Scientists believe they are closer to
being able to change the DNA of
wild mosquitoes in order to
combat malaria.
In the laboratory, they made a
gene spread from a handful of
mosquitoes to most of the
population in just a few
generations, according toa report
in Nature.
If the right gene can be made to
spread then researchers hope to
reduce the number of cases of
malaria.
Other academics have described the
study as a "major step forward".
The World Health Organisation
estimated that malaria caused
nearly one million deaths in 2008.
Spreading resistance
Research groups have already
created "malaria-resistant
mosquitoes" using techniques such
as introducing genes todisrupt the
malaria parasite's development.
The research, however, has a great
challenge - getting those genes to
spread from the genetically-
modified mosquitoes to the vast
number of wild insects across the
globe.
Unless the gene gives the mosquito
an advantage, the gene will likely
disappear.
Scientists at Imperial College
London and the University of
Washington, in Seattle, believe
they have found a solution.
They inserted a gene into the
mosquito DNA which is very good
at looking after its own interests - a
homing endonuclease called I-SceI.
The gene makes an enzyme which
cuts the DNA in two. The cell's repair
machinery then uses the gene as a
template when repairing the cut.
As a result the homing
endonuclease gene is copied.
It does this in such a way that all
the sperm produced by a male
mosquito carry the gene.
So all its offspring have the gene.
The process is then repeated so the
offspring's offspring have the gene
and so on.
In the laboratory experiments, the
gene was spread to half the caged
mosquitoes in 12 generations.
Defeating malaria
Professor Andrea Crisanti, from the
department of life sciences at
Imperial College London, said: "This
is an exciting technological
development, one which I hope will
pave the way for solutions to many
global health problems.
"At the beginning I was really quite
sceptical and thought it probably
would not work, but the results are
so encouraging that I'm starting to
change my mind."
He said the idea had been proved
in principle and was now working
on getting other genes to spread in
the same way.
He believes it could be possible to
introduce genes which will make
the mosquito target animals rather
than humans, stop the parasite
from multiplying in the insect or
produce all male offspring which do
not transmit malaria.
Professor Janet Hemingway, from
the Liverpool School of Tropical
Medicine, said the work was an
"exciting breakthrough".
She cautioned that the technique
was still some way off being used
against wild mosquitoes and there
were social issues around the
acceptability of using GM
technology.
"This is however a major step
forward providing technology that
may be used in a cost effective
format to drive beneficial genes
through mosquito populations
from relatively small releases," she
added.
Dr Yeya Touré, from the World
Health Organisation, said: "This
research finding is very important
for driving a foreign gene in a
mosquito population. However,
given that it has been
demonstrated in a laboratory cage
model, there is the need to conduct
further studies before it could be
used as a genetic control strategy."
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Wednesday, April 27, 2011
Wednesday, January 19, 2011
N’Assembly to spend N10m on cleaning services monthly
The National Assembly will this year spend N240.3m on the cleaning of its Phase III building and another N450.7m on fuelling of generators installed in the premises of the same edifice.
The fuel cost will also cover generators in the Phase 11 of the same building and its Annex I & II complex.
The sums are contained in the details of the 2011 national budget, which is awaiting the approval of the 469-member National Assembly.
The new Phase 111 building and its extension serve as office accommodation for the federal lawmakers whose, “jumbo salaries” have elicited public outcry.
If the N240.3m to be spent on ‘cleaning services’ is spread over the 12 calendar months in this year, keeping the building neat will cost tax payers N10.25m monthly.
Similarly, if the N450.7m budgeted for the purchase of fuel is also spread over the same period, keeping Phases 11 and 111 of the new building as well as Annex I&II Complex lit will cost N37.56m every month.
“Fueling of plants for the New Building II and III and annex I and II complex is to cost N450.7m this year,” part of the details of the proposed expenditure reads.
The details of the budget which our correspondent obtained on Tuesday, also show that “engineering maintenance” for the Phase III building will gulp N601m.
The figure is broken down into N330.5m for the Senate and N270.4m for the House of Representatives.
According to the details, orientation courses for senators and members of the House of Representatives who will form the 7th session of the National Assembly will also cost an estimated N450.77m.
The current 6th session, which was inaugurated on June 5, 2007, will come to a close on June 4 this year.
There are 109 senators and 360 members of the House of Representatives.
If the N450.77m is divided by 469, it means that the National Assembly will spend around N962,000 on each lawmaker participating in the orientation courses.
Findings indicate that the orientation programme is meant for new legislators coming to the National Assembly for the first time, but those re-elected (after the April poll) are also expected to participate.
A National Assembly source confided in The PUNCH in Abuja that the orientation courses involved “teaching legislators, especially the new comers, parliamentary etiquette.”
It was learnt that new comers would be taught the right language to use while “addressing the chair or how to observe the rules of the parliament.”
“In moving a motion for example, or walking in front of the mace, there are procedures to be adopted.
“It is essentially about basic things they need to know on how to approach their duties as lawmakers”, the source added.
However, the budget for the orientation courses is separate from the funds budgeted yearly for “training and re-retraining” of legislators for the four years in a tenure.
The Senate budgeted N1.7bn for “consulting and professional services” in 2010, besides a separate expenditure of N58m on “generator fuel.”
Another expenditure of N450m on “maintenance of White House and Annex I & II” was incurred in 2010.
The House of Representatives had a total budget of N2.44bn on “maintenance and general issues” in 2010, in addition to N460.6m it spent on fuelling.
“Fumigation” cost N100m, while another sub-head on “cleaning and gardening” had a provision of N200m in 2010.
The fuel cost will also cover generators in the Phase 11 of the same building and its Annex I & II complex.
The sums are contained in the details of the 2011 national budget, which is awaiting the approval of the 469-member National Assembly.
The new Phase 111 building and its extension serve as office accommodation for the federal lawmakers whose, “jumbo salaries” have elicited public outcry.
If the N240.3m to be spent on ‘cleaning services’ is spread over the 12 calendar months in this year, keeping the building neat will cost tax payers N10.25m monthly.
Similarly, if the N450.7m budgeted for the purchase of fuel is also spread over the same period, keeping Phases 11 and 111 of the new building as well as Annex I&II Complex lit will cost N37.56m every month.
“Fueling of plants for the New Building II and III and annex I and II complex is to cost N450.7m this year,” part of the details of the proposed expenditure reads.
The details of the budget which our correspondent obtained on Tuesday, also show that “engineering maintenance” for the Phase III building will gulp N601m.
The figure is broken down into N330.5m for the Senate and N270.4m for the House of Representatives.
According to the details, orientation courses for senators and members of the House of Representatives who will form the 7th session of the National Assembly will also cost an estimated N450.77m.
The current 6th session, which was inaugurated on June 5, 2007, will come to a close on June 4 this year.
There are 109 senators and 360 members of the House of Representatives.
If the N450.77m is divided by 469, it means that the National Assembly will spend around N962,000 on each lawmaker participating in the orientation courses.
Findings indicate that the orientation programme is meant for new legislators coming to the National Assembly for the first time, but those re-elected (after the April poll) are also expected to participate.
A National Assembly source confided in The PUNCH in Abuja that the orientation courses involved “teaching legislators, especially the new comers, parliamentary etiquette.”
It was learnt that new comers would be taught the right language to use while “addressing the chair or how to observe the rules of the parliament.”
“In moving a motion for example, or walking in front of the mace, there are procedures to be adopted.
“It is essentially about basic things they need to know on how to approach their duties as lawmakers”, the source added.
However, the budget for the orientation courses is separate from the funds budgeted yearly for “training and re-retraining” of legislators for the four years in a tenure.
The Senate budgeted N1.7bn for “consulting and professional services” in 2010, besides a separate expenditure of N58m on “generator fuel.”
Another expenditure of N450m on “maintenance of White House and Annex I & II” was incurred in 2010.
The House of Representatives had a total budget of N2.44bn on “maintenance and general issues” in 2010, in addition to N460.6m it spent on fuelling.
“Fumigation” cost N100m, while another sub-head on “cleaning and gardening” had a provision of N200m in 2010.
Study: Women's Tears Lower Men's Testosterone, Sex Drive
Categories: News
Men are turned off when women cry, according to a study by Israeli scientists.The researchers found that female tears led to a drop in men's testosterone levels, which in turn caused a dip in their sex drive.
"This study reinforces the idea that human chemical signals -- even ones we're not conscious of -- affect the behavior of others," lead author Noam Sobel, professor at the Weizmann Institute of Science and Wolfson Hospital in Tel Aviv, said in a statement.
Sobel and his team found a previously unknown chemical in tears from women that triggered a physiological response in men. They called it a "chemo-signal," a type of pheromone. Pheromones are messages transmitted by the sense of smell. Tears, however, are odorless.
A group of men who participated in the study were told to sniff tears that had been collected by women who watched sad movies. Another group was told to breathe in saline solution. A pad with either tears or saline was attached under the men's noses. Then were then asked to rate the faces of women shown to them in photographs.
Surprisingly, the men who'd sniffed tears expressed less sexual interest in the women than those who hadn't.
The next day, the experiment was repeated, with the tears/saline groups switched. Neither the researchers nor the participants knew what they were sniffing. The men had been pre-screened to see whether they could distinguish the scents of tears from saline -- and they could not.
But the results were the same.
"Physiologically the finding makes sense," Dr. Igor Galynker, a psychiatrist at Beth Israel Medical Center with a background in organic chemistry, told AOL Health. "It could be that the odorless tears go into the olfactory system and bind to some receptor that alters hormone levels."
In addition to measuring their testosterone from saliva samples, the men also had their respiratory rates checked and their brains scanned. All suggested a drop in their sex drive.
The scientists didn't measure the impact of men's tears on female sexual arousal because they weren't able to collect enough tears from men, they said.
Researchers in the past have offered up a wide array of theories on why women cry more often then men do. Biochemist William Frey, for example, found that emotional tears contain higher amounts of the hormone prolactin than tears that are brought on by an eye irritation. It was theorized that, because women have more prolactin in their bodies than men, they cry more often.
Though the Israeli study seems to reinforce certain gender stereotypes, Galynker doesn't believe the research is flawed.
"There was no bias," he said. "They needed somebody to produce one milliliter of tears in the course of several minutes. Very, very few humans can do that."
He offered a possible explanation for the response.
"It could be that tears put men on alert that something's wrong," he said. "Sex drive could interfere with that."
The researchers hope their findings, published in Science Express, will help in treatments for prostate and other cancers believed to be linked to elevated testosterone levels.
Intestinal Parasites May Be Causing Your Energy Slump
Last year I saw a patient who had returned from her Christmas vacation complaining of persistent dizziness and fatigue that had not improved for over a year.
Before visiting my office she had consulted three other doctors but no cause for the dizziness was found.
When I questioned her about the vacation, which took place at a Caribbean resort, I discovered that she had experienced a transient episode of diarrhea there and since returning home had been unusually constipated and gassy.
She had never mentioned these intestinal symptoms to a doctor before, because it was dizziness and fatigue that bothered her the most.
I've seen many patients with chronic fatigue caused by intestinal parasites, so I had this woman tested at a specialized laboratory. The test revealed infection with a parasite called Giardia lamblia, a condition called giardiasis.
After treatment with anti-parasitic medication, her gastrointestinal symptoms slowly resolved, along with her main complaints of dizziness and fatigue.
Two Types of Parasites
There are two general groups of parasites. The first consists of worms -- tapeworms and roundworms -- which attach themselves to the lining of the small intestine, causing internal bleeding and loss of nutrients. People infested with worms may have no symptoms or may slowly become anemic.
The second category is the protozoa, one-celled organisms like Giardia, which can cause acute or chronic diarrhea or can cause symptoms that are not ordinarily associated with parasitic infection like constipation, fatigue, dizziness, joint pain or hives.
Parasites Can Be Acquired Anywhere
You don't need to travel to a tropical location to contract a protozoan infection. Epidemics of giardiasis have occurred at ski resorts in the dead of winter because of drinking water contamination.
Outbreaks commonly occur at day care centers that serve toddlers who wear diapers. Twenty to thirty percent of workers in day care centers harbor Giardia. Most have no symptoms; they are merely carriers.
Eating at a salad bar increases your risk of food borne infection. Just observe the unhygienic habits of patrons or the way in which handles of serving spoons and tongs fall into the food.
A study at Johns Hopkins medical school demonstrated antibodies against Giardia in 20 percent of randomly chosen blood samples from patients in the hospital. This means that at least twenty percent of these patients had been infected with Giardia at some time in their lives and had mounted an immune response against the parasite. Most were unaware of having been infected.
Giardia contaminates streams and lakes throughout North America and has caused epidemics of diarrheal disease in several small cities by contaminating their drinking water.
One epidemic, in Placerville, California, was followed by an epidemic of Chronic Fatigue Syndrome, which swept through the town's residents at the time of the Giardia epidemic. Possibly, this epidemic was due to failure of some people to eradicate the parasite.
In 1991, my colleagues and I published a study of two hundred patients with chronic fatigue and demonstrated active Giardia infection in 46 percent. Most of the patients with giardiasis had only minor gastrointestinal symptoms but were really ill with muscle pain, muscle weakness, flu-like feelings, sweats and enlarged lymph nodes. In fact, 61 percent of fatigued patients with giardiasis had been diagnosed elsewhere as suffering from chronic fatigue immune dysfunction syndrome (CFIDS), compared to only 19 percent of fatigued patients without giardiasis. Cure of giardiasis resulted in clearing of fatigue and related viral symptoms (muscle pain, sweats, flu-like feelings) in 70 percent of cases, some reduction of fatigue in 18 percent, and was of no benefit in only 12 percent.
Another protozoan that's achieved notoriety in the U.S. is Cryptosporidium parvum, which contaminated Milwaukee's water supply in the 1990's, causing the largest epidemic of diarrhea in U.S. history, infecting about 400,000 people and causing over one hundred deaths. Most municipal water supplies in the U.S. today are home to protozoa like Giardia and Cryptosporidium and one in five Americans drinks water that violates Federal health standards. Every year, almost a million North Americans become sick from water-borne diseases.
In 1990 I presented a paper to the American College of Gastroenterology which demonstrated Giardia infection in about half of a group of two hundred patients with chronic diarrhea, constipation, abdominal pain and bloating. Most of these patients had been told they had irritable bowel syndrome, which is commonly referred to as "nervous stomach."
I reached two conclusions from this study: 1. Parasitic infection can be a common event among patients with chronic gastrointestinal symptoms. 2. Many people are given a diagnosis of irritable bowel syndrome without a thorough evaluation.
My presentation was reported by numerous magazines and newspapers, including The New York Times. My office was flooded with hundreds of phone calls from people who were suffering with chronic gastrointestinal complaints. Most of them had been given a diagnosis of Irritable Bowel Syndrome (IBS) by their physicians. The standard treatment for this syndrome had not helped them. All they had received was a label. Many had been told there was no cure.
In evaluating these patients, I found that the majority had intestinal parasites, food intolerance or a lack of healthy intestinal bacteria. (For more information about intestinal bacteria, see Probiotics or Friendly Bacteria) These conditions were not mutually exclusive. Many patients had more than one reason for chronic gastrointestinal problems.
Treating these abnormalities as they occurred in various patients produced remarkably good therapeutic results. A year later, researchers in the Department of Family Medicine at Baylor University in Houston reported findings similar to mine.
Despite the research and the news reports about parasites, I still find that intestinal parasites are a common and often unsuspected cause of mystery illness.
For more on gastrointestinal health, see my article "Do you Have Leaky Gut Syndrome?"
And to get information on how to reduce the risk of infection next time you travel, read my article "Pills for Your Upcoming Trip."
Resolving parasites and other digestive problems and improving gastrointestinal health is vitally important to healing. Learn how to assess your digestive function and the presence of intestinal toxicity in my book "Power Healing: Use the New Integrated Medicine to Cure Yourself."
Now I'd like to hear from you ...
Have you traveled in the past year?
Did you experience any stomach upset or other complaints?
Have you taken anything for it, and what helps?
Please let me know your thoughts by posting a comment below.
Best Health,
Leo Galland, M.D.
Important: Share the Health with your friends and family by forwarding this article to them, and sharing on Facebook.
Leo Galland, MD is a board-certified internist, author and internationally recognized leader in integrated medicine. Dr. Galland is the founder of Pill Advised, a web application for learning about medications, supplements and food. Sign up for FREE to discover how your medications and vitamins interact. Watch his videos on YouTube and join the Pill Advised Facebook page.
References
Galland L, "Intestinal Protozoan Infestation and Systemic Illness", in Textbook of Natural Medicine, 3rd Edition, Volume 2, J. Pizzorno and M. Murray, editors, Churchill Livingstone Elsevier, St. Louis, 2005, pp. 655-660.
Galland L. "The Effect of Systemic Microbes on Intestinal Immunity" Post-Viral Fatigue Syndrome (Myalgic Encephalomyelitis) R. Jenkins and J. Mowbray, editors. John Wiley & Sons Ltd. London. 1991. pp 405-430.
Galland, L., Lee M., Bueno H. and Heimowitz C. (1990) "Giardia lamblia infection as a cause of chronic fatigue." Journal of Nutritional Medicine, 2, 27-32.
Galland, L. (1989) "Intestinal protozoan infection is a common unsuspected cause of chronic illness." Journal of Advancement in Medicine, 2, 529-552.
This information is provided for general educational purposes only and is not intended to constitute (i) medical advice or counseling, (ii) the practice of medicine or the provision of health care diagnosis or treatment, (iii) or the creation of a physician--patient relationship. If you have or suspect that you have a medical problem, contact your doctor promptly.
Before visiting my office she had consulted three other doctors but no cause for the dizziness was found.
When I questioned her about the vacation, which took place at a Caribbean resort, I discovered that she had experienced a transient episode of diarrhea there and since returning home had been unusually constipated and gassy.
She had never mentioned these intestinal symptoms to a doctor before, because it was dizziness and fatigue that bothered her the most.
I've seen many patients with chronic fatigue caused by intestinal parasites, so I had this woman tested at a specialized laboratory. The test revealed infection with a parasite called Giardia lamblia, a condition called giardiasis.
After treatment with anti-parasitic medication, her gastrointestinal symptoms slowly resolved, along with her main complaints of dizziness and fatigue.
Two Types of Parasites
There are two general groups of parasites. The first consists of worms -- tapeworms and roundworms -- which attach themselves to the lining of the small intestine, causing internal bleeding and loss of nutrients. People infested with worms may have no symptoms or may slowly become anemic.
The second category is the protozoa, one-celled organisms like Giardia, which can cause acute or chronic diarrhea or can cause symptoms that are not ordinarily associated with parasitic infection like constipation, fatigue, dizziness, joint pain or hives.
Parasites Can Be Acquired Anywhere
You don't need to travel to a tropical location to contract a protozoan infection. Epidemics of giardiasis have occurred at ski resorts in the dead of winter because of drinking water contamination.
Outbreaks commonly occur at day care centers that serve toddlers who wear diapers. Twenty to thirty percent of workers in day care centers harbor Giardia. Most have no symptoms; they are merely carriers.
Eating at a salad bar increases your risk of food borne infection. Just observe the unhygienic habits of patrons or the way in which handles of serving spoons and tongs fall into the food.
A study at Johns Hopkins medical school demonstrated antibodies against Giardia in 20 percent of randomly chosen blood samples from patients in the hospital. This means that at least twenty percent of these patients had been infected with Giardia at some time in their lives and had mounted an immune response against the parasite. Most were unaware of having been infected.
Giardia contaminates streams and lakes throughout North America and has caused epidemics of diarrheal disease in several small cities by contaminating their drinking water.
One epidemic, in Placerville, California, was followed by an epidemic of Chronic Fatigue Syndrome, which swept through the town's residents at the time of the Giardia epidemic. Possibly, this epidemic was due to failure of some people to eradicate the parasite.
In 1991, my colleagues and I published a study of two hundred patients with chronic fatigue and demonstrated active Giardia infection in 46 percent. Most of the patients with giardiasis had only minor gastrointestinal symptoms but were really ill with muscle pain, muscle weakness, flu-like feelings, sweats and enlarged lymph nodes. In fact, 61 percent of fatigued patients with giardiasis had been diagnosed elsewhere as suffering from chronic fatigue immune dysfunction syndrome (CFIDS), compared to only 19 percent of fatigued patients without giardiasis. Cure of giardiasis resulted in clearing of fatigue and related viral symptoms (muscle pain, sweats, flu-like feelings) in 70 percent of cases, some reduction of fatigue in 18 percent, and was of no benefit in only 12 percent.
Another protozoan that's achieved notoriety in the U.S. is Cryptosporidium parvum, which contaminated Milwaukee's water supply in the 1990's, causing the largest epidemic of diarrhea in U.S. history, infecting about 400,000 people and causing over one hundred deaths. Most municipal water supplies in the U.S. today are home to protozoa like Giardia and Cryptosporidium and one in five Americans drinks water that violates Federal health standards. Every year, almost a million North Americans become sick from water-borne diseases.
In 1990 I presented a paper to the American College of Gastroenterology which demonstrated Giardia infection in about half of a group of two hundred patients with chronic diarrhea, constipation, abdominal pain and bloating. Most of these patients had been told they had irritable bowel syndrome, which is commonly referred to as "nervous stomach."
I reached two conclusions from this study: 1. Parasitic infection can be a common event among patients with chronic gastrointestinal symptoms. 2. Many people are given a diagnosis of irritable bowel syndrome without a thorough evaluation.
My presentation was reported by numerous magazines and newspapers, including The New York Times. My office was flooded with hundreds of phone calls from people who were suffering with chronic gastrointestinal complaints. Most of them had been given a diagnosis of Irritable Bowel Syndrome (IBS) by their physicians. The standard treatment for this syndrome had not helped them. All they had received was a label. Many had been told there was no cure.
In evaluating these patients, I found that the majority had intestinal parasites, food intolerance or a lack of healthy intestinal bacteria. (For more information about intestinal bacteria, see Probiotics or Friendly Bacteria) These conditions were not mutually exclusive. Many patients had more than one reason for chronic gastrointestinal problems.
Treating these abnormalities as they occurred in various patients produced remarkably good therapeutic results. A year later, researchers in the Department of Family Medicine at Baylor University in Houston reported findings similar to mine.
Despite the research and the news reports about parasites, I still find that intestinal parasites are a common and often unsuspected cause of mystery illness.
For more on gastrointestinal health, see my article "Do you Have Leaky Gut Syndrome?"
And to get information on how to reduce the risk of infection next time you travel, read my article "Pills for Your Upcoming Trip."
Resolving parasites and other digestive problems and improving gastrointestinal health is vitally important to healing. Learn how to assess your digestive function and the presence of intestinal toxicity in my book "Power Healing: Use the New Integrated Medicine to Cure Yourself."
Now I'd like to hear from you ...
Have you traveled in the past year?
Did you experience any stomach upset or other complaints?
Have you taken anything for it, and what helps?
Please let me know your thoughts by posting a comment below.
Best Health,
Leo Galland, M.D.
Important: Share the Health with your friends and family by forwarding this article to them, and sharing on Facebook.
Leo Galland, MD is a board-certified internist, author and internationally recognized leader in integrated medicine. Dr. Galland is the founder of Pill Advised, a web application for learning about medications, supplements and food. Sign up for FREE to discover how your medications and vitamins interact. Watch his videos on YouTube and join the Pill Advised Facebook page.
References
Galland L, "Intestinal Protozoan Infestation and Systemic Illness", in Textbook of Natural Medicine, 3rd Edition, Volume 2, J. Pizzorno and M. Murray, editors, Churchill Livingstone Elsevier, St. Louis, 2005, pp. 655-660.
Galland L. "The Effect of Systemic Microbes on Intestinal Immunity" Post-Viral Fatigue Syndrome (Myalgic Encephalomyelitis) R. Jenkins and J. Mowbray, editors. John Wiley & Sons Ltd. London. 1991. pp 405-430.
Galland, L., Lee M., Bueno H. and Heimowitz C. (1990) "Giardia lamblia infection as a cause of chronic fatigue." Journal of Nutritional Medicine, 2, 27-32.
Galland, L. (1989) "Intestinal protozoan infection is a common unsuspected cause of chronic illness." Journal of Advancement in Medicine, 2, 529-552.
This information is provided for general educational purposes only and is not intended to constitute (i) medical advice or counseling, (ii) the practice of medicine or the provision of health care diagnosis or treatment, (iii) or the creation of a physician--patient relationship. If you have or suspect that you have a medical problem, contact your doctor promptly.
Fertile Women Attracted to Men With 'Macho'
Women whose significant others aren't "macho" 
tend to fantasize more about super masculine-looking men during their fertile phases than women who are paired with those types, a new study suggests.
Researchers from the University of Colorado at Boulder and the University of New Mexico say their findings, published in Evolution and Human Behavior, also showed that those with macho romantic partners don't necessarily become more attracted to them over time.
"Basically, you want what you can't have," summed up University of Pennsylvania psychiatrist Dr. Christos Ballas in an interview with AOL Health. "The scientists would like it to make evolutionary sense that a woman would be sexually attracted to masculine men during her fertile phase regardless of who she's with. However, it could simply be a social phenomenon."
The authors also said that intelligence doesn't seem to factor in to fertile women's sexual fantasies.
The team identified a "masculine face" as one with a strong, defined jaw and chin, a pronounced brow and narrow eyes. Think George Clooney, advised study author Steven Gangestad of the University of New Mexico.
Wider eyes and a less defined jaw and face shape -- like Pee-Wee Herman, for example -- would be characteristic of a less-masculine face.
While women might find the macho-faced men more attractive when they're in a sexually charged state, they don't think they make the best life partners. If anything, they tend to gravitate more toward the softer type of man.
"When they rate men's sexiness, in a sense, that's when (women) show the shift," Gangestad told LiveScience. "If they rate men's attractiveness as a long-term partner, then they don't show it."tend to fantasize more about super masculine-looking men during their fertile phases than women who are paired with those types, a new study suggests.Researchers from the University of Colorado at Boulder and the University of New Mexico say their findings, published in Evolution and Human Behavior, also showed that those with macho romantic partners don't necessarily become more attracted to them over time.
"Basically, you want what you can't have," summed up University of Pennsylvania psychiatrist Dr. Christos Ballas in an interview with AOL Health. "The scientists would like it to make evolutionary sense that a woman would be sexually attracted to masculine men during her fertile phase regardless of who she's with. However, it could simply be a social phenomenon."
The authors also said that intelligence doesn't seem to factor in to fertile women's sexual fantasies.
The team identified a "masculine face" as one with a strong, defined jaw and chin, a pronounced brow and narrow eyes. Think George Clooney, advised study author Steven Gangestad of the University of New Mexico.
Wider eyes and a less defined jaw and face shape -- like Pee-Wee Herman, for example -- would be characteristic of a less-masculine face.
While women might find the macho-faced men more attractive when they're in a sexually charged state, they don't think they make the best life partners. If anything, they tend to gravitate more toward the softer type of man.
Researchers interviewed 66 heterosexual couples, with the women ranging in age from 18 to 44 and the relationship lengths from a month to 20 years. Nine of the couples were married.
Prior research has found that "macho" males' sex appeal spikes when a woman is ovulating. This is the first to examine whether the phenomenon happens within actual romantic relationships.
Biologists who study evolution have put forth the "choosy females" theory -- women are more selective about mates when they're ovulating and are drawn to the one they think is the best, usually as determined by masculinity and physical appearance because those traits signal strength, ability to survive and good genes.
"The effects of facial masculinity and attractiveness fit in a larger picture that has emerged," another study author, Christine Garver-Apgar of the University of Colorado, said in a statement.
Past research has consistently led scientists to the same conclusion that a shift in sexual interest occurs during ovulation, she said.
"There's probably 30-plus papers documenting ovulatory cycle shifts and women's preferences," Garver-Apgar told AOL Health. "Those were predicted based on evolutionary theory."
Men who have "highly testosteronized features" -- the macho types -- may be signaling a more stable gene pool to women, she added.
"They are potentially displaying a surplus energy budget, because it means they had high levels of testosterone during critical development periods," she said.
But Ballas disputed the notion that attraction to a "hyper masculine" man -- or for men, a "hyper feminine" woman -- has anything to do with biology or evolution.
"The effects of facial masculinity and attractiveness fit in a larger picture that has emerged," another study author, Christine Garver-Apgar of the University of Colorado, said in a statement.
Past research has consistently led scientists to the same conclusion that a shift in sexual interest occurs during ovulation, she said.
"There's probably 30-plus papers documenting ovulatory cycle shifts and women's preferences," Garver-Apgar told AOL Health. "Those were predicted based on evolutionary theory."
Men who have "highly testosteronized features" -- the macho types -- may be signaling a more stable gene pool to women, she added.
"They are potentially displaying a surplus energy budget, because it means they had high levels of testosterone during critical development periods," she said.
But Ballas disputed the notion that attraction to a "hyper masculine" man -- or for men, a "hyper feminine" woman -- has anything to do with biology or evolution.
"If you're with someone but they're not the 'hyper masculine' or 'hyper feminine,' you fantasize about the hyper masculine or feminine," he said. "When you're already with that type, you don't need to fantasize about it. It doesn't have to be so crazy complicated. They want it to be that women biologically want a hyper male because he's a better mate."
He drew a comparison to men who are with brunettes fantasizing about blondes, and men who are with blondes fantasizing about brunettes.
"It's like the male 'I wish I had a blonde' thing," Ballas said. "Whatever you have, you fantasize about the other. It doesn't mean that blondes are better for mating."
He drew a comparison to men who are with brunettes fantasizing about blondes, and men who are with blondes fantasizing about brunettes.
"It's like the male 'I wish I had a blonde' thing," Ballas said. "Whatever you have, you fantasize about the other. It doesn't mean that blondes are better for mating."
A Gene to Explain Depression
As powerful as genes are in exposing clues to diseases, not even the most passionate geneticist believes that complex conditions such as depression can be reduced to a tell-tale string of DNA.
But a new study confirms earlier evidence that a particular gene, involved in ferrying a brain chemical critical to mood known as serotonin, may play a role in triggering the mental disorder in some people.
Researchers led by Dr. Srijan Sen, a professor of psychiatry at University of Michigan, report in the Archives of General Psychiatry that individuals with a particular form of the serotonin transporter gene were more vulnerable to developing depression when faced with stressful life events such as having a serious medical illness or being a victim of childhood abuse. The form of the gene that these individuals inherit prevents the mood-regulating serotonin from being re-absorbed by nerve cells in the brain. Having such a low-functioning version of the transporter starting early in life appears to set these individuals up for developing depression later on, although the exact relationship between this gene, stress, and depression isn't clear yet. (More on Time.com: How to Win Friends: Have a Big Amygdala?)
Sen's results confirm those of a ground-breaking study in 2003, in which scientists for the first time confirmed the link between genes and environment in depression. In that study, which involved more than 800 subjects, individuals with the gene coding for the less functional serotonin transporter were more likely to develop depression following a stressful life event than those with the more functional form of the gene. But these findings were questioned by a 2009 analysis in which scientists pooled 14 studies investigating the relationship between the serotonin transporter gene, depression and stress, and found no heightened risk of depression among those with different versions of the gene.
Sen's group decided to put the continued controversy to rest by culling all of the available studies on the subject, 54 total, which included data from nearly 41,000 volunteers. Based on this broader analysis, the team concluded that the less functional form of the transporter gene does indeed confer a greater risk of depression when combined with stress. And to determine why the 2009 team found contradictory results, Sen also re-evaluated their data using his analytical model and found that when he limited his investigation to their 14 studies, he also found no relationship between the gene and depression. (More on Time.com: Placebos Work Even if You Know They're Fake: But How?)
“One of the hopes I have is that we can settle this story, and move on to looking more broadly across the genome for more factors related to depression,” he says. “Ideally we would like to find a panel of different genetic variations that go together to help us predict who is going to respond poorly to stress, and who might respond well to specific types of treatment as opposed to others.”
He believes that the 2009 findings do not contradict those from 2003, or the latest results, but rather reflect a difference in the way the study was conducted. In order to conduct a consistent analysis with similarly collected data, the 2009 analysis focused only on the 14 studies that included stressful life events, and did not incorporate other stressors, such as childhood abuse or medical illness. The more complete set of 54 studies, which folded in these stressors as well, showed a robust interaction between the serotonin gene, stress and depression.
Sen stresses, however, that this gene is only one player in the cast of genetic and environmental factors that contribute to depression. “All things considered, this [gene] is a relatively small factor, and for this finding to be clinically useful, we really need to find many, many more factors. Ultimately we may identify new pathways that are involved in depression to come up with new and better treatments.”
But a new study confirms earlier evidence that a particular gene, involved in ferrying a brain chemical critical to mood known as serotonin, may play a role in triggering the mental disorder in some people.
Researchers led by Dr. Srijan Sen, a professor of psychiatry at University of Michigan, report in the Archives of General Psychiatry that individuals with a particular form of the serotonin transporter gene were more vulnerable to developing depression when faced with stressful life events such as having a serious medical illness or being a victim of childhood abuse. The form of the gene that these individuals inherit prevents the mood-regulating serotonin from being re-absorbed by nerve cells in the brain. Having such a low-functioning version of the transporter starting early in life appears to set these individuals up for developing depression later on, although the exact relationship between this gene, stress, and depression isn't clear yet. (More on Time.com: How to Win Friends: Have a Big Amygdala?)
Sen's results confirm those of a ground-breaking study in 2003, in which scientists for the first time confirmed the link between genes and environment in depression. In that study, which involved more than 800 subjects, individuals with the gene coding for the less functional serotonin transporter were more likely to develop depression following a stressful life event than those with the more functional form of the gene. But these findings were questioned by a 2009 analysis in which scientists pooled 14 studies investigating the relationship between the serotonin transporter gene, depression and stress, and found no heightened risk of depression among those with different versions of the gene.
Sen's group decided to put the continued controversy to rest by culling all of the available studies on the subject, 54 total, which included data from nearly 41,000 volunteers. Based on this broader analysis, the team concluded that the less functional form of the transporter gene does indeed confer a greater risk of depression when combined with stress. And to determine why the 2009 team found contradictory results, Sen also re-evaluated their data using his analytical model and found that when he limited his investigation to their 14 studies, he also found no relationship between the gene and depression. (More on Time.com: Placebos Work Even if You Know They're Fake: But How?)
“One of the hopes I have is that we can settle this story, and move on to looking more broadly across the genome for more factors related to depression,” he says. “Ideally we would like to find a panel of different genetic variations that go together to help us predict who is going to respond poorly to stress, and who might respond well to specific types of treatment as opposed to others.”
He believes that the 2009 findings do not contradict those from 2003, or the latest results, but rather reflect a difference in the way the study was conducted. In order to conduct a consistent analysis with similarly collected data, the 2009 analysis focused only on the 14 studies that included stressful life events, and did not incorporate other stressors, such as childhood abuse or medical illness. The more complete set of 54 studies, which folded in these stressors as well, showed a robust interaction between the serotonin gene, stress and depression.
Sen stresses, however, that this gene is only one player in the cast of genetic and environmental factors that contribute to depression. “All things considered, this [gene] is a relatively small factor, and for this finding to be clinically useful, we really need to find many, many more factors. Ultimately we may identify new pathways that are involved in depression to come up with new and better treatments.”
Tucson Tragedy: Is Gun Control a Dead Issue?
Like them or not, guns are as American as covered wagons and the infield-fly rule. The revolutionaries and pioneers who forged the nation and peopled its wilderness really did cling to their guns as tenaciously as they clung to their religion. And while modern cosmopolitans may be shocked by the gun violence in this country — the worst among wealthy nations by far — well, that's an American tradition too.
Gun control is not. The mayhem in Tucson has revived a debate over America's gun culture that resurfaces every time some lunatic overexercises his right to bear arms. How could Jared Loughner be considered too dangerous to attend community college but not too dangerous to buy a Glock? Why are we allowed to pack heat at a Safeway when we can't pack shampoo in our carry-ons? Does the Second Amendment really protect our right to a magazine that holds 30 bullets? It's a necessary debate, but in the political arena, at least, the results are consistently lopsided. As National Rifle Association executive vice president Wayne LaPierre proclaimed two years ago, the guys with the guns make the rules. (See pictures of gun culture in America.)
Arizona, with its Old West heritage, has been at the forefront of the gun-rights movement. Last year, it passed a law making it the third state — after predominantly rural Vermont and Alaska — to allow citizens to carry concealed weapons without a permit. Another law allows Arizonans to carry guns in bars, as long as they're not drinking. The vast majority of the state's politicians — including Loughner's primary target, Congresswoman Gabrielle Giffords, a Democrat and gun owner — are strong Second Amendment supporters. Congressman Trent Franks, a Republican and gun owner, points out that Arizona has a much lower gun-violence rate than Washington, D.C., which has much more restrictive gun laws. "Criminals always prefer unarmed victims," Franks says. There have been no reports out of Arizona of any credible push for new gun restrictions; in fact, several reports show citizens are flocking to gun shops to increase their firepower. (See pictures of politicians and their guns.)
Unfortunately, the gun-rights vision of well-armed citizens shooting down an outlaw like Loughner midrampage did not come true in this case. Nationally, less than 1% of all gun deaths involve self-defense; the rest are homicides, suicides and accidents. In a study of 23 high-income countries, the U.S. had 80% of the gun deaths, along with a gun homicide rate nearly 20 times higher than the rest of the sample. Still, the gun-control movement has gotten little political traction outside selected major cities, and all but three states have laws that invalidate local gun restrictions. According to the NRA, 25 states have adopted "your home is your castle" laws that give homeowners wide latitude to shoot people on their property without fear of prosecution, and only 10 states prohibit or severely restrict the carrying of firearms in public. (Read "Why Are the Mentally Still Bearing Arms?")
In recent years, despite periodic spasms of attention after mass killings like those at Columbine and Virginia Tech, gun control has made no headway at the federal level either. It's telling that a progressive Chicago Democrat like President Obama — a longtime gun-control advocate whose election inspired fervent warnings about Big Government's confiscating firearms — has carefully avoided the topic in the White House. He even signed two laws that included provisions expanding gun access, one in national parks and one on Amtrak trains. If he objected to the provisions, he kept his objections to himself. A Brady Campaign to Prevent Gun Violence report gave Obama an F for leadership on gun control. "We haven't seen a lot of political courage on this issue," says Brady Campaign president Paul Helmke, a former Republican mayor of Fort Wayne, Ind. "Republicans march in lockstep with the NRA, and Democrats are scared to death."
Gun control is not. The mayhem in Tucson has revived a debate over America's gun culture that resurfaces every time some lunatic overexercises his right to bear arms. How could Jared Loughner be considered too dangerous to attend community college but not too dangerous to buy a Glock? Why are we allowed to pack heat at a Safeway when we can't pack shampoo in our carry-ons? Does the Second Amendment really protect our right to a magazine that holds 30 bullets? It's a necessary debate, but in the political arena, at least, the results are consistently lopsided. As National Rifle Association executive vice president Wayne LaPierre proclaimed two years ago, the guys with the guns make the rules. (See pictures of gun culture in America.)
Arizona, with its Old West heritage, has been at the forefront of the gun-rights movement. Last year, it passed a law making it the third state — after predominantly rural Vermont and Alaska — to allow citizens to carry concealed weapons without a permit. Another law allows Arizonans to carry guns in bars, as long as they're not drinking. The vast majority of the state's politicians — including Loughner's primary target, Congresswoman Gabrielle Giffords, a Democrat and gun owner — are strong Second Amendment supporters. Congressman Trent Franks, a Republican and gun owner, points out that Arizona has a much lower gun-violence rate than Washington, D.C., which has much more restrictive gun laws. "Criminals always prefer unarmed victims," Franks says. There have been no reports out of Arizona of any credible push for new gun restrictions; in fact, several reports show citizens are flocking to gun shops to increase their firepower. (See pictures of politicians and their guns.)
Unfortunately, the gun-rights vision of well-armed citizens shooting down an outlaw like Loughner midrampage did not come true in this case. Nationally, less than 1% of all gun deaths involve self-defense; the rest are homicides, suicides and accidents. In a study of 23 high-income countries, the U.S. had 80% of the gun deaths, along with a gun homicide rate nearly 20 times higher than the rest of the sample. Still, the gun-control movement has gotten little political traction outside selected major cities, and all but three states have laws that invalidate local gun restrictions. According to the NRA, 25 states have adopted "your home is your castle" laws that give homeowners wide latitude to shoot people on their property without fear of prosecution, and only 10 states prohibit or severely restrict the carrying of firearms in public. (Read "Why Are the Mentally Still Bearing Arms?")
In recent years, despite periodic spasms of attention after mass killings like those at Columbine and Virginia Tech, gun control has made no headway at the federal level either. It's telling that a progressive Chicago Democrat like President Obama — a longtime gun-control advocate whose election inspired fervent warnings about Big Government's confiscating firearms — has carefully avoided the topic in the White House. He even signed two laws that included provisions expanding gun access, one in national parks and one on Amtrak trains. If he objected to the provisions, he kept his objections to himself. A Brady Campaign to Prevent Gun Violence report gave Obama an F for leadership on gun control. "We haven't seen a lot of political courage on this issue," says Brady Campaign president Paul Helmke, a former Republican mayor of Fort Wayne, Ind. "Republicans march in lockstep with the NRA, and Democrats are scared to death."
The Troubled Life of Jared Loughner
Navigating the cluttered corridors of Jared Loughner's mind will take psychiatrists months or years. We will likely never know all the reasons he took a cab to that Safeway on Jan. 8, paid with a $20 bill, calmly got his change and then killed six people and wounded 14 others.
But snapshots of his life are accumulating from acquaintances and his few friends. (His parents issued a short statement of apology, but they are said to be too distraught to speak about their son.) These snapshots depict a quiet, normal boy who had grown into a man descending steadily into serious mental illness. A partisan, highly nonscientific debate has erupted over whether extreme right-wing rhetoric could have inflamed whatever illness he may have and caused him to target Democratic Representative Gabrielle Giffords. We don't know the answer, but psychological research suggests that political rhetoric could never be the single cause that leads a person with complex mental problems to commit violence. (See pictures from a grieving Tucson.)
Case History
Pinpointing the precise moment a mental illness takes root is guesswork at best. As a young man, Loughner seemed ordinary enough — occasionally withdrawn, as all teens can be, and a little nerdy. He loved music and played the sax well. A classmate who had known him since elementary school, Ashley Buysman, says that when she heard the charges against him, "it just blew my mind."
But a darkness began massing around Loughner sometime after he dropped out of Mountain View High School in Tucson, Ariz., before his senior year. He started drinking a lot, according to Kylie Smith, who had known him since preschool. She lost contact with him between 2006 and 2008 and was stunned by how much he had changed. "He seemed out of it, like he was somewhere else," she says. "I could tell he wasn't just drunk and he wasn't just high."
Was a psychiatric illness beginning? Maybe, but it's difficult to tell, because Loughner had by then used a lot of drugs — not just pot but also hallucinogens like acid, according to Smith. It was at about this time that Loughner did something odd: he worked out for months so he could join the Army. Yet after traveling to the military processing station in Phoenix, he told an Army official that he smoked marijuana excessively — which meant he would never be accepted. The weird part: he actually passed a drug test that day, so he had not been using for at least a couple of weeks. (See photos of the world of Jared Lee Loughner.)
Loughner's behavior became increasingly erratic after the Army incident. Friends say he would occasionally speak in random strings of words. He had run-ins with police over drugs and his vandalization of a street sign. He became paranoid that the government was trying to control him — or everyone. He couldn't keep jobs at Quiznos and an animal shelter because he wouldn't — or could no longer — follow instructions.
When classes began at Pima Community College last year, Loughner's behavior frightened fellow students from Day One. "He had this hysterical kind of laugh, laughing to himself," says Benjamin McGahee, his math professor. He would say nonsensical things about "denying math." Says McGahee: "One lady in the back of the classroom said she was scared for her life, literally."(Comment on this story.)
Such Stuff as Dreams
It seems clear that Loughner was developing a mental illness, but which one? Many signs point to one of the psychotic disorders — delusional disorder, say, or schizophrenia, for which the average age of onset is roughly 20, about when Loughner started showing symptoms. The Diagnostic and Statistical Manual of Mental Disorders includes "substance-induced psychotic disorder," which is also a possibility in Loughner's case. (See six warning signs of whether someone is mentally ill.)
By several accounts, Loughner had become fascinated with lucid dreaming, a dream state you can enter when you're half asleep. You are aware while you're in that state that you're dreaming. Loughner's interest in his lucid dreams is significant, because last year the European Science Foundation reported that lucid dreaming "creates distinct patterns of electrical activity in the brain that have similarities to the patterns made by psychotic conditions." Loughner's drug use could have kept him from falling into deep sleep and encouraged lucid dreaming. The European group said paranoid delusions can occur when lucid dreams are replayed repeatedly after the subject wakes up. Loughner was replaying his lucid dreams in an extensive dream journal, according to his friend Bryce Tierney, who spoke with Mother Jones magazine.
See TIME's complete coverage of the Tucson shooting.
See pictures of messages for the Tucson victims.
But snapshots of his life are accumulating from acquaintances and his few friends. (His parents issued a short statement of apology, but they are said to be too distraught to speak about their son.) These snapshots depict a quiet, normal boy who had grown into a man descending steadily into serious mental illness. A partisan, highly nonscientific debate has erupted over whether extreme right-wing rhetoric could have inflamed whatever illness he may have and caused him to target Democratic Representative Gabrielle Giffords. We don't know the answer, but psychological research suggests that political rhetoric could never be the single cause that leads a person with complex mental problems to commit violence. (See pictures from a grieving Tucson.)
Case History
Pinpointing the precise moment a mental illness takes root is guesswork at best. As a young man, Loughner seemed ordinary enough — occasionally withdrawn, as all teens can be, and a little nerdy. He loved music and played the sax well. A classmate who had known him since elementary school, Ashley Buysman, says that when she heard the charges against him, "it just blew my mind."
But a darkness began massing around Loughner sometime after he dropped out of Mountain View High School in Tucson, Ariz., before his senior year. He started drinking a lot, according to Kylie Smith, who had known him since preschool. She lost contact with him between 2006 and 2008 and was stunned by how much he had changed. "He seemed out of it, like he was somewhere else," she says. "I could tell he wasn't just drunk and he wasn't just high."
Was a psychiatric illness beginning? Maybe, but it's difficult to tell, because Loughner had by then used a lot of drugs — not just pot but also hallucinogens like acid, according to Smith. It was at about this time that Loughner did something odd: he worked out for months so he could join the Army. Yet after traveling to the military processing station in Phoenix, he told an Army official that he smoked marijuana excessively — which meant he would never be accepted. The weird part: he actually passed a drug test that day, so he had not been using for at least a couple of weeks. (See photos of the world of Jared Lee Loughner.)
Loughner's behavior became increasingly erratic after the Army incident. Friends say he would occasionally speak in random strings of words. He had run-ins with police over drugs and his vandalization of a street sign. He became paranoid that the government was trying to control him — or everyone. He couldn't keep jobs at Quiznos and an animal shelter because he wouldn't — or could no longer — follow instructions.
When classes began at Pima Community College last year, Loughner's behavior frightened fellow students from Day One. "He had this hysterical kind of laugh, laughing to himself," says Benjamin McGahee, his math professor. He would say nonsensical things about "denying math." Says McGahee: "One lady in the back of the classroom said she was scared for her life, literally."(Comment on this story.)
Such Stuff as Dreams
It seems clear that Loughner was developing a mental illness, but which one? Many signs point to one of the psychotic disorders — delusional disorder, say, or schizophrenia, for which the average age of onset is roughly 20, about when Loughner started showing symptoms. The Diagnostic and Statistical Manual of Mental Disorders includes "substance-induced psychotic disorder," which is also a possibility in Loughner's case. (See six warning signs of whether someone is mentally ill.)
By several accounts, Loughner had become fascinated with lucid dreaming, a dream state you can enter when you're half asleep. You are aware while you're in that state that you're dreaming. Loughner's interest in his lucid dreams is significant, because last year the European Science Foundation reported that lucid dreaming "creates distinct patterns of electrical activity in the brain that have similarities to the patterns made by psychotic conditions." Loughner's drug use could have kept him from falling into deep sleep and encouraged lucid dreaming. The European group said paranoid delusions can occur when lucid dreams are replayed repeatedly after the subject wakes up. Loughner was replaying his lucid dreams in an extensive dream journal, according to his friend Bryce Tierney, who spoke with Mother Jones magazine.
See TIME's complete coverage of the Tucson shooting.
See pictures of messages for the Tucson victims.
The Health IT Paradox: Why More Data Doesn't Always Mean Better Care
Recently, while I was working an overnight shift in the emergency department, two paramedics wheeled an elderly woman into the busy ER. She was clearly very ill: her eyes were sunken and her mouth was parched, she was slumped over and unable to do much more than moan. The paramedics told me that her family members, who had stayed home (not uncommon!), wanted to make sure we knew that she wasn't usually "like this" and that she had recently been hospitalized at a different facility where many tests and "other stuff" had been done. Unfortunately, all her records were locked up at the other hospital's medical-record room, which was closed in the middle of the night.
We had to start from scratch. We ordered a CAT scan of her brain to look for stroke, put a catheter in her bladder and gave her a chest X-ray to look for infection, and applied a rectal exam to look for bleeding. We may have ended up doing all of this anyway, but having more information about her recent hospitalization would clearly have allowed us to be more efficient and directed in her care. My colleague, another doctor, turned to me and said, "I cannot wait until HIT [industry shorthand for 'health-information technology'] makes this problem goes away." (See the top 10 medical breakthroughs of 2010.)
The "problem," of course, is that medical errors and excess costs increase when health information isn't portable or easily accessible. The conventional wisdom is that electronic medical records, electronic prescriptions and electronic order-entry systems save costs and lives. Since 2009, the federal government has invested over $20 billion into improving HIT. And this month, the federal government will start doling out dollars to doctors' offices and hospitals to encourage them to adopt electronic health records. On its face, this makes absolute sense — who, after all, would argue that more information isn't essential to improved care at lower cost? During the last presidential campaign, both Senators John McCain and Barack Obama called for HIT enhancements as key to fixing health care. (See 10 players in health care reform.)
But an overzealous push toward HIT can also lead to unintended consequences. In Pittsburgh, a study showed that the rollout of an electronic system for doctors' orders was associated with increased odds of infant deaths in an intensive-care unit. And a study conducted in Philadelphia demonstrated that computerized physician-order-entry systems facilitated medication-prescribing errors. What was going on? In Pittsburgh, medications were given too frequently because the computer used standardized dosing times to order medication (as opposed to using the time of the first dose to calculate time to the next dose). In the Philadelphia study, many of the problems arose from what are known as human-machine interface flaws. For example, doctors would sometimes assume that a display of standard doses were suggested doses specific to the patient being treated at that moment (not the same thing!). Or doctors sometimes picked the wrong medication or dose because they didn't know that all of their options did not fit on a single computer screen and that they could click through to a second screen for more choices.
Remember the giant whiteboard used to keep track of patients and their room numbers on the TV show ER? The whiteboard is a great example of a low-tech device that can easily be customized to maximize patient care. A colleague of mine who lectures widely on patient safety shows a picture of an ER whiteboard where nurses put teddy-bear magnets next to the names of children in order to distinguish them from adult patients. Similarly, social scientists have observed how doctors and nurses gather around the whiteboard to discuss patients and their care in an effective manner. But with efforts to maximize patient privacy and go high tech, the whiteboard has largely been replaced by computerized electronic tracking systems which often reside on small monitors and frequently have no way to display information as efficiently and elegantly as a teddy-bear magnet. (Watch TIME's video "Uninsured Again.")
Of course, some of these problems will diminish as HIT systems themselves become better designed and more flexible (where I work, the computerized tracking system is customizable and has a big screen display so that doctors and nurses can easily gather around it). And implementation problems (when people are asked to do things differently than the way they have always done it, they mess it up at first) will get better as everyone gets used to using HIT. But there are some insidious factors that come with electronic health information that can be difficult to identify and measure, especially when the human element is removed from health care by technology. Here is an example: not that long ago, if I ordered an X-ray on a patient, I had to walk into the radiology-reading area to look at it. Often there would be a radiologist sitting there in the dark room; we would talk about the patient in a way that would often lead to closer examination of one part of the X-ray. Sometimes this conversation would lead to a cooperative reconsideration of the findings. But now, unless I have a specific question or concern, I don't have to go back to the radiology reading room — HIT allows me to look at both the X-ray and the radiologist report almost instantly on my desktop computer in the ER. Sure, it is efficient and helps me see more patients and spend more time on other emergency tasks. But the result, I worry, is that I may be more likely to miss something important. Experts in the field of medical informatics attribute this error to the loss of feedback. In other words, communication should be more than just transferring information — it needs to be about getting people to act in the right way. In my X-ray case, HIT leads to standardized and reliable information exchange but unintentionally takes away the conversation, and the opportunity that conversation presents to improve patient care. (See how to prevent illness at any age.)
So should we scale back our efforts to expand and improve HIT? Absolutely not. My elderly patient who arrived by ambulance (who, it turned out, had a colon and blood-stream infection) and the many patients like her, need to have their medical information made available in a comprehensive, reliable and efficient way. But we also need to be aware that electronic health information is not a panacea. The federal government has issued strict criteria for electronic health records called "meaningful use" which will seek to expand access to information and minimize disparities in care. But explicit plans to minimize unintended consequences of health information technology appear to be limited. HIT can change the way we deliver health care in ways that may be both hard to monitor and sometimes worse for our patients. And it is essential to keep an eye out for these influences. (Comment on this story.)
Dr. Meisel is a Robert Wood Johnson Foundation Clinical Scholar and an emergency physician at the University of Pennsylvania. The Medical Insider, his column for TIME.com appears every Wednesday.
Clarification: The original version of this story has been updated to make clear that the federal government does not yet have many explicit plans to minimize unintended adverse consequences of health information technology.
We had to start from scratch. We ordered a CAT scan of her brain to look for stroke, put a catheter in her bladder and gave her a chest X-ray to look for infection, and applied a rectal exam to look for bleeding. We may have ended up doing all of this anyway, but having more information about her recent hospitalization would clearly have allowed us to be more efficient and directed in her care. My colleague, another doctor, turned to me and said, "I cannot wait until HIT [industry shorthand for 'health-information technology'] makes this problem goes away." (See the top 10 medical breakthroughs of 2010.)
The "problem," of course, is that medical errors and excess costs increase when health information isn't portable or easily accessible. The conventional wisdom is that electronic medical records, electronic prescriptions and electronic order-entry systems save costs and lives. Since 2009, the federal government has invested over $20 billion into improving HIT. And this month, the federal government will start doling out dollars to doctors' offices and hospitals to encourage them to adopt electronic health records. On its face, this makes absolute sense — who, after all, would argue that more information isn't essential to improved care at lower cost? During the last presidential campaign, both Senators John McCain and Barack Obama called for HIT enhancements as key to fixing health care. (See 10 players in health care reform.)
But an overzealous push toward HIT can also lead to unintended consequences. In Pittsburgh, a study showed that the rollout of an electronic system for doctors' orders was associated with increased odds of infant deaths in an intensive-care unit. And a study conducted in Philadelphia demonstrated that computerized physician-order-entry systems facilitated medication-prescribing errors. What was going on? In Pittsburgh, medications were given too frequently because the computer used standardized dosing times to order medication (as opposed to using the time of the first dose to calculate time to the next dose). In the Philadelphia study, many of the problems arose from what are known as human-machine interface flaws. For example, doctors would sometimes assume that a display of standard doses were suggested doses specific to the patient being treated at that moment (not the same thing!). Or doctors sometimes picked the wrong medication or dose because they didn't know that all of their options did not fit on a single computer screen and that they could click through to a second screen for more choices.
Remember the giant whiteboard used to keep track of patients and their room numbers on the TV show ER? The whiteboard is a great example of a low-tech device that can easily be customized to maximize patient care. A colleague of mine who lectures widely on patient safety shows a picture of an ER whiteboard where nurses put teddy-bear magnets next to the names of children in order to distinguish them from adult patients. Similarly, social scientists have observed how doctors and nurses gather around the whiteboard to discuss patients and their care in an effective manner. But with efforts to maximize patient privacy and go high tech, the whiteboard has largely been replaced by computerized electronic tracking systems which often reside on small monitors and frequently have no way to display information as efficiently and elegantly as a teddy-bear magnet. (Watch TIME's video "Uninsured Again.")
Of course, some of these problems will diminish as HIT systems themselves become better designed and more flexible (where I work, the computerized tracking system is customizable and has a big screen display so that doctors and nurses can easily gather around it). And implementation problems (when people are asked to do things differently than the way they have always done it, they mess it up at first) will get better as everyone gets used to using HIT. But there are some insidious factors that come with electronic health information that can be difficult to identify and measure, especially when the human element is removed from health care by technology. Here is an example: not that long ago, if I ordered an X-ray on a patient, I had to walk into the radiology-reading area to look at it. Often there would be a radiologist sitting there in the dark room; we would talk about the patient in a way that would often lead to closer examination of one part of the X-ray. Sometimes this conversation would lead to a cooperative reconsideration of the findings. But now, unless I have a specific question or concern, I don't have to go back to the radiology reading room — HIT allows me to look at both the X-ray and the radiologist report almost instantly on my desktop computer in the ER. Sure, it is efficient and helps me see more patients and spend more time on other emergency tasks. But the result, I worry, is that I may be more likely to miss something important. Experts in the field of medical informatics attribute this error to the loss of feedback. In other words, communication should be more than just transferring information — it needs to be about getting people to act in the right way. In my X-ray case, HIT leads to standardized and reliable information exchange but unintentionally takes away the conversation, and the opportunity that conversation presents to improve patient care. (See how to prevent illness at any age.)
So should we scale back our efforts to expand and improve HIT? Absolutely not. My elderly patient who arrived by ambulance (who, it turned out, had a colon and blood-stream infection) and the many patients like her, need to have their medical information made available in a comprehensive, reliable and efficient way. But we also need to be aware that electronic health information is not a panacea. The federal government has issued strict criteria for electronic health records called "meaningful use" which will seek to expand access to information and minimize disparities in care. But explicit plans to minimize unintended consequences of health information technology appear to be limited. HIT can change the way we deliver health care in ways that may be both hard to monitor and sometimes worse for our patients. And it is essential to keep an eye out for these influences. (Comment on this story.)
Dr. Meisel is a Robert Wood Johnson Foundation Clinical Scholar and an emergency physician at the University of Pennsylvania. The Medical Insider, his column for TIME.com appears every Wednesday.
Clarification: The original version of this story has been updated to make clear that the federal government does not yet have many explicit plans to minimize unintended adverse consequences of health information technology.
10 Questions for Jimmy Wales
How did Wikipedia start? —Anushka Gole, MUMBAI
Wikipedia was my second attempt at creating a free encyclopedia for everyone. The first attempt was called Nupedia, which was a failure. The model we used to try to create Nupedia was very top-down, very academic and not very much fun for the volunteers. I launched the Wiki in 2001, and it just grew and grew and grew.
Why did you decide to allow users to edit Wikipedia? —Lewis Boone IV, KANSAS CITY, KANS.
The main reason we allow everyone to edit is quality. It's about allowing for an open, democratic dialogue to get the best possible entry that we can. The great beauty of the Internet is that it allows for a huge range of people to participate constructively. (See pictures of Jimmy Wales.)
Is the traditional encyclopedia dead? —Peter Heidener, AARHUS, DENMARK
I'm not sure if it's dead, but it certainly is ailing--although it was ailing long before we came along. Britannica took a severe hit from Microsoft Encarta, which dramatically reduced the cost of the encyclopedia.
Does Wikipedia as it is now fulfill the expectations you had when you started it? —Sharon Lecluyse, GHENT, BELGIUM
I remember, in the early days of Wikipedia, looking at a list of the top 100 websites and seeing an encyclopedia-reference site ranked around No. 50. I thought, If we do a really good job, maybe we can make it into the top 100. Now we're the fifth most popular website in the world, with over 400 million people visiting every month. It's much bigger than I expected. (Watch the interview with Jimmy Wales.)
Is Wikipedia financially sustainable? —Joonpyo Sohn, SEOUL
We think it is. We exist through the donations of the general public. The vast majority of [them] come from our annual giving campaign. That gives us enough money for another year. Is it sustainable in the long term? I think it is, but time will tell.
Would you run ads if the need occurred? Or would you shut down Wikipedia? —James Lillin, HAMBURG, N.Y.
We're opposed to having advertising on Wikipedia, but we will do what it takes to keep Wikipedia alive. In the event that the public was no longer willing to support us to the degree that we needed, we would first look at cost-cutting measures. We would eventually have to look at putting some ads in some obscure part of the site. [But] it's not something that we even think is likely to happen.
When is censorship of entries acceptable? —Carlos Castellar, MIAMI
We need to make a very careful distinction between censorship and editorial judgment. Censorship is forbidding the publication of certain knowledge. Editorial judgment [means asking], Are these facts relevant? Are they verifiable? Every entry has to be subject to thoughtful editorial judgment. But it's never the case that we should accept censorship. (See the 50 best websites of 2010.)
In what ways can the accuracy and integrity of information on Wikipedia be improved? —Jawad Farooq, LONDON
By improving the software that's available to the community to monitor Wikipedia, the degree to which they can control things, diversifying the contributor base. We're very, very good on topics that are of interest to the late-20s, early-30s tech-geek male because that's our core contributor group. We need more participation in topics outside that range.
Do you worry that WikiLeaks is giving Wikipedia a bad name? —Dennis Pope, RIVERSIDE, CALIF.
We have absolutely nothing to do with WikiLeaks. We shouldn't get credit for it, and we shouldn't get criticized for it. I've had a couple of cringing moments where I see some head of state who makes the error, and I'm like, Oh, come on.
What lie would you allow on your Wikipedia page? —Jeremy Parilla, TAGUIG CITY, PHILIPPINES
[Laughs.] It should say, "He always has a clever response to every question." Absolutely a lie.
Wikipedia was my second attempt at creating a free encyclopedia for everyone. The first attempt was called Nupedia, which was a failure. The model we used to try to create Nupedia was very top-down, very academic and not very much fun for the volunteers. I launched the Wiki in 2001, and it just grew and grew and grew.
Why did you decide to allow users to edit Wikipedia? —Lewis Boone IV, KANSAS CITY, KANS.
The main reason we allow everyone to edit is quality. It's about allowing for an open, democratic dialogue to get the best possible entry that we can. The great beauty of the Internet is that it allows for a huge range of people to participate constructively. (See pictures of Jimmy Wales.)
Is the traditional encyclopedia dead? —Peter Heidener, AARHUS, DENMARK
I'm not sure if it's dead, but it certainly is ailing--although it was ailing long before we came along. Britannica took a severe hit from Microsoft Encarta, which dramatically reduced the cost of the encyclopedia.
Does Wikipedia as it is now fulfill the expectations you had when you started it? —Sharon Lecluyse, GHENT, BELGIUM
I remember, in the early days of Wikipedia, looking at a list of the top 100 websites and seeing an encyclopedia-reference site ranked around No. 50. I thought, If we do a really good job, maybe we can make it into the top 100. Now we're the fifth most popular website in the world, with over 400 million people visiting every month. It's much bigger than I expected. (Watch the interview with Jimmy Wales.)
Is Wikipedia financially sustainable? —Joonpyo Sohn, SEOUL
We think it is. We exist through the donations of the general public. The vast majority of [them] come from our annual giving campaign. That gives us enough money for another year. Is it sustainable in the long term? I think it is, but time will tell.
Would you run ads if the need occurred? Or would you shut down Wikipedia? —James Lillin, HAMBURG, N.Y.
We're opposed to having advertising on Wikipedia, but we will do what it takes to keep Wikipedia alive. In the event that the public was no longer willing to support us to the degree that we needed, we would first look at cost-cutting measures. We would eventually have to look at putting some ads in some obscure part of the site. [But] it's not something that we even think is likely to happen.
When is censorship of entries acceptable? —Carlos Castellar, MIAMI
We need to make a very careful distinction between censorship and editorial judgment. Censorship is forbidding the publication of certain knowledge. Editorial judgment [means asking], Are these facts relevant? Are they verifiable? Every entry has to be subject to thoughtful editorial judgment. But it's never the case that we should accept censorship. (See the 50 best websites of 2010.)
In what ways can the accuracy and integrity of information on Wikipedia be improved? —Jawad Farooq, LONDON
By improving the software that's available to the community to monitor Wikipedia, the degree to which they can control things, diversifying the contributor base. We're very, very good on topics that are of interest to the late-20s, early-30s tech-geek male because that's our core contributor group. We need more participation in topics outside that range.
Do you worry that WikiLeaks is giving Wikipedia a bad name? —Dennis Pope, RIVERSIDE, CALIF.
We have absolutely nothing to do with WikiLeaks. We shouldn't get credit for it, and we shouldn't get criticized for it. I've had a couple of cringing moments where I see some head of state who makes the error, and I'm like, Oh, come on.
What lie would you allow on your Wikipedia page? —Jeremy Parilla, TAGUIG CITY, PHILIPPINES
[Laughs.] It should say, "He always has a clever response to every question." Absolutely a lie.
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