Health is a fundamental human right

“The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition”.

Almost 70 years after these words were adopted in the Constitution of the World Health Organization, they are more powerful and relevant than ever. via WHO news Read More Here..

Vaccination plea after Halesworth boy's meningitis death

The parents of a boy, six, who died from meningitis B have called on all children to be vaccinated. via BBC News - Health Read More Here..

Mum campaigns for disabled toilets with selfies on the loo

A mum is taking photos of herself on the loo to campaign for disabled toilet facilities. via BBC News - Health Read More Here..

'Pimp My Zimmer' reduces falls

Care home residents in Wales have been decorating their Zimmer frames to make them more identifiable. via BBC News - Health Read More Here..

Uganda ends Marburg virus disease outbreak

Uganda has successfully controlled an outbreak of Marburg virus disease and prevented its spread only weeks after it was first detected, the World Health Organization said on Friday (December 8).

“Uganda has led an exemplary response. Health authorities and partners, with the support of WHO, were able to detect and control the spread of Marburg virus disease within a matter of weeks,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. via WHO news Read More Here..

Uganda ends Marburg virus disease outbreak

Uganda has successfully controlled an outbreak of Marburg virus disease and prevented its spread only weeks after it was first detected, the World Health Organization said on Friday (December 8).

“Uganda has led an exemplary response. Health authorities and partners, with the support of WHO, were able to detect and control the spread of Marburg virus disease within a matter of weeks,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. via WHO news Read More Here..

Call for lung health screening in top football clubs

Three in 10 elite footballers may be affected by exercise-induced asthma, a study has found. via BBC News - Health Read More Here..

Warning over eating raw dough due to E. coli risk in flour

US food chiefs have updated guidelines after investigating an E. coli outbreak caused by flour. via BBC News - Health Read More Here..

'£1 saved my life and found me love'

Two young stroke survivors meet by chance and fall in love. via BBC News - Health Read More Here..

A mother's loneliness

When Lauren Thomas, 19, became a mother, she found the experience incredibly lonely. via BBC News - Health Read More Here..

Dying mother starts petition to lower age of breast screening

A mother dying from breast cancer has set up a campaign to expand a screening programme. via BBC News - Health Read More Here..

Anorexic student Averil Hart 'let down' by NHS

University student Averil Hart's family said she starved herself to death in 10 weeks. via BBC News - Health Read More Here..

The Neuroscience Behind the Placebo Effect

As a child, did you ever feel better after your mother kissed your bumped knee? How do you think that worked? The power of suggestion—or the placebo effect—is a powerful psychological phenomenon that affects every aspect of our lives, dictating our preferences for food, drink, medication, social activities, and more.

Pioneering experiments describing the use of sham drugs date back to the late 18^th century. A version of John Quincy’s Lexicon Medicum published in 1811 defines the placebo as ‘an epithet given to any medicine adapted more to please than to benefit the patient’. However, physicians of the past tended to use forms of treatment that they assumed were ineffective, as opposed to the modern day usage of inert substances.

A wide variety of conditions have been proven to be amenable to placebos, including depression, sleep disorders, Parkinson’s disease, and pain². The placebo effect has been shown to impart tangible changes on the immune system similar to those who received real medication, where patients given syrup had increased white blood cell counts. Remarkably, patients with Parkinson’s disease stopped experiencing tremors and muscle stiffness after taking inert sugar pills. The success of mirror therapy in relieving phantom pain in amputees can be thought of as another example of the power of suggestion.

How our minds are fooled is not fully understood. The placebo effect may be an evolutionary adaptation that allows the brain to make quick decisions and assumptions about the environment. Consider this: if we had to analyse every single stimulus that our environment threws at us, we’d go mad in no time.

Scientists have identified that the psychological mechanisms of the placebo effect lie in both conscious expectations and learning. Although learning and expectations are not mutually exclusive, they are heavily dependent on each other.

To explain, when we expect a drug to reduce pain levels, our brains release endogenous endorphins that in turn are responsible for alleviating pain. On the other hand, the learning process involves integrating environmental and social cues in order to generate an internal expectation and subsequent placebo response. Experiencing repeated patterns of learning conditions (as in classical conditioning – think Pavlov’s dogs), causes a person to respond in a way that has spill-over-effects effects that influence unconscious physiological processes.

Multiple studies have singled out the ventromedial prefrontal cortex (vmPFC) as a main player in mediating the placebo effect. Other areas of significant importance are the dorsolateral PFC, lateral orbitofrontal cortex, periaqueductal grey area, rostroventral medulla, and nucleus accumbens-ventral striatum.

In short, the complex underlying neuronal circuits involve the higher functioning areas of the brain (frontal cortices) and the seat of unconscious processes such as breathing, the brainstem. Interestingly, rsearch reports that the placebo effect is absent in those with Alzheimer’s disease (due to degeneration of the frontal cortex) and in patients subjected to external suppression of frontal cortex function via transcranial magnetic stimulation.

The endogenous opioid system and its role in placebo-induced analgesia is perhaps the best studied neurotransmitter system involved in the placebo effect. Naloxone, an opioid receptor antagonist, has been found to nullify the effects of placebo pain-killers. Other systems that have been implicated include the cannabinoid system.

These neuroanatomical and neurobiological findings likely have much room for growth and refinement considering that different placebo responses have been found to invoke different parts of the placebo circuit.

Given the complicated psychological mechanisms behind the placebo, it comes as no surprise that various factors are able to modulate its strength. Social context has a real impact on the placebo effect, as it fosters preconceived notions regarding treatment. For example, several trials showed that similar benefits were experienced by both groups of patients who underwent either traditional or sham Chinese acupuncture (the latter involving superficial needling at non-acupuncture points). The physician attitude and appearance of competency, as well as the cost, branding, shape, size, color, and taste of the pills were able to affect the perceived treatment efficacy.

It is common beleif that one must be unaware of the placebo in order for the placebo effect to work. Not so, argue a group of researchers from the University of Basel (Switzerland) and Harvard Medical School. They demonstrated that participants who were told that they were getting placebos and who received detailed explanations of the placebo effect experienced significant relief from heat-induced pain compared to those that were not told that they were given bogus drugs.

These surprising results underscore the formidable effects of the placebo effect and how much more there is still left to learn. Furthermore, this study opens doors to more ethically designed placebo-controlled studies. Withholding potentially beneficial treatment from patients in placebo-controlled trials is considered inherently unethical. However, with this study, it appears that full disclosure may not be that different to the traditional practices of keeping placebo patient groups in the dark.

In order to manipulate the placebo effect for clinical benefit, the notion of placebo responders and non-placebo responders was investigated. Are some people more amenable to the power of suggestion than others? If so, is it due to unchangeable genetic makeup or individual personality? Other questions that come to mind regard the persistency of the placebo effect. For how long does it last and does it transfer to other types of placebos? To illustrate, will a person responding to placebo painkillers for pain relief also respond to placebo antidepressants for improved moods?

In conclusion, we know that the placebo is a strong weapon in the clinician’s armamentarium. Despite that, the unpredictable variability of its effects obligates future research that enables us to get a better understanding of exactly when and for how long the placebo effect will work.

References:

de craen A, Kaptchuk T, Tijssen J et al. Placebos and placebo effects in medicine: historical overview. J R Soc Med. 1999;92:511-515. PMCID: PMC1297390

Price DD, Finniss DG, Benedetti F. A comprehensive review of the placebo effect: recent advances and current thought. Annu. Rev. Psychol. 2008. 59:565–90. doi:10.1146/annurev.psych.59.113006.095941

Colloca L, Miller FG. How placebo responses are formed: a learning perspective. Philosophical Transactions of the Royal Society B: Biological Sciences. 2011;366(1572):1859-1869. doi:10.1098/rstb.2010.0398.

Geuter S, Koban L, Wager TD. The cognitive neuroscience of placebo effects: concepts, predictions and physiology. Annu. Rev. Neurosci. 2017. 40:167–88. doi:10.1146/annurev-neuro-072116-031132.

Wager TD, Atlas LY. The neuroscience of placebo effects: connecting context, learning and health. Nat Rev Neurosci. 2015 Jul;16(7):403-18. doi:10.1038/nrn3976.

Miller FG, Colloca L, Kaptchuk TJ. The placebo effect: illness and interpersonal healing. Perspectives in biology and medicine. 2009;52(4):518. doi:10.1353/pbm.0.0115.

Buckalew LW, Coffield KE. An investigation of drug expectancy as a function of capsule color and size and preparation form. J Clin Psychopharmacol. 1982 Aug;2(4):245-8. PMID: 7119132

Howe LC, Goyer, J. P., & Crum, A. J. Harnessing the placebo effect: Exploring the influence of physician characteristics on placebo response. Health Psychology. 2017;36(11):1074-82. doi:10.1037/hea0000499.

Locher C, Frey Nascimento A, Kirsch I et al. Is the rationale more important than deception? A randomized controlled trial of open-label placebo analgesia. Pain. 2017 Dec;158(12):2320-2328. doi:10.1097/j.pain.0000000000001012.

Image via frolicsomepl/Pixabay.

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Dementia: number of people affected to triple in next 30 years

As the global population ages, the number of people living with dementia is expected to triple from 50 million to 152 million by 2050.

"Nearly 10 million people develop dementia each year, 6 million of them in low- and middle-income countries," says Dr Tedros Adhanom Ghebreyesus, Director-General of WHO. "The suffering that results is enormous. This is an alarm call: we must pay greater attention to this growing challenge and ensure that all people living with dementia, wherever they live, get the care that they need." via WHO news Read More Here..

Diphtheria is spreading fast in Cox’s Bazar, Bangladesh

Diphtheria is spreading fast in Cox’s Bazar via WHO news Read More Here..

Babies' brains damaged by pollution, Unicef says

Toxic air is putting the brain development of millions of infants under one at risk, Unicef says. via BBC News - Health Read More Here..

'People with schizophrenia aren't all dangerous'

Alice, a married 26-year-old mother-of-two, has schizophrenia and is fed up of being portrayed as dangerous because of her condition. via BBC News - Health Read More Here..

'I went from a screaming room of people to deadly silence'

Mother-of-two Hannah Freimanis suffered flashbacks after the traumatic birth of her first son, Marleigh. via BBC News - Health Read More Here..

Why some people can hear this silent gif

Why are some people able to hear this gif even though it is silent? via BBC News - Health Read More Here..

Nigerian governor's sister made 'Commissioner of Happiness'

A governor appoints his sister to the new post - which also covers "couples' fulfilment". via BBC News - Health Read More Here..

Nappy sacks 'should carry death warnings'

Retailers urged to put warning signs on packs after reports of 17 infant deaths. via BBC News - Health Read More Here..

How I beat type 2 diabetes with a liquid diet

Isobel took part in an intensive weight loss programme to reverse her type 2 diabetes via BBC News - Health Read More Here..

'I beat type 2 diabetes with 200 calorie drinks'

Isobel was one of 300 people on a trial that reversed type 2 in nearly half of patients. via BBC News - Health Read More Here..

Grow your own

Heart transplantation has become a routine surgical operation, but the future promises equally amazing progress. via BBC News - Health Read More Here..

India leprosy patient's pension restored after outrage over ID card

The Indian woman could not provide fingerprints or a retina scan to get her new welfare card. via BBC News - Health Read More Here..

Lethal adrenaline rush

Frank has a heart condition that means a sudden rush of adrenaline could kill him. via BBC News - Health Read More Here..

My brain 'exploded'

A brutal attack changed Colin Robertson's life and he is now helping brain injury victims. via BBC News - Health Read More Here..

Colorado police start 'cuddle club' for colleague's baby

When a police officer's baby was born prematurely, colleagues formed a "cuddle club" to comfort him. via BBC News - Health Read More Here..

One in five patients regularly miss GP appointments

Missed GP appointments cost the NHS time and money and a new study reveals the extent of the problem. via BBC News - Health Read More Here..

'Lady bro' convinces Calgary airport to cut tampon price

An anonymous hero has been dubbed a "lady bro" for offering free tampons in an airport bathroom. via BBC News - Health Read More Here..

Asthma sufferers urged to wear scarves in cold to stop attacks

This can help to warm up winter air before it is breathed in and reduce the risk of an attack. via BBC News - Health Read More Here..

Philippines launches probe into dengue vaccine scare

French firm Sanofi has said it could worsen the potentially deadly disease in people not previously infected. via BBC News - Health Read More Here..

India doctors fired for mistakenly declaring newborn dead

The hospital which employed the doctors said the "strict action" was taken after an initial inquiry. via BBC News - Health Read More Here..

Mental health: 'I was offered help two years later'

George Hodgson was referred to adolescent mental health services - but faced a two-year wait. via BBC News - Health Read More Here..

Improving the lives of people with disability – the role of data

Gloria Cerón knows disability is an important issue all over the world, particularly in her own country of Chile.

But through a WHO-backed initiative, she and her colleagues at Chile’s National Disability Service have developed up-to-date information on disability in her Latin American nation, and are using this to strengthen services for people who need them. via WHO news Read More Here..

Fresh heart

It is 50 years since the first heart transplant took place, ushering in a new era of media attention and medical celebrity. via BBC News - Health Read More Here..

United Nations leaders call on the Saudi-led coalition to fully lift blockade of Yemeni Red Sea ports

The partial lifting of the blockade of Yemen’s Red Sea ports by the Saudi-led coalition in recent days is allowing humanitarian organizations to resume the provision of life-saving assistance to people in desperate need. Given the massive scale of Yemen’s humanitarian crisis, however, all this does is slow the collapse towards a massive humanitarian tragedy costing millions of lives. It does not prevent it. Without the urgent resumption of commercial imports, especially food, fuel and medicines, millions of children, women and men risk mass hunger, disease and death.

Ongoing commercial import restrictions have led to shortages of fuel, food and other essentials, driving up prices and devastating lives and livelihoods. The price of wheat flour has risen by 30 per cent, while the price of fuel has doubled and that of trucked water has skyrocketed by 600 per cent in some locations. via WHO news Read More Here..

1.4 million vaccines from global stockpile support yellow fever control in Nigeria

The International Coordinating Group (ICG) on vaccine provision for yellow fever has provided 1.4 million vaccine doses for an immunization campaign that starts on Saturday (2 December) to help control an ongoing yellow fever outbreak in Nigeria. via WHO news Read More Here..

Completely blind backpacker travelling around the world

Mr Giles’s first solo trip was to New Orleans in 2000 - he has now visited more than 120 countries. via BBC News - Health Read More Here..

Migraine is 'not just a headache'

Tania suffers from extreme migraines that cause vomiting. A new treatment could ease that. via BBC News - Health Read More Here..

'We aim to hit the charts'

Pete Hirst has bipolar disorder and was sectioned after a spell of psychosis. via BBC News - Health Read More Here..

Anger as India doctor mistakenly declares newborn dead

The error was found when the baby's parents saw him move en route to the funeral in India. via BBC News - Health Read More Here..

World AIDS Day 2017

Statement by Dr Tedros for World AIDS Day, 1 December 2017 via WHO news Read More Here..

World Aids Day: The pioneering work of a Brighton gynaecologist

A gynaecologist from Brighton was the first doctor in the UK to enable a HIV-positive man to conceive a child who was HIV-free. via BBC News - Health Read More Here..

The autistic dance group body popping in Europe

Autism With Attitude (AWA) will be representing the UK at next year's European dance championships in Germany. via BBC News - Health Read More Here..

Mum's sign to help people understand her autistic son

Lisa has put a sign outside asking neighbours not to phone the police if Ryan has a 'meltdown'. via BBC News - Health Read More Here..

World Hacks: The secret HIV protection for women with cheating husbands

Could this vaginal ring help protect women from HIV in communities where men refuse to use condoms? via BBC News - Health Read More Here..

NI nursing shortage is 'worrying picture' - RQIA chief

The health regulator formally notifies the health department there is a serious nursing shortage. via BBC News - Health Read More Here..

Chris Packham wants better education for children with autism

The TV presenter and author says families want a better education for their autistic children. via BBC News - Health Read More Here..

PMQs: Thornberry and Green on NHS and Brexit funding

The government finds £350m to fund NHS services through winter in the Budget, but 11 times that amount for Brexit, says Emily Thornberry. via BBC News - Health Read More Here..