четверг, 31 марта 2011 г.
среда, 30 марта 2011 г.
Can Cavities Be Contagious?
Everyone knows you can catch a cold orthe flu. But can you catch a cavity?
Researchers have found that not only is it possible, but it occurs all the time.
While candy and sugar get all the blame,cavitiesare caused primarily by bacteria that cling to teeth and feast on particles of food from your last meal. One of the byproducts they create is acid, which destroys teeth.
Just as a cold virus can be passed from one person to the next, so can these cavity-causing bacteria. One of the most common is Streptococcus mutans. Infants and children are particularly vulnerable to it, andstudies have shown that most pick it up from their caregivers— for example, when a mother tastes a child’s food to make sure it’s not too hot, said Dr.Margaret Mitchell, a cosmetic dentist in Chicago.
A number of studies have also shown that transmission can occur between couples, too. Dr. Mitchell has seen it in her own practice.
“In one instance, a patient in her 40s who had never had a cavity suddenly developed two cavities and was starting to get some gum disease,” she said. She learned the woman had started dating a man who hadn’t been to a dentist in 18 years and had gum disease.
To reduce the risk, Dr. Mitchell recommends frequent flossing and brushing, and chewing sugar-free gum, which promotes saliva and washes away plaque and bacteria.
THE BOTTOM LINE
Cavities can be transmitted from one person to another.
ANAHAD O’CONNOR
вторник, 29 марта 2011 г.
‘The Panic Virus’ Review - Seth Mnookin on Vaccines and Autism
Or so I thought before opening Seth Mnookin’s new book. Barely a dozen pages in, I began to reconsider, and by the end I had completely changed my mind: Mr. Mnookin’s passionate defense of vaccination may be just what the public needs, in equal parts because of what it says and because of who is saying it.
Mr. Mnookin is no expert in the field— at least he wasn’t when he entered the fray. Neither a doctor nor a scientist, he has no vested interest in upholding the medical status quo (thus avoiding an accusation regularly flung at vaccine proponents). He hails instead from what might be called, sadly enough, exactly the opposite demographic: he is young and hip, got a good liberal arts education, lives in an upscale enclave and works in another, as a contributing editor of Vanity Fair. He is the father of a young child.
And it is people of precisely this description who are slowly picking apart the safety net that protected their own childhoods, prompted by a well-intentioned mixture of arrogance, ignorance and confusion.
It is not that these parents buy into some of the more lurid accusations out there, like the one floated by a British doctor that all pediatric vaccinations cause some degree of neurologic damage. It is more that the parents are alarmed by the hubbub and prefer to play it safe— but wind up defining“safe” in exactly the wrong way. In some communities nonvaccination rates have hit the double digits— well into the danger zone.
Expert opinion seems to have oddly little influence over these parents, but perhaps an analysis by a peer, rather than an expert, will change some minds. It certainly doesn’t hurt that Mr. Mnookin has put it all together in a readable narrative encompassing celebrity high jinks worthy of Vanity Fair at its snarkiest.
But those come at the end. Mr. Mnookin doggedly begins at the very beginning, with the first vaccine consisting of freshsmallpoxpus. Subsequent vaccines were refined, first with the use of less dangerous germs and then with noninfectious germ fragments. The first great triumph of mass vaccination, the Salk polio vaccine, made its debut in 1954, promptly followed by the first great vaccine-associated disaster: a sloppily made batch that paralyzed several dozen children in California.
One shudders to think of the fallout from such an event today, but back in the’50s parents were still familiar with the toll of childhood diseases, and vaccine momentum barely stumbled. Now, Mr. Mnookin reflects, cases of vaccine-preventable disease have become so uncommon that in 2003 one desperately ill infant (too young to be vaccinated) managed to cough the unmistakable“whoop” ofwhooping coughin the faces of dozens of baffled medical professionals before the disease was correctly diagnosed— too late to save her life.
Autism, meanwhile, was first named during World War II, and since then rates have skyrocketed. The first to claim a vaccine-autism link was a British physician namedAndrew Wakefield, in a small study published in 1998. Dr. Wakefield ultimately lost his medical license for a variety of misbehaviors, and this flagship study, under investigation for years, wasformally discreditedseveral months ago.
Dr. Wakefield held thatmeaslesvirus from the measles-mumps-rubellavaccine spread through the intestinal tracts of vulnerable children and then caused brain damage. Meanwhile, separate speculation focused on the mercury-based preservativethimerosal(used not in the M.M.R. but in other vaccines up until 2003); the idea here was that toxic mercury levels damaged the brain. Neither notion has stood up to careful analysis, and studies have repeatedly failed to confirm any clear association between these vaccinations and autism.
Mr. Mnookin traces out all these separate threads (with the footnotes of a true scholar), even venturing away from the tangle long enough to explain how scientists are trained to think about causation and how profoundly this measured approach is bound to infuriate a distraught parent with a suddenly altered child.
But he really hits his stride when he turns to the social history of autism advocacy; his section on the actress Jenny McCarthy is a tour de force. To promote her 2007 book describing the purported vaccine-induced autism of her young son and his subsequent cure, Ms. McCarthy staged a media blitz, a medical tent show writ large. Blond and charismatic, she waved away the science, energized the people who wanted to believe her message (the not inconsiderable“I feel, therefore it is” segment of our society, as Mr. Mnookin puts it) and managed to do quite nicely for herself as well, netting a deal withOprah Winfrey’s production company.
I suspect that it was never among Mr. Mnookin’s goals in life to become the de facto sparring partner of such an individual, but this book sealed his fate, and he has acquitted himself nobly. Parents who want to play it safe, but are not altogether sure how, should turn with relief to this reasoned, logical and comprehensive analysis of the facts.
понедельник, 28 марта 2011 г.
Philadelphia School Battles Students’ Bad Diets
The scourge the parents were combating was neither the drugs nor the violence that plagues this North Philadelphia neighborhood. It was bad eating habits.
“Candy!” said one of the parents, McKinley Harris, peering into a small bag one child carried out of the store.“That’s not food.”
The parents standing guard outside the Oxford Food Shop are foot soldiers in a national battle over the diets of children that has taken on new fervor. With 20 percent of the nation’s children obese, theUnited States Department of Agriculturehas proposed new standards for federally subsidized school meals that call for more balanced meals and, for the first time, a limit oncalories. The current standard specifies only a minimum calorie count, which some schools meet by adding sweet foods.
Earlier this year, whenMichelle Obama, as part of her campaign against childhoodobesity, announced that Wal-Mart would reduce salt and sugar in its packaged foods, she said,“We’re beginning to see the ripple effects on the choices folks are making about how they feed their kids.”
But this effort is up against an array of powerful forces, from economics to biology, all of which are playing out in Philadelphia, where the obesity rate is among the nation’s highest. At the intersection of North 28th and West Oxford Streets, the Oxford Food Shop and the William D. Kelley School are in a tug of war over the cravings of kids.
Amelia Brown, the principal of the kindergarten through eighth grade school, said that deplorable diets caused headaches and stomachaches that undermine academic achievement, and that older students showed a steady progression of flab. So inside the school, thenutritionbug is rampant.
The gym teacher, Beverly Griffin, teaches healthy eating using a toy model of the federal food pyramid and rewritten children’s songs.“And on his farm he had some carrots,” Tatyana, a first grader, belted out one recent morning, skipping around the gym with her classmates.
Like schools throughout the nation, Kelley has expelled soda and sweet snacks. Instead of high-calorie fruit juices, the school nurse, Wendy Fine, said,“I push water.”
The Agriculture Department wants to change the content of federally subsidized school meals— 33 million lunches and 9 million breakfasts a day— by the fall of 2012. Beyond the calorie cap, the new standards would emphasize whole grains, vegetables and fruits and set tighter limits on sodium and fats.
“This will mean a huge shift in school meals,” said Margo G. Wootan, the director of nutrition policy at theCenter for Science in the Public Interest, a consumer advocacy group.
Fernando Gallard, a spokesman for the Philadelphia School District, said schools were meeting the new federal meal proposals by using more dark green and orange vegetables, as well as fruits, whole grains and legumes.
The food industry is defending products by focusing on their mineral and vitamin content. The National Potato Council, for example, is warning against cutting starch, saying children need potatoes’ potassium and fiber.
Some companies are adjusting their recipes, although hardly drastically. After Philadelphia schools stopped buying the sugary products of the local bakery icon Tastykake, the company created a 190-calorie muffin, reducing sugar enough to move it below flour on the list of ingredients. The new formulation, which uses whole grains, got Tastykake muffins back on the school breakfast menu and classified as bread.“It is sweet,” said Autumn R. Bayles, a company senior vice president.“Sugar is just not the first ingredient.”
To match the efforts inside the school, one of Ms. Brown’s first acts as principal last August was to ask owners of nearby corner stores to stop selling to students in the morning.
There was a reason for this. While research suggests that as little as an extra 200 calories a day can make an adult overweight, a recent study led by Gary D. Foster, the director of the Center for Obesity Research and Education atTemple University, found that children were getting 360 calories a day from chips, candy and sugary drinks— all for an average of $1.06.
Gladys Tejada, who owns the Oxford shop, said,“It’s a good thing, what they’re trying to do, but I can’t control who comes in.”
Nor can she control what they buy.“They like it sweet,” she said.“They like it cheap.”
Since 2001, a Philadelphia organization called Food Trust has worked to get corner stores to offer healthier foods, including fresh fruit, vegetables and water, as well as products with reduced sugar, salt and fat. But just 507 of the city’s estimated 2,500 corner stores have signed on.
воскресенье, 27 марта 2011 г.
In N.H.L., Regulating Hits to Head Challenges Tradition
The extremes in thecurrent standoffinclude general managers, sponsors and fans who favor a ban on hits to the head and their old-school counterparts who see such a drastic rule change as potentially robbing the league of its rugged appeal just when its popularity is growing.
“The nature of the game is always being changed, but the rules, regulations, understandings and mythologies don’t change,” Ken Dryden, the Hall of Fame goalie from theMontreal Canadiens, said in describing the traditionalist impulse.
“That’s when you get into trouble,” he added,“when you don’t recognize the immense changes on one side, and don’t have the corresponding changes that make sense to the different game that evolves.”
Dryden broke his long silence on hockey matters this month, joining the team sponsorsAir Canadaand Via Rail, and the team ownersMario Lemieuxof Pittsburgh and Geoff Molson of Montreal in urging the league’s general managers to recommend a prohibition of all hits to the head. The International Ice Hockey Federation, theN.C.A.A.and the Ontario Hockey League— all feeder organizations to the N.H.L.— have bans.
At their recentannual meeting, the general managers took a middle path, calling instead for stricter enforcement of boarding and charging rules, and for harsher fines and suspensions. In 2010, the league imposed a partial ban, outlawing blindside hits to the head and those that deliberately target the head. According to league statistics, 14 percent of concussions sustained by N.H.L. players were the result of legal checks to the head, meaning ones delivered from straight ahead.
Still, the N.H.L. remains bound by an ethos of toughness, an arena where fighting is tolerated and even encouraged as rough justice, and where playing through concussions and gruesome lacerations are marks of courage.
A leading voice among traditionalists isToronto Maple LeafsGeneral Manager Brian Burke, who has spoken often about the need to preserve“the fabric of our game.”
Recently, Burke said:“We want that hit in our game. What’s distinctive about our game from anywhere else in the world is the amount of body contact. So we have to try to take out the more dangerous hits and make it safer for the players, but keep hitting in the game.”
The calls for change grew in volume in response to increased speed in the sport, a result of stricter rules against obstruction adopted after the 2004-5 lockout. That change undoubtedly made the game more exciting, but some of the spectacular collisions that followed led to more concussions. And it happened just as scientific evidence was emerging of the long-term damage caused by brain trauma.
Charting a middle course between rock’em, sock’em hockey and greater player safety has long been characteristic of the N.H.L., which has one of the most comprehensive concussion-evaluation and postconcussion return-to-play standards in professional sports. Only in 2009 did theN.F.L.adopt hockey’s protocol.
The N.H.L. policy, in place since 1997, was strengthened this month. Now, a player suspected of having a concussion is taken from the rink to a quiet room and evaluated for 15 minutes by a team doctor. The move was praised by several general managers, including Pittsburgh’s Ray Shero,Carolina’s Jim Rutherford and Buffalo’s Darcy Regier.
“It’s a step in the right direction,” said Shero, who sustained a concussion as a college player and who this season has dealt with concussions to his star player,Sidney Crosby, and his 15-year-old son, Chris.
But traditionalists were not pleased.
“This is an overreaction, a knee-jerk reaction,” one general manager told The Calgary Sun, saying the 15-minute examination period was too long.“This is what doctors told the league is best to do, but we’re the ones to have to put the thing in practice and it doesn’t make sense.”
Dryden, a member of Parliament from Toronto since 2004, said a pattern of resistance to change followed by change was a recurring theme in hockey.
“At one point, one of the prides of hockey is this is a game when you stay on the ice the whole time, like soccer,” he said.“It’s not real hockey if you have substitutions. But substitutions were allowed.
“Then it wasn’t real hockey if you can pass the puck forward— that’s like cheating— instead of skating it forward like an individual. And then it’s not real hockey if you use helmets or goalie masks. And so on and so on.”
To many, there is a sense of inevitability regarding the eventual adoption of a ban on head contact. A poll of Canadian hockey fans by MacLean’s magazine revealed this month that 83 percent support the outlawing of all checks to the head. (And if there is doubt that Canadian fans have gone soft, only 13 percent would outlaw fighting.)Dryden said, however, that today’s traditionalists were unable to conceive of hockey as being hockey if hits to the head were banned. But the faster game has made hockey so dangerous, he said, that change is necessary.
суббота, 26 марта 2011 г.
пятница, 25 марта 2011 г.
четверг, 24 марта 2011 г.
Algenist’s Algae-Based Skin Products Rise From the Sea
Retailing for $65 to $95, Algenist moisturizers, serum and eye balm are already available at Sephora.com and will go on sale in the company’s stores this week.“When we saw it, we thought it was so unique, such innovation, something our clients could really understand,” Mrs. Slater said of the line.“The whole story about this being an unexpected discovery.”
Mrs. Slater added that it made sense to her that alguronic acid (a compound that protects microalgae cells, according to Algenist’s maker, Solazyme) could also protect middle-aged faces from environmental assault.“Think about how algae can live anywhere, live in the coldest of places, or the harshest of places, and think about translating that to skin care,” she said.
Dermatologists might not wholeheartedly share Sephora’s enthusiasm. But a surprising story about a product’s genesis can be just as important for generating sales as the product’s demonstrable efficacy. Consider Crème de la Mer, which, like Algenist, contains sea matter, and also involves an enterprising scientist: an aerospace physicist trying to heal scars he suffered in a lab accident.
“It’s a slightly different story,” said Nica Lewis, the head consultant of beauty innovation at Mintel, a market research firm.“But it’s still‘brainy scientist comes up with cosmetic product.’ ”
According to Jonathan Wolfson, the chief executive of Solazyme, the alternative-energy company that makes Algenist, the product came about after a fortuitous suggestion roughly six years ago by Arthur Grossman, a microalgae expert who’s now an adviser to the brand. At first, Solazyme executives had a good chuckle about the idea of getting into skin care, Mr. Wolfson said.“I really never thought I’d be standing in a store like this,” he told a gathering of reporters during a preview at Sephora Fifth Avenue, amid shiny display cases of primer and volumizing mascara.
It may seem novel for a nonbeauty company to get into skin care, but these days, it really isn’t, Mrs. Lewis said.“There are ingredient suppliers that provide ingredients to health care, food and drink industries, and cosmetic companies,” she said. In Japan,“food and health care companies have found cosmetic applications for their ingredients, so they are creating skin care brands.”
For example,Frutarom, a flavor-ingredient house based in Israel, makes Alguard, a purified polysaccharide shield from a red microalgae that it says protects skin from daily assaults and reduces roughness as well as the look of fine lines.
There are more than 100 algae-derived ingredients used in cosmetics worldwide, Mrs. Lewis said. The patent-pending alguronic acid in Algenist is a“single, purified, highly bioactive compound,” said Tony Day, the vice president for research and development at Solazyme, and therefore delivers“much higher activity to the skin” than products using only a microalgae extract.
Studies conducted by an independent lab and commissioned by Algenist, none of which have been published in a peer-reviewed journal, showed alguronic acid increased cell regeneration and the synthesis of elastin (which gives skin that snap-back youthful quality). This testing also demonstrated that alguronic acid provided protection against cell damage induced by ultraviolet rays, and inhibited the enzymes that break down elastin.
After reviewing press materials and Solazyme’s 84-page patent application, Dr. David McDaniel, a dermatologist and the director of theInstitute of Anti-Aging Researchin Virginia Beach, Va., said he was impressed by the in-vitro testing of alguronic acid.“In the petri dish, their data seems to show some substantial benefits to their active ingredient,” he said. But he cautioned that in-vitro testing does not demonstrate how a final formulation works off the shelf.
Dr. Dana Sachs, an associate professor of dermatology at theUniversity of Michigan, Ann Arbor, wrote in an e-mail after looking at Algenist’s dossier that“the claims on cell regeneration and elastin synthesis are based on in vitro models, which is hard to extrapolate to in vivo, and again no statistical significance is presented, so this is a weak claim.”
Dr. Day, who has a doctorate in biochemistry, said that statistical significance was found but not included in press materials. And, according to the company, a study of 30 women showed that after 10 days of using the Algenist serum, they had a 25 percent decrease inwrinklesas shown by silicone replicas of their faces.
Dr. Ellen Marmur, the chief of the division of dermatologic andcosmetic surgeryatMount Sinai Medical Centerin Manhattan, did say Algenist could fairly claim that alguronic acid offers protection against ultraviolet damage to cells, and that she might use the product as“a nice sun protection on top of S.P.F. protection.”
Algenist literature touts alguronic acid’s superiority to hyaluronic acid,retinolandvitamin C, among other anti-aging ingredients, in encouraging elastin synthesis and cell regeneration. But Dr. McDaniel, who does research into using plant-derived products to lengthen the life of cells, says he thinks the comparative data must be viewed with caution because the studies that yielded it are“challenging to do accurately, hard to interpret and not necessarily predictive of final products.”
Soon, consumers will judge whether Algenist products are a breakthrough. In an unusual move, Sephora is introducing the line in 800 locations in 8 countries all at once, in a rollout coordinated with QVC.“It was a brand nobody has ever heard of,” said Allen Burke, the senior adviser for beauty strategy and development at QVC.“We want to give it a lot of visibility all at the same time.” But Mr. Burke knows that marketing has its limits.“It can be the most interesting story in the world,” he said.“But if it doesn’t deliver, it’s not a business that we can do.”
среда, 23 марта 2011 г.
Frittata With Grated Zucchini - Recipes for Health
2 tablespoons extra virgin olive oil
1 pound zucchini, grated (about 4 cups)
2 garlic cloves, minced
Salt and freshly ground pepper to taste
8 eggs
2 ounces goat cheese, crumbled (about 1/2 cup)
1/4 cup chopped fresh dill
1.Heat 1 tablespoon of the oil over medium heat in a 10-inch heavy nonstick skillet. Add the zucchini. Cook, stirring, until the zucchini begins to wilt, about two minutes. Stir in the garlic. Cook for another minute or until the zucchini has just wilted— it should still be bright green. Season to taste with salt and pepper, and remove from the heat.
2.Beat the eggs in a large bowl with the goat cheese. Add salt and pepper, and stir in the zucchini and the dill.
3.Clean and dry the pan, and return to the burner, set on medium-high. Heat the remaining tablespoon of olive oil in the skillet. Drop a bit of egg into the pan; if it sizzles and cooks at once, the pan is ready. Pour in the egg mixture. Tilt the pan to distribute the eggs and filling evenly over the surface. Shake the pan gently, tilting it slightly with one hand while lifting up the edges of the frittata with the spatula in your other hand, to let the eggs run underneath during the first few minutes of cooking.
4.Turn the heat to low, cover and cook 10 minutes, shaking the pan gently every once in a while. From time to time, remove the lid, tilt the pan and loosen the bottom of the frittata with a wooden spatula so that it doesn’t burn. The bottom should have a golden color. The eggs should be just about set; cook a few minutes longer if they’re not.
5.Meanwhile, heat the broiler. Uncover the pan and place under the broiler, not too close to the heat, for one to three minutes, watching very carefully to make sure the top doesn’t burn (at most, it should brown very slightly and puff under the broiler). Remove from the heat, and shake the pan to make sure the frittata isn’t sticking. Allow it to cool for at least five minutes and for as long as 15 minutes. Loosen the edges with a wooden or plastic spatula. Carefully slide from the pan onto a large round platter. Cut into wedges or into smaller bite-size diamonds. Serve hot, warm, at room temperature or cold.
Yield:Six servings.
Note:For four servings, use the same recipe but reduce the number of eggs to six.
Advance preparation:In Mediterranean countries, flat omelets are served at room temperature, which makes them perfect do-ahead dishes. They’ll keep in the refrigerator for a few days, and they make terrific lunchbox fare. They do not reheat well.
Nutritional information per serving:192calories; 5 gramssaturated fat; 2 grams polyunsaturated fat; 7 grams monounsaturated fat; 258 milligramscholesterol; 3 gramscarbohydrates; 1 gramdietary fiber; 134 milligrams sodium (does not include salt to taste); 12 grams protein
Martha Rose Shulman is the author of"The Very Best of Recipes for Health."
вторник, 22 марта 2011 г.
G. Alan Marlatt, Advocate for Shift in Addiction Treatment, Dies at 69
The cause waskidney failure, said his wife,Kitty Moore.
For 30 years, Dr. Marlatt was director of theAddictive Behaviors Research Center, an arm of theUniversity of Washingtonin Seattle that nurtured a movement among therapists holding that addiction treatment should take a more moderated approach than is common in traditional 12-step programs calling for complete abstinence, like that of Alcoholics Anonymous. Dr. Marlatt was perhaps the leading proponent of the approach, called“harm reduction.”
His data demonstrated that reducing an addict’s level ofalcohol usecan lead directly to reduced troubles at home and at work. He maintained that while addicts may not be able to stop using a substance immediately, individualized counseling— a“meet them where they are” approach, as the movement calls it— can bring about changes in their“life conditions” and eventually lead to abstinence.
Through his research, much of it involving students on campus, Dr. Marlatt also identified factors that can predict a relapse, among them negative emotions, conflicts with others and recurring thoughts that the substance will make the addict feel better.
“Alan found that these high-risk situations can be planned for, and that by being taught appropriate coping responses the person can learn to avoid relapse,” saidMary Larimer, who worked with Dr. Marlatt for 27 years and is now associate director of the research center.“Prior to Alan’s work there was a perception that relapse was an inevitable part of the disease of addiction, primarily triggered by biological processes.”
In his book“Relapse Prevention” (1985, revised in 2005), considered a seminal work in the field, Dr. Marlatt drew a distinction between a lapse and a full relapse. He postulated that a lapse can be seen as a warning sign, not as failure, and that the addict can get back on track through counseling.
While his approach has gained many adherents, it has also been the subject of debate.
“Alcoholismcauses brain damage, and Marlatt never considered that in his analyses,” said Irving Maltzman, an emeritus professor ofpsychologyat theUniversity of California, Los Angeles, who specialized in alcoholism.“I support complete abstinence.”
But Marc Schuckit, a professor ofpsychiatryat theUniversity of California, San Diego, and an expert in genetic factors contributing to alcohol and drug dependence, saw value in both approaches.
“Where Alan and I differed was where the problems with alcohol get really serious,” Dr. Schuckit said.“I agree that abstinence isn’t always essential for people who drink more than may be healthy for them, but who don’t have serious problems. However, when somebody meets criteria for alcohol dependence, I read the data as saying it is very unlikely they will ever be able to go back to controlled drinking.”
Frederick Rotgers, president of theSociety of Addiction Psychology, said Dr. Marlatt’s work was“the foundation for much of the psychological research in treatment today,” having“shifted it toward a more humane and respectful approach.”
Gordon Alan Marlatt was born in Vancouver, British Columbia, on Nov. 26, 1941, to Vera and Sholto Marlatt, a Royal Canadian Air Force flight officer who died in a plane crash in England during World War II.
Besides his wife, he is survived by a son, Kit; a stepson, Colin; two stepdaughters, Charlotte and Melanie; a half-brother, Robert; a grandson; and two stepgranddaughters. His three previous marriages ended in divorce.
Dr. Marlatt received a bachelor’s degree in psychology from the University of British Columbia in 1964 and a Ph.D. in clinical psychology fromIndiana Universityfour years later.
After teaching at the University of British Columbia and theUniversity of Wisconsin, he joined the University of Washington faculty in 1972.
In recent years, Dr. Marlatt took a lead role in efforts to deal with alcohol abuse on college campuses.
He developed a counseling program called Basics—Brief Alcohol Screening and Intervention for College Students— that uses so-called harm-reduction techniques. It is now in place at more than 1,800 colleges.
понедельник, 21 марта 2011 г.
Shar-pei Wrinkles and Fevers Linked to Single Gene
Researchers are now reporting that the same gene mutation is responsible for both thewrinklesand the fever.
“All shar-pei dogs have this mutation that causes the wrinkles, but the more copies they have, the higher the risk to have this fever,” said Mia Olsson, a doctoral student at Uppsala University in Sweden who worked on the study. Theresearch appears in the journal PLoS Genetics.
It was already known that the wrinkles were a result of excess production of a substance called hyaluronic acid distributed throughout the dogs’ skin. That excess is likely caused by to the overactivation of a gene calledhyaluronan synthase 2.
Dogs that carry multiple mutations of the gene seem predisposed toperiodic fever, Ms. Olsson and her colleagues reported. Although the fever is short-lived, it can be intense and frequent, and cause inflammation.
With more information, breeders might be able to avoid breeding shar-peis that have duplications of the gene mutation, Ms. Olsson said.
“Our highest priority right now is to see if there’s some way to create some kind of test or tool to reduce the number of dogs with the fevers,” she said.
The research was conducted with the help and support of breeders in the United States, Sweden and Spain, who have an interest in improving shar-peis’ health.
The fever closely resembles certain periodic fevers that humans inherit, and studying the mutation in the dogs could help human geneticists develop treatments.
The most common periodic fever among humans is known asfamilial Mediterranean fever. It tends to affect people of Mediterranean and Middle Eastern descent, and there is no cure for the disorder.
воскресенье, 20 марта 2011 г.
Health Care Overhaul Waivers Draw Kudos, and Criticism
Instead, Republicans have seized on the waivers as just more evidence that the law is fundamentally flawed because, they say, it requires so many exceptions. To date, for example, the administration has relaxed the $750,000 standard for more than 1,000 health plans covering 2.6 million people.
The waivers have become a flash point as supporters and opponents try to shape public perceptions of the law, theAffordable Care Act, signed byPresident Obamalast March 23.
Administration officials, labor unions and consumer advocates plan to celebrate the first anniversary with a week of events highlighting benefits of the law to consumers. But SenatorMichael B. Enziof Wyoming, the senior Republican on the Senate health committee, asked,“If the law is so good, why are so many waivers needed?”
Waivers are usually seen as a way to deal with exceptional circumstances in which the enforcement of a law or policy might cause hardship. But with the new health care law, exceptions like these have become increasingly common. They provide wiggle room in a law originally thought to be strict and demanding.
Maine has just won a three-year reprieve from a provision of the law stipulating that insurers selling coverage to individuals and families must spend at least 80 percent of premium revenues on medical care and efforts to improve it. The White House had described this as one of the law’s most beneficial provisions, guaranteeing that consumers would get“more value for your dollars.”
The Obama administration lowered the requirement to 65 percent for Maine, after finding“a reasonable likelihood” that the tougher standard would drive one big carrier out of the market for individuals, leaving thousands without insurance.
Five other states— Florida, Georgia, Kentucky, Nevada and New Hampshire— have requested similar waivers, and at least a dozen other states are considering whether to apply.
President Obama recently embraced legislation that would let states opt out of the law’s most contentious provisions, including a requirement for most Americans to carry insurance, if the states come up with alternatives that cover at least as many people.
And Representative Mike Rogers, Republican of Michigan, has introduced a bill that would allow people to seek exemptions from major provisions of the law if they could show they would be harmed.
Under the law and rules issued by the administration, health plans this year must generally provide at least $750,000 in annual coverage for essential benefits like hospital care, doctors’ services and prescription drugs. The government may grant a one-year exemption from the requirement if it is shown that compliance would cause a significant increase in premiums or a significant decrease in access to benefits.
Such waivers have gone to entities as diverse as the Waffle House and Ruby Tuesday, health plans run by Aetna and Cigna, and labor unions representingTeamsters, electrical workers, plumbers, carpenters and food and commercial workers.
Administration officials said the waivers showed a pragmatic, flexible approach to carrying out the law. Without the waivers, saidKathleen Sebelius, the secretary of health and human services, many employers would have increased premiums, and some would have dropped coverage altogether.
Edmund F. Haislmaier, a health policy expert at the conservativeHeritage Foundation, said the waivers“result in unequal application of the law and create a temptation to engage in political favoritism.”
Republicans like RepresentativeDarrell Issaof California said that in granting waivers, the administration had favored political allies, including labor unions.
Tom Leibfried, a lobbyist for theA.F.L.-C.I.O., said:“This is just union bashing. The numbers do not show a pro-union bias.”
Mr. Leibfried said some union health plans had a legitimate need for waivers because they had annual coverage limits lower than $750,000. If they had to increase coverage to that level, he said, they would incur significant new costs. But, Mr. Leibfried said, the main source of financing for such health plans— employer contributions— will not immediately increase because they are set by collective bargaining agreements, which are typically in effect for several years.
Steven B. Larsen, director of the federalCenter for Consumer Information and Insurance Oversight, which carries out many of the health law’s provisions, said the waivers provided a“bridge to 2014,” when more affordable insurance options should be available. He denied that unions had received“special treatment.” Indeed, he said, the center has granted waivers to 94 percent of all applicants.
суббота, 19 марта 2011 г.
Japan Races to Restart Reactors’ Cooling System
TOKYO— Scrambling to corral a widening crisis, engineers linked a power cable to the crippled Fukushima Daiichi Nuclear Power Station early Saturday as they struggled to restart systems designed to prevent overheating and keep radiation from escaping.
The Tokyo Electric Power Company, which runs the plant, said it hoped to connect the electric cord to the cooling equipment inside the facility later Saturday in an attempt to stabilize the reactors that were damaged by the powerful earthquake and tsunami that struckJapaneight days ago.
In a brief statement on Japanese television Saturday morning, an official for Japan’s Nuclear and Industrial Safety Agency said that workers had managed to restart a diesel pump and restored cooling functions at two of the reactors, Nos. 5 and 6, early Saturday morning. He did not provide any details.
Those reactors were not in use when the disaster occurred, but they contained spent fuel rods, and engineers were concerned this week when temperatures in the reactors began to rise.
About 150 of its people were working on the electrical cable, the power company said, and they were planning to start with Reactor No. 2, which on Friday was seen spewing steam, perhaps containing radioactive particles.
Officials have cautioned, however, that restoring electricity to the reactor would prove fruitless if the pumps were not working. In that case, a new cooling system would be needed, leading to more delays in an emergency that has bedeviled the power company and the government and caused anxiety and frustration overseas.
The nuclear safety agency said that the crisis now had wider consequences, and raised its assessment of the accident’s severity to Level 5 on a seven-level scale established by theInternational Atomic Energy Agency. Hidehiko Nishiyama, a senior official at the agency, said the assessment was retroactive to Tuesday and based on the fact that officials now assumed that more than 3 percent of the nuclear fuel at the plant had experienced meltdown.
The adjustment was an admission by Japanese officials that the problem was worse than it had previously stated.“We could have moved more quickly in collecting information and assessing the situation,” said Yukio Edano, the chief cabinet secretary.
Outside experts have said for days that this disaster is worse than the one in 1979 at Three Mile Island— which the United States classified as a 5 on the international scale but which released far less radiation outside the plant than Fukushima Daiichi already has.
Engineers are starting the power cord effort with Reactor No. 2 because its outer building has not blown off, thus making it hard to spray in water the way they can with Nos. 1, 3 and 4, according to NHK, Japan’s national broadcaster, which cited power company officials.
The plan was to lay a 1.5-kilometer power cable between Reactor Nos. 1 and 3 to get to No. 2. If they can hook it up, it will theoretically be able to power all six reactors. The main hazard was the exposure of workers.
Unable to contain the catastrophe on its own, Tokyo Electric has received help from Japanese police and fire departments and the country’s Self-Defense Forces. Assistance has started to flood in as well, with nuclear experts arriving from the United States and international agencies. France and South Korea are also providing support.
Overnight in Japan, crews from the Tokyo Fire Department doused water on Reactor No. 3, which was doused earlier Friday by teams from the Self-Defense Forces and the United States military. Workers planned to continue the spraying on Saturday.
In a further sign of spreading alarm on Friday that uranium in the plant could begin to melt, Japan planned to import about 150 tons of boron from South Korea and France to mix with water to be sprayed onto damaged reactors, French and South Korean officials said Friday. Boron absorbs neutrons during a nuclear reaction and can be used in an effort to stop a meltdown if the zirconium cladding on uranium fuel rods is compromised.
Tokyo Electric Power said this week that there was a possibility of“recriticality,” in which fission would resume if fuel rods melted and the uranium pellets slumped into a jumble on the floor of a storage pool or reactor core. Spraying pure water on the uranium under these conditions can actually accelerate fission, said Robert Albrecht, a longtime nuclear engineer.
Nuclear reactions at the plant were halted immediately after last week’s 9.0-magnitude earthquake and before the tsunami arrived minutes later.
пятница, 18 марта 2011 г.
No Face, but Plants Like Life Too
If you think about it, and it’s much simpler not to, it can be hard to justify other beings suffering pain, fear and death so that we can enjoy their flesh. In particular, given our many connections to animals, not least of all the fact that we are ourselves animals, it can give a person pause to realize that our most frequent contact with these kin might just be the devouring of them.
My entry into what seemed the moral high ground, though, was surprisingly unpleasant. I felt embattled not only by a bizarrely intense lust for chicken but nightmares in which I would be eating a gorgeous, rare steak— I could distinctly taste the savory drippings— from which I awoke in a panic, until I realized that I had been carnivorous only in my imagination.
Temptations and trials were everywhere. The most surprising turned out to be the realization that I couldn’t actually explain to myself or anyone else why killing an animal was any worse than killing the many plants I was now eating.
Surely, I’d thought, science can defend the obvious, that slaughterhouse carnage is wrong in a way that harvesting a field of lettuces or, say, mowing the lawn is not. But instead, it began to seem that formulating a truly rational rationale for not eating animals, at least while consuming all sorts of other organisms, was difficult, maybe even impossible.
Before you hit“send” on your hate mail, let me say this. Different people have different reasons for the choices they make about what to kill or have killed for them to eat. Perhaps there isn’t any choice more personal or less subject to rationality or the judgment of others. It’s just that as far as I was concerned, if eating a tofu dog was as much a crime against life as eating bratwurst, then pass the bratwurst, please.
So what really are the differences between animals and plants? There are plenty. The cells of plants, and not animals, for example, harbor chloroplasts, tiny green organelles that can turn the energy of light into sugar. Almost none of these differences, however, seem to matter to any of us trying to figure out what to eat.
The differences that do seem to matter are things like the fact that plants don’t have nerves or brains. They cannot, we therefore conclude, feel pain. In other words, the differences that matter are those that prove that plants do not suffer as we do. Here the lack of a face on plants becomes important, too, faces being requisite to humans as proof not only that one is dealing with an actual individual being, but that it is an individual capable of suffering.
Animals, on the other hand— and not just close evolutionary relations like chimps and gorillas, but species further afield, mammals like cows and pigs— can experience what pretty much anyone would agree is pain and suffering. If attacked, these animals will look agonized, scream, struggle and run as fast as they can. Obviously, if we don’t kill any of these animals to eat them, all that suffering is avoided.
Meanwhile, whether you pluck a leaf or slice a trunk, a plant neither grimaces nor cries out. Plants don’t seem to mind being killed, at least as far as we can see. But that may be exactly the difficulty.
Unlike a lowing, running cow, a plant’s reactions to attack are much harder for us to detect. But just like a chicken running around without its head, the body of a corn plant torn from the soil or sliced into pieces struggles to save itself, just as vigorously and just as uselessly, if much less obviously to the human ear and eye.
четверг, 17 марта 2011 г.
Warmed-Over Atkins? Don’t Tell the French
PIERRE DUKAN has been called the French Dr. Atkins. Millions of Frenchmen are said to have tried his program, a method that promises— like dozens of diets before and since— no hunger, no calorie counting, instant weight loss and lifelong weight maintenance. The original Dukandietbook sold 3.5 million copies in French and has been translated into 14 languages. Three Dukan books were among the top five best sellers in France last year. Hundreds of online blogs and forums serve as the diet’s virtual support system, not unlike Weight Watchers’ weekly meetings.
Few Americans have even heard of the diet that made the 69-year-old Dr. Dukan famous, but that is about to change.
Next month, the diet will make its American debut when a division of Crown Publishing rolls out the North American edition of“The Dukan Diet,” its cover featuring a plate with two Eiffel Towers and the words,“The Real Reason the French Stay Thin.”
Dr. Dukan, who says he was paid a $1.3 million advance for the North American rights, will attempt to woo American audiences with his well-rehearsed, rapid-fire pitch, which he seasons with medical jargon and wraps in charmingly imperfect English. The diet will be heavily promoted with a national print, television and radio campaign, and outreach viaFacebookandTwitter, all part of the publicity machine that propels diet books— one of the largest revenue generators in publishing— into general consciousness.
The doctor comes across as a missionary.“My dear friends, today I am reaching out to you with the certainty that I can help you put an end to the inevitability of weight problems in North America,” he wrote in the preface of the new edition.“Now let this mutual journey begin!”
The diet has become so central to French culture that almost any public figure who has lost a lot of weight is labeled by the media as a Dukanniste:Jean-Marie Le Pen, until recently the leader of the far-right National Front party; François Hollande, a longtime Socialist Party politician, former party leader and presidential hopeful; David Douillet, a judo gold medalist (who reported losing more than 75 pounds in six months). In Britain, the press has Carole Middleton, mother of future princess Kate, going on the diet in preparation for the royal wedding next month.
For years, critics have dismissed the Dukan diet as a warmed-over version of early Atkins: a simple protein-centric method that divides foods into good and bad categories and relies on the claims of a medical doctor who is long on enthusiasm and short on scientific research.
Asked about Atkins, Dr. Dukan acknowledged that it was a source of inspiration.“I am built on the shoulders of Weight Watchers and Atkins diets,” he said. But he criticized Weight Watchers for its emphasis on quantity sizes and calorie counting, and Atkins for allowing unlimited consumption of fat.“I have a lot of respect for Atkins,” Dr. Dukan said.“He was a legend in his time.” But now, he added,“Atkins is dead.”
His own diet’s high-protein, low-fat approach is organized into four phases: attack, cruise, consolidation and stabilization. The first encourages dieters to eat as much as they want of nonfatty, protein rich foods, including oat bran (a key component) washed down with oceans of water. The second stage introduces vegetables, but no fruit; the third brings with it two slices of bread, a serving of cheese and fruit and two servings ofcarbohydratesa day, with two weekly“celebration” meals with wine and dessert (the diet is French, after all); and the final stage six days a week of“anything goes” and one day of reversion to strict protein-only stage one— for the rest of your life.
The only must-do daily physical exercises are a 20-minute walk and total elevator avoidance, fine in a city like Paris where five-story buildings are common.
Even before its American introduction, the diet is under attack.“This is just another one of those diets invented by a charismatic individual who makes a lot of promises and has loads of testimonials but is not based on any scientific data whatsoever,” said Frank Sacks, professor in the Department of Nutrition atHarvard University’s School of Public Health and chairman of theAmerican Heart AssociationNutrition Committee.
France’s governmental National Agency for Food, Environmental and Work Health Safety has identified it as one of 15 imbalanced and potentially risky diets. The British Dietetic Association, the country’s organization of professional dietitians, branded it one of the five worst diets of 2011.“We call it the‘Do-can’t’ diet,” said Sian Porter, a dietitian and spokeswoman for the British Dietetic Association.“Even if you can survive it for the first few days, it’s hard to stick with it. It’s hard on your kidneys. And it’s expensive.”
Michèle Fitoussi, a columnist for Elle magazine, commented simply that“of course you lose weight at the beginning.”
“You are so bored eating nothing but sliced turkey and fake crab that you lose the desire to eat.”
The diet was an accidental creation, and Dr. Dukan will tell you the story of its inspiration, whether you ask or not. It began in the 1970s with four words:“Let me eat meat.” Dr. Dukan, then a Paris neurologist, was treating an asthmatic and seriously overweight longtime patient, a poetry editor. The patient had tried every sort of diet. They all had failed him. He was determined to try again, but on one condition: he wanted meat.
Dr. Dukan told him to eat nothing but protein, to drink lots of water and to come back in five days. When the man returned, he had lost 11 pounds.
среда, 16 марта 2011 г.
Pain, Persistence, Family - Sickle Cell Disease
Sickle cell anemia is an inherited disease that causes red blood cells to have a distinctive crescentlike, or sickle, shape. These cells are unable to properly carry oxygen throughout the body, and they tend to clump together, blocking blood flow, damaging organs and causing severe pain.
Affecting about 72,000 people in the United States, sickle cell anemia is most common among people of African or South American descent, but the genetic trait is also routinely found in people with ancestry from Central America, India, Saudi Arabia and Mediterranean countries. One in every 500 African-American births results in a child with sickle cell disease,according to the Sickle Cell Disease Association of America.
The challenges of living with sickle cell anemia are great, but with diligent care, the disease can be managed. Here, three people speak about the impact sickle cell anemia has had on their lives and families. Hear more:Patient Voices: Sickle Cell Anemia.
Andre Hinckson, 38
Queens
“With a sickle cell crisis, there’s a lot of pain, unbelievable pain. It’s like a jackhammer on your back, basically. Imagine that kind of pain throughout your whole body. Sometimes there’s pain in your joints, in the abdominal area, in your head, in your chest. Sometimes it’s all over at one time.
I wish people in the medical field would take the disease more seriously. I’ve had experiences where they’ve called me‘drug seeker.’ It’s as if we’re going to the emergency room once a month or once a week for our drug fix. They treat us atrociously, and I’m just tired of the whole situation.
Some people, they smile— that’s how they deal with their pain. Me? I’m very serious, and I know people look at my face and they wonder why I’m so serious or so sad. Maybe its just because of what I’ve experienced, you know?”
Shanoah Moore, 8
Cincinnati
“Every time I have a pain episode, I either get a heating pad or they take my temperature. If it’s over 101, that means I have to go to the hospital.
I know when I’m getting sick because my head starts getting warm, and my mom knows because my eyes kind of turn yellow. It feels like someone is just squeezing my legs or arms. Sometimes it’s very, very painful.
Normally in the middle of the night, I just go and get the heating pad and go back to my bed, but when I wake up and it feels worse, then I just go to my mom or dad.“I don’t like getting sick. I still want to be in school, so I can be there and not be absent a lot.”
Tiffany Dews, 33
Richmond, Va.
“When I first got pregnant, my intention was not to be a stay-at-home mom. My intention was to work and finish school, but of course, plans change.
Both my husband and I have the trait for sickle cell disease, and combined we have two children, Tracy and Riley, with the disease. There’s a one in four chance each time we decide to have kids that we would pass on the disease.
Years ago, {children with sickle cell disease} were not making it past the age of 20 or 21. So my hope is that they will have kids, and hopefully not have kids with the disease.”
вторник, 15 марта 2011 г.
Radiation Exposure Could Curtail Efforts of Workers
The workers are performing what have been described as heroic tasks, like using fire equipment to pump seawater into the three failing reactors to keep the nuclear fuel from melting down and fighting the fire at a fourth reactor.
They are operating in places that have been contaminated by radioactive isotopes from all four reactors. Technicians who have not been evacuated face an escalating exposure, and will have to be replaced if the fight is to go on.
“If they exceed a certain amount, they can’t go back in for a day or a week or longer,” said Dr. Lew Pepper, a professor at the Boston University School of Public Health who has studied the effects of radiation on nuclear weapons workers. And the pool of available replacements is finite, he said:“What do you do? You don’t have a lot of people who can do this work.”
The nuclear plants’ operator, Tokyo Electric Power Company, has declined to provide details about the workers— who they are, how many there are and how they are being assigned to do the most hazardous work.
But Arnold Gundersen, a consultant who worked in American plants nearly identical to the stricken Japanese ones, said it was likely that the company was calling in retirees and workers from unaffected plants for help. And perhaps for sacrifice, as well.“They may also be asking for people to volunteer to receive additional exposure,” he said.
People who are working close to the reactor— pumping water, or operating valves inside the secondary containment structure— would almost certainly be wearing full bodysuits and air packs, Mr. Gundersen said. But some forms of radiation can penetrate any gear.
Gamma rays and other penetrating radiation can cause cancers and other long-term illnesses or, in high amounts, near-term illness or death.
Health physicists should gauge the radiation level in the work area, and the workers would normally be told how long they can remain.“There may be a health physicist who will say, You only have an hour or two to do this job,” Mr. Gundersen said. Each worker would carry a dosimeter, which measures radiation exposure,“and they’ll be looking at it,” he added.“When it hits a certain number, they should leave.”
Suits and air packs are meant to keep radioactive particles off the skin and out of the lungs until the workers return to a safer area.
Workers are trained to remove the gear in a specific way to avoid leaving any particles on their skin that would result in continuing exposure.
While regulations may differ somewhat in Japan, in the United States the usual radiation exposure limit for nuclear power plant workers is 50 millisieverts, or 5 rem, per year (compared with the 0.3 rem that the Environmental Protection Agency says most people get from normal background radiation). When there is an emergency, the limit can be raised to 25 rem, which is still far below the level at which people would show symptoms or get sick.
The explosion at Fukushima’s Reactor No. 2 on Tuesday morning sent radiation levels spiking, to 8,217 microsieverts an hour from 1,941 about 40 minutes earlier.
During the Chernobyl accident in Ukraine in 1986, when the reactor caught fire, operators and firefighters received high doses of radiation, sometimes within minutes and without being made aware of the dangers. More than two dozen of them died of acute radiation illness.“People in Chernobyl were just over overexposed,” Dr. Pepper said.“The outcome for those folks was death.”
Determining allowable exposure is usually based on three principles: distance, time and shielding. In the Japanese plants, extensive contamination would mean that distance and shielding are not really factors, so the controlling variable is time.
Mr. Gundersen said that when he worked at the Vermont Yankee plant, which is nearly identical to some of the crippled Japanese reactors, he had one maintenance task where the“stay time,” in which workers would be exposed to their yearly limit, was three minutes. He hired local farmers, trained them on a mock-up for two weeks, and then sent them in for their brief stint.“Then I’d send them home for a year,” he said.
In Japan, the plant operators do not have the luxury of time for training.“You need somebody who is familiar with the plant, because you need somebody to do it now,” Mr. Gundersen said.
Japanese workers might be so committed that they might be willing to exceed accepted levels of exposure. But that might not extend to extremely high radiation.
“I don’t think anyone is going to take 50 rems,” he said.“But if it’s a difference between 5 and 7, they might say:‘I’ll take it. It’s worth the risk.’”
четверг, 10 марта 2011 г.
Stair-Climbing Workouts and Staircase Races
Still, I enjoy climbing stairs. And at work, at The New York Times building, I climb nine flights, typically three times a day, for a total of 609 steps, up but not down.
The brief treks are back-loosening, head-clearing aerobic jolts— and they may be contributing more to my health than I suspect, according to exercise experts. Stairs, it seems, are a neglected asset in the fitness crusade.
“There’s good scientific evidence that the activity itself is quite beneficial,” said Paul M. Juris, a kinesiologist and executive director ofthe Cybex Institute for Exercise Science, in Medway, Mass., the research arm of the maker of Cybex exercise equipment.
Mr. Juris, a former researcher atBeth Israel Medical Centerin Manhattan and a past consultant to professional sports teams, including the Dallas Mavericks of theN.B.A., pointed to stair-climbing scholarship. It concludes that a few brisk climbs a day, like my modest regimen, can increase aerobic capacity and reducecholesterol.
Most any stair-climbing routine, experts say, is a healthy step, literally, toward achievingthe recommended level of physical activityfor adults, according to the American College of Sports Medicine and theAmerican Heart Association. (The goal: moderate aerobic activity— think purposeful walking— for 30 minutes five or more days a week, or vigorous activity like jogging for 20 minutes or more at least three times a week.)
“It’s not all or nothing,” saidCarla Sottovia, an exercise physiologist at the Cooper Fitness Center in Dallas.“Short bouts of exercise, like climbing stairs, certainly help. It all adds up.”
For real athletes, there are staircase races. Once regarded as oddball curiosities, the races have increased in number and stature. Last year there were more than 160 staircase races in the world, on five continents, chronicled and celebrated on Web sites liketowerrunning.com. One of the earliest races, the 86-floor ascent of theEmpire State Building, begun in 1978, was run for the 34th time on Feb. 1, attracting competitors from around the world.
Serious stair runners seem to be mostly marathoners and triathletes, who find stairs a related but novel challenge.
For Emily Kindlon, 30, a runner and triathlete, gaining access to high-rise buildings for training is an obstacle. Frustrated by her eight-story apartment building in Brooklyn, she asks friends in loftier homes for stair privileges. Yet building managers, she said, are reluctant to open their stairs to outsiders, and one asked her to sign a legal wavier.
“In case I fell and broke my neck,” she explained.
“I’ve honestly considered moving to a high-rise in Manhattan for the stairs,” Ms. Kindlon said.
To James Miller, 52, who runs up to 60 miles a week, stair climbing is a kind of cross-training, as if they were vertical wind sprints.“It really expands the lungs— that has to help the running,” he said.
Like Ms. Kindlon, Mr. Miller participated in the Empire State Building race this year. His training was done at home, by repeatedly scaling the 17 flights of his Central Park West apartment building. The training, he said, got him thinking about the neglected stairs.
“It’s not ingrained in our brains to take the stairs,” Mr. Miller observed.“But we live in New York City, and we have this great resource here— so many buildings with so many stairs.”
среда, 9 марта 2011 г.
Wheat Berries With Winter Squash and Chickpeas - Recipes for Health
3 tablespoons extra virgin olive oil
1 large onion, chopped
2 large garlic cloves, minced
1 teaspoon ground allspice
1/4 to 1/2 teaspoon cayenne (to taste)
1 cup wheat berries
2 tablespoons tomato paste
5 cups water
Salt to taste
1/2 cup chopped fresh parsley
1/4 cup chopped fresh dill or mint
1 pound winter squash, peeled, seeded and cut in large dice
1 can chickpeas, drained
1.Heat the oil in a large heavy soup pot or Dutch oven over medium heat. Add the onion. Cook, stirring, until tender, about five minutes. Stir in the garlic, ground allspice and cayenne. Stir together for about one minute, then add the wheat berries, tomato paste and 4 cups of water. Bring to a boil, and add salt to taste. Reduce the heat, cover and simmer 30 minutes. Add 2 tablespoons each of the parsley and dill or mint, and stir in the winter squash and chickpeas. Bring back to a boil, reduce the heat and simmer for another 45 minutes to an hour until the beans and wheat berries are tender and the squash is beginning to fall apart.
2.Uncover the pot, and turn the heat to high so that the liquid returns to a boil. Boil until the liquid is reduced to a syrupy consistency. Remove from the heat, and stir in the remaining herbs. Taste and adjust salt. Serve hot or warm in wide soup bowls.
Yield:Serves six.
Advance preparation:You can make this a few days ahead through Step 1. Reheat and reduce liquid (which will already be thicker if you’ve made it ahead) on the day you are serving.
Nutritional information per serving:264calories; 1 gramsaturated fat; 2 grams polyunsaturated fat; 5 grams monounsaturated fat; 0 milligramscholesterol; 44 gramscarbohydrates; 9 gramsdietary fiber; 211 milligrams sodium (does not include salt to taste); 9 grams protein
Martha Rose Shulmanis the author of"The Very Best of Recipes for Health."
вторник, 8 марта 2011 г.
Cabbage With Tomatoes, Bulgur and Chickpeas - Recipes for Health
1/4 cup extra virgin olive oil
1 onion, finely chopped
Salt to taste
1 tablespoon sweet paprika
1 medium head green or red cabbage, finely shredded
1 14-ounce can choppedtomatoeswith juice
2 teaspoons sugar
2 teaspoons red wine vinegar, cider vinegar or sherry vinegar
1/4 cup chopped fresh dill
2 cups water
1 cup coarse bulgur
1 15-ounce can chickpeas, drained and rinsed
1.Heat the olive oil over medium heat in a large, heavy lidded skillet or Dutch oven. Add the onion, and cook, stirring often, until tender, about five minutes. Stir in a pinch of salt and the paprika. Cook, stirring, until the onion is thoroughly tender and infused with paprika, three to four minutes.
2.Add the cabbage, and cook, stirring, for three minutes or until it begins to wilt. Stir in the tomatoes, sugar and vinegar, and add salt to taste. Bring to a simmer, lower the heat, cover and simmer 15 minutes until the cabbage is thoroughly tender.
3.Stir in the dill and the water, and bring a to a boil. Add the bulgur and chickpeas. Stir to combine. When the water comes back to a boil, reduce the heat to low and cover. Simmer 10 minutes or until all of the water has been absorbed. Remove from the heat, taste and adjust seasonings, and serve hot or at room temperature.
Yield:Serves six.
Advance preparation:Since this is good served at room temperature, you can make it several hours ahead. Reheat if desired. It will keep for three or four days in the refrigerator.
Nutritional information per serving:281calories; 1 gramsaturated fat; 2 grams polyunsaturated fat; 7 grams monounsaturated fat; 0 milligramscholesterol; 42 gramscarbohydrates; 12 gramsdietary fiber; 311 milligrams sodium (does not include salt to taste); 9 grams protein
Martha Rose Shulmanis the author of"The Very Best of Recipes for Health."
понедельник, 7 марта 2011 г.
When Optimism is Unrealistic
One of the patients was a woman in her late 30s, a mother of three. Known for her cheery disposition— she reminded the doctors and nurses of a brunette Cathy Rigby— she hadmelanomathat had spread through her body despite efforts to halt its growth. By the time I met her, she was already the veteran of two clinical trials at the center. Hertumorhad responded slightly during one of those studies, but slowing the pace of its growth had come at a significant price. She had endured countless hospitalizations, serious bloating, a punctured lung, overwhelming fatigue and two nearly intractable infections.
Nonetheless, when hercancerbegan growing again, she eagerly applied for a third study. This time she would participate in one of the earliest studies of a brand-new drug, a Phase I clinical trial, and would have to undergo major surgery before taking the experimental drug.
On the evening before her operation, she joked with the surgical team and shook her head when we asked if she had any more questions.“Haven’t we talked about this enough?” she said smiling and nodding gamely as the head surgeon explained once more that because this was an early-phase trial, it would benefit research but was not likely to be of any therapeutic help to her. Like other such trials, it would test only for toxicity and the maximum safe doses of the experimental drug; generally fewer than 5 percent of patients ever benefit from such early trials.
The woman nodded and waved her hand for the consent form.“I’ve been through this before,” she said to us as she signed the papers.“I know what I am getting into.”
Then, voice lowered, she added:“I’m a mother. I would do anything for a little extra time with my children.”
We all fell silent when she said those words. She seemed to understand the study, and it was hard not to be in awe of her courage and selflessness. But we were also hesitant to probe any further. None of us wanted to deflate her sense of hope. And knowing what we did about the extent of her disease, it was hard not to convince ourselves that optimism, even if based on somewhat false hopes, had to be helpful for someone in her position.
I remembered her words a little over a year later when I heard she had died. Her tumor never responded to the experimental treatment.
Foralmost four decades, researchers and patient advocates have debated the ethicsof informed consent in early-phase clinical trials, studies that test only toxicity and dosing and offer little, if any, therapeutic benefit to those enrolled. A major part of the debate has focused on the motivations of patients who participate. Some research on patient motivations has had disturbing ethical implications, indicating thatpatients may never fully understand the purpose of trials, despite explanations by the researchers. Others have been more reassuring, noting thatpatients are driven by a sense of altruism and a desireto help others who may one day suffer from the same disease.
More recently, a few studies have offered what appears to be the happiest of hypotheses. Patients maysimply be optimistic and have strong needs to express hope. And because optimism has long been considered an effective coping mechanism for patients with terminal diseases, other researchers have also then assumed that optimism in this context poses few ethical issues.
Nowone group of ethicists has just published a study challenging that assumption. It turns out that when it comes to being hopeful, not all optimism is created equal.
The ethicists surveyed 70 patients enrolled in several early-phase cancer trials and asked them about their expectations and understanding of their respective trials. A solid majority understood that the trials’ purpose was to advance research, not to treat them. But despite clearly understanding the purpose, and limits, of early-phase trials, the patients were also blinded by what researchers called an“unrealistic optimism,” or an optimistic bias, when it came to applying that knowledge to their own particular situations. A majority of patients assumed that the experimental drugs would controltheircancer and thattheywould experience benefits but not complications.
In essence, they believed they would fare better than the average patient enrolled in the same trial.
“It’s the Lake Wobegon effect,” said Dr. Daniel P. Sulmasy, senior author and a professor of medicine and ethics at theUniversity of Chicago.“If you have more than 50 percent of patients saying their chances are better than average of avoiding some harm or obtaining some benefit, they are being unrealistically optimistic because you can’t say that most people are above average.”
Such unrealistic optimism differs from so-called dispositional optimism, or a general optimistic outlook.“This is not about trying to quash hope in dying patients,” said Lynn A. Jansen, lead author and an associate director at the Center for Ethics in Health Care at Oregon Health and Science University in Portland.“It’s about distinguishing between the different kinds of optimism.”
Socialpsychologistspoint to smokers who underestimate their chances of getting cancer or gamblers who believe they will beat the odds as classic examples of unrealistic optimism. But unrealistic optimism can be present in anyone, regardless of whether they have a generally optimistic outlook.“No one is immune to this kind of bias,” Dr. Jansen said.“Optimistic biases are part of humanpsychology.”
But placed in the context of early-phase clinical cancer trials, unrealistic optimism results in a perfect ethical storm.“You have oncology, a field of medicine that is strongly evidence-based and research-intensive, and you have a population of patients who are experiencing an immediate threat to their lives,” said Dr. Neal J. Meropol, a researcher who has done extensive work on the ethics of early-phase cancer trials and chief of the division of hematology and oncology at UniversityHospitalsCase Medical Center and Case Western Reserve University in Cleveland.“Patients almost invariably take part in early-phase clinical trials because they believe they will personally benefit.”
While the study represents a breakthrough in understanding how different types of optimism affect the informed consent process, doing something about these biases presents a whole different issue. Unrealistic optimism is notoriously difficult to recognize because most individuals are completely unaware that it even exists.“We would probably be able to walk away from these types of biases,” Dr. Jansen said,“if we realized when we were operating under them.”
Dr. Jansen and her colleagues are hoping next to delineate the factors involved in evoking this biased response in patients. By gaining a deeper appreciation of how unrealistic optimism develops, they believe they may be able to help patients and cancer researchers more easily recognize those optimistic biases that impair a patient’s autonomy and compromise the ethics of clinical trials.
“We all need to care about this kind of research,” Dr. Jansen said.“It’s how we advance knowledge and cure disease.”
She added:“We just need to realize that not all optimism is ethically benign.”
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