Things tagged health:

The big sleep

Julia Medew in The Age:

The two scientists relished life. They skied, went bushwalking and climbed mountains, often taking their three young daughters with them. Their cultural and intellectual pursuits were many - classical music, opera, literature, wine, arguments over dinner with their many friends. They donated 10 per cent of their annual income to political and environmental movements. Family events were spent thoroughly debating the topics of the day.

As their capacity declined, the conversation about ending their own lives became more serious and their rejection of what Peter called “religious do-gooders” became more fierce.

“It was also a way into their favourite topics; philosophy, ethics, politics, the law …,” says their youngest daughter, Kate. “The idea that their end-of-life decisions could be interfered with by people with the superstitions of medieval inquisitors astounded them, and alarmed them.”

Via Next Draft



What the Dust in Your House Says About You

Emily Anthes in The New Yorker:

Each bit of dust is a microhistory of your life,” Rob Dunn, a biologist at North Carolina State University, told me recently. For the past four years, Dunn and two of his colleagues—Noah Fierer, a microbial ecologist at the University of Colorado Boulder, and Holly Menninger, the director of public science at N.C. State—have been deciphering these histories, investigating the microorganisms in our dust and how their lives are intertwined with our own.

Most of our microscopic roommates are unlikely to present a real threat; many species of bacteria, scientists now know, are crucial partners in maintaining our health. “We’re surrounded by microbes all the time, and that’s not a bad thing,” Fierer said. In the next phase of their research, he and Dunn hope to identify connections between a home’s microscopic inhabitants and the health of its human ones. And there are likely to be more findings lurking in the dust that the volunteers already collected. How does the use of antimicrobial cleaning products alter a home’s profile? Is there a link between our genomes and the species that occupy our homes? There’s far more data than the scientists can analyze themselves, so they have posted it all online; members of the public can download the complete data set and hunt for new correlations and patterns.



What Are a Hospital’s Costs? Utah System Is Trying to Learn

Gina Kolata in the NYT:

Only in the world of medicine would Dr. Vivian Lee’s question have seemed radical. She wanted to know: What do the goods and services provided by the hospital system where she is chief executive actually cost?

Most businesses know the cost of everything that goes into producing what they sell — essential information for setting prices. Medicine is different. Hospitals know what they are paid by insurers, but it bears little relationship to their costs.

No one on Dr. Lee’s staff at the University of Utah Health Care could say what a minute in an M.R.I. machine or an hour in the operating room actually costs. They chuckled when she asked.



Doubts Raised About Breast Cancer Treatments for Early Stage Condition

Gina Kolata in the NYT:

As many as 60,000 American women each year are told they have a very early stage of breast cancer — Stage 0, as it is commonly known — a possible precursor to what could be a deadly tumor. And almost every one of the women has either a lumpectomy or a mastectomy, and often a double mastectomy, removing a healthy breast as well.

Yet it now appears that treatment may make no difference in their outcomes. Patients with this condition had close to the same likelihood of dying of breast cancer as women in the general population.



The Work We Do While We Sleep

For a long time, sleep’s apparent uselessness amused even the scientists who studied it. The Harvard sleep researcher Robert Stickgold has recalled his former collaborator J. Allan Hobson joking that the only known function of sleep was to cure sleepiness. In a 2006 review of the explanations researchers had proposed for sleep, Marcos Frank, a neuroscientist then working at the University of Pennsylvania (he is now at WSU Spokane) concluded that the evidence for sleep’s putative effects on cognition was “weak or equivocal.”

But in the past decade, and even the past year, the mystery has seemed to be abating. In a series of conversations with sleep scientists this May, I was offered a glimpse of converging lines of inquiry that are shedding light on why such a significant part of our lives is spent lying inert, with our eyes closed, not doing anything that seems particularly meaningful or relevant to, well, anything.



Can we reverse the ageing process by putting young blood into older people?

Ian Sample at The Guardian:

A series of experiments has produced incredible results by giving young blood to old mice. Now the findings are being tested on humans.



Could regularly eating spicy foods help you live longer?

Ariana Eunjung Cha in The WaPo:

Scientists seeking to better understand the alluring properties of hot foods have found evidence that we may be so drawn to them because they are good for us. While the research is still preliminary, it suggests spicy food may have all kinds of health benefits ranging from boosting metabolism and preventing gastric damage to reducing the risk of heart disease and cancer.

The newest study, published this week in The BMJ, finds a link between regular consumption of spicy foods and a lower risk of death.



How America Overdosed on Drug Courts

Maia Szalavitz in Pacific Standard:

Hailed as the most compassionate way for the criminal justice system to deal with addicts, drug courts were designed to balance punishment with rehabilitation. But after 25 years, the verdict is in: Drug courts embolden judges to practice medicine without a license—and they put lives in danger.



The case for drinking whole milk

Deena Shanker in Quartz:

For all the debate surrounding the latest recommendations from the committee that proposed federal dietary guidelines, the group’s endorsement of low-fat and fat-free milk over whole has garnered little attention. This suggests that while many of us scoff at the misguided anti-fat crusades of recent years (nuts to you, 1980s!) whole milk remains an unpopular outlier. And that’s just ridiculous.

Surprise! Dairy fat actually helps avoid obesity Though it would seem to follow that consuming less fat would lead to being less fat, that’s not quite what the science says, at least when it comes to dairy—even if whole milk is more caloric than skim.



The Irrationality of Alcoholics Anonymous

Gabrielle Glaser in The Atlantic:

The 12 steps are so deeply ingrained in the United States that many people, including doctors and therapists, believe attending meetings, earning one’s sobriety chips, and never taking another sip of alcohol is the only way to get better. Hospitals, outpatient clinics, and rehab centers use the 12 steps as the basis for treatment. But although few people seem to realize it, there are alternatives, including prescription drugs and therapies that aim to help patients learn to drink in moderation. Unlike Alcoholics Anonymous, these methods are based on modern science and have been proved, in randomized, controlled studies, to work.



Diets do not work: The thin evidence that losing weight makes you healthier.

Harriet Brown in Slate:

If you’re one of the 45 million Americans who plan to go on a diet this year, I’ve got one word of advice for you: Don’t. You’ll likely lose weight in the short term, but your chance of keeping if off for five years or more is about the same as your chance of surviving metastatic lung cancer: 5 percent. And when you do gain back the weight, everyone will blame you. Including you.



Why Is This Rogue Needle Exchange Handing Out Meth Pipes?

Brendan Kiley in The Stranger:

As Allan Clear, executive director of the Harm Reduction Coalition in New York City, puts it, “If you want to engage with drug users and build their trust, you have to provide something meaningful to them. A stem or a pipe helps build that relationship… it makes it more likely that they’ll return for advice or medical care if you have provided them with something useful in your first interaction—something you didn’t have to give them.”



The Problem With ‘Fat Talk’

Renee Engeln in The New York Times:

Conversational shaming of the body has become practically a ritual of womanhood (though men also engage in it). In a survey that a colleague and I reported in 2011 in the Psychology of Women Quarterly, we found that more than 90 percent of college women reported engaging in fat talk — despite the fact that only 9 percent were actually overweight. In another survey, which we published in December in the Journal of Health Psychology, we canvassed thousands of women ranging in age from 16 to 70. Contrary to the stereotype of fat talk as a young woman’s practice, we found that fat talk was common across all ages and all body sizes.



R U There?

Alice Gregory in The New Yorker

In 2011, a young woman named Stephanie Shih was working in New York City at DoSomething.org, a nonprofit that helps young people start volunteer campaigns. Shih was responsible for sending out text messages to teen-agers across the country, alerting them to various altruistic opportunities and encouraging them to become involved in their local communities: running food drives, organizing support groups, getting their cafeterias to recycle more. Silly, prankish responses were not uncommon, but neither were messages of enthusiasm and thanks. Then, in August, after six months on the job, Shih received a message that left her close to tears for the rest of the day. “He won’t stop raping me,” it said. “He told me not to tell anyone.” A few hours later, another message came: “R u there?”



This Top-Secret Food Will Change the Way You Eat

Despite the linkbait headline, this is a decent article anyway:

Rowan Jacobsen in Outside:

Brown’s aha moment came in 2009, when the Worldwatch Institute published “Livestock and Climate Change,” which carefully assessed the full contribution to greenhouse-gas emissions (GHGs) of the world’s cattle, buffalo, sheep, goats, camels, horses, pigs, and poultry. An earlier report by the United Nations Food and Agriculture Organization had pegged that contribution at 18 percent, worse than cars and trucks. That’s shocking enough, but the Worldwatch study’s authors, two analysts from the World Bank, found that the FAO hadn’t taken into account the CO2 breathed out by our 22 billion livestock animals, the forests being felled to make room for pasture and feed crops, or the total impact of the 103 million tons of methane belched into the air by ruminants each year. When everything was tallied up, Worldwatch estimated, livestock were on the hook for 51 percent of GHGs.

That was all Brown needed to hear to put the plant-based McDonald’s back at the top of his agenda. Forget fuel cells. Forget Priuses. If he could topple Meatworld, he thought, he could stop climate change cold.



A new test measures analytical thinking linked to depression, fueling the idea that depression may be a form of adaptation

“Depression has long been seen as nothing but a problem,” says Paul Andrews, an assistant professor of Psychology, Neuroscience & Behaviour at McMaster. “We are asking whether it may actually be a natural adaptation that the brain uses to tackle certain problems. We are seeing more evidence that depression can be a necessary and beneficial adaptation to dealing with major, complex issues that defy easy understanding.”



The Dreadful Inconvenience of Salad

Olga Khazan in The Alantic:

At a drab community center on Chicago’s West side, there’s a room where families sit around idly. Unemployment is high here, and so is crime: Last month, East Garfield Park was ranked the seventh most violent out of 77 Chicago neighborhoods. The center offers everything from domestic-violence help, to financial assistance, to warmth during the long winter.

It also offers salads, which visitors can purchase from a futuristic-looking vending machine. The salads are made from high-end ingredients like blueberries, kale, fennel, and pineapple. Each one comes out in a plastic mason jar, its elements all glistening in neat layers, the way fossils might look if the Earth had been created by meticulous vegans.


She finally gets there: “It’s not the money, it’s the time.” I’m sick of rich people wondering why poor people eat shit food. Duh.



What if Age Is Nothing but a Mind-Set?

Bruce Grierson in the NYT Magazine:

One day in the fall of 1981, eight men in their 70s stepped out of a van in front of a converted monastery in New Hampshire. They shuffled forward, a few of them arthritically stooped, a couple with canes. Then they passed through the door and entered a time warp. Perry Como crooned on a vintage radio. Ed Sullivan welcomed guests on a black-and-white TV. Everything inside — including the books on the shelves and the magazines lying around — were designed to conjure 1959. This was to be the men’s home for five days as they participated in a radical experiment, cooked up by a young psychologist named Ellen Langer.

The subjects were in good health, but aging had left its mark. “This was before 75 was the new 55,” says Langer, who is 67 and the longest-serving professor of psychology at Harvard. Before arriving, the men were assessed on such measures as dexterity, grip strength, flexibility, hearing and vision, memory and cognition — probably the closest things the gerontologists of the time could come to the testable biomarkers of age. Langer predicted the numbers would be quite different after five days, when the subjects emerged from what was to be a fairly intense psychological intervention.



Coverage for End-of-Life Talks Gaining Ground

Pam Belluck in the NYT:

“We think it’s really important to incentivize this kind of care,” said Dr. Barbara Levy, chairwoman of the A.M.A. committee that submits reimbursement recommendations to Medicare. “The idea is to make sure patients and their families understand the consequences, the pros and cons and options so they can make the best decision for them.”

Now, some doctors conduct such conversations for free or shoehorn them into other medical visits. Dr. Joseph Hinterberger, a family physician here in Dundee, wants to avoid situations in which he has had to decide for incapacitated patients who had no family or stated preferences.

Recently, he spent an unreimbursed hour with Mary Pat Pennell, a retired community college dean, walking through advance directive forms. Ms. Pennell, 80, who sold her blueberry farm and lives with a roommate and four cats, quickly said she would not want to be resuscitated if her heart or lungs stopped. But she took longer to weigh options if she was breathing but otherwise unresponsive.

“I’d like to be as comfortable as I can possibly be,” she said at first. “I don’t want to choke, and I don’t want to throw up.”

With reimbursement, “I’d do one of these a day,” said Dr. Hinterberger



What Should Medicine Do When It Can’t Save You?

There are two things I care passionately about, and believe american culture (western culture generally) have wrong; education, and death. Here is a great piece on the latter. This is not something we can fix through legislation. (see: Death councils). It will have to be a cultural shift.

Atul Gawande in The New Yorker:

A few days before Thanksgiving, she had another CT scan, which showed that the pemetrexed—her third drug regimen—wasn’t working, either. The lung cancer had spread: from the left chest to the right; to the liver; to the lining of her abdomen; and to her spine. Time was running out.

This is the moment in Sara’s story that poses a fundamental question for everyone living in the era of modern medicine: What do we want Sara and her doctors to do now? Or, to put it another way, if you were the one who had metastatic cancer—or, for that matter, a similarly advanced case of emphysema or congestive heart failure—what would you want your doctors to do?

The issue has become pressing, in recent years, for reasons of expense. The soaring cost of health care is the greatest threat to the country’s long-term solvency, and the terminally ill account for a lot of it. Twenty-five per cent of all Medicare spending is for the five per cent of patients who are in their final year of life, and most of that money goes for care in their last couple of months which is of little apparent benefit.

And the hour long documentry on Frontline is here. Trailer for that: