Nicole Obert – Brain Blogger http://brainblogger.com Health and Science Blog Covering Brain Topics Wed, 30 May 2018 15:00:03 +0000 en-US hourly 1 https://wordpress.org/?v=4.9.6 When Entertainment Encourages Epidemics http://brainblogger.com/2008/03/12/when-entertainment-encourages-epidemics/ http://brainblogger.com/2008/03/12/when-entertainment-encourages-epidemics/#comments Wed, 12 Mar 2008 14:20:59 +0000 http://brainblogger.com/2008/03/12/when-entertainment-encourages-epidemics/ The American Academy of Pediatrics issued a press release calling for ABC to cancel its pilot episode of a new drama Eli Stone. Renee R. Jenkins, MD, President of the AAP, accused ABC of “reckless irresponsibility” in screening a television program that may give parents the false impression that vaccines cause autism. She goes on to say that, “If parents watch this program and choose to deny their children immunizations, ABC will share in the responsibility for the suffering and deaths that occur as a result.”

Pediatricians have been battling a public perception that a link exists between autism and childhood vaccinations since the infamous 1998 British study published in The Lancet in which a researcher asserted that he had discovered a link between the MMR vaccine and autism. The study was performed on only twelve patients, and the onset of symptoms was associated only retrospectively and by the parents with the MMR vaccine. Study after study performed since then have debunked the link, but the perception remains among parents worldwide, leading many of them to delay or forego important childhood vaccinations.

Parents can hardly be blamed for their hesitancy; autism and autism spectrum disorders present a frightening specter for any parent, and with bad science clouding reality, it’s easy to see how even educated parents may teeter on the edge of the decision. On the one hand is the potential that a child might contract a disease that most people haven’t seen in the US for years (measles, mumps, or rubella), and on the other is the notion that by protecting the child from the infectious diseases, he might develop a disorder that manifests itself in an inability to interact with and relate to others normally.

Reading articles with an eye toward the bias of the author is a learned skill that is typically taught in high school and refined in the university setting. Students pursuing the hard or social sciences have additional training in reading research papers by evaluating hypotheses, interpreting statistical analyses, and determining whether the conclusions presented are adequately supported by experimental results. Many adults have never had the opportunity to read or interpret primary literature and are at the mercy of those that interpret the results and present them to the world in the popular media. We can presume that most experts in a given field are competent and forthright in presenting results, but we must also acknowledge that holding advanced degrees does not guarantee honesty, particularly when other interests and biases are present. The popular news media, therefore, does bear some responsibility for reporting data accurately and with as little bias as possible.

But what responsibility does the entertainment industry bear in presenting bad science as legitimate in a fictional setting? How much poetic license is allowable if the subject matter could potentially cause serious bodily harm, however indirect, to viewers? Where is the line between art imitating life, and life being adversely influenced by art?

References

American Academy of Pediatrics. (2008). American Academy of Pediatrics Calls for Cancellation of “Eli Stone” Premier.

WAKEFIELD, A., MURCH, S., ANTHONY, A., LINNELL, J., CASSON, D., MALIK, M., BERELOWITZ, M., DHILLON, A., THOMSON, M., HARVEY, P. (1998). Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. The Lancet, 351(9103), 637-641. DOI: 10.1016/S0140-6736(97)11096-0

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Emotional Vitality May Protect Against Heart Disease http://brainblogger.com/2008/03/03/emotional-vitality-may-protect-against-heart-disease/ http://brainblogger.com/2008/03/03/emotional-vitality-may-protect-against-heart-disease/#comments Mon, 03 Mar 2008 15:36:56 +0000 http://brainblogger.com/2008/03/03/emotional-vitality-may-protect-against-heart-disease/ BioPsychoSocial_Health.jpgWhile a number of studies have shown that negative social behaviors and emotional states tend to correlate with a lower overall level of physical health, few have sought to illuminate a link between emotional vitality and physical well-being. A recent study provides evidence that there may, indeed, be a connection. Six thousand twenty-five men and women were surveyed and followed for fifteen years; results showed that those with higher levels of emotional vitality were less likely to develop coronary heart disease (CHD).

One of the compounding factors in the study is the correlation between emotional well-being and positive lifestyle choices, such as exercising and choosing not to smoke. Similarly, lower emotional vitality levels tend to be found in smokers and people with higher BMIs. The researchers identified and adjusted for these variables, and still found a positive relationship between emotional vitality and decreased incidence of CHD.

Emotional vitality was defined by the researchers as “a sense of positive energy, the ability to effectively regulate emotion and behavior, and positive well-being, which includes feeling engaged and interested in life.” Past research has shown that measures of emotional vitality tend to remain very consistent over time. Because researchers were able to show a positive effect of emotional vitality on incidence of CHD, even when factoring out the associated positive lifestyle choices, indications remain that emotional vitality exerts a positive physiological effect on the body. Identifying the pathways by which emotional well-being affects and protects the body may prove to be a promising and productive area of research.

Because emotional vitality is known to be a highly stable characteristic, early intervention may be a critical link in contributing to overall well-being; that is, preventing depressive behaviors from dominating one’s sense of self and energy may not only lead to more positive psychological outcomes, but also a more positive physiological well-being. In addition, re-training the brain to enhance emotional vitality may also be a critical component in combating major health issues.

Reference

Kubzansky, L.D., Thurston, R.C. (2007). Emotional Vitality and Incident Coronary Heart Disease: Benefits of Healthy Psychological Functioning. Archives of General Psychiatry, 64(12), 1393-1401. DOI: 10.1001/archpsyc.64.12.1393

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Publication Bias in Reporting Drug Efficacy http://brainblogger.com/2008/02/18/publication-bias-in-reporting-drug-efficacy/ http://brainblogger.com/2008/02/18/publication-bias-in-reporting-drug-efficacy/#comments Mon, 18 Feb 2008 14:22:31 +0000 http://brainblogger.com/2008/02/18/publication-bias-in-reporting-drug-efficacy/ Drugs_Clinical_Trials2.jpgMost of us rely on the pharmaceutical industry to some extent for our health and well-being, whether it’s for an occasional round of antibiotics, a flu vaccination, or medication regularly taken for a chronic condition. The industry is regularly under fire for inflating drug prices, misleading or inappropriate advertisements, and concentrating research efforts on drugs that will elicit the highest profit, rather than on lifesaving treatments for rarer conditions. It’s easy to understand the disgruntled customer’s reaction to an exorbitantly priced pill for a necessary treatment, but it’s also not hard to rationalize that the drug companies must make sound economic decisions in order to successfully develop new lifesaving products, especially in light of the nature of the business, which is that a significant amount of the research and development budget is spent on drugs that simply don’t work as anticipated, or whose risks don’t outweigh the potential benefits.

It’s an ethically charged situation: the pharmaceutical industry does indeed profit from the illnesses and maladies of the general public, and they often hold the key to well-being, and indeed, survival, which means that the price on that key can be very dear. However, profitability in the industry attracts some of the best and brightest minds, without which, the key might never be discovered. Admittedly, there must exist a balance, and drug companies do negotiate pricing with governments and other agencies to ensure that lifesaving treatments are often available when they are needed, even to those who can’t afford the market value.

One of the crucial factors in profitability is marketability of the product. In the case of prescription drugs, the marketability depends upon the perception of efficacy by the prescribing entities, or the physicians. The medical community relies in large part on published results of clinical trials, so the nature and comprehensiveness of the body of published work about a new drug is critical to its success in the marketplace. Herein lies an ethical conflict for the drug companies: publishing perceptually negative results may negatively affect the likelihood that a drug is regularly chosen to treat a particular malady; however, not publishing available clinical results may artificially inflate the positive perception of a less-than-ideally-effective treatment.

A recent study published in the New England Journal of Medicine indicates that there may indeed exist a publication bias toward perceptually positive clinical trials. The study examined 74 industry studies reported to the FDA on twelve antidepressant drugs. The FDA evaluates all studies as positive, negative, or neither clearly positive nor clearly negative; according to the FDA evaluations, 51% of the conducted trials were positive. A thorough literature search revealed that 31% of the conducted trials never made it to publication; an analysis of the published studies revealed a 94% positive result.

The intention of this study was not to determine wrongdoing by the pharmaceutical companies or the publishing entities, but rather to determine whether a bias existed. As the results indicate that a bias does exist toward publishing positive data, or in making questionable studies appear positive, it is clear that more attention needs to be given to all clinical studies, and that the medical community may need to consider the positive bias in making treatment decisions.

Reference

Turner, E.H., Matthews, A.M., Linardatos, E., Tell, R.A., Rosenthal, R. (2008). Selective Publication of Antidepressant Trials and Its Influence on Apparent Efficacy. New England Journal of Medicine, 358(3), 252-260. DOI: 10.1056/NEJMsa065779

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Expensive Wine Just Tastes Better http://brainblogger.com/2008/02/04/expensive-wine-just-tastes-better/ http://brainblogger.com/2008/02/04/expensive-wine-just-tastes-better/#respond Mon, 04 Feb 2008 17:35:27 +0000 http://brainblogger.com/2008/02/04/expensive-wine-just-tastes-better/ Neuroscience_Neurology2.jpgA recent study reported in the Proceedings of the National Academy of Sciences demonstrates that marketing can have a significant effect on the neural mechanisms governing decision-making. The study measured the “experienced pleasantness” of three different wines, both by subjective reporting of the test subjects’ perceptions of the wines, and by measuring activity in the medial orbitofrontal cortex, a known “pleasure center” in the brain. Test results indicated that even when wines were identical, subjects’ levels of experienced pleasantness differed according to the reported price of the wine; the same wine tasted better when the subject believed that it was a sample from a $45 bottle of wine than when she was told it was from a $5 bottle.

Investigators recognized that subjects may be influenced, at least in their subjective reports of the wines, by a sense that they should find the more expensive wines to be more pleasant; however, the MRI results bore out the reports of experienced pleasantness. Furthermore, two months after the initial experiment, subjects were re-tested with the same wines, but without the pricing information. Results of the follow-up interviews showed, as expected, no difference in the perception of the identical wines.

Interestingly, areas of the brain considered primary taste centers were not affected by the difference in pricing, indicating that the experienced pleasantness is a combination of actual sensory perception and cognitive expectation of pleasure. Why might the brain make these connections? The investigators suggest that the complex task of decision-making may actually be enhanced by the expectation/sensory perception combination, in that the act of making choices often depends on past experiences. In cases like these, past experience may indicate that higher prices, at least in wines, typically translate to higher quality; coupled with neutral sensory perceptions, price truly does increase the pleasure of the taste.

How might these results affect advertising, marketing, and the economy in general? While further study on the neural basis for experienced pleasantness is necessary, it seems reasonable to conjecture that marketing and advertisements that are designed to raise the expectation of the quality of a product may, in fact, increase the consumer’s satisfaction with the project in a physiological way. This may warrant an adjustment to contemporary economic thinking, which asserts that the intrinsic quality of a product will derive its place in the market; this study indicates that artificially increasing (or decreasing) its price significantly changes the experiential pleasantness of the product. Thus, an externally-applied characteristic of the product designed to change the expectation of the quality of the product can and should be factored into its experienced utility.

Reference

Plassmann, H., O’Doherty, J., Shiv, B., & Rangel, A. (2008). Marketing actions can modulate neural representations of experienced pleasantness. Proceedings of the National Academy of Sciences, 1050-1054.

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Nuns Provide Key Insight on Aging: Oral Health and Dementia http://brainblogger.com/2008/02/02/nuns-provide-key-insight-on-aging-oral-health-and-dementia/ http://brainblogger.com/2008/02/02/nuns-provide-key-insight-on-aging-oral-health-and-dementia/#comments Sat, 02 Feb 2008 18:05:43 +0000 http://brainblogger.com/2008/02/02/nuns-provide-key-insight-on-aging-oral-health-and-dementia/ A recent finding of the Nun Study identifies oral disease as a potential risk factor for dementia, with conclusions indicating that a low number of teeth — fewer than ten — may be an accurate predictor of dementia in later life. Furthermore, the study showed that subjects with the fewest number of teeth presented with the most severe incidence of dementia.

Funded by the National Institute on Aging as well as a number of private foundations, the Nun Study is an endeavor of the Sanders-Brown Center on Aging at the University of Kentucky Chandler Medical Center intended to further research on Alzheimer’s disease and other diseases and disorders associated with the aging process. Many, if not most, studies of aging have historically focused on middle-aged, white males, and the Nun Study provides an opportunity to study women exclusively. Limitations in studies on Alzheimer’s patients often include the inability of subjects to recall information about earlier life choices and arrangements. The Nun Study is uniquely able to compensate for this probability with the contents of the convent archives, which provide records about birthplace, family history, as well as autobiographies written in mid-lives. Additionally, the sisters provide a number of built-in control factors: they live very similar lifestyles, including not smoking, drinking very little if at all, and all have similar housing, marital and reproductive statuses, occupations (approximately 85% of the sisters are or were teachers), and have similar access to health care.

The participating nuns are Roman Catholic sisters from the School Sisters of Notre Dame drawn from seven religious provinces across the United States. The 678 participants have all pledged to donate their brains to the study upon their deaths, as post-humus examination of the brain allows the researchers to accurately determine whether Alzheimer’s disease was indicated pathologically. This information is coupled with clinical indicators, such as memory loss, impairment in language, and/or impairment in social functioning to support a positive diagnosis of Alzheimer’s disease. The subjects were all between the ages of 75 and 102 when the study began. Each year, the participants are assessed in terms of cognitive and physical function, and submit to medical exams and blood tests which look at genetic and nutritive factors in aging.

The study identifying a link between oral health and dementia is only the most recent finding to be published out of the Nun Study. Other investigations have provided important information about Alzheimer’s disease and aging. One study provided a definitive neuropathological method to distinguish Alzheimer’s patients from control patients. Another utilized autobiographies gleaned from the convent archives which were written by the subjects at the age of 22. This study showed that a lower measure of linguistic ability demonstrated at this early age was correlated with higher degrees of impairment, cerebral atrophy, and clinical diagnosis of Alzheimer’s disease.

Reference

Stein, P., Desrosiers, M., Donegan, S., Yepes, J., and Kryscio, R. (2007). Tooth loss, dementia and neuropathology in the Nun Study. Journal of the American Dental Association , 138, 1314-1322.

Link to the Nun Study Web site.

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