field trips to a dozen locations around the world as part of the School’s Field Immersion Experiences for Leadership Development, a new supplement to its traditional curriculum.

“You should never underestimate the power of trying to do big, collective things as an organization,” said Moon, adding, “the transformative nature of the [new HBS program] is palpable.”

The symposium’s attendees ranged from the deans of Harvard Schools and distinguished professors to staff, students, and participants from beyond the Harvard community who were eager to develop and share their thoughts on innovative teaching and learning.

“Getting all these great minds together from all across the University is a great thing,” said Harvard senior Senan Ebrahim, a neurobiology concentrator and former Undergraduate Council president, who helped to create a video for the conference that captured student perspectives on teaching and learning. “The opportunity for these experts to share what they do and explore how it can be applied to different disciplines is amazing.”

Michael D. Smith, dean of the Faculty of Arts and Sciences and a longtime proponent of innovative pedagogy and excellence in undergraduate teaching, was impressed by the symposium. “This has been tremendous. … I think the culture is already changing on campus, and this is an example of it,” Smith said.

The conference showed that the University is “on the cutting edge of great change in learning and teaching,” said Rita E. Hauser, who attended the symposium with her husband, Gustave M. Hauser. “Harvard 50 years from now will be very different from Harvard today; it’s inevitable.”

The event also featured a resource fair with representatives from the University’s teaching and learning centers, related interfaculty initiatives, academic technology resources, museums, and libraries.

By Colleen Walsh
Harvard Staff Writer

###

…

The inaugural HILT Symposium opened a Harvard-wide conversation, engaging faculty and students in dialogue, debate, and the sharing of ideas about pedagogical innovation. The event convened invited members of the Harvard community and presenters from within Harvard and externally who offered interesting and informative perspectives on teaching and learning in higher education, with an emphasis on evidence-based approaches.

###

About Harvard Medical School (HMS)

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The search for life’s stirrings.

Editor — Mon, 06 Feb 2012 18:44:07 +0000

The search for life’s stirrings.
Nobel laureate Szostak says knotty problems sometimes have simple solutions.

Nobel Prize winner Jack Szostak’s research focuses on understanding primitive cells, how they might have been created, and how they might have behaved and divided. Rose Lincoln/Harvard Staff Photographer

Scientists studying how life arose on Earth are stumped by several key steps in that eventual process, but a Harvard scientist studying the earliest cells says that seemingly intractable problems in this field have sometimes proved to have simple, even elegant solutions.

Those pondering the earliest stirrings of life expect that it will either turn out to be easy to create and a natural outgrowth of the primordial conditions found on planets like Earth: rocky, not too hot, not too cold, with water and other key elements. If that’s the case, the rapid acceleration of discoveries of extrasolar planets would mean there are potentially millions of other worlds that are Earth-like enough for life to arise.

Or, life may be hard to get going, requiring a precise combination of conditions and chemicals that were present on Earth, perhaps fleetingly and only once. If that’s the case, such conditions may be difficult to locate in other places, and we may find ourselves in thin company — or even entirely alone — in the universe.

So far, researchers have run into one knotty problem after another. But Nobel laureate Jack Szostak, a genetics professor at Harvard Medical School, and distinguished investigator at Harvard-affiliated Massachusetts General Hospital, said Feb. 1 that we shouldn’t interpret the difficulty of the problems so far to mean that life is most likely rare in the universe.

“At this stage in our thinking, there are a lot of gaps in our understanding, places where we have no idea what happened,” Szostak said. But “problems that looked so intractable in retrospect look simple.”

Szostak, who won the 2009 Nobel Prize in physiology or medicine, spoke at the Harvard Museum of Natural History in the kickoff lecture of the season’s “Evolution Matters” series. Szostak gave a packed Geological Lecture Hall an overview of the work of researchers like himself who are seeking to answer life’s most fundamental question: Where did we come from?

Szostak’s research focuses on understanding primitive cells, how they might have been created, and how they might have behaved and divided. Among other findings, Szostak and colleagues have shown that cell-like vesicles are relatively easy to create from fatty acid molecules suspended in water. He has also shown that vesicles divide naturally when passed through a smaller pore, and explored other possible methods of early cell division.

One of the early problems researchers in this field faced was how genetic information in the first cells was transmitted. The way cells work today, Szostak said, is that the information in DNA is taken by RNA and used to create a vast array of proteins, which do much of the body’s work. This DNA-to-RNA-to-protein process feeds back on itself, with proteins playing key roles in creating RNA from DNA. Scientists found such a closed loop difficult to unravel: With no proteins in an early cell, how do you get the DNA’s information out to create RNA and then more proteins?

That changed in the early 1980s, when researchers discovered that RNA, in addition to having the ability to carry genetic information, also can catalyze chemical reactions, something thought to be the domain of proteins. The discovery gave rise to the possibility that early cells held their genetic information not in DNA, but in RNA molecules, as some viruses do today, and that RNA, not proteins, could have played a role in catalyzing the cellular processes. The problem changed from needing three kinds of molecules that interacted in complex ways to needing just one kind.

While that presented a plausible scenario, many details remain problematic. Two of them, it turns out, are solved with a single solution, Szostak said. One issue is that when two RNA molecules are joined to form a double helix, pulling them apart to get at their genetic information is very difficult without using cellular enzymes, which wouldn’t have been present in early cells.

The second problem is that the molecular backbone occurring in RNA that is created through chemical processes like those possible on early Earth is not the same as that manufactured inside cells. When cells make RNA, the molecular backbone bonds with different atoms at specific locations. When RNA is made through primitive chemical processes, there is more sloppiness, with atoms attached in the wrong spot in some cases.

Both seemed intractable problems, Szostak said. But when members of his lab replicated the situation, evolving an RNA molecule through chemical processes, they realized that instead of being a problem, the sloppiness in the backbone was actually a solution. A few misplaced atoms didn’t affect the whole RNA molecule’s structure, and with those atoms out of place, it didn’t bond quite as strongly to another RNA molecule, allowing them to come apart more easily and letting replication proceed, solving the first problem as well.

“Instead of being a fatal problem for RNA, we now think that backbone heterogeneity may be what allowed RNA to emerge as primordial genetic material,” Szostak said. “Our thinking on this problem is just completely inverted.”

By Alvin Powell
Harvard Staff Writer

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About Harvard Medical School (HMS)

Driving Change. Building Momentum. Making History.

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For cutting-edge biomedical materials, try corn.

Editor — Mon, 06 Feb 2012 18:30:37 +0000

For cutting-edge biomedical materials, try corn.
Students explore plant-derived materials for wound closures, tissue engineering.

Eliza Grinnell/ SEAS/ Students in the undergraduate teaching labs at SEAS are investigating plant-based materials that may help regrow damaged neurons. The team includes (from front to back) Godwin Abiola ’14, Undergraduate Studies in Biomedical Engineering Assistant Director Sujata Bhatia, and Erfan Soliman ’12.

One might expect, these days, to find corn products in food, fuel, and fabric, but a corn-based glue that can heal an injured eyeball? That’s a-maize-ing.

Creating new materials from abundant, natural plant sources, today’s biomedical and biochemical engineers are finding clinical uses for new “custom” materials that were not even remotely considered in recent decades.

Both renewable and remarkable, plant-based medical products are on the cutting edge of a field called “sustainable biomaterials,” a topic so intriguing that 23 undergraduates chose to spend an extra week at the Harvard School of Engineering and Applied Sciences (SEAS) to take a course on it during their winter break.

“It was engaging, comprehensive, and demonstrated just how ‘sexy’ science can be,” said Aubrey Walker ’15.

The seminar-style mini-course was led by Sujata Bhatia, assistant director for Undergraduate Studies in Biomedical Engineering, who arrived at SEAS last spring. As an industry scientist at DuPont, Bhatia had been at the forefront of research resulting in clinically relevant products, including plant-based tissue adhesives. She now brings that expertise to guide an agile and modern curriculum at SEAS.

Bhatia, who received a grant from the Harvard President’s January Innovation Fund for Faculty to offer the course, intended it as a “vehicle to really get undergraduates thinking about their paths in engineering, and to give a broader overview than they might get in any single course during the semester.”

“I hope that this will both draw undergraduates into the concentration and give concentrators the tools necessary to begin asking their own questions within the field,” she said.

For Walker, a freshman, the course was an inspiring introduction to the breadth of opportunities available in engineering.

“Through the lens of a bioengineer, I felt myself at the precipice of innovative solutions to some of our generation’s biggest problems,” he said. “I can’t imagine a more concise, intellectually stimulating, or rewarding program. I am very glad to have come back from my long break to gain this experience.”

During the week, the students attended foundational lectures on biomaterials and new methods of drug delivery. They also had the opportunity to survey some of the current research in the field by attending the Bio-Inspired Engineering International Symposium, which was hosted by Harvard’s Center for Nanoscale Systems on Jan. 17.

Brandon Geller and Robyn Tsukayama of the Harvard Office for Sustainability gave a guest lecture on biopolymers, providing students insight into the strides that the University is making to integrate the fruits of bioengineering research into its operations.

In addition to seeing the work of experts in the field, students were able to learn about research that their classmates are undertaking. Seniors in engineering, including Erfan Soliman ’12, led one of the week’s sessions by discussing their thesis research and introducing the groups to the laboratory and design spaces that are available to students at SEAS.

Soliman’s work, which combines agar gel and corn-derived carbon nanotubes into a substrate for neural regeneration, extends far beyond the traditional boundaries of his own concentration, electrical engineering.

In addition to presenting a poster at the Bio-Inspired Engineering Symposium, Soliman was able to connect with other students, across disciplines. He teamed up in the lab with Godwin Abiola ’14, a biomedical engineering student, in January, teaching him about circuit theory in order to measure the electrical conductivity of the agar gels.

The partnership between Soliman and Abiola is typical of a trend of collaboration at SEAS that Bhatia believes is here to stay.

“It’s very powerful, and it helps students appreciate early on the importance of bringing diverse perspectives to a project,” she said. “I’ve always been interested in the interfaces between different disciplines. That’s where all the cool things can happen.”

By Mureji Fatunde ’12
SEAS Communications

###

About Harvard Medical School (HMS)

Driving Change. Building Momentum. Making History.

“Since 1872, Harvard Medical School has been the incubator of bold ideas—a place where extraordinary people advance education, science and health care with unrelenting passion.

More at Harvard Medical School & Harvard Medical School. Generations of Leaders.

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Bunches of support.

Editor — Fri, 03 Feb 2012 21:10:00 +0000

Bunches of support.
Daffodil Days returns to aid cancer patients.

It’s that time of year again! Harvard’s 25th annual Daffodil Days campaign to help raise money for the American Cancer Society is under way through March 1, with gifts scheduled for delivery on March 19.

This year’s gift options are a bouquet of 10 daffodils, for $10; bear and a bunch, $25; potted daffodil bulbs, $15; Gift of Hope (a bunch of daffodils delivered to a local hospital), $25; and Bear Hug of Hope (a Daffodil Days teddy bear delivered to a local hospital), $25.

All orders must be placed through a department coordinator via check, money order, or online. For more information.
###

About Harvard Medical School (HMS)

Driving Change. Building Momentum. Making History.

“Since 1872, Harvard Medical School has been the incubator of bold ideas—a place where extraordinary people advance education, science and health care with unrelenting passion.

More at Harvard Medical School & Harvard Medical School. Generations of Leaders.

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About Harvard School of Public Health (HSPH)

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From the Balance Beam to the State Bar.

Editor — Fri, 03 Feb 2012 17:05:27 +0000

From the Balance Beam to the State Bar.
UCSF Patient Turns Life-Threatening Condition into Source of Strength.

Angelica Galang loves competition. Feisty and determined for as long as she can remember, Galang became interested in gymnastics at the age of four after watching the U.S. women’s team win the team bronze medal at the 1992 Summer Olympics.

“We didn’t have a pool so I couldn’t be a swimmer and I just thought, ‘Well, let me try gymnastics,’” said the 23-year-old East Bay resident. “I have a living room and I have a couch, so I used to walk along the edge of the couch pretending it was a balance beam.”

…
UCSF Saves Life of Patient with Spine Tumor

Twenty three year-old Angelica Galang is a former gymnast. She was a fun-loving college student when her doctor discovered a five-inch benign tumor in her spinal column in 2009 after she fell down multiple times earlier that year. If the tumor had continued to grow, Angelica would have become a quadriplegic unable to breathe on her own.

Surgery to remove the tumor involved a very complicated procedure and only a handful (less than ten) of neurosurgeons in the United States are skilled enough to successfully perform it. UCSF Dr. Philip Weinstein performed the surgery in 2009.

Angelica is in a wheelchair now, but her tumor is completely gone and she doesn’t have to worry about not being able to breathe on her own. She recently applied to law school and got accepted by her number one choice: UC Berkeley School of Law.

…

At first Galang started practicing three hours a day, three days a week. Eventually her time commitment increased to more than 22 hours a week, when she started entering competitions. Angelica did well, winning multiple awards including a first-place finish in the California bar championship and contributing to a team gold medal.

“I loved the feeling of performing and it was really cool to be able to do the things that a lot of your friends couldn’t do,” she said. “The feeling of just sticking a landing or staying on the beam was really exhilarating.”

Galang hung up her gymnastics leotard when she entered UCLA as a freshman. She studied communications and political science with the goal of becoming a journalist.

A Life-Changing Diagnosis

During her junior year, the once graceful gymnast suddenly became clumsy and weak, falling down stairs and losing her balance. She dismissed throbbing neck pains as nagging reminders of old gymnastics injuries.

Galang started seeing a chiropractor near the UCLA campus in Westwood, California. An X-ray of her neck came back negative. Her MRI, taken weeks later, told a different story.

Angelica Galang, left, and her teammates with the United States Quad Rugby Association

“My orthopaedic doctor sat down and looked at me,” Galang recalled. “He said, ‘We’ve found something. There’s something very, very wrong and it needs to be treated immediately.’”

A five-inch tumor was growing in midway up Galang’s spine. The operation needed to save her life is one of the most complex spinal tumor surgeries.

When Galang’s doctor presented her case to some of the country’s top neurosurgeons, most of them refused to treat her, saying the surgery was “too risky.”

But one said yes: UCSF neurosurgeon Philip Weinstein, MD, agreed to operate on Galang.

“I felt confident that I could give her the best possible chance of coming through the surgery with preservation of as much spinal cord function as possible,” said Weinstein, a professor in the UCSF Department of Neurological Surgery. “The astonishing aspect of her case was that she had no neurological deficit at the time of initial diagnosis. She was functioning normally, yet there was this very large tumor occupying the entire central portion of her spinal cord.”

Galang bonded almost immediately with Weinstein, saying he was easy to trust.

“He was optimistic and I was very happy to have found him, especially after several other prominent neurosurgeons said no,” she said.

Without surgery, the tumor would have continued to grow, encroaching on vital functions. Ultimately, the condition would have proved fatal.

Reaching a Monumental Milestone

The surgery, which usually takes three hours, took almost 10 hours because the tumor was bigger than anticipated and it was in a precarious location – close to the C4 vertebrae. A spinal cord injury of C4 or higher typically paralyzes the diaphragm and the abdominal muscles, which control breathing. Using microscopes to guide microsurgical incisions, Weinstein separated the tumor from the spinal cord.

Waking up from the surgery, Galang found she couldn’t move her arms or legs, requiring members of her family to feed her. Sensation to her extremities started returning after about two months, but Galang still lacks fine motor skills, unable to write or even be able to feel how hot something is. She felt helpless and frustrated, especially when routine chores such as brushing her hair or putting contact lens in her eyes became Herculean tasks.

“I knew that the initial response to the surgery would be physically devastating, that she would require a long period of time to recover her functions,” Weinstein said. “She dedicated herself in a really inspiring way.”

Philip Weinstein, MD

After several months of intense physical therapy, Galang regained most sensation in her arms and some in her legs. Today, two years and seven months, after surgery, she is able to take a few steps with the aid of crutches, but mostly gets around in her wheelchair.

Galang’s perspective remains positive. Her adjustment has been on multiple levels.

“The disability is almost a bigger problem mentally than it is physically,” Galang said. “It really changes your outlook on a lot of things and your perspective on life.”

She returned to UCLA to complete her undergraduate degree. It was a difficult senior year for Galang, who quickly realized the hills of Westwood, once beautiful and welcoming to her, had become a challenging series of mountainous obstacles. The buildings she used to walk in without a thought were now a maze of wheelchair ramps and elevators.

When Galang graduated from UCLA last year, her thoughts were with those who helped her reach the monumental milestone. She faxed her diploma to Weinstein.

“Angelica is one of the most courageous patients I’ve ever had and one of the most remarkable young people I’ve ever met,” Weinstein said. “The day I heard she graduated from UCLA was one of the finest days in my neurosurgical career.”

Starting A New Chapter

As Galang began to understand the challenges ahead, she switched career paths from journalism to law, with the goal of helping people with disabilities. She took the LSAT (Law School Admissions Test) in the fall of 2011.

“I want to shatter the myth that people in wheelchairs are not going to be able to do things that able-bodied people can do,” Galang said. “I encounter a lot of little kids who come up to me and ask me why I’m in a wheelchair and their parents say, ‘No, no, no, no. Don’t do that; don’t look at her.’ And that sticks with the kids and they grow up thinking that there’s something wrong with people in wheelchairs.”

Galang applied to some of the top law schools in the country, including UC Berkeley’s law school, her number one choice.

Late last year just before Christmas, Galang received a call from Edward Tom, the admissions dean of Berkeley Law School.

She was accepted.

Looking back, Galang is at peace with the recent turn of events, even with the tumor that almost ended her life. She is even grateful for what happened, even if she may never walk unaided again.

“My life before all this was mostly about me. I never would have found this renewed perspective on so many things,” Galang said. “I’ve met the most inspiring and the most memorable people because of this injury. And I now have a new purpose in life, a goal much bigger than myself.”

The former gymnast who used to balance herself on the edge of her living room sofa now has a new athletic passion: wheelchair rugby. She became interested in the sport after her boyfriend introduced her to “Murderball,” a 2005 film about paraplegic athletes competing in full-contact rugby with wheelchairs specially designed for impact.

During a practice session one January evening with members of the United States Quad Rugby Association, Galang was the only woman among a group of eight athletes. A fierce competitor by nature, she is one of the more productive members of the team, known to her friends and teammates by her nickname, Jelly.

“Jelly has great reflexes and great intuition,” said Scott Pope, team captain of the Northern California chapter of the U.S. Quad Rugby Association. “She’s not afraid of anything and just goes for it. I love that about her.”

After a non-stop two-hour practice session, Galang winds up dripping with sweat and out of breath, but smiling. She is proud of her accomplishments and grateful for the lives she’s touched – and those who have touched her – in spite of, or maybe, because of her injury.

“I love my life, I love how many people that I’ve met through this and how many friendships have grown because of this,” she said. “It’s really a gift and I would never, ever return it.”

…
Wheelchair Rugby Athletes Practice at Riekes Center

UCSF patient Angelica Galang and members of the United States Quad Rugby Association (USQRA) practice at Riekes Center for Human Enhancement, located in Menlo Park. USQRA exists to provide opportunity, support, and structure for competitive wheelchair rugby to people with disabilities. For more info, go to http://www.quadrugby.com

…

By Leland Kim
Public Information Representative
University of California, San Francisco (UCSF)

###

> About University of California, San Francisco (UCSF).

The University of California, San Francisco (UCSF) is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. It is the only UC campus in the 10-campus system dedicated exclusively to the health sciences.

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Bed Nets, Water Filters, Condoms, and Education.

Editor — Fri, 03 Feb 2012 17:00:06 +0000

Combined Approach to Global Health Can Save Lives at Lower Cost.
Analysis of Kenya Study Shows Simultaneously Confronting HIV/AIDS, Malaria, and Waterborne Illness Improves Health.

A volunteer in 2008 shows people from the Lurambi District in Western Kenya how to use incecticide-treated bednets to prevent the spread of malaria during the Integrated Prevention Demonstration Campaign sponsored by Vestergaard Frandsen. Photo by Georgina Goodwin courtesy Vestergaard Frandsen

The great paradox of global health efforts is that regions of the world most plagued by poverty, poor infrastructure and rampant disease are often the most difficult to support. Now, scientists have demonstrated that confronting several diseases at once can make the most of thinly-stretched donor dollars and national health care budgets, to help to save lives.

A new analysis published this week in the open-access journal PLoS ONE focused on a combined public health campaign in Western Province, Kenya led by the Swiss-based company Vestergaard Frandsen, the Kenyan Ministry of Health and the U.S. Centers for Disease Control and Prevention (CDC). The analysis looked at the cost effectiveness of simultaneously confronting the problems of HIV/AIDS, malaria, and diarrhea caused by waterborne pathogens.

The researchers used the results of the campaign to build an analysis of the impact such efforts could have if carried out more broadly. The analysis found that for every 1,000 people reached through such campaigns, some $16,015 in health care costs would be avoided and more than 16 lives would be saved. As a result, local populations would gain hundreds of years of healthy life. The cost would be $32 per person, but averted health care costs would be greater, leading to the net savings.

James G. Kahn, MD, MPH

“That’s a very attractive deal,” said James G. Kahn, MD, MPH, a professor of health policy, epidemiology and global health at the University of California, San Francisco (UCSF), who is the senior author on the PLoS ONE study and led the economic aspect of the research. “This kind of a campaign is an excellent use of global health dollars.”

Bed Nets, Water Filters, Condoms, and Education

Health care workers distributed “CarePacks” at 37 locations in Kenya over seven days in 2008. These packs contained insecticide-treated bed nets to reduce the spread of malaria, water filters for preventing diarrheal diseases, and condoms.

Some 47,000 people ultimately received the packs, which also contained educational information as incentive for local residents to participate in a voluntary HIV testing and counseling program.

By combining efforts to reduce the burdens of malaria, diarrhea, and HIV/AIDS, the program efficiently stretched the impact of its funds, Kahn said, which is important in areas where per capita health expenditures may amount to little more than a few dollars a year. Combining these public health efforts into one program also saved a great deal of time, he added.

“This program was implemented in seven days, reaching 80 percent of the local population,” Kahn said. “This rapid implementation means more health benefits were quickly achieved.”

Other co-authors of the article, “Integrated HIV Testing, Malaria, and Diarrhea Prevention Campaign in Kenya: Modeled Health Impact and Cost-effectiveness” are N. Muraguri, B. Harris, E. Lugada, T. Clasen, M. Grabowsky, J. Mermin and S. Shariff.

Kahn is based in the UCSF Philip R. Lee Institute for Health Policy Studies, the Department of Epidemiology and Biostatistics, and Global Health Sciences.

In addition to UCSF, authors on this study are affiliated with the Kenyan Ministry of Public Health and Sanitation, CHF International, the London School of Hygiene & Tropical Medicine, the ESP/UN Foundation, and the CDC.

The analysis was funded by the U.S. National Institute on Drug Abuse and by the company Vestergard Frandsen, which managed the campaign and manufactured the water filters and bed nets distributed.

UCSF is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care.

By Jason Bardi
Senior Public Information Representative
University of California, San Francisco (UCSF)

###

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Basketball, with perspective.

Editor — Thu, 02 Feb 2012 18:59:07 +0000

Basketball, with perspective
Lippert set to score 1,000th point, but focuses on volunteering too

Crimson forward Victoria Lippert, who left sunny San Diego three years ago to take up residence in chilly Cambridge, “hasn’t looked back since.” Now she’s set to surpass the 1,000-point mark this spring./ Amanda Swinhart/Harvard Staff Photographer

In a refreshing twist, atypical of many Harvard students, Victoria Lippert doesn’t have a plan for what to do after graduation. “I don’t know,” she shrugs. “I’ve been exploring that a lot lately, thinking about possibilities.”

But the junior history and science concentrator isn’t the least bit worried. There’s her soon-to-be historic basketball career with the Crimson in which she’s poised to surpass the 1,000-point mark in one of her upcoming games — a feat that Lippert was blithely unaware of. But in reaching that goal, she’ll be only the sixth underclassmen and 16th player overall to reach 1,000 points. “It’s kind of cool,” Lippert says.

Lippert, who left sunny San Diego three years ago to take up residence in chilly Cambridge, “hasn’t looked back since.”

“I love Harvard,” she says. “And the snow was marvelous the first time I saw it.”

When not racking up baskets as a forward for the Crimson, the down-to-earth Lippert is involved with the campus Christian group Athletes in Action. In the summer of 2010 she traveled with the organization to Pretoria, South Africa, where for a month the athletes worked to create a tutoring program at a local school.

“It was a humbling experience, seeing the conditions there, listening to the kids’ stories, and knowing they have to deal with so much — disease, AIDS, poverty,” she recalls. “I grew a lot from that trip; it was a really powerful experience.”

As the Crimson head into the final games of their season, Lippert’s versatility and scoring touch will be critical to their success. “We really want an Ivy League championship this year,” she says. “This group of girls is very special. We have amazing chemistry off the court, which really helps us on the court. Right now, we’re trying to bring consistency to the competition. Anything can happen on any given night. We have to have our game faces on.”

“Vic is exceptional in many regards, both on and off the floor. First, she is an extremely talented, versatile player, who has a passion for the game that is contagious,” says Crimson coach Kathy Delaney-Smith. “And one of her most remarkable qualities is her unselfishness and will to win. Even though she’s a tremendous scorer in many ways, she puts the team first. She’ll do whatever it takes for the team to win.”

And this determination will certainly aid her in whatever career path she chooses, too. There is, of course, the possibility of playing basketball overseas, but Lippert is considering an option closer to home, too.

“I wrote a paper on the history of fingerprinting, and it got me thinking about crime and crime-fighting technology,” she says. “I’m considering something in law enforcement or the intelligence community. But I’m just poking around right now.”

There’s plenty of time to figure all that out, of course. “I’m not afraid of change or adventure,” Lippert says. “I’m generally pretty adaptable. I like exciting, new possibilities.”

By Sarah Sweeney
Harvard Staff Writer

###

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More at Harvard School of Public Health (HSPH) & Harvard School of Public Health (HSPH). History.

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* The above story is adapted from materials provided by Harvard University

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Making the worms turn.

Editor — Thu, 02 Feb 2012 18:58:55 +0000

Making the worms turn
Biophysicist and his lab pioneer ways to track, influence roundworm nervous systems

Aravinthan Samuel and researchers in his lab set to work designing equipment that could measure nerve activity in living, wiggling worms. They first succeeded three or four years ago, becoming the first to record neural activity in freely moving worms. Then, last year, they topped that, using pulses of green and blue light on worms that had been genetically modified so that their nerves contained light-activated proteins. This allowed researchers to exert control over the worms by aiming pulses of light at specific nerves./ Stephanie Mitchell/Harvard Staff Photographer

To biophysicist Aravinthan Samuel, the roundworm Caenorhabditis elegans provides a pathway to understanding the brain and nervous system, first of the worm, then of higher animals, and even, perhaps, of humans.

But to Samuel, working on anesthetized or immobilized worms can only tell you so much about how the brain and nervous system work. To truly understand the system, researchers need to see it in action.

So Samuel and researchers in his lab set to work designing equipment that could measure nerve activity in living, wiggling worms. They first succeeded three or four years ago, becoming the first to record neural activity in freely moving worms. Then, last year, they topped that, using pulses of green and blue light on worms that had been genetically modified so that their nerves contained light-activated proteins. This allowed researchers to exert control over the worms by aiming pulses of light at specific nerves.

To do this, they had to design some sophisticated equipment: a tracking microscope to follow the worms’ movements and image-processing software to estimate the location of individual neurons and control a mirror to direct light to the target nerve cells.

The system worked spectacularly. Researchers were able to simulate a touch that caused the worms to recoil by shining a light at a nerve near the worms’ front. They were able to goose the worms into action by shining a light at a nerve toward their back end. They were able to steer a worm left and right and even get it to lay an egg, all without a single physical touch.

At the time, Samuel described the method as perhaps his lab’s “greatest invention” and said it would provide a new tool in the arsenal of researchers seeking to understand the nervous system.

Today, Samuel and members of his lab are moving ahead with their work on the roundworm. Samuel, a physics professor who uses the tools of that field to explore important biological questions, said he chose to work on C. elegans, a millimeter-long roundworm often used in laboratory research, for several reasons. It is transparent, so researchers can see what’s going on inside it, and it’s so simple that researchers have all of its 302 neurons mapped out. That means researchers seeking a beachhead from which to explore the complex workings of the nervous system can look for basic principles in C. elegans that would also apply to more complex creatures.

After years working on C. elegans, Samuel’s laboratory is tackling increasing complexity. A few years ago, the researchers began working on larva of the fruit fly Drosophila. While Drosophila is another commonly studied laboratory animal — favored for genetics research because of its short life span — it is usually studied in its adult fly form. Its wormlike larva, which Samuel said has a nervous system an order of magnitude more complex than C. elegans, is not as widely studied. One project, if successful, will yield a complete map of the nerves involved in the larvae’s sensitivity to light and heat.

Although he has been on Harvard’s faculty since 2003, Samuel has been at the University far longer, for 23 years. After growing up in Sidney, New York with an interest in mathematics and physics, Samuel came to Harvard as an undergraduate. While looking for laboratories where he could conduct biological or physics research, he visited the lab of Howard Berg, a biophysicist who studies movement in bacteria. Samuel found a home there, conducting both undergraduate and graduate studies under Berg.

“Everything he touched seemed to work. He roamed and read widely. At one point he was learning Japanese … and reading James Joyce,” Berg said. “We are lucky to have him here. He is working at the interface of physics and biology and needs the support of both communities.”

Samuel said he was attracted to Berg’s lab — and biophysics generally — because so many fundamental biological questions remain unanswered that he felt there were ample opportunities to conduct basic research.

“You can do fundamental work quickly. That’s not so easy to do in physics,” Samuel said.

Samuel received his doctorate in biophysics in 1999, spent four years doing postdoctoral research at Harvard, and then became an assistant professor of physics in 2003. He became an associate professor in 2007 and professor of physics in 2010.

Over his career, Samuel has come to understand what he calls the “inefficiencies” in science, the research down blind alleys that can consume a lot of effort but yield no results. As the leader of his own lab, Samuel said he tries to touch base with each lab member daily instead of waiting for lab meetings, to head off forays down paths that won’t prove fruitful.

“I try to make sure everyone is working on solvable problems,” Samuel said.

###

About Harvard Medical School (HMS)

Driving Change. Building Momentum. Making History.

“Since 1872, Harvard Medical School has been the incubator of bold ideas—a place where extraordinary people advance education, science and health care with unrelenting passion.

More at Harvard Medical School & Harvard Medical School. Generations of Leaders.

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About Harvard School of Public Health (HSPH)

More at Harvard School of Public Health (HSPH) & Harvard School of Public Health (HSPH). History.

_________________________________________________

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About Harvard University.

More About Harvard University & About Harvard University. Information.

###

* The above story is adapted from materials provided by Harvard University

_________________________________________________________________

Making the worms turn. is an article review from: Medicinezine.com

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As strong as an insect’s shell

Editor — Thu, 02 Feb 2012 18:55:15 +0000

As strong as an insect’s shell
Wyss research takes cue from nature to create tough, low-cost material

Postdoctoral fellow Javier Fernandez (right) and Don Ingber, director at the Wyss Institute, have created a new material made from discarded shrimp shells and proteins derived from silk called “shrilk.” It is thin, clear, flexible, and hard as aluminum at half the weight. Shrilk not only will degrade in a landfill, but its basic components are used as fertilizer, and so will enrich the soil./ Jon Chase/Harvard Staff Photographer

Harvard researchers at the Wyss Institute for Biologically Inspired Engineering have come up with a tough, low-cost, biodegradable material inspired by insects’ hard outer shells. The material’s inventors say it has a host of possible applications and someday could provide a more environmentally friendly alternative to plastic.

The material, made from discarded shrimp shells and proteins derived from silk, is called “shrilk.” It is thin, clear, flexible, and strong as aluminum at half the weight, according to postdoctoral fellow Javier Fernandez, who began work on chitin-based material as a doctoral student at the University of Barcelona and developed shrilk during a year-and-a-half stint working at the Wyss Institute with Director Donald Ingber.

Ingber, the Judah Folkman Professor of Vascular Biology at Harvard Medical School and Harvard-affiliated Children’s Hospital and professor of bioengineering at the Harvard School of Engineering and Applied Sciences, said companies have already expressed interest in the material, particularly for medical applications. Possible medical uses are boosted by the fact that the ingredients in shrilk have already been approved by the Food and Drug Administration. Potential uses include sutures that would dissolve over time in hernia repair, protective coverings for burns and wounds, and a scaffold on which cells can grow to regenerate tissue.

A major benefit of the material, which was described in a December issue of the journal Advanced Materials, is its biodegradability, Ingber and Fernandez said. Plastic’s toughness and moldability represented a revolution in materials science during the 1950s and ’60s. Decades later, however, plastic’s very durability is raising questions about how appropriate it is for one-time applications such as plastic bags, or short life-span consumer goods, used in the home for a few years and then tossed into a landfill where they will decompose for centuries.

“All this plastic, what’s the point of making something that lasts 1,000 years?” Fernandez asked.

Shrilk not only will degrade in a landfill, but its basic components are used as fertilizer, and so will enrich the soil.

Natural materials, Fernandez said, were supplanted by synthetic materials partly because synthetics can be easily controlled in manufacturing and made into a wide variety of goods. Natural materials are making a comeback, however, as scientists learn from nature the manufacturing techniques needed to mimic the properties that make them desirable. Shrilk is a good example of the Wyss Institute’s mission, which is to learn how to make things from nature’s own engineering.

“This is the second chance for natural materials,” Fernandez said.

Shrilk’s secret, Fernandez and Ingber said, is not just its chemistry but also its design. There are two basic ingredients, a variation on the material chitin that makes up a large part of an insect’s tough outer layer, called chitosan, and fibroin, a protein derived from silk. But just combining those two ingredients doesn’t produce a hard, flexible material. Instead of blindly combining the materials, Fernandez and Ingber looked to nature to see not just what materials were used, but how.

In an insect’s body, the fibroin protein and chitin are layered, creating the kind of stiff design that gives plywood its strength and rigidity. By mimicking nature’s design and layering the chitosan and fibroin protein, shrilk was born.

“Much of the structural properties found in nature are not just chemistry, they’re architecture,” Ingber said.

Shrilk has great potential, the two said. Chitin is one of the most abundant materials in nature, found in everything from shrimp shells to insect bodies, snail and clam shells. That makes shrilk not only low cost, but also potentially scalable should it be used in applications demanding a lot of material.

Work on shrilk is continuing in the lab, the two said. Ingber said the material becomes flexible when wet, so they’re exploring ways to use it in moist environments. They’re also developing simpler manufacturing processes, which could be used for products in non-medical applications, like for computer cases and other products inside the home. They’re even exploring combining it with other materials, like carbon fibers, to give it new properties.

By Alvin Powell
Harvard Staff Writer

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About Harvard Medical School (HMS)

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### * The above story is adapted from materials provided by Harvard University

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Blood test for depression?

Editor — Thu, 02 Feb 2012 18:53:59 +0000

Blood test for depression?
Found to accurately distinguish depressed patients from healthy controls

“Traditionally, diagnosis of major depression and other mental disorders has been made based on patients’ reported symptoms, but the accuracy of that process varies a great deal, often depending on the experience and resources of the clinician conducting the assessment,” says George Papakostas, an associate professor of psychiatry at Harvard Medical School and lead and corresponding author of the report./ Amanda Swinhart/Harvard Staff Photographer

The initial assessment of a blood test to help diagnose major depressive disorder indicates it may become a useful clinical tool.

In a paper published in the journal Molecular Psychiatry, a team including Harvard-affiliated Massachusetts General Hospital (MGH) researchers reports that a test analyzing levels of nine biomarkers accurately distinguished patients diagnosed with depression from control participants without significant false-positive results.

“Traditionally, diagnosis of major depression and other mental disorders has been made based on patients’ reported symptoms, but the accuracy of that process varies a great deal, often depending on the experience and resources of the clinician conducting the assessment,” says George Papakostas of the MGH Department of Psychiatry and an associate professor of psychiatry at Harvard Medical School, lead and corresponding author of the report. “Adding an objective biological test could improve diagnostic accuracy and may also help us track individual patients’ response to treatment.”

The study authors note that previous efforts to develop tests based on a single blood or urinary biomarker did not produce results of sufficient sensitivity, the ability to detect the tested-for condition, or specificity, the ability to rule out that condition. “The biology of depression suggests that a highly complex series of interactions exists between the brain and biomarkers in the peripheral circulation,” says study co-author John Bilello, chief scientific officer of Ridge Diagnostics, which sponsored the current study. ”Given the complexity and variability of these types of disorders and the associated biomarkers in an individual, it is easy to understand why approaches measuring a single factor would not have sufficient clinical utility.”

The test developed by Ridge Diagnostics measures levels of nine biomarkers associated with factors such as inflammation, the development and maintenance of neurons, and the interaction between brain structures involved with stress response and other key functions. Those measurements are combined using a specific formula to produce a figure called the MDDScore — a number from 1 to 100 indicating the percentage likelihood that the individual has major depression. In clinical use the MDDScore would range from 1 to 10.

The initial pilot phase of the study enrolled 36 adults who had been diagnosed with major depression at the MGH, Vanderbilt University, or Cambridge Health Alliance in Cambridge, Mass., along with 43 control participants from St. Elizabeth’s Hospital in Brighton, Mass. MDDScores for 33 of the 36 patients indicated the presence of depression, while only eight of the 43 controls had a positive test result. The average score for patients was 85, while the average for controls was 33. A second replication phase enrolled an additional 34 patients from the MGH and Vanderbilt, 31 of whom had a positive MDDScore result. Combining both groups indicated that the test could accurately diagnose major depression with a sensitivity of about 90 percent and a specificity of 80 percent.

“It can be difficult to convince patients of the need for treatment based on the sort of questionnaire now used to rank their reported symptoms,” says Bilello. “We expect that the biological basis of this test may provide patients with insight into their depression as a treatable disease rather than a source of self-doubt and stigma. As we accumulate additional data on the MDDScore and perform further studies, we hope it will be useful for predicting treatment response and helping to select the best therapies.”

Papakostas adds, “Determining the true utility of this test will require following this small research study with larger trials in clinical settings. But these results are already providing us with intriguing new hints on how powerfully factors such as inflammation — which we are learning has a major role in many serious medical issues — contribute to depression.”

By Sue McGreevey
Masschusetts General Hospital Public Affairs

###

About Harvard Medical School (HMS)

Driving Change. Building Momentum. Making History.

“Since 1872, Harvard Medical School has been the incubator of bold ideas—a place where extraordinary people advance education, science and health care with unrelenting passion.

More at Harvard Medical School & Harvard Medical School. Generations of Leaders.

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About Harvard School of Public Health (HSPH)

More at Harvard School of Public Health (HSPH) & Harvard School of Public Health (HSPH). History.

_________________________________________________

###

About Harvard University.

More About Harvard University & About Harvard University. Information.

###

* The above story is adapted from materials provided by Harvard University

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Blood test for depression? is an article review from: Medicinezine.com

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Found to accurately distinguish depressed patients from healthy controls