Health relates to a wider range of issues than merely the physical body. Optimal health also includes the emotional & spiritual bodies, and even financial. Join Kath Bartlett, MS, LAc as she shares thoughts, news articles, recipes & tips derived from a wide variety of source material, as it relates to chinese medicine and how to achieve and preserve optimal health for the body, mind and spirit.


Tuesday, November 24, 2009

Vinegar & Acids Help Lower Blood Sugar



The "Really?" column in today's Science Times (NY Times) reports on studies showing that including vinegar in a meal will help lower blood sugar. These findings help explain why Dr. Richard Tan's recommendation of drinking lime water throughout the day lowers blood sugar for diabetics.

To do this, juice a lime and pour the juice in a bottle of water and sip throughout the day. Apparently the 'white part' is important, so keep the pulp. Dr. Tan says that within 3 months blood sugar levels will drop. I have a current patient who is using key limes and after 3 weeks has been noticing lower blood sugar levels.

Reporter Anahad O'Connor astutely points out that amongst other perils of the Holiday Madness season, are the difficulties diabetics face navigating social gatherings and work place break rooms during the last 6 weeks of the year.

I've posted the NY Time's column below. I wasn't able to post the study cited. Here's the link to the abstract: http://care.diabetesjournals.org/content/27/1/281.long

The author's concluded that:

These data indicate that vinegar can significantly improve postprandial insulin sensitivity in insulin-resistant subjects. Acetic acid has been shown to suppress disaccharidase activity (3) and to raise glucose-6-phosphate concentrations in skeletal muscle (4); thus, vinegar may possess physiological effects similar to acarbose or metformin. Further investigations to examine the efficacy of vinegar as an antidiabetic therapy are warranted.


I was able to post a few abstracts of other studies relating to vinegar and blood sugar levels by the authors of the cited study. KB


The New York Times
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November 24, 2009
Really?

The Claim: Vinegar Can Help Lower Blood Sugar Levels

THE FACTS Thanksgiving marks the start of a season that poses particular hazards for people with diabetes and others who are sensitive to the blood-sugar spikes that can follow big meals.

But several studies have revealed a possible way to reduce the impact of a carb-laden dish: add a little vinegar. Doing so seems to help slow the absorption of sugar from a meal into the bloodstream, apparently because vinegar helps block digestive enzymes that convert carbohydrates into sugar.

One study by Italian researchers showed, for example, that when healthy subjects consumed about 4 teaspoons (20 milliliters) of white vinegar as a salad dressing with a meal that included white bread with a little less than 2 ounces (50 grams) of carbohydrates, there was a 30 percent reduction in their glycemic response, or rise in blood sugar, compared with subjects who had salad with a dressing made from neutralized vinegar.

In 2004, a study published in Diabetes Care, a journal of the American Diabetes Association, found similar effects in people with diabetes or insulin resistance who consumed a vinegar solution or placebo before a carb-heavy meal.

Nothing replaces increased physical activity and portion control, said Sue McLaughlin, a spokeswoman for the diabetes association. But people with diabetes might find it worth a try, she said, to consume two similar meals — one with vinegar, and another without — and compare their effect on blood sugar.

THE BOTTOM LINE Studies suggest that adding vinegar to a meal may reduce its impact on blood sugar.

ANAHAD O’CONNOR scitimes@nytimes.com



J Am Diet Assoc. 2005 Dec;105(12):1939-42.

Vinegar and peanut products as complementary foods to reduce postprandial glycemia.

Johnston CS, Buller AJ.

Department of Nutrition, Arizona State University, Mesa 85212, USA. carol.Johnston@asu.edu

Mealtime glycemic load is associated with risk for chronic disease. This study examined whether complementary foods (vinegar and peanut products) could lower postprandial glycemia without altering mealtime glycemic load. Eleven healthy subjects consumed two test meals (bagel and juice, glycemic load=81; or chicken and rice, glycemic load=48) under three conditions (control, vinegar, or peanut) using a randomized, crossover design. Vinegar or peanut ingestion reduced the 60-minute glucose response to both test meals by approximately 55%, but these reductions were significant only for the high-glycemic load meal. After consumption of the high-glycemic load meal, energy consumption for the remainder of the day was weakly affected by the vinegar and peanut treatments, a reduction of approximately 200 to 275 kcal (P=.111). Regression analyses indicated that 60-minute glucose response to the test meals explained 11% to 16% of the variation in later energy consumption. In conclusion, the addition of vinegar or peanut products to a high-glycemic load meal significantly reduced postprandial glycemia.

PMID: 16321601 [PubMed - indexed for MEDLINE]





Diabetes Res Clin Pract. 2009 May;84(2):e15-7. Epub 2009 Mar 9.

Preliminary evidence that regular vinegar ingestion favorably influences hemoglobin A1c values in individuals with type 2 diabetes mellitus.

Johnston CS, White AM, Kent SM.

Department of Nutrition, Arizona State University, 6950 E. Williams Field Road, Mesa, AZ 85212, United States. carol.johnston@asu.edu

This report examined whether daily acetic acid ingestion as vinegar, dill pickle, or commercial vinegar pill influenced hemoglobin A1c in diabetic patients. Hemoglobin A1c values fell 0.16% with vinegar use but rose 0.06% and 0.22% for pill and pickle use respectively (p=0.018). Hence, regular vinegar use modestly improved glycemic control.

PMID: 19269707 [PubMed - indexed for MEDLINE]

Sunday, November 22, 2009

Studies Show Meditation Reduces Heart Attacks, Strokes & Hypertension





Two recent studies have demonstrated that meditation reduces heart attacks, strokes and hypertension. Many past studies have shown health benefits of meditation, including decreased depression, anxiety and improved sleep and ability to handle stress. These two studied the effects of the Transcendental Meditation technique. I have posted the NY Times report about the studies and abstracts of them below.

Here's a little bit about TM from Wikipedia:

The Transcendental Meditation technique, or TM technique is a form of mantra meditation introduced in India in 1955[1][2][3][4] by Maharishi Mahesh Yogi (1917-2008).[5] It is reported to be the most widely researched and one of the most widely practiced meditation techniques in the world today.[6][7][8][9] Taught in a standardized seven-step course by certified teachers, the technique involves the use of a sound or mantra and is practiced for 15–20 minutes twice per day, while sitting comfortably with closed eyes.[10]

In 1957, Maharishi Mahesh Yogi began a series of world tours during which he introduced and taught his meditation technique.[11] In 1959, he founded the International Meditation Society and, in 1961, he began to train teachers of the Transcendental Meditation technique.[11][12] From the late 1960s through the mid 1970s, both the Maharishi and the TM technique received significant public attention in the USA, especially among the student population.[13][14] During this period, a million people learned the technique, including well-known public figures. . . .

Beginning in 1968, a number of celebrities such as Donovan, The Beatles, members of the The Beach Boys, The Rolling Stones, Doug Henning, Clint Eastwood, Deepak Chopra, Andy Kaufman, Jane Fonda, Mia Farrow, Shirley MacLaine, Joe Namath, Stevie Wonder, and Howard Stern . . .

The Beatles, of course, were the most famous of these. They stayed at the Maharishi's ashram in India for more than 8 months from August of 1967 to April of 1968. A well known riff developed btwn them, causing the Beatles to leave. The time spent with the Maharishi was a prolific one for the Beatles. The Maharishi helped them to get off LSD: Lennon had a heavy user. While they were with him, and after they returned to England the Beatles wrote and recorded the 30 songs on the double "White Album".

The hallmark of the TM technique is it's reliance on an mantra or sacred sound. From Wiki:

During the initial personal instruction session, the student is given a specific sound or mantra. The sound is utilized as a thought in the meditation process,[23] allowing the individual’s attention to be directed naturally from an active style of functioning to a less active or quieter style of mental activity.[23]

An important distinction between the Transcendental Meditation technique and other practices that involve mantras is in the way the mantra, or sound, is used. In Transcendental Meditation the mantra is not chanted—either verbally or mentally, but is instead a vehicle on which the attention rests.[24][19]

According to Russell, the sounds used in the Transcendental Meditation technique are taken from the ancient Vedic tradition.[24] Maharishi Mahesh Yogi explains that the selection of a proper thought or mantra "becomes increasingly important when we consider that the power of thought increases when the thought is appreciated in its infant stages of development".[25] William Jefferson in The Story of the Maharishi, explains the importance of the "euphonics" of mantras. Jefferson says that the secrets of the mantras and their subsequent standardization for today's teachers of the technique were unraveled by Maharishi Mahesh Yogi after his years of study with his own teacher, Guru Dev (Brahmananda Saraswati) so that selection is foolproof, and that the number of mantras from the Vedic tradition, which could number in the hundreds, have been brought by Maharishi to a minimum number. . .

In 1975, Time Magazine reported that each TM meditator is instructed to keep their mantra private. Each TM teacher assigns each student's mantra based on a formula that is presumed to include temperament and profession. The article says that there are 17 mantras.[13] In his 1997 book, The Sociology of Religious Movements William Sims Bainbridge wrote that the mantras given for Transcendental Meditation are "supposedly selected to match the nervous system of the individual but actually taken from a list of 16 Sanskrit words on the basis of the person's age".[28]

The 1995 expanded addition of Conway and Siegelman's Snapping: America's Epidemic of Sudden Personality Change describes a teacher of Transcendental Meditation who says: "I was lying about the mantras — they were not meaningless sounds they were actually the names of Hindu demigods - and about how many different ones there were — we had sixteen to give out to our students".[30] In the 1977 court case Malnak vs. Yogi (see below), an undisputed fact in the case was that the mantras are meaningless sounds.[31]

In a speech the Maharishi gave in Kerala, India, in 1955, he mentions a connection between the mantras and personal deities and occasionally similar references can also be found in his later works.[32][33] More commonly, the Maharishi describes the mantras as working automatically.[33]

Jonathan Shear in his book The Experience of Meditation: Experts Introduce the Major Traditions, characterizes the mantras used in the TM technique as independent of meaning associated with any language, and are used for their mental, sound value alone.[18] A 2009 article published in the International Journal of Psychophysiolgy says that "unlike most mantra meditations, any possible meaning of the mantra is not part of Transcendental Meditation practice".[17]

In his book Alternative Religions: A Sociological Introduction, author Stephen Hunt says that the mantra used in the Transcendental Meditation technique has no meaning but that the sound itself is sacred.


I don't believe that you must do the TM technique to gain health benefits from meditation. In fact, a current patient has a 15y history of hypertension. After 4-6 weeks of guided meditation she saw her blood pressure return to normal during a period of high stress.

The important thing is to begin a regular practice. In the beginning, the discipline of sitting regularly and listening to the mind chatter is difficult. But if you stick with it, you'll find in time the mind will calm. This can take years, but you will reap the rewards of your continued effort.

Commonly breath meditation is done, where one focuses on the in and out breath as a mechanism to calm the mind. Especially worriers and those experiencing much stress and anxiety have particular difficulty with this because the mind chatter and dramas continue to play. For those people I recommend beginning with a guided meditation recording, or even just beginning by listening to quiet, relaxing music and concentrating on the notes and sounds.

Over time, one works through the disturbing memories and emotions that come up during meditation and begins to tire of the repetitive tape of the mind chatter. Then one becomes more able to reject the drama of the mind and increases the ability to quiet the mind. This process can take years, but the effort is worthwhile. Once mastered, meditation becomes a way to leave the daily stresses and come into a calm peaceful state of mind. I have found that more regular meditation helps to keep the mind calm. I notice a difference when meditating twice a day verses once daily, or between daily meditation and meditating several times a week or weekly.

If you have difficulty developing the discipline of the practice, you might seek out a group of mediators in your area to sit with. Wednesday nights seems to be a common meeting time for meditation and spiritual groups. KB





November 20, 2009, 12:47 pm

Can Meditation Curb Heart Attacks?

Richard Patterson for The New York Times Recent research suggests transcendental meditation may be good for the heart.

When Julia Banks was almost 70, she took up transcendental meditation. She had clogged arteries, high blood pressure and too much weight around the middle, and she enrolled in a clinical trial testing the benefits of meditation.

Now Mrs. Banks, 79, of Milwaukee, meditates twice a day, every day, for 20 minutes each time, setting aside what she calls “a little time for myself.”

“You never think you’ve got that time to spare, but you take that time for yourself and you get the relaxation you need,” said Mrs. Banks, who survived a major heart attack and a lengthy hospitalization after coronary artery bypass surgery six years ago.

“You have things on your mind, but you just blot it out and do the meditation, and you find yourself being more graceful in your own life,” she said. “You find out problems you thought you had don’t exist — they were just things you focused on.”

Could the mental relaxation have real physiological benefits? For Mrs. Banks, the study suggests, it may have. She has gotten her blood pressure under control, though she still takes medication for it, and has lost about 75 pounds.

Findings from the study were presented this week at an American Heart Association meeting in Orlando, Fla. They suggest that transcendental meditation may have real therapeutic value for high-risk people, like Mrs. Banks, with established coronary artery disease.

After following about 200 patients for an average of five years, researchers said, the high-risk patients who meditated cut their risk of heart attacks, strokes and deaths from all causes roughly in half compared with a group of similar patients who were given more conventional education about healthy diet and lifestyle.

Among the roughly 100 patients who meditated, there were 20 heart attacks, strokes and deaths; in the comparison group, there were 32. The meditators tended to remain disease-free longer and also reduced their systolic blood pressure by five millimeters of mercury, on average.

“We found reduced blood pressure that was significant – that was probably one important mediator,” said Dr. Robert Schneider, director of the Institute for Natural Medicine and Prevention, a research institute based at the Maharishi University of Management in Fairfield, Iowa, who presented the findings. The study was conducted at the Medical College of Wisconsin in Milwaukee, in collaboration with the institute.

An earlier study of high-risk Milwaukee residents, many of them overweight or obese, also found transcendental meditation, along with conventional medications, could help reduce blood pressure. Most of those in the study had only high-school educations or less, about 40 percent smoked and roughly half had incomes of less than $10,000 a year.

The participants found transcendental meditation easy to learn and practice, Dr. Schneider said.

“Fortunately, it does not require any particular education and doesn’t conflict with lifestyle philosophy or beliefs; it’s a straightforward technique for getting deep rest to the mind and body,” he said, adding that he believes the technique “helps to reset the body’s own self-repair and homeostatic mechanism.”

Dr. Schneider said other benefits of meditation might follow from stress reduction, which could cause changes in the brain that cut stress hormones like cortisol and dampen the inflammatory processes associated with atherosclerosis.

“What is it about stress that causes cardiovascular disease?” said Dr. Theodore Kotchen, associate dean for clinical research at the Medical College of Wisconsin. “Hormones, neural hormones, cortisol, catecholamines — all tend to be elevated in stress. Could they in some way be contributing to cardiovascular disease? Could a reduction in these hormones with meditation be contributing to reduction in disease? We can only speculate.”

Another recent study focusing on transcendental meditation, published in The American Journal of Hypertension, focused on a young healthy population. It found that stressed-out college students improved their mood through T.M., and those at risk for hypertension were able to reduce their blood pressure. Dr. Schneider was also involved in that study, which was carried out at American University in Washington and included 298 students randomly assigned to either a meditation group or a waiting list.

Students who were at risk of hypertension and practiced meditation reduced systolic blood pressure by 6.3 millimeters of mercury and their diastolic pressure by 4 millimeters of mercury on average.


From Roni Rabin: Some of the researchers are affiliated with Maharishi University, but it should be noted the Milwaukee clinical trial [on the students with hypertension] was funded through an $3.8 million grant from the National Institute of Health’s National Heart, Lung, and Blood Institute. It was a randomized controlled clinical trial, of the kind considered the gold standard in medicine.

Copyright 2009 The New York Times Company

Wednesday, November 18, 2009

Chinese Medicine for Cold and Flu Prevention

I've been getting questions about flu vaccines and Chinese herbs for flu.

The decision to vaccinate is a personal one. One must weigh the risks of side effects from the vaccine against the risk of contracting the flu. For those who are weak, frail or immune deficient there is a stronger argument to vaccinate. Those who are healthy and could mount a strong defense against the flu might want to forgo the vaccine and the risk of side effects incurred.

Chinese medicine can support you in 2 ways:
  1. Acupuncture and Chinese herbs can strengthen your overall health and immune function, better preparing you to ward off an attack.
  2. Chinese medicine can treat the flu symptoms should you contract it. Patients are generally pleased, even amazed by the results of acupuncture and herbs in treating colds, flu and other respiratory conditions.
I have a few formulas that have recently been advised in Beijing for use in treating Swine flu. All are to be taken upon suspected contact. One is a gargle for sore throat that could be used for any sore throat. The others are specific for the most venerable patient populations: children, seniors and pregnant women. These formulas could be used prophylactically for any suspected contact with cold or flu. They are only to be used for 4 or 5 days as a preventative upon contact.

One frequently used preventative formula for any cold, flu or respiratory illness, including allergies is called Jade Windscreen. It is comprised of 3 herbs (astragalus is one) that are considered a precious (hence the word 'jade') formula to boost immune function and ward off viruses, bacterias and irritants brought in from the external environment (wind-screen). It is often begun in August or early September, 6-10 weeks before the flu or allergy season, and continued through the winter for those who frequently contract colds, flus and allergies or sinusitis. Generally the herbalist will add other herbs to build a constitutional formula suitable for the individual patient being treated.

Periodic acupuncture treatments strengthen the immune system and alleviate stress, which depletes immune function.
Making sure you eat well, get adequate rest, don't overwork, exercise regularly and engage in stress reduction activities will keep your body and immune system healthy and strong.

When disease symptoms occur, acupuncture and Chinese herbal formulas can effectively treat the symptoms and strengthen the bodies ability to mount an defense against the attack. KB

Thursday, November 12, 2009

Study Shows Qi Gong Effective for Cancer Patients


A recent study published in Annals of Oncology shows that medical Qi Gong improves the quality of life, mood and inflammation in cancer patients.

I've posted the abstract of the article below. There is no definition given for medical (vs non-medical?) Qi Gong, but I understand that the patients in the study practiced 2x/week with an instructor and were asked to do additional practice at home between classes. If you are interested in taking qi gong classes with a teacher be sure to tell the instructor about your disease and purpose for learning qi gong so that more specific instruction can be tailored to your needs. In fact, a private or series of private lessons, interspersed with group lessons might be optimal. If for whatever reason working with an instructor in person is not an option for you, then look for a Qi Gong DVD.

Qi Gong is meditation exercises, preformed slowly in repetition, designed to build, cultivate and move one's qi. The term 'qi gong' literally translates as qi work. Just as acupuncture circulates one's qi, so do these relaxing exercises. Qi gong builds qi, eliminating fatigue. The meditative quality of the exercises hones, focuses and calms the mind. All cancer patients are under a tremendous amount of stress and can thus benefit from these gentle exercises. KB


Ann Oncol. 2009 Oct 30. [Epub ahead of print]

Impact of Medical Qigong on quality of life, fatigue, mood and inflammation in cancer patients: a randomized controlled trial.

Oh B, Butow P, Mullan B, Clarke S, Beale P, Pavlakis N, Kothe E, Lam L, Rosenthal D.

Department of Medicine, Concord Repatriation General Hospital, University of Sydney, Concord.

BACKGROUND: Substantial numbers of cancer patients use complementary medicine therapies, even without a supportive evidence base. This study aimed to evaluate in a randomized controlled trial, the use of Medical Qigong (MQ) compared with usual care to improve the quality of life (QOL) of cancer patients.

PATIENTS AND METHODS: One hundred and sixty-two patients with a range of cancers were recruited. QOL and fatigue were measured by Functional Assessment of Cancer Therapy-General and Functional Assessment of Cancer Therapy-Fatigue, respectively, and mood status by Profile of Mood State. The inflammatory marker serum C-reactive protein (CRP) was monitored serially.

RESULTS: Regression analysis indicated that the MQ group significantly improved overall QOL [quality of life] (t(144) = -5.761, P < p =" 0.021)">

CONCLUSIONS: This study indicates that MQ can improve cancer patients' overall QOL [quality of life] and mood status and reduce specific side-effects of treatment. It may also produce physical benefits in the long term through reduced inflammation.

PMID: 19880433 [PubMed - as supplied by publisher]




Tuesday, November 10, 2009

Boundaries Create the Ego




Boundaries
create the ego.

Or put another way: the ego is comprised of boundaries between self and other.

To weaken or destroy the ego, one must first dissolve the boundaries, carefully. The id and ego do not take well to threats, and due to this fear will fight hard to protect their existence. This inner struggle can be quite difficult to endure. KB


Sunday, November 8, 2009

Study Shows Acupuncture as Effective as Drugs for Carpel Tunnel Syndrome

A study published in May 2009 in The Clinical Journal of Pain compared acupuncture to the steroid drug prednisone for treatment of pain in carpal tunnel syndrome. The study concluded that:

"
Short-term acupuncture treatment is as effective as short-term low-dose prednisolone for mild-to-moderate CTS. For those who do have an intolerance or contraindication for oral steroid or for those who do not opt for early surgery, acupuncture treatment provides an alternative choice."

This is big for a western medical study to recommend acupuncture as an effective alternative to drug therapy. For the symptoms of night time awakening due to pain and for motor function, the acupuncture group had better results. I've included an abstract of the article below.

Carpal Tunnel Syndrome is a repetitive use injury, commonly ca
used by excessive computer use (typing on the keyboard). The carpal tunnel is the hole that the (median) nerve travels through, located on the inside of the wrist where the wrist and hand meet. When the wrist is flexed, the carpal tunnel compresses, and the ligament on the roof of the tunnel presses on the median nerve, causing pain. The median nerve controls the thumb, index and middle fingers and the thumb (radial) side of the ring finger. Carpal tunnel patients experience pain in those fingers and palm area, not the pinkie finger as the median nerve which travels through the carpal tunnel does not affect the last finger or the pinky (ulna) side of the palm. (see diagram) Pain can also radiate into the arm. KB





Clin J Pain. 2009 May;25(4):327-33.

Acupuncture in patients with carpal tunnel syndrome: A randomized controlled trial.

Yang CP, Hsieh CL, Wang NH, Li TC, Hwang KL, Yu SC, Chang MH.

Department of Neurology, Kuang Tien General Hospital, Taiwan.

OBJECTIVES: To investigate the efficacy of acupuncture compared with steroid treatment in patients with mild-to-moderate carpal tunnel syndrome (CTS) as measured by objective changes in nerve conduction studies (NCS) and subjective symptoms assessment in a randomized, controlled study.

METHODS: A total of 77 consecutive and prospective CTS patients confirmed by NCS were enrolled in the study. Those who had fixed sensory complaint over the median nerve and thenar muscle atrophy were excluded. The CTS patients were randomly divided into 2 treatment arms: (1) 2 weeks of prednisolone 20 mg daily followed by 2 weeks of prednisolone 10 mg daily (n = 39), and (2) acupuncture administered in 8 sessions over 4 weeks (n = 38). A validated standard questionnaire as a subjective measurement was used to rate the 5 major symptoms (pain, numbness, paresthesia, weakness/clumsiness, and nocturnal awakening) on a scale from 0 (no symptoms) to 10 (very severe). The total score in each of the 5 categories was termed the global symptom score (GSS). Patients completed standard questionnaires at baseline and 2 and 4 weeks later. The changes in GSS were analyzed to evaluate the statistical significance. NCS were performed at baseline and repeated at the end of the study to assess improvement. All main analyses used intent-to-treat.

RESULTS: A total of 77 patients who fulfilled the criteria for mild-to-moderate CTS were recruited in the study. There were 38 in the acupuncture group and 39 in the steroid group. The evaluation of GSS showed that there was a high percentage of improvement in both groups at weeks 2 and 4 (P < p =" 0.15)." p =" 0.03)." p =" 0.012).">

CONCLUSIONS: Short-term acupuncture treatment is as effective as short-term low-dose prednisolone for mild-to-moderate CTS. For those who do have an intolerance or contraindication for oral steroid or for those who do not opt for early surgery, acupuncture treatment provides an alternative choice.

PMID: 19590482 [PubMed - indexed for MEDLINE]






Wednesday, October 28, 2009

Could Women Use Smaller Vaccine Doses?

The decision to vaccinate is a personal one. Do your own research and weigh the side effects and disease risks against the benefits of the vaccine. Keep in mind that those who are immuno-compromised, weak or frail are in a higher risk group than healthy young and middle aged adults. The authors of this NY Time's Op-Ed piece contend that clinical studies are showing that women produce as many antibodies to half the dose of flu vaccine that men do at the full dose, and that the rule holds up for other diseases such as measles, mumps, rubella, hepatitis A & B and herpes simplex. If women were given a lower dose they might suffer fewer side effects than they do at the higher dose. In the case of H1N1, where there is a shortage of the vaccine, giving women a lower dose, the authors argue, would make the limited quantities of vaccine available for more people.

Drugs are usually only tested on men age 18-45 before they are given FDA approval. Ethically the drug companies can't give a new drug that much about the potential side effects are unknown to higher risk groups. These groups include women in their reproductive years because if they were to become pregnant while taking the drug, the drug may have detrimental effects on the fetus. Children, older adults and seniors have weaker immune systems to which an unknown drug could potentially cause harm. This means that most drugs are not tested on children, elderly or women before they are released onto the public. For this reason, I do not recommend using a new drug unless it is the only alternative. It has only been tested in a small group of men, and there are a lot of unknowns about it. KB


The New York Times


October 28, 2009
Op-Ed Contributors

Do Women Need Such Big Flu Shots?

THE emergence of the H1N1 swine flu has added urgency to what has become an annual ritual for millions of Americans: getting a flu shot. The good news is that scientists have developed a vaccine against the H1N1 virus. But it is taking much longer than expected to produce the hundreds of millions of doses the government had planned to distribute. And it is still too soon to know how effective the vaccine will be in preventing swine flu.

In all likelihood, we’d have a better H1N1 vaccine — and more of it — if in our preparations we had accounted for the biological differences between men and women.

Under the current guidelines, men and women are to get equal-sized doses of the H1N1 vaccine. Yet women’s bodies generate a stronger antibody response than men’s do, research shows, so less vaccine may be needed to immunize them. If we could give women a smaller dose, there would be more vaccine to go around. And we might also spare them the mild side effects that vaccines can cause, like pain at the injection site, inflammation and fever. All of these are more common in women than in men.

To be clear, it is essential that women get their flu shots, even if the current dose is more than they need. Pregnant women in particular should make sure they are protected, since those who get the swine flu are at least four times as likely as others with the virus to be hospitalized. (We don’t know whether pregnant women are more susceptible to the H1N1 virus, but it’s clear that once they are infected, they have a higher-than-average risk of complications.)

But ultimately we should do everything we can to vaccinate as many people as possible.

Many clinical studies have shown that men and women differ in their responses to several viral vaccines. A recent study demonstrated that women produce as many antibodies in response to a half dose of the seasonal flu vaccine as men make in response to a full dose. Other studies have revealed similar sex differences in response to vaccines for yellow fever virus, measles, mumps and rubella, hepatitis A and B viruses and herpes simplex virus.

Whether vaccines work differently in males than in females is not known. Clearly, more research on sex-dependent immune responses is needed.

In planning for the swine flu, however, public health authorities ignored the evidence that vaccines affect women more strongly than men. To determine the proper dose of H1N1 vaccine, the National Institutes of Health set up studies involving 600 children, from babies to teenagers — but neglected to investigate whether males and females should get the same dose.

Although our public health authorities remain confident they will eventually have enough vaccine for all Americans who want it, there almost certainly won’t be enough for all the vulnerable populations in poorer countries. Only a handful of countries have plants to manufacture influenza vaccine, and the world’s wealthiest countries have locked up most of what these plants can produce with signed purchasing contracts. We could make much more — and potentially save millions of lives — if we stopped giving women larger doses than they need.

Sabra L. Klein is an assistant professor of molecular microbiology and immunology at the Johns Hopkins Bloomberg School of Public Health. Phyllis Greenberger is the president and chief executive of the nonprofit Society for Women’s Health Research.


Saturday, October 17, 2009

Stanford Research Study Shows Acupuncture Reduces Hot Flashes

Here's a study published a few years ago by a Stanford researcher showing the benefits of acupuncture for hot flashes. The study followed patients for seven weeks of treatment. In Chinese Medicine we treat in courses: a clinical course of treatment being 10-12 visits or weeks of herbal medicine. I have found in clinic that the first course of treatment tends to be 10-15 visits. In that amount of time I can usually get mild or acute symptoms resolved, and more chronic symptoms reduced and under control. Inexplicably this study tracked patients for only 7 visits. I'm sure the results would have dramatically increased had the patients continued treatment for a full course, or longer.

I have noticed that studies usually show a lower percentage effectiveness than what I and others in the field see in clinic. I've discussed this paradox with colleagues, and our explanation is that in studies the researchers choose one simple protocol and give it to everyone in the study, often not a protocol actually used in clinic. One of the hallmarks of Chinese medicine is individualized treatments. So although 10 women may all come in for hot flashes, they would get different treatments based on their constitutional differences in clinical presentation.

That being said, I do have a simple point combination that I have found generally effective for most all women with hot flashes. However, I potentiate the treatment by adding additional points to treat the constitutional individualities.

I don't like to quote percentages of effectiveness of my treatments, because I've noticed phenomenally that as soon as I do, someone comes in who is a non-responder. But I will say, based on my clinical experience that hot flashes is a condition I expect to respond well and eradicate with Chinese medical treatment that includes a combination of acupuncture and individualized Chinese herbal formulas. KB


Acupuncture reduces nighttime hot flashes caused by menopause, according to a study published in the journal, Fertility and Sterility.

Researchers found that seven weeks of acupuncture treatment reduced the severity of nighttime hot flashes by twenty-eight percent among menopausal women compared with a six percent decrease among women who had a sham acupuncture treatment.

The effects of acupuncture vs. a sham acupuncture treatment on the severity and frequency of nighttime hot flashes were compared. Taking part in the study were twenty-nine menopausal women experiencing at least seven moderate to severe hot flashes per day.

All of the women underwent nine treatments from trained acupuncturists in sessions over seven weeks. Twelve of the women received real acupuncture using points selected to target hot flashes and sleepiness. The rest of the women received a sham acupuncture treatment using non-penetrating needles at random acupuncture channel points.

Throughout the study, the women reported the number and severity of their hot flashes. The results showed that nighttime hot flash severity decreased significantly (twenty-eight percent) among the women who received acupuncture vs. a six percent drop among the women who got the sham treatment. However, they did not see a similar finding in the frequency of nighttime hot flashes between the two groups.

Researcher Mary Huang, M.S., of Stanford University, and colleagues say the results suggest acupuncture deserves further study as an alternative treatment for menopausal hot flashes.

Source:
Huang, M. Fertility and Sterility, September 2006; Vol. 86: pp. 700-710. News release, American Society of Reproductive Medicine.

Tuesday, October 13, 2009

Food for Thought: Better to Eat a Cow than a Fish

I am vegan; however I often talk to folks who are sometimes vegetarians, or those who abstain from red meat. I think for them, the idea of eating a mammal is abhorrent, but occasional fish or chicken seems a tolerable or even desirable protein source. Even for those on an unabased meat-based diet, the following discussion about which meats to eat may be insightful:

I was fortunate to attend a reading of a discourse read by Ven. Zhaxi Zhuoma Rinoche a couple of Sundays ago. Periodically, she paused to add in editorial comments and take questions that further illuminated and clarified the text. At one point she made a comment which spoke to me. That is that if one is going to eat meat, it is preferable to eat a large mammal which can feed many, such as a cow, rather than smaller life forms such as fish or shrimp. The logic is that if one eats a large animal, only one life is lost to feed many. With the consumption of smaller life forms, such as shrimp or shellfish, it takes many lives to feed one.

I thought this point was important to consider when making food choices. According to this idea, if one does eat fish or foul, larger animals such as tuna, swordfish, salmon, turkey or goose would be preferable to smaller species such as chicken, game hen, trout, catfish, lobster, and so on.

Do not get me started on the lobster.

And do remember if you are eating animals, to be sure they are humanly raised and slaughtered (no slaughter houses) and that they have eaten an organic diet that is hormone and pesticide free. (I will write a future blog post about this issue. Until then, see my September post regarding ways to lower risk of breast cancer for some preliminary thoughts on this topic.)

Eat happy, relaxed, humanely, nutritiously and be fully involved in your food. KB

Friday, October 9, 2009

Studies Show Acupuncture More Effective than Drugs for Headaches

In a December 2008 two doctors from the Department of Anesthesiology at Duke University Medical Center published the results of their systematic review of 25 studies on the use of acupuncture for treatment of headaches in Anesthesia and Analgesia. The authors concluded that acupuncture is more effective than drug therapy in relieving headaches. Here's a short NY Time's piece on their work. KB


The New York Times


December 16, 2008
Vital Signs

Regimens: Acupuncture Provides Headache Relief

For chronic headaches the best treatment may be one of the oldest: acupuncture.

In 1998, the National Institutes of Health accepted acupuncture as a useful alternative treatment for headaches, but warned that there were not enough clinical trials to draw firm conclusions about its efficacy. Now a systematic review of studies through 2007 concludes that acupuncture provides greater relief than either medication or a placebo.

The report, which appears in the December issue of Anesthesia and Analgesia, reviewed 25 randomized controlled trials in adults that lasted more than four weeks. In seven trials comparing acupuncture with medication, researchers found that 62 percent of 479 patients had significant response to acupuncture, and only 45 percent to medicine. . .

“People who get acupuncture prefer it to medication, because of the potential side effects of drugs,” said Dr. Tong J. Gan, a co-author of the review and a professor of anesthesiology at Duke. “This is an alternative treatment that is starting to move into the mainstream.”


Wednesday, October 7, 2009

Words to Live By



Abstain from all that is evil.

Perform all that is good.
Purify your thoughts.
This is the teaching of the Buddhas.

Common Cold Remedy



Dr. Tan, with whom I study, recommends this implausible remedy for common cold. I'm assured it is effective. You must do it early, when you first notice symptoms:

1 clove garlic
1 lemon, juiced
1 shot hard alcohol

You eat the clove of garlic, mix the lemon juice into a glass of water and drink it and the shot of alcohol. You can do this in any order, but you might want to do the garlic first, and follow it with the lemon water. Or you could chop the garlic into small pieces, and then swallow it like a pill using the lemon water. Go directly to bed, and when you wake the cold symptoms should be relieved or gone. You must do this in the early stage.

This NY Times column may explain just why this implausible remedy works: the garlic. Garlic has many purported virtues. Odes could be written extolling the virtues of garlic, from warding off vampires to a boon for longevity. Yogis love it and devouring it daily. Among many other benefits, studies verify it's ability to ward off the common cold.


I welcome a review of your experiences using this remedy.
KB



The New York Times
This copy is for your personal, noncommercial use only. You can order presentation-ready copies for distribution to your colleagues, clients or customers here or use the "Reprints" tool that appears next to any article. Visit www.nytreprints.com for samples and additional information. Order a reprint of this article now.
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October 20, 2009
Really?

The Claim: Garlic Can Be Helpful in Warding Off a Cold

THE FACTS For centuries, garlic has been extolled not just for its versatility in the kitchen but also for its medicinal powers.

Whatever the reason, studies seem to support an effect. In one double-blind study, published in 2001, British scientists followed 146 healthy adults over 12 weeks from November to February. Those who had been randomly selected to receive a daily garlic supplement came down with 24 colds during the study period, compared with 65 colds in the placebo group. The garlic group experienced 111 days of sickness, versus 366 for those given a placebo. They also recovered faster.

Besides the odor, studies have found minimal side effects, like nausea and rash.

One possible explanation for such benefits is that a compound called allicin, the main biologically active component of garlic, blocks enzymes that play a role in bacterial and viral infections. Or perhaps people who consume enough garlic simply repel others, and thus steer clear of their germs.

In a report this year in The Cochrane Database of Systematic Reviews, scientists who examined the science argued that while the evidence was good for garlic’s preventive powers, more studies were needed.

They pointed out that it was still unclear whether taking garlic at the very start of a cold, as opposed to weeks in advance, would make any difference.

THE BOTTOM LINE Research is limited, but it suggests that garlic may indeed help ward off colds.

ANAHAD O’CONNOR scitimes@nytimes.com



Wednesday, September 30, 2009

Health Reform?



Why is it ok to have mandatory auto insurance and mandatory flood insurance but those who are against health care reform think it's not ok to require mandatory health insurance to ensure that everyone has access to affordable health care? And why is it that those who are against universal health care are the one's who already have health insurance? KB

Wednesday, September 9, 2009

Cinnamon Oil is Antiseptic



The New York Times
This copy is for your personal, noncommercial use only. You can order presentation-ready copies for distribution to your colleagues, clients or customers here or use the "Reprints" tool that appears next to any article. Visit www.nytreprints.com for samples and additional information. Order a reprint of this article now.
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September 8, 2009
Really?

The Claim: Cinnamon Oil Kills Bacteria.



THE FACTS

In a country obsessed with germs and sickness, antibacterial soaps and sanitizers are becoming more and more common. But because such products contribute to the growing problem of antibiotic-resistant bacteria, some researchers recommend sanitizers made with cinnamon oil, which has been shown in many studies to have powerful antimicrobial properties.

A recent study by a team of surgeons, for example, found that a solution made with cinnamon oil killed a number of common and hospital-acquired infections, like streptococcus and methicillin-resistant Staphylococcus aureus, or MRSA. The study found it was just as effective as several antiseptics widely used in hospitals. Another study by French researchers in 2008 had similar results, showing that at concentrations of 10 percent or less, cinnamon oil was effective against Staphylococcus, E. coli and several antibiotic-resistant strains of bacteria.

Dr. Lawrence D. Rosen, a pediatrician in New Jersey who dispenses natural health advice on his blog, wholechildcenter.org, recommends a tried-and-true recipe for homemade hand sanitizer called thieves oil. “I add cinnamon bark, lemon oil and eucalyptus,” he said, adding, “The recipe goes back to the Middle Ages, where it was used by these thieves who would go around stealing jewelry from dead bodies, and they never got sick.”



Cinnamon oil, when applied topically, is generally safe. But in some people it can cause an allergic reaction.

THE BOTTOM LINE

Cinnamon oil has antiseptic properties. ANAHAD O’CONNOR scitimes@nytimes.com

Here's a video from NBC that shows how to easily make the thieves oil:

http://www.nbcnewyork.com/station/as-seen-on/Hand_Sanitizer_-_The_Home_Version_New_York.html

Below is an abstract of one of the studies cited in the article.

KB

Reducing Breast Cancer Risk: Excercise, Veg Diet & Limited Alcohol. New York Times Article


Here's a short piece from the NY Time's Science section about a study showing that living a healthy life style decreases breast cancer risk. This study emphasizes maintaining a normal body weight.

Obesity dramatically increases a woman's risk of developing breast cancer by 50-100%, the risk increasing "the older the woman gets and the longer she remains obese." (1) The reason being is that the abdominal fat cells convert steroid (fat soluble) hormones to estrogen. In the breasts, the additional estrogen created binds to the breast cells, promoting "cell division and potentially tumor growth." (2)
Cancer cells are abnormal cell growth: the additional cell division cause the tumor growth. Adipose tissue (fat) contains an enzyme, aromatase, that converts steroid hormones into estrogen. After menopause, the ovaries and pituitary gland are no longer signaling for estrogen production through the monthly menstrual cycle. To compensate, the amount of aromatase in the adipose tissue increases to step up estrogen production. Obese women have higher levels of estrogen production taking place in the body fat of the hips and stomach, which increases during menopause, which raises the risk of tumors developing in the breast.

"Glucose [blood sugar] is the preferred substrate for cancer cells. . . [In a study] mice injected with aggressive mammary [breast] tumors were placed on 3 diets. After 70 days 95% of the mice on the low-sugar diet were alive. Of the mice on the moderate-sugar diet 67% were alive. And only 33% on a high-sugar diet were alive. Also 'moderate' alcohol consumption is associated with elevation in the risk for breast cancer from 50-100%." (3)

Phytoestrogens have a chemical structure similar to estrogen. They bind to the receptor sites on the breasts, preventing the body's estrogen from binding and causing tumor cell growth. The phytoestrogens that bind to the breast cell estrogen receptor sites have a weaker influence on breast cell production, so that it is less likely that tumors will form. Common food sources of phytoestrogens include: soy (tofu, tempeh, miso), flax and raw pumpkin seeds, clover and mung bean sprouts. Avoid powdered soy concentrate, these have caused some to develop Hashimoto's thyroid disease. (4)

Studies have shown that phytoestrogens increase the effectiveness of breast cancer treatments. Borage oil has shown to decrease the growth of breast cancer cells. (5)

Eating an organic diet, and limiting exposure to chemicals, including household cleaners, detergents, pesticides, food packaging (plastics leach into foods, especially when warm foods are put into plastic containers) is also important to reduce cancer risk. Chemicals and pesticides can change the DNA of cells, causing them to mutate into cancer cells. Studies have shown higher levels of pesticides and pollutants in fat and blood of women with breast cancer than in healthy women. (6) KB

1-6. Lahans, T. Integrating Conventional and Chinese Medicine in Cancer Care. Elsevier 2007; 92-102.



The New York Times
This copy is for your personal, noncommercial use only. You can order presentation-ready copies for distribution to your colleagues, clients or customers here or use the "Reprints" tool that appears next to any article. Visit www.nytreprints.com for samples and additional information. Order a reprint of this article now.
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September 8, 2009
Vital Signs

Regimens: Habits Help in Avoiding Breast Cancer, Study Finds

Women can cut their risk of breast cancer by almost half if they watch their weight, exercise daily, breast-feed their babies and limit alcoholic beverages, according to a new report by the American Institute for Cancer Research.

The report is an update of a 2007 review of more than 800 studies, adding information from 81 new studies, said Susan Higginbotham, director of research for the cancer institute, which examines the role of nutrition and lifestyle in cancer.

Among the preventive steps women can take are maintaining a healthy body weight, getting 30 to 60 minutes of physical activity a day, breast-feeding and having no more than one alcoholic drink a day.

The role of hormones in breast cancer, including both postmenopausal hormone therapy and oral contraceptives, was not examined.

“This makes us more certain than ever that the choices we make every day can protect us from breast cancer,” Dr. Higginbotham said, adding that any amount of physical activity is beneficial, including climbing stairs and walking.

To reduce the risk of cancer generally, diets should be mostly plant-based, emphasizing fruits, vegetables, beans and whole grains and limiting red meat, Dr. Higginbotham said.

The review estimated that nearly 40 percent of new breast cancer cases in the United States — some 70,000 each year — could be prevented if every woman followed the recommendations.


Tuesday, September 1, 2009

Study Shows How Acupuncture Stops Pain

This article from the Medicine.net website discusses a western scientific study designed to explain acupuncture's pain relieving effect. It's a quick, interesting read. I would offer the caveat that no acupuncturist would recommend using morphine or other opiates after treatment, a conclusion a quoted researcher mistakenly draws from the study findings. It is validating to see western studies that scientifically verify acupuncture's results. KB

Imaging Sheds Light on How Acupuncture Works

THURSDAY, Aug. 27 (HealthDay News) -- Traditional Chinese acupuncture, increasingly popular in the West for a variety of ills, eases pain by regulating key receptors in the brain, according to a new study.

The study showed that acupuncture increases the binding availability of mu-opioid receptors in regions of the brain that process and weaken pain signals -- specifically the cingulate, insula, caudate, thalamus and amygdala. By directly stimulating these chemicals, acupuncture can affect the brain's long-term ability to regulate pain, the study found.

A report on the findings is in the September issue of NeuroImage.

Using positron emission tomography scans of the brain, the researchers examined 20 women with fibromyalgia, a chronic pain condition. The women took no new medications for their pain during the study period.

"The increased binding availability of these receptors was associated with reductions in pain," Richard Harris, a researcher at the University of Michigan's Chronic Pain and Fatigue Research Center and a research assistant professor of anesthesiology at the University of Michigan Medical School, said in a news release from the university.

What's more, Harris said, the findings could prompt doctors to use morphine and other opioid drugs with greater pain-killing effectiveness after treatment with acupuncture because those drugs bind to the same receptors.

Acupuncture has been used in China for more than 2,000 years. Practitioners insert sharp, thin needles into the body at specific points. Today, people worldwide turn to acupuncture for relief from pain, allergies, respiratory ailments, gastrointestinal disorders and gynecological problems.

Chinese healers claim that acupuncture and traditional remedies work by altering the flow of the body's energy. Practitioners of Western medicine, which follows a more scientific approach, have been investigating exactly how acupuncture works -- or may not work -- for a number of years.

-- Peter West

SOURCE: University of Michigan Medical School, news release, August 2009

Copyright © 2009 ScoutNews, LLC. All rights reserved.

Wednesday, August 26, 2009

Studies Show Chinese Herbs as Effective or Better than Drugs for Endometriosis with Fewer Side Effects



Endometriosis is a condition where endometrial tissue, which normally lines a woman's uterus, is found outside of the uterus. This tissue can grow and shed during a menstrual cycle and cause pain, heavy menstrual bleeding, and infertility. "Medical treatment of endometriosis ranges from symptomatic management with nonsteroidal anti-inflammatory drugs and analgesics to hormonal manipulations that include continual oral contraceptives, progestins, danazol, and gonadotrophin-releasing hormone agonists. However [according to the below study], the benefits are short lived, and symptoms often return to pretreatment levels within six months. Under the best of circumstances, more than a third of patients have symptom recurrence within two or three years after stopping therapy."

Symptoms of endometriosis have been treated with Chinese medicine for hundreds of years. Treatment involving herbal medicine, acupuncture, and dietary therapy have afforded women reduced pain, lighter periods, and restored fertility. While more severe cases of endometriosis may require surgery, Chinese medicine may offer an effective treatment for many women.

Gerry Harringon, Harmony TCM Weblog





Chinese Herbs Show Promise for Endometriosis



By Charles Bankhead, Staff Writer, MedPage Today
Published: July 08, 2009
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco and
Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner


HOUSTON, July 8 -- Chinese herbal medicine provided relief to symptoms of endometriosis that was equivalent or superior to conventional therapies following laparoscopic surgery, a systematic review indicated.
Action Points
  • Explain to patients that Chinese herbal medicine appeared to relieve postsurgical endometriosis symptoms at least as well as conventional medical therapy.


  • The findings were based on a retrospective review of a large database and involved a small number of patients.

Herbal medicine achieved symptom relief comparable to that of gestrinone but with fewer side effects, Andrew Flower, PhD, of Southampton University in Ringmer, England, and colleagues reported in the Cochrane Database of Systematic Reviews. The pregnancy rate was similar with either treatment.

Compared with danazol, Chinese herbal medicine led to better postsurgical symptom control with fewer side effects.

"These findings suggest that Chinese herbs may be just as effective as certain conventional drug treatments for women suffering from endometriosis, but at present we don't have enough evidence to generalize the results," Dr. Flower said in a statement.

The authors noted that more rigorous research is needed to assess the potential role of Chinese herbal medicine in treating endometriosis. Investigators initially identified 110 studies for their review. However, all but two had to be excluded because of methodologic flaws.

Medical treatment of endometriosis ranges from symptomatic management with nonsteroidal anti-inflammatory drugs and analgesics to hormonal manipulations that include continual oral contraceptives, progestins, danazol, and gonadotrophin-releasing hormone agonists.

Hormonal therapies provide comparable symptom relief and reduction of endometriosis-related lesions, the authors said.

However, the benefits are short lived, and symptoms often return to pretreatment levels within six months. Under the best of circumstances, more than a third of patients have symptom recurrence within two or three years after stopping therapy, the authors noted.

Additionally, the benefits of conventional therapy have to be balanced against potentially serious adverse effects, the authors continued.

Surgery also carries a risk of serious adverse events, such as bowel perforation and peritonitis, and offers no assurance of long-term symptom relief.

"In summary, current treatments all have high rates of recurrence and their short-term benefits have to be balanced with concerns over immediate and longer-term side effects," they said.

Chinese herbal medicine has a clinical history that dates back to ancient times. Among the medical applications is treatment of symptoms associated with endometriosis.

The origin of Chinese herbs' activity in endometriosis is unclear. Suggested mechanisms have included regulation of endocrine and immune systems, improved circulation, and anti-inflammatory activity.

But no English-language systematic review had been conducted to determine whether Chinese herbal medicine has a role in the treatment of endometriosis.

To address that void, Dr. Flower and colleagues searched multiple databases for randomized controlled trials of Chinese herbal medicine versus placebo, conventional medical therapy, another Chinese herb, or as an add-on to conventional therapy.

Of 110 studies originally considered, only two met the authors' inclusion criteria. All 110 studies were conducted in China and were reported in Chinese.

The two studies involved a total of 158 women whose mean age was 30. Diagnostic criteria included laparoscopic diagnosis, American Fertility Society staging, and vaginal or rectal B-ultrasound.

Additionally, all of the patients had been diagnosed according to traditional Chinese medicine as having stagnation of Qi (vital energy) and blood with an underlying kidney deficiency.

All patients had laparoscopic surgery as primary therapy.

One study compared a Chinese herbal medicine enema and gestrinone. In the second trial, patients were randomized to Chinese herbal medicine pills alone, herbal pills plus an herbal enema, or danazol.

Gestrinone led to a symptomatic relief rate of 93.87% compared with 95.6% for the Chinese herbal medicine enema.

During 24 months of follow-up, 69.6% of women assigned to the enema became pregnant, as did 59.1% of patients treated with gestrinone. Neither difference achieved statistical significance.

No adverse events occurred in patients treated with the Chinese herbal medicine enema. In contrast, 13 of 49 patients treated with gestrinone developed acne, while19 had elevated liver enzymes, and 31 had oligomenorrhea.

In the second trial, oral Chinese herbal medicine alone or in combination with an herbal enema led to significantly greater symptom relief compared with danazol (RR 5.06, 95% CI 1.28 to 20.05 and RR 5.63, 95% CI 1.47 to21.54, respectively).

Additionally, the combined Chinese herbal medicine reduced dysmenorrheal pain significantly more than danazol and resulted in a significantly higher rate of disappearance or shrinkage of adnexal masses (MD -2.90, 95% CI -4.55 to -1.25, RR 1.70, 95% CI 1.04 to 2.78, respectively).

Four of 16 patients randomized to Chinese herbal pills alone had dry mouth, and one patient developed acne. Among 24 patients randomized to herbal pills and an herbal enema, two had dry mouth, while 11 developed rectal tenesmus during the first two weeks of treatment, and one patient had weight gain of 3 kg.

Of 18 patients treated with danazol, 13 developed acne, while three had weight gain of 3 kg, two gained 2 kg, one gained 1.5 kg, two had elevated liver enzymes, and four had oligomenorrhea.

The authors reported no relevant financial disclosures.

Primary source: Cochrane Database of Systematic Reviews
Source reference:
Flower A et al. "Chinese herbal medicine for endometriosis" Cochrane Database Syst Rev 2009; DOI: 10.1002/14651858.CD006568.pub2.

Sunday, August 16, 2009

Should Junk Food Be Sin-Taxed?

Let me take this opportunity to discuss the proposed surtax on soft drinks to help pay the costs of universal health care. First off, I'm for it, and here's why:

If we go to a universal health care plan, that would mean that we are all in the same insurance pool: we all put money in, and the sick and infirm take money out as needed to provide for their health care. That means that those of us who do preventative care, live a healthy lifestyle and cultivate our health are subsidizing the health care expenses of those who do not take care of their health. Obesity is at epidemic proportions in this country, and has been for some years. The costs of obesity in terms of disease has proportionally been on the rise, namely diabetes is now epidemic also. Other obesity related conditions include hypertension and hypercholesterolemia. These diseases lead to increased incidents of strokes, heart attacks and in the case of diabetes, kidney failure (requiring dialysis and transplants), blindness, peripheral neuropathy due to poor circulation, leading to amputations and so on. Obviously the dollar costs of these procedures as well as on going pharmaceutical use to treat these conditions is high: 150-200 billion $/annually in the US. (Smoking, for comparison, costs 120-150 billion annually). In a universal system that gets averaged out to all who pay in, meaning the healthy subsidize these costs as the rates rise for everyone in the system in order to pay out for those requiring the care.

Obesity is caused by poor diet. The cheap junk foods are the cause of the obesity epidemic. The government subsidizes wheat, corn, soy and tobacco. All of these contribute to poor health, and the heavily subsidized foods are used to make junk food cheap. Corn is used to make corn syrup, the cheap sugar substitute heavily utilized in junk food. Junk food is mainly purchased because it is cheap, so price directly correlates to its use. When price increases, usage decreases. As junk food is a direct cause of obesity and it's related diseases (diabetes, hypertension, hypercholestemia), decreasing the use of junk food will have a direct effect of reducing these diseases and the costs to society (under a universal health care system) for treating them. And because folks choose to eat these offending foods largely because they are cheap, one of the most direct results one can have in affecting behavior that causes obesity is too raise the price of the foods that cause it: junk foods. (Which by the way isn't really food: contrary to popular belief soda, red wine, chocolate and potato chips are not the 4 food groups, and corn chips do not count as a serving of vegetables).

Therefore I feel not only that the cost of soft drinks ought to be taxed, but all junk foods: fast food, donuts, pizza, Twinkies, chips, candy and so on, with the proceeds going to pay for the universal health care/insurance, to offset the costs of additional health care that the consumption of those offending foods cause are incurred by society.

It seems to me that in a society that sin taxes smoking and drinking (cigarettes and alcohol) obesity should be similarly sin-taxed by taxing junk foods.

In addition, I advocate for
tax breaks to companies and individuals rewarding preventative care, such as gym memberships, healthy foods at cafeterias and menus, weight loss, smoking cessation, acupuncture, chiropractic and nutritional counseling, stress management, meditation, yoga, tai qi and qi gong classes. Tax breaks should be given when healthy foods are displayed prominently at eye level in stores and cafeterias, with junk foods and sodas/alcohol placed at the bottom/floor level of display cases, or high on shelves where children are present. Rather than subsidizing foods that cause disease, thereby increasing costs to the health care system that we all must incur, namely tobacco, soy, corn and wheat (these subsidized foods become the cheap, raw material of junk foods), the government should instead be subsidizing produce and organically grown foods (which have higher nutritional content and incur less cost to the environment). Remembering that frest produce is often unavailable or entirely unaffordable in impoverished neighborhoods. As the NY Times reports in the article pasted below, the cost of produce has risen 40% in the past 3 decades, while the price of soda (made with government subsidized corn syrup) has fallen 33% during that same time period. Combined with an increasingly seditary lifestyle and increased use of restaurants and fastfood = a fool proof recipe for our obesity epidemic. KB



The following article is from today's Sunday magazine section of the NY Times:



The New York Times
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August 16, 2009
The Way We Live Now

Fat Tax

Two years ago, the Cleveland Clinic stopped hiring smokers. It was one part of a “wellness initiative” that has won the renowned hospital — which President Obama recently visited — some very nice publicity. The clinic has a farmers’ market on its main campus and has offered smoking-cessation classes for the surrounding community. Refusing to hire smokers may be more hard-nosed than the other parts of the program. But given the social marginalization of smoking, the policy is hardly shocking. All in all, the wellness initiative seems to be a feel-good story.

Which is why it is so striking to talk to Delos M. Cosgrove, the heart surgeon who is the clinic’s chief executive, about the initiative. Cosgrove says that if it were up to him, if there weren’t legal issues, he would not only stop hiring smokers. He would also stop hiring obese people. When he mentioned this to me during a recent phone conversation, I told him that I thought many people might consider it unfair. He was unapologetic.

“Why is it unfair?” he asked. “Has anyone ever shown the law of conservation of matter doesn’t apply?” People’s weight is a reflection of how much they eat and how active they are. The country has grown fat because it’s consuming more calories and burning fewer. Our national weight problem brings huge costs, both medical and economic. Yet our anti-obesity efforts have none of the urgency of our antismoking efforts. “We should declare obesity a disease and say we’re going to help you get over it,” Cosgrove said.

You can disagree with the doctor — you can even be offended — and still come to see that there is a larger point behind his tough-love approach. The debate over health care reform has so far revolved around how insurers, drug companies, doctors, nurses and government technocrats might be persuaded to change their behavior. And for the sake of the economy and the federal budget, they do need to change their behavior. But there has been far less discussion about how the rest of us might also change our behavior. It’s as if we have little responsibility for our own health. We instead outsource it to something called the health care system.

The promise of that system is undeniably alluring: whatever your ailment, a pill or a procedure will fix it. Yet the promise hasn’t been kept. For all the miracles that modern medicine really does perform, it is not the primary determinant of most people’s health. J. Michael McGinnis, a senior scholar at the Institute of Medicine, has estimated that only 10 percent of early deaths are the result of substandard medical care. About 20 percent stem from social and physical environments, and 30 percent from genetics. The biggest contributor, at 40 percent, is behavior.

Today, the great American public-health problem is indeed obesity. The statistics have become rote, but consider that people in their 50s are about 20 pounds heavier on average than 50-somethings were in the late 1970s. As a convenient point of reference, a typical car tire weighs 20 pounds.

This extra weight has caused a sharp increase in chronic diseases, like diabetes, that are unusually costly. Other public-health scourges, like lung cancer, have tended to kill their victims quickly, which (in the most tragic possible way) holds down their long-term cost. Obesity is different. A recent article in Health Affairs estimated its annual cost to be $147 billion and growing. That translates into $1,250 per household, mostly in taxes and insurance premiums.

A natural response to this cost would be to say that the people imposing it on society should be required to pay it. Cosgrove mentioned to me an idea that some economists favor: charging higher health-insurance premiums to anyone with a certain body-mass index. Harsh? Yes. Fair? You can see the argument. And yet it turns out that the obese already do pay something resembling their fair share of medical costs, albeit in an indirect way. Overweight workers are paid less than similarly qualified, thinner colleagues, according to research by Jay Bhattacharya and M. Kate Bundorf of Stanford. The cause isn’t entirely clear. But the size of the wage difference is roughly similar to the size of the difference in their medical costs.

It’s also worth noting that the obese, as well as any of the rest of us suffering from a medical condition affected by behavior, already have plenty of incentive to get healthy. But we struggle to do so. Daily life gets in the way. Inertia triumphs.

The question of personal responsibility, then, ends up being more complicated than it may seem. It’s hard to argue that Americans have collectively become more irresponsible over the last 30 years; the murder rate has plummeted, and divorce and abortion rates have fallen. And our genes certainly haven’t changed in 30 years.

What has changed is our environment. Parents are working longer, and takeout meals have become a default dinner. Gym classes have been cut. The real price of soda has fallen 33 percent over the last three decades. The real price of fruit and vegetables has risen more than 40 percent.

The solutions to these problems are beyond the control of any individual. They involve a different sort of responsibility: civic — even political — responsibility. They depend on the kind of collective action that helped cut smoking rates nearly in half. Anyone who smoked in an elementary-school hallway today would be thrown out of the building. But if you served an obesity-inducing, federally financed meal to a kindergartner, you would fit right in. Taxes on tobacco, meanwhile, have skyrocketed. A modest tax on sodas — one of the few proposals in the various health-reform bills aimed at health, rather than health care — has struggled to get through Congress.

Cosgrove’s would-be approach may have its problems. The obvious one is its severity. The more important one is probably its narrowness: not even one of the nation’s most prestigious hospitals can do much to reduce obesity. The government, however, can. And that is the great virtue of Cosgrove’s idea. He is acknowledging that any effort to attack obesity will inevitably involve making value judgments and even limiting people’s choices. Most of the time, the government has no business doing such things. But there is really no other way to cure an epidemic.

David Leonhardt is an economics columnist for The Times and a staff writer for the magazine.


Saturday, August 15, 2009

3 Tempeh Recipes

Occasionally patients mention that they would like to try tempeh, but aren't sure how to cook it. Tempeh is a soy product, made with fermented soybeans and formed into cakes. Often times other ingredients are added, such as grains or seaweed (sea veg). Tempeh has a strong flavor and needs to be marinated or cooked in sauces to moderate the taste. Here are 3 of my favorite tempeh recipes, taken form Peter Berley's cookbook "The Modern Vegetarian Kitchen". Berley is a vegetarian chef who cooked for many years at Angelica's Kitchen, one of New York's original and favorite veg restaurants. I love his cookbook and all of the recipes in it.

In his book Peter recommends using unpasteurized tempeh, which he claims is available in the freezer section. I have never seen it in Asheville. He praises its' texture and ability to absorb marinades.



Barbecued Tempeh

I have brought this to pot lucks and the plate always comes home empty. Non-vegs like to try it and always like it.

1lb tempeh
1/2 C cider vinegar
1/2C soy sauce (i use tamari)
1/2C olive oil
1/3C pure maple syrup
2t ground cumin
2t ground chipoti chili (i sub a Koren red chili i have on hand)
1t dried thyme
1t sweet paprika

I usually double this and bake it in a 9x12 pan.

Preheat oven to 350 degrees.

Slice each block of tempeh in half horizontally, then slice each piece in half. Use a baking dish that will hold the slices in a snug, single layer.

Whisk together the liquids and spices. Pour half the marinade in the baking dish. Place the tempeh on top and cover with remaining marinade. Cover dish with foil, shiny side down, creating a tight seal. Bake 35min in a convection oven or 45-50min in a conventional oven, until most of the marinade is absorbed. Uncover and bake an additional 10 min (conventional oven). Convection: turn off oven and bake additional 9min, until well browned.

Remove and cool. If you are bringing it to a bar-be-que, i like to thrown it on the grill for a few min.

Peter recommends making Bar-be-qued Tempeh into sandwiches with toppings such as: chopped lettuce, sliced kirby or pickling cucumber, clover spouts, watercress and shredded carrots.

I like it as a main dish, served over a bed of brown basmati rice and steamed veggies on the side.

This dish freezers well. Peter advises that it keeps up to 10 days in the refridge.




Apple-Mustard Baked Tempeh Sandwich Filling

I generally double this recipe. The Natural Import Store in Asheville as wonderful, high quality sesame oil, avail mail order or pick-up. I have a link to their website on the bottom of the Resources page of my website www.AcupunctureAsheville.com



1lb tempeh
1 1/3C apple juice or fresh cider
1/3C olive or light sesame oil
3T soy sauce (i use tamari)
3T mustard (i use brown)
1t ground caraway seeds
1t ground cumin (i have successfully subbed curry pwd for the spices)
1/4 t black pepper
Sour kraut


Preheat oven to 350 degrees.

Slice each block of tempeh in half horizontally, then slice each piece in half. Transfer to a steamer and steam over boiling water for 8min.

Whisk together the liquids and spices.
Place the tempeh a baking dish that will hold the slices in a snug, single layer. Pour the marinade over the tempeh and bake uncovered 28min in a convection oven or 35-40min in a conventional oven, until most of the marinade is absorbed and tempeh is nicely browned.

To serve, spread tahini and mustard (i use brown) on sandwich bread. Top with tempeh, sour kraut, and spouts or lettuce (i like dandelion greens). I think this makes great summer sandwiches.



Tempeh Simmered in Broth

This simple dish is surprisingly lite. Peter suggests adding a few chopped veggies and some leftover grains or pasta to the broth for a one-pot meal. I like to serve it over a bed of rice with steamed vegs on the side.

1lb tempeh, sliced in bite sized pieces
4C water
3T soy sauce (i use tamari)
1T olive oil
3-4 garlic cloves, lightly bruised with the side of the knife (apparently bruising affects the taste of garlic)
2-3 quarter-sized ginger root slices
1 sprig rosemary
1 sprig thyme
thinly sliced green onions (scallion) for garnish

Combine all ingredients, excepting scallion) in a pot and bring to boil. Reduce to simmer, cover and cook 30min. Remove herb sprigs and serve with sprinkled scallion.

4-6 servings


Wednesday, July 22, 2009

On the Hidden/Real Costs of Healthcare/Insurance: NY Times Article

I avoid getting political in matters relating to my practice, which would include on this blog. In the case of universal health care, the political relates to my practice, and I find myself no longer able to restrain my urge to speak out.

I suppose first off I should straight out say that I am emphatically for universal health care because it is the humane and compassionate thing to do. With the advances in western medical technology causing health care costs to rise astronomically, I can not see any reason why the so called 'most advanced nation on earth' does not provide health care/insurance for all members of it's society.
The notion of not providing health care to all, and rather only providing it to the 'haves', is medieval, IMO.

On the day that Obama will address the nation regarding providing universal health care for all, the New York Times has published an article regarding the hidden costs of health care, which it reports has risen annually to $7,500/person, $15,000/household. Up 5x the cost, from about $1,500/person, in 1960. I've including excerpts from the Times article below. KB



The New York Times
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July 22, 2009
Economic Scene

Challenge to Health Bill: Selling Reform

WASHINGTON — What’s in it for me?

On the subject of health care reform, most Americans probably don’t have a good answer to the question. And that, obviously, is a problem for the White House and for Democratic leaders in Congress.

Current bills would expand the number of insured — but 90 percent of voters already have insurance. Congressional leaders say the bills would cut costs. But experts are dubious. Instead, they point out that covering the uninsured would cost billions.

So the typical person watching from afar is left to wonder: What will this project mean for me, besides possibly higher taxes?

Barack Obama was able to rise from the Illinois State Senate to the presidency in large measure because of his ability to explain complex issues and then to make a persuasive argument. He now has a challenge worthy of his skills.

Our health care system is engineered, deliberately or not, to resist change. The people who pay for it — you and I — often don’t realize that they’re paying for it. Money comes out of our paychecks, in withheld taxes and insurance premiums, before we ever see it. It then flows to doctors, hospitals and drug makers without our realizing that it was our money to begin with.

The doctors, hospitals and drug makers use the money to treat us, and we of course do see those treatments. If anything, we want more of them. They are supposed to make us healthy, and they appear to be free. What’s not to like?

The immediate task facing Mr. Obama — in his news conference on Wednesday night and beyond — is to explain that the health care system doesn’t really work the way it seems to. He won’t be able to put it in such blunt terms. But he will need to explain how a typical household, one that has insurance and thinks it always will, is being harmed.

The United States now devotes one-sixth of its economy to medicine. Divvy that up, and health care will cost the typical household roughly $15,000 this year, including the often-invisible contributions by employers. That is almost twice as much as two decades ago (adjusting for inflation). It’s about $6,500 more than in other rich countries, on average.

We may not be aware of this stealth $6,500 health care tax, but if you take a moment to think, it makes sense. Over the last 20 years, health costs have soared, and incomes have grown painfully slowly. The two trends are directly connected: employers had to spend more money on benefits, leaving less for raises.

In exchange for the $6,500 tax, we receive many things. We get cutting-edge research and heroic surgeries. But we also get fabulous amounts of waste — bureaucratic and medical.

One thing we don’t get is better health than other rich countries, whether it’s Canada, France, Japan or many others. In some categories, like emergency room care, this country seems to do better. In others, like chronic-disease care, it seems to do worse. “The fact that we spend all this money and don’t have better outcomes than other countries is a sign of how poorly we’re doing,” says Dr. Alan Garber of Stanford University. “We should be doing way better.”

So far, no one has grabbed the mantle as the defender of the typical household — the opponent of spending that creates profits for drug companies and hospitals at no benefit to people’s health and at significant cost to their finances.

Republicans have actually come out against doing research into which procedures improve health. Blue Dog Democrats oppose wasteful spending but until recently have not been specific. . .

Mr. Obama says many of the right things. Yet the White House has not yet shown that it’s willing to fight the necessary fights. Remember: the $6,500 tax benefits someone. And that someone has a lobbyist. The lobbyist even has an argument about how he is acting in your interest.

These lobbyists, who include big names like Dick Armey and Richard Gephardt, have succeeded in persuading Congress to write bills with a rather clever feature. They include some of the ideas that would cut costs — but defang them.

One proposal would pay doctors based on the quality of care, rather than quantity, but it’s a pilot project. Doctors who already provide good care may well opt in; doctors providing wasteful but lucrative care surely will not. The bills would also finance research on which treatments are effective. But Medicare officials would not be prevented from continuing to spend taxpayer money on ineffective treatments.

In reaction, some people who should be natural supporters of reform have become critics. The Mayo Clinic — one of Mr. Obama’s favorite models of care — says the legislation fails to “help create higher-quality, more affordable health care.”

On Thursday, Mr. Obama will visit another example he likes to cite, the Cleveland Clinic. Its successes capture what real reform would look like. Like Mayo, the Cleveland Clinic pays its doctors a salary, rather than piecemeal, and delivers excellent results for relatively little money.

“I came here 30-some years ago,” Delos Cosgrove, a heart surgeon who is the clinic’s chief executive, told me. “And I have never received any additional pay for anything I did. It never made a difference if I did five heart operations or four — I got paid the same amount of money. So I had no incentive to do any extra tests or anything.”

This is the crux of the issue, economists say: the current fee-for-service system needs to be remade. . .

E-mail: Leonhardt@nytimes.com


Mahatma Gandhi Kitcharee: Rice & Grain Dish Works Well for Poor Appetite

In TCM (Traditional Chinese Medicine) we often prescribe a rice porridge called congee for those with poor appetite or difficult digestion, esp. for chronic illness, cancer or chemotherapy. Congees are traditionally made with rice, although any grain can be uses. They are cooked with lots of water (8:1 water: rice) and cooked for a long time (4-8hr: a crock pot is often used). Herbs, meats, dried fruits, sweeteners and nuts are added for flavor and medicinal effect. A respected teacher of mine gave accounts of bedridden patients with cancer brought back from the precipice through the use of congee.

In India, they make a traditional dish called kitcharee, which is similar to the medicinal effect of congee, but less water and cooking time is involved. Kitcharee works well for those who can eat solid foods, but have poor appetite. It's an Indian comfort food. I also think it's a spiritual food, being merely rice and dal (lentils), which may explain why Gandhi enjoyed this simple, nourishing dish.

2:1 rice to dal (yellow lentils)

Any long-cooking rice can be used: basmati, jasmine. I suggest long-grained rice. Being as this is an Indian dish, traditionally basmati rice is used. With loose stools use white rice, with hard or difficult stools use brown.

1: 1 1/2 rice & dal (pre-soaked): water/stock. I suggest soaking the rice for 24h in advance to make it more digestible. According to Paul Pitchford, author of "Healing With Whole Foods" soaking grains for 24h helps to prevent fatigue.

1:2 - 2 1/2 rice/grain: water/stock Use this proportion when using unsoaked grains.

I suggest using 50/50 water & stock (vegetable, beef or chicken). For vegetarians & meditators use vegetable stock. I believe eating a meatless diet aids the transcendence to the spiritual realms. You'll find many spiritual peoples - Buddhists, hindis - eat a vegetarian diet.

Example: 1C long-grain rice: 1/2C dal (yellow lentils). 1 1/2C rice (soaked)/dal: 2 1/4C water/stock or 1 1/2C rice (unsoaked)/dal: 3 - 3 3/4C water/stock.

+ salt (1/2t) I suggest sea salt because it is high in valuable trace minerals. I like to add a few sprigs of fresh parsley.

Pressure cook 15min (low pressure) with soaked rice, longer (30-40min) unsoaked grain. If you are not using a pressure cooker, cook it longer: 40m-1h, until lentils are soft and all the water is absorbed. (First bring to a boil, then turn down to a simmer and cook).

Here's the special favor enhancer:

As soon as the grain has finished cooking heat some high heat oil (1T - olive, sunflower) in a small frying pan on medium heat. As soon as the oil is hot (just a few minutes on a gas stove) add cumin seeds (1/2t) and let them fry for 10 seconds until the aroma arrives and they are foaming. Immediately lift the lid on the grains and pour in the fried cumin seeds, and quickly replace the lid. Let them sit in the pot for 1 minute or so. Then stir and serve. I like to garnish with fresh, chopped parsley or pesto.

Kitcharee can be eaten for any meal - breakfast, lunch or dinner. You can make up a larger quantity and reheat it at meal time. It travels well for brown bagging. KB


Sunday, July 19, 2009

Dangers of Using Cellphone While Driving, NY Times Article

The New York Times is running a series on the dangers of using cellphones while driving. Here are excerpts from Sunday's article. KB


This copy is for your personal, noncommercial use only. You can order presentation-ready copies for distribution to your colleagues, clients or customers here or use the "Reprints" tool that appears next to any article. Visit www.nytreprints.com for samples and additional information. Order a reprint of this article now.

July 19, 2009
Driven to Distraction
Drivers and Legislators Dismiss Cellphone Risks

By MATT RICHTEL
OKLAHOMA CITY — On his 15th birthday, Christopher Hill got his first cellphone. For his 16th, he was given a used red Ford Ranger pickup, a source of pride he washed every week.
Mr. Hill, a diligent student with a reputation for helping neighbors, also took pride in his clean driving record. “Not a speeding ticket, not a fender bender, nothing,” he said.
Until last Sept. 3. Mr. Hill, then 20, left the parking lot of a Goodwill store where he had spotted a dresser he thought might interest a neighbor. He dialed her to pass along news of the find.
Mr. Hill was so engrossed in the call that he ran a red light and didn’t notice Linda Doyle’s small sport utility vehicle until the last second. He hit her going 45 miles per hour. She was pronounced dead shortly after.
Later, a policeman asked Mr. Hill what color the light had been. “I never saw it,” he answered.
Extensive research shows the dangers of distracted driving. Studies say that drivers using phones are four times as likely to cause a crash as other drivers, and the likelihood that they will crash is equal to that of someone with a .08 percent blood alcohol level, the point at which drivers are generally considered intoxicated. Research also shows that hands-free devices do not eliminate the risks, and may worsen them by suggesting that the behavior is safe.
A 2003 Harvard study estimated that cellphone distractions caused 2,600 traffic deaths every year, and 330,000 accidents that result in moderate or severe injuries.
Yet Americans have largely ignored that research. Instead, they increasingly use phones, navigation devices and even laptops to turn their cars into mobile offices, chat rooms and entertainment centers, making roads more dangerous.
A disconnect between perception and reality worsens the problem. New studies show that drivers overestimate their own ability to safely multitask, even as they worry about the dangers of others doing it.
Device makers and auto companies acknowledge the risks of multitasking behind the wheel, but they aggressively develop and market gadgets that cause distractions.
Police in almost half of all states make no attempt to gather data on the problem. They are not required to ask drivers who cause accidents whether they were distracted by a phone or other device. Even when officers do ask, some drivers are not forthcoming.

The federal government warns against talking on a cellphone while driving, but no state legislature has banned it. This year, state legislators introduced about 170 bills to address distracted driving, but passed fewer than 10.
Five states and the District of Columbia require drivers who talk on cellphones to use hands-free devices, but research shows that using headsets can be as dangerous as holding a phone because the conversation distracts drivers from focusing on the road.
Fourteen states have passed measures to ban texting while driving, and the New York State Assembly sent such a bill to the governor on Friday.
The states that rejected any efforts to limit distracted driving this year include Oklahoma.
“I’m on the phone from when I leave the Capitol to when I get home, and that’s a two-hour drive,” said Tad Jones, the majority floor leader in the Oklahoma House, who helped block the legislation. “A lot of people who travel are used to using the phone.”
Scientists who study distracted driving say they understand the frustrations of colleagues who publicized the dangers of tobacco. Like cigarettes, they say, gadgets are considered cool but can be deadly. And the big device companies even offer warnings that remind them of labels on cigarette packs.
Verizon Wireless, for instance, posts instructions on its Web sites not to talk while driving — with or without a headset. But neither Verizon nor any other cellphone company supports legislation that bans drivers from talking on the phone. And the wireless industry does not conduct research on the dangers, saying that is not its responsibility.
Some researchers say that sufficient evidence exists to justify laws outlawing cellphone use for drivers — and they suggest using technology to enforce them by disabling a driver’s phone. “Just outlawing the behavior cannot possibly go very far toward getting people not to do it,” said Robert D. Foss, senior research scientist at the Highway Safety Research Center at the University of North Carolina. “The behavior is too ingrained and compelling.”
For his part, Mr. Hill rarely talks when he drives now. His mother gave him a hands-free headset two months after the accident. She thought it would create less distraction. He tried it once, and found his mind wandering into his phone call so much that “I nearly missed a light,” he said.
He pleaded guilty to negligent homicide, a misdemeanor, for the death of Ms. Doyle. Now, when he is a passenger in a car, it makes him nervous when the driver starts talking on the phone. But Mr. Hill, who is polite and deferential, said he doesn’t want to badger drivers about the risks.
“I hope they don’t have to go through what I did to realize it’s a problem,” he added.
Dangerous Overconfidence
Sgt. Matthew Downing, a tough-talking 11-year veteran on the Oklahoma City police force, drives a car with no lights on the roof. That way, drivers are less likely to notice him as he waits for speeders.
Increasingly, he sees erratic behavior — swerving across lanes, running red lights — that looks just like drunken driving. Instead, he sees drivers talking on their phones, or texting. “A ton of people pass me literally unaware of their surroundings,” he said.
Sergeant Downing, who often handles traffic fatalities, arrived at the scene of Mr. Hill’s crash after paramedics had extracted Ms. Doyle, who was 61, from her car. He found Mr. Hill sitting on a fire truck, acting “hysterical.”
There was no mystery about the accident’s cause; the roads were dry. “He told me he was talking on the phone and didn’t see the light,” Sergeant Downing said.
“He’s a nice kid,” he said of Mr. Hill. But he said he felt angry, both at Mr. Hill and at what he sees as an epidemic of multitasking on the road. “Driving and talking are automatic,” he said.
Over all, cellphone use has soared. From 1995 to 2008, the number of wireless subscribers in the United States increased eightfold, to 270 million, and minutes talked rose 58-fold.
Last year, the federal agency dealing with road safety, the National Highway Traffic Safety Administration, published a study, based on researchers’ observations of drivers, suggesting that at any time during daylight hours in 2007, 11 percent — or 1.8 million drivers — were using a cellphone.
And in a survey of 1,506 people last year by Nationwide Mutual Insurance, 81 percent of cellphone owners acknowledged that they talk on phones while driving, and 98 percent considered themselves safe drivers. But 45 percent said they had been hit or nearly hit by a driver talking on a phone.
“When we ask people to identify the most dangerous distraction on the highway today, about half — correctly — identify cellphones,” said Bill Windsor, associate vice president for safety at Nationwide. “But they think others are dangerous, not themselves.”
He and others who favor restrictions say drivers regularly make what amount to ill-informed analyses of cost-benefit tradeoffs, often deciding that the value of constant communication outweighs any risks.
Seven years ago, when cellphones and services like texting were less common, federal researchers estimated that drivers using cellphones caused about 1,000 fatalities and played a role in 240,000 crashes. (In 2007, drunken driving caused 13,000 fatalities.)
By other measures, American roads are becoming safer. According to the highway safety agency, the number of driving fatalities has remained around 42,000 a year for most of the last decade, though it fell to 37,261 in 2008, when gas prices rose sharply and Americans drove less.
From 1997 to 2007, the number of reported accidents fell to 6 million a year from 6.7 million, according to the highway safety agency. “There are more drivers, more talking drivers,” said John Walls, spokesman for the Cellular Telecommunications and Internet Association. “If it’s so risky, then logically one would think there would be more accidents.”
The association, a trade group, fought rules to ban phone use while driving until January, when it shifted to a neutral position on the issue. “I wouldn’t say, ‘Talk on the phone more and have fewer accidents,’ ” Mr. Walls added. “I’m just saying, ‘How does this square?’ ”
Some scientists say this argument is flawed. “We’ve spent billions on air bags, antilock brakes, better steering, safer cars and roads, but the number of fatalities has remained constant,” said David Strayer, a psychology professor at the University of Utah and a leading researcher in the field of distracted driving.
“Our return on investment for those billions is zero,” he added. “And that’s because we’re using devices in our cars.”
Better data would help settle the debate. But 21 states do not include a box on accident forms for police to mark electronic devices as a cause. Those that now account for it started doing so only recently. Mr. Windsor of Nationwide Mutual said that such data, while valuable, would greatly underestimate the problem because it relies on driver confessions. Sometimes drivers say they just finished a call. Cellphone records are not much help because of the difficulty of establishing the precise time of an accident.
“By the time you get to a crash, it’s very, very difficult to determine whether someone was talking on the phone and whether the phone caused the crash,” said Rae Tyson, a spokesman for the National Highway Traffic Safety Administration.
For Mr. Windsor and many scientists who study the issue, accident figures are not necessary to prove the risks.
“The research is just so strong,” Mr. Windsor said.
Risks of Multitasking
In a windowless room at the University of Utah, Professor Strayer has spent a decade studying driver distraction.
On a recent afternoon, Anne McLaren, 19, who just finished her freshman year studying dental hygiene and who gets class credit for volunteer work, climbed behind the wheel of Mr. Strayer’s $100,000 driving simulator. Her task was to closely follow a white car that often slowed abruptly. A voice on a speaker phone asked Ms. McLaren questions like, “When you do a pull-up, do your palms face toward you?” and “Can you touch your elbow to your ear?”
For the most part, she ably multitasked. But sometimes she took her hands from the wheel when trying to answer a question, like, “True or false: A peanut butter jar opens clockwise.” And she was so focused on her call that she seemed to miss surprises, like a body at the side of the road.
Texting while driving was more difficult; she soon slammed into the virtual car in front of her.
Mr. Strayer’s research, using a small camera to track his volunteers’ eye movements, shows that texting drivers regularly focus on their screens for stretches of more than five seconds.
“I should pay attention to the road,” she said afterward. But sometimes it’s hard to ignore the phone, she added, like when her parents want to reach her. “My dad gets more mad if I don’t have the phone than if I’m talking and driving.”
Mr. Strayer’s research, showing that multitasking drivers are four times as likely to crash as people who are focused on driving, matches the findings of two studies, in Canada and in Australia, of drivers on actual roads.
The highway safety administration estimates that drivers using a hand-held device are at 1.3 times greater risk of a crash or near crash, and at three times the risk when dialing, compared with others who are simply driving. The agency based its conclusions on research from the Virginia Tech Transportation Institute, which placed cameras inside cars to monitor drivers for more than a year. The study found cellphones to be the most common cause of driver distraction.
Research also shows that drivers conversing with fellow passengers do not present the same danger, because adult riders help keep drivers alert and point out dangerous conditions and tend to talk less in heavy traffic or hazardous weather.
Scientists note that there are limits to how much the brain can multitask. The brain has trouble assessing separate streams of information — even if one is visual and the other aural, said Steve Yantis, professor of psychological and brain sciences at Johns Hopkins University.
Further, he said, when people talk on the phone, they are doing more than simply listening. The words conjure images in the mind’s eye, including images of the person they are talking to. That typically doesn’t interfere with driving. The problem starts when a car swerves unexpectedly or a pedestrian steps into traffic, he said, and the mind lacks the processing power to react in time.
“There is zero doubt that one’s driving ability is impaired when one is trying to have a cellphone conversation — whether hands-free or hand-held, it doesn’t matter,” said David E. Meyer, professor of psychology at the University of Michigan.
In fact, some scientists argue that hands-free laws make driving riskier by effectively condoning the practice. As early as July 2003, researchers at the National Highway Traffic Safety Administration reached that conclusion based on what they referred to, in a proposed draft of a cellphone policy for the agency, as “a significant body of research worldwide.”
The draft policy said: “We are convinced that legislation forbidding the use of handheld cellphones while driving will not be effective since it will not address the problem. In fact, such legislation may erroneously imply that hands-free phones are safe to use while driving.”
The agency’s current advice is that people should not use cellphones while driving and that hands-free devices do not eliminate the risks of distracted driving.
Scientists are grappling, too, with perhaps the broadest question hanging over the phenomenon of distracted driving: Why do people, knowing the risk, continue to talk while driving? The answer, they say, is partly the intense social pressures to stay in touch and always be available to friends and colleagues. And there also is the neurological response of multitaskers. They show signs of addiction — to their gadgets.
John Ratey, an associate professor of psychiatry at Harvard University and a specialist on the science of attention, explained that when people use digital devices, they get a quick burst of adrenaline, “a dopamine squirt.” Without it, people grow bored with simpler activities like driving. Mr. Ratey said the modern brain is being rewired to crave stimulation, a condition he calls acquired attention deficit disorder.
“We need that constant pizzazz, the reward, the intensity,” he said. He largely dismisses the argument that people need the time in the car to be productive. “The justification for doing work is just that — a justification to be engaged,” he said.
In many legislatures, including Oklahoma’s, the concerns of such scientists have made little impression. . .

. . .A woman nearby talked of how her husband often became so engrossed in his cellphone calls he would miss the turn for the road to their home. The cellphone, Ms. Tibbs decided, isn’t like other distractions. “When you’re eating, you’re not concentrating like when you’re on the cellphone,” she said. . .

. . .But he said he recognized from using his phone while driving that it could be dangerous, particularly when dialing. “There’s definitely a time when you’re looking at your cellphone,” said Mr. Jones, who uses a hands-free device. “If you’re going to do it, you have to be extremely cautious.” . . .

. . .Some states have overcome opposition to pass restrictions. Joe Simitian, a state senator in California, managed to get his hands-free legislation, an effort he began in 2001, passed in 2006. He argued, based on data collected by the California Highway Patrol, that drivers using cellphones caused more fatalities than all the drivers distracted by eating, children, pets or personal hygiene.
In each previous year, the bill was killed — after lobbying by cellphone carriers, including Sprint, AT&T and T-Mobile. Mr. Simitian said that in the first two years, he would visit the offices of his colleagues on the Transportation Committee on the day of the vote and “find three cellphone industry lobbyists sitting in the legislator’s office,” Mr. Simitian said. “They’d just smile.”
He said they fought him even though their brochures said that distracted driving was dangerous. The exception was Verizon Wireless, which supported his efforts from the start.
Opposition gradually eased, and his bill requiring use of headsets while driving took effect in July 2008. In the first six months the California law was in effect, a preliminary California Highway Patrol estimate showed that fatalities dropped 12.5 percent — saving 200 lives. Mr. Simitian said it was too soon to determine whether the law or other factors caused the drop.
Mr. Simitian said one reason political opposition eased was that fellow legislators saw the dangers firsthand. “They’d come to me and say: ‘You may be bringing me around. I almost got creamed at the corner,’ ” he recalled.
For its part, the cellphone industry trade group said it had dropped its objection to restricting cellphone use by drivers — it now is neutral on the subject — because it decided the industry should play no role in trying to shape public policy on the issue. “The change came after we had an epiphany that, if you will, we’re in the business of providing service, and how they use that service is at their discretion,” said Mr. Walls, the industry spokesman.
But Mr. Windsor from Nationwide Mutual and others are skeptical of the cellphone industry’s explanation. They believe its position changed because its business has changed to rely less on total minutes that people spend talking. Cellphone companies’ growth is coming more from customers surfing the Internet, downloading games and using other data services — things that people typically do less of behind the wheel.
Mr. Simitian believes that a ban on talking on cellphones while driving would save even more lives. But he hasn’t proposed one, and has no plans to. “It’s a political nonstarter,” he said. “It’ll be a cold day in hell before people give up their phones altogether in cars.”
Not to mention other devices. . .

. . .David Teater of Spring Lake, Mich., is also fighting distracted driving; he works for the National Safety Council on transportation issues. His son Joe was killed on Martin Luther King’s Birthday in 2004, hit by a young woman talking on the cellphone to someone from her church, where she volunteered. Even after the accident, Mr. Teater said, he had trouble breaking his cellphone habit.
“With all the motivation in the world I couldn’t do it,” he said, adding that he eventually took more decisive action: “I put the cellphone in the trunk.”
Some drivers who caused accidents themselves have become activists, too. Mr. Hill, as part of his misdemeanor charge, must devote 240 hours to community service — talking about the risks of distracted driving, as well as working with animals, as Ms. Doyle’s family said she would have liked.
He spoke to a classroom of fellow students about his experience, sparing no details.
“Their jaws just dropped,” he said. “They couldn’t believe they had someone standing in front of them who was talking on the cellphone and killed someone.”
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Thursday, July 16, 2009

Studies Show Childhood Stress & Trauma Increase Risk For Auto Immune Diseases & Asthma

There have been some interesting studies published recently showing a positive correlation between childhood stress & trauma and auto immune diseases and asthma. Deepak Chopra has been discussing the findings of one of these studies on auto immune diseases on various news channels lately. I have pasted abstracts from a few of these studies published in Psychosomatic Medicine below for your perusal.

As an acupuncturist, this information has peaked my interest.

There are a couple of reasons I wanted to learn more about these findings. First, as a holistic medicine (meaning one that treats the whole: mind/body/spirit, and considers the organism to be inseparable or part of its surrounding environment) Traditional Chinese Medical (TCM) theory has long recognized the relationship between emotions and diseases. In fact, TCM considers the 7 emotions (joy, grief, sorrow, anger, worry, fright, fear) to be a direct cause of disease and pathology in the body. Trauma (coming from the exterior environment) would involve fright, fear, anger, sorrow, grief and worry all of which bind qi (prevent energy in the body from circulating smoothly) causing disease processes to set in: when qi, and hence blood & fluids (it takes qi or energy to move blood & fluids) do not flow smoothly, pain arises, growths (tumours) develop, phlegm accumulates (causing allergy & asthma symptoms) and so on. So a top priority in TCM treatment of any disease is to keep the qi (and hence blood and fluids) flowing smoothly.

The 7 emotions cause qi (blood & fluids) to stagnate (slow down or stop moving). I'll demonstrate this idea with anger: when we get angry we get tense and tighten up. This tightening prevents qi from moving smoothly. Likewise grief and sorrow result in emotional and physical depression, meaning qi slows down or stops moving. With fear & fright we stop, or freeze. Animals demonstrate this physically when they realize there is a predator near. When worrying, we get stuck in a feedback loop, going over and over the same thoughts: like an eddy in a river. The river of qi swirls around itself rather than moving forward with the current.

The studies mentioned here have focused on pediatric factors, but the implications are not limited to childhood trauma. The results can be extrapolated to include adult traumas & stresses as well, according to TCM theory of the 7 emotional causes of disease.

Secondly, I find it interesting that the recent study showed a high correlation between autoimmune diseases and stress & traumas. Let's explore this idea for a moment.

With autoimmune diseases, the immune system is attacking itself. It misidentifies it's own tissues, marking them as foreign bodies (pathogens) that must be attacked and neutralized. Deepak Chopra's interpretation of the study's results is that in the case of abuse or trauma, esp. for a child, one's boundaries begin to blur regarding who is friend and foe: most often the abuser is a family member. The confusion is registered in the body's immune system.

I would postulate that when under stress, this effect is amplified. We feel we are under attack by the outside force who's interaction with us becomes stressful, and due to that stress, we begin an inner dialogue which may in someways be self-abusive. We ruminate, are fearful, depressed and in perpetuating and nurturing these adverse emotions we are attacking ourselves, impeding our own inner peace and harmony. Thus our immune system identifies ourselves (physically) as a pathogen, or a disease causing agent. In a way, in the case of those who have a positive correlation between compromised immunity and high stress or trauma, the immune system can be seen as doing it's job by diagnosing/identifying ourselves (emotions & thoughts) as the disease pathogen, and it then goes on with its mission to attack and destroy the offending agent.

Maybe the lesson here with immune disorders (or any disease process for that matter) is to see if there is something we are doing in mind or lifestyle that is detrimental to the homeostasis of our well being and if so address it.

I realize that I am going out on a limb here with this extrapolation of the study findings. I am not suggesting that all autoimmune diseases can be cured merely by correcting poor life habits and state of mind. Or even that all autoimmune disease are correlated with stress & trauma in every case. What I am saying is that in TCM we know that lifestyle and emotions are a causative factor in the formation of diseases, and that an important component of any treatment plan is to address the role of these adverse factors in the disease process. KB


Psychosomatic Medicine 71:243-250 (2009)
© 2009 American Psychosomatic Society


ORIGINAL ARTICLES

Cumulative Childhood Stress and Autoimmune Diseases in Adults

Shanta R. Dube, PhD, MPH, DeLisa Fairweather, PhD, William S. Pearson, PhD, MHA, Vincent J. Felitti, MD, Robert F. Anda, MD, MS and Janet B. Croft, PhD

From National Center for Chronic Disease Prevention and Health Promotion (S.R.D., W.S.P. R.F.A., J.B.C.), Centers for Disease Control and Prevention, Division of Adult and Community Health, Atlanta, Georgia; Department of Environmental Health Sciences (D.F.), Bloomberg School of Public Health and Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, Maryland; and the Department of Preventive Medicine (V.J.F.), Southern California Permanente Medical Group (Kaiser Permanente), San Diego, California.

Address correspondence and reprint requests to Shanta R. Dube, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Adult and Community Health, 4770 Buford Highway, N.E., MS K-50, Atlanta, GA 30341-3717. E-mail: skd7@cdc.gov

Objective:

To examine whether childhood traumatic stress increased the risk of developing autoimmune diseases as an adult.

Methods:

Retrospective cohort study of 15,357 adult health maintenance organization members enrolled in the Adverse Childhood Experiences (ACEs) Study from 1995 to 1997 in San Diego, California, and eligible for follow-up through 2005.

ACEs included

  • childhood physical
  • emotional
  • or sexual abuse
  • witnessing domestic violence
  • growing up with household substance abuse
  • mental illness
  • parental divorce
  • and/or an incarcerated household member.

The total number of ACEs (ACE Score range = 0-8) was used as a measure of cumulative childhood stress.

The outcome was hospitalizations for any of 21 selected autoimmune diseases and 4 immunopathology groupings:

  • T- helper 1 (Th1) (e.g., idiopathic myocarditis)
  • T-helper 2 (Th2) (e.g., myasthenia gravis)
  • Th2 rheumatic (e.g., rheumatoid arthritis)
  • and mixed Th1/Th2 (e.g., autoimmune hemolytic anemia).

Results:

Sixty-four percent reported at least one ACE.

The event rate (per 10,000 person-years) for a first hospitalization with any autoimmune disease was 31.4 in women and 34.4 in men.

First hospitalizations for any autoimmune disease increased with increasing number of ACEs (p < .05).

Compared with persons with no ACEs, persons with ≥2 ACEs were at a

  • 70% increased risk for hospitalizations with Th1,
  • 80% increased risk for Th2,
  • and 100% increased risk for rheumatic diseases (p < .05).

Conclusions:

Childhood traumatic stress increased the likelihood of hospitalization with a diagnosed autoimmune disease decades into adulthood.

These findings are consistent with recent biological studies on the impact of early life stress on subsequent inflammatory responses.

Key Words: childhood abuse • traumatic stress • autoimmune diseases • stress • inflammatory response

Abbreviations: ACE = adverse childhood experience; AD = autoimmune disease; Th1 = T-helper 1; Th2 = T-helper 2; CRP = C-reactive protein; CRH = corticoid releasing hormone


Psychosomatic Medicine 71:243-250 (2009)
© 2009
American Psychosomatic Society

Cumulative Childhood Stress and Autoimmune Diseases in Adults

Shanta R. Dube, PhD, MPH, DeLisa Fairweather, PhD, William S. Pearson, PhD, MHA, Vincent J. Felitti, MD, Robert F. Anda, MD, MS and Janet B. Croft, PhD

From National Center for Chronic Disease Prevention and Health Promotion (S.R.D., W.S.P. R.F.A., J.B.C.), Centers for Disease Control and Prevention, Division of Adult and Community Health, Atlanta, Georgia; Department of Environmental Health Sciences (D.F.), Bloomberg School of Public Health and Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, Maryland; and the Department of Preventive Medicine (V.J.F.), Southern California Permanente Medical Group (Kaiser Permanente), San Diego, California.

Address correspondence and reprint requests to Shanta R. Dube, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Adult and Community Health, 4770 Buford Highway, N.E., MS K-50, Atlanta, GA 30341-3717. E-mail: kd7@cdc.gov

http://www.psychosomaticmedicine.org/cgi/content/abstract/71/2/243



Psychosomatic Medicine 71:243-250 (2009)
© 2009 American Psychosomatic Society


ORIGINAL ARTICLES

Received August 5, 2008
Returned for revision November 20, 2008

Double-Exposure to Acute Stress and Chronic Family Stress is Associated With Immune Changes in Children With Asthma

Teresa J. Marin , MA, Edith Chen , PhD, Jennifer A. Munch , BA, Gregory E. Miller , PhD


Address correspondence and reprint requests to: Teresa J. Marin, MA, E-mail: teresamarin@psych.ubc.ca.

 Abstract

Objective: To understand how psychological stress heightens risk for asthma flare-ups, we examined the relationship between acute stress, chronic family stress, and the production of asthma-related cytokines. Methods: Seventy-one children with asthma and 76 medically healthy children completed interviews regarding life stress, and peripheral blood samples were collected. After mononuclear cells had been mitogenically stimulated, production of the cytokines interleukin (IL)-4, IL-5, IL-13, and IFN-{gamma} was measured. All measurements were repeated every 6 months for 2 years. Children reported on their asthma symptoms for 14 days after each study visit. Results: Children with asthma who had higher levels of chronic family stress showed increased production of IL-4, IL-5, and IFN-{gamma} at times when they had experienced an acute event compared with times when they had not. These stress-related changes did not occur in asthmatic children with lower levels of chronic family stress, or in healthy controls. The combination of acute and chronic stress was also associated with increased asthma symptoms. Conclusion: These findings suggest that acute negative life events have a particularly strong impact among a subgroup of children with asthma who are under high chronic family stress. The heightened inflammatory profile in this group suggests an explanation for why children experiencing life stressors are at greater risk for asthma exacerbations.

Psychosom Med 2009, doi:10.1097/PSY.0b013e318199dbc3


























































© 2009 by American Psychosomatic Society


Psychosomatic Medicine 70:1035-1043 (2008)
© 2008 American Psychosomatic Society


ORIGINAL ARTICLES

Childhood Adversity, Early-Onset Depressive/Anxiety Disorders, and Adult-Onset Asthma

Kate M. Scott, PhD, Michael Von Korff, ScD, Jordi Alonso, MD, PhD, Matthias C. Angermeyer, MD, Corina Benjet, PhD, Ronny Bruffaerts, PhD, Giovanni de Girolamo, MD, Josep Maria Haro, MD, PhD, Ronald C. Kessler, PhD, Viviane Kovess, MD, PhD, Yutaka Ono, MD, Johan Ormel, PhD and José Posada-Villa, MD

From the Department of Psychological Medicine (K.M.S.), School of Medicine and Health Sciences, Otago University, Wellington, New Zealand; Center for Health Studies (M.V.K.), Group Health Cooperative of Puget Sound, Seattle, Washington; Health Services Research Unit (J.A.), Institut Municipal d'Investigacio Medica (IMIM) and CIBER en Epidemiologia y Salud Publica (CIBERESP), Barcelona, Spain; Center for Public Mental Health (M.C.A.), Gösing am Wagram, Austria; National Institute of Psychiatry (C.B.), Calzada Mexico Xochimilco, Mexico City, Mexico; Department of Neurosciences and Psychiatry (R.B.), University Hospital, Gasthuisberg, Leuven, Belgium; Regional Health Care Agency (G.G.), Emilia-Romagna Region, Bologna, Italy; Sant Joan de Deu-SSM (J.M.H.), RETICS RD06/0011 REM-TAP, Barcelona, Spain; Department of Health Care Policy (R.K.), Harvard Medical School, Boston, Massachusetts; Fondation MGEN pour la Santé Publique (V.K.), Université Paris 5, Paris, France; Health Center (Y.O.), Keio University, Tokyo, Japan; Department of Psychiatry (J.O.), University Medical Center, Groningen, Netherlands; and Colegio Mayor de Cundinamarca University (J.P.-V.), Bogota, Colombia.

Address correspondence and reprint requests to Kate M. Scott, Department of Psychological Medicine, School of Medicine and Health Sciences, Otago University, Wellington, PO Box 7343, Wellington South, New Zealand. E-mail: kate.scott@otago.ac.nz

Objectives: To investigate a) whether childhood adversity predicts adult-onset asthma; b) whether early-onset depressive/anxiety disorders predict adult-onset asthma; and c) whether childhood adversity and early-onset depressive/anxiety disorders predict adult-onset asthma independently of each other. Previous research has suggested, but not established, that childhood adversity may predict adult-onset asthma and, moreover, that the association between mental disorders and asthma may be a function of shared risk factors, such as childhood adversity.

Methods: Ten cross-sectional population surveys of household-residing adults (>18 years, n = 18,303) assessed mental disorders with the Composite International Diagnostic Interview (CIDI 3.0) as part of the World Mental Health surveys. Assessment of a range of childhood family adversities was included. Asthma was ascertained by self-report of lifetime diagnosis and age of diagnosis. Survival analyses calculated hazard ratios (HRs) for risk of adult-onset (>age 20 years) asthma as a function of number and type of childhood adversities and early-onset ( for current age, sex, country, education, and current smoking.

Results: Childhood adversities predicted adult-onset asthma with risk increasing with the number of adversities experienced (HRs = 1.49–1.71). Early-onset depressive and anxiety disorders also predicted adult-onset asthma (HRs = 1.67–2.11). Childhood adversities and early-onset depressive and anxiety disorders both predicted adult-onset asthma after mutual adjustment (HRs = 1.43–1.91).

Conclusions: Childhood adversities and early-onset depressive/anxiety disorders independently predict adult-onset asthma, suggesting that the mental disorder-asthma relationship is not a function of a shared background of childhood adversity.

Key Words: asthma • childhood adversity • comorbidity • depressive disorders • anxiety disorders

Abbreviations: CIDI = Composite International Diagnostic Interview; HR = hazard ratio; WMH = World Mental Health; HPA = hypothalamic-pituitary-adrenal; CI = Confidence Interval.


Thursday, July 2, 2009

Chinese Medicine Explained in Video



A couple of lovely young ladies who are recent grads from my acupuncture college, Pacific College of Oriental Medicine (PCOM) and now fellow North Carolinians have put together this thoughtfully written & produced video, called School Me, to explain about Chinese Medicine's history & theory, including herbal medicine, and the educational level of a Licensed Acupuncturist. It's a 30min video, but I'm sure those interested in learning more about the topic will find it complete and interesting. KB


http://www.vimeo.com/5403390

Tuesday, June 30, 2009

Michael Jackson 1958-2009, RIP



MJ's death has affected me on a deep level. This grief caught me by surprise. In reflection, I've remembered that MJ was my first pre-teen heart-throb, and I didn't realize that I had kept a place for him tucked away in my heart all these years. Throughout his magnificent 40 year career
I have maintained tremendous respect & admiration of him as one of the great entertainers of out time. More than his music, I think my continued connection to him was in his dancing and his showmanship.

Last nite I went back on YouTube and watched a number of live performances not included in the weekend video marathon on all of the music channels (there were times this weekend when 5 channels were simultaneously running a marathon of videos, often in amazing synchronization, a tribute that went on 24/7 for 4 days).

Here's a couple that I found that exemplify his power and showmanship:

First, the Motown 25 billie jean, you've watched cuts of his moonwalk debut here many times. Part of his enduring magic is that you cannot take your eyes off him (notice this quality when watching his group dances in his video legacy). As his final choreographer put it, "He's electric". BTW: YouTube also has the full performance, which begins with he and his brothers preforming at the Jackson 5. As Michael points out, it's a nostalgic walk down memory lane to listen to the old songs:

http://video.google.com/videosearch?q=michael+jackson+billie


Second, may i present the 30th anniversary billie jean. His showmanship is amazing. he begins by walking out on stage with an old 1930's suitcase, and placing it on the stool. The house is quiet, his shoes are mic'd so that the sound of his steps, the clicks of the heels of his shoes and the buckles of the suitcase are amplified as he walks over to a stool and opens the case. First he removes a black sparkling shirt and puts it on. the crowd roars in anticipation of what's about to occur. he does a twirl, displaying the shirt for all to adore. then he walks back to the case and removes a worn black fedora. again the crowd goes wild as he carefully places it on his head and pulls the brim down low over his nose. you know the pose, and so does the crowd, which continues to cheer as he reaches back into the case, and takes out a sparkly white glove. (one fan said she wished she were a left hand white glove). he quickly places it on his hand and puts the case and stool up stage. Next the props of the glove & hat wave to the screaming fans as he wiggles his fingers behind his back and tips the hat, completing this reverse striptease. he shows off many moves, in addition to the famous moonwalk, including the robot and a few from "dangerous":

http://video.google.com/videosearch?q=michael+jackson+billie+jean&hl=en&emb=0&aq=5&oq=mich#

I will leave you with a live performance of "remember the time". Clearly injured (he had sprained his ankle) and ever the showman, he sits in a golden Egyptian throne, befitting the king of pop, and sings with no dancing. what amazes me here is the remarkable showmanship exhibited: he's not dancing (though as if unable to contain himself he gives us a few choice head and shoulder moves in a short dance in the chair) and i cannot keep my eyes off him. even sitting in a chair he manages to captivate and hold the attention:

http://video.google.com/videosearch?q=michael+jackson+remember+the+time+live&www_google_domain=www.google.com&hl=en&emb=0&aq=6&oq=michael+jackson+re#

Michael Jackson flew high in the stratosphere, with the likes of elvis, lennon, garland, monroe, astaire, kelly and barishnikov.

goodbye Michael. you remain ever in our broken yet always adoring hearts.

KB