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WHO calls for coordinated action to reduce suicides worldwide

Posted on Sep 6, 2014 7:28:37 AM

4 SEPTEMBER 2014  GENEVA – More than 800,000 people die by suicide every year – around one person every 40 seconds, according to WHO's first global report on suicide prevention, published today. Some 75% of suicides occur in low– and middle–income countries.

Pesticide poisoning, hanging, and firearms are among the most common methods of suicide globally. Evidence from Australia, Canada, Japan, New Zealand, the United States, and a number of European countries reveals that limiting access to these means can help prevent people dying by suicide. Another key to reducing deaths by suicide is a commitment by national governments to the establishment and implementation of a coordinated plan of action. Currently, only 28 countries are known to have national suicide prevention strategies.

Suicide is a global phenomenon

Suicide occurs all over the world and can take place at almost any age. Globally, suicide rates are highest in people aged 70 years and over. In some countries, however, the highest rates are found among the young. Notably, suicide is the second leading cause of death in 15–29 year–olds globally.

“This report is a call for action to address a large public health problem which has been shrouded in taboo for far too long,” said Dr. Margaret Chan, Director–General of WHO.

Generally, more men die by suicide than women. In richer countries, 3 times as many men die by suicide than women. Men aged 50 years and over are particularly vulnerable.

In low– and middle–income countries, young adults and elderly women have higher rates of suicide than their counterparts in high–income countries. Women over 70 years old are more than twice as likely to die by suicide than women aged 15–29 years.

Suicides are preventable

Reducing access to means of suicide is one way to reduce deaths. Other effective measures include responsible reporting of suicide in the media, such as avoiding language that sensationalizes suicide and avoiding explicit description of methods used, and early identification and management of mental and substance use disorders.

Follow–up care by health workers through regular contact, including by phone or home visits, for people who have attempted suicide, together with provision of community support, are essential, because people who have already attempted suicide are at the greatest risk of trying again.

“No matter where a country currently stands in suicide prevention,” said Dr. Alexandra Fleischmann, Scientist in the Department of Mental Health and Substance Abuse at WHO, “effective measures can be taken, even just starting at local level and on a small–scale.”

WHO recommends countries involve a range of government departments in developing a comprehensive coordinated response. High–level commitment is needed not just within the health sector, but also within education, employment, social welfare, and judicial departments.

“This report, the first WHO publication of its kind, presents a comprehensive overview of suicide, suicide attempts, and successful suicide prevention efforts worldwide. We know what works. Now is the time to act,” said Dr. Shekhar Saxena, Director of the Department of Mental Health and Substance Abuse at WHO.

The report’s launch comes just a week before World Suicide Prevention Day, observed on 10 September every year. The Day provides an opportunity for joint action to raise awareness about suicide and suicide prevention around the world.

In the WHO Mental Health Action Plan 2013–2020, WHO Member States have committed themselves to work towards the global target of reducing the suicide rate by 10% by 2020. WHO’s Mental Health Gap Action Programme includes suicide prevention as a priority and provides evidence–based technical guidance to expand service provision.

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Tags: suicide prevention, world health organization

Scientists looking across human, fly, and worm genomes find shared biology

Posted on Aug 28, 2014 7:01:45 AM

dna

Researchers analyzing human, fly, and worm genomes have found that these species have a number of key genomic processes in common, reflecting their shared ancestry. The findings, appearing Aug. 28, 2014, in the journal Nature, offer insights into embryonic development, gene regulation and other biological processes vital to understanding human biology and disease.

The studies highlight the data generated by the modENCODE Project and the ENCODE Project, both supported by the National Human Genome Research Institute (NHGRI), part of the National Institutes of Health. Integrating data from the three species, the model organism ENCyclopedia Of DNA Elements (modENCODE) Consortium studied how gene expression patterns and regulatory proteins that help determine cell fate often share common features. Investigators also detailed the similar ways in which the three species use protein packaging to compact DNA into the cell nucleus and to regulate genome function by controlling access to DNA.

Launched in 2007, the goal of modENCODE is to create a comprehensive catalog of functional elements in the fruit fly and roundworm genomes for use by the research community. Such elements include genes that code for proteins, non–protein–coding genes and regulatory elements that control gene expression. The current work builds on initial catalogs published in 2010. The modENCODE projects complement the work being done by the ENCyclopedia Of DNA Elements (ENCODE) Project, which is building a comprehensive catalog of functional elements in the human and mouse genomes.

“The modENCODE investigators have provided a valuable resource for researchers worldwide,” said NHGRI Director Eric Green, MD, PhD. “The insights gained about the workings of model organisms’ genomes greatly help to inform our understanding of human biology.”

“One way to describe and understand the human genome is through comparative genomics and studying model organisms,” said Mark Gerstein, PhD, Albert L. Williams Professor of Biomedical Informatics at Yale University in New Haven, Connecticut, and the lead author on one of the papers. “The special thing about the worm and fly is that they are very distant from humans evolutionarily, so finding something conserved across all three — human, fly and worm — tells us it is a very ancient, fundamental process.”

In one study, scientists led by Dr. Gerstein and others, analyzed human, fly and worm transcriptomes, the collection of gene transcripts (or readouts) in a genome. They used large amounts of gene expression data generated in the ENCODE and modENCODE projects — including more than 67 billion gene sequence readouts — to discover gene expression patterns shared by all three species, particularly for developmental genes.

Investigators showed that the ways in which DNA is packaged in the cell are similar in many respects, and, in many cases, the species share programs for turning on and off genes in a coordinated manner. More specifically, they used gene expression patterns to match the stages of worm and fly development and found sets of genes that parallel each other in their usage. They also found the genes specifically expressed in the worm and fly embryos are re–expressed in the fly pupae, the stage between larva and adult.

The researchers found that in all three organisms, the gene expression levels for both protein–coding and non–protein–coding genes could be quantitatively predicted from chromatin features at the promoters of genes. A gene’s promoter tells the cell’s machinery where to begin copying DNA into RNA, which can be used to make proteins. DNA is packaged into chromatin in cells, and changes in this packaging can regulate gene function.

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Tags: Medical news, genomes

Gut microbiome analysis improved noninvasive colorectal cancer screening

Posted on Aug 23, 2014 8:37:56 AM

PHILADELPHIA — Analysis of the gut microbiome more successfully distinguished healthy individuals from those with precancerous adenomatous polyps and those with invasive colorectal cancer compared with assessment of clinical risk factors and fecal occult blood testing, according to data published in Cancer Prevention Research, a journal of the American Association for Cancer Research.

gutmicro

“A person’s gut microbiome is the collection of all the bacteria in their gut,” said Patrick D. Schloss, PhD, associate professor in the Department of Microbiology and Immunology at the University of Michigan in Ann Arbor. “The number of bacteria in the gut is huge; it outnumbers the number of cells in our bodies 10 to one, and the diversity of the bacteria present is critical to our health. By sequencing the V4 region of the 16S rRNA gene we were able to identify the bacteria present in each individual’s gut microbiome.

“We found that the composition of the gut microbiome allowed us to identify who in our study had precancerous adenomatous polyps and who had invasive colorectal cancer,” continued Schloss. “If our results are confirmed in larger groups of people, adding gut microbiome analysis to other fecal tests may provide an improved, noninvasive way to screen for colorectal cancer.”

By analyzing stool samples from 90 individuals—30 healthy individuals, 30 patients with precancerous adenomatous polyps, and 30 patients with invasive colorectal cancer—Schloss and his colleagues established that the composition of the gut microbiome was different for individuals in the three groups.

Using this information, they identified gut microbiome signatures for each group. Adding analysis of these signatures to assessment of age and race, which are clinical risk factors for precancerous adenomatous polyps, improved prediction of the presence of precancerous adenomatous polyps 4.5–fold. Adding analysis of the gut microbiome signatures to assessment of age, race, and body mass index (BMI), which are clinical risk factors of invasive colorectal cancer, improved prediction of the presence of invasive colorectal cancer 5.4–fold.

In addition, analysis of the gut microbiome signatures was better than fecal occult blood testing at distinguishing individuals with precancerous adenomatous polyps from those with invasive colorectal cancer (AUC=0.617 and AUC=0.952, respectively). Assessing BMI, fecal occult blood test results, and gut microbiome signatures together further improved the ability to distinguish between the two conditions (AUC=0.969).

“Our data show that gut microbiome analysis has the potential to be a new tool to noninvasively screen for colorectal cancer,” said Schloss. “We don’t think that this would ever replace other colorectal cancer screening approaches, rather we see it as complementary.

“The study involved not just microbiologists but also researchers skilled in statistics, genomics, and epidemiology,” continued Schloss. “Its success shows just how important interdisciplinary science is.”

source: American Association for Cancer Research News

 

Tags: colorectal cancer, polyps

World Humanitarian Day: WHO calls for protection of health workers in conflicts, disasters

Posted on Aug 19, 2014 7:18:11 AM

World Humanitarian Day

 As major emergencies around the globe increase in scale, complexity and frequency, the World Health Organization is calling for an end to the targeting of health workers in conflicts and other humanitarian crises, which represent a breach of the fundamental right to health.

World Humanitarian Day, celebrated every 19 August, WHO will draw attention to the continued trend of attacks on health care workers, hospitals, clinics and ambulances in Syria, Gaza, Central African Republic, Iraq, South Sudan and other areas.

Threats and harassment of health workers in West African countries have also been a worrying element of the Ebola Virus Disease outbreak. These professionals are taking personal risks to provide critical medical care, but have been threatened, shunned and stigmatized.

“Doctors, nurses and other health workers must be allowed to carry out their life–saving humanitarian work free of threat of violence and insecurity,” says Dr. Margaret Chan, WHO Director–General.

Dr. Richard Brennan, Director of WHO’s Department of Emergency Risk Management and Humanitarian Response, adds: “Assaults on health workers and facilities seriously affect access to health care, depriving patients of treatment and interrupting measures to prevent and control contagious diseases. WHO has a specific mandate to protect the human right to health, especially for people affected by humanitarian emergencies.”

While the adverse impacts of attacks on health care have been well documented in conflicts such as Syria and South Sudan, Gaza, health workers are also being prevented from carrying out their essential work outside of war–zones. In Pakistan and Nigeria, polio vaccinators, most of them female, have been specifically targeted.

As part of its lead role in coordinating the health response to international emergencies, WHO is working with partners to better document, prevent and respond to such incidents. Protecting those who care for the sick and vulnerable in the world’s most difficult circumstances is one of the most pressing responsibilities of the international community.


 

 

'Shape-shifting' material could help reconstruct faces

Posted on Aug 14, 2014 7:24:32 AM

surgery Researchers reported that they have developed a “self–fitting” material that expands with warm salt water to precisely fill bone defects, and also acts as a scaffold for new bone growth. The team described their approach in one of nearly 12,000 presentations at the 248th National Meeting & Exposition of the American Chemical Society (ACS).

To develop a material, Grunlan and her colleagues at Texas A&M University made a shape–memory polymer (SMP) that molds itself precisely to the shape of the bone defect without being brittle. It also supports the growth of new bone tissue. SMPs are materials whose geometry changes in response to heat. The team made a porous SMP foam by linking together molecules of poly(epsilon–caprolactone), an elastic, biodegradable substance that is already used in some medical implants. The resulting material resembled a stiff sponge, with many interconnected pores to allow bone cells to migrate in and grow.

 

Upon heating to 140 degrees Fahrenheit, the SMP becomes very soft and malleable. So, during surgery to repair a bone defect, a surgeon could warm the SMP to that temperature and fill in the defect with the softened material. Then, as the SMP is cooled to body temperature (98.6 degrees Fahrenheit), it would resume its former stiff texture and “lock” into place. The researchers also coated the SMPs with polydopamine, a sticky substance that helps lock the polymer into place by inducing formation of a mineral that is found in bone. It may also help osteoblasts, the cells that produce bone, to adhere and spread throughout the polymer. The SMP is biodegradable, so that eventually the scaffold will disappear, leaving only new bone tissue behind.

 

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Tags: Surgery

A blood test for suicide? Alterations to a single gene could predict risk of suicide attempt

Posted on Aug 1, 2014 5:00:00 AM

July 31, 2014 source: Johns Hopkins Medicine

 

Johns Hopkins researchers say they have discovered a chemical alteration in a single human gene linked to stress reactions that, if confirmed in larger studies, could give doctors a simple blood test to reliably predict a person’s risk of attempting suicide.

The discovery, described online in The American Journal of Psychiatry, suggests that changes in a gene involved in the function of the brain’s response to stress hormones plays a significant role in turning what might otherwise be an unremarkable reaction to the strain of everyday life into suicidal thoughts and behaviors.

“Suicide is a major preventable public health problem, but we have been stymied in our prevention efforts because we have no consistent way to predict those who are at increased risk of killing themselves,” says study leader Zachary Kaminsky, PhD, an assistant professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine. “With a test like ours, we may be able to stem suicide rates by identifying those people and intervening early enough to head off a catastrophe.”

For his series of experiments, Kaminsky and his colleagues focused on a genetic mutation in a gene known as SKA2. By looking at brain samples from mentally ill and healthy people, the researchers found that in samples from people who had died by suicide, levels of SKA2 were significantly reduced.

Within this common mutation, they then found in some subjects an epigenetic modification that altered the way the SKA2 gene functioned without changing the gene’s underlying DNA sequence. The modification added chemicals called methyl groups to the gene. Higher levels of methylation were then found in the same study subjects who had killed themselves. The higher levels of methylation among suicide decedents were then replicated in two independent brain cohorts.

In another part of the study, the researchers tested three different sets of blood samples, the largest one involving 325 participants in the Johns Hopkins Center for Prevention Research Study found similar methylation increases at SKA2 in individuals with suicidal thoughts or attempts. They then designed a model analysis that predicted which of the participants were experiencing suicidal thoughts or had attempted suicide with 80% certainty. Those with more severe risk of suicide were predicted with 90% accuracy. In the youngest data set, they were able to identify with 96% accuracy whether or not a participant had attempted suicide, based on blood test results.

The SKA2 gene is expressed in the prefrontal cortex of the brain, which is involved in inhibiting negative thoughts and controlling impulsive behavior. SKA2 is specifically responsible for chaperoning stress hormone receptors into cells’ nuclei so they can do their job. If there isn’t enough SKA2, or it is altered in some way, the stress hormone receptor is unable to suppress the release of cortisol throughout the brain. Previous research has shown that such cortisol release is abnormal in people who attempt or die by suicide.

Kaminsky says a test based on these findings might best be used to predict future suicide attempts in those who are ill, to restrict lethal means or methods among those at risk, or to make decisions regarding the intensity of intervention approaches. He says that it might make sense for use in the military to test whether members have the gene mutation that makes them more vulnerable. Those at risk could be more closely monitored when they returned home after deployment. A test could also be useful in a psychiatric emergency room, he says, as part of a suicide risk assessment when doctors try to assess level of suicide risk. The test could be used in all sorts of safety assessment decisions like the need for hospitalization and closeness of monitoring.


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Tags: suicide

Dual training may help physicians obtain leadership roles, greater career acceleration

Posted on Jul 31, 2014 5:45:32 PM

Dual training may help physicians obtain leadership roles, greater career acceleration


social media and physiciansHow can physicians obtain the leadership roles and career acceleration they desire? Perhaps an MBA can help. Graduates with dual training increasingly pursue leadership roles and experience greater career acceleration. According to a new study from researchers at the Perelman School of Medicine and the Wharton School at the University of Pennsylvania, physician graduates from the MBA program in health care management at Penn’s Wharton School report that their dual training had a positive effect on their individual careers and professional lives. Study respondents reported such benefits as career acceleration, professional flexibility, and credibility in multidisciplinary domains. Aside from clinical practice, the MD was more often cited as providing professional credibility, whereas the 40 to 50 percent of respondents said the MBA conveyed leadership, management, and business skills. Respondents said that the combination of degrees helped to inform their overall business and medical perspectives, supply multidisciplinary experience, and improve communication between the medical and business worlds.

For more information on career oportunities visit the MDLinx Career Center.

Tags: physician jobs, physician job search, Medical news, Medical Education,

Catholic Health gains another Alliance –

Posted on Jun 16, 2014 12:46:00 PM

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Medina Memorial Hospital, Orleans County, NY

 


social media and physicians With the changes that are currently taking place in the healthcare field, smaller healthcare groups are finding themselves agreeing to affiliations with larger health systems. This week Medina Memorial Hospital, which is part of the Orleans Community Health System, signed an affiliation agreement with Catholic Health based in Buffalo, NY.

The Affiliation agreement is said to focus on helping Medina with their operations, as well as, aid in their physician recruitment needs. Joe McDonald, President and CEO of Catholic Health, commented on the efforts by stating, “ Our goal is to earn the trust of the residents of Orleans County by first helping to strengthen healthcare services in the local community, and then, when needed, by improving access to specialty services like advanced cardiac, stroke, orthopedic and vascular care.”

During this transition, Orleans Community Health Board of Directors will continue with their governance of the responsibility for Medina Memorial.

By Zena Vargas, MDlinx

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Check Out the Latest Medical Articles From Dr. Cunningham

Posted on Jun 3, 2014 10:31:00 PM

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Check Out The Latest Highlights from
Scott Cunningham, M.D., Ph.D

 

social media and physiciansDr. Cunningham is a Site Editor at MDLinx and oversees the selection of the top articles each day. With a broad background and interest in general medicine, he reviews approximately 1500 papers in 13 specialties weekly and brings you the most interesting findings via brief messages.

Check out his latest article highlights below:

Fish intake associated with increased sperm counts
As reported in the Journal of Nutrition, consumption of processed meat is associated with decreased normal sperm morphology, while consumption of fish is associated with increased sperm count and increased normal sperm morphology.

Aripiprazole adjunctive therapy effective in anti-depressant monotherapy non-responders
As reported in CNS Spectrums, aripiprazole adjunctive therapy is effective in patients who did not respond to anti-depressant monotherapy (n=1065; 36.6% vs. 22.5%) compared to adjunctive therapy with placebo.

>>If you would like to receive his weekly highlights register here.

 

Tags: MDLinx News, medical article, Medical Article absrtact

Meet Scott Cunningham, M.D., Ph.D

Posted on May 19, 2014 4:10:00 PM

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Meet Scott Cunningham, M.D., Ph.D

 

social media and physiciansDr. Cunningham is an Oncology Site Editor at MDLinx and oversees the selection of the top articles in oncology each day. With a broad background and interest in general medicine, he reviews approximately 1500 papers in 13 specialties weekly and brings you the most interesting findings via brief messages.

As a member of MDLinx you will be privy to exclusive content like weekly articles highlighted by Dr. Cunningham. Examples of these highlights include:

Menopausal vulvovaginal atrophy associated with distinct microbiota
As reported in Menopause, menopausal women have a distinct microbiota (Streptococcus spp. and Prevotella spp., and decreased Lactobacillus spp.), which increases the risk of vulvovaginal atrophy (OR = 25.89) compared with pre-menopausal women.

Quetiapine and olanzapine effective in violent schizophrenics
As reported in Neuropsychiatric Disease and Treatment, quetiapine (525 + 45 mg) and olanzapine (18.5 + 4.8 mg) are effective in reducing impulsivity and psychotic symptoms in violent schizophrenics from baseline to day 70 of treatment.

>>If you would like to receive his weekly highlights register here.

 

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