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  • March 18, 2010
  • 10:02 PM
  • 5 views

The Eco-Elite

by Roberta Kwok in Journal Watch Online

Consumers may choose green products to boost social status

... Read more »

Griskevicius, V., Tybur, J., & B. Van den Bergh. (2010) Going green to be seen: Status, reputation, and conspicuous conservation. Journal of Personality and Social Psychology, 98(3), 392-404. DOI: 10.1037/a0017346  

  • March 18, 2010
  • 08:12 PM
  • 5 views

Germs in Tobacco

by Dirk Hanson in Addiction Inbox


Bacteria found in major cigarette brands.
It’s not enough that smoking causes all manner of cardiopulmonary complications, or that more than 3,000 chemicals and heavy metals have been identified as additives. Now comes evidence that tobacco particles extracted from cigarettes contain markers for hundreds of known bacteria. Lung infections in some smokers may be caused by germs on shredded tobacco, rather than the act of smoking itself.
According to a report by Janet Raloff in Science News, Amy Sapkota and a team of researchers at the University of Maryland screened tobacco flakes from cigarettes for bacterial DNA using known markers. In an online paper for Environmental Health Perspectives, the scientists explored the bacterial metagenomics of cigarettes using standard cloning and sequencing processes. The team provided evidence for the presence of Campylobacter (a cause of food poisoning), E. coli, several Staphylococcus varieties, as well as a number of bacteria, such as Clostridium, which is directly associated with pneumonia and other infections. Fifteen different classes of bacteria in all, with no significant variation from one cigarette brand to another. 
The time has come, Sapkota and coworkers conclude, “ to further our understanding of the bacterial diversity of cigarettes,” given the more than 1 billion smokers worldwide.  Smoking is now recognized as a risk factor for a basketful of respiratory illnesses, including influenza, asthma, bacterial pneumonia, and interstitial lung disease. In light of this, the authors have advanced their study as solid evidence that “cigarettes themselves could be the direct source of exposure to a wide array of potentially pathogenic microbes among smokers and other people exposed to secondhand smoke.”
In 2008, researcher John Pauly and coworkers at the Roswell Park Cancer Institute in Buffalo, New York, helped provide early evidence by conducting a tobacco flake assay and publishing the results in the journal Tobacco Control. The scientists opened a package of cigarettes “within the sterile environment of a laminar flow hood. A single flake of tobacco was collected randomly and aseptically from the middle of the cigarette column and placed onto the surface of a blood agar plate. The test cigarettes included eight different popular brands, and these were from three different tobacco companies.”
And the results? “After 24 hours of incubation at 37 degrees C, the plates showed bacterial growth for tobacco from all brands of cigarettes. Further, more than 90% of the individual tobacco flakes of a given brand grew bacteria.” Pauly believes that “the results of these studies predict that diverse microbes and microbial toxins are carried by tobacco microparticulates that are released from the cigarette during smoking, and carried into mainstream smoke that is sucked deep into the lung.”

In a recent study published in Immunological Research , Pauly and others expanded on their findings, writing that “Cured tobacco in diverse types of cigarettes is known to harbor a plethora of bacteria (Gram-positive and Gram-negative), fungi (mold, yeast), spores, and is rich in endotoxin (lipopolysaccharide).” This time out, the researchers conclude that “lung inflammation of long-term smokers may be attributed in part to tobacco-associated bacterial and fungal components that have been identified in tobacco and tobacco smoke.”
Cigarette manufacturers already use antibacterial washes during the curing process in order to reduce infection by fungi and bacteria.
If the findings are sound, they could place the argument over secondhand smoke in a vastly different light—cigarettes smoke may be taking the rap for respiratory infections cause by extant bacteria. With smoking rates in the U.S. holding at a steady 21 percent of the population, the issue is not trivial.
Graphics Credit: http://commons.wikimedia.org/
Sapkota, A., Berger, S., & Vogel, T. (2009). Human Pathogens Abundant in the Bacterial Metagenome of Cigarettes Environmental Health Perspectives, 118 (3), 351-356 DOI: 10.1289/ehp.0901201
Pauly, J., Smith, L., Rickert, M., Hutson, A., & Paszkiewicz, G. (2009). Review: Is lung inflammation associated with microbes and microbial toxins in cigarette tobacco smoke? Immunologic Research, 46 (1-3), 127-136 DOI: 10.1007/s12026-009-8117-6

... Read more »

  • March 18, 2010
  • 05:05 PM
  • 13 views

Parkinsonian emotion recognition impairment better accounted for by sleep deprivation

by William Lu in The Quantum Lobe Chronicles

The New York Times recently covered a paper by Grey and Tickle-Degnen, published in the journal Neuropsychology, finding that people with Parkinson's Disease (PD) are not able to recognize facial and vocal emotions very well. The article states that it's not clear why this seems to be the case. I briefly reviewed the original meta-analytic paper (the pdf can be found here) and saw that the research team accounted for 1) the emotion recognition tasks used, 2) the medication the participants were on, and 3) the existence of depression as possible moderatoring variables for the impairment in emotion recognition. They suggest that "the likely cause of this deficit is pathology in neural circuits involved in emotion recognition, particularly within basal ganglia structures including the ventral striatum and STN." This tentative speculation is just fine and dandy, but it doesn't really provide an explanation for why people with PD have this particular deficit in the first place. They rule out comorbid depression and visualspatial impairment, but go on to postulate that Lewy bodies disease, an abnormal amount of protein found inside the nerve cells of many PD patients, may be affecting their visual cortex, therefore affecting their emotion recognition abilities. Too bad there's no shred of evidence found in the research literature to support this hypothesis (they make sure to note this). What I found surprising what that they made no mention of sleep disturbances' possible moderating role in explaining their findings. Drawing from my previous entry on sleep deprivation's deleterious affects on emotion recognition, maybe it's the fact that people suffering from PD commonly have concomitant sleep problems, therefore leading to their emotion recognition impairment. Numerous studies have shown that PD significantly affects rapid eye movement sleep behavior leading to a variety of cognitive impairments (Massicotte-Marquez et al., 2009, Norlinah et al., 2009, Seugnet et al., 2009,). We now also know that REM sleep is crucial in the processing of emotional memory (Nishida, 2008). And like I said before, sleep deprivation takes a heavy toll on emotion recognition functioning (van der Helm, Gujar, & Walker, 2010). Sleep seems to account for much of our emotional life! In light of the aformentioned studies, it makes the most sense that sleep deprivation would be the more likely pathway to emotional recognition impairment in people with PD; not working memory dysfunction as the authors suggest. There may be many potential sources for interpersonal difficulties in PD individuals who are unable to read emotions accurately. Perhaps future sleep treatment can help prevent such difficulties from ever occurring. Just a thought... Gray HM, & Tickle-Degnen L (2010). A meta-analysis of performance on emotion recognition tasks in Parkinson's disease. Neuropsychology, 24 (2), 176-91 PMID: 20230112Massicotte-Marquez J, Décary A, Gagnon JF, Vendette M, Mathieu A, Postuma RB, Carrier J, & Montplaisir J (2008). Executive dysfunction and memory impairment in idiopathic REM sleep behavior disorder. Neurology, 70 (15), 1250-7 PMID: 18216303Seugnet L, Galvin JE, Suzuki Y, Gottschalk L, & Shaw PJ (2009). Persistent short-term memory defects following sleep deprivation in a drosophila model of Parkinson disease. Sleep, 32 (8), 984-92 PMID: 19725249Norlinah, M., Afidah, K., Noradina, A., Shamsul, A., Hamidon, B., Sahathevan, R., & Raymond, A. (2009). Sleep disturbances in Malaysian patients with Parkinson's disease using polysomnography and PDSS Parkinsonism & Related Disorders, 15 (9), 670-674 DOI: 10.1016/j.parkreldis.2009.02.012... Read more »

  • March 18, 2010
  • 04:25 PM
  • 14 views

Death by human stampede

by Tom Rees in Epiphenom

Over the past 30 years, stampedes have killed at least 7,000 people and injured another 14,000. That's the conclusion that Edbert Hsu (Johns Hopkins Medical Institutions) and colleagues reached after a painstaking trawl of news reports in the world's English-language media.The real toll is probably even higher, of course, but the data were enough to allow Hsu to work out the characteristics of the most lethal stampedes. They found reports on 215 stampedes, of which 49 occurred at sporting events, 25 at musical events, 38 were political and 41 were religious. The rest (totalling 60) were due to a mixed bag of causes and were mostly spontaneous.And the award for the most lethal type of stampede goes to... religious ones! In simple terms of the number of fatalities per stampede, religious events come out over double that of their closest rival.The simple comparison is not a very fair, however. Religious stampedes take place in different parts of the world (often in the Middle East, which is the most dangerous place to be in a stampede), often in low income nations (also very dangerous), and often outdoors (slightly more dangerous than indoor stampedes).But even when you take all this into account, religious stampedes still come out on top of the lethality stakes - but sporting stampedes are so close as to make it a photo finish.There's one other factor that contributes to the lethality of a stampede, and that's the size of the crowd. Unfortunately, Hsu was only able to determine the size of the crowd in 130 cases.But even taking into account crowd size, religious stampedes are still pretty dangerous. When you look at fatality rate (i.e. deaths per crowd member), they're 6 times riskier than stampedes at sporting events.But with with crowd size taken into account, religious stampedes drop into third place. The riskiest kind of stampede by a long way are the spontaneous ones (because of the lack of crowd control), followed by political ones.The explanation for all this is fairly simple. Religion is the one event that brings together truly massive crowds, often in settings that are poorly controlled.One of the most lethal stampedes in recent history occurred in Iraq in 2005, when nearly 1000 people died when fears of a suicide attack sparked panic. In the same year, over 250 died (out of a crowd of 400,000) when Hindu worshippers set fire to shops.But the biggest contributor is the annual Hajj, which these days draws crowds in excess of 2 million. Five of the biggest stampedes in the past100 years occurred in Mina Valley, Saudi Arabia, during the Hajj.Over the past 3 decades, nearly 3,000 people have been killed in stampedes during the Hajj - the last big disaster being in 2006. With crowds that big, I suppose the surprise is that there are so few casualties!Hsieh, Y., Ngai, K., Burkle, F., & Hsu, E. (2009). Epidemiological Characteristics of Human Stampedes Disaster Medicine and Public Health Preparedness, 3 (4), 217-223 DOI: 10.1097/DMP.0b013e3181c5b4ba This article by Tom Rees was first published on Epiphenom. It is licensed under Creative Commons.

... Read more »

Hsieh, Y., Ngai, K., Burkle, F., & Hsu, E. (2009) Epidemiological Characteristics of Human Stampedes. Disaster Medicine and Public Health Preparedness, 3(4), 217-223. DOI: 10.1097/DMP.0b013e3181c5b4ba  

  • March 18, 2010
  • 03:54 PM
  • 11 views

Unique Fossils Record the Dining Habits of Ancient Sharks

by Laelaps in Laelaps



A photograph and line drawing (left side) of the fossil dolphin Astadelphis gastaldii. The crescent-shaped line in the line drawing represents the bite of a large shark, with the red portions representing damage done directly to the bone. From Bianucci et al, 2010.




Shark attacks are events of speed and violence. When they have locked on to a prey item sharks seem to come out of nowhere, and though they can be quite gentle with their jaws (as on occasions when they are unsure about whether something is food or not) their ranks of serrated teeth can inflict a devastating amount of damage. They are not the cruel, vicious, or bloodthirsty villains they have often been portrayed as, but instead are exquisitely-adapted predators which rely on their ability to catch and consume a variety of prey. And, just as it is among present day sharks, so it was among their prehistoric relatives.

Between 19 and 8 million years ago Maryland's Calvert Cliffs were covered by the ocean. Those shallow waters were inhabited by at least fifteen different genera of sharks, and their teeth (typically all that is left of them) are scattered everywhere along the beaches. Indeed, they are abundant enough that paleontologists Christy Visaggi and Stephen Godfrey recently cataloged of 26,000 of them to determine what kinds of sharks lived off the shores of ancient Maryland and in what numbers.

Their findings, printed in the Journal of Vertebrate Paleontology, reveal that this habitat was home to a mix of both living and extinct shark genera. There were fossils from Hemipristis (snaggletooth sharks), Galeocerdo (tiger sharks), Carcharias (sand tiger sharks), Carcharhinus (a subset of requiem sharks), and Isurus (mako sharks) in addition to the famous superpredator Carcharocles megalodon, most of which came from the time interval between 19 and 14 million years ago. (Teeth from many other genera, such as those related to whale sharks and great white sharks, were also found, but were so rare that they did not constitute a significantly significant sample.) While not exactly the same as their living relatives, these Miocene sharks would have looked very familiar to us, and clearly the area that would become the Calvert Cliffs was a very productive marine ecosystem which could support such a wide array of predators. Not surprisingly, there was plenty of prey in the water, too. Although not explicitly considered in their study, Visaggi and Godfrey noted that fish, sea turtles, crocodiles, birds, seals, sea cows, and numerous whale species all lived in the same place, and every now and then a specimen of one of these animals is found showing evidence of shark attack. Read the rest of this post... | Read the comments on this post...... Read more »

CHRISTY C. VISAGGI and STEPHEN J. GODFREY. (2010) VARIATION IN COMPOSITION AND ABUNDANCE OF MIOCENE SHARK TEETH FROM CALVERT CLIFFS, MARYLAND. Journal of Verterbrate Paleontology, 30(1), 26-35. info:/

BIANUCCI, G., SORCE, B., STORAI, T., & LANDINI, W. (2010) Killing in the Pliocene: shark attack on a dolphin from Italy. Palaeontology, 53(2), 457-470. DOI: 10.1111/j.1475-4983.2010.00945.x  

  • March 18, 2010
  • 02:12 PM
  • 20 views

“Skunk bear” snowfall ecology (a.k.a what wolverines want)

by DeLene Beeland in Wild Muse

Recently, the only known wolverine in Michigan passed away. Unlike the life and death of most wild animals, which unfold without human fanfare, her life and death were noticed. Scrutinized even. Rare species catch our attention. Rare species persisting outside their normal range even more so. Wolverines are often characterized as solitary creatures, thinly distributed [...]... Read more »

Copeland, J., McKelvey, K., Aubry, K., Landa, A., Persson, J., Inman, R., Krebs, J., Lofroth, E., Golden, H., Squires, J.... (2010) The bioclimatic envelope of the wolverine (Gulo gulo): do climatic constraints limit its geographic distribution?. Canadian Journal of Zoology, 88(3), 233-246. DOI: 10.1139/Z09-136  

  • March 18, 2010
  • 01:51 PM
  • 19 views

On the Origins of Polar bears

by TwoYaks in Gene Flow


From PNAS  March 16, 2010   vol. 107  no. 11  5053-5057 "Complete mitochondrial genome of a Pleistocene jawbone unveils the origin of polar bear" Lindqvist et al. 2010.
The polar bear has become the flagship species in the climate-change discussion. However, little is known about how past climate impacted its evolution and persistence, given an extremely poor fossil record. Although it is ... Read more »

Lindqvist, C., Schuster, S., Sun, Y., Talbot, S., Qi, J., Ratan, A., Tomsho, L., Kasson, L., Zeyl, E., Aars, J.... (2010) Complete mitochondrial genome of a Pleistocene jawbone unveils the origin of polar bear. Proceedings of the National Academy of Sciences, 107(11), 5053-5057. DOI: 10.1073/pnas.0914266107  

  • March 18, 2010
  • 01:48 PM
  • 16 views

LRR proteins help neurons find a partner

by Kevin Mitchell in Wiring the Brain

Matching 100 billion neurons with their appropriate partners is a daunting task, especially when each neuron can make synaptic contact with about 1,000 other cells. Nevertheless, the developing brain accomplishes this feat with remarkable specificity – neurons from each area of the brain send out axons which follow a stereotyped pathway to find their appropriate targets, guided by signpost proteins along the way. Once in the right general area they have to select specific cell types with which to form a synapse, often limited to a certain layer or sub-region. Many cells will even form synapses specifically with distinct subcellular compartments of their target cells – on distal or proximal parts of the dendrites or directly on to the cell body, for example. Specifying this level of connectivity, with the numerical complexity of the mammalian brain, obviously requires a large number of labels that can be used to match synaptic partners (even allowing for some level of combinatorial logic that increases the coding capacity). One class of molecules that has emerged recently as important in this process are members of the leucine-rich repeat (LRR) superfamily. These are secreted or transmembrane proteins which are characterised by a domain called the leucine-rich repeat in their extracellular region. LRR domain proteins are well known in the immune system, where they recognize a diversity of pathogenic factors. In the nervous system, these proteins are also involved in recognizing a diversity of factors, but in this case, the factors are protein labels on the surface of other neurons. A role for these proteins in the process of neuronal target selection first came to light in studies in fruitflies, where different LRR proteins act as labels to match specific motor neurons with their appropriate target muscles. In parallel, studies in mammals have identified a number of subfamilies of LRR proteins which are capable of inducing one neuron to form a synapse with another one in a cellular assay in culture. A couple of recent studies have highlighted the important roles of one such subfamily, called the LRRTM proteins in this process. These studies found that LRRTM2 can induce the formation of a synapse and that it accomplishes this by binding to the protein Neurexin-1 on the opposing cell. Neurexins were already known to be involved in this kind of process, through binding to a different family of proteins, the Neuroligins. What makes these studies particularly interesting is not just the identification of the additional role of LRRTM proteins in thise process, but that Neurexins, Neuroligins and the LRRTM genes have all previously been implicated in autism and/or schizophrenia (and in the case of LRRTM1 in the genetics of left-handedness). Failing to form the right kinds of connections, especially the correct balance of excitatory and inhibitory connections, can, it seems, lead to the kind of dysfunction of neural circuits and networks that ultimately results in psychopathology. The complement of LRR proteins has expanded dramatically over mammalian evolution, and individual members have diverged rapidly in protein sequence (see Dolan et al., below). These findings, in the light of the functions of various members of this superfamily, suggest that LRR proteins collectively contribute to the complexity of connectivity of the mammalian brain and may have been important in its evolution. Ko J, Fuccillo MV, Malenka RC, & Südhof TC (2009). LRRTM2 functions as a neurexin ligand in promoting excitatory synapse formation. Neuron, 64 (6), 791-8 PMID: 20064387de Wit J, Sylwestrak E, O'Sullivan ML, Otto S, Tiglio K, Savas JN, Yates JR 3rd, Comoletti D, Taylor P, & Ghosh A (2009). LRRTM2 interacts with Neurexin1 and regulates excitatory synapse formation. Neuron, 64 (6), 799-806 PMID: 20064388Dolan J, Walshe K, Alsbury S, Hokamp K, O'Keeffe S, Okafuji T, Miller SF, Tear G, & Mitchell KJ (2007). The extracellular leucine-rich repeat superfamily; a comparative survey and analysis of evolutionary relationships and expression patterns. BMC genomics, 8 PMID: 17868438... Read more »

  • March 18, 2010
  • 01:00 PM
  • 20 views

And The Winner Is…

by Moselio Schaechter in Small Things Considered

by Elio The transposases! The contest, in case you wonder, was for the most abundant set of genes in the known universe, or at least in the genomic data banks available on Earth. Aziz, Breitbart, and Edwards examined some 10 million genes from 2137 sequenced genomes (47 archaeal, 725 bacterial, 29 eukaryotic and 1336 viral) plus 187 metagenomes, in search...... Read more »

  • March 18, 2010
  • 12:00 PM
  • 24 views

Qualitative exercise adherence studies - participants with back pain and knee pain

by PhD Blogger in Exercise Psychology

Slade et al. (2009) is a qualitative study on people with non-specific chronic low back pain and examines their exercise adherence.  It examines their experiences of exercise past and present and also how they felt during the research study programme.  Many of the findings are in line with expectations from people who have been unsuccessful at establishing long term exercise behaviour, low exercise self efficacy and feelings of fear and helplessness.  The participants also reported that they felt that they lacked sufficient expertise on gym equipment and all expressed a desire for better instruction and feedback of all exercises.  Its a good qualitative paper with exerts from focus group transcripts which really help to understand how some people with injuries and chronic conditions feel about exercise and physical activity.  The full paper can be found here.Another qualitative paper from a broadly similar population is  Hendry et al (2006) and examines the experience of people with Osteoarthiritis of the knee.  The themes of the focus groups are broadly similar and its good to read the two studies to compare the experiences of the two groups.  The Hendry study can be found here.Slade SC, Molloy E, & Keating JL (2009). People with non-specific chronic low back pain who have participated in exercise programs have preferences about exercise: a qualitative study. The Australian journal of physiotherapy, 55 (2), 115-21 PMID: 19463082... Read more »

  • March 18, 2010
  • 11:30 AM
  • 20 views

Tasmanian devil colony shows immunity against cancer

by Katie Kline in EcoTone

In the tragic battle against devil facial tumor disease (DFTD), scientists may have found the first “glimmer of hope” near Cradle Mountain in northwestern Tasmania. At least that is what Katherine Belov of the University of Sydney and colleagues are saying about this unique colony that has resisted the disease. The results are paradoxical.... Read more »

  • March 18, 2010
  • 11:19 AM
  • 18 views

When population booms in poor nations

by Dave in The Daily Monthly

As I’ve mentioned in previous posts, population isn’t growing evenly across the world. While some areas are growing quickly, other places are stagnating. In nearly every case, population growth is slowest in rich countries and faster in poor countries. These two maps from the UN Population Division perhaps show the trend most dramatically:


As you can [...]... Read more »

Nikos Alexandratos. (2005) Countries with Rapid Population Growth and Resource Constraints: Issues of Food, Agriculture, and Development. Population and Development Review, 31(2), 237-258. info:other/

  • March 18, 2010
  • 08:00 AM
  • 23 views

Quality vs. quantity in protecting habitat for birds

by Rob Goldstein in Conservation Maven

A new study from South Africa touches on an interesting conservation question about whether we should place greater importance on quality or quantity when it comes to protecting habitat to conserve biodiversity...... Read more »

  • March 18, 2010
  • 08:00 AM
  • 23 views

Are big brains better for long trips?

by Zen Faulkes in NeuroDojo

For many birds, migration is a major component of life. You'd expect think that migration would have a whole cascade of effects on those birds, including the nervous system. But which way?

On the one hand, migration might be correlated with large brains to handle the the complex navigation tasks. On the other hand, migration might be correlated with small brains that are energetically efficient.

Sol and colleagues compared over six hundred species of birds (measuring over 4,000 skulls). Species ranged from non-migratory, to some members of a population where migratory, to some that were extensively migratory. They found, as had previous authors, that migratory birds tended to have smaller brains than non-migratory birds. Unsurprisingly, there is a substantial amount of variation from species to species. For instance, corvids (e.g., crows and allies) don't show this effect.

But what these authors are really trying to figure out is not the correlation, but the direction of causation. Do lineages become migratory because their small brains allow it, or does migration cause brains to become smaller, as neurons as jettisoned over evolutionary time for efficiency?

And here, there's a lot of math. It's not easy going for someone who doesn't do these kinds of models routinely, and I don't. Sol and colleagues argue that the models they tested indicate that migration causes brain size to reduce, rather than the other way around. Again, however, a good chunk of variation appears to be due to factors that were not included in the model. They also suggest that some brain areas may be more subject to selection pressures, and it's more complex than just the overall brain size alone.

When people think about the evolution of brains, the most common thing that leaps to mind is brains getting larger. Maybe that's just because that's such a major aspect of human evolution. This work is a nice example of selection pressure working to reduce brain size.

Reference

Sol, D., Garcia, N., Iwaniuk, A., Davis, K., Meade, A., Boyle, W., & Székely, T. (2010). Evolutionary Divergence in Brain Size between Migratory and Resident Birds PLoS ONE, 5 (3) DOI: 10.1371/journal.pone.0009617

Picture from user philip.bitnar on Flickr. Used under a Creative Commons license.... Read more »

Sol, D., Garcia, N., Iwaniuk, A., Davis, K., Meade, A., Boyle, W., & Székely, T. (2010) Evolutionary Divergence in Brain Size between Migratory and Resident Birds. PLoS ONE, 5(3). DOI: 10.1371/journal.pone.0009617  

  • March 18, 2010
  • 07:26 AM
  • 20 views

A heads-up about head-up displays

by Daniel Simons in The Invisible Gorilla

A new GM design that effectively turns the windshield of your car into a monitor, augmenting reality and aiding driving in poor conditions. But that can cause problems too.... Read more »

Wickens C.D., & Alexander, A. L. (2009) Attentional tunneling and task management in synthetic vision displays. International Journal of Aviation Psychology, 182-199. info:/

  • March 18, 2010
  • 06:14 AM
  • 17 views

Measles week, part IV: Some of the answers

by iayork in Mystery Rays from Outer Space







Various workers affected by measles punish a god of measles, while a doctor and drugstore keeper try to protect the god from them. (1862



Well, here we are already at Part IV of Measles Week.  Doesn’t time fly? Remember how young we all were, back at Part I, when I raised the question I’m trying [...]... Read more »

  • March 18, 2010
  • 03:43 AM
  • 34 views

rethinking quantum states and computers

by Greg Fish in weird things

By now, it’s well known that atoms and molecules can be in more than one state at the same time and do very odd things depending on their quantum states. However, somewhere along the line, this odd behavior has to stop, otherwise our world would be a very strange one. Objects would change temperatures and [...]... Read more »

O’Connell, A., Hofheinz, M., Ansmann, M., Bialczak, R., Lenander, M., Lucero, E., Neeley, M., Sank, D., Wang, H., Weides, M.... (2010) Quantum ground state and single-phonon control of a mechanical resonator. Nature. DOI: 10.1038/nature08967  

  • March 18, 2010
  • 12:19 AM
  • 16 views

Palliative Care in Cancer Centers - Horses of many different colors

by Christian Sinclair, MD in Pallimed: a Hospice & Palliative Medicine Blog

The third Palliative Care related article released for St. Patrick's (Palladius) day is a article that speaks to what many of us in the field know already:

Palliative Care is a chameleon: it looks different depending on the background of the institution.
But as the editor-in-chief of the Lancet has said: "It is not true, until it is published." Well JAMA has published a little bit of truth with the article: "Availability and Integration of Palliative Care at US Cancer Centers."  We have already known from CAPC data about a variability in access among states. This data helps underscore the variability in palliative care services, staffing, education and research at major cancer centers in the US.
I won't belabor the data here as it is relayed well in the abstract. But a few things impressed me about the study. It made a strong effort to differentiate between the simple question of 'Do you have a palliative care program?' which in a few institutions I have seen consists of a well stocked brochure rack and a single staff member (usually a nurse) who has 20 other job responsibilities that are prioritized by the administration above palliative care. Instead the authors focused on the structure, process and outcomes (also known as a Donabedian tripartite division, but of course you already knew that.)

Also a question to cancer center executive about barriers to palliative care seemed to be somewhat contradictory to other findings. Thee highest rated barriers (around 50-60%) were:
limited institutional budgets
poor reimbursement
limited trained palliative care staff
despite 89% of cancer centers surveyed claiming to have palliative care programs. And conversely very few center executives (less than 10%) reported the following as barriers:
limited palliative care needs
lack of evidence for palliative care
palliative care may increase mortality
palliative care may affect national rating
palliative care available but not utilized

So if I understand this right, 89% of cancer center executives have palliative care programs with staff who get paid from the budget but the around 60% feel the biggest barrier to getting palliative care access is that there is no budget/reimbursement or staff?

Couldn't be the culture of cure (see the media study), or the fact they are a tertiary referral center focused on the 'save'? Or the drive to get more patients enrolled in experimental drug trials which is a major source of funding/prestige? Or that palliative care may still not be well integrated into the culture?

I'm merely speculating here, but I think there is a juicy qualitative/anthropological study in this data.

One last thing...only 57% of NCI Cancer Centers had board certified palliative medicine physicians. And the data was collected in 2009. Come on people get board certified in hospice and pallaitive medicine this fall.

(Image from Funnycancershirts.com)

David Hui, MD, MSc, Ahmed Elsayem, MD, Maxine De La Cruz, MD, Ann Berger, MD, Donna S. Zhukovsky, MD, Shana Palla, MS, Avery Evans, Nada Fadul, MD J. Lynn Palmer, PhD; Eduardo Bruera, MD (2010). Availability and Integration of Palliative Care at US Cancer Centers JAMA, 303 (11), 1054-1061

... Read more »

David Hui, MD, MSc, Ahmed Elsayem, MD, Maxine De La Cruz, MD, Ann Berger, MD, Donna S. Zhukovsky, MD, Shana Palla, MS, Avery Evans, Nada Fadul, MD, & J. Lynn Palmer, PhD; Eduardo Bruera, MD. (2010) Availability and Integration of Palliative Care at US Cancer Centers. JAMA, 303(11), 1054-1061. info:/

  • March 17, 2010
  • 11:52 PM
  • 23 views

Cancer Reporting in the Media - Guess what they report on?

by Christian Sinclair, MD in Pallimed: a Hospice & Palliative Medicine Blog

Image via WikipediaSt. Patrick's day is good for celebrating your Irish heritage or fondness for food coloring, but it may have a new tradition, the release of major Palliative Care articles. Three major articles came out this week. Today JAMA published "Availability and Integration of Palliative Care at US Cancer Centers", yesterday the Archives of Internal Medicine released "Cancer and the Media: How Does the News Report on Treatment and Outcomes?" and on the 15th CMAJ released "Why do patients with cancer visit the emergency department near the end of life?"

(And all apparently with open access free pdf's!)

Today we are going to review all three (in separate posts JAMA review here, CMAJ review here)!

So why the St. Patrick's day logjam of articles? Some may say it is mere coincidence, but I think there may be some meta-meaning here. By the power of Grayskull Wikipedia I found that St. Patrick is very likely two different people, one of which is named Palladius...very similar to 'palliative'...which is why I am sure the editors of these three journals got together to plan this bounty of articles. (I guess the New England Journal of Medicine missed the conference call). We will see if next year the same thing happens. Enough conspiracy talk...

This study by Fischman, Have and Casarett shines a light on the bias present in the media towards the 'fight' against cancer. The researchers looked at 8 newspapers (Chicago Sun-Times, Chicago Tribune, Daily-Herald Chicago, New York Daily, New York Post, New York Times, Philadelphia Daily News , Philadelphia Inquirer) and 5 magazines (Newsweek, Parade, People, Redbook, Time). (What no Washington Post or Cosmo?)

The main points in the articles that were coded if they were mentioned were:
Survival
Mortality
Aggressive/curative
Treatment failures
Adverse events
Palliative focus

The researchers found a very significant bias towards reporting cures/survivors (32%) over deaths (8%) and sadly only 2% that mentioned both. Also they found that adverse events and treatment failures were rarely reported (both less than 30%).

And of course the result you have been waiting for, 11 articles out of 436 (3%) mentioned aggressive and pallaitive measures and only 2 (two, dos, deux, zwei!) of the articles focused exclusively on end of life care exclusively. Well the researches only searched from 2005-7 and so they missed the whole past year of New York Times articles we have been writing about. Still it is shocking in 'cancer focused' articles only 0.5% mention end-of-life care exclusively?!

Pallimed was initially focused on EBM style analysis of palliative care articles, but we have expanded our scope to report on palliative care in the media also, and this study justifies the importance of getting the story about good palliative care into the main media news cycles. It is not just enough that there are articles about cancer treatments (mainly read by cancer patients and their families) or articles about hospice or palliative care programs (read by hospice and palliative care staff and families with hospice experience.) We need articles that combine the two so people are equally exposed to the balance of treatments that exist out there. Few patients or families facing cancer diagnoses will choose to read the 'hospice is valuable' headline when juxtaposed with a 'new cancer treatment' headline.

But it is important to understand the view of the journalist and editors as well. 'New cancer treatment' headlines may sell more copies than 'hospice is valuable' headlines. Also a new treatment being available is news because it is new, different, interesting. Having articles about how people have poor survival with a cancer diagnosis is not new, different or interesting. Palliative care and hospice organizations need to make sure the journalists and editors hear the great stories we see every day in our work. The human interest perspective is very powerful. Some hospices are better at connecting with the media than others. Maybe it was time we all had a lesson in how to best interact professionally with the media.

For reference I have uploaded a slidedeck I gave at the NHPCO conference in 2007 titled: Working With the Media: How to Reach the Widest Audience Possible. It is embedded below.

View more presentations from Christian Sinclair, MD.If you know of any other good media resources for medical professionals please comment below.  Hospice Foundation of America also posted about this today.

Fishman, J., Ten Have, T., & Casarett, D. (2010). Cancer and the Media: How Does the News Report on Treatment and Outcomes? Archives of Internal Medicine, 170 (6), 515-518 DOI: 10.1001/archinternmed.2010.11


... Read more »

  • March 17, 2010
  • 09:42 PM
  • 29 views

Genetics of Alcoholism

by Allison in Dormivigilia

A recent paper in PNAS identified many single-nucleotide polymorphisms and environmental factors, such multiple drug abuse, tied to alcoholism... Read more »

Bierut LJ, Agrawal A, Bucholz KK, Doheny KF, Laurie C, Pugh E, Fisher S, Fox L, Howells W, Bertelsen S.... (2010) A genome-wide association study of alcohol dependence. Proceedings of the National Academy of Sciences of the United States of America. PMID: 20202923  

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