A Year Later: Never Again! Enough is Enough! We Call BS! ‘Survivors of a Cruel and Silent Nation’

Republished below from February 2018 on this anniversary of the horrific shooting. Our hearts  go out to families, friends, and a nation still trying to heal. The cries for hope to the end of violence still resonate.

Parkland, Fla.

Parkland has well-manicured lawns, new developments, and huge parks, with trails and tennis courts and basketball courts and ballfields. At the intersection of Coral Springs and Parkland is a horse riding academy, Malachi Acres, with a boarding stable, amidst the palms.  Town hall is beautiful, and residents talk about the sense of community. A resident recalls how there was a mini-scandal when there were some car break-ins in a neighborhood.  The reason, he said with a near smile: “The owners left their doors unlocked.” It’s that kind of place. A month ago, my wife and I left Parkland, heading to the airport after visiting relatives there. The Lyft driver told us why he moved to Parkland, this proud man from Brazil. For the schools, he said. For the schools.

Yesterday, it was about all of this, a sense of place,  the schools, and something much more profound:  passion, determination, unyielding force. Angry teen-agers with a grudge, clutching a sadness no one should have, fighting to curb gun violence, restrict the access to guns — assault weapons – and vowing, vowing, vowing to make politicians know they will be ousted from office if they don’t comply. So there is no more  terrible nonsense of gun violence that is taking lives, the “17 angels” — the 17 people –  students,  a football coach and athletic director, who were killed at Marjory Stoneman Douglas High School on Valentine’s Day. There were 14 wounded. The gunman was mentioned only in passing yesterday during the March For Our Lives rally, only in a word like horrible, but also as a pathetic reason why, why, why laws must be changed, gun laws, mental health laws, funding, you name it. All our hearts are broken, and we’ve had enough was the refrain, constant and true.

Parkland was center stage as a place, but its students were also taking the center stage  in  a rally in Washington D.C. Parkland is one piece of the gun-control puzzle. So is Chicago. So is New York. So is Miami. So is Los Angeles and everywhere where marches were held.  One bullet that fells any kid in a school, on a street. That’s what they fought against yesterday, mostly these kids, but there was plenty of support, no doubt about it, from parents, teachers, friends, the elderly.  Stop the gun violence. Stop people from having assault weapons.  Down with NRA. Thump the Trump. (ok, my term). Placard after placard. Sign after sign. The message was clear: Lawmakers and the President, if you don’t do enough you will be voted out by their supporters, damn it, when they are old enough to vote.  One student from Parkland told how she thought the privilege of the town helped draw it attention, but the fight  represents all races, all genders, all lifestyles. Those  voices at rallies across the country related personal experiences of friends, relatives, loved-ones cut down in senseless violence, in emotional, drive you to tears speeches. Eyes welling up all over.  Let’s hold those thoughts.

“We are survivors of a cruel and silent nation,” said D’Angelo McDade, 18, of Chicago at the Washington D.C. rally.  “I too, am a victim, a survivor and a victor of gun violence,” McDade said. “We are survivors not only of gun violence but of silence. I come from a place where minorities are controlled by both violence and poverty, leading us to be deterred by success. But today we say, ‘No More.’

No more, he said: violence, no more poverty, no more unjust policies and lack of resources. “You must be the change,” he told the crowd.

In 1970, after National Guard troops shot students at Kent State, we were young and demonstrated with passion and fury. We were convinced the wrongs of America would turn to rights.

We didn’t have social media. We had bull horns.

There’s something magical going  on now amidst the sadness.

These kids are articulate and their speeches are raw and practical. Blunt.  No more BS!

There are still huge bureaucratic mountains to climb, but as the protestors insisted yesterday, this is just the beginning. We’ll be hearing more of the words Ballet Box. — Joe Cantlupe

Want to Get Healthy? Location, Location, Location

First of Two Parts:


You hear the words all the time when strategizing for business. Yes, that well-worn cliché.

Location, Location, Location.

How about when it comes to personal health in the U.S.?

Well….

Location, location, location.

Do you want to live among healthy neighbors? Overland Park, KS, has the lowest share of “physically unhealthy adults.” How about not making overly costly doctor visits (that can make you sick!)….Go to Laredo, TX where patients spend the least per physician’s visit. Want to join a fitness club? Amarillo, TX has the lowest average monthly cost for a fitness-club membership. 

Those are among the findings in a WalletHub report released this week, titled 2019’s Healthiest & Unhealthiest Cities in America. Its  accompanying videos also show that “place matters” in the U.S. when it comes to being healthy – or at least what areas “prioritize residents’ well-being,” WalletHub said.

It reviewed 174 cities and what the personal finance website said were dozens – 47 —  indicators of good health. The data ranges from cost of medical care to fruit and vegetable consumption to the number of fitness clubs per capita, WalletHub said.

The top ranked? San Francisco, followed by Seattle, San Diego, Portland, Ore. and Washington DC.” Rounding out the top 10 are: New York City, Denver, Honolulu, Scottsdale, AZ, an Irvine, CA.

The lowest ranked are Brownville, Tex, Laredo, (yes, despite the low cost per doctor’s visit),  Gulfport, MS, Shreveport, LA, Huntington, West VA, Fort Smith, Ariz, Augusta, GA, Memphis, Tenn, Detroit, Montgomery, Ala, and Toledo, Ohio.

“Location matters when it comes to health,” WalletHub said in a report of its findings. “Some places promote wellness by expanding access to nutritious food and recreational facilities. Others strive to keep healthcare costs affordable for everyone or keep parks clean and well-maintained.” – Joe Cantlupe, HealthDataBuzz

Cancer: Meet T-cells.

T-Cells In Cancer Therapy

Using a patient’s own immune system is becoming a more important focus for study in cancer treatment.

Let’s talk T-cells. They are a type of white blood cells that are targeted to fight infection and diseases, particularly pathogens linked to cancer.

When a T-cell recognizes something as a threat, like a cell infected by a virus, it attacks and destroys it. The T stands for thymus, the organ in which these cells mature.

Leukemia

Such treatment is considered specifically important in the study of the treatment of leukemia because the disease “relapse occurs in 30 to 50 percent of patients and remains unacceptably high,” according to the American Society of Hematology.

Researchers say that leukemia specific T-cells that are genetically changed have proven successful in trials against leukemia.

Childhood Cancer

Children with certain cancers and other disorders of the blood and immune system also may benefit from this therapy, known as cellular immunotherapy.

CAR T-cell therapy.

T-Cells are important for CAR T-cell therapy, which directs the T-cells to cancer cells. It is a type of immunotherapy. T cells are collected from a patient, and then T cells are sent to a laboratory or a drug manufacturing facility, where CAR T cells are then infused into a patient. 

Technically, after what is known as reengineering, the T cells become known as chimeric antigen receptor CAR T cells. CAR T cells thwart the cancer cells and stay in the body after the infusion.  Early development of CAR T-cell therapies has focused largely on acute lymphoblastic leukemia, (ALL) the most common cancer in children.

“Once we infuse them back into a patient’s body through an IV, they begin multiplying and attacking tumor cells,” says Sattva Neelapu, MD, in an MD Anderson Cancer Center report at the University of Texas.  “Eventually, the hope is that CAR T-cell therapy could replace chemotherapy and stem cell transplants altogether. But first we have to show that it’s at least as effective or more effective than those therapies.

Changing Cancer Treatment

While surgery, chemotherapy and radiation were at the core of cancer treatment for years, immunotherapy that buttresses the patient’s own immune system to attack tumors as gained ground as a key element in cancer treatment.

CAR T-cell therapy has been among the most distinguished in clinical development.

“Until recently, the use of CAR T-cell therapy has been restricted to small clinical trials, largely in patients with advanced blood cancers,” said the National Cancer Institute. “But these treatments have nevertheless captured the attention of researchers and the public alike because of the remarkable responses they have produced in some patients – both children and adult – for whom all the treatments have stopped working.”

FDA approvals

In 2017, two CAR T-cell therapies were approved by the Food and

Drug Administration; one for the treatment of children with ALL, and others for adults with advanced lymphomas. That includes patients with adult B-cell, non-Hodgkin’s lymphoma.

More study ahead

Researchers caution that, “in many respects, it’s still early days for CAR T cells and other forms of ACT, including questions about whether they will ever be effective against solid tumors like breast and colorectal cancer,” the NCI says. – Joe Cantlupe, HealthDataBuzz. Contributed to hcpnow.com

References:

UPMC Hillman Cancer Center.  CAR T-Cell Therapy at UPMC Hillman Cancer Center. 2018.  Retrieved from: http://hillman.upmc.com/cancer-care/blood/treatment/car-t-cell-therapy?&gclid=Cj0KCQiAuf7fBRD7ARIsACqb8w4gYzlmUK-56EyFH4bhK062hQ7wZewhdV46dUyT1BPdeGST367tongaAo2KEALw_wcB&gclsrc=aw.ds

Dolnikov, A, Sylvie, S, et al. Stem Cell Approach to Generate Chimeric Antigen Receptor Modified Immune Effector Cells to Treat Cancer. Blood Journal. 124-2437. American Society of Hematology. 2014.  

Leukemia & Lymphom Society. 2018. Chimeric Antigen Receptor (CAR) T-Cell Therapy. 2018. Retrieved from:

https://www.lls.org/treatment/types-of-treatment/immunotherapy/chimeric-antigen-receptor-car-t-cell-therapy

Children’s Hospital of Philadelphia. 2018. Cancer Immunotherapy Program. Retrieved from: https://www.chop.edu/centers-programs/cancer-immunotherapy-program

Cynthia DeMarco. MD Anderson Cancer Center. The University of Texas. 2018. https://www.mdanderson.org/publications/cancerwise/2018/02/car-t-cell-therapy–9-things-to-know.html

National Cancer Institute. CAR T Cells: Engineering Patients’ Immune Cells to Treat Their Cancers. 2018. Retrieved from: https://www.cancer.gov/about-cancer/treatment/research/car-t-cells

A tree in China: a hope for cancer researchers

A Cancer Fighting Tree In China

Purdue University researchers are studying a tiny family of fir trees in China in hopes of finding its potential to decrease cancer-causing proteins.  It is special work because there are only a few of the trees left in the world.

The trees can grow as high as 6,000 feet and are known as Abies beshanzuensi, native to Baishanzu Shanin, the southern Zheijiang province in eastern China.

The trees have special molecules that are inhibitors of SHP2, a type of cancer-causing protein. As a result, scientists are pinpointing the protein for treating cancer, according to  Purdue University, citing a study in the Journal of the American Chemical Society.

Targeted Molecules


Targeted therapeutic action may interfere with specific proteins that help tumors grow and spread.

Unlike many of the molecules now used to target Shp2, the molecule discovered by Purdue researchers form a chemical bond with the Shp2 protein that may make it more effective. In one way, it is considered longer lasting.  It may also adhere to an FDA approved cancer drug that targets DNA for potential combination therapy. The drug Etoposide is used for multiple types of cancer.


“This is one of the most important anti-cancer targets in the pharmaceutical industry right now, for a wide variety of tumors,” said Mingji Dai, an organic chemist at Purdue University said, according to the journal of Shp2.  “A lot of companies are trying to develop drugs that work.”

Studies show that Shp2 is associated with many cancers, including breast cancer, leukemia, lung cancer, liver cancer, gastric cancer and others.  Because of that link to many cancers, Shp2 is being investigated on many fronts. “Based on the structure and function of Shp2, scientists have investigated specific mechanisms involved in cancer. Shp2 may be a potential therapeutic target,” according to the Journal of Cellular and Molecular Medicine. 

The journal adds: “In cancer, Shp2 plays different roles in various (tumors) and different microenvironments. Although great progress has been observed in studies focused on Shp2-related mechanisms, specific processes involved in such mechanisms should be further investigated.”

While targeted therapy and drug resistance are major focuses in cancer research, many molecular interactions are unknown and therefore more study is important, researchers said.

Researchers are examining the structural features of Abies beshanzuensis, particularly for its lignin, structural materials that support some plants. “Lignin are particularly important in the formation of cell walls, especially in wood and bark” and do not rot easily, experts say.

Chemists in China were initially studying the tree Abies beshanzuensis, for the possibility of treating diabetes and obesity. But the tree apparently wasn’t as effective for those conditions.


Nearly extinct


Examining the tree for its potential cancer-fighting potential has opened the door for more studies. And scientists say they don’t want to waste time in their studies. That’s because the tree is almost extinct, according to Purdue researchers. Organizations described the tree as critically endangered.


When the tree was discovered years ago, only several trees were found. By 1987, there were only three trees left in the wild, making it among the most rare – if not the rarest – conifer in the world, according to the Purdue study. New plantings have been successful, but the species is still endangered.

As a result, researchers “are racing against the extinction-clock to better understand these trees, as they could inspire powerful new ways to treat various cancer,” according to Dai, the journal said. – Joe Cantlupe, HealthDataBuzz….from publication in hcpnow.com

References:

Dexter C. Davis, Dominic G. Hoch, Li Wu, Daniel Abegg, Brandon S. Martin, Zhong-Yin Zhang, Alexander Adibekian, Mingji Dai. Total Synthesis, Biological Evaluation, and Target Identification of Rare Abies SesquiterpenoidsJournal of the American Chemical Society, 2018; 140 (50): 17465 DOI: 10.1021/jacs.8b07652

Zhang, J, Zhang, F et al. Functions of Shp2 in cancer. Journal of Cellular and Molecular Medicine. 2015. Sep; 19(9): 2-75-2083. Doi: 10.111/jcmm.12681. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4568912/

Purdue University. Science News. Researchers race against extinction to uncover tree’s cancer-fighting properties. Are we killing the cure? Retrieved from https://www.sciencedaily.com/releases/2019/01/190117115906.htm

Big Dreams of Fighting Cancer, Small Steps At a Time: Nanoparticle Research


Nanoparticles are among the tiniest in the world, but researchers have big plans for them to treat cancer.

Let’s think about what a nanoparticle is. Let’s compare it. A kiwi, which is a fruit like a pear, would actually be the size of the Earth compared to a nanoparticle, according to Sciencelearn.com. That’s how small, tiny a nanoparticle is.

Because the properties are so small, nanoparticles can easily change their structures. By doing so, they made inroads in destroying cancerous tumors, and cause less damage to healthy tissues or organs. Scientists say nanoparticles may thwart cancer cells even before they become tumors.

Targeted therapy of nanoparticles treating cancer
Researchers focus on nanoparticles for targeted drug therapy. That refers to the method in which drugs are directed to certain organs, cells, or tissues. “Nanotechnology offers the means to target chemotherapies directly and selectively to cancerous cells and neoplasms,” according to the National Cancer Institute.


For instance, the NCI said, nanoparticles can help guide surgeries or better use radiation. “All of this can add up to a decreased risk to the patient and an increased probability of survival,” the NCI said.

Nanoparticles are a focus of research into many diseases. “Research on nanotechnology cancer therapy extends beyond drug delivery into the creation of new therapeutics available only through the use of nanomaterial properties,” the NCI said.

Much research is occurring throughout the world into nanotechnology to fight cancer.

A team of researchers, affiliated with the Republic of Korea’s UNiST, recently said it introduced a “novel targeted drug delivery system that improves the pharmacological and therapeutic properties of conventional cancer treatments.” Simply put, the study involves regulating the interaction between nanoparticles and biological systems, according to a study from UNiST. 


Nanotherapy’s new technology may dramatically reduce side effects. As a result, it could show a marked improvement over existing drug therapy. “Even when the drug reaches a target such as a cancer cell, the treatment efficiency is very low and other side effects have been observed,” some of which are toxic, the study says.

According to Professor Ja-Hyoung Ryu, one of the authors of the study published in Nature Communications: “The new technology is much like the strategy where you take control of your enemies, using enemies.”


“Aside from treating cancer, our findings can also be applied to a variety of fields, such as the diagnosis and treatment of various diseases,” he adds.

Prostate cancer
Other research into nanoparticles around the world includes chemotherapy treatment research conducted at the University of Georgia. It aims to fight prostate cancer.

Researchers are using nanoparticles to deliver a certain molecule, known as IPA-3, to cancer cells. In laboratory studies involving mice, the molecule “appears to reduce the growth of prostate cancer cells,” the research shows.

Scientists at the Fred Hutchinson Research Center in Seattle, Wash. say they developed “an inexpensive way to make tumors temporarily vulnerable” using nanotechnology, says Hutch News. 

Immune-boosting drugs
The Fred Hutchinson team said it used nanoparticles “to carry immune-boosting drugs directly to solid tumors.” The immune system is the body’s defense against infection and cancer. It is made up of billions of different types of cells. T-cells are collected from patients and sent to laboratories where they are genetically engineered.

Concerns


While there is progress in nanotechnology, some experts say they are drawbacks. The concerns are “toxicity, environmental harm and organ damaged caused by nanoparticles,” says International Journal of Development and Research.  “There are some ethical issues concerned with the use of nanotechnology too.” — Joe Cantlupe. HealthDataBuzz From hcpnow.com

References:

Science Learning Hub. Retrieved from: https://www.sciencelearn.org.nz/images/2035-nanoparticle-size-comparison

Sabrina Richards. Fred Hutch. Hutch News. Nanoparticles open doors to cancer-fighting CAR T-cells. 2018. Retrieved from https://www.fredhutch.org/en/news/center-news/2018/07/liposome-nanoparticles-tumors-vulnerable-immunotherapy.html

UNiST News Center. Joo Hyeon Heo. Public Relations Team. Nature Communications. 2018. Nanoparticle Breakthrough in the Fight Against Cancer.

UnderstandingNano.com. Nanotechnology and Nanoparticles in Cancer Treatment. 2019. Retrieved from: https://www.understandingnano.com/cancer-treatment-nanotechnology.html

National Cancer Institute. Division of Cancer Treatment & Diagnosis. Treatment and Therapy. 2019. Retrieved from:  https://www.cancer.gov/sites/nano/cancer-nanotechnology/treatment

Kwatra Shubhika. International Journal of Drug Development and Research. 2017. Retrieved from: http://www.ijddr.in/drug-development/nanotechnology-and-medicine–the-upside-and-the-downside.php?aid=5003

 

Northam Mess: Physician heal thyself…(AMA weighs in…a bit)


Virginia Gov. Ralph Northam has also been a physician.

As he weighs his next move amid the swirl of controversy over his wearing blackface or KKK garb on his 1986 yearbook page at medical school, I wondered: what does the nation’s most influential association representing physicians think.

Shouldn’t the American Medical Association weigh in?

Several days after I asked the American Medical Association about what Northam did, the AMA issued a statement today to HealthDataBuzz saying it has “zero tolerance” for any kind of discrimination.

“Respecting the diversity of patients and the physicians who care for them is a fundamental value of the medical profession,” the AMA said.

The AMA did not reiterate or reflect on the tawdry Northam incident.

Last Friday it exploded. The Hill reported why: “Northam’s 1986 medical school yearbook page showed two individuals, one in blackface and the other in a Ku Klux Klan robe. The governor initially apologized for appearing in the photo, but later insisted he was not in the image. He has resisted calls for his resignation from state and national Democrats.”

‘Bigotry in Medicine’

Northam the politician is in trouble. But his conduct in medical school not only has “stirred a national political furor,” as the Associated Press reported, but it also “reopened the long history of bigotry in American medicine.”

“The revelations about Northam gave many African-Americans a new reason to be distrustful of doctors,” AP said.

In its statement, the AMA did not mention Northam or the particulars of the controversy. The AMA said it is “committed to improving health outcomes for all patients, confronting disparities in health care, and increasing the ranks of minority physicians so the workforce accurately represents the diversity of America’s patients.”

The AMA wasn’t asked that question. But it took the occasion of the Northam outrage to say there is a way to go that there may be enough minority physicians to reflect the face of America as it is today.

According to a Deloitte report, for instance, 68.2% of physicians and surgeons in the U.S. in 2016 were white, “making that the most common race or ethnicity in the occupation.” About 5.7 % are black — although African-Americans comprise 11.9% of the workforce, it said.

There is a way to go before racism is erased.

In July 2008, the AMA “issue a formal apology for discriminating against black physicians well into the 1960s, with damaging effects that persist today,” MedPage Today reported at the time.

The AMA acknowledged “its past history of racial inequality toward African-American physicians,” it was reported.

Joe Cantlupe, Health Data Buzz

Battlefield Relief: Acupuncture

The U.S. Army has tapped into acupuncture therapy to help its soldiers thwart potential opioid abuse.

One of the most popular forms has been called “battlefield acupuncture, ” according to Dr. Richard Niemtzow, who developed the program in 2001, according to military.com.

An important component of acupuncture is that treatment can help reduce pain quickly without the risk of addiction that can happen with opioids.  The acupuncture approach used in the military involves ear acupuncture, or auricular, and Army officials said that has been effective in reducing pain.

Battlefield Acupuncture, also known as BFA, is effective because it can allow soldiers to easily continue their work without waiting for medications to kick-in, officials have said.  “The BFA, which involves a small needle inserted into the ear, has a “central effect” on the nervous system and the cingulate gyrus, an area of the brain that processes pain,” according to an Army report.“The up-to-10 needles, five per ear, used are only 1 millimeter in length and are either gold-plated or made of steel,” said the Army, reporting on its troops in Afghanistan early last year. “Minimal pain is experienced when they are placed in the outer ear. Eventually they fall out after three to seven days on average.”

Acupuncture and other forms of alternative and complementary medicine are helping to cut the use of opioids in Army patients. Opioid use is a major healthcare issue inside and outside the military because of the potential for abuse. Early last year, the Army Times reported that about “22 percent of active-duty soldiers had at least one opioid prescription at any given time as of the end of fiscal 2016.” The paper said it was 19 percent drop over a four year period.

Changing culture

The Army has changed its culture on the use of medication since 2010. The Pain Management Task Force issued recommendations and the Veterans Health Administration examined best practices for pain management at its medical centers.  In fact, the Army’s use of acupuncture and other alternative procedures has been included in its Comprehensive Pain Management Plan.

Impacting veterans

Veterans, too, have had more access to acupuncture. Acupuncturists certified by the National Certification Commission for Acupuncture and Oriental Medicine can treat veterans for pain and opioid addiction as of last year, according to the organization.

That is important because “the opioid epidemic has significantly affected many of our veterans,” said Dr. Kory Ward-Cook, NCCAOM Chief Executive Officer in a statement. “A report by the American Public Health Association in 2011 found that the fatal overdose rate among VA patients is nearly double the national average. This new government occupational standard will enable the most experienced and qualified acupuncturists to treat the thousands of veterans who are suffering from debilitating pain and addiction to overprescribed opioids at the many Veterans hospitals and medical centers.”

The National Center for Complementary and Integrative Health (NCCIH) said that veterans are more likely to endure severe pain conditions than individuals who have never served, according to Chiropractic Economics. 

It cited a 2014 study published in the JAMA Internal Medicine journal found that chronic pain and opioid use by military members not being treated “were higher than estimates in the general civilian population.”

About 44 percent of the study participants reported having chronic pain, compared to 26 percent of the general population. Opioid use was higher as well, with 15.1 percent of military personnel using this category of drugs compared to 4 percent of the population at large, it said. — Joe Cantlupe, HealthDataBuzz. Most of the contents in this story was written for  hcpnow.com

References:

Nicole Bauke. Battlefield acupuncture? Yes, it exists and the military is using it to fight troops’pain. 2018. MilitaryTimes. Retrieved from: https://www.militarytimes.com/news/your-military/2018/02/09/battlefield-acupuncture-yes-it-exists-and-the-military-is-using-it-to-fight-troops-pain/

Jon Michael Connor. Battlefield Acupuncture’s proven pain reduction treatment becoming popular with caregivers, patients. U.S. Army. 2019. Retrieved from:https://www.army.mil/article/215786/battlefield_acupunctures_proven_pain_reduction_treatment_becoming_popular_with_caregivers_patients

Christina DeBusk. Why the use of acupuncture in the military is on the rise. Chiropractic Economics. 2018. Retrieved from: https://www.chiroeco.com/military-acupuncture/

National Certification Commission for Acupuncture and Oriental Medicine. Acupuncturists Now Included in the Veterans Health Administration. 2018. Press Release. Retrieved from: http://www.nccaom.org/blog/2018/03/01/acupuncturists-in-va/

Oh, That Brain: It Doesn’t Have A (Complete) Mind of Its Own…

You Are in Control of Your Brain

Sometimes when you make a sudden decision, or feel you are doing something without much thought, you might feel that the brain has a mind of its own.

Well, it kind of does. The brain has collected your past decisions, so you don’t have to overthink, a process called conditioning.

But when it comes to the brain, that’s a simplicity that ends there. You have the power of breaking patterns of behavior and changing your focus.

The brain likes to do things to ensure it keeps going. It’s not specifically interested in the intricacies of what you do. So it may be used to following preconditioned patterns. But some patterns, such as certain behaviors, can hurt you.

But the brain’s ways can be changed, by what scientists call its durability and neuroplasticity, and you have an impact on what you do. You can change your brain’s behavior – and train it, researchers say.

How the Brain Works

Scientists note that different regions of the brain often work on their own, relying on neurons inside that region to do the work. At other times, the regions must cooperate. Each region of the brain contains millions of neurons.

With separate networks in the brain, one area may determine the risk versus reward of individual choices, and another may guidehow you actually behave.

Cognitive Control

It’s cognitive control within the brain that keeps you on track despite distractions, scientists say. “Cognitive control and value-based decision-making tasks appear to depend on different brain regions within the prefrontal cortex,” said Jan Glascher, lead author of the study at the California Institute of Technology at Pasadena, according to Time.

You Guide the Way

You should direct your mind to focus on what you want rather than repeating past mistakes, and that can help you make better decisions.

Break Bad Habits

That’s why it’s important to examine your decision-making process. That could be a key to breaking bad habits or addiction.

“Understanding the neuroscience behind making a decision can be helpful when targeting new behaviors and changing bad habits,” says Psychology Today. “Decision-making is in the locus of your control. You have the power to break patterns of behavior simply by making better decisions.”

Changes in behavior and attitudes can be a powerful way to make your thinking go on a different course.

“Unfortunately, the brain’s responses follow preconditioned patterns regardless if they are good or bad habits, so not all of its functions are serving you for the maximum growth,” according to Psychology Today. “The untrained brain is focused survival, not creativity. This means your brain may continue to repeat old patterns of decision-making to keep you in your comfort zone rather than help you reach your full potential.”

Don’t Over Do!

And yes, the brain gets tired.

“The brain works like a muscle: when depleted, it becomes less effective,” says Time.  “We should take this knowledge into account when making decisions.”

For instance, if we spent a lot of time focusing on a task, exercising self-control, or many choices, you probably shouldn’t make significant decision then, the article states.

Think of Other Parts of Your Body

And maybe don’t over rely on your brain; think about the connections to your body and environment, says Alan Jasanoff, professor of biological engineering at MIT and author of The Biological Mind.

 

“If we want to solve our problems, we shouldn’t reduce them to problems of the brain,” Jasanoff says in an interview with National Geographic.

He adds: “We need to keep a broad view, which recognizes how the brain is connected both to the body and to the environment; and look for solutions wherever they happen to lie.”

“Explaining human behavior in terms of brain function alone stems from a kind of mystical view of the brain and keeps us from advancing in a way that science can encourage us.”

 

REFERENCES:

 

Debra Maldonado, CEO Creative Mind Media, Inc. online. 2018. Want to Make A Better Decision? Start By Understanding Your Brain. Here’s How: Retrieved from: https://www.inc.com/debra-maldonado/want-to-make-better-decisions-start-by-understanding-your-brain-heres-how.html

 

Christopher Bergland. Psychology Today. 2018. The Neuroscience of Making a Decision. Retrieved from: https://www.psychologytoday.com/us/blog/the-athletes-way/201505/the-neuroscience-making-decision

 

Mark Humphries. Medium. How Your Brain Decides What You Are Seeing. 2017. Retrieved from: https://medium.com/s/theories-of-mind/how-your-brain-decides-what-youre-seeing-b9729670ec6d

 

Maia Szalavitz. Time. Making Choices: How Your Brain Decides. 2012. Retrieved from: http://healthland.time.com/2012/09/04/making-choices-how-your-brain-decides/

 

On Amir. Scientific American. How Making Tough Choices Tires Your Brain. 2008. Retrieved from: https://www.scientificamerican.com/article/tough-choices-how-making/

 

Simon Worrall. Book Talk. National Geographic. 2018. Retrieved from: https://news.nationalgeographic.com/2018/03/why-the-brain-body-connection-is-more-important-than-we-think/

 

Dentists Retooling Anti-Opioid Initiatives

While there is much discussion about the opioid crisis, you may not immediately think of dentistry. Yet in the 1990s, dentists were the top clinical prescribers of opioids. With a number of innovative and educational initiatives, prescriptions ordered by dentists dropped more than 50 percent by 2012, according to the Journal of the American Dental Association.

There can be lessons learned by dentists and also physicians and other medical care practitioners. Dentists themselves say they are working to continually improve their oversight of opioid prescriptions to reduce opioid misuse and abuse.

For years, dentists have prescribed opioids, but are routinely making limits on such prescriptions. They prescribe the opioids for different reasons: such as controlling acute pain following dental procedures, including when tooth are extracted, where dental implants are placed. Periodontal and endodontic surgeries are also included, according to Dr. Martha Somerman, director of the National Institute of Dental and Cranofacial Research, Journal of the American Dental Association, and Nora Volkow, director of the National Institutes of Drug Abuse.

Whether it’s prescribed from dentists or physicians, routine use of opioids has resulted in much dependence among American patients, and misuses sparked by such dependence. The results have been catastrophic, what the Trump Administration has called a public health emergency in America.

When dentists were considered the top specialty prescribers of immediate-release opioids, they accounted for more than 15 percent of all immediate-release opioid prescriptions. Immediate-release opioids are usually conventional drugs, such as tablets and capsules, taken orally or by the mouth. By the 2000s, dentists prescribed fewer opioids in relation to other medical professionals. In 2009, dentists represented 8 percent of immediate-release opioid prescriptions, but that amount dropped to 6.4 percent.

Opioids are also prescribed in emergency departments (EDs) to manage dental pain until treatment can be started.

Dentists Make Prescription Changes

Over the years, however, dentists used alternative approaches toward treating pain, following plans initiated by the American Dental Association, and the rate of opioid prescriptions that dentists ordered dropped “considerably.”

The American Dental Association launched a new policy earlier this year to reduce the misuse of opioids and to “keep prescription opioids from harming dental patients and their families.”

Among other things, the policy establishes prescribing limits on opioid dosages, such as no longer than 7 days for treatment of chronic pain. The policy also advises mandatory continuing education on prescribing opioids and other controlled substances. Dentists are developing educational interventions to encourage what is known as “risk mitigation strategies,” such as registering with and using Prescription Drug Monitoring Programs before prescribing opioids for pain management.

Databases

Prescription Drug Monitoring Programs are electronic databases that track controlled substance prescriptions in a state. As such they can provide health authorities timely information about prescribing and patient behaviors that contribute to the epidemic and facilitate a nimble and targeted response, according to the Centers for Disease Control and Prevention.

Experts say that more must be done, however. Some of the problems involve general physicians and nurses who treat dental pain. For instance, emergency department physicians often prescribe opioid and other analgesic medications to manage acute dental pain. Indeed, “an examination of a nationally representative data set suggested no reduction in the rate of opioid analgesic prescriptions for dental pain in emergency settings,” according to the studies.

The reports noted that a separate study of Medicaid recipients found that patients having a dental condition were almost three times as likely to receive an opioid from a nurse practitioner as a dentist.

More Research Necessary

To better understand dentists’ opioid prescribing practices, the National Institutes of Dental and Craniofacial Research (NIDCR) is using the National Dental Practice-Based Research Network. The Network includes than 6,000 dental practitioners who regularly see patients and seek to conduct research on their work.

The network seeks to develop tools to improve clinical-decision making related to alternatives among other plans.

“Dentists play a key role in addressing the opioid crisis,”  researchers said. “(American Dental Association’s) new opioid policy has the potential to lead to further reductions in opioid prescribing for acute dental pain and may serve as a model for other clinical professions.”

The ADA says it is partnering with the National Institutes of Health “that underscores the importance of scientific evidence to guide clinical decision- making and helps ensure that dental practitioners are kept abreast of the latest research.” – Joe Cantlupe, HealthDataBuzz

References

Centers for Disease Control and Prevention. Opioid overdose. 2018. National Center for Injury Prevention and Control, Division of Unintentional Injury Prevention. https://www.cdc.gov/drugoverdose/index.html.

Ibid. What States Need to Know about PDMPs. 2017. Retrieved from: https://www.cdc.gov/drugoverdose/pdmp/states.html

 

Dr. Martha Somerman, director of the National Institute of Dental and Craniofacial Research, Journal of the American Dental Association, and Nora Volkow, director of the National Institute of Drug Abuse. The Role of the Oral Health Community in Addressing the Opioid Overdose Epidemic. Retrieved from: https://jada.ada.org/article/S0002-8177(18)30419-7/fulltext and

https://www.drugabuse.gov/news-events/news-releases/2018/07/journal-commentary-addresses-role-dentists-in-opioid-crisis 

Dr. Nora Volkow. National Institutes of Health blog: NIH Partners with the Dental Community to Help Curb the Opioid Crisis.

Miriam Valverde, Donald Trump declares public health emergency over opioid crisis. Here’s what that means. 2017. Politifact. Retrieved from: https://www.politifact.com/truth-o-meter/article/2017/oct/30/opioid-epidemic-united-states-and-trump-administra/