New York Times profiles Harvard cognitive psych prof Elizabeth Spelke and BHN baby enrolls in one of her experiment

The Times’ “Profiles in Science” feature seems to favor Harvard types. Today’s offers a video and story on cognitive psychologist Elizabethe Spelke. If you’ve had a baby in the Boston area any time in the past 15 years or so, you probably got a letter from a lab like hers asking if scientists could use your tot for research. (We took her up on it — more on that later.)

From the Times:

Dr. Spelke studies babies not because they’re cute but because they’re root. “I’ve always been fascinated by questions about human cognition and the organization of the human mind,” she said, “and why we’re good at some tasks and bad at others.”       

But the adult mind is far too complicated, Dr. Spelke said, “too stuffed full of facts” to make sense of it. In her view, the best way to determine what, if anything, humans are born knowing, is to go straight to the source, and consult the recently born.       

Decoding Infants’ Gaze

Dr. Spelke is a pioneer in the use of the infant gaze as a key to the infant mind — that is, identifying the inherent expectations of babies as young as a week or two by measuring how long they stare at a scene in which those presumptions are upended or unmet. “More than any scientist I know, Liz combines theoretical acumen with experimental genius,” Dr. Carey said. Nancy Kanwisher, a neuroscientist at M.I.T., put it this way: “Liz developed the infant gaze idea into a powerful experimental paradigm that radically changed our view of infant cognition.”       

Note that the story includes a comment from Steven Pinker — another Harvard prof  profiled by the paper — who famously debated Spelke over the whether gender differences are learned or, to some degree, innate. Also note that The New Yorker profiled Spelke in 2006.  

Bombarded with letters from Spelke and other researchers after my son was born, I decided enroll my son in one of her studies. He got a shirt and a tippy cup. I got a story, which ran in The Boston Globe.

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Health Wonk Review: Wearing the Green for the St. Patrick’s Day Edition

Here in Boston, researchers have looked into that most pressing of St. Patrick’s Day health questions: Is Guinness really good for you? Red wine gets all the press, but Tufts researchers found a positive association between beer and bone density.

For this edition of the Health Wonk Review, we take a a look at the Irish Times and find that even with a national health plan, Ireland has to deal with barriers to care. One story details slow progress in the establishment of promised primary care centers, and another story, asks “Is the EU good for your health?”

So, while we refight the battle over birth control, the Irish health ministry — of the largely Catholic country — is releasing a “sexual health” app.

Back here in the new world, the great grandchildren of Irish immigrants celebrate their heritage as Linda Leu at the Health Access Blog writes about a report that “highlights the need for cultural competency and language access, to welcome all ethnicities from California (and America’s) diverse communtiies….The Importance of Equity in the Bridge to Reform: As St. Patrick’s Day celebrates Irish ethnic pride, we need to take note of the full diversity of our states and nation. As we get ready for 2014, remember the communities that will be newly served may not look (or speak) the same as those that the current system serves.” 

For the once-a-year step dancers,Gary Schwitzer at Health News Review answers questions about outcomes data on knee replacement surgeryAlso see posts on the JGIM paper on  data on  shared decision-making in prostate cancer surgery & coronary stents decisions   and an online “Daily Deal” coupon for preventive MRI scan – disease-mongering du jour

Boston’s own David Williams notes: “Profits are up at Massachusetts health plans –should you be upset? On his Health Business Blog, he writes: The Globe reports higher profits and CEO compensation at Massachusetts health plans. But profit margins are low and if anything the CEOs are underpaid.”

More of the best of recent health policy posts

At The Hospitalist Leader, Brad Flansbaum examines physician pay,fairness, and how it relates to the reinvigoration of primary care. Specialty physicians take note.”

Another post on health care providers — and their support teams — notes: “There’s been much discussion of the potential impact of health reform, aka Obamacare, on employment”  Joseph Paduda at ManagedCareMatters.com writes: “Most has referenced employers cutting jobs to avoid the mandate or save dollars for premiums.  What hasn’t received much attention are the new jobs – mostly high-paying ones– that will be created as more Americans are insured and seek coverage and care.”

Julie Ferguson of Workers’ Comp Insider asks “If you had to guess what workplace experienced most assaults by customers/patrons what would you guess? If you guessed healthcare, you would be right.” She informs us that 61% of all workplace assaults are committed by healthcare patients, according to a recent report issued by NCCI.

Two posts came in on shady practices.

Colorado Health Insurance Insider offers: Colorado AG Files Lawsuit Against Discount and Mini-Med Health Plan:  “It’s a pretty typical website for that sort of product, with lots of great-sounding claims and sample cases where members have supposedly saved thousands of dollars.  But they also have a link for people who want to “become a reseller”.  And their process of getting recruits enrolled to sell the product is what has come under the watchful eye of the Colorado AG.”

 Calling it “The latest example of misbehavior by a large health care corporation,”  Roy M. Poses at Health Care Renewal writes : Gentiva’s Odyssey Healthcare Settles Again, Signs Yet Another Corporate Integrity Agreement and gets “little more than a financial wrist slap.  The case was about allegations that a for-profit hospice enrolled patients who did not meet the regulations for federal reimbursement for hospice care.  In particular, they were alleged to be patients who really did not seem to have extremely limited life expectancies.  It is true that enrolling such patients lead the government to pay more for their care than might otherwise be the case.  But the real problem is that patients may have been denied treatments that could have improved, or even lengthened their lives. 

Two on workplace wellness:

Wellness Program Implementation at WCS Looks a Lot Like Dating” says Kat Haselkorn Corporate Wellness Insights. This post details the similarities between customer satisfaction and romantic relationships. Although wellness program implementation and dating do not seem to have much in common, we have found that the process of making a client happy mirrors the act of keeping a romantic prospect satisfied. When it comes to setting up a wellness program, we do whatever it takes!

Henry Stern, LUTCF,  at the CBC InsureBlog writes about “Health vs Common $ense, challenging “the conventional wisdom that workplace health promotion programs work.”

And two on HIT:

“Competition today in healthcare encourages care providers to hoard patient data.”  says Vince Kuraitis of the  e-CareManagement blog in a post called “Stage 2 MU Rules : The proposed Stage 2 Meaningful Use rules support moving competition in healthcare to the right bases — sharing and adding value to patient health record data.

Health Affairs offers a post by Danny McCormick, of Harvard Medical School and the Cambridge Heath Alliance, and coauthors David Bor, Stephanie Woolhandler, and David Himmelstein. The title of the post is  “The Effect Of Physicians’ Electronic Access To Tests: A Response To Farzad Mostashari

The four authors of the post are also the authors of an article in the March issue of Health Affairs. The article reported that electronic access to computerized imaging results (either the report or the actual image) by physicians was associated with a 40% -70% increase in imaging tests, including sharp increases in expensive tests like MRIs and CT scans; the findings for blood tests were similar. The article prompted a critical blog post by national health IT coordinator Farzad Mostashari.

Jason Shafrin writes: “Americans are a litigious culture.  The malpractice claims that make it to court, however, are not many as you may think.The Healthcare Economist explains why.

Finally, how does health care In the U.S. compare to other countries?  On the Disease Management Care Blog  Dr. Jaan Sidorov tests our knowledge of and finds: We’re not so bad after all!

So, our days of drinking black — or green  — beer are over. But, on Saturday I’ll boil up some cabbage and — sorry Walter Willett — and a hunk of  corned beef in honor of my Irish nanny and the Readys and Gradys  and Murphys who left their green shores and made their way across the sea to settle in Boston and New York.  Happy St. Patrick’s Day from BHN.

 

Occupy Health Care: Boston protesters say Wall Street makes them sick

While health reform may not be at the top of their agenda, some of the Occupy Boston protesters down at Dewey Square had no problem linking the high cost of medical care to their complaints about Wall Street.  Some support Obama’s reforms; others called for a single payer system. But, nearly everyone interviewed had universal health care on his or her list of demands.

Even MIT professor Noam Chomsky said  the health care system is tainted by what he described as a government dominated by private corporations. Speaking on Saturday night, he told the crowd that the  federal budget deficit could be eliminated if the US had a health care system like other countries in the developed world — presumably single payer.

Medicare itself is not the problem, he said.

“It’s a problem because it goes through the privatized, unregulated system,” he said. “It is totally dysfunctional. You can’t talk about this in Washington because of the power of the financial institutions. ”

More from the rank and file below.

Report: Heroin overdose deaths down in Massachusetts

The Globe offers an advance on a Boston substance abuse survey that reports a decline in city heroin overdose deaths from 2007 to -2008.  The state also reports a drop in the same period, after a two-year spike in overdose deaths.

Click below for a 2010 radio report from Boston Health News on the program that distributes overdose prevention drugs to users. Both the city and the state credit the program for the drop in fatalities.

For more on the Narcan program, listen to this September 2010 report:

http://www.prx.org/pieces/54390

or

https://tinkerready.files.wordpress.com/2011/06/troverdose.mp3

From the Globe

Deaths from heroin and  opiate abuse plunged in Boston after the city launched a controversial program in 2006 that supplies addicts with medicine to reverse their overdose, according to a report to be released today by the Boston Public Health Commission.

The report says the death rate dropped by 32 percent between 2007 and 2008, the most recent year for which data are available – a decrease that specialists said bucks the national trend.

Since 2006, the city has distributed the overdose drug Narcan to 2,080 people and has recorded 215 cases in which overdoses were reversed, a city health official said yesterday.

Opioid overdose  deaths were down statewide over the same time period, 2007 to 2008. From the state Bureau of Health Information, Statistics, Research, and Evaluation:

Opioids, including heroin, oxycodone, morphine, codeine, and methadone, continue to be the agent most associated with poisoning deaths (69%). This year there was a drop in the number of opioid deaths—43 fewer deaths, from 637 to 594. While this change did not achieve statistical significance, it is important to note that this drop may reflect the effectiveness of the Departments focused efforts to reduced opioid overdoses, including the OpioidOverdose Prevention and Reversal Program, which began in 2008.

“Beast Hunter” faces his toughest challenge yet: cancer

Added 8/18: stay updated on Pat Spain via Instagram. 

When Pat Spain, 31, stepped up to the podium this morning, he looked much thinner than he does on his Animal Planet show, “Beast Hunter.” That’s because the unpleasant feeling he noticed at the end of the  show’s taping turned out to be colon cancer. He’s since lost 30 pounds.

Spain stopped by the Cancer Action Network’s New England Research Breakfast at the Museum of Science to talk about coping with colon cancer.  (First, he shot a photo of the museum’s huge cricket model for his Facebook page. ) After the talk, he was off to chemotherapy.

“So,” he said “…this is the best I’m going to feel for two  weeks,”

A Genzyme scientist and wildlife biologist, Spain was discovered by National Geographic after spending all his money and free time producing a show on You Tube called “Nature Calls TV.”

But as the NatGeo show was about to wrap, he began to feel “not quite right.”

Having recently visited Sumatra, Mongolia and the Amazon, he thought he had picked up something traveling.  After five months and numerous misdiagnoses, his doctors did a colonoscopy and, in January, discovered the cancer.

Without blaming anyone, he said found the experience “pretty embarrassing and dehumanizing.” A low point – waking up from an induced coma to learn he had undergone an ileostomy.

The experience made him understand why people don’t talk about cancer.

“That’s why I’m very happy to speak to everybody and anybody,” Spain said. “When you are on TV and you’re in front of the camera as much as I am all the time, you tend to make your mistakes in public and that tends to remove that embarrassment factor.”

Since then, his ostomy has been reversed and his bedsores have healed.

But, he noted that chemotherapy is “much harder than I  thought it would be.” He compared it to a ritual he went through for his show – being bitten hundreds of times by bullet ants which, he said, “have the worst sting in the animal kingdom.”

He thought if he could handle that, he could handle anything. But, he said “cancer has been harder…Chemo is my bullet ants.”

So, he got involved with the American Cancer Society because  he wants people to know: “There is no rule that only smokers and people over 50  get cancer.”

And, he got a standing ovation.

Did journalists overstate the promise of the human genome project?

Note that in the Nature Network Boston report on Tuesday’s panel on the human genome project, Broad Institute chief Eric Lander says that journalists naively reported that the genome map would rapidly lead to cures for many diseases.

 Lander said that expectations for the impact of the research were  “fabulously naïve. Journalists wrote about how we were going to have drugs for all these disease in the next decade. Somebody was smoking something. This was just nuts.”

They say journalism is the art of verification. So we went back to try to find some of these stoner reporters and their overblown claims by reviewing reporting in The New York Times and USA Today. 

Although the paper on the research was published in 2001, the results were announced in the summer of 2000 at a White House press conference. A June 27  NYTimes package entitled “READING THE BOOK OF LIFE: A Historic Quest; Double Landmarks for Watson: Helix and Genome” seemed pretty measured:

The human genome project may be the gateway to the biology and medicine of the 21st century…

Identifying the genetic variations that predispose people to diseases like cancer, diabetes and schizophrenia was a major purpose of the Human Genome Project…

Even incomplete, the databases of DNA sequences are a treasure trove for researchers, providing answers in a few minutes at a computer terminal rather than after months of laborious, expensive laboratory experiments. For pharmaceutical companies, that speeds the development of new drugs with several promising compounds already undergoing human clinical trials.

For university researchers, that opens up areas of inquiry that would previously not have been worth the time and effort.

More than a year later, on December 25, 2001, a Times update read:

With the Human Genome Project — the effort to work out the sequence of the three billion chemical letters that embody human heredity — nearly complete, biologists are facing a daunting transition.

They must move from their traditional pursuit of understanding one gene at a time to the challenge of figuring out how tens of thousands of genes work in concert in the human cell.

Should they succeed, in 20 years it may be possible to compute the behavior of a cell, perhaps of a living organism, and to calculate how changing one unit of DNA may affect human health or performance.

Now, here’s a little hyperbole, but from a scientist, not a journalist. Granted, the reporter chooses who to quote.

Dr. Richard Lifton of Yale predicted that in 20 years researchers would be ”able to identify the genes and pathways predisposing to every human disease.” A panel of biologists led by Dr. Michael Snyder, also of Yale, said that in two decades they would like to know the effects on the organism of the smallest possible change in the genetic programming, the switch of a single unit of DNA.

Here’s how USA Today reported on the genome map on June 23, 2000:

Generations of scientists will spend most of the next century interpreting the code’s meaning and learning to play it on computers in increasingly complex ways that they believe will lead to treatments for most, if not all, human diseases.

The genetic code also will launch a mammoth growth industry and marry the new darlings of Wall Street: computer technology and biotechnology. Scientists from the public and private projects predict that the information contained in the genetic code will allow them for the first time to study the interactions of many different genes involved in
complex diseases such as cancer and heart disease and to develop drugs that target these diseases at their most fundamental root levels.

Were they generating this hype or just reporting it? And, is there any difference? Here’s more from that story:

(Francis) Collins, the U.S. leader of the international Human Genome Project, are expected to announce the completion of their projects at news conferences Monday in Washington….

“Achieving this milestone is an exhilarating moment in history, and a credit to the ingenuity and dedication of some of the brightest scientists of the current generation,” Collins told USA TODAY. “Even more importantly, it brings us a major step closer to understanding and better treating a host of diseases for which genomics offers the best hope of prevention and cure.”…

Some predict the expected health benefits will beginto appear with regularity in about 10 years.

“We will see an increasing proportion of gene-based medicines coming to the market that are targeted to the disease process,” says Paul Herrling, director of global research at Novartis Pharmaceutical Corp. in Basel, Switzerland. “Many traditional therapies address the end stages of disease. These new therapies will address the disease process, so if a person has Alzheimer’s disease or diabetes, we will develop medicines that stop or slow down the disease process.
Having the human sequence is just the beginning.”

 And, do note that Lander was the first author in the  actual paper on the findings, which was, published ten years ago in Nature, concluding:

The scientific work will have profound long-term consequences for medicine, leading to the elucidation of the underlying molecular mechanisms of disease and thereby facilitating the design in many cases of rational diagnostics and therapeutics targeted at those mechanisms.

Finally, Lander made a bold prediction of his own at Tuesday’s panel:

He cited ” an explosion of work that will culminate, I think in the next five years, in a pretty comprehensive list of all the target that lead to different kinds of cancers and give us a kind of roadmap for finding the Achilles heel of cancers for therapeutics and diagnostics.”

 

BHN report: Hackers, health and the Boston Code-a-thon

Sometimes,  hackers have to work on meaningless problems in windowless cubicles. But on Saturday, a group of number crunchers and tech enthusiasts gathered at Microsoft’s sun-soaked Cambridge offices to find new ways to use health data.

Last week’s “code-a-thon” was the latest “Developer Challenge” hosted by a Health 2.0, a group that organizes conferences around the rich possibilities at the intersection of data, technology and health.

Here’s how Health 2.0 puts it on their website:

Healthcare has big challenges. And technology might not solve them all. But we believe in progress one app at a time. Have a technical problem that needs working out? An app you wish existed? Data that’s sitting on the shelves getting dusty that could be made more useful?

In other words, hospitals, insurers and policy makers have been capturing huge amounts of health data and mining it for years. This effort aims to use that information — much of it in public data sets— for more than claims analysis, and utilization review. With the rise of mobile communication, do-it-yourself science and the quantified self, it’s time to let the hackers at it.

So, with the sponsorship of DIY magazine “Make,” the event attracted about a 100 people, including programmers, web designers and wired epidemiologists. Sitting with his laptop open in an airy space overlooking the Zakim Bridge, Jason Morrison said he is a big fan of gatherings like this one. A web developer for a Boston company called thoughtbot,  he finds it satisfying to work on health problems.

“It is a very ripe field for people to come in and use all this data and then turn it into information and knowledge people can use,” Morrison said. Ideally, the event would produce “actionable” tools that people can use to change their behavior or find information on treatments they might be interested in, he said.

At the end of the day, coders were expected to regroup and present their ideas. Click here for a link to Health 2.0 news site to find out who won.

In this video report, Morrison (in the black jacket) and others talk about what brought them to the meeting.  Postdoc Rumi Chunara of the Children’s Hospital Boston made a presentation on using HealthMap for real time epidemic surveillance.  Psych resident Daniel Karlin wants to track prescribing trends and Bio-hacker Mac Cowell, of DYI Bio Boston, talks about inventing a home PCR kit for those interested in DIYgenotyping.