Nebraska became the 20th state to adopt a law that makes it possible for nurses in a variety of medical fields with most advanced degrees to practice without a doctor’s oversight. Maryland’s governor signed a similar bill into law this month, and eight more states are considering such legislation, according to the American Association of Nurse Practitioners. Now nurses in Nebraska with a master’s degree or better, known as nurse practitioners, no longer have to get a signed agreement from a doctor to be able to do what their state license allows — order and interpret diagnostic tests, prescribe medications and administer treatments.
Loaded with Lead. America has an estimated 10,000 gun ranges and 40 million annual recreational shooters. But when guns are fired with lead-based ammunition, they spread a toxin: lead vapor and dust. A year-long Seattle Times investigation shows that due to poor ventilation and contact with lead-coated surfaces, thousands of workers, shooters and their family members have been contaminated and been made sick at shooting ranges nationwide. Reckless range owners/operators, unenforced regulations as well as a lack of oversight and inspections are to blame. [more inside]
The Last Day of Her Life. When Cornell psychology professor Sandy Bem found out she had Alzheimer’s, she resolved that before the disease stole her mind, she would kill herself. The question was, when? [more inside]
For the past few years, a small group of psychiatrists, researchers, educators, and game designers have run a quiet but intense footrace to become the first to earn FDA approval for a medically sound, prescription-strength video game for ADHD. That’s not a metaphor. They are seeking approval for a game that a doctor can actually prescribe..In this excerpt from his new book, posted on Medium, journalist Greg Toppo discusses a variety of new neurogames and how they may in the future treat conditions like ADHD and anxiety, strengthen skills like multitasking and mindfulness, and reduce the need for pharmaceutical interventions for children. (Fair warning, the article has an animated header image that may annoy, so you may want to scroll right on down past it before you start reading.)
An avalanche of unnecessary medical care is harming patients physically and financially. What can we do about it? By Atul Gawande, previously on Metafilter.
The CRISPR Revolution [ungated: 1,2,3] - "Biologists continue to hone their tools for deleting, replacing or otherwise editing DNA and a strategy called CRISPR has quickly become one of the most popular ways to do genome engineering. Utilizing a modified bacterial protein and a RNA that guides it to a specific DNA sequence, the CRISPR system provides unprecedented control over genes in many species, including perhaps humans. This control has allowed many new types of experiments, but also raised questions about what CRISPR can enable." [more inside]
In the coverage and discussions, our voices are unheard, our lived experience silenced from a discussion that impacts our lives in a way that journalists and think-piece writers and even doctors cannot understand. I struggle sometimes when I hear stories of people with cancer that most likely would be cured if only they followed the treatment regime suggested by their doctors who make the decision to follow a [complementary and alternative medicine] remedy. Not even your doctor will judge you though.Elizabeth Caplice writes about of living with (likely terminal) cancer, the temptation to believe in miracle cures when the reality of having to undergo cancer treatments are so dire and how little cancer patients themselves are heard in the ongoing debates about treatment and alternative medicine.
Fish oil: it's been touted as a solution to heart health, dementia, glaucoma, and a host of other ailments. Unfortunately, it turns out that most of the evidence for its benefits is equivocal at best. And it turns out that fish oil isn't particularly useful for our pets, either. Worse, it turns out that the foundational study that kicked off interest in fish oil as a supplement is not quite as promising for fish oils as it is usually construed and cited. Given that fish oil can induce strokes in high quantities (and may interfere with treatments like chemotherapy), is poorly regulated, and is expensive, should we be promoting fish oil supplements as strongly as we do?
The nurses and doctors summoned to the hospital room of 16-year-old Pablo Garcia early on the morning of July 27, 2013, knew something was terribly wrong. Just past midnight, Pablo had complained of numbness and tingling all over his body. Two hours later, the tingling had grown worse.
A five part series from Backchannel at Medium.
Part One - How Medical Tech Gave a Patient a Massive Overdose
I am in my first month of nursing school. It is the early 70s and this is a three-year program, hospital-based, all practical training. It is my first day in my first ward...A remembrance, by English professor and disability studies scholar, Janet Lyon.
Franz Anton Mesmer (1735-1815) was a Viennese doctor who incorporated hypnosis (which he called “Animal Magnetism”, meaning that planets had a “tidal” influence on the human body) into his medical practice. His peers considered him a charlatan, but he grabbed the attention of the rich, royal, and famous. And then he volunteered to cure the blind composer and pianist Maria Theresia von Paradis. [more inside]
Every day, news sources report on medical studies that describe promising new treatments. Most of them don't pan out in the end. Julia Belluz reports on "why you shouldn’t believe that exciting new medical study." Her article includes a figure showing which foods are reported to cause cancer and which ones are reported to prevent it. (Spoiler: they're the same foods.)
In the asylums, the garrison hospitals, the rogues’ hovels, and so on back through time, it is possible to see medicine moving toward this moment, when the malingerer ceases to be a monster and becomes a mirror to ourselves.
The world's first successful penis transplant has been performed in South Africa.
Health-conscious people are haunted by the idea that they “should” correct their posture, and many fight a chronic, uncertain and tedious battle against crookedness. But is it necessary? After working as a massage therapist for many years, I became confident that poor posture is a “real” thing. I think it is sometimes a factor in chronic pain, mostly later in life, and probably can also be improved in some cases with a little effort. But it’s not a straightforward business, this posture stuff! There aren’t many “easy wins” for people here. And there’s plenty of potential to waste time and money — or even get hurt. Delving deeper into the topic as a journalist, studying the scientific literature and learning more from countless readers and experts, I have developed many reasonable doubts about posture’s importance.
Douglas Starr, in Blood, quotes the British Secretary of War, asked in 1937 what the nation proposed to do about a mass blood supply. The secretary was dismissive. Blood could not be stored for long or in great quantities, he said. On the hoof was better. “It was more satisfactory to store our blood in our people.” Janet Vaughan did not agree, and Janet Vaughan did something about it. Her medical director gave her £100, and she sent off her assistants in taxis to find all the tubing that London shops could provide.Longreads profiles Janet Vaughan, a British scientist who found better treatments for anemia than arsenic using herself as a test subject, was a major force in creating London's first blood banks using cheap tubing and ice cream trucks, studied emergency nutrition in a post-liberation concentration Nazi death camp, and continued active research into blood and radiation into her eighties, while occasionally serving as a model for Virginia Woolf characters.
Your new kidney is in the cloud. When former software developer David Jacobs was fortunate enough to get a kidney transplant eleven years ago, it occurred to him that there had to be a better way to match recipients with potential donors... so he bankrolled a company, and designed the cloud-based software needed to do it. As a result, thanks to paired kidney exchanges, a single kidney donation in San Francisco is saving six lives over the next few days... and will soon be saving a total of twelve lives, while removing people from the kidney waiting list, reducing the organ wait time for patients who don't have the time to spare.
Eddie Marritz, a cinematographer and photographer in remission from small-cell carcinoma, was a participant in one of NYU's Psilocybin Cancer Anxiety research studies. Marritz, and the researchers, take us through the experience. Magic Mushrooms and the Healing Trip. (7 min) [more inside]
How Quincy M.E. Changed American Law and Saved Lives discusses the serendipitous way that a young man's need for medication for Tourette's syndrome came to the attention of a family member of actor Jack Klugman and resulted in the Orphan Drug Act of 1983. (main article by MeFi's own Garius) [more inside]
In memoriam: Dr. Michael Davidson, cardiac surgeon, killed while doing a job he loved. A reflection on bad outcomes versus mistakes and taking risks versus playing it safe.
Medical researchers at Columbia University have developed a smartphone accessory that can diagnose HIV and syphilis in 15 minutes. The device is estimated to cost $34 to manufacture, compared to $18,450 for existing equipment. It also does not require an external power source, which is a major benefit for use in areas without reliable access to electrical power.
"Dying to be free : there’s a treatment for heroin addiction that actually works. Why aren’t we using it?" -- A long-form article, focusing on heroin addiction and its "treatment" in Kentucky, by Jason Cherkis. (Huffington Post Projects) [more inside]
This fundamental lesson is conveyed by a metric known as the number needed to treat, or N.N.T. Developed in the 1980s, the N.N.T. tells us how many people must be treated for one person to derive benefit. An N.N.T. of one would mean every person treated improves and every person not treated fails to, which is how we tend to think most therapies work.So it turns out that e.g. you need 2000 People to take a daily aspirin for two years to prevent one heart attack. [more inside]
Violet Pietrok was born with a Tessier Cleft, a skull defect. Surgeons at Boston Children's Hospital used 3-D prints of her skull to practice before cutting into Violet's own skull to repair the damage.
Cold cream is mostly known from the beauty routines of old ladies or as a makeup remover for stage actors. However, its lengthy history goes back a ways further, to a medical treatment from the Renaissance, perhaps even to the ancient Greeks.
The annual James Dyson Award is open to current and recent design engineering students. The winner this year is James Roberts with his inflatable incubator MOM. The device costs around £250 compared to £30,000 for modern incubators and could prevent up to 75% of fatalities in premature birth cases in the developing world.
"Look around Endell Street in Holborn today and you could be forgiven for thinking it just an average London street. But one hundred years ago this year, this non-descript spot just off of Shaftesbury avenue was home to an important, and now near-forgotten, part of British history – the Endell Street Military Hospital, the first British Army hospital staffed, and managed, entirely by women.”In WW1 Dr Flora Murray and Dr Louisa Garrett Anderson (daughter of the first Englishwoman to qualify as a physician) were determined to show that there was a place in military medicine for women. This is the story of the Women’s Hospital Corps and the now-forgotten pioneering London hospital they founded.
It's easy to break a patient like Rogelio—Mexican and poor and chronically ill—down to his potassium level and to make medical decisions according to a number. But that's only part of the story of how the undocumented ill are cared for here in Houston. Within this city's history—a history that includes segregation during the 1960s, a large immigrant population, strong economic growth over the past half century, not to mention the world's largest medical center—is the story of how Houston sought local solutions to provide compassionate care to its indigent and undocumented, the latter of which, some might say, have helped the city grow.Dr. Ricardo Nuila reports from the emergency room at Houston's Ben Taub Hospital, where Harris County's undocumented ill can avail themselves of some of the country's best health care: Taking Care of Our Own. [more inside]
Locked-In Man - "Martin Pistorius spent more than a decade unable to move or communicate, fearing he would be alone, trapped, forever. NPR's new show Invisibilia tells how his mind helped him create a new life."
The Art of Saving a Life, sponsored by the Gates Foundation, is a collection of stories about vaccination and immunization, as told by more than 30 world-renowned photographers, painters, sculptors, writers, filmmakers, and musicians. The intent is to promote vaccination just in time for an international effort to raise funds to inoculate millions, especially in poor nations. The full collection of art will be unveiled over the course of January 2015.
For the first time in nearly thirty years, a new
class of antibiotics may be on the way — and the good news doesn't end there. [more inside]
It’s that time of year again: the British Medical Journal‘s Christmas Edition is out, featuring some of the most hilarious research published since… well, since forever! All this week, Discover's Seriously, Science? will be featuring the best of this and past years’ BMJ Christmas Research Articles to get you in the holiday spirit. First up: Sword swallowing and its side effects [more inside]
How Tripping On Mushrooms Changes The Brain - "New research [pdf] suggests that psilocybin, the main psychoactive ingredient in magic mushrooms, sprouts new links across previously disconnected brain regions, temporarily altering the brain's entire organizational framework." [more inside]
She started by diving into PubMed—an online search engine for biomedical papers—hunting down everything she could on Charcot-Marie-Tooth. She hoped that her brief fling with a scientific education would carry her through. But with pre-med knowledge that had been gathering dust for 30 years and no formal training in genetics, Kim quickly ran head first into a wall of unfamiliar concepts and impenetrable jargon. “It was like reading Chinese,” she says.
“If there was anything I hated, it was investigating the organs of the female pelvis.” [more inside]
2014 marks the 100th anniversary of the outbreak of World War 1: a pivotal time for Europe and a key transition point for medical science. The Lancet marks this centenary with a three part series ‘Legacy of the war 1914-1918’. The three papers examine the impact of World War 1 on infectious disease, military psychiatry, and amputation related pain.
Do you hate swallowing pills? Let NPR's Nina Totenberg show you how using animated GIFs. A new study shows that the pop bottle technique for tablets and the lean forward method for capsules improve pill swallowing for 60% of people who use the pop bottle and 90% of people who lean forward. For kids, there are extensive resources that teach them how to swallow pills. Why swallowing pills is hard is a subject of study, and is a big deal, since it causes around 40% of people to delay, skip, or avoid taking medicine.
Black laboratory technician Vivien Thomas was paid a janitor's wage, never went to college or medical school, and was one of the pioneers of open heart surgery.
Paul Farmer, back from Sierra Leone, discusses Ebola treatment strategies. Brigham and Women's Hospital Grand Rounds, October 31, 2014. Almost an hour but worth it for the depth of info and analysis.
Today is Jonas Salk's 100th birthday. Salk, who reimagined the idea of a vaccine by suggesting that immunity could be established in the body by using inactivated viruses chose not to patent his polio vaccine, which he first tested on his own family. [more inside]
If mega-rich people could buy places on clinical trials, would this help drive forward the development of new treatments that could benefit everyone? [more inside]
"During the 2013-2014 flu season, according to the Centers for Disease Control and Prevention, only 46 percent of Americans received vaccinations against influenza, even though it kills about 3,000 people in this country in a good year, nearly 50,000 in a bad one." [more inside]
There are various changes that come with the greying of the traditional television audience, including the kinds of ads being aired, as the median age of a broadcast or cable television viewer is increasing faster than the median age of the US population at large. Older people are treated to a litany of drug ads, filled with lists of horrifying side effects, thanks to the ability for drug companies to market directly to customers. The rise in such advertising is now the most prominent type of health communication that the public encounters, but it hasn't always been the case.
According to the American Society of Addiction Medicine, addiction is “a primary, chronic disease of brain reward, motivation, memory and related circuitry.” However, that’s not what the epidemiology of the disorder suggests. By age 35, half of all people who qualified for active alcoholism or addiction diagnoses during their teens and 20s no longer do, according to a study of over 42,000 Americans in a sample designed to represent the adult population.
Only a quarter of people who recover have ever sought assistance in doing so (including via 12-step programs). This actually makes addictions the psychiatric disorder with the highest odds of recovery.Metafilter's own maias on myths surrounding the disease(?) of substance addiction, and their impact on medicine and policy.
“True, the Nazis were trying to find the Ark of the Covenant so they could destroy the world,” Canuto says. “But methodologically and legally they were in the right.” Why archeologists hate Indiana Jones. Also, why doctors don't like medical dramas; what is inaccurate about TV portrayals of lawyers and the legal process (PDF); and, finally, the terrific analysis of the portrayal of academics in children's books. When your profession is portrayed on TV, what do they get wrong?