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Maintaining body weight isnt as simple as burning off all the calories eaten in a day. The brain plays an important role. It determines what you eat, how much and when. And the brains immune cells contribute, too, a new study in mice shows. Turning on these cells can make a fatty diet more fattening. Getting rid of those cells, known as microglia, can make the animals eat less and gain less weight.

These microglia caninflamea particular area of the brain. And in mice, this process could make the animals gain weight even when they werent eating a fatty diet.

I think its really neat, says Kate Ellacott, who was not involved in the study. This is the first time anyones shown if you change the way microglia can behave if you make them more inflammatory you can impact bodyweight. Ellacott is a neuroscientist, someone who studies the brain, at the University of Exeter in England.

The immune system is a collection of cells that can move throughout the body to help fight infection and damage. When a part of the body is stressed or injured, the hurt part sends out chemical distress calls. Those messages are like an alarm. They tell immune cells where to swoop inso that they can destroy damaged cells or gobble up germs.

Along the way, immune cells cause inflammation. This response can include redness and swelling. People often think of inflammation as a swollen knee or the redness surrounding a cut. Here, Ellacott points out, the immune system works to restore balance. The immune system tries to repair tissues and get back to normal, she explains.

But sometimes, inflammation sticks around for the long term, even when its not supposed to. Such chronic inflammation does not have to include redness. But it will cause harm. If you have a disease where inflammation never goes away, you can get damage to the tissue, she points out.

One condition where chronic inflammation occurs is obesity. Eating a high-fat diet for a while makes animals gain weight and activates their immune cells, says Joshua Thaler. Hes an endocrinologist (someone who studies the hormones in the body) and a neuroscientist. He works at the University of Washington in Seattle.There,his team performed the new study.

The brain is full of cells called neurons. But they arent alone. A variety of other cell types live there too, Thaler notes. For a while, scientists thought some of these cells, called glia (GLEE-ah), were just there to support neurons and to hold them together. (In fact, glia comes from the Greek word for glue.) But glia are far more than just brain glue. Some of them, called microglia, act as an immune army in the brain. They move into injured areas and can turn on inflammation when things go wrong.

Microglia cells, like the one shown here, can become activated by a high fat diet. Afterward, it can foster a state of chronic inflammation in the brain.

TimoninaIryna/istockphoto

Thalers team already had found that one brain area gets inflamed when mice eat a high-fat diet. Called the hypothalamus, this brain area helps to regulate how much mice and people eat. They even showed similar changes in the brains of people with obesity.

Could the microglia in the hypothalamus be the reason why? To find out, Thaler and his colleagues fed high-fat diets to more mice. Then they gave some of these mice a drug that killed off microglia. Without these immune cells, those mice gained less weight and ate less food. But losing their microglia had no effect on mice dining on low-fat chow.

The researchers wanted to make sure microglia were causing the inflammation that led to weight gain. So they deleted a gene a set of cellular instructions. Microglia use this gene to make their inflammatory signals. Thetreated mice gained less weight on a high-fat diet, just as in themice with no microglia at all.

If stopping inflammatory signals made mice gain less weight, more inflammation might have the opposite effect. Thalers group decided to test that idea. They worked with mice that were unable to make an important inflammation-fighting molecule. These mice developed inflammation in their brains. They also gained weight even when they werent on a high-fat diet! That confirmed that brain inflammation alone could contribute to obesity.

Thaler and his colleagues published their findings July 5 in the journal Cell Metabolism.

Calling in the immune cavalry

Microglia are full-time brain residents. Theyre always there, Ellacott says. These cells move to wherever the brain needs them.

When mice eat a high-fat diet, the hypothalamus recruits microglia. And these immune cells then call for backup. In the new study, some of those backup immune cells had come from a mouses bone marrow.

Usually, immune cells in the marrow cant reach the brain. Theres a barrier between the blood and the brain that stops them. That blood-brain barrier exists to keep potentially dangerous cells and other foreign substances from getting in.

Somehow, a high-fat diet let those marrow-based backup cells break into the brain.

Some scientists had seen immune cells getting into other organs after a high-fat diet, Thaler notes. But his group has now shown it also happens in the brain. I was not a believer that the [immune cells] were going to come marching into the brain, he recalls, so it was a bit of a surprise.

Scientists might someday be able to reduce inflammation by targeting the microglia, Ellacott says. If they can develop a drug that works this way in people, scientists might use it to treat all types of brain diseases linked with inflammation, not just obesity.

Microglia in the brain may contribute to weight gain, Thaler says. But clearly they arent the whole story. Turning off the microglia, or stopping them from sending inflammatory distress calls, causes mice to gain less weight. But in the end, those mice still became overweight. And while mice with brain inflammation gained weight on even a low-fat diet, he notes that they never got as fat as did the mice downing high-fat chow.

The brains immune system may be a part of the obesity story, Thaler says, but theres clearly more we need to learn.

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Brain's immune system can play role in weight gain - Science News for Students

Vaccines are one of humanitys greatest achievements. Credited with saving millions of lives each year from diseases like smallpox, measles, diphtheria, and polio, one would expect vaccines to be enthusiastically celebrated or, at the very least, widely embraced. Why is it, then, that we are witnessing the widespread proliferation of anti-vaccination sentiment? Why is it that some communities in North America, including, for example, areas of Vancouver, are now turning their backs on vaccines in numbers large enough to threaten herd immunity? Current research has shown that over 25% of Canadian parents are concerned or uncertain about the association between vaccines and autism. A similar percentage of parents worry that vaccines could cause serious harm to their children. What are the social forces contributing to this rise in vaccine hesitancy?

There are multiple interrelated reasons for the existence and spread of both aggressive anti-vaccination and subtle vaccine-hesitant perspectives, but they often stem from issues surrounding trust, personal choice, and fear. Vaccination myths are being circulated in communities and wide social networks, and these myths create scientifically unwarranted concerns about the risks and safety of vaccines. While many parties contribute to the proliferation of these myths, there is little doubt that complimentary and alternative (CAM) practitioners are playing a role.

Numerous studies have demonstrated links between CAM and anti-vaccination attitudes; CAM use is associated with not vaccinating children, and CAM training is associated with anti-vaccination attitudes. In our recent investigation of 330 naturopath websites in the Canadian western provinces of British Columbia and Alberta, we found 53 websites containing vaccine-hesitant discourse. That is to say, these websites explicitly denounced vaccinations, raised issues with the harms and risks of vaccines, and/or offered alternative vaccination services such as homeopathic prophylaxes. This easily accessible discourse can contribute to confirmation bias for those already critical of vaccines, and can also heighten skepticism among those with doubts. With increasing numbers of the population going online for health information, it is reasonable to be concerned that discourse of this kind might plant unwarranted seeds of doubt in the minds of some individuals previously comfortable with vaccines. These messages could also spread: if youve ever seen someone share fake news on Facebook, you know what we are talking about.

Notably, it is incorrect and unfair to arrive at the conclusion that CAM = antivaxx. It is, however, important to recognize the presence of significant anti-vaccination sentiment in these communities. We must begin to think of ways to tackle myths and behaviours that put both individuals and communities in harms way.

The solutions, of course, will vary by jurisdiction. As outlined in our paper, in Canada the Competition Bureau and Health Canada could modify advertising standards to curb treatment and performance claims online, and the latter institution could even act to entirely prevent the sale of demonstrably ineffective natural health products like homeopathic remedies. In addition, the right of CAM practitioners like naturopaths to self-regulate their profession could be reconsidered, as there is little indication that evidence-based standards are enforced. Alternatively, third party oversight could force the adoption of such standards. Lastly, better application and enforcement of existing law could help. As more naturopaths and other CAM practitioners position themselves as primary care providers, they become legally responsible to uphold existing common law standards of informed consent. Failing to disclose the overwhelming scientific evidence supporting vaccines when recommending not to vaccinate or to use an ineffective vaccine alternative likely constitutes negligence.

Vaccines are a matter of life and death. We live in a society privileged to have access to incredible medical developments that empower us to make decisions that improve life for ourselves and others. We owe it to ourselves and others to ensure the science of vaccines is not obscured by those attempting to inject doubt and fear into the conversation.

Featured image credit: Virus by qimono. CC0 public domain via Pixabay.

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Combatting the spread of anti-vaccination sentiment - OUPblog (blog)

Almost four and a half years ago, then minister for health Dr James Reilly ordered the Health Service Executive not to destroy more than one million blood samples taken from newborn children in the Republic between 1984 and 2002.

The heel-prick tests, known as Guthrie tests, are carried out on all babies to screen for genetic conditions.

The decision to destroy the cards with the blood samples on them came after it emerged that those taken before July 1st, 2011, were being retained without consent, and therefore in breach of national and EU data protection law.

The Royal College of Physicians at the time said there was an explosion of molecular genetics every day that was being added to and that the museum piece cards could prove to be even more valuable in the future.

The Irish Heart Foundation, which had campaigned to save the cards, said some 1,400 families that had lost a member through sudden adult death syndrome would, as a result, be able to get a genetic diagnosis to see if they were at risk.

The debate over those cards and the legality of retaining them still rumbles on, as do ethical questions about the privacy of highly sensitive medical data obtained for one purpose and whether it should ever be used for another without the consent of the original subject, in the absence of a legal exemption.

Meanwhile, medical and scientific researchers are closely watching the new EU General Data Protection Regulation (GDPR) and what it might mean for them and their work after it takes effect next May.

While the regulation allows certain exemptions for processing special cateogories of data, including genetic and biometric data, the Irish legislation hasnt been written yet and researchers are waiting to see what it will mean for their work.

In some cases, they are worried about what the new law will mean for historic datasets and longitudinal studies and whether they will have to delete them on the grounds that they will not have the appropriate standards of explicit consent post May 2018 to retain them.

Even in just a few years, the medical, legal, ethical and social dilemmas involved in processing health data, including biological samples obtained from patients or research study volunteers have become vastly more complex.

The ethical issues that arise around areas such as stem cell research, embryo research and reproductive cloning, genome sequencing, gene editing and population-scale biobanks are huge.

Opportunities for uncovering the causes of disease, for resolving fertility issues, for fixing genetic conditions, for treating cancers, are within the grasp of scientists and researchers, but there is still no international consensus on many issues.

Concerns are evolving too in light of new models for funding research, such as venture capital-backed projects where highly sensitive data used for research, and effectively a permanent record, may ultimately end up being used by or sold for profit to companies or other third parties anywhere in the world.

Researchers are still uncertain what exactly the GDPR will mean for them in terms of the exemptions from data protection legislation that will apply to so-called special categories of data including genetic and biometric health data used for research.

At a recent event in Dublin, the Irish Platform for Patients Organisations, Science and Industry (IPPOSI) explored the concerns about data protection, consent and the forthcoming regulation.

IPPOSI chief executive Dr Derick Mitchell told the event: Patients are aware that the altruistic benefit of being involved in research far outweighs the risks, but they do expect that they will be consulted on the use of their data.

He said empowerment of the data owner was fundamental to the forthcoming changes in the law, and the event explored a model of so-called dynamic consent to allow people consent to have their data used for research, possibly allowing broad consent at the outset and opt-outs at a later stage where they did not agree to new uses. The legal jury is still out on whether such a model is even possible.

Dr Mitchell said a national response was required to GDPR and not just for health research.

He hoped that guidance on the question of consent for processing of personal data expected later in the year from the independent body representing all of the EUs national data protection authorities would be a step forward.

But I think the real crux is the code of conduct and each institution in effect will have to develop their own code of conduct as to how they approach data protection from the beginning of projects rather than having it as a kind of tick-box exercise at the end of a project, he said.

Dr Mitchell said the explicit consent referred to in the EU regulation, for example, had very real consequences for the continuation of large-scale population biobanks, for example.

There was also an ethical argument going on as to whether a persons consent could be said to be informed if they ultimately did not know what the research project might ultimately examine.

Prof Jane Grimson, a member of the e-health Ireland committee and a former director of Health Information in the Health Information and Quality Authority, said the potential of health data and research had to be balanced with a patients right to privacy.

Ownership of patient records was critical, she said.

I think the way we are moving now is much more towards electronic health records that will be owned and controlled by the individual. Its their information and they should be in control of who has a right to see information and the information (that is used in research).

Ethics research committees were critical and needed to operate to a very high standard to ensure the trust of people, she added.

Its an absolute minefield but I really think that ethics committees are critical.

Prof Orla Sheils, director of the Trinity Translational Medicine Institute and director of medical ethics at the School of Medicine, TCD, said she believed GDPR would have immediate consequences for data already being processed by researchers. It was a very grey area.

The difficulty with that is that if data has been collected over a long period of time that a person may not want to be reminded of the time that they were ill. Thats the balance you are trying to find there. So the way to get around that is to try to give people enough options up front to decide yes, I want to gift my sample and provided the research thats going to be done is ethical and has been approved, thats okay by me.

Prof Sheils, who sits on the St Jamess and Tallaght hospital research ethics committee, said all research involving humans had to be approved by such a committee.

Its never an ethical issue if the answer is easy, she said.

Like everything else in life, its about finding that happy balance that people are comfortable with, she said.

There is never really a right answer when there is an ethical dilemma. What I always say to students is that you are hoping for the least bad option.

Cathal Ryan of the office of the Data Protection Commissioner told the IPPOSI event the new EU regulation would bring harmonisation, transparency and accountability to a very dense and complex area. The regulation was very pragmatic and the code of conduct within it would act as a form of self-regulation, with the additional oversight of an independent monitoring body. But he said adequate transparency on data protection in the sector had been lacking.

If there is an erosion of trust, if the health sector doesnt treat an individuals data in the right way, there will be problems.

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Should your medical data be off the record? - The Irish Times - Irish Times

Just as smaller animals of a given species generally live longer than their larger cousins, one might expect that taller humans are genetically programmed to sacrifice longevity for height.

But its not that simple.

A major multinational study of 841 men and women from across four populations found lower levels of insulin-like growth factor 1 (IGF-1) in men living to age 100 and yet most of them were taller than men in the younger control group.

The apparent explanation for this head-scratcher is that some long-lived men and only men have a genetic mutation that makes their growth hormone receptors more sensitive to the effects of the hormone. The cells absorb less growth hormone, yet protein expression is increased by several times.

This mutation seems to be responsible for their ability to live about 10 years longer than the control group of 70-year-old men without the mutation, even though they have a lower amount of growth hormone and are about 1.18 inches taller.

The lead author of the study is professor Gil Atzmon of Albert Einstein College of Medicine in New York and head of the Laboratory of Genetics and Epigenetics of Aging and Longevity at the University of Haifa. Since 2001, Atzmon has been studying the human genome and its impact on aging and longevity.

The researchers working with Atzmon looked at four elderly populations: 567 Ashkenazi Jews in theLongevity Genes Projectat Einstein, 152 from a study of Amish centenarians, and the rest from an American cardiovascular health study and a French longevity study.

In 2008, the Longevity Genes Project found a genetic mutation in the IGF-1 receptor of some women, although its not the same as the one affecting mens lifespans.

We knew in the past that genetic pathways associated with growth hormone were also associated with longevity, and now we have found a specific mutation whose presence or absence is directly related to it, Atzmon said.

This study makes it an established fact that there is a relationship between the function of the growth hormone and longevity. Our current goal is to fully understand the mechanism of the mutation we found to express it, so that we can allow longevity while maintaining quality of life, he added.

The 16 researchers involved in the study, published June 16 inScience Advances, are associated with institutions in Israel and France as well as in New York, Maryland, California, Vermont, Massachusetts and Washington.

While more research is needed to understand why the receptor mutation affects longevity and why it happens only in men, the study suggests that making a slight change in this specific piece of DNA could possibly make people live longer.

Although the presence of the mutation almost certainly ensured longevity, Atzmon stressed that many other factors affect longevity and that many men without the mutation also live to 100 and older.

Atzmon is one of the principal researchers in the Longevity Genes Project at Einstein, along with Israeli endocrinology specialist Dr. Nir Barzilai.

Their groundbreaking 10-year study of healthy Ashkenazi Jews between the ages of 95 and 112 and their children attempted to understand why humans dont all age at the same rate, and why only one in 10,000 individuals lives to 100.

The centenarians were found to have genetic protective factors (longevity genes) that overcame factors such as diet and lifestyle.

The rest is here:
Genetic mutation explains why some men live to 100 - Jewish Journal

Laura Deming is not your typical venture capitalist. Then again, she isnt typical in many ways.

For starters, the 23-year-old, New Zealand native was home schooled, developing along the way a love of math and physics and, perhaps most interestingly, the biology of aging. In fact, she became so preoccupied with the latter that at age 11, Deming wrote to Cynthia Kenyon, a renowned molecular biologist who specializes in the genetics of aging, asking if she could visit Kenyons San Francisco lab during a family trip to the Bay Area. Kenyon said yes. When, soon after the visit, Deming asked if she could work in the lab, Kenyon said yes again.

Demings family moved to the U.S. to make it possible, and its highly doubtful they regret the decision. Indeed, by age 14, Deming was a student at MIT, and two years after that at the tender age of 16 she was a college drop-out, having been accepted into Peter Thiels two-year-old Thiel Fellowship program, which gives $100,000 to young people who want to build new things.

Often, those new things evolve along the way. Not for Deming, who pitched the idea of a venture fund that would support aging-related startups, and has since turned that early concept intoLongevity Fund, an early-stage venture outfit that just closed its second fund with $22 million.

Earlier today we caught up with Deming to learn more about her path and which technologies shes betting on to extend the human lifespan.

TC: Its incredible that this all started with an email to a UCSF professor.

LD: [Cynthia Kenyon] is the most amazing person Ill ever meet.

TC: What did you do in her lab, exactly?

LD: We were working with tiny, see-through worms. You put them on a plate of jelly and you see what happens if you change their genetic material. Do they live longer or die faster? If you starve them, they live longer. If you starve worms and also turn off certain genes, could you get them to live even longer? I was nave, but I really wanted to make the longest-living worms ever. [Laughs.]

TC: What did you study at MIT?

LD: I majored in physics actually, but I continued to work in a couple of labs, including [one overseen by] Lenny Guarente [a biologist known for his research on lifespan extension]. It was a lot of fun. I thought Id be a scientist, but a grad student familiar with the Thiel fellowship told me I should apply and I did. Its funny, one of the directors of the [Thiel] program told me recently that he thought Id fail, even though he was very supportive. After we closed the first fund, he was like, I never thought that would work out.

TC: Why?

LD: In part because not long ago, if you talked with most VCs about aging, they didnt think there was anything there. I think aging is such a young science, they hadnt heard about it. Meanwhile, I care a lot about it, and though we dont know if itll work or not, its not unlike [biotech companies trying to tackle] cancer in that way, and if you believe in cancer companies, you should also care about aging companies.

TC: How much did you raise for that first fund?

LD: A grand total of $4 million, and I was very proud of this. To be honest, Id assumed $100,000 was enough to build a fund until I arrived in San Francisco and realized it was really enough to live on for two years. When I started fundraising, I was 17 too young to legally sign contracts. Id never managed money before. But I could talk to people about the science and got them on board with that. In the end, we had great anchor investors come together, and we invested in five companies that kind of proved out the strategy.

TC: Were one of those anchor investors Peter Thiel?

LD: We dont really talk about our LPs.

TC: You say we, though youre the sole general partner of Longevity. Is that correct?

LD: Yes, but I have a lot of back-office support. The way Longevity is structured, Im also able to pull in the best people who have expertise from different domains, so its not one person who looks at all the deals.

TC: And these advisors get a stake in the company?

LD: Sometimes. Others especially grad students like to be paid up front. Well find the best incentive for that individual and work with that.

TC: One of your portfolio companies is Unity Biotechnology, a company thats trying to reverse aging through therapeutics. Didnt it just raise a giant Series B round this week?

LD: It did. All of the companies in that portfolio have [at least] raised Series A rounds of $30 million or more to get to that proof of concept.

TC: Given the amounts involved, is the plan to form special purpose vehicles, or SPVs, around your break-out winners?

LD:We like to help LPs follow on, so we look to do that in whatever way makes sense for both parties. With Unity, we put in money as early as possible because Ned Davis, who runs the company, is amazing and we thought its aging thesis would succeed.

TC: How many companies do you expect to fund with your newly closed fund?

LD: Eight to 10 companies.

TC: Do you think your work will be harder, given that investors seem to be paying much more attention to aging suddenly?

LD: No. With our first fund, we spent up to six months with each deal, tracking the company before it was even raising. Its something LPs really value from us; they know when they invest in something that they dont need to re-do the diligence, that weve already looked at a bunch of stuff and we know this is the best possible investment in [a particular vertical].

Earlier, our biggest challenge was getting other investors on board and convincing them that aging has become a place to play. Now thats a non-issue, which is great. Our job is to help the companies get other investors on board, so its wonderful to see excitement in the space begin to build.

TC: You look at a lot of technologies. I have to ask: do you find these new blood transfusion startupsas interesting as the writers of HBOs Silicon Valley?

LD: [Laughs.] While scientifically interesting, I think they get a little over-discussed in the press because of that vampirism. Its not as sexy to talk about new genetic regulatory elements that control the aging process. Thats not going to get as many clicks as a story about drinking the blood of your five-year-old.

Excerpt from:
This 23-year-old just closed her second fund which is focused on ... - TechCrunch

The Osher Center for Integrative Medicine, Harvards outreach into complementary medicine recently announced a partnership where three researchers associated with the Harvard Osher Center will each summarize a top recent publication from the burgeoning mind-body literature and provide commentary on why they chose to shine a light on it. Harvard is not alone in this effort. Just Tuesday Wolters Kluver announced Ovid Insights,a current awareness service, citing the exponentially expanding volume of research.

As the volume of research worldwide continues to increase, staying current on the latest medical findings and practice guidelines is an overwhelming, yet necessary, task for healthcare professionals.

Ironically, the academics first filled, in the sense of a firehouse filling a cup, the journals with studies predicated on the concept of publish or perish. And having overwhelmed our attention, they now introduce a solution, the era of curated journal reading.

Harvards collaborative partner is the Journal of Alternative and Complementary Medicine (JACM) considered to be in the top quartile of journals covering this area. To give you a sense of the journals academic reach you might considertwo reported measures of citation rates. The SJR, a size independent measure of scientific influence is 0.581, for comparison, the New England Journal of Medicine's (NEJM) is 17.736. The SJR puts JACM 17th among their peers (96 journals) after the Journal of Natural Products and Journal of Ginseng Research. Citations per document reflect how often a journal is cited; it is a commonly used measure of the journals impact on research. Here JACM has a value of 1.537 (the NEJM is 33.902) placing it 22nd amongst its peers, just after Chiropractic and Manual Therapies but before Chinese Medicine [1]

The three Harvard faculty members [2], all JACM associate editors, select a theme and then choose one study from the literature to abstract and to comment upon. I read the articles they presented, while they are a bit too touchy feely for me, and have the usual problems that plague the literature (small sample size, p-hacking, and data mining), they were all thoughtful articles to read and consider. My concern was the descriptions of studies within their abstracts, for example:

Cherkin and colleagues' beautiful randomized prospective studyThis powerful study demonstrates

In an elegantly designed and rigorously conducted comparative effectiveness trial supported by the National Center for Complementary and Integrative Health (NCCIH)/National Institutes of Health (NIH)

Stephen Ross and colleagues conducted a small but methodologically elegant double-blind, placebo-controlled, crossover trial

Perhaps it is me, but I detect a tone of advocacy, and with advocacy comes conflicted interests. I have no issue with knowledgeable people suggesting reading, but there is a fine line between organizing and sorting of information dispassionately and content curation that is, an editorial process. It's a mix of art and science. It requires a clear and definable voice,and editorial mission,and an understanding of your audience and community.[3] Can we reliably expect these academics to cite articles that do not favor alternative and complementary medicine? So far, in the year of this collaboration, no article they have chosen has taken an unfavorable view. Are the Harvard faculty acting as fair witness or advocates, do they shed light or only increase the echo? The goals of JACMs editor, John Weeks, JACMs editor, provides additional clues when he states that his goal that JACM becomes an arbiter of the conversation and content that shapes the course of healthcare. Perhaps I am mistaken, but I want my journals to provide me with unbiased research so that I can form my own view and be the arbiter of my conversations.

[1] The SCImago Journal & Country Rank is a publicly available portal that includes the journals and country scientific indicators [that] can be used to assess and analyze scientific domains.

[2] Osher Center's Director of Research Peter Wayne, PhD, Gloria Yeh, MD, MPH, Research Fellowship Director, and Darshan Mehta, MD, MPH, the center's Director of Education

[3] Is Curation Overused? The Votes Are In

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Harvard's Continued Embrace of Integrative Medicine Finds a Partner and a New Conflict of Interest - American Council on Science and Health

TUCSON Faculty at the University of Arizona Center for Integrative Medicine and their collaborators successfully demonstrated the feasibility and effectiveness of an online approach to train more family medicine residents in integrative medicine.

The American Board of Physician Specialties defines integrative medicine "as the practice of medicine that reaffirms the importance of the relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches, healthcare professionals and disciplines to achieve optimal health and healing."

Effective online training in integrative medicine is important given the increased demand for physicians with expertise in integrative medicine coupled with the call from medical and public health organizations for alternatives to traditional medical approaches to such matters as pain management.

With that in mind, Dr. Patricia Lebensohn, professor of Family and Community Medicine at the UA College of Medicine-Tucson, directed the development of an Integrative Medicine in Residency program, a robust, online curriculum with the aim of establishing integrative medicine as a routine part of family medicine residency education throughout the country.

An in-depth evaluation of the project and its results was published in the July-August 2017 issue of the journal Family Medicine.

The study tested a 200-hour online curriculum, at eight sites offering integrative medicine residencies across the United States. Study subjects included 186 family medicine residents who participated in the IMR and 53 residents in other programs without integrative medicine training who served as controls.

Of the 186 IMR residents, 77 percent completed the program and tested significantly higher in their medical knowledge of integrative medicine than the control residents.

"Despite how busy the residents were, there was a very high completion rate," says Dr. Victoria Maizes, executive director of UACIM. "The level of knowledge improves in those who complete the curriculum and doesn't change in those who don't."

"When we started this study in 2008, it was a novel idea to deliver common curriculum online across eight sites," says Maizes. "This curriculum is now shared at 75 residencies and has expanded well beyond family medicine. We started with this project in family medicine. Now, we're in pediatrics, internal medicine, preventive medicine and we have a pilot program in psychiatry."

"I am pleased with the results of the residents' evaluation of the high clinical utility of the curriculum and the ease of navigating the online delivery," says Lebensohn. "Most of the residents in an exit survey stated that they intend to utilize integrative medicine approaches in their future practice of family medicine."

Additional study authors included Audrey J. Brooks and Paula Cook, UA; Dr. Benjamin Kligler, Icahn School of Medicine at Mount Sinai; Dr. Raymond Teet, Albert Einstein School of Medicine, New York; and Dr. Michele Birch, Carolinas Medical Center, Charlotte, North Carolina.

Submitted by the University of Arizona Communications

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UA integrative medicine residency program flourishes - Sierra Vista Herald

She wielded a kitchen knife, not a scalpel, but Serena Silberman was doing her part Saturday to heal the human body, one chop of parsley, peach and pomegranate at a time.

Food can be medicine, said Silberman, an instructor at the University of California San Diego Integrative Medicine Natural Healing Cooking Program, as she prepped a meal for more than 200 people at the Sanford Consortium for Regenerative Medicine in La Jolla.

Her feast was to commemorate the debut of UC San Diegos Centers for Integrative Health, an initiative throughout the university and health network to unify current research, education and clinical programs ranging from nutrition and acupuncture to meditation and yoga.

Saturdays all-day conference rang in the new collaborative health effort at UC San Diego by discussing how western science can be better wedded to traditional folk cures and alternative medicine to offer better outcomes for patients.

Charlie Neuman/U-T

At the Sanford Consortium, UC San Diego on Saturday launched the new Centers for Integrative Health. At the beginning of the event attendees participate in meditation.

At the Sanford Consortium, UC San Diego on Saturday launched the new Centers for Integrative Health. At the beginning of the event attendees participate in meditation. (Charlie Neuman/U-T)

To Silberman, that means parsley. Rich in antioxidants, the green leaves naturally contain the anti-inflammatory luteolin; Vitamin A to boost the white blood cells that attack infection; and folate, which can help protect patients from heart attack, stroke and hardened arteries.

And then theres her generous dusting of turmeric, the orange-colored herb from the ginger family that doubles as a curry spice and dye. Researchers are studying whether it might heal heart disease and diabetes with very few side effects.

Indian cooks have only been doing it for 5,000 years, so they might know something, said Silberman, punctuating her point with the chop-chop-chop of peaches.

None of this is new to UC San Diego. The Center for Integrative Medicine, for example, was established seven years ago and now treats more than 10,000 patients annually, but organizers hope future consultations will seamlessly involve the Centers for Mindfulness, Integrative Research, Integrative Nutrition and Integrative Education into a one-stop experience.

That means 26 practitioners in 10 clinics within eight departments throughout the health system will be integrated.

Dr. Dan Slater, a physician and UC San Diego professor of family medicine and public health, presented to a packed Sanford Consortium audience a case study he thinks might guide future patient care.

Charlie Neuman/U-T

Attendees to the launch of UC San Diego's Centers for Integrative Health get acupuncture and massages while listening to therapeutic harp music by Carolyn Worster.

Attendees to the launch of UC San Diego's Centers for Integrative Health get acupuncture and massages while listening to therapeutic harp music by Carolyn Worster. (Charlie Neuman/U-T)

A 61-year-old woman was suffering from symptoms suggesting ulcerative colitis, a painful inflammatory bowel disease. The wait had grown to six months in her small town for a colonoscopy that peeked at the lining of her intestine and took a sample of the tissue, a procedure Slater noted was not cheap and was not necessarily convenient.

So he and his team of integrative health specialists prescribed a diet high in fiber, fruits and vegetables and low in fats and sweets. A little more turmeric and a few dollops of probiotics good bacteria to boost the digestive system and within three months she was feeling better. By the time her colonoscopy rolled around, her condition was either in remission or cured.

To Slater, that highlights what the Centers for Integrative Health might do best researching many pathways to a cure but letting the body do most of the work by exploring everything from aromatherapy to zen.

cprine@sduniontribune.com

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Top UCSD researchers pitch yoga, massage and integrative ... - The San Diego Union-Tribune

Physicians practicing integrative medicine have improved quality of life and spend more time with their patients, according to a new survey.

The study, conducted by Pure Branding, a market research company, looked at why doctors leave conventional practices for integrative medicine, which pairs standard treatments with complementary therapies to care for a patients mind, body and spirit. The study included 1,133 integrative medical doctors and doctors of osteopathyfrom 49 states.

As more doctors report burnout, which has increased by 25% in just four years, a rapidly growing number of doctors are exploring integrative approaches to clinical care. The study identified five factors that define integrative medicine:

These ... doctors are at the forefront of a paradigm shift in medicine that will significantly impact the value chain from healthcare systems and payers to medical schools and suppliers, said Yadim Medore, founder and CEO of Pure Branding.

RELATED: Alternative medicine becomes a lucrative business for U.S. top hospitals

Some of the findings from the survey included:

Excerpt from:
Integrative medicine physicians say quality of life is better - FierceHealthcare

A new nonprofit created by heavy hitters from Nevadas business and medical communities gave the state a D grade on its first report card on the states health care system.

The report card was released Wednesday by the Nevada Medical Center and is intended to focus attention on improving access to quality health care in the state.

Larry Matheis, the NMCs CEO, said the report card will help state leaders focus on the gaps that must be filled to improve Nevadas medical standing. Currently, he said, the states medical system resembles a series of isolated communities due to the lack of collaboration among medical professionals and the dearth of thought given to enhancing our communitys reputation.

The report cards grades, based on analysis of data supplied by the Centers for Disease Control and Prevention and other government agencies, show how Nevada fares in the categories of health care access, chronic disease, nutrition and activity, mental health and substance abuse. The grades werent all bad, with the state receiving a passing C grade on chronic disease and a better-than-average B on nutrition and activity.

The report is online at http:// nvmedicalcenter.org/nevada- healthcare-statistics/.

A guide and resource

Matheis, former executive director of the Nevada State Medical Association, said the report is intended to guide policymakers and recommend new approaches.

We are creating a Nevada Health Commission to use the report as a basis for recommending health policy priorities to the private and public sectors, said Matheis, We also are working with the UNLV School of Medicine to explore the potential for integrative medicine.

Integrative medicine is an approach to care that puts the patient at the center and addresses the full range of physical, emotional, mental, social, spiritual and environmental influences that affect a persons health.

The report card, unveiled Wednesday evening at Delta Point, a community health center near downtown Las Vegas, is among the NMCs first major public initiatives. The organization was founded in 2013 by Eric Hilton, who died in 2016 after 49 years directing the Hilton hotel chain established by his father, Conrad Hilton.

Earlier this month, NMC partnered with the Las Vegas-Clark County Library District to organize play camps at two area libraries, aimed at demonstrating the impact of purposeful play on physical and mental health to young children, Matheis said. It also is developing a similar demonstration program with the Clark County School District to be rolled out at elementary schools in the fall, he said.

Though NMC boosts some high-profile talent board members include New York-New York CEO Cynthia Kiser Murphey and Dr. Florence Jameson, founder of the nonprofit Volunteers in Medicine of Southern Nevada the organization had largely stayed out of the public spotlight before the release of the report card.

The rankings, based on statistics from the 50 states and the District of Columbia, gave the state an F for access to health care through primary care doctors and insurance availability.

Only Mississippi had a worse rate of primary care providers, 53 per 100,000 people, compared with Nevadas 56. The nations capitol, with 116 providers per 100,000 people, fared best.

No quick fix for doctor shortage

Given that Nevadas explosive growth the population nearly doubled from 1.5 million in 1995 to nearly 3 million in 2016 is expected to continue, the NMC set a modest target for access improvement: only one more provider per 100,000 by 2020. Even the creation of the new UNLV School of Medicine its 60 graduates wont be entering residencies for graduate medical education for four years cant do much to help offset retirements by doctors in the near future.

The report cards chronic disease section tracks cases and deaths rates for cancer, diabetes, heart disease and stroke, respiration and kidney disease.

Nevada ranked 21st nationally in the age-adjusted death rate from all forms of cancer, with 157 deaths per 100,000 people per year. Kentucky, at 196 deaths, and Utah, at 125 deaths per year, represented the worst and best states, respectively. The NMC set an improvement target of 155 deaths per 100,000 people for Nevada by 2020. The national average is 159.

Although Nevada received an overall grade of C on issues pertaining to mental health, it received a D on the rate of suicides, with 18 per 100,000 people. Wyoming, at 28 suicides, had the nations highest rate, while the District of Columbias was the lowest at five. The national average is 13. NMC set an improvement target of 17 by 2020.

On substance abuse, Nevada earned an overall C, ranking 26th in the nation on excessive drinking, 21st in smoking, 14th in impaired driving accidents and 39 in fatal drug overdoses.

Nevada did its best on nutrition and activity, largely because of exercise opportunities and physically active adults. The NMC noted, however, that Nevada ranks at or below average in food insecurity (D) and food environment (C), meaning Nevada has room for improvement in making sure people have enough good and the right foods.

The NMCs report card is similar to rating systems used by other organizations to measure Nevadas health care delivery system, including recent reports that found the state lacking on hospital safety and the overall health of its senior citizens.

Contact Paul Harasim at pharasim@reviewjournal.com or 702 387-5273. Follow @paulharasim on Twitter.

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Nevada earns D on nonprofit's new health-care report card - Las Vegas Review-Journal

The new approach to treating arthritis is based on brown algae. Credit: istockphoto / Empa

Researchers at ETH Zurich, Empa and the Norwegian research institute SINTEF are pursuing a new approach to treating arthritis. This is based on a polysaccharide, a long-chain sugar molecule, originating from brown algae. When chemically modified, this "alginate" reduces oxidative stress, has an anti-inflammatory effect in cell culture tests and suppresses the immune reaction against cartilage cells, thereby combating the causes of arthritis. The research is, however, still in its infancy.

Arthritis is the most-widespread joint disease, with around 90 percent of all people over 65 being affected to varying degrees, but this degenerative disease is also widespread amongst younger people. In arthritis, the cartilage in the joint, a type of protective layer on bones that "lubricates" the joint, degenerates over time. This can be extremely painful for sufferers, because inflammatory reactions are associated with cartilage degeneration. In the later stages of the disease, bones are no longer adequately protected and can directly rub against each other.

Arthritis can affect all joints in the body, but most often affects the knee joint, hip joint and fingers. The disease has been considered incurable until now. Current treatment methods, such as anti-inflammatory drugs and painkillers, mainly address the symptoms. Often, the only remaining option is an operation to replace the affected joint with an artificial one.

Initial research results are encouraging

In laboratory tests, the team led by ETHZ researcher Marcy Zenobi-Wong and Empa researcher Katharina Maniura has now succeeded, together with SINTEF in Norway, in identifying a substance with the potential to halt cartilage degeneration in joints. This substance is the polysaccharide alginate extracted from the stems of brown algae - or more precisely cuvie (Lat. Laminaria hyperborea), which is similar to specific extracellular biomolecules in cartilage. The researchers chemically modified the alginate with sulfate groups and then added it in dissolved form to cell cultures to examine the reaction of various cell types to the modified polysaccharide. This revealed that alginate sulfate can significantly reduce oxidative stress, which is a frequent cause of cell damage or even cell death, and the more sulfate groups attached to the alginate molecule, the greater this reduction.

Alginate sulfate was also able to suppress the inflammatory reaction, again depending on the number of sulfate groups, and was able to down-regulate the expression of genes that trigger an inflammatory reaction in both human cartilage cells, known as chondrocytes, and in macrophages, the "scavenger cells" of our immune system. The algal molecules should therefore slow down cartilage degeneration. "The hope is that they can even stop this degeneration," says Empa researcher Markus Rottmar.

Further research work necessary

The alginate sulfates have so far only been tested in vitro, i.e. in the laboratory with cell cultures. However, the encouraging results mean that research will now continue. The next stage is to test the substances on animals. If this is also successful, clinical trials can then be conducted on people. These tests are, however, laborious and time-consuming. If everything were to work perfectly, it would still be a few years before arthritis patients could be treated with alginate sulfate.

Explore further: Prolactin reduces arthritis inflammation

More information: Anne Kerschenmeyer et al. Anti-oxidant and immune-modulatory properties of sulfated alginate derivatives on human chondrocytes and macrophages, Biomater. Sci. (2017). DOI: 10.1039/c7bm00341b

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Treating arthritis with algae - Medical Xpress - Medical Xpress

GETTY

Doctors battling to find ways of stopping or easing the pain caused by the disease launched a nationwide campaign to highlight the true impact on patients.

It came as research shows arthritis costs the UK economy 2.6billion a year.

More than 10 million people in Britain suffer from the disease, which causes swelling of the joints.

Yet while it is the leading cause of pain in the UK, campaigners say it remains largely invisible.

Dr Liam OToole, chief executive of Arthritis Research UK, said: We have this sort of culture of suffer in silence, grin and bear it, its what my granny used to suffer from.

"Actually it affects all of us directly and indirectly. We all lose out from it and we want to make sure people dont suffer in silence.

GETTY

Launching the campaign, Dr OToole added: Today we have taken an important step in changing the way the nation sees this major public health issue.

New research shows 25 million working days are lost annually in the UK due to the two most common forms, osteoarthritis and rheumatoid arthritis.

The figure is set to rise to 25.9 million lost days at a cost of 3.4billion to the economy by 2030, according to research by the York Health Economics Consortium at the University of York.

By 2050 the figures will increase to 27.2 million working days, costing the economy 4.7billion a year.

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Change will only come if we can win acknowledgement that there is a problem in which we all have a stake

Dr OToole

The NHS and wider healthcare system will spend 10.2billion treating the conditions this year and a total of 118.6billion in the next decade.

Consortium director Matthew Taylor said: Our research highlights just how significant that impact is and the fact that its set to increase.

"Its imperative that we all understand arthritis better, so that we can take the necessary steps to help people living with it.

A separate survey showed that around three in four people with all types of arthritis say their family and social lives are compromised.

Just over half of those quizzed feel they are a nuisance to their families, while around a third of sufferers report a negative effect on physical intimacy with their partners.

While 88 per cent of sufferers describe it as a debilitating and life-restricting condition, the report reveals the condition is largely hidden from public view.

The survey found 86 per cent of people with the condition try hard not to let arthritis define them or their personality.

And even though it impacts people of all ages, 89 per cent of people living with it believe the condition is viewed by society as an old persons disease.

GETTY

More than 100million is being spent this year to develop breakthrough treatments and find a cure.

But campaigners insist more resources need to be ploughed into the issue.

Dr OToole said: There is a complete mismatch between the enormous impact arthritis has on individuals, their families and society and the attention, priority and resources society currently gives to it.

He added: One of the root causes of this is the conditions invisibility. Change will only come if we can win acknowledgement that there is a problem in which we all have a stake.

GETTY

Anne Kearl, 55, from Hampshire has osteoarthritis.

She said pain is always there, adding: When friends and colleagues cant physically see anything wrong with you, they assume youre OK and often I let people think that rather than be honest about my arthritis.

Original post:
Arthritis: Experts STEP UP battle to beat agonising condition - Express.co.uk

Do you suffer from arthritis and take over-the-counter (OTC) arthritis drugs? You could be at risk of adverse drug events.

You are not alone. The most commonly used OTC arthritis drugs are non-steroidal anti-inflammatory drugs (NSAIDs) such as Ibuprofen, Motrin, Advil, Aleve, and Naproxen. The FDA estimates that 17% of adults in the United State took Ibuprofen and 3.5% of adults took Naproxen in any given week. While these drugs are extremely effective in reducing pain and inflammation associated with arthritis, they are also responsible for many adverse drug reactions, and are associated with stomach ulcers, high blood pressure, heart attacks, heart failure and liver failure.

The label instructions for use of both Ibuprofen and Aleve recommend that you consult with your physician if you take these drugs for more than 10 days for arthritis pain. It goes on to say that the drugs temporarily relieve minor aches and pain due to----minor pain of arthritis. Id like to emphasize the word temporary and advise all with arthritis pain that these drugs are not indicated for long term use unless supervised by your physician.

According to a recent report, the use of these NSAIDs increase the risk of acute kidney injury by 50% in the general population and patients with chronic kidney disease (CKD). The report also estimated that the incidence of acute kidney injury doubled in patients over 50 compared to those that did not take NSAIDs.

There are many forms of acute kidney injury associated with NSAIDs including kidney failure requiring dialysis, allergic disease of the kidney, worsening of underlying chronic kidney disease, worsening high blood pressure and elevation of blood potassium levels. NSAIDs also can cause interactions with other drugs that you may be taking for other diseases. Many of these adverse drug events can be life-threatening.

I recommend that if you are interested in taking NSAIDs that you consult with your physician and review your medical history. You should avoid long term use of these agents and you should be monitored carefully while you are taking these drugs over extended periods of time.

Learn more about pain medications.

The Morning Email

Wake up to the day's most important news.

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Arthritis Drugs and Kidney Disease - HuffPost

MONTPELIER The next meeting for the Fibromyalgia and Arthritis Support Group will be held on Tuesday, Sept. 5, at 7 p.m. at the Montpelier Senior Center, 325 N. Jonesville St.

Fibromyalgia is a common and disabling disorder affecting two to four percent of the population. Patients with fibromyalgia usually ache all over, sleep poorly, are stiff on walking, and tired all day.

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sharon@bryantimes.com

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Fibromyalgia, arthritis support group to meet Sept. 5 - The Bryan Times (subscription)

Photo

Taking oral contraceptives may reduce the risk for rheumatoid arthritis, a new study has found.

The exact cause of rheumatoid arthritis is unclear, but since it is about three times more common in women than in men, some have suggested hormonal factors might be involved.

Swedish researchers studied 2,641 women with the disease and 4,251 healthy controls. They did blood tests and collected health and behavioral data, including information about their reproductive history, breast-feeding and use of contraception. The study, in the Annals of the Rheumatic Diseases, followed them for eight years.

Women in the study had used oral contraceptives for an average of seven years. Over all, after adjusting for age, alcohol consumption, smoking and other factors, current users were 15 percent less likely, and past users 13 percent less likely, than those who had never used oral contraceptives to develop rheumatoid arthritis. Users with positive blood tests for the antibody called ACPA, a predictor of rheumatoid arthritis, reduced their risk by 16 percent.

Although some smaller studies have found a link between women who had breast-fed their babies and a lower risk of rheumatoid arthritis, this study found none.

If youre already using oral contraception, you dont need to stop if you have a family history of R.A. or are diagnosed with the disease, said the lead author, Cecilia Orellana, a postdoctoral fellow at the Karolinska Institute in Stockholm. But we are not recommending you start them as a preventive. We cant overlook the other potential side effects of the drugs on other conditions.

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Oral Contraceptives Tied to Lower Rheumatoid Arthritis Risk - New York Times

Embryonic stem cells (ES cells) are pluripotent stem cells derived from the inner cell mass of a blastocyst, an early-stage preimplantation embryo.[1][2] Human embryos reach the blastocyst stage 45 days post fertilization, at which time they consist of 50150 cells. Isolating the embryoblast or inner cell mass (ICM) results in destruction of the blastocyst, which raises ethical issues, including whether or not embryos at the pre-implantation stage should be considered to have the same moral or legal status as embryos in the post-implantation stage of development.[3][4]

Human ES cells measure approximately 14 m while mouse ES cells are closer to 8 m.[5]

Embryonic stem cells, derived from the blastocyst stage early mammalian embryos, are distinguished by their ability to differentiate into any cell type and by their ability to propagate. Embryonic stem cell's properties include having a normal karyotype, maintaining high telomerase activity, and exhibiting remarkable long-term proliferative potential.[6]

Embryonic stem cells of the inner cell mass are pluripotent, that is, they are able to differentiate to generate primitive ectoderm, which ultimately differentiates during gastrulation into all derivatives of the three primary germ layers: ectoderm, endoderm, and mesoderm. These include each of the more than 220 cell types in the adult body. Pluripotency distinguishes embryonic stem cells from adult stem cells found in adults; while embryonic stem cells can generate all cell types in the body, adult stem cells are multipotent and can produce only a limited number of cell types. If the pluripotent differentiation potential of embryonic stem cells could be harnessed in vitro, it might be a means of deriving cell or tissue types virtually to order. This would provide a radical new treatment approach to a wide variety of conditions where age, disease, or trauma has led to tissue damage or dysfunction.

In 2012, the Nobel Prize for Medicine was attributed conjointed to John B. Gurdon and Shinya Yamanaka for the discovery that mature cells can be reprogrammed to become pluripotent.[7]

Additionally, under defined conditions, embryonic stem cells are capable of propagating themselves indefinitely in an undifferentiated state and have the capacity when provided with the appropriate signals to differentiate, presumably via the formation of precursor cells, to almost all mature cell phenotypes.[8] This allows embryonic stem cells to be employed as useful tools for both research and regenerative medicine, because they can produce limitless numbers of themselves for continued research or clinical use.

Because of their plasticity and potentially unlimited capacity for self-renewal, embryonic stem cell therapies have been proposed for regenerative medicine and tissue replacement after injury or disease. Diseases that could potentially be treated by pluripotent stem cells include a number of blood and immune-system related genetic diseases, cancers, and disorders; juvenile diabetes; Parkinson's disease; blindness and spinal cord injuries. Besides the ethical concerns of stem cell therapy (see stem cell controversy), there is a technical problem of graft-versus-host disease associated with allogeneic stem cell transplantation. However, these problems associated with histocompatibility may be solved using autologous donor adult stem cells, therapeutic cloning. Stem cell banks or more recently by reprogramming of somatic cells with defined factors (e.g. induced pluripotent stem cells). Embryonic stem cells provide hope that it will be possible to overcome the problems of donor tissue shortage and also, by making the cells immunocompatible with the recipient. Other potential uses of embryonic stem cells include investigation of early human development, study of genetic disease and as in vitro systems for toxicology testing.[6]

According to a 2002 article in PNAS, "Human embryonic stem cells have the potential to differentiate into various cell types, and, thus, may be useful as a source of cells for transplantation or tissue engineering."[9]

Current research focuses on differentiating ES into a variety of cell types for eventual use as cell replacement therapies (CRTs). Some of the cell types that have or are currently being developed include cardiomyocytes (CM), neurons, hepatocytes, bone marrow cells, islet cells and endothelial cells.[10] However, the derivation of such cell types from ESs is not without obstacles and hence current research is focused on overcoming these barriers. For example, studies are underway to differentiate ES in to tissue specific CMs and to eradicate their immature properties that distinguish them from adult CMs.[11]

Besides in the future becoming an important alternative to organ transplants, ES are also being used in field of toxicology and as cellular screens to uncover new chemical entities (NCEs) that can be developed as small molecule drugs. Studies have shown that cardiomyocytes derived from ES are validated in vitro models to test drug responses and predict toxicity profiles.[10] ES derived cardiomyocytes have been shown to respond to pharmacological stimuli and hence can be used to assess cardiotoxicity like Torsades de Pointes.[12]

ES-derived hepatocytes are also useful models that could be used in the preclinical stages of drug discovery. However, the development of hepatocytes from ES has proven to be challenging and this hinders the ability to test drug metabolism. Therefore, current research is focusing on establishing fully functional ES-derived hepatocytes with stable phase I and II enzyme activity.[13]

Researchers have also differentiated ES into dopamine-producing cells with the hope that these neurons could be used in the treatment of Parkinsons disease.[14][15] Recently, the development of ESC after Somatic Cell Nuclear Transfer (SCNT) of Olfactory ensheathing cells (OEC's) to a healthy Oocyte has been recommended for Neuro-degenerative diseases.[16] ESs have also been differentiated to natural killer (NK) cells and bone tissue.[17] Studies involving ES are also underway to provide an alternative treatment for diabetes. For example, DAmour et al. were able to differentiate ES into insulin producing cells[18] and researchers at Harvard University were able to produce large quantities of pancreatic beta cells from ES.[19]

Several new studies have started to address this issue. This has been done either by genetically manipulating the cells, or more recently by deriving diseased cell lines identified by prenatal genetic diagnosis (PGD). This approach may very well prove invaluable at studying disorders such as Fragile-X syndrome, Cystic fibrosis, and other genetic maladies that have no reliable model system.

Yury Verlinsky, a Russian-American medical researcher who specialized in embryo and cellular genetics (genetic cytology), developed prenatal diagnosis testing methods to determine genetic and chromosomal disorders a month and a half earlier than standard amniocentesis. The techniques are now used by many pregnant women and prospective parents, especially those couples with a history of genetic abnormalities or where the woman is over the age of 35, when the risk of genetically related disorders is higher. In addition, by allowing parents to select an embryo without genetic disorders, they have the potential of saving the lives of siblings that already had similar disorders and diseases using cells from the disease free offspring.[20]

Scientists have discovered a new technique for deriving human embryonic stem cell (ESC). Normal ESC lines from different sources of embryonic material including morula and whole blastocysts have been established. These findings allows researchers to construct ESC lines from embryos that acquire different genetic abnormalities; therefore, allowing for recognition of mechanisms in the molecular level that are possibly blocked that could impede the disease progression. The ESC lines originating from embryos with genetic and chromosomal abnormalities provide the data necessary to understand the pathways of genetic defects.[21]

A donor patient acquires one defective gene copy and one normal, and only one of these two copies is used for reproduction. By selecting egg cell derived from embryonic stem cells that have two normal copies, researchers can find variety of treatments for various diseases. To test this theory Dr. McLaughlin and several of his colleagues looked at whether parthenogenetic embryonic stem cells can be used in a mouse model that has thalassemia intermedia. This disease is described as an inherited blood disorder in which there is a lack of hemoglobin leading to anemia. The mouse model used, had one defective gene copy. Embryonic stem cells from an unfertilized egg of the diseased mice were gathered and those stem cells that contained only healthy hemoglobin genes were identified. The healthy embryonic stem cell lines were then converted into cells transplanted into the carrier mice. After five weeks, the test results from the transplant illustrated that these carrier mice now had a normal blood cell count and hemoglobin levels.[22]

Differentiated somatic cells and ES cells use different strategies for dealing with DNA damage. For instance, human foreskin fibroblasts, one type of somatic cell, use non-homologous end joining (NHEJ), an error prone DNA repair process, as the primary pathway for repairing double-strand breaks (DSBs) during all cell cycle stages.[23] Because of its error-prone nature, NHEJ tends to produce mutations in a cells clonal descendants.

ES cells use a different strategy to deal with DSBs.[24] Because ES cells give rise to all of the cell types of an organism including the cells of the germ line, mutations arising in ES cells due to faulty DNA repair are a more serious problem than in differentiated somatic cells. Consequently, robust mechanisms are needed in ES cells to repair DNA damages accurately, and if repair fails, to remove those cells with un-repaired DNA damages. Thus, mouse ES cells predominantly use high fidelity homologous recombinational repair (HRR) to repair DSBs.[24] This type of repair depends on the interaction of the two sister chromosomes formed during S phase and present together during the G2 phase of the cell cycle. HRR can accurately repair DSBs in one sister chromosome by using intact information from the other sister chromosome. Cells in the G1 phase of the cell cycle (i.e. after metaphase/cell division but prior the next round of replication) have only one copy of each chromosome (i.e. sister chromosomes arent present). Mouse ES cells lack a G1 checkpoint and do not undergo cell cycle arrest upon acquiring DNA damage.[25] Rather they undergo programmed cell death (apoptosis) in response to DNA damage.[26] Apoptosis can be used as a fail-safe strategy to remove cells with un-repaired DNA damages in order to avoid mutation and progression to cancer.[27] Consistent with this strategy, mouse ES stem cells have a mutation frequency about 100-fold lower than that of isogenic mouse somatic cells.[28]

The major concern with the possible transplantation of ESC into patients as therapies is their ability to form tumors including teratoma.[29] Safety issues prompted the FDA to place a hold on the first ESC clinical trial (see below), however no tumors were observed.

The main strategy to enhance the safety of ESC for potential clinical use is to differentiate the ESC into specific cell types (e.g. neurons, muscle, liver cells) that have reduced or eliminated ability to cause tumors. Following differentiation, the cells are subjected to sorting by flow cytometry for further purification. ESC are predicted to be inherently safer than IPS cells because they are not genetically modified with genes such as c-Myc that are linked to cancer. Nonetheless, ESC express very high levels of the iPS inducing genes and these genes including Myc are essential for ESC self-renewal and pluripotency,[30] and potential strategies to improve safety by eliminating c-Myc expression are unlikely to preserve the cells' "stemness". However, N-myc and L-myc have been identified to induce iPS cells instead of c-myc with similar efficiency.[31][32]

In 1964, Lewis Kleinsmith and G. Barry Pierce Jr. isolated a single type of cell from a teratocarcinoma, a tumor now known to be derived from a germ cell.[33] These cells isolated from the teratocarcinoma replicated and grew in cell culture as a stem cell and are now known as embryonal carcinoma (EC) cells.[34] Although similarities in morphology and differentiating potential (pluripotency) led to the use of EC cells as the in vitro model for early mouse development,[35] EC cells harbor genetic mutations and often abnormal karyotypes that accumulated during the development of the teratocarcinoma. These genetic aberrations further emphasized the need to be able to culture pluripotent cells directly from the inner cell mass.

In 1981, embryonic stem cells (ES cells) were independently first derived from mouse embryos by two groups. Martin Evans and Matthew Kaufman from the Department of Genetics, University of Cambridge published first in July, revealing a new technique for culturing the mouse embryos in the uterus to allow for an increase in cell number, allowing for the derivation of ES cells from these embryos.[36]Gail R. Martin, from the Department of Anatomy, University of California, San Francisco, published her paper in December and coined the term Embryonic Stem Cell.[37] She showed that embryos could be cultured in vitro and that ES cells could be derived from these embryos. In 1998, a breakthrough occurred when researchers, led by James Thomson at the University of Wisconsin-Madison, first developed a technique to isolate and grow human embryonic stem cells in cell culture.[38]

On January 23, 2009, Phase I clinical trials for transplantation of oligodendrocytes (a cell type of the brain and spinal cord) derived from human ES cells into spinal cord-injured individuals received approval from the U.S. Food and Drug Administration (FDA), marking it the world's first human ES cell human trial.[39] The study leading to this scientific advancement was conducted by Hans Keirstead and colleagues at the University of California, Irvine and supported by Geron Corporation of Menlo Park, CA, founded by Michael D. West, PhD. A previous experiment had shown an improvement in locomotor recovery in spinal cord-injured rats after a 7-day delayed transplantation of human ES cells that had been pushed into an oligodendrocytic lineage.[40] The phase I clinical study was designed to enroll about eight to ten paraplegics who have had their injuries no longer than two weeks before the trial begins, since the cells must be injected before scar tissue is able to form. The researchers emphasized that the injections were not expected to fully cure the patients and restore all mobility. Based on the results of the rodent trials, researchers speculated that restoration of myelin sheathes and an increase in mobility might occur. This first trial was primarily designed to test the safety of these procedures and if everything went well, it was hoped that it would lead to future studies that involve people with more severe disabilities.[41] The trial was put on hold in August 2009 due to FDA concerns regarding a small number of microscopic cysts found in several treated rat models but the hold was lifted on July 30, 2010.[42]

In October 2010 researchers enrolled and administered ESTs to the first patient at Shepherd Center in Atlanta.[43] The makers of the stem cell therapy, Geron Corporation, estimated that it would take several months for the stem cells to replicate and for the GRNOPC1 therapy to be evaluated for success or failure.

In November 2011 Geron announced it was halting the trial and dropping out of stem cell research for financial reasons, but would continue to monitor existing patients, and was attempting to find a partner that could continue their research.[44] In 2013 BioTime (NYSEMKT:BTX), led by CEO Dr. Michael D. West, acquired all of Geron's stem cell assets, with the stated intention of restarting Geron's embryonic stem cell-based clinical trial for spinal cord injury research.[45]

BioTime company Asterias Biotherapeutics (NYSE MKT: AST) was granted a $14.3 million Strategic Partnership Award by the California Institute for Regenerative Medicine (CIRM) to re-initiate the worlds first embryonic stem cell-based human clinical trial, for spinal cord injury. Supported by California public funds, CIRM is the largest funder of stem cell-related research and development in the world.[46]

The award provides funding for Asterias to reinitiate clinical development of AST-OPC1 in subjects with spinal cord injury and to expand clinical testing of escalating doses in the target population intended for future pivotal trials.[47]

AST-OPC1 is a population of cells derived from human embryonic stem cells (hESCs) that contains oligodendrocyte progenitor cells (OPCs). OPCs and their mature derivatives called oligodendrocytes provide critical functional support for nerve cells in the spinal cord and brain. Asterias recently presented the results from phase 1 clinical trial testing of a low dose of AST-OPC1 in patients with neurologically-complete thoracic spinal cord injury. The results showed that AST-OPC1 was successfully delivered to the injured spinal cord site. Patients followed 2-3 years after AST-OPC1 administration showed no evidence of serious adverse events associated with the cells in detailed follow-up assessments including frequent neurological exams and MRIs. Immune monitoring of subjects through one year post-transplantation showed no evidence of antibody-based or cellular immune responses to AST-OPC1. In four of the five subjects, serial MRI scans performed throughout the 2-3 year follow-up period indicate that reduced spinal cord cavitation may have occurred and that AST-OPC1 may have had some positive effects in reducing spinal cord tissue deterioration. There was no unexpected neurological degeneration or improvement in the five subjects in the trial as evaluated by the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) exam.[48]

The Strategic Partnership III grant from CIRM will provide funding to Asterias to support the next clinical trial of AST-OPC1 in subjects with spinal cord injury, and for Asterias product development efforts to refine and scale manufacturing methods to support later-stage trials and eventually commercialization. CIRM funding will be conditional on FDA approval for the trial, completion of a definitive agreement between Asterias and CIRM, and Asterias continued progress toward the achievement of certain pre-defined project milestones.[49]

In vitro fertilization generates multiple embryos. The surplus of embryos is not clinically used or is unsuitable for implantation into the patient, and therefore may be donated by the donor with consent. Human embryonic stem cells can be derived from these donated embryos or additionally they can also be extracted from cloned embryos using a cell from a patient and a donated egg.[50] The inner cell mass (cells of interest), from the blastocyst stage of the embryo, is separated from the trophectoderm, the cells that would differentiate into extra-embryonic tissue. Immunosurgery, the process in which antibodies are bound to the trophectoderm and removed by another solution, and mechanical dissection are performed to achieve separation. The resulting inner cell mass cells are plated onto cells that will supply support. The inner cell mass cells attach and expand further to form a human embryonic cell line, which are undifferentiated. These cells are fed daily and are enzymatically or mechanically separated every four to seven days. For differentiation to occur, the human embryonic stem cell line is removed from the supporting cells to form embryoid bodies, is co-cultured with a serum containing necessary signals, or is grafted in a three-dimensional scaffold to result.[51]

Embryonic stem cells are derived from the inner cell mass of the early embryo, which are harvested from the donor mother animal. Martin Evans and Matthew Kaufman reported a technique that delays embryo implantation, allowing the inner cell mass to increase. This process includes removing the donor mother's ovaries and dosing her with progesterone, changing the hormone environment, which causes the embryos to remain free in the uterus. After 46 days of this intrauterine culture, the embryos are harvested and grown in in vitro culture until the inner cell mass forms egg cylinder-like structures, which are dissociated into single cells, and plated on fibroblasts treated with mitomycin-c (to prevent fibroblast mitosis). Clonal cell lines are created by growing up a single cell. Evans and Kaufman showed that the cells grown out from these cultures could form teratomas and embryoid bodies, and differentiate in vitro, all of which indicating that the cells are pluripotent.[36]

Gail Martin derived and cultured her ES cells differently. She removed the embryos from the donor mother at approximately 76 hours after copulation and cultured them overnight in a medium containing serum. The following day, she removed the inner cell mass from the late blastocyst using microsurgery. The extracted inner cell mass was cultured on fibroblasts treated with mitomycin-c in a medium containing serum and conditioned by ES cells. After approximately one week, colonies of cells grew out. These cells grew in culture and demonstrated pluripotent characteristics, as demonstrated by the ability to form teratomas, differentiate in vitro, and form embryoid bodies. Martin referred to these cells as ES cells.[37]

It is now known that the feeder cells provide leukemia inhibitory factor (LIF) and serum provides bone morphogenetic proteins (BMPs) that are necessary to prevent ES cells from differentiating.[52][53] These factors are extremely important for the efficiency of deriving ES cells. Furthermore, it has been demonstrated that different mouse strains have different efficiencies for isolating ES cells.[54] Current uses for mouse ES cells include the generation of transgenic mice, including knockout mice. For human treatment, there is a need for patient specific pluripotent cells. Generation of human ES cells is more difficult and faces ethical issues. So, in addition to human ES cell research, many groups are focused on the generation of induced pluripotent stem cells (iPS cells).[55]

On August 23, 2006, the online edition of Nature scientific journal published a letter by Dr. Robert Lanza (medical director of Advanced Cell Technology in Worcester, MA) stating that his team had found a way to extract embryonic stem cells without destroying the actual embryo.[56] This technical achievement would potentially enable scientists to work with new lines of embryonic stem cells derived using public funding in the USA, where federal funding was at the time limited to research using embryonic stem cell lines derived prior to August 2001. In March, 2009, the limitation was lifted.[57]

The iPSC technology was pioneered by Shinya Yamanakas lab in Kyoto, Japan, who showed in 2006 that the introduction of four specific genes encoding transcription factors could convert adult cells into pluripotent stem cells.[58] He was awarded the 2012 Nobel Prize along with Sir John Gurdon "for the discovery that mature cells can be reprogrammed to become pluripotent." [59]

In 2007 it was shown that pluripotent stem cells highly similar to embryonic stem cells can be generated by the delivery of three genes (Oct4, Sox2, and Klf4) to differentiated cells.[60] The delivery of these genes "reprograms" differentiated cells into pluripotent stem cells, allowing for the generation of pluripotent stem cells without the embryo. Because ethical concerns regarding embryonic stem cells typically are about their derivation from terminated embryos, it is believed that reprogramming to these "induced pluripotent stem cells" (iPS cells) may be less controversial. Both human and mouse cells can be reprogrammed by this methodology, generating both human pluripotent stem cells and mouse pluripotent stem cells without an embryo.[61]

This may enable the generation of patient specific ES cell lines that could potentially be used for cell replacement therapies. In addition, this will allow the generation of ES cell lines from patients with a variety of genetic diseases and will provide invaluable models to study those diseases.

However, as a first indication that the induced pluripotent stem cell (iPS) cell technology can in rapid succession lead to new cures, it was used by a research team headed by Rudolf Jaenisch of the Whitehead Institute for Biomedical Research in Cambridge, Massachusetts, to cure mice of sickle cell anemia, as reported by Science journal's online edition on December 6, 2007.[62][63]

On January 16, 2008, a California-based company, Stemagen, announced that they had created the first mature cloned human embryos from single skin cells taken from adults. These embryos can be harvested for patient matching embryonic stem cells.[64]

The online edition of Nature Medicine published a study on January 24, 2005, which stated that the human embryonic stem cells available for federally funded research are contaminated with non-human molecules from the culture medium used to grow the cells.[65] It is a common technique to use mouse cells and other animal cells to maintain the pluripotency of actively dividing stem cells. The problem was discovered when non-human sialic acid in the growth medium was found to compromise the potential uses of the embryonic stem cells in humans, according to scientists at the University of California, San Diego.[66]

However, a study published in the online edition of Lancet Medical Journal on March 8, 2005 detailed information about a new stem cell line that was derived from human embryos under completely cell- and serum-free conditions. After more than 6 months of undifferentiated proliferation, these cells demonstrated the potential to form derivatives of all three embryonic germ layers both in vitro and in teratomas. These properties were also successfully maintained (for more than 30 passages) with the established stem cell lines.[67]

Read more:
Embryonic stem cell - Wikipedia

Almost four and a half years ago, then minister for health Dr James Reilly ordered the Health Service Executive not to destroy more than one million blood samples taken from newborn children in the Republic between 1984 and 2002.

The heel-prick tests, known as Guthrie tests, are carried out on all babies to screen for genetic conditions.

The decision to destroy the cards with the blood samples on them came after it emerged that those taken before July 1st, 2011, were being retained without consent, and therefore in breach of national and EU data protection law.

The Royal College of Physicians at the time said there was an explosion of molecular genetics every day that was being added to and that the museum piece cards could prove to be even more valuable in the future.

The Irish Heart Foundation, which had campaigned to save the cards, said some 1,400 families that had lost a member through sudden adult death syndrome would, as a result, be able to get a genetic diagnosis to see if they were at risk.

The debate over those cards and the legality of retaining them still rumbles on, as do ethical questions about the privacy of highly sensitive medical data obtained for one purpose and whether it should ever be used for another without the consent of the original subject, in the absence of a legal exemption.

Meanwhile, medical and scientific researchers are closely watching the new EU General Data Protection Regulation (GDPR) and what it might mean for them and their work after it takes effect next May.

While the regulation allows certain exemptions for processing special cateogories of data, including genetic and biometric data, the Irish legislation hasnt been written yet and researchers are waiting to see what it will mean for their work.

In some cases, they are worried about what the new law will mean for historic datasets and longitudinal studies and whether they will have to delete them on the grounds that they will not have the appropriate standards of explicit consent post May 2018 to retain them.

Even in just a few years, the medical, legal, ethical and social dilemmas involved in processing health data, including biological samples obtained from patients or research study volunteers have become vastly more complex.

The ethical issues that arise around areas such as stem cell research, embryo research and reproductive cloning, genome sequencing, gene editing and population-scale biobanks are huge.

Opportunities for uncovering the causes of disease, for resolving fertility issues, for fixing genetic conditions, for treating cancers, are within the grasp of scientists and researchers, but there is still no international consensus on many issues.

Concerns are evolving too in light of new models for funding research, such as venture capital-backed projects where highly sensitive data used for research, and effectively a permanent record, may ultimately end up being used by or sold for profit to companies or other third parties anywhere in the world.

Researchers are still uncertain what exactly the GDPR will mean for them in terms of the exemptions from data protection legislation that will apply to so-called special categories of data including genetic and biometric health data used for research.

At a recent event in Dublin, the Irish Platform for Patients Organisations, Science and Industry (IPPOSI) explored the concerns about data protection, consent and the forthcoming regulation.

IPPOSI chief executive Dr Derick Mitchell told the event: Patients are aware that the altruistic benefit of being involved in research far outweighs the risks, but they do expect that they will be consulted on the use of their data.

He said empowerment of the data owner was fundamental to the forthcoming changes in the law, and the event explored a model of so-called dynamic consent to allow people consent to have their data used for research, possibly allowing broad consent at the outset and opt-outs at a later stage where they did not agree to new uses. The legal jury is still out on whether such a model is even possible.

Dr Mitchell said a national response was required to GDPR and not just for health research.

He hoped that guidance on the question of consent for processing of personal data expected later in the year from the independent body representing all of the EUs national data protection authorities would be a step forward.

But I think the real crux is the code of conduct and each institution in effect will have to develop their own code of conduct as to how they approach data protection from the beginning of projects rather than having it as a kind of tick-box exercise at the end of a project, he said.

Dr Mitchell said the explicit consent referred to in the EU regulation, for example, had very real consequences for the continuation of large-scale population biobanks, for example.

There was also an ethical argument going on as to whether a persons consent could be said to be informed if they ultimately did not know what the research project might ultimately examine.

Prof Jane Grimson, a member of the e-health Ireland committee and a former director of Health Information in the Health Information and Quality Authority, said the potential of health data and research had to be balanced with a patients right to privacy.

Ownership of patient records was critical, she said.

I think the way we are moving now is much more towards electronic health records that will be owned and controlled by the individual. Its their information and they should be in control of who has a right to see information and the information (that is used in research).

Ethics research committees were critical and needed to operate to a very high standard to ensure the trust of people, she added.

Its an absolute minefield but I really think that ethics committees are critical.

Prof Orla Sheils, director of the Trinity Translational Medicine Institute and director of medical ethics at the School of Medicine, TCD, said she believed GDPR would have immediate consequences for data already being processed by researchers. It was a very grey area.

The difficulty with that is that if data has been collected over a long period of time that a person may not want to be reminded of the time that they were ill. Thats the balance you are trying to find there. So the way to get around that is to try to give people enough options up front to decide yes, I want to gift my sample and provided the research thats going to be done is ethical and has been approved, thats okay by me.

Prof Sheils, who sits on the St Jamess and Tallaght hospital research ethics committee, said all research involving humans had to be approved by such a committee.

Its never an ethical issue if the answer is easy, she said.

Like everything else in life, its about finding that happy balance that people are comfortable with, she said.

There is never really a right answer when there is an ethical dilemma. What I always say to students is that you are hoping for the least bad option.

Cathal Ryan said the new EU regulation would bring harmonisation, transparency and accountability to a very dense and complex area. The regulation was very pragmatic and the code of conduct within it would act as a form of self-regulation, with the additional oversight of an independent monitoring body. But he said adequate transparency on data protection in the sector had been lacking.

If there is an erosion of trust, if the health sector doesnt treat an individuals data in the right way, there will be problems.

Go here to read the rest:
How processing health data has become increasingly problematic - Irish Times

California has never been reluctant to take the lead on critical issues facing the nation. When federal funding was cut off for embryonic stem cell research, it created its own state program. It adopted standards for vehicle emissions and fuel efficiency that have been emulated by other states, and it has doubled down on a commitment to climate change policy in the face of disinterest, if not outright hostility, from the Trump administration. But perhaps nothing is more welcome than California's decision to advance the science of gun violence prevention with the establishment of the country's first publicly funded research center.

The Firearm Violence Research Center, launched last month at the University of California at Davis with a $5 million appropriation from the state, aims to find effective ways to prevent firearm violence through scientific investigation and understanding. Located at the university's Sacramento campus, the research institute will augment the work of Garen Wintemute, an emergency room physician and nationally recognized expert on the epidemiology of firearm violence who serves as its director.

California's decision to be at the forefront of research on gun violence as a public health issue stands in contrast to the dismal abdication of the federal government. Legislation passed by Congress in 1996 barring the Centers for Disease Control and Prevention from spending any funds "to advocate or promote gun control" made the agency skittish about conducting research. Scientific investigation has been key in devising lifesaving solutions to other public health issues, such as automobile safety and swimming pool safety, so the dearth of research into firearms, a leading cause of death for Americans under the age of 65, is intolerable.

Indeed, it is instructive that the lawmaker who successfully carried the National Rifle Association's water in getting the restrictive rider through Congress eventually came to have a change of heart. The late Jay Dickey, a Republican from Arkansas whose amendment led to the scarcity of gun research, joined forces with Mark Rosenberg, former director of the CDC's National Center for Injury Prevention and Control, to advocate federally funded gun research as well as champion in the face of predictable opposition from the gun lobby the establishment of California's center.

Wintemute stressed that the center is not about validating predetermined political agendas but rather, as he told the Los Angeles Times, "understanding the problem of firearm violence that cuts across pro-gun and anti-gun boundaries." In wanting to confront the problem of gun violence with sound data about causes, consequences and effective solutions, California once again sets a good example.

Another voice: On gun violence research, California sets an example for the nation 08/23/17 [Last modified: Wednesday, August 23, 2017 3:40pm] Photo reprints | Article reprints

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Another voice: On gun violence research, California sets an example for the nation - Tampabay.com

A textiles company have been fined 300,000 after their wilful blindness led to a 21-year-old having to have his left hand partially amputated.

Heathcoat Fabrics, based in Tiverton, admitted contravening health and safety regulations by failing to prevent access to the dangerous parts of the L-Stenter mangle at their plant in Westexe.

Exeter Magistrates Court on Tuesday heard that an investigation was launched by the Health and Safety Executive after an incident that occurred in the factory on August 23 which led to Anthony Seward, an employee with the company, suffering a serious crush injury to his left hand.

Prosecuting, Mr Mannell said that a light curtain, which automatically stops the rollers on the L-Stenter mangle machine when the beam of light is broken, had been installed in 2009 for the machine, but it has broken down in January 2014. Replacement parts had been ordered, but rather than being installed, a risk assessment had been undertaken that decided that the use of an emergency stop-cord would be sufficient as a safety measure.

On August 23, 2016, Mr Seward was preparing and cleaning the L-Stenter mangle for the night shift when his left hand became entangled in the machine when he didnt realise that the rollers were on.

Mr Mannell said: The stenter had been used for two years and seven months without a light curtain as they felt that the stop-cord would be sufficient to prevent the risk of injury, but they failed to appreciate what could happen due to a lack of concentration or other factors when someone entered the danger zone. They were wrong that a stop-wire would be enough to reduce the risk of injury.

Mr Seward suffered severe crush injuries to four fingers on his left hand and he was flown by Air Ambulance to Bristol.

Explaining his injuries to the court, he said that he currently has no use of his left hand, he has to go back and forth to Bristol twice-a-week, he is not expected to gain the full use of his hand, and he may require an amputation.

He said that he was a retained firefighter but as a result of the injuries, this was no longer a career option.

Mr Mannell said: This case is about the fact that they failed to reinstate the light curtain to stop access to the danger zone. They knew this was a risk as they had installed it as a control measure prior to the incident happening.

The fact that they had assessed the risk and had put in the control of the light curtain previously shows how avoidable and preventable this accident was. What they did instead was inadequate and resulted in this very serious injuries.

Their wilful blindness to the risk that was in place meant that the controls did not reach industrial standard.

Mitigating on behalf of Heathcoat Fabrics, Mr Christopher Ducann said: This was a complete tragedy as to what had happened and it is truly regrettable. This was an avoidable accident and to that extent, we fully apologise for it.

He said that although it was not entirely clear as to the circumstances that led to the injury occurring, it was irrelevant as the law was about the risk of injury occurring.

He added: This is a company with no previous convictions and it is a matter of considerable shame and embarrassment that they are in this court today. Within a matter of days, they stop steps to prevent this happening again and they have fully co-operated with the investigation.

Sentencing the company, District Judge Stephen Nicholls said that it was clear that Mr Seward had suffered a considerable injury.

He fined Heathcoat Fabrics Ltd 300,000, and also ordered them to pay costs of 2,862.30 and a victim surcharge of 170.

Heathcoat Fabrics Ltd pleaded guilty to the charge of contravening a health and safety regulation in that between 18 January 2014 adn 24 August 2016 being an employer within the meaning of the Health & Safety at Work etc Act 1974 ("theAct"), contravened regulation 11(1) of the Provision and Use of Work Equipment Regulations 1998 in that you failed to take effective measures to prevent access to dangerous parts of the L-stenter mangle and in particular, its mangle rollers, whereby you are guilty of an offence contrary to Section 33(1)(c) of the Act.

Speaking after the sentence, Cameron Harvie, managing director of Heathcoat Fabrics said in a statement: Heathcoat Fabrics deeply regrets the incident which resulted in todays hearing. As the Court has today acknowledged, the Company takes health and safety serious and has an established track record in safety performance.

In the aftermath of the incident, we have taken the opportunity to further review and improve our existing safety systems. We have co-operated fully with the HSE in its investigation into the incident.

The court also heard that Mr Seward was pursuing a civil action about the company.

Founded in 1808, Heathcoat Fabrics is the leading supplier of engineered textile solutions. From off the shelf fabrics to bespoke solutions our innovative, customer-focused approach ensures that we can design, develop, test and deliver a wide variety of fabrics across the continents to many of the world's leading companies

Original post:
Company fined after 'wilful blindness' led to employee's hand being ... - Devon Live

A FORMER Northern Rivers resident has been charged with defrauding the Commonwealth by pretending she was blind to obtain a disability pension.

And it was an inside job - as Rebecca Teece, now 35, was working for Centrelink at the time.

Teece, also known as Rebecca O'Grady, is facing four counts of obtaining financial advantage by deception over her alleged use of fake medical reports and fake names to claim eligibility for pension payments between 2012 and 2015.

Teece worked at Centrelink offices in Coffs Harbour and then Pottsville when the alleged fraud took place.

In August 2012, Teece allegedly lodged a fake report from an opthamologist called Dr D. Gregor to justify a claim for a blindness disability pension. She was working in North Boambee Valley at the time.

As a result of the alleged deception, Teece received payments between December 17, 2012, and May 1, 2015.

Two years later, while working in Pottsville, Teece is alleged to have used a fake name, Rachel Lewis, to lodge another fraudulent claim for a disability pension.

Court papers allege Teece made the claim between October 30, 2014, and May 1, 2015, and as a result received payments between November 28, 2014, and May 1, 2015.

During this period Teece allegedly struck a third time, this time between March 5 and 9, 2015.

On this occasion she made and then approved her own claim for a carer's payment under the fictitious name of Margereet Lewis.

She is alleged to have done this twice.

Teece was served with a court attendance notice on January 30 this year and the matter was mentioned in Lismore Local Court on Tuesday this week.

It was adjourned to September 19 to return to Lismore Local Court.

Magistrate David Heilpern said no further adjournments would be allowed.

See original here:
Centrelink worker faked blindness for disability pension - Northern Star