Tuesday, 31 May 2016

Nurturing The Brain – Part 9, Blueberries

Astronauts on space missions can be exposed to radiation for long periods of time, which can pose significant dangers to their health. The fact that the administration of blueberry extract has been proposed as a preventive therapy to protect them from harmful radiation is a great indication of just how powerful these fruits might be.

The more blueberries are studied, the more evident it becomes that they are a superfood. Blueberries contain important biologically active compounds, such as polyphenols, phenolic acids, and vitamins, with countless beneficial effects. Within polyphenols, there are many different types of chemicals found in blueberries with great health benefits, such as flavonoids; these include anthocyanins, which are particularly interesting due to their potent antioxidant properties. Among fresh fruits and vegetables, blueberries are the ones that contain the highest concentration of anthocyanins.

Blueberries’ potent antioxidant effects are indeed their most outstanding property. This is important because oxidation in one of the main sources of cellular damage. A process known as oxidative stress can arise from an increase in oxidant factors known as reactive oxygen species. Although they are normal product of cellular metabolism, and quickly neutralized by antioxidant defenses in normal conditions, they may escape neutralization and give rise to oxidative stress. This can have serious consequences, leading to the development of several pathologies, particularly in aged subjects, who are more vulnerable to the effects of oxidative stress.

So, anything that provides an antioxidant effect can help counterbalance the detrimental effects of oxidative stress, as is the case with blueberries, which can be used to boost our endogenous antioxidant defense system. But blueberries’ benefits are not restricted to their antioxidant action; they also have anti-inflammatory, antimutagenic, antihypertensive and hypoglycemic effects, and are even inhibit different types of tumors.

Blueberries confer great cardiovascular protection. Their biologically active molecules can inhibit inflammatory responses in endothelial cells, the cells that form the lining of all blood vessels. This improves endothelial function and prevents the development of vascular diseases. Daily blueberry consumption can improve blood pressure, arterial stiffness, myocardial and coronary performance, and protect the heart against ischemia – the shortage of oxygen and glucose due to restricted blood supply.

The neuroprotective effects of blueberries

The increase in antioxidant defenses that blueberries can provide is relevant not only in vascular disorders, but also in neurodegenerative conditions. Oxidative stress is particularly harmful to the brain because of its higher oxygen demands compared with other tissues, and of the higher exposure to oxidative damage that it entails. In fact, oxidation is the main agent of many age-related and neurodegenerative diseases, giving rise to cognitive and motor impairments and to a decrease in the sensitivity to several neurotransmitters.

Various anthocyanins contained in blueberries are able to cross the blood brain barrier. Those have been detected in the brains of aged rats receiving a long-term blueberry-supplemented diet, specifically in brain regions which are important for learning and memory. Blueberries’ anthocyanins are effective in decreasing oxidative stress in neurons. By counterbalancing oxidative damage, the antioxidant action of blueberries may contribute to a delayed onset of aging signs or even reverse injuries that have already occurred.

An example of the latter is a study that showed that transgenic mice predisposed to the development of Alzheimer’s disease, whose diet was supplemented with blueberry extracts, demonstrated an improvement in neuronal signaling pathways with a neuroprotective effect. In this case, a genetic predisposition to cognitive deficits was counterbalanced through dietary changes, suggesting a direct effect of blueberries on genetic expression. This impressive ability has been further evidenced by studies showing a reduction of the expression of proinflammatory genes in advanced age rats to the levels of young animals, with a corresponding improvement in memory.

Blueberries can also induce an increase in neuronal plasticity and in the generation of new neurons in the hippocampus, having therefore valuable effect in memory and learning mechanisms. This has been verified by studies demonstrating that blueberry supplementation can induce improvements in spatial memory, long-term memory, and in the ability to learn new information in animal models of aging.

The vascular effects of blueberries can also manifest themselves in brain. It has been shown that blueberries are able to prevent cerebral damage induced by ischemia, reducing the neurological deficits and increasing neurogenesis in the affected areas.

Inflammation is another crucial driver of aging and neurodegeneration. Blueberry extracts also have potent anti-inflammatory effects, inducing a significant decrease in the production of proinflammatory molecules. These anti-inflammatory mechanisms can complement their antioxidant action, potentiating their overall neuroprotective effect, and having an anti-neurodegenerative action.

In models of neuronal inflammation, blueberry polyphenols were shown to attenuate learning impairment resulting from neurotoxicity, and to exert anti-inflammatory effects through changes in genetic expression associated with synaptic plasticity, leading to memory improvement and the improvement of cognitive performance in mice.

Most of this data comes from animal studies, but there is also evidence supporting these effects in humans – in a study where elderly subjects received blueberry juice supplementation for 12 weeks, it was shown that there was an improvement in memory tests and in mood. Also, a normalization of glycemic and insulin levels was detected, which can also contribute to a decrease in the levels of inflammatory mediators associated with neurodegenerative diseases.

So, although blueberries’ antioxidant power is their most recognized feature, they can actually be beneficial through many other mechanisms – they can regulate cellular balance by acting on gene expression, signaling pathways, and synaptic plasticity, for example. All these actions can give rise to anti-ageing, anti-inflammatory and antitoxic effects, leading to an improvement in motor and cognitive performance.

Given this broad range of beneficial actions, blueberry extracts promise a multitude of clinical applications, namely in the context of neurological disorders in which oxidative stress, inflammation, and neurodegeneration are associated – Alzheimer’s, Parkinson’s, amyotrophic lateral sclerosis… Just to name a few.

References

Chen, J., Zhao, Y., Tao, X., Zhang, M., & Sun, A. (2015). Protective effect of blueberry anthocyanins in a CCL4-induced liver cell model LWT – Food Science and Technology, 60 (2), 1105-1112 DOI: 10.1016/j.lwt.2014.10.010

Giacalone, M., Di Sacco, F., Traupe, I., Topini, R., Forfori, F., & Giunta, F. (2013). Antioxidant and neuroprotective properties of blueberry polyphenols: a critical review Nutritional Neuroscience, 14 (3), 119-125 DOI: 10.1179/1476830511Y.0000000007

Huang, W., Liu, Y., Wang, J., Wang, X., & Li, C. (2014). Anti-Inflammatory Effect of the Blueberry Anthocyanins Malvidin-3-Glucoside and Malvidin-3-Galactoside in Endothelial Cells Molecules, 19 (8), 12827-12841 DOI: 10.3390/molecules190812827

Huang, W., Zhu, Y., Li, C., Sui, Z., & Min, W. (2016). Effect of Blueberry Anthocyanins Malvidin and Glycosides on the Antioxidant Properties in Endothelial Cells Oxidative Medicine and Cellular Longevity, 2016, 1-10 DOI: 10.1155/2016/1591803

Johnson, S., Figueroa, A., Navaei, N., Wong, A., Kalfon, R., Ormsbee, L., Feresin, R., Elam, M., Hooshmand, S., Payton, M., & Arjmandi, B. (2015). Daily Blueberry Consumption Improves Blood Pressure and Arterial Stiffness in Postmenopausal Women with Pre- and Stage 1-Hypertension: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial Journal of the Academy of Nutrition and Dietetics, 115 (3), 369-377 DOI: 10.1016/j.jand.2014.11.001

Krikorian, R., Shidler, M., Nash, T., Kalt, W., Vinqvist-Tymchuk, M., Shukitt-Hale, B., & Joseph, J. (2010). Blueberry Supplementation Improves Memory in Older Adults

Journal of Agricultural and Food Chemistry, 58 (7), 3996-4000 DOI: 10.1021/jf9029332

Pojer, E., Mattivi, F., Johnson, D., & Stockley, C. (2013). The Case for Anthocyanin Consumption to Promote Human Health: A Review Comprehensive Reviews in Food Science and Food Safety, 12 (5), 483-508 DOI: 10.1111/1541-4337.12024

Shukitt-Hale, B., Carey, A., Jenkins, D., Rabin, B., & Joseph, J. (2007). Beneficial effects of fruit extracts on neuronal function and behavior in a rodent model of accelerated aging Neurobiology of Aging, 28 (8), 1187-1194 DOI: 10.1016/j.neurobiolaging.2006.05.031

Image via elizadean / Pixabay.

via Brain Blogger Read More Here..

Lupus a Tough Disease to Spot, Treat

But experts say scientists are working to unearth genetic causes of autoimmune disorder

HealthDay news image

Source: HealthDay
Related MedlinePlus Page: Lupus via MedlinePlus Health News Read More Here..

New Test Helps Identify Rare Genetic Diseases in Newborns

'Next-generation gene sequencing' could speed up the time to a diagnosis, study suggests

HealthDay news image

Source: HealthDay
Related MedlinePlus Pages: Genetic Testing, Uncommon Infant and Newborn Problems via MedlinePlus Health News Read More Here..

Even Kiddie Pools Pose Danger

Vigilance a must around any swimming area, expert says
Source: HealthDay
Related MedlinePlus Pages: Children's Health, Water Safety (Recreational) via MedlinePlus Health News Read More Here..

Lifestyle May Be Key to Improving ADHD in Kids

Healthier habits related to exercise and diet could help many with the disorder, researcher says

HealthDay news image

Source: HealthDay
Related MedlinePlus Page: Attention Deficit Hyperactivity Disorder via MedlinePlus Health News Read More Here..

Sun Protection Comes in Many Forms

Thorough and frequent application of sunblock is crucial, expert says

HealthDay news image

Source: HealthDay
Related MedlinePlus Page: Sun Exposure via MedlinePlus Health News Read More Here..

Pet Pooch May Help Ease PTSD in Veterans

Dogs also helped reduce depression and loneliness, researchers found

HealthDay news image

Source: HealthDay
Related MedlinePlus Pages: Post-Traumatic Stress Disorder, Veterans and Military Health via MedlinePlus Health News Read More Here..

Asthma Symptoms Can Bloom in Springtime

Follow your care plan to prevent attacks, expert says

HealthDay news image

Source: HealthDay
Related MedlinePlus Page: Asthma via MedlinePlus Health News Read More Here..

Exploring Zika's Path Through the Placenta

Researchers find the virus can replicate in immune cells

HealthDay news image

Source: HealthDay
Related MedlinePlus Page: Zika Virus via MedlinePlus Health News Read More Here..

New Labeling Offers More Protection for Meat Lovers

Warns consumers that mechanically tenderized beef can raise bacteria risk, so more careful cooking needed

HealthDay news image

Source: HealthDay
Related MedlinePlus Pages: Food Safety, Foodborne Illness via MedlinePlus Health News Read More Here..

U.S. Officials Confirm Superbug Resistant to All Antibiotics

Pennsylvania case suggests it's almost 'the end of the road' for these drugs

HealthDay news image

Source: HealthDay
Related MedlinePlus Page: Antibiotic Resistance via MedlinePlus Health News Read More Here..

Fewer Inhaled Steroids May Be OK for Asthmatic Children

Study suggests some kids don't need daily dosing, but one expert worries the strategy might have risks

HealthDay news image

Source: HealthDay
Related MedlinePlus Pages: Asthma in Children, Steroids via MedlinePlus Health News Read More Here..

Cigarette plain packs to 'go global'

Plain packaging for cigarettes is about to "go global" in a move that will have a "huge impact" on health, the World Health Organization says. via BBC News - Health Read More Here..

Relax – your phone probably isn’t going to give you cancer

A study in rats suggests high cellphone radiation exposure is linked to tumours, but the experiment can't tell us much about how we normally use phones via New Scientist - Health Read More Here..

World No Tobacco Day, 31 May 2016: Get ready for plain packaging

30 May 2016 – To mark World No Tobacco Day, WHO is launching a new guide to plain packaging of tobacco products, which gives governments the latest evidence and guidance on implementing the measure. via WHO news Read More Here..

India transfusions infect many with HIV

At least 2,234 people in India contract the deadly HIV virus while getting blood transfusions in hospitals in the past 17 months. via BBC News - Health Read More Here..

Rise in junior doctor applications in Scotland

27% increase in a year to practise north of the border

Related items from OnMedica

Scotland sets out health and social care blueprint for next decade
Survey reveals GP recruitment crisis in Scotland
New models of healthcare needed in Scotland
Contract debacle prompts medical students to consider careers overseas
Agreement reached in junior doctor dispute
via OnMedica News Read More Here..

Backtrack on plans for full GP surgery weekend opening

Full surgery Sunday service unlikely to be needed, says Hunt

Related items from OnMedica

Doctors warn seven-day service will damage weekday services
Demand for seven-day GP services will grow with time
It ‘beggars belief’ that seven-day NHS plans are uncosted, say MPs
Five year plan for general practice unveiled
To improve GP access, we all need to step out of the trenches
via OnMedica News Read More Here..

Hereditary heart and diabetes problems raise risk for children

Third of children have inherited higher levels of cardiometabolic risk

Related items from OnMedica

Stress in childhood linked to disease risk in adulthood
Loneliness and isolation linked to increased heart disease/stroke risk
Child health risks of gestational diabetes
Thousands unaware they have deadly inherited heart condition
Researchers develop single blood test for all known inherited heart conditions
via OnMedica News Read More Here..

The power of vaccinating pregnant women

Why they are vital for plugging the "immunisation loophole" via BBC News - Health Read More Here..

Experts call for end to ‘systemic neglect’ of lung disease

Deaths due to lung disease unchanged over past decade

Related items from OnMedica

Genetic data shows smoking and lung disease link
Lung cancer surgery survival increases
Could ultrasound replace CXR for spotting pneumonia?
Fewer lung symptoms in children as air pollution levels drop
Loss of lung function faster with COPD exacerbations
via OnMedica News Read More Here..

Only quarter of 12-year-olds have all diabetes care checks

Overall diabetes control improving in children and young people

Related items from OnMedica

Rising health toll for children with type 1 diabetes
NICE recommends tighter blood sugar control in diabetes
Traumatic childhood events raise risk of diabetes
Child health risks of gestational diabetes
NHS must hold CCGs accountable for poor diabetes care
via OnMedica News Read More Here..

Care home scandal families' plea to PM

Families of victims of the Winterbourne View scandal write to the prime minister demanding he shuts outdated care home institutions. via BBC News - Health Read More Here..

Reducing cancer risk more than ‘just a walk in the park’

The science behind headlines claiming physical activity can reduce the risk of 13 types of cancer

Related items from OnMedica

Cancer cases have risen 12% since mid-1990s
GPs slash total antibiotic scrips by over 7% in a year
Annual diabetes checks still being missed
Third of gym-goers use drugs or supplements to lose weight
Pressure mounts on government to introduce sugar tax
via OnMedica Blogs Read More Here..

Vaccines might be able to stop Alzheimer’s plaques from forming

The plaques linked to Alzheimer's disease seem to be made by the brain defending itself from attack. Dialling down this defence may stop the disease via New Scientist - Health Read More Here..

Monday, 30 May 2016

Drop in Google searches reveals success of chickenpox vaccine

It can be difficult to gauge the success of an immunisation programme, but declines in searches for "chickenpox" show they work via New Scientist - Health Read More Here..

How to nap like a pro

Napping isn’t lazy – it’s a smart way to reap the rewards of sleep. Here's the science behind the secrets of the true power nappers via New Scientist - Health Read More Here..

VIDEO: Staying still at work 'as bad as smoking'

New data suggests more than half of us only go for a walk at work when we need the toilet. via BBC News - Health Read More Here..

How the corporate well-being trend can lead to discrimination

To boost health and profits, companies are offering wellness programmes that gather data on staff including steps, calories and even genetic information via New Scientist - Health Read More Here..

Sunday, 29 May 2016

How mental health needs sleep – and vice versa

Sleep and mental health are intricately linked, so Russell Foster wants to use sleep for diagnosing and treating troubled brains and minds via New Scientist - Health Read More Here..

A Resident’s Reflections from within the American Board of Psychiatry & Neurology (ABPN)

Most residents have a very limited understanding of the American Board of Psychiatry and Neurology (ABPN), and understandably so.

I myself thought of the ABPN as a large, bureaucratic, governmental organization that spent most of its time siphoning money from hapless residents in order to administer board certification examinations. I was therefore surprised, and a bit skeptical, when my chairman asked me if I was interested in a three-month administrative fellowship at the ABPN during my final year of neurology residency. Although I had an interest in administration, I was hesitant because I was unfamiliar with the fellowship’s objectives, because it would be the first year it was offered.

Three weeks before my administrative fellowship was to begin, a thick binder arrived containing a detailed, day-by-day schedule and multiple articles including, 10 Most Common Mistakes Made by Administrators and Understanding Financial Statements of Not-for Profits. I also received three books on self-improvement: Drive, Talent is Overrated, and, ironically, Being Wrong. Reviewing the schedule, I was surprised to see that I would be spending, collectively, almost four weeks traveling (including internationally).

The binder clearly spelled out the objectives of the fellowship. I was expected to learn about the mission and structure of the ABPN as a whole, and in particular the fiduciary responsibilities of the board of directors. I was to have scheduled meetings with the senior staff to appreciate their role in the day-to-day workings of the ABPN. In addition, I was expected to complete a research project, suitable for submission for presentation and publication. Finally, I was to have weekly meetings with Dr. Larry Faulkner, the President and CEO of the ABPN. It would be these weekly meetings that I would find most useful, as they provided perhaps the greatest educational value of the entire fellowship.

About the ABPN

Prior to my arrival at the ABPN, I learned that it had been formed by psychiatrists and neurologists in 1934 in order to distinguish qualified specialists from those offering neurological or psychiatric care without adequate experience or training.

Rather than a large, bureaucratic organization, the ABPN is relatively small. It consists of less than 40 staff, of which only one is a salaried physician (Dr. Faulkner). The ABPN sitting directors essentially volunteer their time. I quickly learned that the ABPN does not have members (unlike the American Academy of Neurology (AAN) or the American Psychiatric Association) and is an organization that is primarily responsible to the American public. Its main mission is to ensure the public that ABPN diplomates are competent to practice neurology and psychiatry. It does this by first certifying candidates who have graduated from accredited residency programs and by developing methods to assess that practicing physicians continuously keep up with the rapid pace of medical advancement. Initial certification for neurologists and psychiatrists now consists of a computer based examination.

Interestingly, the ABPN is also a driving force behind residency education. Recently, the Accreditation Council of Graduate Medical Education (ACGME) decided that it would not accredit additional combined training programs. Instead of dissolving these programs (in which almost 200 residents are currently enrolled), the ABPN decided to review and approve these combined training programs which include neurology-internal medicine and neurology-psychiatry. While the ACGME establishes minimal requirements for neurology and psychiatry residency programs, the ABPN establishes the necessary pre-requisites a resident must have in order to be eligible to become board certified. Often the ACGME follows suit. For example, initially there was no ACGME requirement that a graduating neurology resident see a single critical care patient. The ABPN determined that an intensive care unit (ICU) clinical skill examination (CSE) would be required in order to apply for an initial board certification exam. Shortly thereafter, the ACGME adopted the ICU CSE as a requirement for residency accreditation.

A recent focus of the ABPN is supporting education and research activities of academic faculty. Given the increasing clinical demands on faculty, I noted that the ABPN grants for innovative education projects placed particular emphasis on ensuring that faculty had protected time to complete those activities. The ABPN will shortly begin another grant program to support research on issues relevant to its mission. In both of the ABPN grant programs, awardees are selected by panels of neurologists and psychiatrists that includes members from within the academic community with established expertise in education or research.

Crucial Issue Forums

The ABPN has also begun to host a yearly “Crucial Issue Forum”. These Forums focus on pressing issues central to the fields of neurology and psychiatry and are used to obtain feedback from professional organizations and others on those issues. Experts in the field, including program directors, department chairs, representatives of national professional organizations, residents, and fellows are invited.

The most recent Forum focused on residency education, and included a discussion about whether the process of the CSEs should be modified to produce a more meaningful educational experience. A growing body of literature has suggested that the CSEs are not as effective as they might be. These sentiments were echoed by several residents, including myself. After attending this Forum, it became clear to me how seriously the ABPN took this Forum. Had the attendees of the Forum voted for the ABPN to conduct site visits to monitor the CSEs at every institution, it is likely that we would have site visits. Conversely, if a clear consensus had been to abolish the CSEs, it is likely that they would no longer exist.

My fellowship

A requirement of the fellowship is a research project with the expectation of publication. Several opportunities exist towards this end, including use of the ABPN’s wealth of data on their initial certification examinations, maintenance of certification exam and CSEs. Given my preexisting interest in both headache and education I surveyed adult neurology residency program directors and chief residents to determine their views on the appropriate amount of headache education in neurology residency. The goal of this project was to determine if headache education had significantly increased from a decade ago when a similar survey had been done. I had the opportunity to present the results to the senior staff of the ABPN as well as at the American Headache Society Annual Scientific Meeting in June 2015. The manuscript was accepted for publication in Headache, The Journal of Head and Face Pain.

The most memorable moments of my fellowship were spent in Dr. Faulkner’s office for our weekly 10 o’clock meetings. These ‘one on one’ meetings typically lasted between 1-2 hours. Rarely was there a set agenda. We discussed everything from Dr. Faulkner’s top ten rules for financial investment, to the inexact science of hiring employees. We talked about the slim evidence base behind maintenance of certification (MOC) and the impetus to have an MOC program despite the lack of strong evidence. We explored why continuing medical education (CME) has not met the same opposition as MOC Part IV, despite the fact that CME is the most time intensive component of MOC.

Behind the backdrop of the formal curriculum, readings, and scheduled meetings, a large part of the fellowship consisted of informal education. Every moment of downtime with Dr. Faulkner was an opportunity for me to learn about the process of becoming a successful administrator. While we waited for our flights we would often talk about everything from family to how important it is to take care of oneself physically and mentally. As Dr. Faulkner put it, “If you fall apart, everything falls apart. If you’re not healthy, you won’t be able to fulfill your family, social, or work responsibilities.” He impressed upon me the importance of being on the same page as one’s spouse and family. We discussed the value of doing a few tasks, but doing them well. I understand now that the real value of this unique experience truly lay in the in-depth immersion that I had into all things administrative, from the ABPN, to academic departments, to professional organizations, and even to my family.

Finally, the fellowship gave me the opportunity to meet with some of the most influential leaders in neurology and psychiatry. It was eye-opening to see the work that goes on behind the scenes at organizations like the AAN, APA, and ACGME. Despite their different responsibilities, each of these national organizations and their respective leaders had the singular goal of furthering the fields of neurology and psychiatry through focused initiatives. I began to appreciate the extraordinary effort that went into the large annual professional meetings. I spent a day at the AAN in Minneapolis learning about their different sections and the spectrum of resources they provide for their members. It was humbling to realize that I could probably spend my whole life on the AAN website and still not be able to take advantage of all the resources they have to offer.

In the ABPN I found an organization that not only tried to uphold the standards that make our profession credible, but also an organization that was dedicated towards the advancement of neurology and psychiatry education. In Dr. Faulkner I found a leader who tried to be fair. He cultivated the potential of those around him into a kinetic energy that translated into a collective success. Much of his time was spent advocating for the best interests of neurologists and psychiatrists against those who would like to propose greater physician scrutiny and regulation.

The mounting pressures of lower reimbursement in the setting of higher patient volumes, the oft-repeated mantra of ‘Do more with less’, and the overwhelming paperwork often overshadow our initial motivation to become physicians. More than anything else, my time at the ABPN and my interaction with the leaders in neurology and psychiatry have given me hope and optimism that we can find our way through the pressured maze of bureaucracy and increasing scrutiny to an era where we will be able to provide the best care for our patients while seamlessly documenting the quality of our work. There are multiple initiatives towards this end, not the least of which is the commitment and support of leaders in neurology to the AAN Axon Registry. In summary, my experience at the ABPN taught me that our future is in our hands and that our collective involvement and effort will be crucial to effectuate the outcomes we desire.

References

ABPN Awards Program. Faculty innovation in education award. American Board of Psychiatry and Neurology website. Accessed December 21, 2015.

Aminoff, MJ. Faulkner RF. (2012). The American Board of Psychiatry and Neurology, Looking Back and Moving Ahead. Arlington, VA: American Psychiatric Publishing.

Kay, Jerald. (1999(. Administrative Mistakes Handbook of Psychiatric Education and Faculty Development. Washington D.C., American Psychiatric Press.

Schuh, L., London, Z., Neel, R., Brock, C., Kissela, B., Schultz, L., & Gelb, D. (2009). Education Research: Bias and poor interrater reliability in evaluating the neurology clinical skills examination Neurology, 73 (11), 904-908 DOI: 10.1212/WNL.0b013e3181b35212

Image via StartupStockPhotos / Pixabay.

via Brain Blogger Read More Here..

What does ‘natural’ mean? Time to ditch a dangerous concept

The US regulator wants to define "natural" so it can decide which foods can use the label, but the word is also abused by Greens and fans of alternative medicine via New Scientist - Health Read More Here..

Can you catch up on missed sleep?

Skipping sleep can hurt both body and mind, but there are ways to make amends via New Scientist - Health Read More Here..

Saturday, 28 May 2016

Sixty-ninth World Health Assembly closes

The Sixty-ninth World Health Assembly closed on 28 May 2016 after approving resolutions on WHO’s Framework for Engagement with Non-State Actors; the Sustainable Development Goals; the International Health Regulations. via WHO news Read More Here..

Can you cheat the sleep system with a smart napping schedule?

Some people get extra hours awake by hacking their sleep patterns – be careful, though via New Scientist - Health Read More Here..

Let’s take a knife to the world’s rising tide of type 2 diabetes

Surgery is now a proven but underused treatment for type 2 diabetes. Time to unleash its full potential around the globe, say Francesco Rubino and Paul Zimmet via New Scientist - Health Read More Here..

WHO seeks to allay Zika Olympics fears

The World Health Organization says it has moved to tackle the Zika virus in Brazil, amid calls for this summer's Rio Olympics to be postponed. via BBC News - Health Read More Here..

WHO public health advice regarding the Olympics and Zika virus

WHO Public Health Advice Regarding the Olympics and Zika virus via WHO news Read More Here..

VIDEO: Call for Olympic Games move over Zika

The World Health Organization has dismissed calls for the Rio Olympic Games to be moved because of the Zika outbreak in Brazil. via BBC News - Health Read More Here..

How to sleep better

There’s a big difference between dozing and getting proper refreshing sleep. Here’s how to make the most of your shut-eye via New Scientist - Health Read More Here..

Friday, 27 May 2016

Alzheimer’s may be caused by brain’s sticky defence against bugs

The amyloid plaques associated with Alzheimer’s disease may be the brain’s way of trapping invading microbes that have crossed the blood-brain barrier via New Scientist - Health Read More Here..

VIDEO: Dr Heimlich saves choking woman

Dr Henry Heimlich has used the Heimlich manoeuvre to save a choking woman at his retirement home. via BBC News - Health Read More Here..

5 tips for beating insomnia

Struggling to get to sleep? Do you wake up too soon? We can help you master your slumber via New Scientist - Health Read More Here..

Sixty-ninth World Health Assembly update

Delegates at the World Health Assembly have agreed resolutions and decisions on air pollution, chemicals, the health workforce, childhood obesity, violence, noncommunicable diseases, and the election of the next Director-General. via WHO news Read More Here..

UK to trial HPV vaccine in gay men but no plans yet for all boys

The HPV vaccine is to be offered to 40,000 men who have sex with men, but campaigners have repeated the call to offer the jab to all adolescent boys via New Scientist - Health Read More Here..

Two-way trust is needed to make the most of health data

A lack of transparency breeds concern over projects using digital health data. Only open discussion can allay fears, say Ellen Broad and Tom Sasse via New Scientist - Health Read More Here..

Dr Heimlich saves choking woman

The 96-year-old man behind the Heimlich manoeuvre has used the technique to save a woman choking at his retirement home. via BBC News - Health Read More Here..

Neurofeedback Therapy for The Management of Pain

Pain is a subjective feeling that can be influenced by sensory, affective, and cognitive factors. Chronic pain can have a widespread impact on overall brain function, and both cognitive and psychological factors play key roles in the development and management of pain.

Patients with long-term pain often present structural and emotional impairments associated with cortical regions of the brain that are linked not only to pain itself, but also to the many co-morbidities that often develop in association with chronic pain: depression, anxiety and sleep disturbances, for example.

Patients with chronic pain may require long-term pharmacological treatment; this entails a number of drawbacks mainly due to the undesirable side-effects that often arise with a continued use of analgesic drugs. There is a constant search for better pain management options, including non-pharmacological approaches. In the last decades, neurofeedback has been gaining ground as a potentially successful option.

What is neurofeedback?

Neurofeedback is a form of biofeedback. Biofeedback was born from the observation that one can control and manipulate certain bodily functions by being aware of them. By using instruments that measure physiological activity such as heartbeat, breathing, muscle activity, or skin temperature, a subject can receive fast and accurate information regarding those functions. The use of these monitoring systems allows the perception of the physiological functions, and in turn, and along with changes in thinking, emotions, and behavior (and adequate training), this allows the manipulation of those functions.

Biofeedback is widely applied to processes associated with the autonomic nervous system, such as heart rate, breathing rate or muscle tone. Biofeedback may be used to control those processes, and to improve health and physical performance. Over time, these changes can become long-lasting, enduring even without the continued use of monitorization instruments.

In the case of neurofeedback, these biofeedback techniques are applied to the brain. Neurofeedback, also known as EEG-biofeedback, uses electroencephalograms (EEG) to monitor brain waves, producing a signal that can be used as feedback to learn how to self-regulate brain functions. Lately, other monitorization techniques have begun to be applied, namely functional magnetic resonance imaging (fMRI) biofeedback.

It has actually been known for decades that, with adequate training, brain waves can be controlled. Intellectual activity induces fluctuations in cerebral bioelectric activity that can translate into neurophysiological changes. By understanding the association between the bioelectric activity of different brain areas and the associated cognitive, emotional, behavioral, or even pathological processes, neurofeedback can allow the modification of those specific processes.

Neurofeedback has proven useful in inducing relaxation and attention, in enhancing creativity, and as a therapy for a number of contexts – sleep disorders, epilepsy, depression, anxiety, language processing, neurorehabilitation in stroke, or enhancement of perception and learning. Another context in which neurofeedback has shown interesting effects is chronic pain.

Neurofeedback and pain management

Neurofeedback can have a direct influence on the processing of pain. By learning self-regulation of brain functions, a patient can modify the electrical activity of areas of the brain involved in pain processing, pain perception, or pain memory. This allows the reduction or even elimination of pain, along with many of its co-morbidities, including depression or anxiety, for example.

The psychological factors that influence pain perception have the ability to modify our body’s biochemical processes. Thoughts can have a direct impact on these processes and potentially produce analgesia. In fact, there is evidence indicating that cognitive control of pain can have a direct effect on opiod activity, stimulating the production of endorphins.

Another mechanism through which neurofeedback can modulate pain is the regulation of the emotional component of pain. The frontal cortex is associated with the feeling of unpleasantness associated with pain, and neurofeedback training applied to this region of the brain has been found to be able to induce changes in pain affect in patients with acute and chronic pain syndromes, leading to an increased pain tolerance.

Chronic pain can also induce changes in the functional organization of the brain. Neurofeedback can allow the control of pain by altering the connectivity between brain regions, thereby inducing long-lasting changes in neuronal networks that can counterbalance the changes induced by chronic pain.

Indeed, clinical data has demonstrated the efficacy of neurofeedback therapy in a number of chronic pain conditions: it can decrease headache intensity, being particularly effective in children and adolescents, as well as migraine and pain associated with fibromyalgia. Neurofeedback can also be effective in post-operative pain and in cancer pain.

During the last decades, neurofeedback training approaches and protocols have been steadily improving, along with its efficacy. As new methods arise, it is likely that neurofeedback can gain awareness and importance as a non-pharmacological therapy for a multitude of disorders. fMRI imaging, for example, can be a great upgrade for this therapy by allowing the detection of brain areas affected by chronic pain, and consequently allowing a more targeted intervention.

If one can learn to directly control the activation of specific brain regions, one can potentially be able to control neurophysiological mechanisms that may help in the treatment of disease.

References

Bandura, A., O’Leary, A., Taylor, C., Gauthier, J., & et al, . (1987). Perceived self-efficacy and pain control: Opioid and nonopioid mechanisms. Journal of Personality and Social Psychology, 53 (3), 563-571 DOI: 10.1037/0022-3514.53.3.563

deCharms, R., Maeda, F., Glover, G., Ludlow, D., Pauly, J., Soneji, D., Gabrieli, J., & Mackey, S. (2005). Control over brain activation and pain learned by using real-time functional MRI Proceedings of the National Academy of Sciences, 102 (51), 18626-18631 DOI: 10.1073/pnas.0505210102

Gorini, A., Marzorati, C., Casiraghi, M., Spaggiari, L., & Pravettoni, G. (2015). A Neurofeedback-Based Intervention to Reduce Post-Operative Pain in Lung Cancer Patients: Study Protocol for a Randomized Controlled Trial JMIR Research Protocols, 4 (2) DOI: 10.2196/resprot.4251

Ibric, V., Dragomirescu, L., & Hudspeth, W. (2009). Real-Time Changes in Connectivities During Neurofeedback Journal of Neurotherapy, 13 (3), 156-165 DOI: 10.1080/10874200903118378

Kumano, H., Horie, H., Kuboki, T., Suematsu, H., Sato, H., Yasushi, M., Kamei, T., & Masumura, S. (1997). EEG-driven photic stimulation effect on plasma cortisol and beta-endorphin. Applied Psychophysiology and Biofeedback, 22 (3), 193-208 DOI: 10.1023/A:1026215910176

Litt, M. (1988). Self-efficacy and perceived control: Cognitive mediators of pain tolerance. Journal of Personality and Social Psychology, 54 (1), 149-160 DOI: 10.1037/0022-3514.54.1.149

Megumi, F., Yamashita, A., Kawato, M., & Imamizu, H. (2015). Functional MRI neurofeedback training on connectivity between two regions induces long-lasting changes in intrinsic functional network Frontiers in Human Neuroscience, 9 DOI: 10.3389/fnhum.2015.00160

Nestoriuc, Y., Martin, A., Rief, W., & Andrasik, F. (2008). Biofeedback Treatment for Headache Disorders: A Comprehensive Efficacy Review Applied Psychophysiology and Biofeedback, 33 (3), 125-140 DOI: 10.1007/s10484-008-9060-3

Nestoriuc, Y., & Martin, A. (2007). Efficacy of biofeedback for migraine: A meta-analysis Pain, 128 (1), 111-127 DOI: 10.1016/j.pain.2006.09.007

Prinsloo, S., Gabel, S., Lyle, R., & Cohen, L. (2013). Neuromodulation of Cancer Pain Integrative Cancer Therapies, 13 (1), 30-37 DOI: 10.1177/1534735413477193

Image via agnesliinnea / Pixabay.

via Brain Blogger Read More Here..

Knee Replacement Patients May Be Able to Hit the Shower Sooner

Getting area wet before sutures or staples are removed doesn't seem to raise infection risk, study finds

HealthDay news image

Source: HealthDay
Related MedlinePlus Pages: After Surgery, Knee Replacement, Wounds and Injuries via MedlinePlus Health News Read More Here..

Breast Milk Best from the Breast?

Babies were more likely to get ear infections if they were fed pumped milk, study found

HealthDay news image

Source: HealthDay
Related MedlinePlus Pages: Breastfeeding, Diarrhea, Ear Infections via MedlinePlus Health News Read More Here..

FDA Approves Implant to Battle Opioid Addiction

Experts say steady dosing eliminates need to take medication daily to combat heroin, powerful painkillers

HealthDay news image

Source: HealthDay
Related MedlinePlus Page: Prescription Drug Abuse via MedlinePlus Health News Read More Here..

Fewer U.S. Kids Die from Abusive Head Trauma: CDC

Parent training helps prevent shaken baby syndrome, other forms of violence, experts agree
Source: HealthDay
Related MedlinePlus Pages: Child Abuse, Traumatic Brain Injury via MedlinePlus Health News Read More Here..

Fastballs a Fast Track to 'Tommy John Surgery'?

Other pitches not linked to the elbow injury, study says

HealthDay news image

Source: HealthDay
Related MedlinePlus Pages: Elbow Injuries and Disorders, Sports Injuries via MedlinePlus Health News Read More Here..

Message for Heart Failure Patients: Exercise

You'll feel better and maybe even live longer, researcher says

HealthDay news image

Source: HealthDay via Exercise and Physical Fitness New Links: MedlinePlus RSS Feed Read More Here..

Tough Economy, Alcohol Fuels Suicide Risk in Men

But similar link not seen for women
Source: HealthDay
Related MedlinePlus Pages: Alcoholism and Alcohol Abuse, Men's Health, Suicide via MedlinePlus Health News Read More Here..

Healthy Living May Offset Genetic Breast Cancer Risk

Lifestyle may matter even more when your DNA is working against you, research shows

HealthDay news image

Source: HealthDay
Related MedlinePlus Pages: Breast Cancer, Genes and Gene Therapy, Healthy Living via MedlinePlus Health News Read More Here..

Message for Heart Failure Patients: Exercise

You'll feel better and maybe even live longer, researcher says

HealthDay news image

Source: HealthDay
Related MedlinePlus Pages: Exercise and Physical Fitness, Heart Failure via MedlinePlus Health News Read More Here..

1.2 Million U.S. College Students Boozing on Average Day

And over 700,000 use marijuana, government report says

HealthDay news image

Source: HealthDay
Related MedlinePlus Pages: Alcoholism and Alcohol Abuse, College Health, Underage Drinking via MedlinePlus Health News Read More Here..

Global Recession May Have Contributed to Cancer Deaths

Health-care cuts, unemployment linked to more than 260,000 additional deaths, study finds
Source: HealthDay
Related MedlinePlus Pages: Cancer, Health Insurance, Health Statistics via MedlinePlus Health News Read More Here..

How much sleep do you really need?

We are used to hearing that 8 hours is the magic number – here's the truth via New Scientist - Health Read More Here..

Concern over high death rates for teenage cancer

Teenagers and young adults fare worse than young children for many common cancers

Related items from OnMedica

Survivors of childhood cancer more prone to autoimmune diseases
New genetic testing for childhood cancers
Beam therapy hope for childhood cancer treatment
Early life factors could increase prostate cancer risk
UK slower to diagnose child cancer than Germany
via OnMedica News Read More Here..

Healthy deserts

Article May 27, 2016

Have your cake and eat it with these delicious healthy desert recipes

via Healthy Eating Read More..

NHS spending on private ambulances trebles

BBC investigation finds the NHS spends three times more on private ambulances than four years ago

Related items from OnMedica

Thousands of ambulance patients caught in A&E queues
Ambulance trust criticised for 111 ‘failings’
Alcohol plays central role in ambulance assaults
Better funding and capacity vital for A&E to survive
Missed A&E targets reflect cuts in social care and NHS funding
via OnMedica News Read More Here..

Doctors told to halve inappropriate antibiotic prescriptions by 2020

Prime Minister announces tough new measures to curb inappropriate antibiotic use in the UK

Related items from OnMedica

Better use of vaccines could help tackle antimicrobial resistance
Patient safety alert issued on antimicrobial resistance
Superbugs could kill 1 person every 3 seconds
Incentives announced to reduce antibiotic prescribing
GPs slash total antibiotic scrips by over 7% in a year
via OnMedica News Read More Here..

Rise in hospital admissions attributable to smoking

Admissions estimated to be attributable to smoking rise by 5% in ten years

Related items from OnMedica

One in nine people across the EU has tried e-cigarettes
Significant cuts to stop smoking services identified
E-cigarettes beneficial to UK health and help quitting
Higher hospital admission rates for male than female smokers
Smoking causes half of deaths from 12 cancers
via OnMedica News Read More Here..

Scots Ebola nurse 'may never run again'

The Scottish nurse who survived Ebola says she has been left with permanent weakness in her leg and will probably never run again. via BBC News - Health Read More Here..

Infections resist 'last antibiotic' in US

The first case of an infection that can resist the antibiotic of last resort - colistin - has been detected in the US. via BBC News - Health Read More Here..

HPV vaccine to be piloted in gay men

Charities representing gay men have branded the pilot a ‘stalling tactic’ and say a full programme should be rolled out now

Related items from OnMedica

Call for HPV vaccination to be extended to boys
Two HPV jabs protect women from genital warts
HPV vaccination extended to men who have sex with men
Quadrivalent HPV jab cleared of causal link to MS
Vaccinating girls against HPV benefits men
via OnMedica News Read More Here..

On The Pulse - May 2016

The questionable relation between dietary salt, blood pressure and hypertension
via OnMedica Blogs Read More Here..

Teen cancer death rate causes alarm

Too many teenagers and young adults are dying of some types of cancer, a Europe-wide report warns. via BBC News - Health Read More Here..

Why I wrote about my wife's miscarriage

A husband's online account of fertility problems strikes a chord via BBC News - Health Read More Here..

Not all surgeons follow checklists that prevent bad mistakes

Surgical checklists prevent avoidable mistakes, but one audit in a UK hospital found they were completed only 50 per cent of the time – empowering nurses could improve this via New Scientist - Health Read More Here..

Thursday, 26 May 2016

World Health Assembly agrees resolutions on women, children and adolescents, and healthy ageing

Delegates at the World Health Assembly today agreed to implement two new health strategies that are closely aligned with the Sustainable Development Goals. One relates to women’s children’s and adolescents’ health; the other to healthy ageing.

via WHO news Read More Here..

Blogging cells tell their stories using CRISPR gene editing

Engineered cells can use gene editing to monitor your health - a potentially revolutionary technique that could allow us to spy on infections and cancer via New Scientist - Health Read More Here..

See-through brains reveal memory pathways for pleasure and fear

Pleasure and fear memories are laid down using different neuronal pathways, a discovery that could lead to more targeted treatments for depression   via New Scientist - Health Read More Here..

See-through brains reveal memory pathways for pleasure and fear

Pleasure and fear memories are laid down using different neuronal pathways, a discovery that could lead to more targeted treatments for depression   via New Scientist - Health Read More Here..

2 New Findings Offer Hope for Those with Severe Hemophilia

One pinpoints when standard therapy works best, while the other uncovers the promise of a new drug

HealthDay news image

Source: HealthDay
Related MedlinePlus Pages: Hemophilia, Medicines via MedlinePlus Health News Read More Here..

Genetic Insights May Help Kids Battling Developmental Delays

DNA analysis led to better treatments in 4 of 10 cases studied

HealthDay news image

Source: HealthDay
Related MedlinePlus Pages: Children's Health, Developmental Disabilities, Genetic Testing via MedlinePlus Health News Read More Here..

Researchers Find 8 Immune Genes in Aggressive Brain Cancer

Discovery might eventually lead to better treatment for glioblastoma multiforme
Source: HealthDay
Related MedlinePlus Pages: Brain Tumors, Genetic Testing via MedlinePlus Health News Read More Here..

Smoking Harms Black Americans' Kidneys, Study Suggests

Researchers say inflammation or cigarette by-product may play a role

HealthDay news image

Source: HealthDay
Related MedlinePlus Pages: African American Health, Kidney Diseases, Smoking via MedlinePlus Health News Read More Here..

'Fat Shaming' Begins in First Grade

Weight bias affects all aspects of obese kids' lives, researchers say
Source: HealthDay
Related MedlinePlus Pages: Obesity in Children, School Health via MedlinePlus Health News Read More Here..

Hepatitis C Patients More Likely to Drink, Study Finds

And researchers say alcohol can worsen the chronic liver condition

HealthDay news image

Source: HealthDay
Related MedlinePlus Pages: Alcoholism and Alcohol Abuse, Hepatitis C via MedlinePlus Health News Read More Here..

Common Abnormal Heart Rhythm Linked to Cancer Risk

But study only found an association and doesn't prove that atrial fibrillation causes cancer

HealthDay news image

Source: HealthDay
Related MedlinePlus Pages: Atrial Fibrillation, Cancer, Women's Health via MedlinePlus Health News Read More Here..

Kids' Grades May Suffer When Families Move

The more times a family changed homes, the worse kids performed in math, reading, study found

HealthDay news image

Source: HealthDay
Related MedlinePlus Pages: Child Development, Family Issues, School Health via MedlinePlus Health News Read More Here..

Predeployment Riskiest Time for Military Suicide Attempts

Two months into service is a pivotal period, study finds

HealthDay news image

Source: HealthDay
Related MedlinePlus Pages: Suicide, Veterans and Military Health via MedlinePlus Health News Read More Here..

Pot While Pregnant May Raise Premature Birth Risk

Experts' advice to expectant mothers on marijuana use is same as for alcohol and tobacco: Don't do it

HealthDay news image

Source: HealthDay
Related MedlinePlus Pages: Marijuana, Pregnancy, Pregnancy and Substance Abuse via MedlinePlus Health News Read More Here..

Practices struggling to recruit can access up to £12K

NHS England offers allowances to help attract returning GPs into posts vacant for a year

Related items from OnMedica

GP returners to get £2,300 a month in new scheme
Workforce shortages threaten delivery of NHS Five Year Forward View
GP funding has reached dangerous levels
Make GP a more attractive career, agree MPs
Five year plan for general practice unveiled
via OnMedica News Read More Here..

Poor discharge of elderly people costs NHS £820m

Current management by health and social care system is poor value for money, says NAO

Related items from OnMedica

A collaborative cure for NHS discharge communications
NHS issues warning on poor discharge communication
Hospitals discharge processes putting patients at risk, Healthwatch England finds
Use billions wasted on bed-blocking to bolster residential care, urges think tank
Hospitals sending home sick, vulnerable patients
via OnMedica News Read More Here..