Month: November 2013

19 natural remedies for anxiety

You’re anxious, worried, freaked. You’re upset about (pick one): money, health, work, family, love. Your heart is beating fast, your breathing is shallow and rapid, your mind is imagining doom, and you wish you could just relax…now! Whether you have a full-blown anxiety disorder or are just freaking out, you may not want to try medication—at least not yet.

There are many safe nondrug remedies for anxiety, from mind-body techniques to supplements to calming teas. Some start working right away, while others may help lessen anxiety over time.

Chamomile

If you have a jittery moment, a cuppa chamomile tea might help calm you down. Some compounds in chamomile (Matricaria recutita) bind to the same brain receptors as drugs like Valium.

You can also take it as a supplement, typically standardized to contain 1.2 percent apigenin (an active ingredient), along with dried chamomile flowers. In one study at the University of Pennsylvania Medical Center, in Philadelphia, patients with generalized anxiety disorder (GAD) who took chamomile supplements for eight weeks had a significant decrease in anxiety symptoms compared to patients taking placebo.

L-theanine (or green tea)

They say Japanese Buddhist monks could meditate for hours, both alert and relaxed. One reason may have been an amino acid in their green tea called L-theanine, says Mark Blumenthal, of the American Botanical Council.

Research shows that L-theanine helps curb a rising heart rate and blood pressure, and a few small human studies have found that it reduces anxiety. In one study, anxiety-prone subjects were calmer and more focused during a test if they took 200 milligrams of L-theanine beforehand.

You can get that much L-theanine from green tea, but you’ll have to drink many cups—as few as five, as many as 20.

Hops

Yes, it’s in beer, but you won’t get the tranquilizing benefits of the bitter herb hops (Humulus lupulus) from a brew. The sedative compound in hops is a volatile oil, so you get it in extracts and tinctures—and as aromatherapy in hops pillows.

“It’s very bitter, so you don’t see it in tea much, unless combined with chamomile or mint,” says Blumenthal. Hops is often used as a sedative, to promote sleep, often with another herb, valerian. Note: Don’t take sedative herbs if you are taking a prescription tranquilizer or sedative, and let your doctor know any supplements you are taking.

Valerian

Some herbal supplements reduce anxiety without making you sleepy (such as L-theanine), while others are sedatives. Valerian (Valeriana officinalis) is squarely in the second category. It is a sleep aid, for insomnia. It contains sedative compounds; the German government has approved it as a treatment for sleep problems.

Valerian smells kind of nasty, so most people take it as a capsule or tincture, rather than a tea. If you want to try it, take it in the evening—not before you go to work! Valerian is often combined with other sedative herbs such as hops, chamomile, and lemon balm.

Lemon balm

Named after the Greek word for “honey bee,” lemon balm (Melissa officinalis), has been used at least since the Middle Ages to reduce stress and anxiety, and help with sleep. In one study of healthy volunteers, those who took standardized lemon balm extracts (600 mg) were more calm and alert than those who took a placebo.

While it’s generally safe, be aware that some studies have found that taking too much can actually make you more anxious. So follow directions and start with the smallest dose. Lemon balm is sold as a tea, capsule, and tincture. It’s often combined with other calming herbs such as hops, chamomile, and valerian.

Exercise

Exercise is safe, good for the brain, and a powerful antidote to depression and anxiety, both immediately and in the long term. “If you exercise on a regular basis, you’ll have more self-esteem and feel healthier,” says Dr. Drew Ramsey, assistant clinical professor of psychiatry at New York-Presbyterian Hospital, Columbia University.

“One of the major causes of anxiety is worrying about illness and health, and that dissipates when you are fit.”

The 21-minute cure

Twenty-one minutes: That’s about how long it takes for exercise to reliably reduce anxiety, studies show, give or take a minute. “If you’re really anxious and you hop on a treadmill, you will feel more calm after the workout,” Ramsey says.

“I generally ask my patients to spend 20 to 30 minutes in an activity that gets their heart rate up, whether it’s a treadmill or elliptical or stair stepping—anything you like. If you rowed in college, get back to rowing. If you don’t exercise, start taking brisk walks.”

Passionflower

In spite of the name, this herb won’t help you in love. It’s a sedative; the German government has approved it for nervous restlessness. Some studies find that it can reduce symptoms of anxiety as effectively as prescription drugs. It’s often used for insomnia.

Like other sedatives, it can cause sleepiness and drowsiness, so don’t take it—or valerian, hops, kava, lemon balm, or other sedative herbs—when you are also taking a prescription sedative.

Be careful about using more than one sedative herb at a time, and don’t take passionflower for longer than one month at a time.

Lavender

The intoxicating (but safe) aroma of lavender (Lavandula hybrida) may be an “emotional” anti-inflammatory. In one study, Greek dental patients were less anxious if the waiting room was scented with lavender oil. In a Florida study, students who inhaled lavender oil scent before an exam has less anxiety—although some students said it made their minds “fuzzy” during the test.

In one German study, a specially formulated lavender pill (not available in the U.S.) was shown to reduce anxiety symptoms in people with Generalized Anxiety Disorder (GAD) as effectively as lorazepam (brand name: Ativan), an anti-anxiety medication in the same class as Valium.

Hold your breath!

Ok, let it out now. We’re not recommending that you turn blue, but yoga breathing has been shown to be effective in lowering stress and anxiety. In his bestselling 2011 book Spontaneous Happiness, Dr. Andrew Weil introduced a classic yoga breathing technique he calls the 4-7-8 breath.

One reason it works is that you can’t breathe deeply and be anxious at the same time. To do the 4-7-8 breath, exhale completely through your mouth, then inhale through your nose for a count of four. Hold your breath for a count of seven. Now let it out slowly through your mouth for a count of eight. Repeat at least twice a day.

Eat something, quick

“Almost universally, people get more anxious and irritable when they are hungry,” says Ramsey, coauthor of The Happiness Diet. “When you get an anxiety attack, it may mean your blood sugar is dropping. The best thing to do is to have a quick sustaining snack, like a handful of walnuts, or a piece of dark chocolate, along with a glass of water or a nice cup of hot tea.”

In the long term, diet is key to reducing anxiety, says Ramsey. His advice: Eat a whole-foods, plant-based diet with carefully selected meat and seafood, plenty of leafy greens (such as kale) to get folate, and a wide variety of phytonutrients to help reduce anxiety.

Eat breakfast

Stop starving yourself, advises Ramsey. “Many people with anxiety disorders skip breakfast. I recommend that people eat things like eggs, which are a satiating and filling protein, and are nature’s top source of choline. Low levels of choline are associated with increased anxiety.”

Eat omega-3s

You know fish oils are good for the heart, and perhaps they protect against depression. Add anxiety to the list. In one study, students who took 2.5 milligrams a day of mixed omega-3 fatty acids for 12 weeks had less anxiety before an exam than students taking placebo.

Experts generally recommend that you get your omega-3s from food whenever possible. Oily, cold-water fishes like salmon are the best sources of the fatty acids; a six-ounce piece of grilled wild salmon contains about 3.75 grams.

Stop catastrophizing

When you’re attacked by anxiety, it’s easy to get into a mind set known as “catastrophic thinking” or “catastrophizing.” Your mind goes to the bad terrible really horrible just unbearable things and what if they really do happen? “You think, ‘This could really ruin my life,'” says Ramsey.

Instead, take a few deep breaths, walk around the block, and consider the real probability that this problem will really spin out into catastrophe. How likely is it that you’ll lose your job, never talk to your sister again, go bankrupt?

Chances are a catastrophic outcome is a lot less likely than you think when you’re consumed with anxiety. “Very few events really change the trajectory of your life,” says Ramsey.

Get hot

Ever wonder why you feel so relaxed after a spell in the sauna or a steam room? Heating up your body reduces muscle tension and anxiety, research finds. Sensations of warmth may alter neural circuits that control mood, including those that affect the neurotransmitter serotonin. Warming up may be one of the ways that exercise—not to mention curling up by a fire with a cozy cup of tea—boosts mood.

As one group of researchers put it, “Whether lying on the beach in the midday sun on a Caribbean island, grabbing a few minutes in the sauna or spa after work, or sitting in a hot bath or Jacuzzi in the evening, we often associate feeling warm with a sense of relaxation and well-being.”

Take a ‘forest bath’

The Japanese call it Shinrin-yoku, literally “forest bath.” You and I know it as a walk in the woods. Japanese researchers measured body changes in people who walked for about 20 minutes in a beautiful forest, with the woodsy smells and the sounds of a running stream.

The forest bathers had lower stress hormone levels after their walk than they did after a comparable walk in an urban area.

Learn mindfulness meditation

Mindfulness meditation, originally a Buddhist practice but now a mainstream therapy, is particularly effective in treating anxiety, says Teresa M. Edenfield, a clinical psychologist in the Veterans Administration Medical Center in Durham, N.C., who often uses it to treat anxiety patients. “The act of practicing mindful awareness allows one to experience the true essence of each moment as it really occurs, rather than what is expected or feared,” she says.

How to begin? You can start by simply “paying attention to the present moment, intentionally, with curiosity, and with an effort to attend non-judgmentally,” Edenfield says.

Breath and question

To stay mindful, ask yourself simple questions while practicing breathing exercises, Edenfield suggests. “Sit in a comfortable place, close your eyes, and focus on how your breath feels coming in and out of your body. Now ask yourself silent questions while focusing on the breath.”

What is the temperature of the air as it enters your nose? How does your breath feel different as it leaves your body? How does the air feel as it fills your lungs?

Give yourself credit

Are you having anxious thoughts? Congratulations. You’re aware of your emotional state, and that awareness is the first step in reducing anxiety, says Edenfield.

“Remember to give yourself credit for being aware that you are having anxious thoughts, and probably body changes. This is truly a skill of mindfulness that must be learned, and is essential in making the next steps of intervening through strategies such as positive self-talk, cognitive reframing, or the use of mindfulness or relaxation strategies.”

Source: Fox News

 

20 %of Nations Medical Education Funds Go to NY

 

New York state received 20 percent of all Medicare’s graduate medical education (GME) funding while 29 states, including places struggling with a severe shortage of physicians, got less than 1 percent, according to a report published today by researchers at the George Washington (GW) University School of Public Health and Health Services (SPHHS).

New York suffers from no lack of physicians yet in 2010 the state received $2 billion in federal GME funding according to the study, which appears in the November issue of Health Affairs. At the same time, the researchers found that many states struggling with severe physician shortages received a fraction of that funding: For example, Florida received one tenth the GME funding ($268 million) and Mississippi, the state with the lowest ratio of doctors to patients in the country, received just $22 million in these federal payments.

“Such imbalances play out across the country and can affect access to health care,” said lead author Fitzhugh Mullan, MD, the Murdock Head Professor of Medicine and Health Policy, a joint position at SPHHS and the GW School of Medicine and Health Sciences. “Due to the rigid formula that governs the GME system, a disproportionate share of this federal investment in the physician workforce goes to certain states mostly in the Northeast. Unless the GME payment system is reformed, the skewed payments will continue to promote an imbalance in physician availability across the country.”

Other authors of the study include Candice Chen, MD, MPH, assistant professor of health policy and pediatrics and Erika Steinmetz, MBA, senior research scientist at the SPHHS Department of Health Policy.

The study adds to the evidence suggesting that the current system of allocating graduate medical education or GME money is based on an inflexible and outdated method, one that contributes to large imbalances in payments and a growing shortfall of physicians in some areas of the country. Since its start, the Medicare GME program has paid teaching hospitals to provide residency training for young physicians. In 2010, those teaching facilities received $10 billion in GME payments, an amount that represents the nation’s single largest public investment in the health workforce.

To find out how that $10 billion was distributed, the researchers analyzed the 2010 Medicare cost reports that list federal GME payments to teaching hospitals all over the country. The team found a disproportionate amount of Medicare GME dollars flowing to Northeastern states such as New York, Massachusetts and Rhode Island. In fact, the study shows that in these three states Medicare supports twice as many medical residents per person as the national average. And New York alone has more residents than 31 other states combined.

“Teaching hospitals in the Northeastern United States have a long history of large residency training programs, which capture a large share of GME funding,” Mullan said. “But these states also have the highest physician-to-population ratios. They are not doctor shortage states.”

While some residents move elsewhere after training, the majority of newly minted physicians set up a practice near where they were trained. Therefore, it is important that states with rural and growing populations receive appropriate support for starting and maintaining residency programs, Mullan said.

 

The study shows that many other parts of the country lose out when it comes to Medicare GME funding. Many Southern and Western states — which already face shortfalls in their physician workforce — such as Montana, Idaho, Arkansas, Wyoming, Florida and even California do not do well in terms of Medicare GME funding under the current system, according to the authors.

The researchers also found:

Large state-level differences in the number of Medicare-funded medical residents even when the density of the population is taken into account. For example, New York again is at the top of all the states with 77 Medicare-funded medical residents per 100,000 people while California has 19, Florida 14, and Arkansas has just 3.

Medicare GME payments have not kept pace with factors such as rapidly growing populations in Southern and Western United States. For example, Florida, Texas and California have rapidly growing populations yet they received substantially less GME funding in 2010.

Medicare’s current GME formula pays very different amounts to train medical residents depending on the state. For example, the federal government pays Louisiana $64,000 per year to train each medical resident but gives Connecticut $155,000 for the same job

 

  • The findings from this paper document a substantial imbalance in GME payments, one that has been frozen in place since 1997 when Congress passed a law that capped the number of residency positions at each hospital. Under the 1997 law, teaching hospitals can train any number of physicians but Medicare pays for the training only up to the allocated cap, the authors point out.
  • The end result of the cap and other inflexible attributes of the current GME system is a system that gives teaching hospitals in certain states with large numbers of practicing physicians big incentives to train more residents while shortchanging many smaller and rural states.

Ways to fix the problem include revisiting the GME payment formula and devising one that distributes GME funding so as to stimulate the growth of residency training in parts of the country that are chronically underserved or are growing rapidly. In addition, the authors say the GME funding system needs an oversight body that would look now and in the future at the distribution of GME dollars and make decisions about the best places to steer funding so that the federal government is making the wisest investment in the physician workforce.

 

Source: Science Daily

Medical education is still worth the cost

 

In 2000, the soaring dot.com industry crashed. Seven years later, the housing boom ended abruptly. With tuition rates swelling, could the medical education market be the next bubble to burst?

Probably not, concludes a paper published Oct. 30 in the New England Journal of Medicine and co-authored by Cornell health economist Sean Nicholson, since such a collapse would occur only if doctors’ incomes dropped sharply and before medical schools could act to rein in costs. However, for veterinarians, optometrists, pharmacists, dentists and certain types of newly minted M.D.s, the prognosis is not so encouraging.

The article, “A Medical Education Bubble Market?,” is co-authored by David A. Asch, M.D. ’84, professor of medicine at the University of Pennsylvania, and Marko Vujicic of the American Dental Association.

A bubble market occurs when a good becomes overvalued because buyers are willing to pay higher prices in hopes of selling it for a greater payoff. The bubble deflates when the asset suddenly returns to a more reasonable intrinsic value, leaving buyers from the peak of the boom with something worth far less than what they paid.

In U.S. health care, medical education costs have risen sharply in recent decades, but medical school slots remain competitive in part because applicants believe their lucrative future wages justify taking on significant debt. But the economics have become much less favorable in the past 15 years, the authors found, based on debt-to-income ratio – the average debt of a graduating student compared to the average annual income of a newly employed physician in that field.

chart

 

“Debt-to-income ratios reflect what students must borrow rather than what they must pay and, given whatever other assets they may have, how much into the hole they have to go,” the authors write. “Thus, these ratios may better reflect how students actually feel about buying education.”

Family physicians and psychiatrists are the worst off their first year out of school: In 2010, their debt equaled about 85 percent and 80 percent of their yearly income, respectively. That’s roughly double the ratio new doctors in those same fields faced in 1996. Doctors in specialized fields fared much better: Orthopedists, cardiologists and radiologists held a debt-to-income ratio under 35 percent – only a slight rise from 1996 levels.

But the picture is far more troubling for other doctors. The ratio for new veterinarians climbed above 160 percent in 2010, with optometrists (130 percent), pharmacists (110 percent) and dentists (95 percent) not far behind. In fact, veterinary medicine may already be in a bubble market, the authors argue.

As long as physician salaries remain high enough to justify their debt burden, medical education should avoid a similar fate. But, the authors warn, “there are strong signs that we can’t or won’t … keep paying doctors a lot of money.”

The Affordable Care Act is funded largely by reduced Medicare payments to hospitals, part of a growing demand to cut U.S. health care costs. Doctors’ incomes, though sluggish, have been spared so far but could be targeted soon as more savings are sought.

“The main point we are trying to make is the connection between what we as a society are spending on physician services and how much medical schools can charge for tuition,” said Nicholson, professor of policy analysis and management in the College of Human Ecology. “If we are serious about reducing health care spending, then that means we also need to cut the cost of creating new doctors if we want to continue to attract the most promising applicants into the profession.”

The study was funded, in part, by the American Dental Association.

Source; Cornell Chronicle

At 107, nation’s oldest veteran enjoys limelight

Richard Overton, believed to be the oldest living United States veteran at 107, accepted a box of cigars and a standing ovation Thursday with a humble demeanor and a beaming smile.

More than 100 people packed a conference room at the Stephen F. Austin building in downtown Austin to attend a pre-Veterans Day ceremony in Austin honoring Overton and Ken Wallingford, who spent 10 months in a tiger cage as a prisoner of war in Vietnam.

“I’ve gotten so many letters and so many thank yous and I enjoy every bit of it, but I’m still going to enjoy some more,” said Overton, who is planning a visit with President Barack Obama next week in Washington, D.C.

Ex-state employee

Overton, identified by the General Land Office as the nation’s oldest veteran, was born in Bastrop County. He served in the Army during World War II in the South Pacific and now lives in Austin. He sold furniture in Austin after the war and later worked for the state Treasurer’s Office.

He drives and walks without a cane. During a television interview in March, he told a reporter that he doesn’t take medicine, smokes cigars every day and takes whiskey in his morning coffee. The key to living to his age, he said, is simply “staying out of trouble.”

The day’s ceremony, sponsored by the General Land Office, also recognized Wallingford, who shared his experience in captivity in the Cambodian jungle as the audience listened in amazement.

The former Army sniper, now 65, alternately laughed and became emotional as he told the story of his imprisonment and triumphant return home.

“As we look forward to Veterans Day I hope each and every one of us can remember those who have served, and importantly, those who serve today,” said Wallingford, who is veterans liaison for the Veterans Land Board.

Emotional memories

Wallingford brought a food and water bowl, sandals, pajamas and photos from his imprisonment in April 1972 to being set free in February 1973. His voiced cracked as he described his return to the United States.

“We weren’t going to leave without you guys,” Wallingford remembered hearing in the Army helicopter on his way out.

President Lyndon B. Johnson offered Wallingford and the other POWs who returned with him the presidential suite and staff of the Brooke Army Medical Center in San Antonio, he said.

Bill McLemore, deputy commissioner for the Veterans Land Board and a retired Army colonel, served with Wallingford. “Most veterans are just looking to have someone reaffirm that what they’ve done was an honorable thing to do,” McLemore said.

Source: Houston Chronicle

 

 

Baby Carrots with Dill, Butter, and Lemon

Prep: 10 minutes; Cook: 10 minutes.

 Yield: 6 servings (serving size: about 1/2 cup)

 Nutritional Information

 Calories per serving:   82

Fat per serving:           3g

Saturated fat per serving:       1g

Monounsaturated fat per serving:      1g

Polyunsaturated fat per serving:        0.0g

Protein per serving:     2g

Carbohydrates per serving:     13g

Fiber per serving:        3g

Cholesterol per serving:          6mg

Iron per serving:          1mg

Sodium per serving:    341mg

Calcium per serving:   57mgIngredients

 Ingredients

  1. 2 cups fat-free, less-sodium chicken broth
  2. 2 pounds baby carrots, peeled and tops trimmed to 1 inch
  3. 1 tablespoon butter
  4. 2 teaspoons chopped fresh dill
  5. 1 tablespoon chopped fresh chives
  6. 1 tablespoon grated lemon rind
  7. 1 tablespoon fresh lemon juice
  8. 1/2 teaspoon salt
  9. 1/2 teaspoon freshly ground black pepper

Preparation

1. Place broth in a large pot. Arrange carrots in a metal steamer insert or bamboo steamer; place in pot. Cover; bring broth to a boil. Steam carrots for 10 minutes or just until crisp-tender. Transfer carrots to a large bowl. Add remaining ingredients; toss well. Serve immediately.

Source: Health

Kids of less-educated moms may have noisier brains

A mother’s level of education has strong implications for a child’s development. Northwestern University researchers show in a new study that low maternal education is linked to a noisier nervous system in children, which could affect their learning.

 “You really can think of it as static on your radio that then will get in the way of hearing the announcer’s voice,” says Nina Kraus, senior author of the study and researcher at the Auditory Neuroscience Laboratory at Northwestern University.

The study, published in the Journal of Neuroscience, is part of a larger initiative working with children in public high schools in inner-city Chicago. The adolescents are tracked from ninth to 12th grade. An additional group of children in the gang-reduction zones of Los Angeles are also being tracked.

Kraus and colleagues are more broadly looking at how music experience, through classroom group-based musical experience, could offset certain negative effects of poverty.  But first, they wanted to see what biological effects poverty may have on the adolescents’ brain. In this particular study, 66 children – a small sample – in Chicago participated.

Those whose mothers had a “lower education” tended to have not graduated from high school. Kraus’s study did not directly track income of families, but most children in the study qualified for free lunch (to be eligible, a family of four must have income of about $29,000 or less).

Researchers found “children from lower-SES (socioeconomic status) backgrounds are exposed to less complex and linguistically rich input in addition to hearing fewer words per hour from their caregivers,” according to the study.

The new study shows that in a group of adolescents from inner-city Chicago, the nervous system is different, depending on an individual’s mother’s level of education– both in the absence of stimulation, and when the brain is stimulated by sound. The same children who showed more “noise” in the nervous system performed worse on standardized tests of memory and reading. Researchers used scalp electrodes to measure the ongoing electrical activity in kids’ brains.

Among children of less-educated mothers, study authors found more noise in the absence of sound, compared to those with mothers who had more education.  Additionally, the nervous system’s response to sound was less strong and less precise among children of less-educated mothers.

“You have this double whammy, if you will, of having a poorer signal coming through, and heightened background neural activity,” Kraus said. “That’s a signal-to-noise disaster.”

Kraus and colleagues also found that when children of lower-educated mother hear the same sound repeatedly, nervous system responses tended to vary, whereas those of more highly-educated mothers responded the same way each time.

“If the nervous system responds inconsistently to the same sound, how is a kid to learn what the sound means, because he’s getting this jittered input?” Kraus said.

Researchers saw that the sound waves and brain waves physically resemble each other, so they could see what components of the sounds a child’s brain is processing, or not. “The implications are very important once, vis-a-vis education. It just reinforces the idea that education is important, not just for you but for your children,” Kraus said.

You might be asking yourself: Is nature or nurture to blame? “It’s difficult to know where the deprivation starts,” Kraus said. “The data here point to environmental causes.”

Although this study did not measure other lifestyle factors directly, low maternal education is associated with poorer nutrition, less availability of books in the home, less exercise and less encouragement of children do their homework, Kraus said. All of these deficiencies could play a role in the development of a child’s nervous system.

Previous research has also indicated that a mother’s education matters in terms of a child’s auditory development and auditory language enrichment, which is necessary for language skills to develop. A study by Betty Hart and Todd R. Risley found that by the time a child from a family on welfare is 3 years old, he or she will have heard 30 million fewer words than if the parents are professionals. By the fourth year, an average child in a professional family would have accumulated experience with almost 45 million words, compared to an average child in a welfare family (13 million words).

Welfare children tend to also hear far more discouraging language than those whose parents are professionals, the research showed. When young children aren’t being exposed to a wealth of words, and the language they do hear is more negative than what their peers hear, their development can be noticeably different.

The researchers are interested to see what effect music education has on these children and the others in their study. Their hypothesis is that music will help, especially with strengthening language skills.

“In the same way as getting linguistic stimulation is a form of enrichment, because you are making sound-to-meaning connections all the time, and you are strengthening circuits in the nervous system that are important for language, music also strengthens many of these same circuits,” Kraus said.

A second study released this week in JAMA Pediatrics shows poverty also affects the hippocampus and amygdala parts of children’s brains.

Source: CNN health

A baby’s gaze may signal autism, study finds

When and how long a baby looks at other people’s eyes offers the earliest behavioral sign to date that a child is likely to develop autism, scientists are reporting.

In a study published Wednesday, researchers using eye-tracking technology found that children who were found to have autism at age 3 looked less at people’s eyes when they were babies than children who did not develop autism.

But contrary to what the researchers expected, the difference was not apparent at birth. It emerged in the next few months, and autism experts said that might suggest a window during which the progression toward autism can be halted or slowed.

The study, published online in the journal Nature, found that infants who later developed autism began spending less time looking at people’s eyes between 2 and 6 months of age and paid less attention to eyes as they grew older. By contrast, babies who did not develop autism looked increasingly at people’s eyes until about 9 months old, and then kept their attention to eyes fairly constant into toddlerhood.

“This paper is a major leap forward,” said Dr. Lonnie Zwaigenbaum, a pediatrician and autism researcher at the University of Alberta who was not involved in the study. “Documenting that there’s a developmental difference between 2 and 6 months is a major, major finding.”

The authors, Warren R. Jones and Ami Klin, both of the Marcus Autism Center and Emory University, also found that babies who showed the steepest decline in looking at people’s eyes over time developed the most severe autism.

“Kids whose eye fixation falls off most rapidly are the ones who later on are the most socially disabled and show the most symptoms,” said Jones, director of research at the autism center.

“These are the earliest known signs of social disability, and they are associated with outcome and with symptom severity. Our ultimate goal is to translate this discovery into a tool for early identification” of children with autism.

The eye-tracking differences are not something parents and pediatricians would be able to perceive without the technology and expertise of an autism clinic, Jones said. “We don’t want to create concern in parents that if a child isn’t looking them in the eyes all the time, it’s a problem,” he said. “It’s not. Children are looking all over the place.”

Autism therapies have not yet been developed for young babies, but there are efforts to adapt intensive behavioral therapy for use with children as young as 12 months, Jones said.

Diagnoses of autism have increased, according to the Centers for Disease Control and Prevention, from one child in 150 in 2002 to one in 88 in 2008. The reasons are unclear, although some factors could be greater awareness of the disorder and a growing number of older fathers.

Jones and Klin, who directs the autism center, studied two groups of babies. One group was at high risk for autism, with a 20 times greater likelihood of developing it because they had siblings with the disorder. The other group was at low risk, with no relatives with autism.

The researchers assessed 110 children, from 2 months to 2 years of age, 10 times while watching videos of friendly women acting like playful caregivers. Eye-tracking technology traced when the babies looked at the women’s eyes, mouths and bodies, as well as toys or other objects in the background. At age 3, the children were evaluated for autism. Ultimately, researchers used data from 36 boys, 11 of whom developed autism. (They excluded data from girls, because only two developed autism.)

While the number of children studied was small – and the researchers are now studying more children – experts not involved in the study said the results were significant because of the careful and repeated measurements that were not just snapshots, but showed change over time.

“It’s well done and very important,” said Dr. Geraldine Dawson, director of the Center for Autism Diagnosis and Treatment at Duke University. She said it was notable that “early on these babies look quite normal; this really gives us a clue to brain development.”

She said a possible explanation was that, early in life, activities like looking at faces are essentially reflexes “controlled by lower cortical regions of the brain that are likely intact” in children with autism. But “as the brain develops, babies begin to use these behaviors in a more intentional way. They can look at what they want to look at. We think that these higher cortical regions are the ones that are not working the same” as in typical children.

The researchers found that children who developed autism paid somewhat more attention to mouths and sustained attention to bodies past the age when typical children became less interested. Even more noticeable was that children who developed autism looked more at objects after the first year, while typical children’s interest in objects declined.

“We’re measuring what babies see, but more importantly we’re measuring what they don’t see,” Jones said.

Source: NDTV

Cornmeal Coconut Biscotti

When I use grainy flour like cornmeal I always include some fat in the biscotti, and this time I went with coconut oil, which contributes great flavor and a sweet perfume. Use fine or medium-grind cornmeal and make sure to use fine coconut flakes. I used organic sugar (not brown) for these; the sugar is off-white rather than white, and coarser than regular granulated sugar.

  • 125 grams (approximately 1 cup) whole wheat flour
  • 30 grams (approximately 1/4 cup) all-purpose flour
  • 125 grams (approximately 3/4 cup) fine or medium-ground cornmeal
  • 90 grams (approximately 1 cup) unsweetened fine coconut flakes.
  • 5 grams (approximately 1 teaspoon) baking powder
  • Pinch of salt
  • 55 grams (2 ounces) coconut oil
  • 125 grams (2/3 cup tightly packed) organic sugar
  • 165 grams (3 large) eggs
  • 5 grams (approximately 1 teaspoon) vanilla extract

1. Preheat the oven to 300 degrees. Line a baking sheet with parchment. Whisk together the flours, cornmeal, coconut flakes, baking powder and salt in a bowl.

2. In the bowl of a stand mixer, or in a large bowl with a whisk or electric beater, beat together the coconut oil and sugar at medium speed for 2 minutes. Scrape down the sides of the bowl and the beater. Add the eggs and vanilla and beat together for another minute. Scrape down the sides of the bowl and the beater. Turn off the mixer and add the flour mixture. Mix in at low speed until combined. The batter will be moist and sticky.

3. using a spatula or a bowl scraper, scrape out half the batter onto the baking sheet. Moisten your hands so the dough won’t stick, and form a log, about 10 inches long by 2 1/2 inches wide. Repeat with the other half of the batter. The logs can be on the same baking sheet but make sure there is at least 2 inches of space between them.

4. Place in the oven and bake 40 to 45 minutes, until lightly browned, beginning to crack on the top, and dry. Remove from the oven and cool on a rack for 20 minutes (or longer). Place on a cutting board and cut 1/2 inch slices straight across the logs.

5. Place the cookies on baking sheets and return, one sheet at a time, to the middle rack of the oven. Bake 15 minutes and flip the biscotti over. Bake another 10 minutes, or until lightly browned. Remove from the heat and allow cooling.

Yield: 3 dozen biscotti

Advance preparation: You can bake the logs a day ahead and slice and double bake the cookies the next day. Biscotti keep for a couple of weeks in a tin or a jar.

Nutritional information per cookie (3 dozen): 76 calories; 4 grams fat; 3 grams saturated fat; 0 grams polyunsaturated fat; 0 grams monounsaturated fat; 16 milligrams cholesterol; 10 grams carbohydrates; 1 gram dietary fiber; 22 milligrams sodium; 2 grams protein

Source: The New York Times

 

AIIMS ties up with Australian University for improving trauma care in India

The All India Institute of Medical Sciences (AIIMS) has tied up with Australia’s Alfred Health and Monash University to strengthen trauma-care systemsacross the country.

Under the project, both the countries will exchange and share their trauma care services, expertise and research information to improve trauma care systems.

The Australian and Indian Governments are investing over 2.6 million dollars through their Australia-India Strategic Research Fund Grand Challenge Scheme, to find the best ways of delivering needed care to injured people.

“Trauma-care systems in India are at a nascent stage of development. Industrialised cities, rural towns and villages co-exist with almost complete lack of organised trauma care. There is gross disparity between trauma services available in various parts of the country,” said Dr Subodh Kumar, Additional Professor of Surgery, Jay Prakash Narayan Apex Trauma Centre, AIIMS.

Rural India has inefficient services for trauma care, due to the varied topography, financial constraints and lack of appropriate health infrastructure, he said, adding there is no national lead agency to co-ordinate various components of a trauma system.

 

Further, he said that, there is no mechanism for accreditation of trauma centres and professionals exists.

“A nation-wide survey encompassing various facilities has demonstrated significant deficiencies in current trauma systems,” he said.

The project will be led by AIIMS Director and AIIMS trauma centre chief M C Mishra.

The National Trauma Research Institute is also a lead partner in the collaboration.

The bilateral research and development collaborative sponsored by the Government of India and the Australian Government will be announced at the sixth International Congress–TRAUMA 2013, to be held here between November 8 and 10.

The event is being organised by the Indian Society for Trauma and Acute Care (ISTAC) along with the AIIMS Trauma Centre.

Source: The Economic Times

 

Dr Santosh Honavar wins Jerry A Shields International Award

Dr Santosh G Honavar, director of medical services, Centre for Sight Group of Eye Hospitals, has won the Jerry A Shields International Award for Excellence in Ocular Oncology. The award will be presented to him at the International Symposium of Ophthalmology at Guangzhou, China on November 10.

Dr Honavar currently heads the Centre of Excellence in Ophthalmic and Facial Plastic Surgery and Ocular Oncology at the Centre for Sight, Hyderabad and has established the National Retinoblastoma Foundation for the comprehensive, cost-effective, and evidence-based care of children with retinoblastoma with life, eye and vision salvage.

He is picked up for the award in recognition of his work on the management of advanced retinoblastoma with improved life, eye and vision salvage. His original clinical research has culminated in safe and cost-effective management protocols for advanced retinoblastoma that have resulted in over 95 per cent patient survival, 90 per cent eye salvage, and 85 per cent vision salvage, a paradigm change from the dismal 50 per cent mortality and 70 per cent chance for loss of an eye only a few years ago, according to a media release.

Retinoblastoma is the most common cancer of the eye in children. Its significance lies in the fact that in countries like India, it is often left undiagnosed, and hence untreated for too long, resulting in high mortality. Over 75 per cent of the children present with very advanced tumours in India, and 50 per cent of them would die, before Dr Honavar applied the existing treatment protocol, the release said.

Dr Honavar’s research has had significant impact on the diagnosis and management of retinoblastoma and its outcome. His major contributions encompass all aspects of diagnosis and management of retinoblastoma including recognition of atypical manifestations, high-dose chemoreduction to optimize visual potential, refinement of the enucleation technique, identification of histopathologic high-risk factors and adjuvant therapy to reduce the risk of metastasis, multimodal therapy for orbital retinoblastoma and identification of genetic mutations.

The work on retinoblastoma led to Dr Honavar being conferred the Shanti Swaroop Bhatnagar Award by the Government of India in 2009. But it has had other, more important consequences; it has led to the consolidation of a distinct subspecialty in eye care, ocular oncology, with students completing their training, and moving on to take this approach to care to other centres in India and elsewhere, the release added.

Source: India medical times