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There is growing evidence that the best way to prevent asthma is to make sure your kids get nice and dirty while young - playing in the backyard, or a farm, and the like.
This Hygiene Hypothesis says that if you get early exposure to those types of things it primes your immune system in a direction away from allergy.
New evidence has come in the form of a study looking at exposure to H. Pylori, the stomach bacteria known to cause ulcers.
The study, published in PLoS ONE, shows that colonization with a certain H. pylori strain is inversely associated with asthma and is associated with an older age of asthma onset in an urban population. In other words H. pylori as one marker, amongst the many possible, for protection.
In the future one might expect that similar studies looking at serosensitivity and asthma status might lead to a type of vaccine for asthma, one of Australia's major health concerns.
I'm making a rare exception here.
This video is one of the most amazing and insane things I have seen in a long time. If I wasn't a man with certain responsibilities to others, and perhaps had missed the all essential self-preservation gene, I'd be doing it too...
In the third quarter of 2008, the first tremors of the financial crisis had been felt, and the number of venture deals in the U.S. fell to its lowest total since early 2005. According to Dow Jones's VentureWire, which tracks venture investment, information technology companies fared particularly badly, with their lowest deal total in more than 10 years.
But for the quarter, total dollars invested stayed fairly steady, off only about 1 percent from each of the first two quarters. So some companies were still getting big paydays. Of the 10 companies with the biggest third-quarter deals, the plurality--four--were in the health-care sector. One of those companies, Pacific Biosciences, builds genome-sequencing machines and figures prominently in Emily Singer's "Interpreting the Genome." The other three are testing promising new therapies for some of the most common medical conditions.
The other three are:
Between 25 and 33 percent of hypertension patients can't control their condition with medication. But the body has its own mechanisms for bringing blood pressure down, which are triggered by nerve cells in the carotid artery that respond to pressure. CVRx has found a way to treat severe, drug-resistant hypertension by stimulating those nerves electrically. A device the size of an iPod Nano is implanted in the patient's chest, with electrical leads snaking up to the carotid artery. The device is now in phase III clinical trials in the U.S. and Europe.
Cells clean up unneeded proteins by shipping them to a structure called the proteasome, which chops them up. If the proteasome can't do its job, the cell eventually dies. By targeting a specific component of the structure, Proteolix has developed a proteasome inhibitor that is particularly deadly to cancer cells. In the right doses, it kills cancer with little damage to healthy tissue. A variation on the molecule targets the proteasomes in immune cells (which differ from those in normal cells), disrupting biochemical pathways that cause autoimmune disorders.
Portola's drugs treat blood clots, which form when collagen-containing plaques on artery walls rupture. Collagen is one of the supportive tissues in blood vessels, so the body reads its sudden appearance as indication of a wound, which it sends blood-clotting agents to repair. Portola designed an imaging system that lets researchers observe blood clots forming in collagen-lined capillary tubes. The simulations led to a drug candidate that's in clinical trials as a competitor to Plavix, the world's second-best- selling drug.
HR and people management would have to be the trickiest little area for any bottom line driven manager. It's necessity has driven the creation of a variety of assessment tools and development programs.
Rypple is an online Performance Management solution. It uses the power of web networking to generate 'giving and getting honest, direct, and insightful feedback to employees'. Rypple allows frequent assessment and eases the burden on supervisors.
How does it work? Employees establish a network of trusted peers, mentors and managers whose opinions they value. They can then send out short questions, such as ?What did you think of my presentation today??, to which their network?s members can respond online. The responses are kept anonymous so that, at least in theory, employees cannot tell who has made them.
Rypple also allows users ask members of their networks to measure their performance against a scale, so they can track how they are doing over time. It also lets employers see what ?tags?, or overarching themes, are being used most often in questions. If, say, creativity is key to a firm?s success but there are few requests for feedback on employees? creativity, then bosses can tell they have not done enough to communicate their priorities.
Companies that have road-tested the product claim it puts the onus of professional development on the employees - a good thing for all - and reduces the importance of the much maligned performance reviews most groups now use.
Economics is a turn off for many of us. But there's a new generation of young things trying to make it palatable. In this Economist article, a few of them are presented. Here's a few facts they've come up with by searching troves of unwanted data:
- People are better at predicting the winner of American gubernatorial elections when they watch the candidates with the sound turned off.
- Harsher jail conditions do nothing to deter prisoners from reoffending. If anything they encourage recidivism.
- Preschoolers who watch television do better academically than children who don?t, especially if their parents have little education or poor English.
What really caught my eye in the Economist article was a group of 'randomistas'.
These economists carry out randomised trials of development projects, much like the clinical trials that prove the efficacy of new drugs. They hope to dissect the underlying physiology of economic problems. With a full anatomy of behaviour?what economists call a structural model?they can determine if a policy or project will work even before it has been attempted. In one study, economists showed that mothers in the Indian state of Rajasthan are three times as likely to have their children vaccinated if they are rewarded with a kilogram of daal (lentils) at the immunisation camp. The result is useful to aid workers, but puzzling to economists: why should such a modest incentive (worth less than 50 cents) make such a big difference? Immunisation can save a child?s life; a bag of lentils should not sway the mother?s decision either way. Had they arrived at this result using some other method, the economists may have assumed they had made a mistake. Randomisation removes such doubts, showing that it was indeed the lentils that made the difference.
Some other economic facts that have recently been found upon: - The Unemployed have sufficient incentive to find work, even if they receive unemployment benefits indefinitely.
- Bequests from one generation to the next should be subsidised by the government, with smaller inheritances receiving higher rates of subsidy. Why?Tthe biggest roll of the dice in life is the family you are born into. Their system of subsidies would take the edge off this uncertainty.
There are many more great examples of the power of economics - particularly when linked to behavioural studies in the article. Check it out sometime.
As a clinician it is near impossible to compare drugs based purely on EBM. Even the best meta-analysis is only a compilation of lesser studies that are, at best, equal comparisons of several treatment types. The real world use of a drug is almost always different, not least because your population in the clinical study may differ to the people you are treating. Hence the need for pragmatic studies.
Pragmatic clinical studies are essentially 'real-world' analyses of drugs and require a major shift in the way we approach pharmaceutical science.
The New York Times , in an occasional series called "The Evidence Gap," examined the "growing movement" among researchers to conduct pragmatic clinical trials to gather evidence "that will fill some of the biggest gaps in medical science: What treatment is best for typical patients with complex symptoms?" According to the Times, "thousands of medical studies are completed every year," but "most have relatively limited goals." The Times reports that while such limited studies "can have value," they "may no longer be enough, particularly when care has become so expensive and real evidence more crucial."
A group of advocates is lobbying the US congress to provide funds for an Institute for Comparative Effectiveness Research, which would assess treatments and identify evidence gaps. The center also would initiate pragmatic studies.
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