Talk: Can we predict and #prevent #suicide?

Students are rolling back into town, and many of them will already be stressed out. Some will try suicide; some will succeed.

As the CDC reported this summer, suicide rates are rising.

Can suicide be prevented?

A top researcher asking that question will be in town Thursday. It’s a bit of a hoof and in the middle of the day, but Maria Oquendo. of UPenn will be at McLean Hospital for a talk on on “Suicidal Subtypes: Delineating Phenotypes to Identify Underlying Biosignatures.”  Noon, Service Building, Pierce Hall.   Details.

Find some of her work here.

Her effort dovetails with that of Matthew Nook of Harvard, who was described in an NYTimes article as “the suicide detective.” 

From the CDC

Suicide is a leading cause of death in the US. Suicide rates increased in nearly every state from 1999 through 2016. Mental health conditions are often seen as the cause of suicide, but suicide is rarely caused by any single factor. In fact, many people who die by suicide are not known to have a diagnosed mental health condition at the time of death. Other problems often contribute to suicide, such as those related to relationships, substance use, physical health, and job, money, legal, or housing stress. Making sure government, public health, healthcare, employers, education, the media and community organizations are working together is important for preventing suicide. Public health departments can bring together these partners to focus on comprehensive state and community efforts with the greatest likelihood of preventing suicide.

States and communities can:

  • Identify and support people at risk of suicide.
  • Teach coping and problem-solving skills to help people manage challenges with their relationships, jobs, health, or other concerns.
  • Promote safe and supportive environments. This includes safely storing medications and firearms to reduce access among people at risk.
  • Offer activities that bring people together so they feel connected and not alone.
  • Connect people at risk to effective and coordinated mental and physical healthcare.
  • Expand options for temporary help for those struggling to make ends meet.
  • Prevent future risk of suicide among those who have lost a loved one to suicide.

 

 

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From Boston — #Sepsis, #ethics and how to waste $5 billion in health dollars.

Not at the same time. Two Boston items.

SEPSIS

Public Citizen argues that a clinical trial of a new approach to sepsis is unethical. One of the lead investigators is at BIDMC. From NPR:

A consumer advocacy organization is asking federal health officials Tuesday to halt a large medical study being conducted at major universities nationwide.

Public Citizen says that the study, involving treatment for sepsis, puts patients at risk and will at best produce confusing results.

The CLOVERS study seeks to answer a key question about sepsis, which is a common and life-threatening response to infection. Sepsis kills more than 250,000 Americans a year, often by triggering the failure of multiple organs. As patients’ blood vessels get leaky as a result of sepsis, it becomes difficult to maintain safe fluid balance and blood pressure.

NPR reports that  Dr. Nathan Shapiro, a professor of Emergency Medicine at Beth Israel Deaconess Medical Center and one of the principal investigators for the CLOVERS study, stands by it.  He declined to talk to the reporter and instead issued a written statement.citing the input of “expert clinicians” who produced a study that “follows a well-accepted design.”

sepsis-cta-question-ig1-small
Centers for Disease Control

Public Citizen also had a written statement on a letter sent to Office for Human Research Protections at HHS.

 An ongoing clinical trial involving seriously ill sepsis patients is deeply flawed, riddled with serious regulatory and ethical lapses, and must be stopped, Public Citizen said today in a letter (PDF) to the federal government.

In the experiment, patients are being given one of two treatments for sepsis, both of which are risky and neither of which is considered standard treatment. Because no other group of patients in the trial is receiving the usual treatment for sepsis, researchers can’t ensure that the experiment isn’t causing increased deaths and organ failure. Sepsis is a life-threatening condition in which bacteria or their toxins get into the bloodstream, causing shock and organ failure.

STAT also has a story on Public Citizen’s action, as well as a great video explaining the hard-to-explain condition.

 

Another item, this one in the Times:

Long-term care hospitals?

This little noticed approach to post-acute care is apparently delivering nearly $5 billion. Amy Finkelstein of MIT was one of the authors of a study that concluded:

There is substantial waste in U.S. healthcare, but little consensus on how to identify or combat it. We identify one specific source of waste: long-term care hospitals (LTCHs). These post-acute care facilities began as a regulatory carve-out for a few dozen specialty hospitals, but have expanded into an industry with over 400 hospitals and $5.4 billion in annual Medicare spending in 2014. We use the entry of LTCHs into local hospital markets and an event study design to estimate LTCHs’ impact. We find that most LTCH patients would have counterfactually received care at Skilled Nursing Facilities (SNFs) – post-acute care facilities that provide medically similar care to LTCHs but are paid significantly less – and that substitution to LTCHs leaves patients unaffected or worse off on all measurable dimensions. Our results imply that Medicare could save about $4.6 billion per year – with no harm to patients – by not allowing for discharge to LTCHs.

The New York times reports on the study here.

 

Biogen Blues Band rocks East Cambridge block party

Some co-workers organize softball teams. Others start bands. There are enough of them in Cambridge for an annual Battle of the Biotech Bands. Last week, the Biogen Blues Band played for a local block party.

Don’t like your #selfie? BU docs say more are asking for facial asymmetry and eyelid #surgery

IMG_6063 (2)The term “Snapchat dysmorphia” is a little deceiving.  Two BU plastic surgeons, writing   in a JAMA plastic surgery journal,  say:  A new phenomenon, dubbed “Snapchat dysmorphia,” has patients seeking out cosmetic surgery to look like filtered versions of themselves instead, with fuller lips, bigger eyes, or a thinner nose.7 This is an alarming trend because those filtered selfies often present an unattainable look and are blurring the line of reality and fantasy for these patients.

They report on this survey:

Current data show that 55% of surgeons report seeing patients who request surgery to improve their appearance in selfies, up from 42% in 2015. The survey also noted an increase in the number of patients sharing their surgical process and results on social media In addition, excessive scrutiny of selfies is also changing the presenting concerns of patients. Prior to the popularity of selfies, the most common complaint from those seeking rhinoplasty was the hump of the dorsum of the nose. Today, nasal and facial asymmetry is the more common presenting concern. Along with rhinoplasties, hair transplants and eyelid surgical procedures are also popular requests to improve selfie appearance.

Washington Post has a nice video on the topic.

 

8/6 Science in the News in the summer in a bar in Somerville

From Science by the Pint

Ling cancer cell, NIH

Monday, August 6th, 6:30-8:00pm at The Burren

(247 Elm St, Somerville, MA 02144) (directions)

Dr. Elma Zaganjor, Ph.D. and
Dr. Jessica Spinelli, Ph.D.

Postdoctoral Research Scientists
Dr. Marcia Haigis’s Lab, Harvard Medical School

Fuel for the Fire: How cancer cells alter their metabolism during tumor development

(247 Elm St, Somerville, MA 02144) (directions)
Events start promptly at 6:30 p.m.

Cancer cells require a continuous source of energy and cellular building blocks to support their rapid rate of growth. Metabolic reprogramming helps cancer cells gain a growth advantage by giving them the ability to consume a wide variety of available fuel sources, from dietary fuels such as fats, sugars and proteins to waste products generated by the cancer cells themselves. Drs. Elma Zaganjor and Jessica Spinelli, two scientists working in Dr. Marcia Haigis’s laboratory, are studying how this reprogramming drives tumor growth in the hope of both better understanding the processes underlying cancer development, as well as how we could potentially use this knowledge to develop new cancer treatments. Please join us for what promises to be an engaging evening with two outstanding speakers and lots of interesting discussion!

Also, on Wednesday, 8/8  science in the summer at the Broad. Be sure to register.

Midsummer Nights’ Science at the Broad Institute takes place at 415 Main Street, in Kendall Square in Cambridge. Each lecture runs from 6:30 – 7:30 pm and is immediately followed by a reception with light refreshments.

The Eliana Hechter Lecture: How do genes control our size and shape?
Joel Hirschhorn
People come in many shapes and sizes, and genes play a strong role in determining how short or tall we are, or whether we are lean or obese. Joel will discuss recent dramatic advances in genetics that have led to the discovery of hundreds or thousands of places in our genomes that influence height or obesity, what this tells us about the biology of human height and weight, and how these discoveries could lead to new treatments for obesity.

 

Alzheimer’s drug promising? Page 1. Alzheimer’s drug not so promising? Page B12

Not sure how STAT played this on their site. In the the print version of The Boston Globe, it ran it on A1 Thursday

Hopes rise again for a drug to slow Alzheimer’s disease

File Oct 30, 9 54 16 AM

The follow-up in today’s print edition ran on B12, with this headline: Interpreting an Alzheimer’s trial.

Have yet to find in on the Globe web site, but here’s the STAT version, with their headline.

Here’s why Biogen lost $7 billion overnight despite ‘positive’ Alzheimer’s data

 

UMass doc comments on pediatricians statement re: plastic food containers

Umass doc weights in on this. Also see research from Silent Spring Institute.

AAP release here.

nci-vol-1926-150
NIH photo

 

From Times: “Because hormones act at low concentrations in our blood, it is not surprising that even low-level exposures to endocrine disrupters can contribute to disease,” said Laura N. Vandenberg, an assistant professor in the department of environmental health sciences at the University of Massachusetts-Amherst’s School of Public Health, who spoke on behalf of the Endocrine Society.