Air pollution as bad for wellbeing as partner"s death, say researchers

The effect on wellbeing of exposure to nitrogen dioxide, a gas mostly produced in diesel fumes, is comparable to the toll from losing a job, ending a relationship or the death of a partner, research suggests.

The study found a “significant and negative association” between life satisfaction and levels of the pollutant, which causes lung problems. These effects were “substantive and comparable to that of many ‘big-hitting’ life events,” according to the researchers behind Can Clean Air Make You Happy?.

Sarah J Knight and Peter Howley of York University took life satisfaction data from the British Household Panel Survey and UK Household Longitudinal Survey and compared it with detailed air quality records from the Department for Environment, Food and Rural Affairs.

Given that far more people are exposed to to nitrogen dioxide than suffer unemployment or end a relationship, Knight and Howley suggest that the benefits to society from reducing such emissions would be substantive.

The highest levels of nitrogen dioxide occur in London, with the lowest levels in parts of south-west England. The capital has the dubious honour of being home to the worst NO2 hotspot in Europe: Marylebone Road, which recorded the highest annual mean levels of the pollutant, more than double the legal EU limit.

Pollution from nitrogen oxides is responsible for tens of thousands of premature deaths across Europe, with the UK suffering a particularly high toll. Much of the pollution is produced by diesel cars, which emit about six times more than allowed in the official lab-based tests.

The European Environment Agency said the UK had 11,940 premature deaths in 2013 from nitrogen dioxide. The number was down from 14,100 the previous year, but was still the second worst in Europe after Italy.

Modern diesel cars produce 10 times more toxic air pollution than heavy trucks and buses, according to European data released in January.

The European commission started legal action late last year against the UK and six other EU members for failing to act against car emissions cheating in the wake of the Volkswagen dieselgate scandal.

Air pollution as bad for wellbeing as partner"s death, say researchers

Is the US facing an epidemic of "deaths of despair"? These researchers say yes

In 2015, the Princeton economists Anne Case and Angus Deaton’s groundbreaking paper in the National Academy of Science’s magazine reported that mortality rates among a section of Americans were suddenly surging – something unheard of in previous decades. Mortality was only rising in a certain group: middle-aged non-Hispanic whites without a college degree.

Case and Deaton have returned with a new paper published last week by the Brookings Institute. It paints a grim picture of two Americas, in which one has recovered from the 2008 economic crisis and the other hasn’t. The latter, once called “blue-collar aristocrats”, consists of families who were previously able to get by with jobs not requiring college degrees. The disappearance of those jobs has been accompanied by an alarming rate of suicides, overdoses, and diseases caused by drugs and alcohol.

Case and Deaton call these “deaths of despair” – and argue they have recently reached disturbing levels. While opioids account for many of the deaths, drug abuse may only be a symptom of a larger, unseen epidemic of despair.

Dr Anne Case answered questions over email.

Could you briefly describe your original research and what this new follow-up paper adds to it?

Our 2015 paper documented a set of facts: that after a century of almost uninterrupted progress on mortality, US white non-Hispanics (WNH) in midlife were experiencing a sustained period in which mortality rates stopped falling and rose instead. This stands in contrast to the continued declines in midlife mortality in other rich countries, and to progress being made in the US by black non-Hispanics, and Hispanics, who are on average poorer than whites.

Our 2015 paper highlighted the role played by suicide, alcohol-related liver mortality, and accidental drug overdoses in pushing mortality rates higher for WNH Americans. Our latest paper allowed us to take a deeper dive, looking at mortality and morbidity in much broader perspective. We found the mortality increases are in sync with the distress midlife WNHs face in many dimensions: poorer health and mental health, social isolation, obesity, marriage (or lack of marriage), poorer labor market opportunities, and weaker attachment to the labor market.

Two additional findings stand out: using these outcomes as measures of wellbeing, there appear to be two Americas: one for people who got a four-year college degree, and one for people who didn’t. In addition, these poorer outcomes for those without a college degree become more and more pronounced the later in the 20th century.

You use the term “deaths of despair”. I’m wondering how you would define “despair” in this context?

We think of drug, alcohol and suicide deaths. In a sense, they are all suicide – either carried out quickly (for example, with a gun) or slowly, with drugs and alcohol.

How do you see religion and marriage as factors in the rise of mortality rates among WNH Americans?

There hasn’t been a decline in religion, but it appears there has been a change in the type of churches to which people report an affiliation. “Legacy” churches (eg Catholic, mainline Protestant) have given way to “seeking” churches, in which there is less structure.

I’m not sure traditional ideas of marriage have changed, but later-born birth cohorts of WNH without a college degree are substantially less likely to get married, or stay married. To be concrete, almost three-quarters of WNH men and women with less than a BA born in 1950 were married when observed at age 30; that fell to two-thirds for the cohort born in 1960 seen at age 30; and to half for the cohort born in 1980.

Scholars in sociology tell us this is closely connected to the fact that men in later-born cohorts can’t marry if they don’t have “a good job”. Those jobs – jobs with on-the-job training, jobs with benefits, jobs where, if you work hard, you can expect to move up – are harder and harder to come by now. While marriage rates fell, rates of cohabitation rose. However, unlike what one sees in many European countries, these cohabitations are fragile in the US. Taken together, this leaves less structure (in religion, in jobs, in marriage). If things go well, this is fine, but if things go poorly, this can lead to suicide.

You write that the recent decline in incomes does not completely explain the rise in “deaths of despair” among white non-Hispanics without a college degree; they also face a “cumulative disadvantage” over the course of their lives. How do you explain this?

Current household income per person doesn’t explain why those without a BA have rising mortality rates. For both those with and without a college degree, incomes rose in the 1990s and fell with the great recession. But those with a BA saw mortality rates fall throughout this period, while those without a BA saw mortality rates rise throughout.

We are working with a model of “cumulative disadvantage” to help us make sense of the rise in despair. You can think of everyone born in a given year (say, 1960 or 1970) as being handed a weight that they have to carry with them. The heavier the weight, the harder it is to carry, and the longer you carry it, the worse things become. That weight may be the kinds of jobs a person can get with a high school degree (measured in wages and opportunities for advancement), and it appears that weight is heavier for each successive birth cohort. The quality of the labor market may affect whether a person marries, and the stability of their personal lives, and whether they risk their health at work.

What current policies, if enacted, could prolong or deepen or halt the epidemic?

Addiction and mental health programs are essential. Working to stop the over-prescription of opioids is essential. Policies that make available educational opportunities for people who don’t want a college degree – that allow people to develop the skills that will be rewarded in the 21st-century economy – would make a big difference.

You suggest that Europeans don’t see the same rise in death rates due in part to a stronger social safety net. Could you see an argument for such a social safety net in America?

This might be more difficult than it sounds. Americans like to think of themselves as individuals who can look after themselves and their families, and expect the same of their neighbors. A stronger safety net may not be politically feasible. The difference between a “helping hand” and a “handout” may be in the eye of the beholder.

• In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In the UK, the Samaritans can be contacted on 116 123. In Australia, the crisis support service Lifeline is on 13 11 14. Hotlines in other countries can be found here
  

Is the US facing an epidemic of "deaths of despair"? These researchers say yes

Multiple sclerosis treatment is debunked by researchers in Canada

A surgical treatment pioneered in Europe that was sought out by thousands of desperate people with multiple sclerosis has been categorically debunked by Canadian researchers.

“Liberation therapy” to widen narrowed veins from the brain and spinal cord was devised by the Italian surgeon Dr Paolo Zamboni, who suggested in 2009 that the neurological disease could be triggered by a build-up of iron where the blood did not flow freely.

Zamboni called this condition chronic cerebrospinal venous insufficiency (CCSVI or CCVI) and widened the veins of people with MS using stents. Many in the medical community were sceptical, and his trials of the technique did not compare people given the procedure with those who were not. But other doctors’ doubts did not stop people with MS from joining the waiting list.

In 2013, a paper was published in the Lancet medical journal by Dr Anthony Traboulsee from the University of British Columbia and colleagues, funded by the MS Society of Canada, which found that Zamboni’s hypothesis was fundamentally flawed. The researchers’ study showed that narrowing of the veins that run from the brain to the heart was as common in people without MS as in those with the condition.

The same team has now carried out a more ambitious study. They performed the vein-widening venoplasty procedure on 49 people, inserting a catheter and inflating their veins with a small balloon and a “sham” operation on 55 others, who just had the catheter insertion. Neither the patients nor the researchers knew which people had undergone which operation.

One year later, assessments involving brain imaging and doctors’ and patients’ own assessment of their symptoms, showed that there was no difference between the disease progression of the two groups.

“We hope these findings, coming from a carefully controlled, ‘gold standard’ study, will persuade people with MS not to pursue liberation therapy, which is an invasive procedure that carries the risk of complications, as well as significant financial cost,” said Traboulsee, a UBC associate professor of neurology.

“Fortunately, there are a range of drug treatments for MS that have been proven, through rigorous studies, to be safe and effective at slowing the disease progression.”

In spite of the earlier Lancet paper, people are still seeking liberation therapy, Traboulsee said. “It is less popular. But there is still an advocacy group that has a conference once a year with guest speakers such as Dr Zamboni,” he said. “There are still researchers dedicated to the topic, not just Dr Zamboni. It has been proposed as important for treatment of Ménière’s [disease] and for dementia diseases.”

Multiple sclerosis treatment is debunked by researchers in Canada

Increased risk of 11 types of cancer linked to being overweight, researchers warn

Being overweight could increase the risk of a host of cancers, including those of the colon, breast, pancreas and ovary, researchers have warned following a wide review of more than 200 studies.

According to previous figures from two leading charities, almost three quarters of people are expected to be overweight by 2035, with 700,000 new cases of obesity-related cancer expected over the next 20 years.

The new study by an international team adds weight to the warning, revealing that there is currently strong evidence for a link between excess body fat and an increased risk of 11 cancers: colon, rectum, endometrium, breast, ovary, kidney, pancreas, gastric cardia, biliary tract system and certain cancers of the oesophagus and bone marrow.

“I think now the public and physicians really need to pay attention to obesity with respect to cancer,” said Marc Gunter, a co-author of the research from the International Agency for Research on Cancer. “Telling people to avoid being overweight not only reduces their risk of, say, diabetes and cardiovascular disease, it also reduces their risk of many different cancers.”

Published in the British Medical Journal, the study examined evidence from 204 previously published studies which each looked at combined results from multiple pieces of research probing the link between body fat and the development of particular cancers.

Of the 95 studies which looked at obesity measures on a continuous scale such as body mass index, 12 were found to offer strong evidence of an association, encompassing a total of nine different cancers.

Analysis of these studies revealed that as BMI (weight divided by height squared) increased, so too did the risk of developing certain cancers. For men, for every 5kg/m² increase in BMI, the risk of developing colorectal cancer rose by 9%, while among women forgoing HRT, the risk of developing postmenopausal breast cancer increased by 11%. The figures were even higher for cancer of the biliary tract system, with risk increasing by 56% for every 5kg/m² increase in BMI.

The authors note the remaining 83 such studies were of mixed quality. While 18% were deemed “highly suggestive” of a link between excess body fat and cancer, 20% had only weak evidence while 25% had no evidence for a link.

When studies that looked at other measures of obesity were included in the analysis, the total number of cancers for which there was strong evidence of a link to body fat came to 11.

While the new study does not shed light on how excess body weight is linked to an increased risk of various cancers, a number of explanations have previously been proposed. “We know that if you are overweight it causes lots of disruption of hormonal and metabolic pathways,” said Gunter, noting that excess fat has been linked to higher oestrogen levels, higher insulin levels and increased inflammation – all of which can affect cell division.

Dr Rachel Orritt, Cancer Research UK’s health information officer, said: “This research uses very strict criteria to evaluate the evidence and confirms that obesity increases the risk of cancer, linking many of the same cancer types that have been linked before.”

Being overweight, Orritt adds, is second only to smoking as the biggest preventable cause of cancer. “Whether it’s taking the stairs or switching to sugar-free versions of your favourite drinks, small changes can make a real difference, helping you keep a healthy weight and reducing your risk of cancer,” she said.

Dr Alison Tedstone, chief nutritionist at Public Health England, added that awareness was key. “Less than half the population realise that being obese increases the risk of cancer and, with almost two-thirds of adults carrying excess weight, this is worrying,” she said.

Paul Aveyard, professor of behavioural Mmedicine at the University of Oxford, agreed that the study highlighted the need for society to take steps to reverse the rise of obesity. “It is one more reason for people to be concerned about the excess body weight that they carry,” he said. “This risk isn’t confined just to people who are really overweight. All of us who carry excess fat, and that is most of us in this country, are at some degree of risk.”

Increased risk of 11 types of cancer linked to being overweight, researchers warn

AI system as good as experts at recognising skin cancers, say researchers

Computers can classify skin cancers as successfully as human experts, according to the latest research attempting to apply artificial intelligence to health.

The US-based researchers say the new system, which is based on image recognition, could be developed for smartphones, increasing access to screening and providing a low-cost way to check whether skin lesions are cause for concern.

“We hope that this is a first step towards early detection,” said Andre Esteva, an electrical engineering PhD student from Stanford University and co-author of the research.

According to the World Health Organisation, skin cancer accounts for one in every three cancers diagnosed worldwide, with global incidence on the rise.

In the UK alone, 131,772 cases of non-melanoma skin cancer were recorded in 2014. In the same year there were 15,419 new cases of the deadliest skin cancer, melanoma, making it the fifth most common cancer, according to Cancer Research UK.

As the disease is often initially spotted by a visual examination, Esteva teamed up with colleagues in fields ranging from dermatology to artificial intelligence to create a computer system that would aid screening.

Their approach, described in the journal Nature, is based on deep learning – a class of algorithms used for artificial intelligence. When fed with a large set of ready-sorted data these algorithms pick out and “learn” patterns and relationships. Once trained, the algorithms can then be used to categorise new, unsorted data.

To create the system, the team harnessed a deep learning algorithm built by Google that had already been presented with 1.28 million images of objects such as cats, dogs and cups. Esteva and colleagues then fed the system more than 127,000 clinical images of skin lesions, each already labelled, encompassing many different skin diseases.

Once trained, the team then tested the system’s ability to classify skin cancer by presenting it with just under 2,000 previously unseen images of skin lesions, whose nature had previously been determined by biopsy, and further compared the results for nearly 400 of the images against the judgement of at least 21 dermatologists.

The results reveal that the system is on a par with – if not better than – the experts in telling apart carcinomas from common benign skin growths and melanomas from moles.

For melanomas, the average dermatologist classified around 95% of malignant lesions and 76% of harmless moles correctly. By comparison, the algorithm is capable of correctly classifying 96% of malignant lesions, and correspondingly 90% of benign lesions.

“The aim is absolutely not to replace doctors nor to replace diagnosis,” said Esteva. “What we are replicating [is] sort of the first two initial screenings that a dermatologist might perform.”

While Esteva and colleagues admit the system needs further testing in clinical settings they believe the approach has great promise, suggesting it could be applied to a host of other medical fields.

Boguslaw Obara, a computer scientist at Durham University and expert in image processing, said that the size and complexity of the dataset used to train the system was impressive. The work, he adds, shows we are likely to see algorithms cropping up more and more in everyday life.

Dr Anjali Mahto, consultant dermatologist and spokesperson for the British Skin Foundation also welcomed the research. “This is an exciting new technology that has the potential to increase access to dermatology at a time where there is a national shortage in this speciality and the rates of skin cancer continue to rise,” she said.

But, Mahto warned, the system will need to be carefully assessed for its benefits before it can be rolled out. The approach is also unlikely to replace the role of dermatologists, she adds, pointing out that during a full-body examination experts often discover skin cancer at different sites to those that initially concerned the patient. “There is therefore a possibility that if you rely on people to self-report what they are worried about, other skin cancers – particularly in hard to see sites, e.g. the back – may be missed,” she said.

AI system as good as experts at recognising skin cancers, say researchers

Individual athletes more prone to depression, researchers find

Athletes in individual sports are more prone to depression than those in team games, according to German research to be presented at a conference in Cardiff.

The research by the Technical University of Munich confirms not just the loneliness of the long distance runner but a range of other depressive symptoms among solo sportsmen and women more generally.

Prof Jürgen Beckmann, the university’s chair of sports psychology who will be presenting the research, said: “Individual athletes attribute failure more to themselves than team sports athletes. They take the blame more than team players. On a team there is a diffusion of responsibility, as social physiologists would say, compared with the performance of an individual athlete.”

One of the studies compared 128 young German footballers and hockey players with 71 junior athletes in a range of individual sports including swimming, speed skating and badminton.

They were assessed on a depression scale that measures symptoms such as guilt, sadness and suicidal feelings. It found that individual athletes showed significantly more signs of such symptoms than athletes in team sports.

The finding was replicated in a study of 162 senior elite athletes including many in various German national teams. Individual athletes including triathletes, golfers and cyclists were found to have higher symptoms of depression than team players in games that included volleyball, rugby and football.

The research, which is to be presented at the British Psychological Society annual sport and exercise conference in Cardiff on Monday, found that the individual athletes tend to blame themselves for sporting failure.

One of the papers to be presented suggests that individual athletes take both sporting success and failure more personally than team players. “The internal attribution could lead to stronger experiences of emotions such as pride (positive events) and guilt or shame (negative events) in athletes in individual sports,” one of the papers says.

The researchers also expected to find more signs of perfectionism among individual athletes but were surprised to discover that team players were more prone to perfectionism.

A separate long-term study found that perfectionism and chronic stress often led to burnout but not depression. Depression was found to be linked with a lack of time to recover from stress and injury.

The research found that swimmers had high prevelance rates for depressive symptoms. Photograph: Matt Cardy/Getty Images

The research also found that depressive symptoms were particularly prevalent among young athletes. Beckmann said: “The real problem is with young athletes. Those who receive social support from parents and peers experience much less stress than those who don’t. That’s especially important during adolescence.

“We found that up to 20% of young athletes do have a problem with higher depression scores. In the general population its range is between 9% and 12%.

“We are not diagnosing them as being depressive, but on the depression scales they have quite a score.”

He said subsequent studies have suggested that the level could be even higher among solo athletes only. “We have very high prevalence rates in swimming, for example,” Beckmann said.

He called for more support to be given to athletes to help them recognise signs of depression and to suggest ways of tackling it.

He said: “In Germany, we have developed a burnout and screening instrument for junior athletes and a website to give them advice on coping with stress and other psychological problems they may experience.”

The mental health charity Mind said the research underlined pressures facing athletes. Hayley Jarvis, Mind’s community programmes manager for sport, said: “Following the increasing number of ex-sportspeople who have spoken out about struggles with their own mental health and some high profile suicides, Mind commissioned research to explore how sports’ governing bodies and players’ organisations currently deal with mental health, and identify best practice which can be shared with other sports.

“To help create an environment where all sports professionals can fulfil their potential, we need to see managers, coaches, clubs, governing bodies and players’ unions all support athletes to manage their mental wellbeing.”

Andy Baddeley’s story

Andy Baddeley: ‘People think admitting mental health problems makes them seem weak.’ Photograph: Michael Steele/Getty Images

Andy Baddeley, a two-time Olympian and Britain’s former No 1 1,500m runner, has blogged about his experiences of depression on the Mind website. Speaking to the Guardian, he said:

The hardest thing about running is that you are on own before a race. When things are great that’s what’s good about it. I’m not dependent on 10 other guys being on the top of their game in order for me to be successful. But there is also nothing to fall back on. The nature of athletics is that one guy gets to win each race, and so there’s 11 or more in my event who don’t. And its that unpredictability that’s the hard bit.

It got to a point with my coach when I couldn’t express how low I was. There are not many people I get to talk to about these things. I’m not surrounded by a team. I don’t have to turn up to a training ground.

I have often felt that I would be better suited to a team sport. What I enjoy most is group training, but the nature of distance running is that that doesn’t happen every day.

You’re the only one who can train hard. It is a lonely decision each day, especially when it’s cold and raining. If I plan to meet someone, I find that’s powerful in terms of motivation. And it’s the days when I am not meeting someone that it takes me a lot longer than it should to get myself out of the door. Talking to someone is what has helped me.

My mental health has been best when I’ve been meeting coaches and other team members.

Having a mental heath struggle doesn’t mean you are not mentally strong for a race. These things are separate. You can still run through the pain barrier but still have bad days – they are not mutually exclusive.

People think admitting mental health problems makes them seem weak or susceptible to being beaten. But after I wrote about my experiences I felt stronger.

I was lucky enough to see a sports psychologist when I was on lottery funding. When I was injured I saw someone privately and that helped. I deliberately chose a non-sports psychologist because I wanted more of an idea of what was normal, rather than what’s normal in elite sport.”

In the UK, the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Hotlines in other countries can be found here.

Individual athletes more prone to depression, researchers find

Sea Hero Quest is of huge benefit to medical researchers. So what’s the catch? | Emily Reynolds

In tech circles, alongside words such as “scaleable” and “the gig economy”, you often hear the phrase “tech for good” bandied around. Sometimes it’s a fairly innocuous but ultimately toothless concept, essentially denoting the idea that technology has the potential to be a driver for positive social change but not doing very much about it. Other times it can take on a more creepily utopian tone, suggesting that should the world more closely represent the shiny libertarian enclaves of Silicon Valley, the world’s problems would be solved. And sometimes – just sometimes – it does what it says on the tin.

A new game, designed to test spatial navigation, appears at first glance to do just that. Sea Hero Quest, which involves navigating a boat through choppy waters, contains a diagnostic test for the early signs of Alzheimer’s disease. The game has now been played by more than 2.4 million people – which the team behind the game say makes it the largest dementia study in history.

It’s now set to be adapted for use in a clinical setting – data could be fed back to clinicians, allowing for earlier diagnosis, better understanding of how medication is working for a particular patient and a more accurate and precise measurement of a patient’s decline. It could even be incorporated into NHS programmes.

This, it goes without saying, is initially incredibly attractive. Understanding and managing an illness or being alerted when you’re at risk simply through the daily use of an app sounds simple, easy and most of all useful. Could this not be a genuine use of tech for good, rather than the banal and empty proclamations often heard from CEOs and founders?

In theory, yes. In practice: maybe not.

More than 2.4 million people have downloaded Sea Hero Quest to their phones. Photograph: The Sea Hero Quest/PA

As with any health data-driven project, it comes with stipulations. A recent study in Lancet Psychiatry suggested that data gathered on Facebook could provide a “wealth of information” about mental health, with a series of language analysis and facial emotion recognition algorithms providing “insights into offline behaviours”. This, too, sounds great. Having your health monitored and managed through the passive use of technology you probably already use – what more could you want?

But there are a number of concerns here: primarily, the safety of private health data. The addition of a private company in the latter study may make it feel different: a towering behemoth such as Facebook obviously feels more threatening than something set up for and run by clinicians. But to not have the same reservations just because the data was being sent to scientists would be incredibly naive.

Science, much like technology, is often presented as objective, reasonable fact, without mentioning the very obvious caveat that it is conducted by human beings, who are often neither reasonable nor objective. Multiple studies about statistical analysis are useful to recall here – the results of such analyses may seem completely objective, but often reflect the preconceived biases of those conducting them. That’s not to say that would be the case with Sea Hero Quest, of course: just that the results of such research can be fallible.

And it’s also important to remember that, should the Conservative party have its way, the NHS may be in the hands of several, separately operated and privately owned companies before too long. This adds further complications: who would have access to our health data? How would they use it? How would data be efficiently and safely communicated across different companies? Would their data protection processes be cohesive? Would they be meticulous enough to protect our most private, personal data? The idea of having your phone feed data to a central NHS database sounds great in principle, but these questions would need to be answered before that could safely become a reality.

In an ideal world, tech would be utilised to help us to diagnose and treat illnesses: anything that can efficiently and effectively help people manage long-term or life-threatening conditions can only be a good thing. Similarly, the idea of a National Health Service that is genuinely innovative, that uses new ways to help people and that has a strong grasp on data security while it does so is incredibly appealing. Unfortunately, as with most utopian ideas, you’re left wondering whether it might just be too good to be true.

Sea Hero Quest is of huge benefit to medical researchers. So what’s the catch? | Emily Reynolds

Sudden infant death syndrome may have a biological cause, say researchers

The first evidence of a biological explanation for newborns dying suddenly in their sleep may have been found by a group of researchers investigating the brain.

Researchers at the Royal Alexandra hospital for children at Westmead say they have discovered babies who die from sudden infant death syndrome (Sids) have greatly decreased levels of a certain brain protein-like neuropeptide, known as orexin, responsible for regulating sleep arousal.

It is hoped the research could eventually lead to babies being screened for low levels of orexin.

Such a test would not be available for at least another decade, however, and parents still need to follow the Sids prevention guidelines, experts caution.

There are many well known and evidence-based environmental risk factors related to Sids, such as smoking, excessive bedding and stomach sleeping.

Dr Rita Machaalani, the sleep unit manager at Westmead, said there was now evidence that Sids was caused by a biological condition in an area of the brain responsible for sleep regulation.

A cohort study of more than 27 Sids cases and 19 controls found the level of orexin was 20% lower in the brains of those babies who had died from Sids.

“That seems to indicate that these babies may have had some defect in the message that says this baby should arouse during their sleep time but it didn’t get through to do so,” Machaalani said.

Machaalani said her team was now conducting research to find the mechanism responsible for this reduction in orexin, which has previously been implicated in sleep disorders in adults.

Medical researcher and associate professor Alexandra Martiniuk from the George institute for global health at the University of Sydney, said the potential to screen was huge.

But orexin could be just “one of many” causes of Sids, Martiniuk added.

“I have read a lot of coroner reports of children who have died of SIDS and there are these other risk factors,” she said. “They do often state that they found the child lying face down or face embedded between mattress and something else.”

Martiniuk said Sids could be the result of a combination of biological and environmental factors, such low levels of orexin and bad sleeping habits.

“It will remain to be seen whether you need a loading of risk factors to have a bad outcome of death.

“But certainly it’s a huge breakthrough because in my knowledge of Sids there hasn’t been anything biological like that before, it has always been environmental risk,” she said.

Sudden infant death syndrome may have a biological cause, say researchers

World lagging behind on global health targets, researchers warn

Substantial change will be required in the way global epidemics such as tuberculosis and HIV are treated if the international community is to eliminate them completely by 2030, a study has found.

According to the report, published in the Lancet, nocountry has met any of the nine global health targets – including the elimination of major disease epidemics and the reduction of health issues like childhood obesity and intimate partner violence – laid down as part of the UN’s sustainable development agenda.

The study provides the first independent analysis of performance on sustainable development goal three, which calls on the world to “Ensure healthy lives and promote wellbeing for all at all ages”. The health SDG is one of 17 universal goals that replaced the millennium development goals (MDGs) after they expired at the end of 2015. Health-related indicators are present in 12 of the 17 goals, which have a 2030 deadline and consist of 169 targets and 230 indicators.

“This paper on the SDGs represents a baseline that informs health policy and decision-makers in all countries, as well as the UN,” said Dr Christopher Murray, director of Seattle’s Institute for Health Metrics and Evaluations (IHME), which led the study.

“It is essential that each year, over the next 15 years, nations be held accountable for the goals their leaders have committed to meet. This report contributes an important element to that accountability.”

Using data compiled by the Global Burden of Diseases, Injuries and Risk Factors study between 1990 and 2015, IHME researchers rated the progress of 188 nations on a score of 0-100. Their aim was to help governments, donors, health professionals and policymakers better identify successes and gaps in global healthcare delivery.

A median health-related SDG index of 59.3% was established, with countries in the highest quintile (over 71.5%) clustering in western Europe, high-income North America, and parts of Asia and Australasia. Iceland, Singapore and Sweden ranked highest overall; Iceland scored 85.5%, thanks largely to tobacco controls and a well-established public health system.

The bottom three countries – Somalia, South Sudan and Central African Republic – were all in Africa. Central African Republic scored 20.4% overall, recording 0% for hygiene, 2% for water, and 3% for malaria indicators.

Even developed countries, including the UK and US, did badly in certain areas. The UK, though fifth overall, fared poorly on childhood overweight, HIV and harmful alcohol consumption. The US scored far worse, ranking 28^th overall, a result shaped partly by deaths due to interpersonal violence and suicide. The US also ranked poorly among high-income countries on maternal, child and neonatal mortality.

A number of countries did better than expected between 2000 and 2015, including Timor-Leste, Tajikistan and Colombia. Others, including Syria and Libya, fared extremely badly, due to war.

The report also indicated that rapid economic growth alone did not necessarily make countries meet targets better. India came 143rd of the 188 countries included in the study, behind Comoros and Ghana.

“Our study is a starting point for further investigation on how and why countries are underperforming, or performing well, compared to the average,” said Professor Steven Lim of IHME, one of the report’s authors.

“This will be an annual effort to ensure progress is maintained and that lessons from successes are learned and rapidly transferred to other countries where progress is less impressive.”

The data showed varied progress among nations. More than 60% of countries have already met the 2030 targets on reducing maternal mortality (less than 70 deaths for every 100,000 live births) and child mortality (25 deaths per 1,000 live births).

But no country has met – or is likely to meet – the goal to completely eliminate tuberculosis or HIV by 2030. The authors warned that a “substantial change” in the current trajectory of HIV and tuberculosis indices, as well as “major technological leaps coupled with universal delivery”, would be required to meet the deadline.

Researchers developed a socio-demographic index in order to differentiate progress made on the SDG index from progress that countries would have been otherwise expected to make. Based on income per capita, educational attainment and total fertility rate – key indices of a country’s development status – the index was highly predictive of health-related SDG indices. But it failed to predict interpersonal violence, self-harm and childhood obesity, with the authors warning that more research is required to understand what helps or hinders progress in such cases.

Devi Sridhar, professor of global public health at the University of Edinburgh, said that the SDGs may be more useful to donors and aid organisations than poor countries, warning that “global priorities risk over-riding local concerns and priorities”.

“Governments find it a tricky balancing act to manage pleasing donors with what their citizens are calling for, and ensuring that they are paying particular attention to marginalised communities who might have even specific needs to be met,” she said. “In the end, governments should be responsible to their communities rather than to external entities.”

World lagging behind on global health targets, researchers warn

Researchers say there are no benefits of testosterone treatments for men

A little more than a year ago, the Food and Drug Administration put the brakes on a massive push by drugmakers to market testosterone treatments to the average middle-aged man. A multimillion-dollar ad campaign had portrayed the drug as having extraordinary power to combat symptoms of ageing. But the FDA had become concerned about the potential for testosterone to increase heart risks.

“The benefits and safety” of testosterone treatments, the agency said in the order that ground the marketing campaign to a halt, “have not been established”.

Now, a group of researchers have announced that they have established the benefits: none.

“The prescription of testosterone supplementation for low-T for cardiovascular health, sexual function, physical function, mood, or cognitive function is without support from randomized clinical trials,” reads a new study, which was published on Wednesday in the open-access journal Plos One.

The study is an analysis of more than 200 others conducted since 1950 which compared testosterone with a placebo. And it is a sharp rebuke to an industry which spent years portraying testosterone as akin to a miracle drug for men feeling the ordinary effects of ageing.

“We don’t need to do further trials,” said Adriane Fugh-Berman, a professor at the Georgetown University Medical Center and one of the study’s authors. Fugh-Berman is also the director of PharmedOut, a Georgetown research group that scrutinizes drugs it suspects are over-diagnosed, often putting it at odds with the pharmaceutical industry, and she briefly acted as an expert witness in testosterone litigation. “The evidence is very clear that testosterone does not help men’s health. And the real risks of testosterone outweigh the illusory benefits.”

The study is likely to deal a further blow to sales for testosterone supplements, which just three years ago topped $ 2bn annually. Driving those sales was a big ad campaign: from 2012 to 2013, the drugmakers AbbVie and Eli Lilly spent more than a quarter-billion dollars extolling testosterone treatments for men with a waning libido or low energy.

Critics saw an effort to put the drug in as many hands as possible with little supporting evidence. A popular test to identify men with “low-testosterone” or “low-T” – which Fugh-Berman at the time criticized as a test “that everyone will fail” – asked men if they found themselves feeling grumpy and becoming tired after dinner. Doctors gave out 2.3 million prescriptions for testosterone in 2013 alone, the FDA found – up 75% from 2010.

But amid the boom, some experts raised concerns that benefits of testosterone were unproven for men experiencing the normal effects of ageing. Moreover, there was evidence that testosterone treatments posed a risk to cardiovascular health.

In late 2014, the FDA’s advisory panel urged the agency to revise testosterone drugs’ labeling. The FDA followed though in March 2015. Eli Lilly and AbbVie had already slashed their ad spending by nearly 40% and seen a 10% drop in sales of the drugs. Now, the FDA had effectively barred them from targeting any more ads at otherwise healthy men who were simply getting old.

But the FDA only regulates the marketing of a drug. Doctors may continue to prescribe testosterone to ageing men off-label if they feel the treatments would be beneficial.

So the researchers – Samantha Huo of Tulane University, Fugh-Berman and a team from Georgetown, and researchers from the University of South Florida, the University of Illinois–Chicago, and toxicology consulting group – set out to determine what the FDA hadn’t: what were the benefits, if any, of regular testosterone supplements?

The researchers deliberately included in their review many low-quality studies that found a benefit from testosterone treatments, Fugh-Berman said. “We wanted to give it the best possible chance of coming out with positive effects, and it didn’t.”

Still, some of the areas where testosterone was found to have no impact were surprising. In bodybuilders, which the study excluded because they take testosterone in very high doses, testosterone is shown to enhance muscle mass and strength. So researchers were puzzled when their findings included no evidence that testosterone increased strength for men diagnosed with “low-T”, even though it increased their muscle mass.

Another surprise came when researchers concluded the drug had no effect on sexual function. “Everybody assumed it was helpful for erectile dysfunction, and we were surprised to find out it just isn’t,” said Fugh-Berman. “There wasn’t good evidence for this.”

The study published on Wednesday did not include the small subset of men whose bodies do not produce any testosterone. In these individuals, who may have been born without or suffered damage to their testicles, testosterone treatment can be necessary to prevent bone loss. The study also excluded trans men, who take testosterone in high doses to help their bodies become more masculine.

So why doesn’t testosterone treatment work?

One big reason may be that there are no agreed-upon parameters for what counts as “normal” and “low” testosterone for different age ranges. While levels tend to wane as men grow older, said Fugh-Berman, “there’s a broad range for ‘normal’ at every age”.

“I think this question is settled,” Fugh-Berman said. “There’s no such thing as the fountain of youth.”

Researchers say there are no benefits of testosterone treatments for men

Lithium should be more widely used for bipolar disorder, researchers say

Britain’s 650,000 people with bipolar disorder should take lithium to help control their condition, despite its reputation for dulling the senses, a significant new study has found.

Researchers claim that although the drug does carry some health risks, its overall effectiveness, especially its ability to reduce self-harm and suicide, mean it should be much more widely used.

The findings are contained in the first study comparing the side-effects of the four main mood-stabilising drugs the NHS prescribes. They have prompted calls for a rethink about attitudes towards lithium, given that only an estimated 10% of those with bipolar disorder use it, mainly because patients fear it will cause loss of personality, weight gain and other problems.

The lead author behind the research told the Guardian that widespread “lithium stigma” among patients is leading to them receiving the wrong treatment and ending up admitted to hospital unnecessarily because their condition is not as well controlled as it could be.

“Lithium is a drug with a bad reputation. It is seen by patients, and some psychiatrists, as a dangerous drug. People rightly have suspicions about it. Patients say that the downsides include emotional numbing – feeling that you aren’t connected with your feelings – as well as tremors,” said Dr Joseph Hayes, a psychiatrist at University College London.

But lithium’s reputation is largely misplaced and based on the experiences of patients from the 1960s to the 1980s who were given too large a dose of the drug, he added. The new research, published in the medical journal PLOS Medicine, found that the side-effects of the mood-stabilising alternatives used by most patients are either the same as or worse than lithium, Hayes said.

The paper, co-written by Hayes and four colleagues from UCL and Oxford University, concluded that: “Lithium remains an important treatment for individuals with bipolar disorder.” It accepts that “there is clear evidence that its use is associated with a number of adverse events.”

However, it adds: “These risks need to be offset with the potentially superior effectiveness and anti-suicidal benefits of the drug compared to other treatment options.”

The researchers studied a nationally representative sample of 6,671 patients across the UK who were treated for bipolar disorder between 1995 and 2013. Of those, 2,148 had taken lithium, 1,670 had used valproate, 1,477 had been on olanzapine and 1,376 had taken quetiapine. They experienced side-effects including chronic kidney disease, thyroid disease, weight gain and high blood pressure.

The researchers’ analysis bore out one of the two main criticisms of lithium, but found the other to be baseless. They found that patients on lithium had a higher risk of suffering kidney function problems and developing hypothyroidism or hyperthyroidism and also hypercalcemia. However, none of the drugs caused more severe kidney problems.

Meanwhile, lithium patients were less likely to put on weight than patients on the other drugs. While 15%-20% of those on the three other drugs were more likely to gain more than 15% of their body weight, just 10% of those on lithium put on the same amount of extra pounds. Those on olanzapine added the most weight and experienced high blood pressure as a result.

I think many patients are missing out quite commonly on the best available treatment

Dr Joseph Hayes

Separate research has shown that patients on the other three medications are 40% more likely to harm themselves than those on lithium. Bipolar disorder carries one of the highest rates of suicide of any mental illness, alongside schizophrenia and alcohol and drug addiction.

The very limited use of lithium is despite the National Institute for Health and Care Excellence (Nice) advising in 2014 that it should be the standard treatment for bipolar disorder, which is also known as manic depression and is characterised by manic highs and bouts of depression. That superseded its previous view, outlined in 2006, that any of the four drugs were useful first lines of treatment for the condition, which affects about one in 100 people.

“Lithium stigma, which includes some people in the psychiatric community, leads to people using drugs that are less effective [than lithium]. To me as a doctor that’s a big worry because my main aim is to help people to be well and if you aren’t doing that with the best available evidence then you are failing patients,” said Hayes.

“I think that many patients are missing out quite commonly on the best available treatment. That means that people end up in hospital more often than they need to and end up achieving less in their lives than they could do if they were on lithium. The high suicide rate with bipolar disorder should encourage greater use of lithium. There should be more sensible use of it.”

Stephen Buckley, head of information at the charity Mind, said: “We welcome research which adds to our understanding of treatments and medications for people experiencing mental health problems, including bipolar disorder. But as with all areas of mental health there is still more research to be done.

“Different people will find that different treatments help with managing their mental health problems. This may be medication, talking therapies, or a mixture of both.”

Lithium should be more widely used for bipolar disorder, researchers say

Researchers cleared of misconduct in row above sugar hyperlink to obesity

Two high-profile Sydney University scientists have been cleared of misconduct in excess of a controversial analysis paper challenging the thought that sugar is a exclusive contributor to Australia’s obesity epidemic.

But an independent investigator did uncover some difficulties with the essential argument of Jennie Brand-Miller and Alan Barclay that Australian sugar consumption has declined above the previous three decades.

Following a six-month investigation by Robert Clark, chair of energy strategy and policy at the University of New South Wales, the two nutritionists have been asked to compose yet another paper “in consultation with the faculty, that particularly addresses and clarifies the key factual problems examined in this inquiry”.

Clark located that the allegations of sugar’s decline in consumption had been unsubstantiated, but mentioned the saga highlighted a amount of “lessons discovered”.

Barclay and Brand-Miller, who is recognized as “GI Jennie” for her function pioneering the glycaemic index, faced what they named a “trial by web” above their 2011 paper, the Australian Paradox, which argued that Australia’s weight problems fee had sharply improved over the past three decades in spite of a “considerable and constant decline” in refined sugar consumption per individual.

The examine has formed component of the food industry’s argument against public wellness initiatives aimed at curbing sugar consumption, this kind of as a sugar tax or ban on additional-large soft drinks.

An ABC radio investigation in February highlighted many alleged errors with the paper raised by the economist and anti-sugar crusader, Rory Robertson.

Amongst his criticisms was that the surveys relied on by Brand-Miller and Barclay to demonstrate a decline in sugar consumption were incomplete and has been abandoned by the Australian Bureau of Statistics. In a strident on the web campaign, Robertson also claimed that the two renowned nutritionists had shut back links with the sugar business, and that Barclay in specific had taken cash from Coca-Cola to current his analysis.

Clark discovered that the information showing that Australian sugar consumption had declined more than the previous 3 decades was discontinued by the ABS in 1999 due to “an emerging reliability issue [that] could presumably impact the dependability of data factors in many years approaching this cessation level”.

But nevertheless, he said, the extended-term trend did display a persistent decline, and it had been realistic for the two nutritionists to depend on the data, which they had sourced from the United Nations’ Meals and Agriculture Organisation.

With no wading into the raging debate about the position of sugar in triggering obesity, Clark mentioned that the paper should not be seen as”exonerating sugar per se”. He speculated that even though national intake of the sweetener appeared to have declined, its consumption amongst individuals sections of the community hardest hit by weight problems might properly have gone up.

He found that neither nutritionist had a conflict of interest, in spite of taking cash from the food industry for some of their operate, however Barclay’s acceptance of payment from Coca-Cola to give a presentation about sugar “might not have demonstrated very good judgment”.

Though the Australia Paradox contained “mistakes of a straightforward arithmetic nature”, Clark mentioned it had been anonymously peer-reviewed and he could see no evidence of “any wilful try … to act deceptively to misrepresent the science”.

Brand-Miller and Barclay stated they welcomed the outcomes of the inquiry. “This is a win for science and a loss for individuals who reject the scientific approach,” they said in a statement.

They mentioned Clark’s report showed them to be “open, honest and effectively-intentioned academics” and vindicated their findings that sugar consumption was in decline.

“[We] are getting ready a paper for a key journal that updates the Australian Paradox, and specifically addresses the issues raised in the inquiry so that the misunderstandings of the unique paper are avoided,” the scientists stated.

Robertson, nevertheless, remained defiant, saying the final result of the inquiry was “a massive, excess fat fail” and “shredded the credibility” of the paper.

“…The investigator has advised that the authors be required to rewrite … [their paper] underneath proper supervision,” he stated.

“I encourage public scrutiny of the paper, I motivate anybody who’s interested to carefully go through the investigator’s report,” he said.

“There is no way any reasonable individual can seem at the data and conclude, as the authors did, that there is an inverse partnership in between sugar consumption and weight problems.”

Whilst Barclay and Brand-Miller agree refined sugars are a important supply of undesired kilojoules, they have argued that “simplistic tips like ‘quit sugar’ may possibly inadvertently boost the intake of refined starches and maltodextrins, high glycaemic index carbohydrates, energy, saturated body fat and salt, which could in reality have adverse well being consequences”.

Researchers cleared of misconduct in row above sugar hyperlink to obesity

Google Flu Trends promises are overstated, researchers say

Google Flu Trends and other hopes of offering public health breakthroughs by analysing enormous quantities of health care data have been overstated, according to a new research published in the American Journal of Preventive Medicine.

“If we actually began relying on the claims made by huge information surveillance in public well being, we would come to some peculiar conclusions, mentioned John Ayers, a investigation professor at San Diego State University who was lead author on the study. “Some of these conclusions might even pose serious public overall health harm.”

The finding casts doubt on claims manufactured by Google’s chief executive Larry Page that a lot more evaluation of peoples’ well being data could conserve up to 100,000 lives per year. Speaking this 12 months, Web page stated that extreme worries about privacy had been holding back developments in the discipline. Web page has not specified how the figure for lives saved is calculated.

Ayers informed the Guardian: “Massive information has huge value, and that consists of saving lives. But to realise these gains we require far better science.”

Nevertheless the authors of the new review stage out that even one particular of Google’s easiest health information mining systems, Google Flu Trends, has constantly failed to offer valuable forecasts of flu circumstances in the US. Google Flu Trends tries to use searches made by way of the website to predict forthcoming numbers of influenza circumstances in the US.

In March 2014 David Lazer, an associate professor at Northeastern University, published a paper showing that Google Flu Trends had overestimated flu degree for one hundred out of 108 weeks when in contrast with authoritative figures from the US Centres for Ailment Control (CDC).

However, Ayers’s staff showed that they could use open-source, publicly obtainable data from Google’s archive to substantially boost the accuracy of the flu prediction.

Rather than monitoring a distinct group of influenza-associated queries – as Google does – they monitored how the queries altered, and gave some queries much more bodyweight than others. They also built in an automated updating system utilizing artificial intelligence methods which adjusted the bias offered to any query each week, rather than the occasional guide program that as Google uses.

They showed that that was far more precise throughout the flu seasons in both 2009 and 2012/13 than Google’s model for every single week.

“With these tweaks, Google Flu Trends could live up to the high expectations it originally aspired to,” Ayers explained.

The researchers pointed out the Google generally predicted far much more circumstances than occurred. In the 2012/13 season, Google’s technique predicted that ten.6% of the population had flu – compared to just six.one% in accordance to patient records, an overstatement of 73%. The revised model recommended 7.seven% infection – a 26% overstatement.

“Big data is no substitute for great strategies, and consumers need to better discern great from bad methods,” Ayers explained.

Like Lazer previously, one of the new paper’s co-authors, Benjamin Althouse, recommended that much more clarity was needed about the models used by “big data” analysis to create public well being details and advice. “When dealing with large information methods, it is very crucial to make positive they are transparent and free of charge,” Althouse said. “Reproducibility and validation are keystones of the scientific strategy, and they must be at the centre of the huge information revolution.”

Google declined to comment particularly on the new paper, but reiterated an earlier comment on Lazer’s research: “We assessment the Flu Trends model every single 12 months to establish how we can boost. We welcome suggestions on how we can refine Flu Trends to assist estimate flu ranges and complement current surveillance techniques.”

Ayers mentioned that the paper’s critiques had been not an indictment of the promise of large information. “We undoubtedly don’t want any single entity or investigator, allow alone Google — whch has been at the forefront of building and sustaining these techniques — to feel like they are unfairly the targets of our criticism,” Ayers said.

“It’s going to take the total neighborhood recognizing and rectifying existing shortcomings. When we do, big data will undoubtedly yield massive impacts.”

• We’re all getting mined for huge information – but who are the real winners?

Google Flu Trends promises are overstated, researchers say

US Government"s marijuana farm grows for researchers

It may possibly be legal to get marijuana in 22 states, but increasing pot is nevertheless against federal law.

And however, the US government grows some of the purest pot in the nation, spending virtually a million dollars a yr on a contract with the University of Mississippi to expand cannabis and manufacture marijuana cigarettes.

The UMiss farm is presently the only source in the US for legal marijuana for researchers, and the government at the moment offers it away to researchers who get all the right approvals.

US Government"s marijuana farm grows for researchers

US Government"s marijuana farm grows for researchers

It may be legal to get marijuana in 22 states, but growing pot is nonetheless against federal law.

And nevertheless, the US government grows some of the purest pot in the country, paying almost a million bucks a year on a contract with the University of Mississippi to expand cannabis and manufacture marijuana cigarettes.

The UMiss farm is at present the only supply in the US for legal marijuana for researchers, and the government at the moment offers it away to researchers who get all the correct approvals.

US Government"s marijuana farm grows for researchers

US Government"s marijuana farm grows for researchers

It may possibly be legal to acquire marijuana in 22 states, but increasing pot is still towards federal law.

And nevertheless, the US government grows some of the purest pot in the country, spending virtually a million dollars a year on a contract with the University of Mississippi to develop cannabis and manufacture marijuana cigarettes.

The UMiss farm is currently the only supply in the US for legal marijuana for researchers, and the government at the moment gives it away to researchers who get all the appropriate approvals.

US Government"s marijuana farm grows for researchers

Leukaemia researchers discover genetic switch to fix cancer cells in mice

The most typical childhood leukaemia can be “cured” in mice with the flick of a genetic switch, Australian researchers have found.

Mice at Melbourne’s Walter and Eliza Institute produced a sort of leukaemia, B-ALL, right after possessing the “tumour suppressor” gene Pax5 deactivated. But when scientists switched the gene back on, they discovered the cancerous cells had been “coaxed” back to their normal state.

“The cells regain their identity,” a lead scientist on the research, Grace Liu, explained. “[The cancer] disappears from the blood, the bone marrow and all the regions exactly where the leukaemia typically develops.”

The findings have been published this week in the journal Genes &amp Improvement.

One particular-third of young children with leukaemia are located to lack healthful levels of Pax5.

When the gene is damaged or only partially current, developing white blood cells can become trapped in an immature state and flip cancerous.

The research is an instance of differentiation treatment, an method to cancer treatment that seeks to rehabilitate cells that have turn out to be malignant. Chemotherapy, by contrast, “just blasts the [cancerous] cells and causes them to die”, Liu stated.

Liu said it was “intriguing” that basically restoring Pax5 was sufficient to flip B-ALL cells to typical, as the gene is just 1 of several that are normally mutated in leukaemia.

But Dr Ross Dickins, yet another scientist on the review, said it would be tough to build medication to restore the Pax5 gene, or the “about 100” other genes known to suppress tumours.

“However, by comprehending the mechanisms by which Pax5 loss leads to leukaemia we can begin to appear at techniques of establishing medicines that could have the very same impact as restoring Pax5 function,” he explained.

Leukaemia researchers discover genetic switch to fix cancer cells in mice

Use of cement in hip replacements questioned by researchers

Surgeon conducting hip substitute surgery. Photograph: Niall Mcdiarmid/Alamy

Experts have raised issues about the use of cement in partial hip replacements – saying it could carry a chance of a patient dying or their heart stopping.

Although these events are rare the issue even now warrants investigation, the researchers stated.

Their comments come right after an examination of the situations of acute patient deterioration linked with hip hemiarthroplasties with the use of cement to support hold the artificial hip joint in area.

A hip hemiarthroplasty is an operation used to replace the upper portion of the femur following a individual has fractured the neck of the femur.

Among 2005 and 2012 there had been 62 reviews of death or significant harm associated with the procedure in the NHS in England and Wales – one particular event for every two,900 operations carried out, they discovered.

This sudden deterioration is referred to as bone cement implantation syndrome (BCIS). In every of the instances studied it caused death, cardiac arrest, or peri-arrest – significant deterioration in the patient’s situation.

Of individuals 62 individuals, 41 of them died and the remainder had to be resuscitated from cardiac arrest or peri-arrest, the authors of the study said.

Most of the reviews describe “acute deterioration” within just a handful of minutes of the insertion of cement, with 80% of the deaths occurring on the operating table.

Considerations had been initial raised about the use of cement in 2009, the authors mentioned in the examine published in the journal BMJ Open.

The Nationwide Patient Security Agency raised the alarm about the use of cement in the operation and issued advice to the NHS on how to minimise the risks.

But 3 quarters of the instances studied happened after this date of this warning which “clearly demonstrates that the implementation of mitigation measures set out in the alert was suboptimal, or that their effectiveness is suboptimal, or both.” The researchers added: “Cement use in hip hemiarthroplasty for fractured neck of femur is associated with instances of perioperative death or severe harm steady with BCIS.

“There is a need to have for stronger proof that weighs the hazards and advantages of cement in hip hemiarthroplasty for fractured neck of femur.”

Use of cement in hip replacements questioned by researchers

Children who perform tennis will have more powerful bones, researchers discover

“The research demonstrate that when you’re older you are much less in a position to get the benefits,” said investigation leader Alex Ireland.

“Childhood as a result represents a very good window of chance to really build strength for bones.

“Making (bones) more powerful and larger in childhood, particularly in adolescence, indicates that you’re less very likely to have breaks when you get older.

“Having a fracture when you are older can be incredibly detrimental to your life, you turn out to be significantly less mobile and become weaker, reinforcing the significance of ensuing normal physical action in youth.”

Research evaluating sports folks with less lively people face criticism that bigger, stronger men and women tend to choose to play sport so distinctions identified could not be a consequence of physical exercise.

In tennis gamers, each arms have the exact same dietary and genetic influences, so researchers say they can be confident that bodily activity is the trigger of the big variations in bone power.

Some tiny in between-arm distinctions in bone strength are located in non-athletes, probably because men and women favour 1 arm when creating or carrying a bag, for example. Nevertheless, the differences found in tennis players are about 10 times greater than individuals in non-players.

In total, 51 male and 37 female gamers were analysed at the LTA Open Veterans Indoor Championships and the Open Veterans Clay Court Championship, and thirty male and twenty female juniors at the LTA British Junior Championships.

The examine was published in the journal Osteoporosis Worldwide.

Children who perform tennis will have more powerful bones, researchers discover

Researchers uncover strategy to dealing with negative memories

“Often we dwell on how sad, embarrassed, or harm we felt throughout an occasion, and that tends to make us really feel worse and worse. This is what takes place in clinical depression-ruminating on the unfavorable elements of a memory,” Dolcos mentioned.

“But we found that as an alternative of considering about your feelings for the duration of a adverse memory, seeking away from the worst emotions and pondering about the context, like a buddy who was there, what the weather was like, or anything else non-emotional that was element of the memory, will rather effortlessly consider your thoughts away from the unwanted emotions related with that memory.

“Once you immerse yourself in other particulars, your thoughts will wander to anything else entirely, and you won’t be centered on the negative emotions as significantly.”

The technique is a extremely promising substitute to other coping mechanisms this kind of as suppression or reappraisal.

“Suppression is bottling up your emotions, attempting to place them away in a box. This is a technique that can be successful in the quick term, but in the prolonged run, it increases nervousness and depression,” says Dolcos.

“Another otherwise successful emotion regulation approach, reappraisal, or searching at the situation differently to see the glass half full, can be cognitively demanding.

“The technique of focusing on non-emotional contextual information of a memory, on the other hand, is as simple as shifting the emphasis in the mental movie of your recollections and then letting your mind wander.”

The approach can be powerful in both the quick term and the long phrase as use of the mechanism can lead to a reduction of the memory’s emotional effect. The review was carried out by initially asking the participants to describe their most adverse and good memories. Following numerous weeks, they were given cues to trigger memories although getting scanned in a magnetic resonance imaging (MRI) machine. They have been asked to focus on the emotion and then also the context of the memory.

“Neurologically, we wanted to know what took place in the brain when individuals had been employing this basic emotion-regulation method to deal with damaging recollections or boost the influence of optimistic recollections,” explained report co-writer Ekaterina Denkova. “1 factor we discovered is that when participants were targeted on the context of the occasion, brain regions involved in basic emotion processing were functioning with each other with emotion management regions in buy to, in the end, decrease the emotional effect of these memories.”

Researchers uncover strategy to dealing with negative memories