Later On

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Archive for the ‘Health’ Category

Sudden Shift at a Public Health Journal Leaves Scientists Feeling Censored

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Lisa Song reports in ProPublica:

For much of its 22-year existence, few outside the corner of science devoted to toxic chemicals paid much attention to the International Journal of Occupational and Environmental Health.

But now, a feud has erupted over the small academic publication, as its editorial board — the scientists who advise the journal’s direction and handle article submissions — has accused the journal’s new owner of suppressing a paper and promoting “corporate interests over independent science in the public interest.”

More is at stake than just the journal’s direction.

IJOEH is best known for exposing so-called “product defense science” — industry-linked studies that defend the safety of products made by their funders. At a time when the Trump administration is advancing policiesand nominees sympathetic to the chemical industry, the journal seems to be veering in the same direction.

“There are many scientists who work for corporations who are honest scientists,” said David Michaels, the former head of the federal Occupational Safety and Health Administration under President Obama. “What we’re concerned about here is the ‘mercenary science’ … that’s published purely to influence regulation or litigation, and doesn’t contribute to public health.”

“I think the IJOEH articles were threatening to that whole industry,” said Michaels, now an environmental and occupational health professor at George Washington University. While Michaels has never served on the journal’s editorial board, he has published an article in the journal and peer-reviewed others.

The journal was one of the relatively few places that provided an outlet for “scientists whose work is independent of the corporations that manufacture chemicals,” he said. “The silencing of that voice would be a real loss to the field.”

Last Thursday, the journal’s 22-member editorial board, along with eight former board members and the journal’s founding editor-in-chief, wrote a letter to the National Library of Medicine requesting disciplinary action against the academic journal’s new publisher, Taylor & Francis Group. In particular, they asked the Library of Medicine to rescind the journal’s listing in the Medline index, which could drastically reduce its scientific influence.

Academic journals are often judged by the reputations of those on their editorial boards, and this list includes a Columbia University dean, the president of the International Commission on Occupational Health and a scientist who helped establish the cancer classification system used by the International Agency for Research on Cancer.

UK-based Taylor & Francis, one of the largest publishers of academic journals, acquired IJOEH and 169 other journals in 2015 by purchasing the journal’s original owner and publisher, Maney Publishing. According to the board’s letter, Taylor & Francis has done the following since taking over:

  • Selected a new editor-in-chief, Andrew Maier, without consulting the editorial board. Board members said it’s “highly unlikely” that they would have approved of Maier. Their letter said he had a tendency to reach scientific conclusions “highly sympathetic to parties with an economic interest in favorable outcomes,” which is at odds with the journal’s mission.
  • Withdrew a peer-reviewed article by the journal’s former editor-in-chief David Egilman that criticized Union Carbide Corporation’s efforts to oppose workers’ claims of asbestos exposure. “Suppression of an accepted paper is a direct assault on academic freedom,” the board members wrote to the Library of Medicine.
  • Flagged three additional studies approved for publication under Egilman as “raising potential concerns,” according to a May 8 email the publisher sent to the board.

A Library of Medicine representative said they’re reviewing the board’s appeal.

Officials at Taylor & Francis declined to speak with ProPublica about the accusations in the letter and did not answer most of the questions we submitted in writing, referring us instead to two emails the publisher sent to the board in May.

In one, Ian Bannerman, manager director of Taylor & Francis Journals, insisted the company had no obligation to consult the board in choosing the journal’s new editor. “The responsibility for selecting and appointing an Editor-in-Chief lies with Taylor & Francis as the owner of the journal,” he wrote.

In the other, Bannerman responded to a question from the board about the publisher’s plans for “repositioning” the journal by saying Taylor & Francis would aim to boost its online readership, citation levels and “rapidity of publication.”

“We do not see this as ‘repositioning’ the journal as such,” Bannerman wrote, “but we do see it as a change of tack — putting in place long-term plans and goals for the journal’s future development, enhanced by our expertise in marketing, online publishing, and bibliometric analysis.”

A Struggling Endeavor

Joseph LaDou, the founding editor-in-chief of IJOEH, launched the journal in 1995 after years of struggling to publish his own research. While studying the health hazards of workers making microelectronics for Silicon Valley in the 1980s, he couldn’t find a single U.S. journal to take his paper, he said, and ended up publishing in a Scandinavian public health journal. So when a Philadelphia-based publisher offered him a chance to start a journal for similar types of studies, he jumped on board. . .

Continue reading.

Written by LeisureGuy

20 November 2017 at 1:54 pm

She Took On Colombia’s Soda Industry. Then She Was Silenced.

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Andrew Jacobs and Matt Richtel report in the NY Times:

It began with menacing phone calls, strange malfunctions of the office computers, and men in parked cars photographing the entrance to the small consumer advocacy group’s offices.

Then at dusk one day last December, Dr. Esperanza Cerón, the head of the organization, said she noticed two strange men on motorcycles trailing her Chevy sedan as she headed home from work. She tried to lose them in Bogotá’s rush-hour traffic, but they edged up to her car and pounded on the windows.

“If you don’t keep your mouth shut,” one man shouted, she recalled in a recent interview, “you know what the consequences will be.”

The episode, which Dr. Cerón reported to federal investigators, was reminiscent of the intimidation often used against those who challenged the drug cartels that once dominated Colombia. But the narcotics trade was not the target of Dr. Cerón and her colleagues. Their work had upset a different multibillion-dollar industry: the makers of soda and other sugar-sweetened beverages.

Their organization, Educar Consumidores, was the most visible proponent of a proposed 20 percent tax on sugary drinks that was heading for a vote that month in Colombia’s Legislature. The group had raised money, rallied allies to the cause and produced a provocative television ad that warned consumers how sugar-laden beverages can lead to obesity and diet-related illnesses like diabetes.

The backlash was fierce. A Colombian government agency, responding to a complaint by the nation’s leading soda company that called the ad misleading, ordered it off the air. Then the agency went further: It prohibited Dr. Cerón and her colleagues from publicly discussing the health risks of sugar, under penalty of a $250,000 fine.

The battle over taxing sugar-sweetened beverages is becoming one of the world’s most ferocious policy brawls — a clash of science, politics and money in dozens of countries and cities.

“The industry sees sugary-drink taxes as an existential threat,” said Dr. James Krieger, executive director of Healthy Food America, which tracks beverage tax initiatives. In the United States, the industry has spent at least $107 million at the state and local levels since 2009 to beat back soda taxes and beverage warning labels, a new study found. Compared to the domestic tactics, Dr. Krieger said, overseas, “it’s much dirtier, much more bare-knuckled.”

The harassment of Dr. Cerón and her colleagues was never proven to be carried out by the industry, and federal prosecutors declined to investigate. In response to questions from The New York Times, Coke and Pepsi said they were not involved, and Postobón, the soda company that filed the complaint about the organization’s ad, deferred comment to The National Business Association of Colombia. The association, which represented national and international beverage makers on the soda tax issue, said it had nothing to do with the episodes.

The International Council of Beverages Associations, the parent organization of trade groups around the world fighting the taxes, would not directly answer the question about whether its allies in Colombia were connected to the alleged harassment, but it condemned such actions.

“We reject under any circumstance the improper influence or harassment of any individual or organization for any purpose, at any time, in any way,” Katherine W. Loatman, executive director of the organization, said in a statement.

The experience in Colombia may be the most extreme, but a juggernaut of industry opposition has killed or stalled soda tax proposals around the globe, including in Russia, Germany, Israel and New Zealand.

Nevertheless, the idea is gaining momentum; such levies have been enacted in 30 countries, including India, Saudi Arabia, South Africa, Thailand, Britain and Brunei. More than a billion people now live in places where such taxes have driven up the price of sugar-sweetened beverages.

The battles have been particularly intense in emerging markets as the industry seeks to make up for falling soda consumption in wealthier nations. . .

Continue reading.

Written by LeisureGuy

14 November 2017 at 1:15 pm

The Grim Food Served on 17th-Century Sea Voyages Wasn’t All Bad

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I found this of interest, although the voyages recounted in Patrick O’Brien’s wondeful series of British Naval novels with Jack Aubrey and Stephen Maturin are late 18th century. Still the Naval food stores seems not to have changed all that much at that point.

Paula Meija writes in Gastro Obscura:

Sailors in the 17th century had it rough. For months, they were away at sea, sustaining themselves on an unsteady diet that included brined beef, dirty water, and tough crackers known as ship biscuit. In the days before pasteurization, seasickness likely came more often from the food than the waves.

A handful of cookbooks and ship journals detail the odious smells and tastes of 17th-century ship fare. But we can only imagine the decomposing food and its effect on the health of sailors.

Until now, that is. These questions led Grace Tsai, a PhD student specializing in nautical archaeology, to recreate ship food aboard an old-timey vessel. She and her fellow researchers at Texas A&M University have spent over three years on what they dubbed the Ship Biscuit & Salted Beef Research Project. They’re now analyzing beef as gnarly as what sailors ate, and are planning to give the rest of us a taste of a sailor’s life.

In August, the team mounted their barrels of ship food, which included salted beef, ship biscuits, peas, and beer, aboard the Elissa in the port of Galveston, TexasTheir model was the English galleon the Warwick, a ship sunk by a hurricane in Bermuda’s Castle Harbor in 1619. A team of archaeologists began excavating the Warwick’s remains in 2010. Among the wreckage, they discovered glass shards containing beer and wine, as well as cow bones. So Tsai packed for Bermuda.

“There are just a handful of ships where you can find remains like this,” Tsai says. “We have a good archaeological record of the bones that are on board.” Studying those (mostly beef) bones gave Tsai a sense of the cuts of meat sailors brought—knowledge she used to butcher beef for the Elissa. Working from an additional year of archival research, she and her team slaughtered and butchered a hog and steer, then made salted food according to a 1682 recipe. Each food and drink put onboard was the product of a similar process, and the plan was to let everything sit for two months. . .

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At the link there are interesting photos along with more text.

Written by LeisureGuy

14 November 2017 at 11:33 am

The backstory of environmental lead abatement (the biggest factor in the declining crime rate)

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Kevin Drum has a very interesting post on the reasons for the phase-out of leaded gasoline, the greatest contributor to environmental lead:

As you all know, I’m smitten by all things lead related. A couple of days ago I came across an interesting little historical anecdote that I’m going to tell you now.

When I was writing my big lead-crime piece several years ago, one of the things I was curious about was why the EPA decided to phase out leaded gasoline starting in 1975. Unfortunately, there aren’t very many people around today who were personally involved in this stuff 40 years ago, and I ended up getting several conflicting answers that I couldn’t really reconcile. Since it wasn’t central to my story anyway, I gave up and skipped the whole thing.

Then, last week, reader David P. pointed me to a column by Barry Nussbaum, chief statistician at the EPA for over a decade and currently president of the American Statistical Association. As soon as I read it I called Nussbaum, who was a young EPA analyst in the late 70s when he—well, we’ll get to that. First, though, the answer to my question.

According to Nussbaum, EPA wanted places like California to reduce smog, and that meant cars would have to be fitted with catalytic converters. However, since gasoline lead ruins catalytic converters, refineries needed to produced unleaded gasoline. This was the initial impetus behind unleaded gasoline. The fact that it also reduced atmospheric lead was basically a happy accident.

Once that was done, however, EPA started looking more closely at the health effects of lead. It was no secret that high levels of lead poisoning were dangerous, but new research was showing that even moderate levels could be dangerous, especially in young children. So now EPA had two reasons to phase out leaded gasoline.

As it happens, they were doing this on two tracks. One track was unleaded gasoline. The other was a phasedown of the amount of lead in leaded gasoline: from 1.7 grams per gallon in 1975 to 1.2 in 1976, 0.9 in 1977, and 0.6 in 1978. But there was a problem with this: reducing the amount of lead also reduced the amount of gasoline you could refine from each barrel of crude oil. The difference wasn’t huge, but after the oil embargo of 1973 it was enough to raise policy questions. Thanks to all this, in 1979 Jimmy Carter was considering whether to halt the EPA phasedown of lead in gasoline.

By coincidence, at the same time HUD was trying to get more funding for its program to remove lead paint from old housing stock. As part of this effort, EPA looked at the incidence of high blood lead levels in children, and Nussbaum produced the following chart:

There are three things to notice about this chart:

  • It shows that blood lead levels spike every year in the summer.
  • It shows that lead levels in children appear to be correlated with gasoline lead emitted into the atmosphere.
  • It shows that black and Hispanic children had really high levels of lead poisoning.¹

The first item—unfortunately for HUD—suggested that lead poisoning was not correlated with lead paint in housing. After all, there’s no reason to think that kids are exposed to more lead paint in the summer. The second item suggests that lead poisoning is correlated with gasoline lead.² And the third item immediately convinced Carter to continue the lead phasedown. “He stated he did not want any policy that might have a particularly deleterious effect on these two groups,” Nussbaum says.

On a statistical note, Nussbaum adds this:  . . .

Continue reading.

Jimmy Carter is a good man.

Written by LeisureGuy

10 November 2017 at 9:46 am

A behind-the-scenes look at Scott Pruitt’s dysfunctional EPA

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Rachel Leven reports for the Center for Public Integrity:

Environmental Protection Agency Administrator Scott Pruitt doesn’t hide his contempt for how the agency has been run, but does profess to care about one of its key programs: Superfund, which oversees the cleanup of the nation’s worst toxic-waste sites. In April, he toured a site in East Chicago, Indiana, contaminated with lead and arsenic, and told residents, “We are going to get this right.”

The following month, Pruitt — Oklahoma’s attorney general before he joined the EPA — tapped one of his former donors, banker Albert “Kell” Kelly, to find ways to accelerate and improve Superfund cleanups. Kelly started by consulting career staff members — often-knowledgeable officials who work at the agency regardless of who holds the White House. But then Kelly closed off the process, conferring with Pruitt to produce a final plan that altered or excluded many of the staffers’ suggestions. Gone, for example, was the idea that EPA officials be identified early on to lead discussions with communities on how contaminated land should be used after cleanup.

“We’re missing a huge opportunity to do something new and different with Superfund,” said one of two EPA employees who described the process to the Center for Public Integrity on the condition of anonymity.

What happened with Superfund is hardly an anomaly. Today’s EPA is wracked with internal conflict and industry influence, and is struggling to fulfill its mission, according to more than two dozen current and former agency employees. A few dozen political appointees brought in under the Trump administration are driving policy. At least 16 of the 45 appointees worked for industries such as oil, coal and chemicals. Four of these people — and another 21 — worked for, or donated to, politicians who have questioned established climate science, such as Pruitt and Sen. James Inhofe, R-Okla.

Career staff members — lawyers, scientists, analysts — are largely being frozen out of decision-making, current and former agency employees say. These staffers rarely get face time with Pruitt and frequently receive top-down orders from political appointees with little room for debate. They must sometimes force their way into conversations about subjects in which they have expertise.

And that is a big mistake, said one of Pruitt’s predecessors.

Career employees are “very dedicated to protecting human health and the environment, and they will change their ways of how they do that if they’re convinced you really want to accomplish that aim,” said Christine Todd Whitman, EPA administrator under President George W. Bush.

One such employee agreed. “I think it’s the fact that we’re not following regular procedures, we’re not sure of what the legal justification is for some of the things they’re asking us to do. We’re just kind of being told ‘Do the opposite thing you did 18 months ago.’ That’s hard to swallow.”

The EPA staffers who spoke to the Center say the isolation of Pruitt’s top staff from the rest of the agency limits the perspectives the administrator is exposed to before making decisions. Two appointment calendars, covering a six-month period beginning in March, show that Pruitt hears overwhelmingly from industry. He was scheduled to meet 154 times during the period with officials from companies such as ExxonMobil and trade associations such as the American Petroleum Institute, the oil industry’s biggest lobby group. API was among at least 17 donors to Pruitt when he ran for state or federal office or led the Republican Attorneys General Association that have met with him as EPA administrator. Those same calendars indicate he saw only three groups representing environmental or public-health interests, though an EPA press release says he met with two others.

EPA spokeswoman Liz Bowman disputed claims that the roughly 15,000-person agency is riven with discord. . .

Continue reading.

Written by LeisureGuy

9 November 2017 at 9:16 am

Psychology’s power tools

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David A Sbarra, professor of psychology at University of Arizona and director of the Laboratory for Social Connectedness and Health, writes in Aeon:

A few years ago, I was attending a conference in Berlin in Germany, and I went out one evening to catch up with a friend I hadn’t seen in years. James lives in the United States and works in the field of psychology, but Berlin was the first time we’d been together in a good while. It was a beautiful evening and the city felt so alive, but James looked nervous. I knew he had something to tell me.

He started: ‘Brian is Briana.’

‘What?’

‘My son is my daughter. He is really a she.’

I didn’t need any more explanation to know what James was saying. His 18-year-old, formerly Brian, identified as a woman, and he was breaking the news to me.

‘Wow.’

‘I know. I know. He’s going to… I mean, she’s having sex-reassignment surgery in Singapore in December, and we’ve been doing hormone treatments for months. It’s been a wild ride.’

When James used the word ‘we’ to describe the hormone treatments, I knew everything would be OK. The ‘we’ in his sentence was a clue that that their family was not split apart by this news. Learning that your son is really your daughter is, for most people, life-changing news, and the few clients I had worked with in therapy around their gender identity were torn apart by how their families had responded.

James had learned so much in the past year about how to connect with his daughter as a trans-woman. Briana’s brother was turning his back on her, and James and his wife felt alone, as if they were walking on quicksand. Throughout the conversation, though, he kept saying: ‘It is what it is.’ James must have said the phrase 10 times, and it dawned on me that he was getting at something profound. With this aphorism, he could avoid getting sucked into potentially painful emotions and instead be present and available to help his daughter.

When I returned from Berlin, I was primed to hear the phrase everywhere I went. I am convinced I hear it at least once a day, and not only from my clients. I hear it from my wife, my friends, my colleagues, my students and, a few days ago, I heard it from the woman working the register at the gas station. I hear myself and others saying these words, but I hardly ever stop to reflect on their meaning. When it finally dawned on me to ask why everyone keeps using this phrase, the answer appeared quickly and with force: the phrase is a way to psychologically disarm powerful negative emotions. It’s an efficient means of distancing ourselves from difficult experiences, to create mental space and, potentially, to ignore – in a good way – percolating negative emotions. In short, this phrase represents what psychologists call an emotion-regulatory strategy.

Research in clinical psychology suggests that a key aspect of maintaining our emotional health is not deepening our connection to painful thoughts – that is, not getting ‘sucked into’ thoughts about inferiority, impossibility, or seeing the potential for bad outcomes around every corner. ‘It is what it is’ reflects the decision not to go down this road and, when we use it, we’re practising one of the best therapies around. Although there are many routes to emotional equanimity, it is the thoughts in our heads, and the words we choose to express them, that are the gatekeepers of our psychological wellbeing.

This notion is at the heart of cognitive behavioural therapy, or CBT, a proven collection of techniques that help us realign our thoughts so our emotions stay in balance and we successfully navigate life.

Imagine you’re strolling across a lovely college campus on your way to grab lunch with a friend. You’re stopped by two students.

‘Could you spare a minute? We’re running a research study on how people perceive the natural environment. Would you like to participate?’

‘Sure, why not?’

This is when things get a little weird. The researchers have you don a backpack that weighs about 20 per cent as much as you do. Then they ask you to estimate the slant of the hill in front of you from completely flat to a vertical cliff. Can you zip up this hill with your backpack on, or did this small hill just become Mount Everest in your mind? Although I’ve glamorised it a bit, this is a real research study. Developed by the psychologist Dennis Proffitt and his colleagues at the University of Virginia, the ‘hill slant’ study is well-known, and has garnered an impressive set of findings about visual perception. It makes sense that people perceive the hill to be steeper when they are wearing a heavy backpack, relative to when they’re not wearing one (That hill with this backpack? No way!), and that they perceive the hill to be steeper if they’re tired.

A more surprising finding emerged in 2008, when psychologist Simone Schnall, director of the Mind, Body, and Behaviour Laboratory at the University of Cambridge, found that people perceive hills to be less steep when they’re with other people or when they imagine a supportive significant other alongside them. Schnall reasoned that the availability of social resources might keep people from ‘being depleted’ when they donned the heavy backpack. It is hard to overstate the significance of these findings: social support alters how we perceive the demands of the physical world.

In fact, the hill-slant study illustrates one of the most important topics in contemporary psychological science: our evaluations of situations, events and people shape how we perceive, or appraise, the world around us. These psychological evaluations are often referred to as cognitive appraisals. When we’re with others we appraise the slant of the hill differently; we evaluate that mound of dirt as less foreboding.

How do you feel about work or school tomorrow? Smooth sailing or another headache? What about that weird look a colleague gave you this morning? Your kid is talking back and being a total pain. Why does it bother you so much after dinner compared with after breakfast?

These questions capture the essence of the calculus we engage in every second of the day. We’re constantly taking our own psychological temperature and evaluating whether we need to rest or spring into action. Our emotional lives hinge in large part on this appraisal process. Whether we feel happy, engaged and full of energy is derived from the belief that we are in harmony with the world around us.

We maintain this sense of harmony by viewing ourselves, others and the events around us in a relatively benign light: things are fine, we’re safe. When we perceive the slings and arrows of life as non-events – when we can say: ‘It is what it is’ – we can face difficult circumstances and effectively disarm potential emotional landmines.

When anxiety makes our thinking disordered, on the other hand, quite the opposite happens. Hills seem insurmountable, and the world becomes a scary and impossible place. As a brief example of appraisals gone awry, stop for a moment and think about what it would feel like to believe that you are absolutely worthless. You contribute nothing to this planet. Zilch! What if you were as certain of these thoughts as you were of the fact that you need light in order to read this article? Now you have an idea about what it’s like to be depressed.

Most of the time, however, these negative appraisals are distortions; they are misappraisals of the world around us based on automatic habits of thought that have rooted themselves deep inside our minds. CBT was designed to help people break these habits, to learn new ways to evaluate the reality of their appraisals and, in general, to think more flexibly about their lives.

Judith Guest’s novel Ordinary People (1976) is, arguably, one of the richest literary explorations of grief. Guest shows us how reactions to loss can insidiously gnaw at the foundation of our psychological health, and explores how the same events can impact people in different ways. In one of the book’s best exchanges, Conrad Jarrett talks with his psychiatrist, Tyrone Berger, about the massive emotional pain he has kept under wraps since the tragic death by drowning of his oldest brother and his own unsuccessful attempt at suicide. Conrad’s mother, Beth, meanwhile, shuts down completely and is totally disconnected from Conrad’s pain. His father, Cal, tries with all his might to protect his son from the throws of depression, and it’s clear that these efforts are in large part to protect himself from the pain of losing his elder son. The Jarretts were just ordinary people, just trying to make sense of their lives. When tragedy struck, they became ordinary people dealing with an extraordinary set of emotions that set them adrift.

Understanding and improving our mental health often hinges on demystifying emotional experience, and any therapist worth a dime should begin his or her treatments with a review of some basic lessons learned from the research on emotions. For starters, emotions are feelings – the conscious experience of pleasure or pain.We experience our emotions along a continuum from good to bad, at intensities from relatively neutral to downright explosive. Thus, we can sit happily on our couches or jump and scream for joy at our favourite sporting events.

Importantly, emotions communicate information, prepare us for action, and have incredible survival value. Without a signalling system to warn us about potential threats in the natural world – that is, without emotions to provide information – humans and other animals would be toast. Quite often, our emotions become disordered when they are out of proportion to the demands of a given situation. Just think of someone who has a panic attack at the idea of being at Costco on a Saturday; it can be overwhelming for anyone, but it is not an emergency that should elicit an immediate and overwhelming fear response. Given the importance of emotions to our survival and the myriad ways in which they can become disordered, the goal of most psychotherapies is to recalibrate our emotional response system.

Over the course of my career, I have worked with many clients who just wanted to figure out how to eliminate every single one of their emotional reactions. Doc, if you had a pill that would stop me from feeling, I’d take it in a heartbeat. There’s a simple and poignant response for such statements: if we eliminated the experience of physical pain, we’d burn our hands off on a hot stove by dinnertime. The same goes for our emotions. Our goal should never be to eliminate our emotions, but rather to regulate or coexist with them better.

Perhaps no psychologist has contributed more to the study of emotion-regulation than James Gross at Stanford University. In one of his earliest studies, Gross showed research participants three silent videos: one of an abstract shape like you might see on a computer screensaver, one of a burn victim receiving treatment, and one of a close-up amputation of an arm. At any point, participants were allowed to ask that a film be stopped. Gross then evaluated participants’ felt experiences and physiological and behavioural responses under one of three conditions: watching as usual; actively trying to suppress emerging emotions; or using techniques of cognitive reappraisal, in which they were asked to think about what they were seeing objectively and technically, and then reappraise the images in those terms.

The big finding from this study was that reappraisal lead to ‘decreases in both behavioural and subjective signs of emotion’, with no hint of elevations in physiological stress. A particularly interesting aspect of the findings was that seven of the participants in the ‘watch’ and ‘suppress’ groups asked for the upsetting films to be stopped, compared with none in the ‘reappraise’ group, suggesting that asking people to view upsetting material from a more detached perspective does indeed alter the nature of the emotional experience.

This fact is a foundational element of CBT: change how you view your circumstance, and you can change how you feel. Gross’s research provided empirical backbone for the link between our thoughts and our emotions. I have long felt this research captures the essence of what most cognitive behavioural therapists do on a daily basis: we help people come to view the hurdles of life less like perilous threats that will slowly eat them alive and more like challenges to be managed and overcome. . .

Continue reading.

The book Feeling Good: The New Mood Therapy, by David Burns, MD, is based on CBT findings.

Written by LeisureGuy

9 November 2017 at 8:32 am

Unlocking the Secrets of the Microbiome

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Jane Brody reports in the NY Times:

Modern technology is making it possible for medical scientists to analyze inhabitants of our innards that most people probably would rather not know about. But the resulting information could one day save your health or even your life.

I’m referring to the trillions of bacteria, viruses and fungi that inhabit virtually every body part, including those tissues once thought to be sterile. Together, they make up the human microbiome and represent what is perhaps the most promising yet challenging task of modern medicine: Determining the normal microscopic inhabitants of every organ and knowing how to restore the proper balance of organisms when it is disrupted.

Proof of principle, as scientists call it, has already been established for a sometimes devastating intestinal infection by the bacterium Clostridium difficile. This infection, popularly called C. diff, often occurs when potent antibiotics wipe out the normal bacterial inhabitants of the gut that otherwise keep it in check.

When all else fails to clear up a recurrent C. diff infection, the Food and Drug Administration has approved treatment with a fecal transplantfrom a healthy gut presumed to contain bacteria that can suppress C. diff activity. The treatment is highly effective, with a cure rate in excess of 90 percent.

Under the auspices of the National Institutes of Health, a large team of scientists is now engaged in creating a “normal” microbiological road map for the following tissues: gastrointestinal tract, oral cavity, skin, airways, urogenital tract, blood and eye. The effort, called the Human Microbiome Project, takes advantage of new technology that can rapidly analyze large samples of genetic material, making it possible to identify the organisms present in these tissues.

Depending on the body site, anywhere from 20 percent to 60 percent of the organisms that make up the microbiota cannot be cultured and identified with the older, traditional techniques used by microbiologists.

If the institutes’ five-year project succeeds in defining changes in the microbiome that are associated with disease, it has the potential to transform medicine, assuming ways can be found to correct microbial distortions in the affected tissues.

Here are some of the demonstration projects already underway:

Skin: Dr. Martin J. Blaser, microbiologist and director of the human microbiome program at New York University School of Medicine, is directing examination of the organisms on the skin of 75 people with and without psoriasis, checking whether agents used to treat the condition adversely alter the microbiome.

Vagina: Jacques Ravel at the University of Maryland School of Medicine and Larry J. Forney at the University of Idaho are studying 200 women to determine the microbial changes that may result in a common and difficult-to-control infection called bacterial vaginosis, which afflicts more than 20 million American women of childbearing age.

Blood: At Washington University in St. Louis, Dr. Gregory A. Storch, a specialist in pediatric infectious disease, and colleagues are examining the role of viruses and the immune system in the blood and respiratory and gastrointestinal tracts of children who develop serious fevers that result in some 20 million visits a year to hospital emergency rooms.

Gastrointestinal tract: Claire M. Fraser-Liggett, a microbiologist, and Dr. Alan R. Shuldiner, a geneticist, both at the University of Maryland School of Medicine, are exploring how the microbiome affects the body’s use of energy and the development of obesity.

Previous studies have already found differences in the gut microbiota of lean and obese adults. There is also evidence that the typical high-calorie American diet rich in sugar, meats and processed foods may adversely affect the balance of microbes in the gut and foster the extraction and absorption of excess calories from food.

A diet more heavily based on plants — that is, fruits and vegetables — may result in a microbiome containing a wider range of healthful organisms. In studies, mice that had a microbiota preconditioned by the typical American diet did not respond as healthfully to a plant-based diet.

Compared to lean mice, obese mice have a 50 percent reduction in organisms called Bacteroidetes and a proportional increase in Firmicutes, and lean mice get fat when given fecal transplants from obese mice. A similar shift has been observed in people, and the distorted ratio of organisms was shown to reverse in people who lose weight following bariatric surgery.

There is also evidence that microbes residing in the gut can affect distant sites through their influence on a person’s immune responses. This indirect action has been suggested as a possible mechanism behind rheumatoid arthritis. In mice, certain bacteria in the gut have been shown to foster production of antibodies that attack the joints, resulting in the joint destruction typical of rheumatoid arthritis.

Similarly, studies have suggested a role of the gut microbiota in the risk of developing neuropsychiatric illnesses like schizophrenia, obsessive-compulsive disorder, attention deficit hyperactivity disorder, autism and even chronic fatigue syndrome. Researchers have suggested that in genetically susceptible people, altered microbes in the gut may disrupt the blood-brain barrier, leading to the production of antibodies that adversely affect normal brain development.

Among the challenges in elucidating the microbiome’s role in health and disease is determining whether changes found in the microorganisms inhabiting various organs are a cause or an effect. . .

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Written by LeisureGuy

8 November 2017 at 10:06 am

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