How our sleep patterns change throughout our lives, and how to cope with the changes

And don't I know it. This article explains a lot:

Sleep Patterns Make Steep Changes During Your Life

[...] MIDLIFE SLEEP CRISIS

A lot of accomplished people claim not to need a lot of sleep. Household arts maven Martha Stewart purports to get only four hours a night. So does Tonight Show host Jay Leno. Napoleon, Winston Churchill, John F. Kennedy, Salvador Dali and Leonard da Vinci didn’t get much shut-eye either. So television journalist Pamela Wallin, who also averages only four hours a night, is in august company. “I’ve been an insomniac for as long as I can remember,” says Wallin, a Saskatchewan native who lives in Toronto. “I’ve tried herbal remedies and chamomile tea. I avoid prescription drugs because I can’t afford to lose my sharpness the next day.” Ultimately, Wallin regards her chronic insomnia as something she just has to live with. “If I needed more sleep,” she reasons, “I probably wouldn’t have gotten done what I have done in my life.”

Sixty-two per cent of Americans experience a sleep problem a few nights a week, according to a National Sleep Foundation study released last month. Two-thirds say sleepiness interferes with their concentration. “We should really get nine or 10 hours of sleep,” says psychologist Coren. “But we’re only getting seven. Sleep is not something we value.” Family stresses, the frenetic pace of life and poor bedtime habits all contribute to an epidemic of sleeplessness. Among modern complications: the wired world. “I know people who have a fax machine at the foot of their bed with a little bleeper so they can get up in the middle of the night to read their faxes,” says Coren. “The pressure to lead a 24-hour life is getting worse.”

At least many poor sleepers know they need help. About 2,000 people a year use the sleep clinic at UBC run by psychiatrist Jon Fleming. Thirty-five per cent of them complain of insomnia, a disorder that often runs in families. Others attend the clinic because of sleep apnea (troubled breathing) and narcolepsy (an overwhelming desire to sleep), among other sleep disorders. “The causes of insomnia are legion,” says Fleming. “It can be caused by psychiatric conditions or drug and alcohol abuse. But the leading cause is stress.” When Vancouver children’s bookstore owner Phyllis Simon can’t sleep, she gets out of bed for a while and writes a list of all the things she has to do. “I try to transfer my anxieties to the list. Then I’ll make myself a cup of warm milk.”

But waking up in the middle of the night and then going back to sleep – – as Simon sometimes does — can be harder on cognition than not sleeping at all, says University of Montreal psychiatrist Roger Godbout. “Your performance the next day will be worse than if you stay up all night,” he explains. While insomnia may lead to fuzzy thinking, those who short-circuit sleep by working long hours could also be compromising their physical health. Research at the University of Chicago shows adults who get fewer than seven hours of sleep are more prone to diabetes, high blood pressure and endocrine dysfunction.

Women also report more sleep problems than men — a consequence, often, of their biology. Just before menstruation, says Toronto Western Hospital sleep researcher Helen Driver, “there is a withdrawal of hormones that triggers poor sleep.” Entering menopause doesn’t make it better. Thirty-six per cent of menopausal women polled by the National Sleep Foundation said hot flashes interfered with their night’s rest. Sleep investigators are becoming more aware of the effects of the female hormones, estrogen and progesterone, says Driver. “Progesterone,” she says, “interacts with a receptor in the brain that seems to have sleep-inducing qualities.” [...]

I used the "Midlife Stage" as an excerpt for this blogpost, because that is about where I am at now. But the entire article starts with infancy, childhood, teen years, all the way through to old age. Something for everyone! Read the whole thing, for embedded links and advice for improving your sleep, whatever stage you may be in.
     

Pioneers of Hospice: Changing the Face of Dying

I saw this video recently. Here is the first 18 minutes on Youtube:



The full video runs about 50 minutes. It's very informative, well worth watching the whole thing. I've been looking for a copy, but the DVD seems to be out of print, with no indication of when it might become available again. Does anyone know? https://www.academicvideostore.com/video/pioneers-hospice offers it for $249.00, but that's way beyond my budget.

I'm surprised the video has not been re-released and made more readily available. IMO, Hospice is a much misunderstood concept. This video does a lot to clear up those misconceptions. I hope that whoever owns the copyright will release the video for publication again, or else release it into the public domain, where it could do a lot of good.
     

Death and dying in America

Seeking a ‘Beautiful Death’

[...] Dr. Volandes, a staff physician at Massachusetts General Hospital in Boston, noted that “in the abstract, fighting every second of the way and pursuing aggressive life-prolonging interventions sounds admirable.” But he wants doctors, patients and families to consider the likely outcome of the fight and how much suffering it will involve.

He recognizes that “there are no right and wrong decisions about medical care at the end of life” but insists that all decisions should be fully informed. To ensure that patients and families understand the options, he has developed a video tour of what medical interventions like ventilation, CPR or placement of a feeding tube look like, which often prompts a change of heart. As one patient put it, “It looks so different on television.”

The video, produced by ACP Decisions, a nonprofit group devoted to advanced-care planning, is licensed to health care providers and insurers who can show it to patients and families to facilitate shared decision making in planning for care at the end of life.

In a randomized trial of the video’s effectiveness among 50 patients with advanced brain cancer, a quarter of patients in the control group who had only a verbal discussion about end-of-life care with their doctors chose life-prolonging care, half opted for limited medical care and only one-quarter chose comfort care. But none of those who saw the video opted for life-prolonging care, a handful chose limited medical care, and 92 percent decided on comfort care, Dr. Volandes reported. After watching the video, patients said they had a better understanding of their choices.

However, even just a discussion with their doctors about goals for end-of-life care can often make a huge difference. The one-third of patients in a 2008 national Coping With Cancer study who had such a discussion were less likely to undergo CPR, be put on a ventilator or be placed in an intensive care unit. Most enrolled in hospice, suffered less and were in better physical shape and better able to interact with others and for a longer time.

Their survivors, too, fared better; six months after the deaths, they were markedly less likely to experience major depression.

Options regarding end-of-life care should be discussed well before an emergency — or for those with dementia, during the early stages of mental decline. “The absolute worst time to contemplate decisions about medical care is when one is critically ill and in the hospital,” Dr. Volandes writes.

The kinds of questions doctors should be asking:

[...]

They are some good questions. Read the whole thing for embedded links and more.

     

One Conservative's Understanding of the Real and Genuine Need for Medical Marijuana

My trip to the pot shop

PUEBLO WEST, Colo. — It’s 9 a.m. on a weekday, and I’m at the Marisol Therapeutics pot shop. This is serious business. Security is tight. ID checks are frequent. Merchandise is strictly regulated, labeled, wrapped and controlled. The store is clean, bright and safe. The staffers are courteous and professional. Customers of all ages are here.

There’s a middle-aged woman at the counter nearby who could be your school librarian. On the opposite end of the dispensary, a slender young soldier in a wheelchair with close-cropped hair, dressed in his fatigues, consults with a clerk. There’s a gregarious cowboy and an inquisitive pair of baby boomers looking at edibles. A dude in a hoodie walks in with his backpack.

And then there’s my husband and me. [...]

It's a very compelling story she tells. And as usual, Michelle Malkin has done her homework, like a real journalist should. Read the whole thing for the interesting story and the embedded links.
     

What happens when vaccinations stop?

The green is Whooping Cough, the red is Measls:



The toll of the anti-vaccination movement, in one devastating graphic

[...] A couple of manifestations stand out. One is the prevalence of measles in Europe -- especially Britain -- and the U.S. Measles is endemic in the underdeveloped world because of the unavailability of the MMR (measles, mumps and rubella) vaccine.

But in the developed world it's an artifact of the anti-vaccination movement, which has associated the vaccine with autism. That connection, promoted by the discredited British physician Andrew Wakefield and the starlet Jenny McCarthy, has been thoroughly debunked. But its effects live on, as the map shows.

Vaccine panic also plays a role in the shocking incidence in the U.S. of whooping cough, also beatable by a common vaccine. Researchers have pointed to the effect of "non-medical exemptions" from legally required whooping cough immunizations -- those premised on personal beliefs rather than medical reasons -- as a factor in a 2010 outbreak of whooping cough in California.

These manifestations underscore the folly and irresponsibility of giving credence to anti-vaccination fanatics, as Katie Couric did on her network daytime TV show in December. We examined the ethics of that ratings stunt here and here.

Among other worthwhile examinations of the impact of the anti-vaxxers, see this piece about growing up unvaccinated in Great Britain in the 1970s, and this disturbing piece by Julia Ioffe about her battle with whooping cough, a disease no American should have. [...]

The original article has embedded links.

Measles Outbreak Spreads from Coast to Coast

State health officials in New York recently reported 16 cases of Measles in northern Manhattan and the Bronx, and others say the Measles are becoming a coast-to-coast problem. The New York City outbreak consists of 7 adults and 9 children, and while 2 of the children were too young for the immunization, 2 others were children whose parents refused to get them their shots. Massachusetts, Rhode Island and Pennsylvania have also witnessed a Measles outbreak in recent weeks.

Measles is a contagious illness spread through respiration. Classic symptoms of Measles include fever, cough, runny eyes or nose, and a recognizable rash. Less severe side effects of Measles include diarrhea to more serious and life-altering ones such as pneumonia, brain damage, and corneal ulceration. Risk factors for Measles are malnutrition, immun0deficiency, pregnancy and Vitamin A deficiency. In developed countries such as the U.S., children are immunized against Measles by the age of 18 months. Un-vaccinated individuals are at risk of contracting Measles. [...]

But what about the nine adults? Had they been vaccinated, and got it anyway? I got measles when I was 15, even though I had a vaccination when I was younger. I don't think it always works.
     

Nattokinase: a replacement for Warfrin?

I've been looking at Nattokinase as a supplement for my mother, who is suffering from a calcified heart valve, due to (I believe) her long term use of Warfrin. Warfrin is known to be a vitamin k antagonist. But without vitamin k (vitamin k2 specifically), the body can't regulate calcium properly, and it goes into the arteries instead of into the bones.

Nattokinase is known to prevent and even reverse atherosclerosis. Pure Natto is a source of vitamin k2. But even though the product description says that it contains pure nattokinase enzyme with all vitamin k removed, there are warnings to not take it if you are taking Warfarin (Coumadin), or to consult your doctor first if you are taking Warfarin. And from what I've read on the customer comments on Amazon, it seems that people use it to replace Warfarin:

Great results so far!

My husband has a blood clotting disorder and was placed on Coumadin for life. He wasn't doing well on Coumadin. There was so many nasty side effects so we looked for an alternative to Coumadin. This supplement was recommended to us 10 months ago. He is doing so much better since taking Nattokinase. He is off of Coumadin (without his Dr's blessing), it has brought his cholesterol down, brought his blood pressure down (along with vitamin C), and improved his cataracts. He just had an eye exam and his eye glasses prescription was the same as two and a half years ago. That has NEVER happened. His eyes have always gotten worse for every exam. His Dr wasn't happy with him when he got off of Coumadin, but he is happy with the results and can't believe hubby is off of cholesterol and high blood pressure meds. He has never see that happen in his patients. We are excited to see other benefits pop up in the future.

In the threads attached to that post, people ask for an update, and the author, Jennifer, replies one year later:

Hubby is still doing well on Natto. He also takes Vitamin E, Cod Liver Oil, and Ginko Biloba in order to get the thinnest blood that he can. His blood clotting disorder is serious, though.

Another person, Mary Turner, posts this under Jennifer's original post:

The first time I took Cumadin, my legs felt like they were on fire. I had to go every thursday to the clinic as you have to be monitored when taking cumadin which is really a low dose of rat poison (for real). They can never get it right. It's take one pill, take one and a half, go back to one pill and so on. I told my doctor, "I cannot keep taking this stuff. " He replied, "I don't know what else to tell you to take." I said, "yes you do but your hands are tied by the FDA."

I had already read about Natto and had been reading about natural cures for over 12 years. So I ordered Natto and stopped taking Cumadin. The Natto arrived the same day my brother passed away. I was off work for a week taking care of funeral arrangements but took the Natto everyday. The following Thursday, I went back to the clinic to give them a blood sample and went to work. They called my job to give me the results as usual.

The nurse was so excited and said to me, "your blood plattelets are perfect; how much Cumadin shall I tell the doctor you took?" I said, "tell the doctor I did not take any of that rat poison." She even got more excited and wanted me to tell her what I took to get these results. She looked it up on line as I spelled it out for her and gave me a big thank you as she wanted it for herself.

Now I had not spoke to anyone about what I had taken but they thought it was Cumidin that did the trick. So what does that tell you. [...]

Jennifer also said in the thread that her husband didn't just stop taking Warfarin/Coumadin, that there was an overlap for about a month, where he took both but transitioned to just Nattokinase.

Many other reviewers reported that it lowered their blood pressure, and improved their overall blood circulation. A handful of people said it did nothing for them (I've found that is usually the case with supplement reviews; there are always some who say that). It does seem that it's used in place of Warfarin/Coumadin, rather than with it.

My sister says that my mother's doctor says, he would not object to any supplements as long as they don't interfere with what he has prescribed for her. It seems to me that the Nattokinase would interfere with the Warfarin.

I thought that I might try her on Vitamin K2 (Jarrow Formulas MK-7), because I read that vitamin k1 interferes with Warfarin's blood thinning, but vitamin K2 does not. Yet the K2 supplements also warn against taking them with Warfarin, or at least with consulting a doctor first before taking them.

So, is the only answer to stop taking Warfarin/Coumadin? That would be a tough sell for my mom. She's afraid to go against what the doctors tell her.


Here are a list of links about vitamin K2, and how it's been used to reverse calcification in arteries and heart valves. There have been studies that show reversal of arterial calcification in rats:

http://www.knowguff.com/2012/05/vitamin-k2-as-mk-7-restores-elasticity.html

http://www.natmedtalk.com/f25/1614-vitamin-k2-shown-reverse-arterial-calcifications.html

http://wholehealthsource.blogspot.com/2008/11/can-vitamin-k2-reverse-arterial.html

http://www.lef.org/magazine/mag2009/jan2009_Vitamin-K-Protection-Against-Arterial-Calcification-Bone-Loss-Cancer-Aging_01.htm


I've looked for information about reversing calcification of heart valves in humans. I could not find a lot of information, and what I did find was anecdotal:



http://www.vitamincfoundation.org/forum/viewtopic.php?f=11&t=7533

http://www.vitamincfoundation.org/forum/viewtopic.php?f=11&t=6207

But even mainstream medicine doesn't rule it out completely, they just say there are insufficient studies to prove it yet:

http://www.ncbi.nlm.nih.gov/pubmed/18196985?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=6

There seems to be no end to articles on the subject:

http://www.lewrockwell.com/sardi/sardi82.html

http://www.lewrockwell.com/sardi/sardi85.html

http://blogs.webmd.com/integrative-medicine-wellness/2007/11/vitamin-k-keeping-calcium-in-your-bones-and-out-of-your-blood-vessels.html

http://www.smart-publications.com/articles/vitamin-k-keeps-calcium-out-of-your-arteries-and-in-your-bones

http://www.preparemd.com/supplements-vitamins-categories-information/vitamin-k2-mk7-reduced-heart-attack/

There was even a book published in 2011, called "Vitamin K2 and the Calcium Paradox: How a Little-Known Vitamin Could Save Your Life":

http://www.amazon.com/Vitamin-K2-Calcium-Paradox-Little-Known/dp/1118065727/ref=sr_1_1?s=books&ie=UTF8&qid=1373147390&sr=1-1&keywords=vitamin+k2+and+the+calcium+paradox

But it's gone out of print, despite getting high ratings from readers. Only the Kindle edition is still available at a reasonable price. Used copies are very expensive. I hope they print more copies soon.


Update 07-12-13:

Our local health food store gave me a report about Nattokinase. It's quite informative, and I found it online in PDF format:

http://www.enzymedica.com/images/enzy/articles_handouts/pdf/CardiovascularHealthandNattokinase_H30.pdf
   

WHO gets ready for MERS

WHO Sets Up Emergency Committee on MERS Virus

GENEVA — The World Health Organization is forming an emergency committee of international experts to prepare for a possible worsening of the Middle East coronavirus, also known as Middle East Respiratory Syndrome (MERS), which has killed 40 people, WHO flu expert Keiji Fukuda said on Friday.

Fukuda said there was currently no emergency or pandemic but the experts would advise on how to tackle the disease if the number of cases suddenly grows. Most of the cases of MERS so far have been in Saudi Arabia, which hosts millions of Muslim visitors every year for the annual haj pilgrimage.

"We want to make sure we can move as quickly as possible if we need to," Fukuda told a news conference.

"If in the future we do see some kind of explosion or if there is some big outbreak or we think the situation has really changed, we will already have a group of emergency committee experts who are already up to speed so we don't have to go through a steep learning curve." [...]

I did a blog post previously about MERS.
     

Drug information at RXlist.com

While doing my on-line Introduction to Pharmacy Technician course, I found some useful websites, like rxlist.com. It lets you look up many things about drugs, like side effect warnings:

Kenalog-40 Injection Consumer (continued)

[...] Tell your doctor immediately if any of these unlikely but serious side effects occur: bone pain, easy bruising/bleeding, black stools, vomit that looks like coffee grounds, severe stomach/abdominal pain, increased thirst/urination, fast/pounding/irregular heartbeat, shortness of breath, swelling of the ankles/feet, persistent weight gain, puffy face, unusual hair growth, thinning skin, slow wound healing, signs of infection (e.g., persistent fever/cough/sore throat, painful urination, eye pain/discharge), muscle weakness/pain, mental/mood changes (e.g., mood swings, depression, agitation), vision changes, seizures, unusual skin growths.

If you have received injection of this medication into the joint, temporary discomfort of the joint may occur. Tell your doctor immediately if you have fever, increased/severe pain with swelling of the joint, weakness in the joint, or decreased range of motion in the joint.

[...]

This medication may make you dizzy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely.

This medication may mask signs of infection or put you at greater risk of developing very serious infections. Report any injuries or signs of infection (e.g., persistent sore throat/cough/fever, pain during urination, muscle aches) that occur while using this medication or within 12 months after stopping it.

Using corticosteroid medications for a long time can make it more difficult for your body to respond to physical stress. Therefore, before having surgery or emergency treatment, or if you get a serious illness/injury, tell your doctor or dentist that you are using this medication or have used this medication within the past 12 months. Tell your doctor right away if you develop unusual/extreme tiredness or weight loss. If you will be using this medication for a long time, carry a warning card or medical ID bracelet that identifies your use of this medication.

Do not have immunizations, vaccinations, or skin tests while you are using this drug unless specifically directed by your doctor. Avoid contact with people who have recently received oral polio vaccine.

Avoid exposure to chickenpox or measles infection while using this medication. If you are exposed to these infections, seek immediate medical attention.

If you have a history of ulcers or take large doses of aspirin or other arthritis medication, limit alcoholic beverages while using this drug. Alcohol may increase the risk of stomach/intestinal bleeding.[...]

That's just a sample. The information seems very complete.
     

"Middle East respiratory symptom coronavirus, or MERS-CoV"

Newly discovered virus takes more lives, spreads

(CNN) -- A new SARS-like virus recently found in humans continues to spread -- with the worldwide total now at 49, the World Health Organization said Wednesday.

Of the 49 known infections with the MERS-CoV virus, 27 have resulted in death, the organization said.

The latest deaths were reported in Saudi Arabia.

The Saudi health ministry said Wednesday that three people died from their infections in the country's eastern region.

The virus is "a threat to the entire world," the WHO's general director said Monday.

[...]

On Tuesday, a patient died in France after having contracted the virus during a trip to the Middle East, the WHO reported.

Coronaviruses cause illnesses ranging from the common cold to SARS, or Severe Acute Respiratory Syndrome, as well as a variety of animal diseases.

However, the new virus is not SARS.

The WHO recently gave it a more specific name: Middle East respiratory symptom coronavirus, or MERS-CoV.

It acts like a cold virus and attacks the respiratory system, the Centers for Disease Control and Prevention has said. But symptoms, which include fever and a cough, are severe and can lead to pneumonia and kidney failure.

Health officials do not yet know much about how the virus spreads, which makes it hard for scientists to prevent infections, Chan said. [...]

   

The changing face of healthcare

I recently came across this article, which is aimed at American physicians:

Getting ready for emerging care models

Like it or not change is coming to healthcare. The government, employer groups and other purchasers of healthcare are demanding higher quality and lower costs in the delivery of healthcare. The Affordable Care Act of 2010 started this evolution and whatever you call it -- value-based purchasing, accountable care, patient-centered healthcare, etc. -- it is taking root and starting to grow rapidly.

[...]

To get an idea of what you should be thinking about, let’s look to a healthcare market where these “new” healthcare delivery models are the norm and have been in place for years. One such market is in the Netherlands, where 90 percent of demand for care is generated in the primary care setting and providers (private) are paid a lump sum based on conditions and work in integrated care networks.

In the Netherlands today, 99 percent of physicians use a computer, 97 percent are Internet-enabled, 90 percent store all types of health records electronically, 84 percent receive lab results electronically, and 26 percent exchange data electronically with other providers – all benchmarks that the United States aims to achieve in the next 3-5 years. The international standards used in the Netherlands are consistent with U.S. conventions, as HL7 and ICD-9 are used in healthcare and ICD-10 is being adopted. Also, as in the United States, Holland does not have a dedicated health ID number or “smart card” for patients that some European countries have adopted but which are not relevant in this country. In these respects, the Dutch market is extremely similar to the U.S. market. This market is where our own company history started, and where our care collaboration and disease management solutions have matured.

Here is what you need and why
To participate in a value-based delivery model you must be willing and able to coordinate and collaborate on patient care with other ambulatory providers; the goal is to render the right amount of preventive care, avoiding health complications and resulting in better patient care with lower attendant costs. Once this mind shift has taken root -- a very different and, for some, a difficult way of thinking -- you need the basic tools and capabilities to engage in care coordination. These tools must:

Enable you to store patient information electronically. This does not have to be the typical full-blown EMR that legacy vendors have been marketing. These EMRs were developed in the fee-for-service model to optimize billing and reimbursement and resemble digital renditions of paper records. Not to mention they are expensive to acquire and maintain even when they may be subsidized by the ACO. Instead, you need a platform that is designed for the new delivery model focused on optimizing patient care, with a workflow that fits your practice pattern. For more on this see the 2010 PCAST Report titled "Realizing The Full Potential of Healthcare Information Technology to Improve Healthcare."

Enable patient-centric care, including making sure that patients receive reminders for preventive services through multiple channels based on their personal profile.

Support the care team network, allowing all providers, physicians, facilities, etc., involved in treating particular patients to share relevant information through collaborative and coordinated care.

Manage patients proactively.

Be able to generate electronic referrals.

Be a cloud-based solution. Cloud-based solutions require little or no local IT support and investment. This is really important for the average physician practice. Also the pricing level and payment structure with predictable cash flow more closely matches the size of the practice.

To distill down these capabilities into specific tool sets means you should expect to have the following: an EHR; a care collaboration/coordination solution; and the ability to exchange electronic referrals. The key in selecting the right solutions for your practice is to pick one with the right workflow for your practice. The solution(s) must be cloud-based so you can avoid the costly hassle of purchasing and supporting local software installations, which is expensive and not your core competency. If you do not have these capabilities you either might not be a candidate to participate in an ACO, clinically integrated care delivery network or PCMH, or the ACO will force you to use their solutions.

You should expect the ACO to provide other required solution capabilities such as clinical decision support (CDS), analytics, population health tools, health information exchange platform (HIE); reporting tools, etc. These are expensive solutions tailored for a large organization to manage and support. [...]

It goes on to describe the current inefficient, entrenched ways of doing things, and how they are going to be forced to rapidly change, as has happened in many other industries (It has an embedded link to an article in Forbes).


Also see:

Have Smart Phones to do Medical Work
     

A new kind of sleeping pill: "Dora-22"

A Sleeping Pill Without The Sleepy Head?

[...] DORA-22 is part of a class of new drugs — one of which the Food and Drug Administration is already considering for approval — known as orexin antagonists.

“It’s high quality research,” says Jerome Siegel, professor of psychiatry at University of California Los Angeles, who was not associated with the study.

The authors compared the sleep-inducing effects of DORA-22 to those of three well-known sleeping pills: diazepam (Valium), zolpidem (Ambien) and eszopiclone (Lunesta), which work by slowing down brain activity. Immediately after giving the animals the drugs, the scientists tested the animals’ memory and reaction time. (While most people take sleeping pills before going to bed, such effects are important to document so researchers, and users, can fully understand how their brains and bodies are affected by the medications in case people don’t take the drugs as prescribed.)

“It’s very enticing because there are some clear results that show [that these drugs] differ from old hypnotic drugs in terms of affecting cognition and memory in two animal species,” says Dr. Emmanuel Mignot, director of the Stanford Center for Sleep Sciences, who wrote a commentary on the research, which was published in Science.

Rats given high enough doses to cause sleep of the three currently available drugs had difficulty recognizing whether they had seen an object previously presented to them, while those dosed with DORA-22 did not show such compromised recall. Similarly, all of the drugs except DORA-22 reduced rhesus monkeys’ ability to react to a touch screen and correctly choose a colored square associated with a reward. In fact, even at doses 30 times higher than the lowest amount needed to affect sleep, the drug did not impair performance on this task.

What makes this new class of drugs different? Orexins, which are also known as hypocretins, are brain chemicals that promote wakefulness. Of the brain’s billions of neurons, only tens of thousands produce orexins. People with narcolepsy who have difficulty staying awake and are prone to suddenly falling asleep without warning are missing almost all of the neurons that produce these chemicals. DORA-22 and similar drugs work by blocking orexins by essentially producing a brief and reversible bout of narcolepsy. [...]

It's an interesting concept. But how many years till we find out the long term side effects?
     

Real Pharmaceutical Marijuana?

Is it comming? Maybe:

Pot in a pill: All the pain relief without the smoke

[...] Let me introduce you to dronabinol. It turns out that the miracle that is modern psychopharmacology has now shown it IS possible to render pot's analgesic effects into capsule form. And according to a new study, it works just as well as smoked marijuana at tamping down pain. But the capsule's effects last longer, and they come with fewer of the "abuse-related subjected effects" (i.e., feeling high) than does smoked marijuana.

Face it, potheads: You knew it was just a matter of time before "the man" got a hold of weed and snagged all the profits. But who knew he'd suck the fun out of it too?

For the record, dronabinol did induce some of smoked marijuana's other side effects, some of which have medicinal value to certain populations: It did increase appetite, decrease nausea and improve sleep.

The new research appeared Monday in the Nature journal Neuropsychopharmacology. It was authored by a group from Columbia University's College of Physicians and Surgeons. [...]

The full article goes on with details about how it was tested, which I also found interesting.

     

My Brilliant Career, part II

Previously, I explored Tax Preparer as an additional source of income. This time, I'm going to look at Pharmacy Technician.

It's a better option than Chickenblogging, and it seems that for the foreseeable future, healthcare is where the most jobs are.

I've been taking some accounting courses from Ed2go.com, and I was perusing some of the other non-college credit courses, and this looked interesting:

Explore a Career as a Pharmacy Technician

Health care is a booming field these days, and pharmacy technicians are in high demand. In this course, you’ll take a look at the many job settings and career paths open to you if you become a pharmacy technician. In addition, you’ll master the skills you need to get an entry-level position as a pharmacy tech or clerk.

You’ll start by learning basic terms for medical conditions and anatomy, gaining the skills you’ll need to read prescriptions and patient records easily. In addition, you’ll find out how common classes of drugs are made and how they work.

Next, you’ll master the simple math that every pharmacy tech needs to know. You’ll learn how to calculate dosages accurately, practice using simple formulas and math tools, and find out how to translate metric measurements into familiar household measures like teaspoons and tablespoons. Turning to the business side, you’ll look at sales and find out how prescription pricing works.

In addition, you’ll learn about the important laws and regulations that govern pharmacies. You’ll also hone your communication skills, learning how to handle customers courteously and efficiently. And finally, you’ll explore the steps you can take to enhance your career prospects becoming a Certified Pharmacy Technician (CPhT). By the time you’re done, you’ll be prepared to start your career in this popular and rapidly-growing field.

Note: This course is designed to give you an introduction to the profession of pharmacy technician. It will not supply enough information to sit for the national exam. If your goal is to become a Certified Pharmacy Technician (CPhT), then upon completion of this introductory course, enrollment into the advanced course is recommended. The advanced course is located in the online Career Training section of the ed2go catalog: http://www.gatlineducation.com/pharmacytechnician.html.

The Advanced Course is 330 hours, and prepares you to take the State Exam. Both courses are on-line (which allows great flexibility), and offer demos so you can see how they work. The introductory course offer's an entire lesson and quiz free. I think I may take the introductory course, just to see if I have what it takes, and if I can see myself doing it. No point in taking an advanced course till I know that.
   

Have Smart Phones to do Medical Work

And save us lots of time and money, too:

Visit NBCNews.com for breaking news, world news, and news about the economy

The doctor being interviewed talks about waste in the medical industry, and suggests that a third of all drugs prescribed are unnecessary or even harmful.

He demonstrates how a Smart Phone can be used to replace many costly and time consuming tests that waste time and money. Yet I wonder how far he will succeed with this medical phone apps technology? It would cut into the profit margins of those who are heavily invested in the old way of doing things.

 http://www.nbcnews.com/id/21134540/vp/50582822#50582822  

Rawanda Healthcare: Lessons for us all?

Rwanda's Historic Health Recovery: What the U.S. Might Learn

[...] Over the last ten years, Rwanda's health system development has led to the most dramatic improvements of health in history. Rwanda is the only country in sub-Saharan Africa on track to meet most of the Millennium Development Goals. Deaths from HIV, TB, and malaria have each dropped by roughly 80 percent over the last decade and the maternal mortality ratio dropped by 60 percent over the same period. Even as the population has increased by 35 percent since 2000, the number of annual child deaths has fallen by 63 percent. In turn, these advances bolstered Rwanda's economic growth: GDP per person tripled to $580, and millions lifted themselves from poverty over the last decade.

The rest of the world, wealthy countries and well as poor, can learn from Rwanda's rapid rise.

[...]

Rwanda achieves exceptional results not from how much money they spend on health, but from how they spend it. A recent article in BMJ, led by Farmer, examined World Health Organization data and sought to identify why Rwanda developed so rapidly, and to clarify the lessons for other countries. Rather than a single cause, the authors identified a series of interconnected factors that contributed to the country's turnaround.

First and foremost, credit belongs to the government of Rwanda's centralized planning. In 2000, the Rwandan government created a plan, called Vision 2020, to develop economically into a middle-income country over the next two decades. Dr. Agnes Binagwaho, Rwanda's Minister of Health, explained that "health is a key pillar of our development" and that without improving health, they will never alleviate the country's poverty.

[...]

While the specific context of Rwanda cannot be replicated, Dr. Farmer contends that Rwanda's focus on evidence-based policy, central planning, health systems, and equitable access to care should be heeded both by countries looking rebuild their health system and those with strong systems already in place. "In our commitment to understanding complexity," said Farmer, "we need to not forget that there are generalizable lessons to delivering care that are not acceptable to ignore."

While the United States still exceeds Rwanda in most traditional health metrics (such as life expectancy), and its hospitals and medical care surpass those in Rwanda, U.S. health outcomes still falter because too many patients fall through the cracks. The U.S. health system relies too heavily on doctors and hospitals to provide care. A growing body of research suggests that more frequent health care use and higher costs may lead to poorer health.

Farmer believes that, if the United States extended health care into the community like Rwanda, care for chronic diseases would markedly improve while costs would over time drop. Indeed, community-based pilots in the United States have proven effective in settings from inner-city Boston to rural Mississippi. [...]

There is much more in the full article. Lots of food for thought.
     

Managing Fat: subcutaneous VS visceral

The Truth About Belly Fat
What you need to know -- and do -- about belly fat.

Belly fat: Did you know that it's not just about your waist size?

It's also about your health. And you can do something about it, starting right now, at any size.

But first, let's be clear: This is not about fat phobia. Your body needs some fat. And it's not about judging yourself or anyone else, or trying to reach some unrealistic ideal.

Instead, it's about getting a handle on your fat -- even the fat you can't see.

Location, Location, Location

That's right: You have fat you can't see. We all do.

People store most of their fat in two ways:

Just under the skin in the thighs, hips, buttocks, and abdomen. That's called subcutaneous (under the skin) fat. It's the fat that you notice.

Deeper inside, around the vital organs (heart, lungs, digestive tract, liver, etc.) in the chest, abdomen, and pelvis. That's called "visceral" fat. It's so deep inside you that you can't notice it from the outside.

Many people are self-conscious about the fat they can see. But actually, it's the hidden fat -- the visceral fat -- that may be a bigger problem, even for thin people.

Like Another Organ

Fat doesn't just sit there. It makes "lots of nasty substances," says Kristen Hairston, MD, assistant professor of endocrinology and metabolism at Wake Forest School of Medicine.

We all have visceral fat -- and it isn't all bad. It provides necessary cushioning around organs.

The problem is when there's too much of it. That's linked to a greater chance of developing high blood pressure, type 2 diabetes, heart disease, dementia, and certain cancers (including breast cancer and colon cancer.)

How Did I Get It?

When obese, a body can run out of safe places to store fat and begin storing it in and around the organs, such as the heart and the liver.

“Fatty liver disease was, until recently, very rare in nonalcoholics. But with obesity increasing, you have people whose fat depots are so full that the fat is deposited into the organs,” says Carol Shively, PhD, professor of pathology-comparative medicine at Wake Forest School of Medicine. “Now there is much interest in fat being deposited around the heart, as well.”

Now that you know more about the fat that we all have, it's time to take action.

[...]

Thin People, Too

Even thin people can have too much visceral fat, though you'd never know it by looking at them.

It's partly about their genes. Some people have a genetic tendency to store visceral fat.

But it's also about physical activity. Visceral fat likes inactivity. For instance, a British study showed that thin people who maintain their weight through diet alone, skipping exercise, are more likely to have unhealthy levels of visceral fat.

So the message is, get active, no matter what size you are.

Controlling Belly Fat: 4 Steps to Take

There are four keys to controlling belly fat: exercise, diet, sleep, and stress management. [...]

It goes on to give advice, about what works, and why.
     

Health Links 09-08-12

Is it "feed a cold, starve a fever" or vice versa? And should you?

[...] The idea, if not the exact wording, dates back to 1574, when a dictionary maker named Withals wrote, "Fasting is a great remedie of feuer."

You're thinking: this guy wrote a dictionarie? His medical advice wasn't so hot either. Doctors have been trying to stamp out the above piece of folklore for years. Current medical thinking is that you want to keep an even strain when you're sick with either a cold or a fever, and you certainly don't want to stress your system by stuffing or starving yourself.

Nobody's sure where the notion of feeding colds and so on arose. (It surely didn't originate with Withals.) One somewhat dubious explanation has it that the proverb really means "If you feed a cold now, you'll have to starve a fever later." A more plausible interpretation is that the feed-a-cold idea arose out of a folk understanding of the disease process, namely that there were two kinds of illnesses, those caused by low temperatures (colds and chills) and those caused by high temperatures (fever). If you had a chill, you wanted to stoke the interior fires, so you pigged. If you had a fever, you didn't want things to overheat, so you slacked off on the fuel. [...]

WebMD goes a bit further, and gives lots of advice on How to Feed a Cold:

Starve a Cold, Feed a Fever?

Do you starve a cold and feed a fever when you're feeling under the weather? Or is it the other way around? Good news -- starving is never the correct answer. [...]

Read the whole thing for detailed recommendations.


8 Lifestyle Tweaks for Restless Legs Syndrome

If you've got restless legs syndrome (RLS), your daily habits can make a difference to your condition.

Revamping your diet, exercise, and medications is just the beginning of what you can do to improve your RLS. You might even find some help in unexpected places. [...]

Can't Sleep? When to Get Out of Bed

You wake up in the middle of the night and can't get back to sleep.

Whether you drank one cup of coffee too many earlier, or you've got a lot on your mind, it's time to decide whether to get up or stay in bed.

Getting out of bed makes sense at some point. Tossing and turning endlessly isn't going to help.

If you do get up, though, you're not giving up for the night. You still need rest. So your goal should be to get back to sleep as soon as possible.

Some activities help with that. Others put sleep even further out of reach.

What you do now, in the wee hours, will affect how the rest of your night goes. That could make all the difference in how you feel tomorrow. [...]

Read on for suggestions.
     

Re-engineering Human DNA?

Sounds like someone wants to:

Breakthrough Changes Thinking About DNA

Sept. 7, 2012 -- In what scientists call the biggest breakthrough in genetics since the unraveling of the human genome, a massive research effort now shows how the genome works.

The human genome contains 3 billion letters of code containing a person’s complete genetic makeup.

The biggest surprise is that most of the DNA in the genome -- which had been called "junk DNA" because it didn't seem to do anything -- turns out to play a crucial role. While only 2% of the genome encodes actual genes, at least 80% of the genome contains millions of "switches" that not only turn genes on and off, but also tell them what to do and when to do it.

Eleven years ago, the Human Genome Project discovered the blueprint carried by every cell in the body. The new ENCODE project now has opened the toolbox each cell uses to follow its individual part of the blueprint. The effort is the work of more than 400 researchers who performed more than 1,600 experiments.

The genome, with its 3-billion-letter code, reads from beginning to end like a book. But in real life, the genome isn't read like a book. The ENCODE data shows it's an intricate dance, with each step carefully choreographed.  [...]

OK, that's all very interesting. It's a fascinating article. But this jumped out at me:

[...] Eric D. Green, MD, PhD, director of the NIH's National Human Genome Research Institute (NHGRI), notes that most known disease-causing DNA mutations are in the small part of the genome that encodes genes.

"Most of these known mutations cause rare diseases," Green said. "But for the great majority of diseases, it's changes in the switches themselves. Diseases that are more common probably involve multiple DNA variants outside the genes. Common diseases like hypertension, heart disease, and diabetes are probably caused by things sitting in these switches." [...]

No. The "switches" don't cause the disease. The causes are things like bad diet and lack of exercise, etc, conditions which in turn cause the body to have a natural response by triggering things in the switches.

The disease is a warning that we are doing something wrong. Dr. Green seems to be implying that if we can turn off the triggers in the switches, we can stop the disease. But if we do that, you can be sure that the imbalance that would have triggered the disease, will then manifest somewhere else, some other way, in perhaps even a worse form.

Duh! I don't need a PhD to see that.

It's an area of study that we will inevitably pursue, but how that knowledge is used should be approached very conservatively. Nature does things for a reason. Altering that should not be approached lightly. Anyway, it IS an interesting read.    

Health Articles, 08-19-12

Blood Types and Heart Disease? Is there a connection?

Blood Type May be a Risk Factor for Heart Disease

The thought of having a heart disease is more than enough to stress an individual. But what if you find out that your blood type may also put you at risk of developing heart problems?

A group of researchers at the Harvard School of Public Health in Boston reviewed 20-year data from two large studies involving adult participants and found a link between blood type and the risk of developing heart disease. Compared to people with blood type O, those whose blood type is AB are found to have 23% increased risk for heart disease while those with type B had an 11% increased risk. Individuals with blood type A have 5% risk for heart disease.

While the researchers did not delve into the mechanisms that cause blood type to affect heart disease risk, evidence from other studies revealed some clues.

Blood type AB, the rarest blood type, is linked to inflammation which can affect how blood vessels work. Blood type A has been associated with higher levels of low-density lipoprotein (LDL) cholesterol, also known as the “bad” cholesterol, that clogs up arteries. Meanwhile, people with blood type O have higher levels of a compound that has a beneficial effect on blood flow and clotting.

But despite the findings, the researchers noted that a healthy lifestyle still play a significant role in protecting people with the higher risk blood types.

So if you are vulnerable to developing heart diseases based on several different factors, including family history, race, age, obesity, stress, or blood type as the recent study suggests, it’s about time you start making some healthy adjustments in your lifestyle.

Does Keen Attention and More Neurons = a more youthful brain?

Probing The Youthful Brains of ‘SuperAgers’

A Northwestern University researcher has identified an elite group of elderly people age 80 and older whose memories are as sharp as people 20 to 30 years younger than them.

Emily Rogalski, Ph.D., who dubbed these seniors “SuperAgers,” said that on 3-D MRI scans, their brains appear as young as the brains of middle-aged people.

[...]

“These findings are remarkable given the fact that grey matter or brain cell loss is a common part of normal aging,” said Rogalski, an assistant research professor at the Cognitive Neurology and Alzheimer’s Disease Center at Northwestern University Feinberg School of Medicine.

By identifying older people who seem to be protected from the deterioration of memory and atrophy of brain cells that accompanies aging, Rogalski hopes to unlock the secrets of their youthful brains so those secrets can be used to protect others from memory loss or even Alzheimer’s disease.

“By looking at a really healthy older brain, we can start to deduce how SuperAgers are able to maintain their good memory,” Rogalski said. “Many scientists study what’s wrong with the brain, but maybe we can ultimately help Alzheimer’s patients by figuring out what goes right in the brain of SuperAgers.”

“What we learn from these healthy brains may inform our strategies for improving quality of life for the elderly and for combatting Alzheimer’s disease.”

Measuring the thickness of the cortex gives her a a sense of how many brain cells are left, Rogalski explained.

“We can’t actually count them, but the thickness of the outer cortex of the brain provides an indirect measure of the health of the brain,” she said. “A thicker cortex suggests a greater number of neurons.”

The study also found that in SuperAgers, another region deep in the brain, the anterior cingulate, was actually thicker than in the 50 to 65 year olds.

“This is pretty incredible,” Rogalski said. “This region is important for attention. Attention supports memory. Perhaps the SuperAgers have really keen attention and that supports their exceptional memories.”

Only 10 percent of the people who “thought they had outstanding memories” met the criteria for the study, she noted. To be defined as a SuperAger, the participants needed to score at or above the norm of the 50 to 65 year olds on memory screenings, she said.

“These are a special group of people,” Rogalski said. “They aren’t growing on trees.” [...]

     

Musical Education for Formerly Deaf Man

Deaf man with new hearing aid hears music for the first time, asks, ‘What I should listen to next?’

Austin Chapman says he was "born profoundly deaf" and has "never understood" music--or the people moved by it.

"My whole life I've seen hearing people make a fool of themselves singing their favorite song or gyrating on the dance floor," Chapman, a 23-year-old filmmaker, wrote in a post on his studio's blog. "I've also seen hearing people moved to tears by a single song."

"[It] was the hardest thing for me to wrap my head around," he continued. "All music sounded like trash through my hearing aids."

But that changed earlier this week, Chapman says, when he tried a new pair of hearing aids for the first time in years:

I sat in the doctor's office frozen as a cacophony of sounds attacked me. The whir of the computer, the hum of the AC, the clacking of the keyboard, and when my best friend walked in I couldn't believe that he had a slight rasp to his voice. He joked that it was time to cut back on the cigarettes.

That night, a group of Chapman's close friends "jump-started" his musical education" with a crash-course: Mozart, the Rolling Stones, Michael Jackson, Sigur Ros, Elvis and Radiohead.

When Mozart's "Lacrimosa" came on, I was blown away by the beauty of it. At one point of the song, it sounded like angels singing and I suddenly realized that this was the first time I was able to appreciate music. Tears rolled down my face and I tried to hide it. But when I looked over I saw that there wasn't a dry eye in the car. [...]

I found "Lacrimosa" on YouTube, and it's lovely. I also found "Radiohead". ACCCCHHH! There is no comparison. The two must not even be used in the same sentence! But they frequently are. Welcome to our Brave New World.

Read the rest of the article to find out the further advice he was given for his musical education.