Monday, August 31, 2009

Exercise beats surgery for some heart patients

updated 3:39 p.m. ET, Sun., Aug 30, 2009

BARCELONA, Spain - Working up a sweat may be even better than angioplasty for some heart patients, experts say.

Studies have shown heart patients benefit from exercise, and some have even shown it works better than surgical procedures. At a meeting of the European Society of Cardiology on Sunday, several experts said doctors should focus more on persuading their patients to exercise rather than simply doing angioplasties.

Angioplasty is the top treatment for people having a heart attack or hospitalized with worsening symptoms. It involves using a tiny balloon to flatten a blockage and propping the heart artery open with a mesh tube called a stent. Most angioplasties are done on a nonemergency basis, to relieve chest pain caused by clogged arteries cutting off the heart's blood supply.

"It's difficult to convince people to exercise instead of having an angioplasty, but it works," said Rainer Hambrecht of Klinikum Links der Weser in Bremen, Germany.

Hambrecht published a study in 2004 that found that nearly 90 percent of heart patients who rode bikes regularly were free of heart problems one year after they started their exercise regimen. Among patients who had an angioplasty instead, only 70 percent were problem-free after a year.


An angioplasty "only opens up one vessel blockage," said Dr. Christopher Cannon, an associate professor of medicine at Harvard University and spokesman for the American College of Cardiology. He was not linked to Hambrecht's research. "Exercise does a lot more than fixing one little problem."

Among other benefits, exercise lowers bad cholesterol while raising good cholesterol, helps the body process sugar better, improves the lining of the blood vessels and gets rid of waste material faster. Exercise also lowers blood pressure and prevents plaque buildup in the arteries.

Previous research has estimated one third of heart disease and stroke could be prevented if patients did two-and-a-half hours of brisk walking every week. In the U.S., that would mean 280,000 fewer heart-related deaths every year.

Joep Perk, a professor of health sciences at Sweden's Kalmar University and spokesman for the European Society of Cardiology, said two thirds of heart patients in line for an angioplasty could probably get better benefits by regularly working up a sweat.

Experts say less than 20 percent of heart patients get the recommended amount of exercise — about 30 minutes of moderate activity five times a week.


Still, doctors admitted that persuading patients to exercise instead of simply going in for an angioplasty, which can take less than a day, would be a tough sell.

"Most patients want the quick fix," Cannon said. Exercise may improve patients' hearts better than an angioplasty, but it may also take months or even longer for patients to feel the benefits. "It's a lot easier to get your artery fixed than it is to exercise every day."

Exercise is much cheaper than surgery, of course. It also helps us feel better.

Saturday, August 29, 2009

Job insecurity leads to health problems in U.S. workers

Aug. 27, 2009
ANN ARBOR, Mich.—Persistent job insecurity poses a major threat to worker health, according to a new study published in the September issue of the peer-reviewed journal Social Science and Medicine.

The study used long-term data from two nationally representative sample surveys of the U.S. population to assess the impact of chronic job insecurity apart from actual job loss.

"Dramatic changes in the U.S. labor market have weakened bonds between employers and employees and fueled perceptions of job insecurity," said University of Michigan sociologist Sarah Burgard, a research assistant professor at the U-M Institute for Social Research. "This study provides the strongest evidence to date that persistent job insecurity has a negative impact on worker health. In fact, chronic job insecurity was a stronger predictor of poor health than either smoking or hypertension in one of the groups we studied."


"It may seem surprising that chronically high job-insecurity is more strongly linked with health declines than actual job loss or unemployment," said Burgard, who is also affiliated with U-M's Department of Sociology and School of Public Health. "But there are a number of reasons why this is the case. Ongoing ambiguity about the future, inability to take action unless the feared event actually happens, and the lack of institutionalized supports associated with perceived insecurity are among them."


Laughing gas is biggest threat to ozone layer

Updated 18:49 28 August 2009 by Lisa Grossman

Nitrous oxide, commonly known as laughing gas, is now the dominant ozone-depleting substance emitted by humans – and is likely to remain so throughout the century, a new study suggests.

Researchers suggest use of the compound – which is produced by the breakdown of nitrogen in fertilisers and sewage treatment plants – should be reduced to avoid thinning the protective ozone layer that blankets the Earth.

The ozone layer shields Earth from the sun's ultraviolet rays, which increase the risk of cancer and threaten crops and aquatic life.

Human-produced chemicals called chlorofluorocarbons (CFCs) made headlines in the 1980s when it became clear they were eating a hole in the ozone layer above Earth's polar regions. An international treaty called the Montreal Protocol regulated production of CFCs and certain other ozone-depleting gases in 1987, and they were phased out completely by 1996.

Since then, Earth's ozone – both the polar hole and the atmospheric layer around the whole planet – has been on the mend. But the emission of nitrous oxide, which is not regulated by the Montreal Protocol, could reverse those gains – and could even make the situation worse.

"Right now, nitrous oxide is the most important ozone-depleting gas that is emitted," says A. R. Ravishankara of the US National Oceanic and Atmospheric Administration, lead author of the new research. "It will continue to be so unless something is done."

Nitrous oxide is also a heat-trapping greenhouse gas in the league of methane or carbon dioxide, so regulating it would also be good for the climate, he says.

Nitrous oxide (N2O) is produced naturally when nitrogen in soil or water is eaten by bacteria. It rises into the stratosphere, where most of it is broken down into harmless molecules of nitrogen and oxygen by the sun's rays.

But some of it remains, and can survive for hundreds of years. The compound reacts with high-energy oxygen atoms to produce a deadlier compound, nitric oxide (NO). This then goes on to destroy ozone, a molecule made up of three oxygen atoms.

Nitrous oxide has no effect on the hole in the ozone layer, Ravishankara points out, but it makes the global layer thinner.


Scientists say humans' role in producing the harmful gas has largely been overlooked. Thanks to fossil fuel combustion, which produces the gas, as well as nitrogen-based fertilisers, sewage treatment plants and other industrial processes that involve nitrogen, about one-third of the nitrous oxide emitted per year is anthropogenic [caused by human activity]


And as CFC levels abate, nitrous oxide could become even more powerful. Nitrogen and chlorine compounds counteract each others' effects on ozone – the more chlorine there is, the less effective nitrogen becomes at destroying ozone, and vice versa. As CFCs are purged from the atmosphere, nitrous oxide will become 50 per cent more potent than it was before, Ravishankara says.

"People were expecting that ozone was just going to recover from the results of human activities that resulted in CFCs," Wuebbles says. "Nitrous oxide could prevent that from happening.".

Health care industry contributes heavily to Blue Dogs

Posted on Wednesday, August 26, 2009
By Halimah Abdullah | McClatchy Newspapers

WASHINGTON — As the Obama administration and Democrats wrangled over the timing, shape and cost of health care overhaul efforts during the first half of the year, more than half the $1.1 million in campaign contributions the Democratic Party's Blue Dog Coalition received came from the pharmaceutical, health care and health insurance industries, according to watchdog organizations.

The amount outstrips contributions to other congressional political action committees during the same period, according to an analysis by the Center for Public Integrity, a nonprofit watchdog organization. The Blue Dogs, a group of fiscally conservative lawmakers, successfully delayed the vote on health care overhaul proposals until the fall.

"The business community realizes that (the Blue Dogs) are the linchpin and will become much more so as time goes on," former Mississippi congressman turned lobbyist Mike Parker told the organization's researchers.

On average, Blue Dog Democrats net $62,650 more from the health sector than other Democrats, while hospitals and nursing homes also favor them, giving, respectively, $5,680 and $5,550 more, according to the Center for Responsive Politics, a nonprofit organization that tracks the influence of money in politics.

The contributions came at a time when health care and pharmaceutical companies were mounting a campaign against a government-run public health insurance option, fearing cost controls and an impact on business. The Blue Dogs' windfall also came at a time when the 52-member coalition flexed its muscle with both the White House and the Democratic leadership in the House of Representatives as an increasingly influential bloc in the health care overhaul debate.

At the same time, many Blue Dogs were also rubbing shoulders with health care and insurance industry executives and their lobbyists at fundraising breakfasts and cocktail receptions that cost upward of $1,000 a plate, according to public information compiled by the nonprofit Sunlight Foundation, which advocates greater government transparency. Since 2008, more than half the Blue Dogs have either attended health care industry fundraising receptions or similar functions co-sponsored by lobbyists representing the health care and insurance industries.

In June, as Rep. Mike Ross, D-Ark., who heads the coalition's task force on health care, publicly expressed the Blue Dogs' misgivings about the Democratic leadership's efforts, the former pharmacy owner was feted at a series of health care industry receptions. Ross has received nearly $1 million in campaign contributions from the insurance and health care industries over his five-term career, according to the Center for Responsive Politics. Calls to Ross' office weren't returned.

That month, the American Medical Association, which lobbies for health care providers and is one of the top contributors to Blue Dogs, came out against a public option.

House Republicans, however, tend to collect more than Democrats — including Blue Dogs — from insurers, health professionals and the broader health sector, the Center for Responsive Politics found.

Many of the Blue Dogs hail from districts that are conservative-leaning and have sizable numbers of Republican voters. According to the Sunlight Foundation, a nonpartisan think tank that focuses on government transparency, Blue Dogs often take positions that are favorable to the health care industry.

During the 2008 cycle, individual members of the Blue Dog Coalition raised a combined $6.24 million from the health sector. The average contribution to a Blue Dog Democrat in the 2008 election cycle was slightly higher — $122,370 — than the average contribution to a non-coalition Democratic lawmaker — $116,748, according to the Sunlight Foundation.

Invest 94

The Atlantic and Pacific Oceans both have tropical waves named Invest 94, which have the potential to develop into tropical storms, maybe hurricanes.

Marijuana robs men of sexual highs

26 August 2009 Magazine issue 2723

DOPE smokers are trading sexual highs for the chemical kind.

That's the conclusion of Marian Pitts and her team at La Trobe University in Melbourne, Australia, who studied the results of a 2005 phone survey of 8656 men and women aged 16 to 64.

Men using marijuana were twice as likely as non-users to have had two or more sexual partners in the previous year. However, men who smoked marijuana daily were four times as likely to report having trouble reaching orgasm as men who didn't use dope.

Some had the opposite problem. Smokers were three times as likely to experience premature ejaculation as non-smokers (The Journal of Sexual Medicine, DOI: 10.1111/j.1743-6109.2009.01453.x).

Cleared man: Freedom like waking from coma

updated 7:01 p.m. ET, Thurs., Aug 20, 2009
HARTFORD, Conn. - Kenneth Ireland recently got a good look at himself in a real mirror for the first time in more than 20 years, and realized just how much he had aged in prison.

A Connecticut judge on Wednesday dismissed murder and rape charges against Ireland, after DNA tests showed he could not have committed the crime.

"It was a surreal moment," Ireland told The Associated Press on Thursday in his first in-depth interview since being released from prison. "I've never been outside in such an open environment without handcuffs and shackles. I didn't have to ask permission to walk any where or move around as I pleased."


Ireland is the third Connecticut inmate freed from prison in the past three years based on new DNA testing. The Connecticut Innocence Project represented all three men. More than 240 people nationwide have had wrongful convictions overturned by DNA testing, according to the group.

Wrongfully convicted man to get $632,000

updated 9:12 p.m. ET, Wed., Aug 19, 2009

RICHMOND, Va. - A Virginia man who spent 22 years in prison for two rapes he did not commit will get more than $632,000 in restitution, following a unanimous decision Wednesday by state lawmakers.

Arthur Whitfield, 54, of Norfolk was convicted in 1982 and sentenced to 63 years in prison. A 2004 DNA test proved his innocence and he was freed.

Whitfield needed paperwork stating his innocence in order to receive state restitution, but the Virginia Supreme Court could not issue such a finding — called a "writ of actual innocence" — because the law at that time allowed that only for those who were incarcerated.

Whitfield's only hope was a pardon from Gov. Timothy M. Kaine, but because one of the rape victims opposed the pardon it took until April for Kaine to grant it.
Eye witness reports have been shown to be very unreliable.

"When we have a victim who continues to assert that the individual is guilty, we obviously had to take some time and make sure we had that right," Kaine said Wednesday.

Whitfield recently was diagnosed with liver cancer and did not attend Wednesday's special legislative session because he was getting chemotherapy, said his lawyer, Michael Fasanaro Jr.

Whitfield has been working in a produce factory but struggles financially, Fasanaro said.

Friday, August 28, 2009

Insurers aim to save from overseas medical tourism

Updated 5d 15h ago
By Tom Murphy, The Associated Press
Elizabeth Kunz left her dentist's office this spring with a mouth full of problems and no way to pay for them.

The South Carolina resident went out of her way, literally, to find a solution, which turned out to be in Central America. Her trip to the tropics is part of a health insurance experiment for trimming medical costs: overseas care.

As Washington searches for ways to tame the country's escalating health care costs, more insurers are offering networks of surgeons and dentists in places like India and Costa Rica, where costs can be as much as 80% less than in America.

Until recently, most Americans traveling abroad for cheaper non-emergency medical care were either uninsured or wealthy. But the profile of medical tourists is changing. Now, they are more likely to be people covered by private insurers, which are looking to keep costs from spiraling out of control.

The four largest commercial U.S. health insurers — with enrollments totaling nearly 100 million people — have either launched pilot programs offering overseas travel or explored it. Several smaller insurers and brokers also have introduced travel options for hundreds of employers around the country.

Growth has been slow in part because some patients and employers have concerns about care quality and legal responsibility if something goes wrong. Plus, patients who have traditional plans with low deductibles may have little incentive to take a trip.

But a growing number of consumers with high-deductible plans, which make patients pay more out of pocket, could make these trips more inviting.

In the meantime, the insurance industry's embrace of overseas care has had a pleasant side effect at home: some U.S. care providers are offering price breaks to counter the foreign competition.

This domestic competition and the slumping economy have led to slower growth for medical tourism over the past year, as patients put off elective procedures that involve big out of pocket costs, said Paul Keckley, executive director of the Deloitte Center for Health Solutions.

Last year, the center estimated that 6 million Americans would make medical tourism trips in 2010. But Keckley has since shaved that projection to about 1.6 million people. Still, that more than doubles the roughly 750,000 Americans who traveled abroad in 2007, the last year for which Deloitte had actual numbers.

Keckley expects the medical tourism industry to recover, as more health insurers offer the option and as more people wind up with high-deductible plans.

Health care costs for employers who offer insurance to their workers were projected to rise 9.2% this year and another 9% in 2010, according to the consulting firm PricewaterhouseCoopers. That could mean double-digit percentage increases for employees through higher premiums, deductibles or copays.

Overseas care can lead to price breaks of more than $40,000, not counting travel costs, for procedures like knee replacement surgery or heart bypasses. Insurers, or employers who provide their own insurance, can save between 50% and 90% on major medical claims, said Jonathan Edelheit, president of the Florida-based Medical Tourism Association. A lower cost of living and lower prices for medical supplies and drugs help drive down care costs overseas compared to American providers.

While employers or insurers reap much of the savings, these lower costs can be the difference between a manageable expense and a bank-breaker for patients with high-deductible plans. These increasingly popular plans can lead to out-of-pocket expenses surpassing $5,000 for individual coverage and $10,000 for family plans.

High out of pocket costs also are common with dental coverage, which is one reason dental care trips have proven popular.

Kunz, 47, initially doubted the potential savings she might see from visiting a Costa Rican dentist though a program offered by her insurer, BlueCross BlueShield of South Carolina. But a little comparison shopping — with help from the insurer — persuaded her to get on a plane.

She had eight crowns replaced, a tooth filled and root canal. The work would have cost her $10,000 out of pocket back home, but she paid just $2,800 after insurance.

Ben Schreiner of Camden, S.C., would have paid the entire $10,000 deductible on his insurance policy if he had his hernia surgery done last year near home. For that reason, Schreiner, 63, had planned to wait until he turned 65 and qualified for Medicare before fixing it.

After reading about medical tourism in his insurer's annual report, the retired bank executive flew to Costa Rica and paid about $4,400, including travel expenses. Frequent flier miles covered his flight.

Schreiner said he was initially skeptical about the quality of care he might receive but reading about the doctors who could perform the surgery put him at ease.

"When you read the bios and the backgrounds of the doctors, you kind of lose your skepticism," he said.

However, apprehension about medical travel remains a high hurdle.

"People still do not understand that there could be a hospital in Thailand that can be as good as any hospital anywhere in the world or in the United States," said John Ferguson, chief marketing officer for Georgia-based BasicPlus Insurance Services.

BasicPlus, which underwrites and provides group health insurance plans to employers, started offering medical tourism as part of a benefits package last year. About 200 employers it contracts with around the country now offer that option, but no patients have used it.

Quality can be a legitimate worry, said Harvard Medical School professor Sharon Kleefield, who has worked overseas with several health care systems to establish quality measurements.

The average patient has no way of comparing hospitals worldwide on quality, which can vary widely. But, Kleefield said, insurers are helping to raise standards through careful inspections of hospitals before including them in an overseas network.

Concerns about liability also may be keeping some employers from adding overseas care options to their plans.

U.S. employers who encourage an overseas medical trip could become litigation targets. It can be difficult to sue an overseas provider in U.S. courts, said Nathan Cortez, a Southern Methodist University law school professor who studies medical tourism. And the average malpractice recovery in Thailand is about $3,000, roughly 1% of the U.S. average.

To ease this fear, medical tourism companies have started offering insurance that protects employers who send employees overseas from liability.

Some employers also have learned they don't have to send people overseas to save money.

Shortly after Hartford, Conn.-based Aetna Inc. and the Maine-based grocery chain Hannaford Bros. Co. launched a program to send patients to Singapore for hip and knee replacements, some New England hospitals countered with their own deals.

So far, three patients have benefited from the competitive pricing; Hannaford has sent no one overseas, even though the program pays travel and lodging costs.

"People travel all the time a couple hours on the interstate," said Dr. Brian Kelly, Aetna's national medical director. "That's no big deal."

WellPoint Calls Attention To Its Own Immoral Practices In Effort To Smear Health Reform

For-profit health insurance giant WellPoint fired off an email blast to its customers (using its Anthem Blue Cross Blue Shield subsidiary) yesterday attacking the public option and Democratic plans for reforming health care, according to Politico’s Ben Smith. The email directs customers to its “grassroots Web site” for instructions on contacting legislators, a website ThinkProgress revealed to be run by the secretive corporate lobbying firm Democracy Data and Communications (DDC). DDC, which is operated by a former veteran of the astroturf organization now known as FreedomWorks, has helped various corporate and Republican interests shape legislation by helping to generate seemingly organic phone calls and letters to Congress.

In the letter to its customers, WellPoint makes a variety of false charges against health reform. Ironically, the attacks WellPoint makes against the public option are more appropriate criticisms of the way the private insurer does business:

1. THE LETTER STATES: Health reform will “increase the premiums of those with private coverage.”

– WELLPOINT POLICIES: In a recent giddy report about WellPoint’s expected profitability to investors, Barrons reported that WellPoint will be “hiking” premiums to at least “6% to 8% annually.” In 2006, WellPoint’s profits increased 34% as premiums and fees surged.

2. THE LETTER STATES: Health reform will cause “millions of Americans to lose their private coverage” and end up in the public option.

– WELLPOINT POLICIES: In March 2007, the state’s Department of Managed Health Care fined Blue Cross of California and its parent company, WellPoint, $1 million after an investigation revealed that the insurer routinely canceled individual health policies of pregnant women and chronically ill patients. Earlier this summer, despite promises by their lobbyists to the public, WellPoint refused to end the controversial practice of rescinding coverage after an applicant files a medical claim.

While WellPoint has been busy shedding customers and increasing premiums, AMNews reported that WellPoint has cut its medical loss ratio this year — meaning a greater percentage of every premium dollar is going to profits and overhead, rather than being spent on actual medical care. Not only that, while WellPoint has tried to put a “human face” on its company by encouraging their employees to show up at town halls with corporate talking points, WellPoint has cut over 1,500 jobs since the beginning of this year. As former CIGNA executive Wendell Potter has explained, private health insurance companies like WellPoint are an ATM machine for Wall Street.

In a recent interview, NPR’s Steve Inskeep forced WellPoint CEO Angela Braly to concede her company fears that “changes in the insurance market and regulations” could cut into her profits the most. That is because, as Igor Volsky has observed, WellPoint’s business model is “antithetical to regulation,” since the company aggressively pursues healthy customers who are less likely to use benefits to pay for medical care. As the company adds healthy customers, WellPoint has made a science of finding ways to deny coverage to the sick. California regulators uncovered more than 1,200 violations of the law by the company in regard to unfair rescission and claims processing practices.

Braly, who earns nearly $10 million a year, wants “sustainable reform,” yet opposes what her company calls “Obamacare,” refuses to stop rescinding coverage to the sick, and is even suspicious of an individual mandate. Although health insurance lobbyists continue to press their case that they truly want reform “this time,” WellPoint and its stealth lobbying efforts severely undermine that claim.

Thursday, August 27, 2009

Nuisance Or Nutrient? Kudzu Shows Promise As A Dietary Supplement

ScienceDaily (Aug. 27, 2009) — Kudzu, the nuisance vine that has overgrown almost 10 million acres in the southeastern United States, may sprout into a dietary supplement. Scientists in Alabama and Iowa are reporting the first evidence that root extracts from kudzu show promise as a dietary supplement for a high-risk condition — the metabolic syndrome — that affects almost 50 million people in the United States alone. Their study appears in the current issue of ACS' Journal of Agricultural and Food Chemistry.

J. Michael Wyss and colleagues note in the new study that people with metabolic syndrome have obesity, high blood pressure, high blood cholesterol, and problems with their body's ability to use insulin. Those disorders mean a high risk for heart attacks, strokes, and other diseases. Scientists have been seeking natural substances that can treat the metabolic syndrome. The new study evaluated kudzu root extracts, which contain healthful substances called isoflavones. People in China and Japan long have used kudzu supplements as a health food.

The study found that a kudzu root extract had beneficial effects lab rats used as a model for research on the metabolic syndrome. After two months of taking the extract, the rats had lower cholesterol, blood pressure, blood sugar, and insulin levels that a control group not given the extract. Kudzu root "may provide a dietary supplement that significantly decreases the risk and severity of stroke and cardiovascular disease in at-risk individuals," the article notes.


Some people use kudzu vines to make baskets.
Also, All parts of the plant are edible. Be careful that they haven't been sprayed with poison. Try to avoid plants grown too close to the roadways as they tend to contain too much dust and automotive exhaust.

Infant Mortality Ranking Shows U.S. at 29th Place

The Centers for Disease Control and Prevention's National Center for Health Statistics says in a report that the U.S. ranks 29th worldwide in infant mortality. This has the U.S. worsening its ranking tying with Slovakia and Poland but falling behind Cuba. In 1960 the U.S. came in at 12th place and it was ranked 27th in 2004, while Japan which is ranked third has an infant mortality rate of less than half the U.S. at 2.8 per thousand live births.

Marian F. MacDorman, PhD, and T.J. Mathews, CDC researchers said, "The U.S. infant mortality rate is higher than rates in most other developed countries. The relative position of the United States in comparison to countries with the lowest infant mortality rates appears to be worsening."

Infant mortality is an indicator of the health in the country and in the U.S. it is at 6.78 infant deaths per 1,000 live births. The data collected through the National Vital Statistics System showed that more than 28,000 American babies die before their first birthday. The countries which came out on the top of the list were Singapore in first place with a mortality rate of 2.0, followed by Hong Kong at 2.5 and Japan came in third at 2.8.

At the current rate infant mortality is 50 % higher than the national goal of 4.5 infant deaths per 1000 live births. The CDC report says the infant mortality rate did not decline from 2000 to 2005 but there was a 2 % decline in the years 2005 to 2006. Non Hispanic black women had an infant mortality rate that was 2.4 times higher than the non Hispanic white women. One of the biggest reasons for two thirds of infant death is premature birth and preterm birth rate in the U.S. went up from 11.6 % in 2000 to 12.7 % in 2005.

The countries that came at the bottom of the list were Russian Federation with 11.5, Bulgaria with 11.7 and Romania was at the bottom with 16.8.

This is what happens when regulatory reform is not immediately passed

Submitted by Robert Oak on Mon, 08/24/2009 - 11:29

This is what happens when regulatory reform on credit ratings, collateralized debt obligations, derivatives and innovative financial products is put on hold.

Wall Street thinks it's all fine and dandy to do the same damn thing all over again.

Big h/t to MTGM.

Wall Street repackages toxic debt:

In recent months investment banks have been repackaging old mortgage securities and offering to sell them as new products, a plan that's nearly identical to the complicated investment packages at the heart of the market's collapse.

These are holdovers from the housing bubble, when home prices soared, banks bought risky mortgages, bundled them with solid mortgages and sold them all as top-rated bonds. With investors eager to buy these bonds, lenders came up with increasingly risky mortgages, sometimes for people who could not afford them. It didn't matter because, in the end, the bonds would all get AAA ratings.

When the housing market tanked, figuring out how much those bonds were worth became nearly impossible. The banks and insurance companies that owned them knew there were still some good mortgages, so they didn't want to sell everything at fire-sale prices. But buyers knew there were many worthless loans, too, so they didn't want to pay full price for the remnants of a real estate bubble.

In recent months, banks have tiptoed toward a possible solution, one in which the really good bonds get bundled with some not-quite-so-good bonds. Banks sweeten the deal for investors and, voila, the newly repackaged bonds receive AAA ratings, a stamp of approval that means they're the safest investment you can buy.

"You've now taken what was an A-rated security and made it eligible for AAA treatment," said Richard Reilly, a partner with White & Case in New York.

What was that definition of insanity? Doing the same thing and expecting different results?

Financial gurus call it a "resecuritization of real estate mortgage investment conduits." On Wall Street, it goes by the acronym Re-Remic (it rhymes with epidemic)

I need to know more but this sounds identical to the creation of CDOs with ABS (asset backed securities).

Lest we not see these new toxic time bombs real target:

That's how the safe stack of bonds gets it AAA rating, which is crucial to the deal. That rating lets banks sell to pension funds, insurance companies and other investors that are required to hold only top-rated investments.

Tim over at MTGM mentions this will blow up if housing prices continue to decline...

So, let's point to this one for starters, NAR Q2 Home Sales & Prices, where Calculated Risk is predicting further decline in home evaluations.

I don't think we have even gotten to the CRE (Commercial Real Estate) yet...which is just starting it's downward spiral.


See the link for informative comments

Tuesday, August 25, 2009

Changes In DNA Patterns Are Linked To Prenatal Smoke Exposure

ScienceDaily (Aug. 24, 2009) — A new study by researchers at the Keck School of Medicine of the University of Southern California (USC) has found that the life-long effects of maternal smoking during pregnancy may occur through specific changes in DNA patterns.

The study found that children exposed in the womb to maternal smoking had differences in DNA methylation, an epigenetic mechanism in which small chemical compounds are added to DNA. The findings provide researchers with valuable insight into a biological process that is not well understood.


Prenatal exposure to smoke is associated with a number of health problems, including childhood asthma, cardiovascular disease and lower pulmonary function later in life.

"Moms should not be smoking during pregnancy," says Linda Birnbaum, Ph.D., the director of the National Institute of Environmental Health Sciences, a component of the National Institutes of Health that helped fund the USC study. "Maternal smoking during pregnancy is not only detrimental to the health of the mom and the newborn child, but research such as this suggests that it may impact the child into adulthood and possibly even future generations as well."

Major Media Outlets Ignore News That CIA Documents Fail To Back-Up Cheney’s Torture Claims

In April, Vice President Cheney received extensive media coverage when he called on the Obama administration to release two CIA memos allegedly showing evidence that the Bush-era interrogation policies saved lives. His request came in response to critics who lambasted the Bush administration’s program and said it actually hurt U.S. efforts. From Cheney’s interview with Sean Hannity on April 20:

HANNITY: And secondly, why is it important that those interrogations took place? I mean, the ones they were talking about were sleep deprivation, waterboarding, putting insects into small, confined areas and telling them they were deadly insects. [...]

CHENEY: It worked. It’s been enormously valuable in terms of saving lives, preventing another mass casualty attack against the United States. … And there are reports that show specifically what we gained as a result of this activity. They have not been declassified.

Yesterday, the CIA released two of those memos from 2004 and 2005, which had been secret until now. As Spencer Ackerman notes, these memos do nothing to back up Cheney’s claims:

Strikingly, they provide little evidence for Cheney’s claims that the “enhanced interrogation” program run by the CIA provided valuable information. In fact, throughout both documents, many passages — though several are incomplete and circumstantial, actually suggest the opposite of Cheney’s contention: that non-abusive techniques actually helped elicit some of the most important information the documents cite in defending the value of the CIA’s interrogations.

This finding is big news. You’d think that since the media reported so much on Cheney’s claims about the documents, they would also rush to report that Cheney was wrong. Not so. Greg Sargent notes that in the major newspapers, this fact was “either not covered at all, buried deep in stories, or described in highly hedged language.”

ThinkProgress went through the coverage on Fox News, CNN, and MSNBC and found that television outlets are performing as poorly as their print counterparts. Most of the networks’ reports omitted the Cheney angle. When they did address it, they tended to give Cheney the benefit of the doubt by saying that it was “not clear” from the heavily-redacted documents. The only individuals to note Cheney’s lie were guest commentators.

Cheney has since put out a carefully worded statement saying that “individuals subjected to Enhanced Interrogation Techniques provided the bulk of intelligence we gained about al Qaeda.” However, the fact remains that there is still no public evidence that those techniques actually saved lives.
And I notice that Cheney's statement didn't claim that the intelligence was obtained as a result of "Enhanced Interrogation Techniques". With Cheney's wording, all of the intelligence we gained could have been obtained before the torture began.

Pentagon Hires Controversial Firm To Screen Whether Embedded Reporters Wrote ‘Positive’ Stories

Maybe the Pentagon doesn't understand that this is a democracy. What the news should give is accurate reporting. (That doesn't mean reporting on things like specific locations or people who are helping us, which might bring harm to our people or allies and not telling us anything useful to us.)

Stars and Stripes reports that the Pentagon has hired The Rendon Group to screen journalists seeking to embed with U.S. forces. Specifically, the contractor will examine whether these reporters gave “positive” coverage to the military’s work in the past:

Rendon examines individual reporters’ recent work and determines whether the coverage was “positive,” “negative” or “neutral” compared to mission objectives, according to Rendon officials. It conducts similar analysis of general reporting trends about the war for the military and has been contracted for such work since 2005, according to the company. [...]

The backgrounders are part of a wide scope of work Rendon does for the Defense Department under its current $1.5 million “news analysis and media assessment” contract, according to military and company officials.

Public affairs officer Air Force Capt. Elizabeth Mathias insists that they “have not denied access to anyone because of what may or may not come out of their biography.” However, last month, the military barred a Stars and Stripes reporter from embedding with a unit in Iraq because he had “refused to highlight” good news. The military was also unhappy that the reporter “would not answer questions about stories he was writing.”

What is particularly troubling about this story is The Rendon Group’s history. The contractor has received millions from the U.S. government since 9/11 (at one point, taxpayers were paying CEO John Rendon $311.26/hour). The “secretive” firm personally set up the Iraqi National Congress and helped install Ahmad Chalabi as leader, whose main goal — “pressure the United States to attack Iraq and overthrow Saddam Hussein” — Rendon helped facilitate.

Professional journalism organizations are decrying the military’s contract with The Rendon Group. Ron Martz, president of the Military Reporters and Editors association, said that the “whole concept of doing profiles on reporters who are going to embed with the military is alarming.” Amy Mitchell, deputy director for Pew Research Center’s Project for Excellence in Journalism, said that the government is “doing things to put out the message they want to hear and that’s not the way journalism is meant to work in this country.”

Monday, August 24, 2009

Many diabetic foot amputations are preventable;_ylt=AsfmPCIDOsFS7tX8kF5RVYas0NUE;_ylu=X3oDMTFkdm9tZ2w4BHBvcwMxNTEEc2VjA2FjY29yZGlvbl9oZWFsdGgEc2xrA21hbnlkaWFiZXRpYw--

By LAURAN NEERGAARD, AP Medical Writer Lauran Neergaard, Ap Medical Writer – Mon Aug 24, 3:34 pm ET

WASHINGTON – It costs $1,400 to cover the oozing sore on the diabetic's foot with a piece of artificial skin, helping it heal if patients keep pressure off that spot. So when Medicare paid for the treatment but not the extra $100 for a simple walking cast to protect it, an artificial skin maker last year started giving free casts to some needy patients.

Without the right cushioning, "the person will walk to the bus stop and destroy it," fumes Dr. David G. Armstrong of the Southern Arizona Limb Salvage Alliance.

Limb-salvage experts say many of the 80,000-plus amputations of toes, feet and lower legs that diabetics undergo each year are preventable if only patients got the right care for their feet. Yet they're frustrated that so few do until they're already on what's called the stairway to amputation, suffering escalating foot problems because of a combination of ignorance — among patients and doctors — and payment hassles.

"There's no magic medicine right now for the diabetic foot," says specialist Dr. Lawrence Lavery of Texas A&M University, who bemoans that simple-but-effective preventive care just isn't attention-getting.

"People come in (saying), 'Hey, my wife noticed a bloody trail today as I was walking across the linoleum in the kitchen. What should I do?'"

President Barack Obama got a drubbing from surgeons this month after a confusing comment about how they're paid for foot amputations that cost $30,000 or more. That tab is the total cost, including hospitalization; surgeon fees range from about $750 to $1,000.

Obama's larger argument: Better payment for early-stage diabetes treatment, or even care to prevent diabetes, could save the nation money.

The money part's hard to prove but it's a lot of misery saved if it's your foot, and the spat highlights a huge problem. Some 24 million Americans have diabetes, meaning their bodies can't properly regulate blood sugar, or glucose. Over years, high glucose levels gradually damage blood vessels and nerves.

One vicious result: About 600,000 diabetics get foot ulcers every year. Poor blood flow in the lower legs makes those ulcers slow to heal. And loss of sensation in the feet, called neuropathy, makes patients slow to notice even small wounds that rapidly can turn gangrenous.

A mere nick while clipping nails, or a blister from an ill-fitting shoe, can begin the march toward amputation — and about half of patients who do lose a foot die within five years.

Saving those feet isn't cheap. Treating a slow-to-heal diabetic foot ulcer can cost up to $8,000. If it gets infected, $17,000. Worse, a fraction of patients gets multiple slow-to-heal ulcers each year.

What helps?

_Routine foot checkups. There's great variability in how insurers pay for foot screenings before someone's deemed at high risk, says Dr. Harry Goldsmith, a consultant on podiatric reimbursement. Yet some simple tests, like one that measures blood pressure at the ankle to predict circulation clogs, can signal later risk of ulcers. Medicare patients who do develop certain risk factors qualify for the next step, regular clinic visits to have a technician trim nails or smooth calluses, time that should include a quick check for any wounds, Goldsmith says.

_Gadgets like $20 telescoping mirrors let diabetics who can't move well check their numb soles for wounds between doctor visits, and infrared foot thermometers that cost up to $100 can detect changes in temperature that mean an ulcer's brewing before the skin breaks. Again, insurance payment varies.

_Taking pressure off the foot is key, starting with supportive shoes or insoles that target weak spots before an ulcer strikes. Medicare will help pay for certain therapeutic shoes although paperwork limits the diabetics who try them, says Lavery. He finds that an athletic shoe checked by a foot specialist for proper fit can help many patients.

When an ulcer demands more advanced care like grafting that artificial skin, Armstrong says removable walking casts — to-the-calf Velcro boots that injured athletes often wear — ease pressure best but seldom are covered. Worried that doctors wouldn't prescribe its wound healer Dermagraft if patients crushed it before it could work, Tennessee-based Advanced BioHealing has provided nearly 1,900 of the boots through a patient-assistance program since last year, said vice president Dean Tozer.

_The "toe and flow" approach, diabetic limb-salvage teams that pair specialists who otherwise seldom work side-by-side, like podiatrists and vascular surgeons. Wound care won't work well until clogged leg arteries are cleared to improve blood flow, notes Armstrong, whose team at the University of Arizona, Tucson, documented a drop in amputations in its first nine months. Such teams can eliminate some of the time diabetics wait for appointments to treat a festering foot, plus stress prevention.

Study finds people who multitask often bad at it

Previous studies have found that multi-tasking is less productive.;_ylt=ArmoIAM3ZXAcFouiHRLRGTGs0NUE;_ylu=X3oDMTFldXZlbnZjBHBvcwMxMTkEc2VjA2FjY29yZGlvbl9zY2llbmNlBHNsawNzdHVkeWZpbmRzcGU-

By RANDOLPH E. SCHMID, AP Science Writer Randolph E. Schmid, Ap Science Writer – Mon Aug 24, 3:06 pm ET

WASHINGTON – The people who multitask the most are the ones who are worst at it. That's the surprising conclusion of researchers at Stanford University, who found multitaskers are more easily distracted and less able to ignore irrelevant information than people who do less multitasking.

"The huge finding is, the more media people use the worse they are at using any media. We were totally shocked," Clifford Nass, a professor at Stanford's communications department, said in a telephone interview.

The researchers studied 262 college undergraduates, dividing them into high and low multitasking groups and comparing such things as memory, ability to switch from one task to another and being able to focus on a task. Their findings are reported in Tuesday's edition of Proceedings of the National Academy of Sciences.

When it came to such essential abilities, people who did a lot of multitasking didn't score as well as others, Nass said.

Still to be answered is why the folks who are worst at multitasking are the ones doing it the most.

It's sort of a chicken-or-egg question.

"Is multitasking causing them to be lousy at multitasking, or is their lousiness at multitasking causing them to be multitaskers?" Nass wondered. "Is it born or learned?"

In a society that seems to encourage more and more multitasking, the findings have social implications, Nass observed. Multitasking is already blamed for car crashes as several states restrict the use of cell phones while driving. Lawyers or advertisers can try to use irrelevant information to distract and refocus people to influence their decisions.

In the study, the researchers first had to figure out who are the heavy and light multitaskers. They gave the students a form listing a variety of media such as print, television, computer-based video, music, computer games, telephone voice or text, and so forth.

The students were asked, for each form of media, which other forms they used at the same time always, often, sometimes or never.

The result ranged from an average of about 1.5 media items at the low end to more than four among heavy multitaskers.

Then they tested the abilities of students in the various groups.

For example, ability to ignore irrelevant information was tested by showing them a group of red and blue rectangles, blanking them out, and then showing them again and asking if any of the red ones had moved.

The test required ignoring the blue rectangles. The researchers thought people who do a lot of multitasking would be better at it.

"But they're not. They're worse. They're much worse," said Nass. The high media multitaskers couldn't ignore the blue rectangles. "They couldn't ignore stuff that doesn't matter. They love stuff that doesn't matter," he said.

Perhaps the multitaskers can take in the information and organize it better? Nope.

"They are worse at that, too," Nass said.

"So then we thought, OK, maybe they have bigger memories. They don't. They were equal" with the low multitaskers, he added.

Finally, they tested ability to switch from one task to another by classifying a letter as a vowel or consonant, or a number as even or odd. The high multitaskers took longer to make the switch from one task to the other.

This particularly surprised the researchers, considering the need to switch from one thing to another in multitasking.

"They couldn't help thinking about the task they weren't doing," lead author Eyal Ophir said. "The high multitaskers are always drawing from all the information in front of them. They can't keep things separate in their minds."

The next step is to look into what multitaskers are good at and see if the difference between high and low multitaskers is one of "exploring" versus "exploiting" information.

"High multitaskers just love more and more information. Their greatest thrill is to get more," he said. On the other hand, "exploiters like to think about the information they already have."

The research was funded by Stanford Major Grant, Volkswagen Grant, Nissan Grant and an Alfred P. Sloan Foundation Grant.

Research finds higher acidity in Alaska waters

Notes: Warmer water can dissolve less of any kind of gas.
The fizz of carbonated water is caused by the carbonic acid, which is dissolved carbon dioxide.
Not too many years ago, some people were claiming the oceans are too big for human activity to harm.;_ylt=AhegeFrZm8_9_.KFoTHZ4Wes0NUE;_ylu=X3oDMTFlMGVmZHYxBHBvcwMxMTgEc2VjA2FjY29yZGlvbl9zY2llbmNlBHNsawNyZXNlYXJjaGZpbmQ-

By DAN JOLING, Associated Press Writer Dan Joling, Associated Press Writer – 2 hrs 1 min ago

ANCHORAGE, Alaska – Erosion threatens to topple coastal Alaska villages. Melting ice threatens polar bears. Now, a marine scientist says the state's marine waters are turning acidic from absorbing greenhouse gases faster than tropical waters, potentially endangering Alaska's $4.6 billion fishing industry.

The same things that make Alaska's marine waters among the most productive in the world — cold, shallow depths and abundant marine life — make them the most vulnerable to acidification, said Jeremy Mathis, a chemical oceanographer at the University of Alaska Fairbanks.

"Ecosystems in Alaska are going to take a hit from ocean acidification," he said. "Right now, we don't know how they are going to respond."

Alaska has already seen more than its share of global warming effects: shrinking glaciers, coastal erosion, the march north of destructive forest beetles formerly held in check by cold winters, melting Arctic Ocean ice that also threatens walrus and other marine mammals.

Ocean acidification, the lowering of basicity and the increase in acidity of marine waters, is tied to increased carbon dioxide levels in the atmosphere.

Oceans absorb 22 million tons of carbon dioxide from human activities per day, removing 30 percent emitted to the atmosphere each year and mitigating the harmful impact of greenhouse gas, according to the Intergovernmental Oceanographic Commission.

When carbon dioxide dissolves in sea water, it forms carbonic acid. That decreases the amount of calcium carbonate, used by marine creatures to construct shells or skeletons.

Mathis last spring collected water in the Gulf of Alaska and found samples to be more acidic than expected — and higher than in tropical waters. The results matched his findings in the Chukchi and Bering seas off Alaska's west and northwest coast. Cold water absorbs and holds more gas than warm water, Mathis said.

His research in the Gulf of Alaska uncovered multiple sites where concentrations of shell-building minerals were so low, that shellfish, including crab, and other organisms would be unable to build strong shells.

"We're not saying that crab shells are going to start dissolving, but these organisms have adapted their physiology to a certain range of acidity," Mathis said. "Early results have shown that when some species of crabs and fish are exposed to more acidic water, certain stress hormones increase and their metabolism slows down.

"If they are spending energy responding to acidity changes, then that energy is diverted away from growth, foraging and reproduction."

Acidification could affect the tiny pteropod, also known as a sea butterfly or swimming sea snail. It is at the base of the food chain and makes up nearly half of the diet of pink salmon. A 10 percent decrease in pteropods could mean a 20 percent decrease in an adult salmon's body weight.

"This is a case where we see ocean acidification having an indirect effect on a commercially viable species by reducing its food supply," Mathis said.

The shallow waters of Alaska's broad continental shelves also retain more carbon dioxide because there is less mixing from deeper ocean waters.

Another contributor is the rich biological life of Alaska waters, from tiny plankton to humpback whales. All use oxygen and emit CO2. Mathis and other scientists call it the "biological pump." Phytoplankton, like other plant life, absorbs CO2 and gives off oxygen, but when it dies and sinks in the shallow Alaska waters, decomposes and adds carbon to the water column.

Mathis has been warning fisheries managers around the state of ocean acidification. He has been hearing back of salmon returns with fewer, smaller fish reaching streams.

"We can't correlate that yet to ocean acidification or any climate process," he said. "We cannot make those connections yet but there's indications in the ecosystem that the ecosystems are stressed."

He said there should be a twofold course of action: increasing studies and observation of the effects of ocean acidification, and reducing carbon emissions.

A future study will look at the physiological impact of acidification on one of Alaska's money fish, pollock. A graduate student will rear pollock from hatch and study them in the larval and juvenile stages under different acidified conditions, looking for decreases in body mass, increases in stress hormones and other physiological indicators.

Pollock is the largest U.S. fishery by volume. Annual catches average 2.5 billion pounds and provide raw material for fish sticks and fast food fish sandwiches. Ocean acidification could be a blow to commercial fishing, which accounts for 50 percent of U.S. seafood production.

The Center for Biological Diversity, citing Mathis' findings, renewed its call for Alaska to declare its waters impaired under the Clean Water Act. The state last year rejected the group's first request for the declaration.

The commercial fishing industry is concerned, said Dave Benton, director of the Marine Conservation Alliance, a trade group representing fishing interests from rural Alaska village associations to factory trawlers, and about 70 percent of the production of North Pacific fisheries.

"It's a real problem," Benton said. "The science is pointing in a bad direction. We don't know how far it may go, we don't now how fast it may progress or anything."

Sunday, August 23, 2009

Feeling lonely is hard on a woman’s arteries

By Linda Carroll contributor
updated 11:30 a.m. ET, Fri., Aug 21, 2009

For some women, a lonely heart may lead to actual heart damage.

A new study has linked feeling forlorn to a nearly 80 percent increase in the risk of heart disease — but only in women.

Other studies have shown that depressed and socially isolated people are at a greater risk for developing heart disease, said the study’s lead author Rebecca C. Thurston, an assistant professor of psychiatry and epidemiology at the University of Pittsburgh School of Medicine. Both of these factors can lead to stress, which can ultimately lead to heart disease. But in a new study published in Psychosomatic Medicine, Thurston found the loneliness link even after accounting for the women’s level of depression and sociability.

Thurston wanted to focus on loneliness because it’s an especially negative and distressing emotion that many people experience.

“I was particularly intrigued by the documented findings that people can feel lonely despite having many people in their lives,” she said. “When it comes to loneliness, it’s not just how many friends you have, but also how supported you feel. You can have a lot of people around you and still feel lonely.”

People feel lonely when they don’t have a sense of connectedness with their friends and families, experts say.

“Loneliness is related to how fulfilled we feel in our relationships,” said Brooke Aggarwal, a researcher in preventive cardiology at Columbia University Medical Center/New York-Presbyterian Hospital. “We experience feelings of loneliness when we feel that what we’re getting from our relationships falls short of what we expect.”


Thurston looked back over the years and found that the loneliest women at the start ended up 76 percent more likely than the other women to develop heart disease.

She suspects that the link showed up only in women because they tend to be more concerned about relationship quality than men. Women also tend to be more distressed when relationships with spouses and friends aren’t as close as they hoped, she said.

The new findings fall in line with other research showing that while any type of marriage can protect a man’s heart, a bad marriage can be harmful for a woman’s health, Thurston said.

Homes pollute

Public release date: 19-Aug-2009
Contact: Michael Bernstein
American Chemical Society
Homes pollute: Linked to 50 percent more water pollution than previously believed

WASHINGTON, Aug. 19, 2009 — They say there's no place like home. But scientists are reporting some unsettling news about homes in the residential areas of California. The typical house there — and probably elsewhere in the country — is an alarming and probably underestimated source of water pollution, according to a new study reported today at the 238th National Meeting of the American Chemical Society.

In the study, Lorence Oki, Darren Haver and colleagues explain that runoff results from rainfall and watering of lawns and gardens, which winds up in municipal storm drains. The runoff washes fertilizers, pesticides and other contaminants into storm drains, and they eventually appear in rivers, lakes and other bodies of water.

"Results from our sampling and monitoring study revealed high detection frequencies of pollutants such as pesticides and pathogen indicators at all sites," Oki says of their study of eight residential areas in Sacramento and Orange Counties in California.

Preliminary results of the study suggest that current models may underestimate the amount of pollution contributed by homes by up to 50 percent. That's because past estimates focused on rain-based runoff during the wet season. "Use of pesticides, however, increases noticeably during the dry season due to gardening, and our data contains greater resolution than previous studies," Oki says.

Pollutants detected in outdoor runoff included ant-control pesticide products. Previous surveys have shown that the majority of pesticides purchased by homeowners are used to control ants. To encourage pollutant reduction, the researchers initiated community outreach programs centered on improving both irrigation control and pest management.

Plastics in oceans decompose, release hazardous chemicals

Public release date: 19-Aug-2009
Contact: Michael Bernstein
American Chemical Society
Plastics in oceans decompose, release hazardous chemicals, surprising new study says

WASHINGTON, Aug. 16, 2009 — In the first study to look at what happens over the years to the billions of pounds of plastic waste floating in the world's oceans, scientists are reporting that plastics — reputed to be virtually indestructible — decompose with surprising speed and release potentially toxic substances into the water.

Reporting here today at the 238th National Meeting of the American Chemical Society (ACS), the researchers termed the discovery "surprising." Scientists always believed that plastics in the oceans were unsightly, but a hazard mainly to marine animals that eat or become ensnared in plastic objects.

"Plastics in daily use are generally assumed to be quite stable," said study lead researcher Katsuhiko Saido, Ph.D. "We found that plastic in the ocean actually decomposes as it is exposed to the rain and sun and other environmental conditions, giving rise to yet another source of global contamination that will continue into the future."

He said that polystyrene begins to decompose within one year, releasing components that are detectable in the parts-per-million range. Those chemicals also decompose in the open water and inside marine life. However, the volume of plastics in the ocean is increasing, so that decomposition products remain a potential problem.

Each year as much as 150,000 tons of plastic debris, most notably Styrofoam, wash up on the shores of Japan alone, Saido said. Vast expanses of waste, consisting mainly of plastic, float elsewhere in the oceans. The so-called Great Pacific Garbage Patch between California and Hawaii was twice the size of Texas and mainly plastic waste.

Saido, a chemist with the College of Pharmacy, Nihon University, Chiba, Japan, said his team found that when plastic decomposes it releases potentially toxic bisphenol A (BPA) and PS oligomer into the water, causing additional pollution. Plastics usually do not break down in an animal's body after being eaten. However, the substances released from decomposing plastic are absorbed and could have adverse effects. BPA and PS oligomer are sources of concern because they can disrupt the functioning of hormones in animals and can seriously affect reproductive systems.

Some studies suggest that low-level exposure to BPA released from certain plastic containers and the linings of cans may have adverse health effects.

Saido described a new method to simulate the breakdown of plastic products at low temperatures, such as those found in the oceans. The process involves modeling plastic decomposition at room temperature, removing heat from the plastic and then using a liquid to extract the BPA and PS oligomer. Typically, he said, Styrofoam is crushed into pieces in the ocean and finding these is no problem. But when the study team was able to degrade the plastic, it discovered that three new compounds not found in nature formed. They are styrene monomer (SM), styrene dimer (SD) and styrene trimer (ST). SM is a known carcinogen and SD and ST are suspected in causing cancer. BPA ands PS oligomer are not found naturally and, therefore, must have been created through the decomposition of the plastic, he said. Trimer yields SM and SD when it decomposes from heat, so trimer also threatens living creatures.

Warning over codeine use after tonsillectomy

Public release date: 19-Aug-2009
Contact: Kathy Wallis
University of Western Ontario

A report out of The University of Western Ontario, published in the New England Journal of Medicine, warns the use of codeine to treat pain following a tonsillectomy could prove fatal for some children. Dr. Gideon Koren, who holds the Ivey Chair in Molecular Toxicology at Western, zeroed in on the danger after investigating the death of a two year old boy following a relatively easy operation to remove his tonsils.

Koren is a pediatrics professor at both Western and the University of Toronto, and the Director of the Motherisk program at the Hospital for Sick Children in Toronto. Enlarged tonsils are usually treated with antibiotics, but Koren says tonsillectomies are still performed in the case of sleep apnea, where the child stops breathing while asleep.

In this particular case, the toddler had a history of snoring and sleep-study-confirmed sleep apnea. He was taken to an outpatient clinic, had the operation, and was taken home. The mother was given syrup of codeine and instructed how to administer it to her child for pain relief. On the second night after surgery, the child developed a fever and wheezing, and was found dead the next morning. Tests later showed the mother had given the proper dosage, and yet the child's body was found to have high levels of morphine. The coroner asked Koren to look at the case.

"The sudden death of a healthy child was quite sobering because tonsillectomies are done every day, all over North America," says Koren. "And more and more of them are done on an outpatient basis, with the child going home the same day." The child was found to have the ultra-rapid metabolism genotype which causes the body to metabolize codeine at a faster rate, producing significantly higher amounts of morphine.

Last year Koren published research showing how mothers who are given codeine for pain following childbirth, can pass toxic levels of morphine to their babies though their breastmilk, if they carry this genotype. It's estimated just over one per-cent of Caucasians carry this gene, but the incidence could be as high as 30% in those of African origin.

Koren has another concern about giving codeine to children following a tonsillectomy for sleep apnea. "If the apnea doesn't go away, codeine will also suppress the child's breathing. This demonstrates the need to keep children in hospital under surveillance for at least 24 hours to see if the apnea persists."

Friendly gut bacteria lend a hand to fight infection

Public release date: 19-Aug-2009
Contact: Kristen Holland Shear
UT Southwestern Medical Center
, UT Southwestern study suggests

IMAGE: Immunology researchers led by Dr. Felix Yarovinsky (left) and including Alicia Benson have found that bacteria in the human gut helps battle the parasite responsible for toxoplasmosis. Generally a mild...
Click here for more information.

DALLAS – Aug. 19, 2009 – Immunology researchers at UT Southwestern Medical Center have found that bacteria present in the human gut help initiate the body's defense mechanisms against Toxoplasma gondii, the parasite responsible for toxoplasmosis.

Toxoplasmosis is generally a mild infection, but it can have serious and potentially fatal effects in pregnant women, their fetuses and others with weakened immune systems.

In mice, T gondii directly activates a specific immune protein in the host, called toll-like receptor 11 (TLR-11), which helps control the animals' immune response to the parasite. Humans, however, don't have an active form of this receptor. Exactly how the body senses T gondii has remained unclear because the parasite doesn't activate any of the functioning toll-like receptors that humans do possess.

In a new study appearing online and in the Aug. 20 issue of Cell Host & Microbe, researchers at UT Southwestern suggest that instead of activating toll-like receptors directly, T gondii's first interaction in the human gut is with the helpful bacteria that live inside us. Those bacteria then release signaling molecules, alerting the human host to the invader.

Elephant with sore feet gets comfy slippers

updated 4:32 p.m. ET, Mon., Aug 17, 2009

Did you hear the one about the elephant who wears slippers? She got ’em so she can sneak up on mice!

Actually, the pachyderm in question — an almost-40-year-old Asian elephant named Gay — needed a solution to a common ailment: sore feet. Her keepers at the Paignton Zoo Environmental Park in Devon, England, noticed an abscess on her right front foot last year, then another one on her left front foot this January.

To help ease her pain, she was given regular pedicures, antibiotic foot baths, aloe vera and anti-inflammatory treatments. But after consulting with experts, zoo workers decided what she really needed was a cozy pair of elephant slippers.

To help design them, Gay’s handlers had to trace around each of her front feet to make a pattern and contact a specialty animal-products company in Australia to hand-craft a pair of high-tech, breathable boots. Each one is about 16 inches across, has super-durable laces and costs a little more than $400. (She could have gotten some nice Prada heels for that price!)

"The boots will help to keep her feet clean between baths and allow us to put on dressings," Ghislaine Sayers, head of veterinary services at Paignton Zoo, explained in a message on the zoo's Web site. "Elephants can get sore places on their feet for all sorts of reasons — posture, age, arthritis, bruising if they stand on stones."

Gay, who weighs about 4 tons, was seeming a little sluggish of late. She had trouble getting up after lying down — a sure symptom of achy feet. Walking on grass and dirt outside her paddock wasn’t so bad, but since Gay likes to spend a lot of time indoors (that’s where the humans hang out, and she likes the company), the paddock’s concrete floor was a problem. So her keepers trucked in 100 tons of sand and installed rubber matting, giving Gay a newly cushy indoor surface. That, plus her slippers, will help her feet to heal and ease her pain.

Now all she needs is a really, really big Snuggie and she’s all set.

Saturday, August 22, 2009

Nonprofit nursing homes provide better care, major study finds

For-profit homes faulted for lower staffing, higher rate of bedsores

Aug. 19, 2009

Gordon Guyatt, M.D.
P.J. Devereaux, M.D.
Mark Almberg, Physicians for a National Health Program

A major new statistical review of 82 individual research studies has revealed that nonprofit nursing homes deliver, on average, higher quality care than for-profit nursing homes. The findings could have a bearing on the present debate about the role of for-profit firms in U.S. health reform.

“The results are unequivocal and completely consistent with other studies comparing for-profit versus nonprofit care,” said Dr. Gordon Guyatt, senior author of the study, professor of medicine at McMaster University in Hamilton, Canada, and a world leader in “evidence-based medicine,” a term he coined. The study was published in the online edition of the British Medical Journal earlier this month.

The authors’ systematic review compared quality-of-care measurements in 82 individual studies that collected data from 1965 to 2003 involving tens of thousands of nursing homes, mostly in the United States.

In 40 of the 82 studies, all statistically significant comparisons favored nonprofit facilities. In three studies, all significant comparisons favored for-profit facilities. The remaining studies had less consistent findings.

The authors’ meta-analysis, i.e. their integration and statistical analysis of the data from the multiple studies, shows that nonprofit facilities delivered higher quality care than for-profit facilities for two of the four most frequently reported quality measures: (1) more or higher quality staffing and (2) less prevalence of pressure ulcers, sometimes called bedsores.

The results also suggest better performance of nonprofit homes in two other quality measures: less frequent use of physical restraints and fewer noted deficiencies (quality violations) in governmental regulatory assessments.

“The reason patients’ quality of care is inferior in for-profit nursing homes is that administrators must spend 10 percent to 15 percent of revenues satisfying shareholders and paying taxes,” said Guyatt. “For-profit providers cut corners to ensure shareholders achieve their expected return on investment.”

About 1.5 million people reside in nearly 16,000 nursing homes in the United States, and more than 3 million Americans will spend at least some time in a nursing home this year, according to the U.S. Centers for Medicare and Medicaid Services. About two-thirds of U.S. nursing home residents live in for-profit facilities.


While most of the data in the studies are from U.S. nursing homes, data from Canada and Taiwan were also reviewed. Results were consistent over time.

The authors note that the results are entirely consistent with other studies. Systematic reviews of the evidence have previously shown higher death rates in for-profit versus nonprofit hospitals, and in for-profit versus nonprofit dialysis facilities. Such reviews have also shown higher costs in for-profit hospitals. Studies of outpatient care have shown higher quality of care in not-for-profit settings.

Walking in circles

Public release date: 20-Aug-2009
Contact: Dr. Susanne Diederich

Max-Planck-scientists show that people really walk in circles when lost

This press release is available in German.

Scientists in the Multisensory Perception and Action Group at the Max Planck Institute for Biological Cybernetics in Tübingen, led by Jan Souman and Marc Ernst, have now presented the first empirical evidence that people really walk in circles when they do not have reliable cues to their walking direction. Their study, published today in the journal Current Biology, examined the walking trajectories of people who walked for several hours in the Sahara desert (Tunisia) and in the Bienwald forest area (Germany). The scientists used the global positioning system (GPS) to record these trajectories. The results showed that participants were only able to keep a straight path when the sun or moon was visible. However, as soon as the sun disappeared behind some clouds, people started to walk in circles without even noticing it.

Speaking about the study, Jan Souman said: "One explanation offered in the past for walking in circles is that most people have one leg longer or stronger than the other, which would produce a systematic bias in one direction. To test this explanation, we instructed people to walk straight while blindfolded, thus removing the effects of vision. Most of the participants in the study walked in circles, sometimes in extremely small ones (diameter less than 20 metres)."

However, it turned out that these circles were rarely in a systematic direction. Instead, the same person sometimes veered to the left, sometimes to the right. Walking in circles is therefore not caused by differences in leg length or strength, but more likely the result of increasing uncertainty about where straight ahead is. "Small random errors in the various sensory signals that provide information about walking direction add up over time, making what a person perceives to be straight ahead drift away from the true straight ahead direction," according to Souman.

Aphids saved from gruesome death by virus-infected bacteria

Public release date: 20-Aug-2009
Contact: Mari N. Jensen
University of Arizona

IMAGE: A parasitoid wasp, Aphidius ervi, stalks pea aphids so she can lay eggs in them. The wasp is a tad bigger than 0.01 inches long.
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The term "beneficial virus" sounds like an oxymoron.

But for pea aphids under attack by parasitic wasps, carrying infected bacteria is the difference between life and a slow death, according to new research.

The wasps lay eggs inside the aphids, and the wasp larvae eat the living aphids from the inside out.

"A parasitoid death would be a very gruesome death," said first author Kerry M. Oliver. "It's like the movie 'Alien' where this thing grows inside of you and then ruptures out of you and kills you."

In laboratory experiments, about eighty percent of aphids carrying uninfected Hamiltonella defensa bacteria died as a result of wasp attacks.

However, most of the aphids whose H. defensa bacteria had a particular virus did survive wasp attacks.

Diabetes drug linked to increased risk of heart failure

Public release date: 20-Aug-2009
Contact: Emma Dickinson
BMJ-British Medical Journal

Research: Adverse cardiovascular events during treatment with pioglitazone and rosiglitazone: Population-based cohort study

Rosiglitazone, a drug used to treat type 2 diabetes, is associated with an increased risk of heart failure and death among older patients compared to a similar drug (pioglitazone), concludes a study published on today.

As such, the researchers say it is difficult to advocate continued use of rosiglitazone for most patients.

Rosiglitazone and pioglitazone belong to a class of drugs called thiazolidinediones and are widely used for the treatment of type 2 diabetes. They help to control blood sugar levels, but both drugs can also cause side effects including weight gain, fluid retention and heart failure.

It is unclear whether there are clinically important differences in the cardiac safety of these two drugs, so researchers in Canada compared the risk of heart attack, heart failure and death in patients treated with rosiglitazone and pioglitazone.

Using prescription records, they identified nearly 40,000 patients aged 66 years and older who started treatment with either rosiglitazone or pioglitazone between April 2002 and March 2008.

Data on hospital admission for either a heart attack or heart failure during the six-year study period were recorded and deaths were identified from a national database.

Detailed analysis showed that patients treated with pioglitazone had a significantly lower risk of heart failure and death compared to patients treated with rosiglitazone, but there was no significant difference in the risk of heart attack.

The researchers estimate that, for every 93 patients treated with rosiglitazone rather than pioglitazone, one additional cardiovascular event or death would be predicted to occur annually.

"Our findings suggest clinically important differences in the cardiovascular safety profiles of rosiglitazone and pioglitazone in clinical practice," say the authors. "Given the accumulating evidence of harm with rosiglitazone treatment and the lack of a distinct clinical advantage for the drug over pioglitazone, it is reasonable to question whether ongoing use of rosiglitazone is justified," they conclude.

This study reinforces the message that thiazolidinediones should be avoided in heart failure patients, but the claim that pioglitazone is safer than rosiglitazone is not fully supported by the data, say two experts from the Universities of Bath and Surrey in an accompanying editorial.

Although it may be tempting to move away from prescribing thiazolidinedione altogether, they write, long term follow-up data for newer products are not yet available.

Given that randomised trials are unlikely ever to provide the full picture, they suggest that enhancements to healthcare databases coupled with well designed studies like this one are essential for determining the full risk-benefit profile of medicines. People who have concerns regarding their diabetes treatment are urged to consult their GP and not to discontinue taking their medication.

Disparities in cancer care reflect hospital resources

Public release date: 20-Aug-2009
Contact: Nicole Fawcett
University of Michigan Health System
Disparities in cancer care reflect hospital resources, U-M study finds
Hospital quality among factors leading to survival differences

ANN ARBOR, Mich. — Hospitals that treat more black cancer patients have worse survival rates on average for patients with breast and colon cancer, regardless of race, according to a new study from the University of Michigan Comprehensive Cancer Center.

The research helps explain why African-Americans with breast or colon cancer are less likely than white patients to survive the disease.

"This work highlights the importance of how where a patient receives treatment for cancer affects survival after cancer surgery. An important next step will be to determine which system factors are amenable to interventions aimed at improving the quality of cancer care," says study author Tara M. Breslin, M.D., assistant professor of surgery at the U-M Medical School.

The study used five year survival data from the Surveillance Epidemiology and End Results–Medicare-linked database, a federal collection of cancer incidence, survival, and prevalence. The researchers analyzed data from 25,571 breast cancer patients, 9.7 percent of whom were black, and 22,168 colon cancer patients, 11.8 percent of whom were black. The patients were treated in 436 hospitals.

The study appears in the Aug. 20 issue of the Journal of Clinical Oncology.

Survival rates were lower for black patients than for white patients with both breast and colon cancer. But hospitals where more than half the patients were black had an increased risk of dying after five years for both black and white patients, compared to hospitals where fewer than 10 percent of patients were black.

All breast cancer patients treated at predominantly black hospitals had a 32 percent increased risk of death after five years, compared with those treated at hospitals that see few black patients. Similarly, colon cancer patients had a 27 percent higher risk of dying at five years.

The researchers also examined patient factors, such as age, cancer stage, other medical conditions and socioeconomic status. They found that after accounting for these factors, black patients still had higher mortality rates.

"Efforts aimed at increasing early detection through screening and decreasing incidence with preventative services are essential for decreasing racial disparities in mortality, but where a patient receives care after a cancer diagnosis may be equally important," says senior study author Arden M. Morris, M.D., M.P.H., assistant professor of surgery at the U-M Medical School and chief of general surgery at the VA Ann Arbor Healthcare System.

The study did not identify what specific hospital factors were at play, but the researchers plan further analyses to determine which hospital systems and aspects of standard therapy are poorly delivered or absent in hospitals serving a high percentage of minority patients.

Blood test can detect brain damage in amateur boxers

News: Aug 18, 2009

A blood test can now be used to detect brain damage in amateur boxers. Deterioration of nerve cells seems to occur even after a two-month break from boxing. This is shown in a new study from the Sahlgrenska Academy.

The results of the study conducted by researchers at the Sahlgrenska Academy and the Erciyes University Medical School in Turkey are published in the current issue of the scientific journal Brain Injury.

The findings constitute further evidence that repeated blows to the head may damage the brain.

'The blows seem to lead to a deterioration of nerve cells that lasts for a relatively long time. It is important that this is made known to participants in sports that involve kicks and blows to the head and to parents who let their children participate', says Henrik Zetterberg, Reader at the Department of Psychiatry and Neurochemistry at the Sahlgrenska Academy.

The study included 44 Turkish amateur boxers, whose blood samples were collected in the beginning of a training camp after a two-month break from boxing. The results were compared to those found in a healthy control group. The researchers analysed several proteins that can be used to identify brain damage, and found that the levels of one protein, called NSE, were higher among the boxers than in the control group.

'Their levels were high even after two months off from boxing. This indicates that the harmful processes in the brain continue even if the boxers have not recently experienced head trauma', says Zetterberg.

The same team of researchers has previously been able to show that amateur boxing leads to increased levels of brain damage markers in spinal fluid.

'A blood test is much easier to take, and it would be interesting to test athletes repeatedly following matches and while they recover from knockouts to see how the levels of NSE change over time. These types of biomarkers could be useful in sports medicine to help decide when an athlete should abstain from training and competition. But the method must first be evaluated further', says Zetterberg.

Friday, August 21, 2009

Possible link between diabetes and wheat

A clue to the elusive cause of type 1 diabetes: Ottawa researchers investigate immune response to wheat

August 20, 2009

Scientists at the Ottawa Hospital Research Institute and the University of Ottawa have discovered what may be an important clue to the cause of type 1 diabetes. Dr. Fraser Scott and his team tested 42 people with type 1 diabetes and found that nearly half had an abnormal immune response to wheat proteins. The study is published in the August 2009 issue of the journal Diabetes.

Early in life, the immune system is supposed to learn to attack foreign invaders such as viruses and bacteria, while leaving the body’s own tissues and harmless molecules in the environment alone (including food in the gut). When this process goes awry, autoimmune diseases and allergies can develop. Type 1 diabetes is an autoimmune disease that occurs when the immune system mistakenly attacks the pancreas, the organ that regulates blood sugar. Dr. Scott’s research is the first to clearly show that immune cells called T cells from people with type 1 diabetes are also more likely to over-react to wheat. His research also shows that the over-reaction is linked to genes associated with type 1 diabetes.

“The immune system has to find the perfect balance to defend the body against foreign invaders without hurting itself or over-reacting to the environment and this can be particularly challenging in the gut, where there is an abundance of food and bacteria,” said Dr. Scott, a Senior Scientist at the Ottawa Hospital Research Institute and Professor of Medicine at the University of Ottawa. “Our research suggests that people with certain genes may be more likely to develop an over-reaction to wheat and possibly other foods in the gut and this may tip the balance with the immune system and make the body more likely to develop other immune problems, such as type 1 diabetes.”

In a commentary accompanying the paper, diabetes expert Dr. Mikael Knip of Finland said “These observations add to the accumulating concept that the gut is an active player in the diabetes disease process.”

Dr. Scott’s previous research has shown that a wheat-free diet can reduce the risk of developing diabetes in animal models, but he notes that more research will be required to confirm the link and determine possible effects of diet changes in humans. Research is also needed to investigate links with celiac disease, another autoimmune disease that has been linked to wheat.

Night home hemodialysis shown to be as good as transplant in treating kidney failure

Public release date: 20-Aug-2009
Contact: Alex Radkewycz
University Health Network

For the first time, it has been shown that patients who receive night home hemodialysis live just as long as those who receive kidney transplants from deceased donors.

In a study entitled, "Survival among nocturnal home hemodialysis patients compared to kidney transplant recipients," published in the international September issue of Nephrology Dialysis Transplantation, a total of 1,239 patients were followed for up to 12 years. Night home hemodialysis patients were compared to patients who received either a deceased donor kidney transplant or a living donor kidney transplant. The study found that the survival between night home dialysis patients and those who received kidney transplants from deceased donors was comparable, while the survival of the patients who received a transplant from a living kidney donor was better than both the other groups.

These results suggest that night home hemodialysis, an intensive dialysis of six to eight hour sessions for up to seven times a week, may be a "bridge to transplant" or a "suitable alternative" to transplant should a patient be too high risk for a transplant or not be able to get a living or deceased donor as the organ shortage continues. Night home hemodialysis patients were from the Toronto General and Humber River Regional Hospitals, both hospitals together representing the largest and longest established group of such patients world-wide.

"This study allows me to actually answer what my patients have been asking me for over a decade: 'What does night home hemodialysis mean for my life span?' I can now tell them that this specific dialysis option is as good as getting a transplant from a deceased donor," says Dr. Christopher Chan, Medical Director of Home Hemodialysis at Toronto General Hospital, University Health Network, the R. Fraser Elliott Chair in Home Dialysis and Associate Professor, University of Toronto.

Until this study, there has been no long-term data on night home hemodialysis patient survival, or on how this type of treatment compares to transplantation. In the study, night home hemodialysis patients' data was carefully matched with deceased and living donor kidney transplantation mortality data from the U.S. Renal Data System on characteristics such as age, race, diabetic status and duration of treatment with conventional in-centre dialysis prior to treatment.

The proportion of deaths in each group was then measured, with final figures of 14.7% for night home hemodialysis patients; 14.3% for patients with transplants from deceased donors; and 8.5% for patients with transplants from living donors.

These results diverge from the evidence to date that dialysis is inferior to transplantation, pointed out Dr. Chan, adding that there is much benefit to be gained by long, frequent dialysis.

Evolution of the appendix: A biological 'remnant' no more

Public release date: 20-Aug-2009
Contact: Michelle Gailiun
Duke University Medical Center

DURHAM, N.C. – The lowly appendix, long-regarded as a useless evolutionary artifact, won newfound respect two years ago when researchers at Duke University Medical Center proposed that it actually serves a critical function. The appendix, they said, is a safe haven where good bacteria could hang out until they were needed to repopulate the gut after a nasty case of diarrhea, for example.

Now, some of those same researchers are back, reporting on the first-ever study of the appendix through the ages. Writing in the Journal of Evolutionary Biology, Duke scientists and collaborators from the University of Arizona and Arizona State University conclude that Charles Darwin was wrong: The appendix is a whole lot more than an evolutionary remnant. Not only does it appear in nature much more frequently than previously acknowledged, but it has been around much longer than anyone had suspected.


Darwin had thought that appendices appeared in only a small handful of animals.

"Darwin simply didn't have access to the information we have," explains Parker. "If Darwin had been aware of the species that have an appendix attached to a large cecum, and if he had known about the widespread nature of the appendix, he probably would not have thought of the appendix as a vestige of evolution."

He also was not aware that appendicitis, or inflammation of the appendix, is not due to a faulty appendix, but rather due to cultural changes associated with industrialized society and improved sanitation. "Those changes left our immune systems with too little work and too much time their hands – a recipe for trouble," says Parker.

That notion wasn't proposed until the early 1900's, and "we didn't really have a good understanding of that principle until the mid 1980's," Parker said. "Even more importantly, Darwin had no way of knowing that the function of the appendix could be rendered obsolete by cultural changes that included widespread use of sewer systems and clean drinking water."

Parker says now that we understand the normal function of the appendix, a critical question to ask is whether we can do anything to prevent appendicitis. He thinks the answer may lie in devising ways to challenge our immune systems today in much the same manner that they were challenged back in the Stone Age. "If modern medicine could figure out a way to do that, we would see far fewer cases of allergies, autoimmune disease, and appendicitis."