Posted By Prucia Buscell,
Thursday, February 5, 2015
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Doctors working in teams may make more accurate diagnoses than doctors working alone, a recent study suggests.
researchers recruited 88 fourth year medical student volunteers and
showed them videos of simulated patient cases. They then asked the
volunteers to select one of 20 possible diagnoses, and order from a menu
of 30 possible tests. Twenty eight of the students worked individually
and the remaining 60 worked in pairs. Those working in pairs were 18
percent more accurate in their diagnoses. The study also found that pairs were more likely to differ in confidence about the diagnosis when the diagnosis was incorrect.
researchers said superior accuracy of the pairs could not be explained
by differences in knowledge or relevant information. "Collaboration may
have helped correct errors, fill knowledge gaps and counteract reasoning
flaws," researcher Dr. Wolf E. Hautz and colleagues said. The findings
appeared in a research letter in the Journal of the American Medical Association.
A story by Sabriya Rice in Modernhealthcare.com
reports that as many as one out of 20 adults in the U.S. may be
misdiagnosed in outpatient visits, and about half of those errors could
hospitals have developed systems for monitoring healthcare acquired
infections and surgical errors and other patient safety issues, experts
say systems for tracking diagnostic mistakes barely exist and causes of
diagnostic error have not been thoroughly researched. The 1999
Institute of Medicine Report "To Err is Human"
brought medical error into public consciousness but did not focus on
diagnostic error. The IOM report due this fall is expected to probe diagnostic error. Complicating the issue, Rice writes, is that there is no universally accepted definition of a diagnostic error.
According to a 2014 study by CRICO Strategies,
a Cambridge, Mass.-based risk-management group, about 20 percent of
23,527 medical malpractice cases filed between 2008 and 2012 were
related to diagnostic concerns,
she reports, and about 73 percent of the 4,705 diagnostic claims
alleged lapses in clinical judgment, such as failure to order diagnostic
tests, establish a differential diagnoses or give a referral.
Some surveys and research indicate time and scheduling pressures contribute to the potential for error.
At Maine Medical Center, a part of MaineHealth in Portland, began an innovative initiative
to get clinicians thinking about diagnoses. The hospital's
patient-safety officer and clinical educator started a pilot project
that ran from January to July 2011 where doctors voluntarily discussed
examples of diagnostic mistakes. During the trial period, doctors found
36 instances where diseases such as cancer, stroke and pneumonia were
missed, misdiagnosed or not identified in a timely fashion. "Just about
every time you talk to clinicians involved in diagnostic errors, it
seems like time and volume is an issue," said Dr. Robert Trowbridge, an internal medicine physician who teaches clinical reasoning at Maine Medical Center.
Dr. Gordon Schiff, a diagnostic error researcher
at Brigham and Women's Hospital in Boston, told Modernhealthcare.com
that diagnosis is really a team effort. He said the idea that diagnosis
is "this heroic, lone ranger thing" that doctors do behind closed doors
is romantic and outdated.
Posted By Prucia Buscell,
Thursday, January 29, 2015
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happiness influences human gene expression, researchers have found,
and different kinds of happiness have surprisingly different effects on
our physical health.
Researchers at the UCLA Cousins Center for Psychoneuroimmunology and the University of North Carolina note that philosophers since antiquity have distinguished between hedonic wellbeing-the kind of happiness that comes from satisfaction from pleasurable experiences-and eudaimonic wellbeing-the
kind that comes from striving toward meaning and noble purpose beyond
self gratification. It turns out the molecular mechanics of good health
tend to favor people who find happiness striving for higher goals.
PhD, a professor of medicine, psychiatry and behavioral sciences at
UCLA and a member of the Cousins Center, and colleagues including Barbara Frederickson, director of the Positive Emotions and Psychology Lab
at the University of North Carolina, have spent a decade studying how
stress, fear, loneliness and other miseries impact the human genome. In
his paper "Social Regulation of Human Gene Expression: Mechanisms and Implications for Public Health,"
Cole reported that people who experienced long term loneliness had a
gene expression profile showing high inflammation and lower immune
function. Inflammation related illnesses include heart disease,
neurodegenerative diseases and some types of cancer.
stress-related gene expression profile characterized by high
inflammation and low immunity is known as CTRA, for "conserved
transcriptional response to adversity." Cole and colleagues wanted to
find whether happiness is just the opposite of misery, or whether it
would activate a different kind of gene expression. They took blood
samples from 80 healthy adults assessed as having either hedonic or
eudaimonic happiness, and used the CTRA gene expression profile to
examine potential biological differences. Both groups had high levels of
positive emotion. Those in the eudaimonic wellbeing group had favorable
gene expression profiles, with low inflammation and functioning
immunity, while those in the hedonic wellbeing group showed the opposite
gene expression profiles. The study appears in the Proceedings of the National Academy of Sciences.
this study shows is that doing good and feeling good have very
different effects on the human genome, even though they generate similar
levels of positive emotion," Cole, the lead author, said in a UCLA release.
"Apparently the human genome is much more sensitive to different ways
of achieving happiness than are our conscious minds." The UCLA release
says this research, showing specific signals and pathways associated
with a positive state of mind and gene expression, is the first of its
his paper on social regulation of genes, Cole wrote that the human
genome is influenced by social environment, and that the "regulatory
architecture" of the genome lies outside the cell "in the constraints
and affordances present in the social ecology."
knowledge and technological advances that allow researchers to examine
the way genes and environment interact on a molecular level can have
profound impact in public health, he suggests. "Social regulation of
gene expression implies many aspects of individual health actually
constitute a form of public health in the sense that they emerge as
properties of an interconnected system of human beings," the paper says.
In an interview, Frederickson
suggested our bodies may respond better to happiness related to human
connectedness and purpose than to hedonic wellbeing, which she called
the emotional equivalent of empty calories.
Posted By Prucia Buscell,
Thursday, January 22, 2015
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whooping cough and other diseases thought to have been eliminated
decades ago are reappearing in California and other states and health
officials worry that widespread resistance to childhood vaccinations
raises potential for dangerous outbreaks of infectious illnesses.
A New York Times story by Adam Nagourney and Abby Goodnough
reports a measles outbreak at Disneyland infected 42 of the 59 people
in California whose illnesses were reported to the state this week. The Center for Disease Control and Prevention (CDC)
reported 644 cases of measles in 27 states in 2014, the biggest number
since 2000. Before common use of measles vaccine in 1963, the story
reports, measles infected three to four million Americans a year and 400
to 500 people died.
Stories by Gary Baum of the Hollywood Reporter
document childhood immunization rates as low 57 percent and 68 percent
in some in some elite preschools in wealthy neighborhoods, numbers that
are on a par with immunization in Chad and South Sudan. And nearly
8,000 cases of whooping cough, including 267 that needed
hospitalization, had been reported to the state during the first nine
months of 2014. Whooping cough, also called pertussis, once killed
thousands of people annually, but introduction of the DPT (diptheria,
tetanus and pertussis) vaccine nearly eliminated the disease.
During the current measles outbreak, unvaccinated children have been banned from going to public school in Orange County. A Washington Post Wonkblog
identifies Orange County as "ground zero in the current epidemic of
anti-vaccine hysteria." California allows parents to avoid vaccinating
their children by filling out personal belief exemptions, and Baum reports an alarmingly high number of families in many of the wealthiest communities have made that choice. The CDC recommends vaccinations, some of which need multiple doses, against 14 diseases.
Radio station WBUR
in Boston reported on a study showing vaccination rates in some states,
including Oregon, West Virginia and Colorado, have dropped below the
level required for herd immunity.
Thresholds differ based on how infectious different illnesses are. The
CDC suggests that threshold is crossed for whooping cough and measles
when more than six percent of the population is not immunized. Herd
immunity means that where a high percentage of the population is immune,
the chance of an infected person meeting a susceptible person is low,
so disease is unlikely to spread. Diseases spread rapidly among people
who are not immunized.
parents worry about discredited research linking vaccines to autism,
and some have religious or philosophical objections. The National Vaccine Information Center raises concerns about vaccines and the Times story quotes a spokesperson as minimizing the hazard of rejecting vaccination. Why do many resist? A 2014 AP-GfK survey reports only 53 percent of adults are "very confident" that childhood vaccines are safe and effective. The Post Wonkblog notes wryly that's about the same percentage who think houses can be haunted by ghosts.
The World Health Organization,
urging universal immunizations, asserts that vaccines save lives and
prevent disability, as well as mitigating severity of many diseases,
reducing secondary infections. Some vaccines provide protection against
related diseases. WHO says, for instance, that measles vaccination
protects against multiple complications including dysentery and
Posted By Prucia Buscell,
Thursday, January 15, 2015
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40 year community-wide effort to promote heart health and healthier
habits in a rural low-income county in Maine has resulted in less
illness, lower mortality, and millions of dollars in savings according
to a study published in the Journal of the American Medical Association.
Authors believe the initiative can be widely adapted and that today's
new data sources and technologies can make implementation even more
feasible than when the program began in the 1970s.
Franklin County Court House
In the late 1960s community groups in Franklin County,
which then had a population of about 22,000, identified cardiovascular
disease prevention as a priority. A Community Action Agency and Rural Health Associates (RHA),
a non profit medical group practice, which were both new at the time,
coordinated their efforts with the community hospital. With the
hospital's sponsorship, RHA established the Franklin Cardiovascular
Health Program (FCHP), which targeted hypertension, cholesterol,
smoking, diet and exercise. FCHP used county health data from the past
decade as a baseline and compared Franklin with other Maine counties and
Dr. Daniel Onion, a MaineGeneral Health physician and one of the researchers, told Kaitlin Schroeder of the Kennebec Journal & Morning Sentinel
the project was powered by volunteers who worked in the community to
help people quit smoking and adopt other healthy behavior. An HPLive story by Gale Scott
describes other details. Federal funds were used to start an insurance
plan for 3,000 indigent residents. The University of Maine developed a
health education degree program and trained local people to be outreach
workers. Hundreds of volunteers, including 200 nurses, did health
screenings and educated residents. Schools were persuaded to serve
healthier meals. A health fitness center with the area's only indoor
swimming pool was built with funds raised by the community. Over the
years, 150,000 people had an average of five contacts each with a
story reports that between 1994 and 2006 lower than expected
hospitalizations saved an estimated $5.4 million per year in hospital
charges for Franklin County residents. The program, which continued
through 2010, had many successes. Among people with hypertension there
was a 24.7 increase in the portion of people in control of their blood
pressure. Control of cholesterol increased 28.5 percent. The quit rate
for smoking improved from 48.5 percent to 69.5 percent. The overall
death rate and the cardiovascular death rate dropped below state levels
during most of the study period.
Darwin R. Labarthe
, MD, MPH, PhD, and Jerome Stamler
, MD, of the Northwestern University Feinberg School of Medicine in Chicago say in a JAMA editorial
that the Franklin County experience deserves to be examined and copied.
They say the results reinforce importance of disease prevention at the
local level. They call on communities to document and publish past
experiences in community health to "inform ongoing work and foster wider
application of program evaluation and implementation research,
exploiting new data sources and technologies to accelerate replication
and scaling up of community-based prevention. Intervening
developments-not least among them the Affordable Care Act-have made this
task clearly more achievable today."
Posted By Prucia Buscell,
Thursday, January 8, 2015
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The risk of developing many kinds of cancer may rely on random luck.
, PhD, and Bert Vogelstein
, MD, cancer scientists at Johns Hopkins University School of Medicine, report in a Science
magazine article that many cancers are caused by random mutations that
happen when healthy stem cells divide. Cancers are known to result from
life styles, inherited proclivities, and environmental exposures, as
well as causes that can't be identified. A New York Times story by Denise Grady
reports that the authors found chance was a bigger factor than they'd
expected. "It was about double what I would have thought," Dr.
Tomasetti, a biostatistician and professor told the Times.
Basically, the risk of cancer is highly correlated with the number of stem cell divisions over time.
A Johns Hopkins press release
explains that Tomasetti and Vogelstein charted the number of stem cell
divisions likely to occur in 31 tissue types during an average life
span, and compared these rates with the lifetime risk of cancer in the
same tissues among adult Americans. Adult stem cells
are a specialized population of cells in each organ or tissue that
divide or self-renew indefinitely to generate replacement parts as other
cells wear out.
researchers report, for example, that the large intestines have more
stem cells than small intestines, and those cells divide 73 times a
year, compared with cells in the small intestines that divide 24 times a
year. The lifetime risk of cancer in the large intestine is 4.8
percent, which is 24 times higher than the risk of a small intestine
cancer. Their calculations show that about two thirds of the variation
in cancer risk was explained by the number of stem cell divisions, and
about one third is explained by heredity and environment.
compare cancer with a car accident. The longer the trip, the higher the
risk of accident. They say the mechanical condition of the car is a
metaphor for inherited genetic factors and road conditions are like
environmental factors. We may not know which of these three conditions
contributed most to a particular wreck, but well maintained roads and
vehicles can reduce overall risks. Knowledge that some factors are
beyond our control may reduce stigma and comfort some cancer patients
who blame themselves for their illness. Findings also suggest more
cancers will appear simply because aging increases the number of stem
cell divisions, the authors say in the release, so research on early detection, treatment and the biology of the disease is more important than ever.
and prostate cancers were not included in the study because researchers
lacked data on breast and prostate stem cell division rates. Lung
cancer cases were divided between smokers and non-smokers, leading some
readers to note that smoking also contributes to many other cancers. The American Lung Association reports that smoking causes nearly 90 percent of all lung cancer cases.
In a lengthy blog post on the article, oncologist David Gorski,
MD, cites research suggesting one third to one half of all cancers are
"potentially preventable," meaning they come from environmental factors
that could be altered, such as smoking, alcohol use and weight control.
He has some quibbles with the article, and wishes the discussion of it
had been more nuanced. Bob O'Hara and GirrlScientist writing in The Guardian
complain that too many news stories about the research confuse the
variation in cancer risk with absolute risk of cancer, thereby blurring
what constitutes bad luck.
Sometimes luck is randomly good. In the press release,
Dr. Vogelstein observes cancer free longevity in people exposed to
tobacco smoke and other carcinogens, often attributed to good genes, is
likely to be good luck.
Posted By Prucia Buscell,
Thursday, January 1, 2015
Updated: Monday, January 5, 2015
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For years, researchers have looked for gene mutations that cause disease. Two scientists who started The Resilience Project
have flipped that effort upside down and started looking for gene
mutations that protect against disease. Discovery of such positively
deviant genes paves the way for drugs that mimic the protective
A New York Times story by Gina Kolata
tells the story of a Port Orchard, Washington, man who has a gene for
early onset Alzheimer's. The man's older brother, mother, nine of his
mother's siblings, and six cousins began showing symptoms in their 40s,
and most died in their 50s. The man, now 65, has no signs of the illness,
and researchers are trying to learn whether he has a genetic mutation
that is counteracting or substantially delaying the horrifying impact of
the Alzheimer's gene that he has.
of trying to fix things that are broken, let's look at people where
things are broken but nature finds a way around it," Dr. Eric E. Schadt, director of the Icahn Institute, a medical research institute at Mount Sinai Hospital in New York, said in an interview with the Times.
have found many gene mutations that cause disease or predispose a
person to an illness, and those seem to be considerably more common than
the beneficial mutations. However, with today's fast and relatively
inexpensive methods of sequencing DNA, and the ever-growing databases of
study subjects whose genomes have been sequenced, scientists can begin
to look for the positive mutations. Dr. Schadt and Dr. Stephen H. Friend, director of Sage Bionetworks,
a nonprofit research organization in Seattle, are searching databases
that hold clinical and genetic information. They are looking for people
who, despite having mutations for fatal diseases that strike early in
life, have remained healthy far past the age when the illness should
have appeared. They have analyzed data from more than 500,000 people,
and found only 20 in which a good gene mutation appears to have blocked a
bad one. But because no names are attached to the data, the scientists
can't contact those people. So they contacted researchers studying
extended families with severe genetic illnesses, and they found the
Some amazing beneficial gene mutations have already been discovered. One prevents HIV from entering cells and causing AIDS, and that discovery has enabled scientists to treat HIV positive patients by directly editing their cells. Discovery of another gene alteration that prevents build up of LDL cholesterol
led to discovery of a drug that is now in the final stage of testing.
Researchers using genetic databases have also found mutations in some
genes that confer partial protection against heart disease, osteoporosis and Type 2 diabetes.
Washington man who seems to have defied his dangerous Alzheimer's gene
retired recently. He told the Times his life's work now is to help
scientists understand the treacherous disease that claimed the lives of so
many members of his family.
Posted By Prucia Buscell,
Thursday, December 4, 2014
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Healthy human excrement is becoming a valuable commodity.
a nonprofit launched by MIT graduate students almost two years ago, is
the nation's first stool bank. Its mission is to provide doctors and
hospitals with safe fecal material from screened donors for use in the
growing number of fecal transplant procedures. Microbiologist Mark Smith, a co-founder, explains in a Boston.com story by Chelsea Rice that the organization is modeled after the Red Cross, to make a medical commodity available in a standardized way.
Fecal transplants-known as fecal microbiota transplants, or FMT, have been found extraordinarily effective in treating patients with Clostridium difficile
infections that afflict half a million patients a year with intestinal
pain and disabling diarrhea. Most are hospital patients who have been
treated with antibiotics that wipe out healthy gut bacteria along with
targeted pathogens. With the microbial competition wiped out, C. diff
takes over, producing toxins that can cause severe and sometimes fatal
illness. With introduction of donated stool into the patient's intestine
or colon, healthy bacteria fight the C. diff and the normal microbial
gut community can be reestablished. The Mayo Clinic first used FMT to treat a C. diff patient in 2011 and the Cleveland Clinic called FMT one of the top medical innovations of 2013.
In The New Yorker story "The Excrement Experiment," Emily Eakin
traces the past and current understanding of fecal microbiota,
describes its potential for treating several autoimmune disorders, and
reports on recent research suggesting the mysteries of the gut biome may
hold keys to many medical conditions, including obesity and mental
health. Researchers at Washington University
in St. Louis found that gut bacteria plays a significant role in
obesity in mice. Mice implanted with gut bacteria from a fat human
gained weight while those injected with gut bacteria from a thin human
stayed slim even when both groups ate the same diet. Research also
suggests gut bacteria influences our moods, minds and emotions.
The average human digestive tract hosts
at least 100 trillion bacterial, fungal, viral and archaeal organisms
that collectively makeup the gut biome. Much of the research focuses on stool, which Eakins explains "remains our best proxy for the brimming universe within." Smith
told Eakin part of his inspiration for OpenBiome was a friend who cured
his extreme suffering from C. diff by transplanting his room-mate's
stool into himself. Transplanting can be done using enemas,
colonoscopies or a turkey baster. OpenBiome absorbs the cost of
screening donors, whose blood is tested for several diseases, and whose
initial stool samples are screened for known harmful pathogens. It is
now sending specimens of clinically prepared excrement to dozens of
hospitals across the country. Boston.com reports screened doors are paid
$40 a day for their contributions. To lighten a gross topic, donors,
who are anonymous to recipients, are given code names such as Winnie the
Poo, Poop King, and Vladimir Pootin. Note the Boston.com graphic.
Meanwhile, for-profit biotech companies are competing to get stool-based therapies through trials and into the market. Scientists are also designing fecal capsules, which some entrepreneurs call "crapsules," that will be more appealing to patients. And the FDA will have to decide
what regulatory measures should be in place. The FDA has viewed
medically used stool as a drug. Smith and others hope it will be
reclassified as a tissue, which has to meet stringent standards but does
not have to go through clinical trials required for FDA drug approval.
Read the New Yorker story here.
Posted By Prucia Buscell,
Thursday, August 28, 2014
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Leana Wen, MD, an emergency physician who has worked in inner city hospitals in St. Louis, Boston and Washington, D.C., writes in her blog about the painful experience of administering short term fixes to patients whose long term afflictions lie beyond her realm.
She describes a 19-year-old who has come to the emergency room three
times with cuts and broken bones and gunshot wounds. An 8-year-old
without an inhaler living among relatives in an overcrowded house with
lots of smokers comes to the emergency room struggling to breathe. A
38-year-old single mother diagnosed with cervical cancer four years ago
never got to see a doctor as she struggled with three part time jobs,
the care of four children and inadequate insurance. By the time Dr. Wen
saw her in the emergency room, her cancer had spread to her lungs and
"We in the ER provide a necessary service, but it's far from being sufficient," she writes in her blog The Doctor is Listening.
"We need to recognize that health does not exist in a vacuum, that it
is intimately tied to issues such as literacy, employment,
transportation, crime and poverty. An MRI here, a prescription there,
these are Band-Aids not lasting solutions. Our communities need
innovative approaches to issues like homelessness, drug addiction,
obesity and lack of mental health services." The route to good health,
Dr. Wen says, is in the community. Dr. Wen is coauthor of the book When Doctors Don't Listen.
When he was still writing the Wonkblog for the Washington Post, Ezra Klein
described an experiment in Oregon to rebuild the state's Medicaid
program around community health rather than individual fee for service
treatments. Klein tells a story Oregon Gov. John Kitzhaber loves to
tell. Kitzhaber, a former emergency room physician himself, calls it an
illustration of what's wrong with our healthcare system. A 90-year-old
woman with well-managed congestive heart failure lives in an apartment
without air conditioning. When her apartment gets too hot, the strain on
her cardiovascular system causes heart failure. Medicare will pay for
an ambulance and $50,000 to stabilize her, but not $200 for a window air
The 90-year-old may be hypothetical, but the story illuminates a
common paradox, and Oregon's experimental approach starts with creation
of 16 Coordinated Care Organizations (CCOs) that are responsible for assessing the health of their communities. Kitzhaber has given the CCOs flexibility on how they can spend Medicaid money. They can buy that air conditioner. An NPR story
describes a Medicaid purchase of a minivan for community health workers
who can be available around the clock to pregnant women trying to stop
substance abuse, and to help mothers get to doctors' appointments,
school and jobs. What makes CCOs different from accountable care
organizations, or managed care, is the community component. Once they
assess needs, they have to come up with ways to address them. So money
can be spent on care coordination and community health workers with the
aim of preventing some expensive emergency care. Gov. Kitzhaber told
Klein, "We're investing in health. It's just a paradigm shift."
With thanks to Annette Garner, who teaches in the nursing program at the Health & Science University, Portland, Oregon.
Posted By Prucia Buscell,
Thursday, August 21, 2014
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makers concerned with income inequality need to focus more attention on
improving the early environment of disadvantaged babies and toddlers,
recent economic analysis suggests. Being born into poverty doesn't have
to mean a lifetime of deprivation, researchers say, and the earlier the
helpful intervention, the higher society's return on the investment.
quality early childhood programs have been shown in numerous studies to
have substantial benefits in reducing crime, raising earnings, and
improving educational outcomes, Frances Campbell, Gabriella Conti, James Heckman and colleagues wrote recently in Science magazine, and now research shows that life's earliest experiences strongly effect adult health.
and Conti are among the top economists who have done extensive studies
on human development. They have found that wealthy children and those
from deprived environments have disparities in cognitive performance
even before they start kindergarten, and the gap doesn't close with
time. Research by Heckman and Flavio Cunha
at the University of Pennsylvania shows that the divergence between
rich and poor kids in math ability is about the same at age 12 as it was
at age six.
Eduardo Porter writes in The New York Times
that the achievement gap between rich and poor American students is one
of the widest among the 65 countries that take part in the Program for International Student Assessment run by the Organization for Economic Cooperation and Development.
Porter suggests the acrimonious debate over how to improve American
education misses the most important time-the years from infancy though
pre-school. Heckman, Conti and others report that interventions from
infancy through age five pay extremely high returns.
Good early programs improve cognitive skills and foster softer skills
such as sociability, motivation, perseverance and self-regulation.
Heckman and colleagues say those are the traits that enable kids to use
their cognitive skills for future learning and adult success.
Two well documented programs are illustrative. The Perry Preschool Project
offered intensive social and cognitive skills building for
disadvantaged three and four year olds from 1962 to 1967 in Ypslanti,
Michigan. A study found Perry graduates at age 40 were more likely than
those in a control group to have finished high school, to hold jobs, and
have higher earnings.
The Abecedarian Project in North Carolina
started in 1972 with 111 infants who were followed from birth through
their mid 30s. The children were randomly assigned with half in an
intervention group and half in a control group. Children in the
treatment group received regular pediatric care, good nutrition, and
stimulation in language, cognition, and emotional self-regulation from
infancy through age five. Parents also were trained. In the second
phase, through age eight, the focus was on math and reading. The group that received the special early care did better
educationally, and by age 30, members of this group were four times
more likely than those in the control group to have graduated from
college, be employed and have health insurance.
health findings were a surprise. Men in the treatment group had less
hypertension and none had metabolic syndrome, the cluster of conditions
that raise the risk of heart disease, diabetes and stroke. One in four
of the control group had metabolic syndrome. Women in the treatment
group were less likely to be obese, less likely to drink before age 17,
and they had healthier habits.
about the small size of these samples? Heckman says the dramatic
disparities between these treatment and control groups actually
strengthen results because such differences are unusual in small sample
In a New York Times article, Heckman wrote
that "the economic rate of return from Perry is in the range of 6
percent to 10 percent per year per dollar invested, based on greater
productivity, and savings in expenditures on remediation, criminal
justice and social dependency. This compares favorably to the estimated
6.9 percent annual rate of return of the U.S. stock market from the end
of World War II to the 2008 meltdown." The Abecedarian Project lasted
five years and cost $67,000 in 2002 dollars, he said, and produced
substantial adult health benefits and cost savings. In Heckman's view:
"Early childhood interventions are an unexplored and promising new
avenue of health policy."
Posted By Prucia Buscell,
Thursday, June 26, 2014
Updated: Wednesday, July 2, 2014
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pictures may record more than milestone events and the little incidents
we love to remember. New technology may help doctors identify rare
genetic conditions by analyzing ordinary digital photos of faces. Facial
recognition software may even be useful in identifying presently
unknown rare disorders with symptoms that baffle families and doctors.
A New Scientist story by Andy Coghlan
explains that while genetic tests exist for common conditions, such as
Down's syndrome, genetic tests for many more unusual conditions aren't
available because the gene variants that cause them haven't been
discovered. A story in The Independent by Charlie Cooper explains that 30 to 40 percent of genetic disorders involve some kind of change to the face or skull. Software developed at Oxford University
by medical researchers collaborating with the university's Department
of Engineering Science was initially "trained" by analyzing thousands of
photos of people diagnosed with eight genetic disorders. Coughlin's
story explains that the computer "learned" to identify each condition
from a pattern of 36 features in each face.
who designed the software with Oxford colleague Andrew Zisserman,
believes it can help family doctors and general pediatricians make
preliminary diagnoses of health conditions that may have puzzled them.
In the future, Nellaker told The Independent, a doctor anywhere
in the world should be able to take an ordinary smartphone picture of a
patient, run a computer analysis, and find out which genetic disorder a
patient is likely to have. The technology isn't meant to replace
traditional diagnoses, but to aid it by giving doctors information not
otherwise available to them.
Alastair Kent, director of the Genetic Alliance UK, a charitable organization dedicated to helping people with genetic disorders, told New Scientist
that because few physicians are skilled in the diagnostic use of facial
analysis, families often wait years to learn the cause of their
children's problems. Many of the combinations of facial characteristics
that have diagnostic significance would be undetectable to a layman.
Oxford database now has nearly 3,000 photos, and the software can
recognize 90 disorders. As the database grows, the software will enable
researchers to study groups of patients with undiagnosed problems who
share similar facial features and skull structures. That could allow
researchers to identify presently unknown disorders and the explore the
gene variants that cause them, which could potentially improvement