Author Archives: Carey Goldberg

In Public Comments, Partners-Coakley Deal Brings Praise And Protest

partners

Quite an “only in Massachusetts” moment.

Patriots owner Robert Kraft and leaders of Raytheon, Suffolk Construction and Putnam Investments have all filed letters in support of an anti-trust agreement that would not normally see the light of day before a judge approves the deal. The opposition includes public health professors, a group of top economists and politicians battling Attorney General Martha Coakley in the governor’s race.

This show of force is weighing in on a deal Coakley negotiated with Partners HealthCare. It would let the state’s largest hospital network expand its market power, but with constraints, some of which would last for 10 years.

Here, in the medical mecca that is Boston, health care is big business, an issue in the governor’s race and a top concern for consumers and employers who struggle to pay for it.

So the agreement is setting a new precedent for public scrutiny. Insurers, physicians and patients are poring through the document, line by line, to understand what it might mean for them and the future of health care in Massachusetts. AG Coakley is collecting public comments through September 15th. She’ll have a week to respond and then Suffolk Superior Court Judge Janet Sanders has scheduled a hearing on the agreement September 29th.

In the first batch of comments out today, most of the supporters focus on Partners’ leadership in the medical community and don’t dive into the details of its alleged anti-trust practices and the proposed remedies. Opponents, on the other hand, plunge right in. Here are a some highlights:

The South Shore Hospital community has submitted at least a dozen letters in support of the agreement, which would clear the way for the hospital to join Partners. Weymouth Mayor Susan Kay applauds the AG’s “significant and even historic benefits for the acute care market place.” And Norfolk County Central Labor Council Secretary James Howard says “enough is enough.”  Please, Howard urges Coakley, “stop letting self interested parties hinder this process.”

I imagine Howard refers to the coalition of Partners’ competitors who say the deal will raise costs, but maybe he means Coakley’s rivals in the race for governor.  Democrat Steve Grossman calls the deal a failure that could “take us down the wrong path for many years to come.” And Don Berwick, who also faces Coakley in the Democratic primary, has submitted a petition with 456 signatures called “Block the Partners deal.” Continue reading

Brain Scientists Learn To Alter And Even Erase Memories

This optogenetic device uses light to activate specific brain cells. (Courtesy McGovern Institute for Brain Research at MIT)

This optogenetic device uses light to activate specific brain cells. (Courtesy McGovern Institute for Brain Research at MIT)

For 32 years, Leslie Ridlon worked in the military. For most of her career she was in army intelligence. Her job was to watch live video of fatal attacks to make sure the missions were successful.

“I had to memorize the details, and I have not got it out of my head, it stays there — the things I saw,” she says. “The beheading — I saw someone who got their head cut off — I can still see that.”

Leslie Ridlon retired from the military eight years ago, but she finds she cannot work because she suffers from severe PTSD. (Courtesy)

Leslie Ridlon retired from the military eight years ago, but she finds she cannot work because she suffers from severe PTSD. (Courtesy)

Ridlon is now 49 and retired from the military last year, but she finds she cannot work because she suffers from severe post traumatic stress disorder. She has tried conventional therapy for PTSD, in which a patient is exposed repeatedly to a traumatic memory in a safe environment. The goal is to modify the disturbing memory. But she says that type of therapy doesn’t work for her.

“They tried to get me to remember things,” she says. “I had a soldier who died, got blown up by a mortar — he was torn into pieces. So they wanted me to bring that back. I needed to stop that. It was destroying me.”

She has concluded that some memories will never leave her. “Everything I could get rid of as far as memory I think I’ve already done it,” she says. “I think the deep ones that you suffer from, I don’t think anyone can take them away. I don’t believe anyone can. I think the ones I have now, they’re going to just stay there. I’m just going to have to manage them.”

But what if these traumatic memories could be altered or even erased permanently? Researchers say they are beginning to be able to do that — not just in animals, but in people as well.

Not long ago, scientists thought of memory as something inflexible, akin to a videotape of an event that could be recalled by hitting rewind and then play. But in recent decades, new technology has helped change the way we understand how memory works — and what we can do with it. Scientists can now manipulate memory in ways they hope will eventually lead to treatments for disorders ranging from depression to post-traumatic stress to Alzheimer’s disease.

“We now understand there are points in time when we can change memory, where we can create windows of opportunity that allows us to alter memories, and even erase specific memories,” says Marijn Kroes, a neuroscientist at New York University.

Kroes is working on doing just that in an NYU lab. On a recent afternoon, he was preparing a 21-year-old female subject for a three-day experiment.

He attached electrodes to the subject’s wrist so he could apply mild electric shocks when certain pictures appeared on the computer. This technique creates a fear memory—which he tests by measuring the subject’s sweat response.

On the second day of the experiment, Kroes shows the subject the same pictures to bring up the fear memory. He then waits 10 minutes — that’s the window, he says, when the memory becomes highly sensitive and vulnerable to change.

NYU neuroscientist Marijn Kroes attaches electrodes to subjects' wrist and applies mild electric shocks when certain pictures appear on a computer. This technique creates a fear memory -- which he tests by measuring the subject’s sweat response. (Courtesy)

NYU neuroscientist Marijn Kroes attaches electrodes to subjects’ wrists and applies mild electric shocks when certain pictures appear on a computer, creating a fear memory. (Courtesy)

“Briefly reactivating the memory weakens or pries the memory loose,” he says. “The connections in the brain for that memory, normally they would re-stabilize again, but if you interfere with that process you cause loss of those connections between brain cells, and as a result you lose the memory.”

After he waits 10 minutes, he again shows the images to the subject without the shocks.

“The trick here is, instead of immediately trying to teach people that a situation is safe, you first remind of their emotional experience,” he says. “And now you wait a little while, and this opens up a window of opportunity in which you can update and alter the memory.”

On the third and final day of the experiment, Kroes tests whether he is successful: Did he get rid of the fear memory?

“In her case, if we truly have been able to override the fear memory, she should not show any fear response to those stimuli,” he says. And indeed, “What we now see is a flat line — that means she doesn’t show fear responses. Thus, we see no evidence that she still has a fear memory.”

While scientists long believed that memories were stored in the brain permanently, they now understand that memory is in fact malleable. Kroes says this knowledge — and the ability to specifically alter memory on a cellular level — could lead to new treatments for people with many conditions.

NYU neuroscientist Marijn Kroes says the ability to alter memories could lead to new treatments for people with many conditions. (Rachel Gotbaum for WBUR)

NYU neuroscientist Marijn Kroes says the ability to alter memories could lead to new treatments for people with many conditions. (Rachel Gotbaum for WBUR)

“By understanding that memory is flexible, we can think of ways we can interfere with that flexibility,” he says. “For example, this allows us to potentially come up with new treatments for psychiatric disorders. But you can also think of ways we can understand how to optimize memories in people with degenerative disorders such as Alzheimer’s and dementia.”

The hope is that these new approaches can also be used to strengthen memories in patients with memory loss. In the meantime studies are underway in patients with PTSD and other disorders such as addiction. But Kroes warns at this point he and other scientists only have a very early grasp of how these new techniques actually work. And they still have much more work to do before these new discoveries can be translated into effective treatments for the millions of patients suffering from memory and anxiety disorders.

Still, he and other researchers see a major shift in the concept of memory.

“I think it forces us not to think of memory as a video tape where we press play at the moment where we experienced an event,” says Elizabeth Kensinger, an associate professor of psychology at Boston College. “But instead think of the process of recalling a past event as a very active process where our brains are constantly trying to fill in pieces.”

And new technology is allowing scientists to manipulate memory directly in animals.

In the lab of Professor Susumu Tonegawa, a Nobel Prize-winning scientist at the MIT Picower Institute for Learning and Memory, researchers are using a powerful new tool called optogenetics to see how memory works in specific cells in real time.

“Moment by moment we our using our memory,” says Tonegawa. “It’s important for us to know how we form a memory, how we record a memory and how it goes bad under certain conditions.”

With optogenetics, scientists use lasers to identify specific memory cells and also to manipulate those cells.

Recently, Tonegawa’s lab used optogenetics to implant false memories into lab mice. Now, his lab is working on altering memories of mice with depression and symptoms of post-traumatic stress. The idea is to modify painful and stressful memories.

People like Leslie Ridlon, the veteran with PTSD, are waiting for the progress in labs to reach the point that it can help them.

“If someone took away all the bad memories and I could function every day, that would be great,” she says.

More:

Project Louise: On Exercise, Sex, Free Stuff And The Secret Of Life

(Edson Fong via Compfight)

(Edson Fong via Compfight)

 

Dear Louise,

Let me be blunt: I’m afraid you’ve been having sex without orgasms.

When it comes to exercise, that is.

To extend this ham-handed metaphor a bit farther: I know some people say there’s no such thing as bad sex unless it hurts you. And of course there’s no such thing as bad exercise unless it hurts you. Any bit of activity, any rise from the couch, any flight of stairs, is good.

But I worry that halfway through your Project Louise year, while you’ve made truly laudable progress on healthier eating and emotional self-care, you clearly have yet to catch the exercise bug. Oh, you’ve tried, heroically, from bike rides to hot yoga to personal training. But it somehow hasn’t stuck.

So that’s the purpose of this letter: To try to jump-start your fitness, to remind you that in your original goals you listed “Create and follow a regular, sustainable exercise plan”; and most importantly, to try to persuade you that exercise — daily exercise, moderate to vigorous — is the magical secret of life.

(Readers, won’t you help? As in, let’s all pile on Louise! I end this letter with a few of my own quirky personal tips for making exercise a daily habit. If you’ll add a few of your own in the comments section, or whatever arguments you think might most help Louise get going, you’ll be rewarded not only by knowing you’ve helped but with a bit of WBUR swag. Just send an email to membership@wbur.org with “exercise tips” in the subject line, and specify whether you want a WBUR cup or baseball cap sent to the address you give.

And we can also all help with accountability. Louise has agreed that beginning tomorrow, she’ll get some form of activity or exercise every day by 7 p.m. and report in on it by 11 p.m. in the comments section below.)

True, we’re aiming for sustainable change and reporting to an online audience every day does not seem like a lifelong practice. But this is just for the month, just to try to establish the habit.

Some say it takes just 21 days to establish a new habit; it’s surely more complex than that – some research suggests the average is more like two months — but here’s how you know you’re there: It’s harder not to do it than to do it.

Louise, I do believe that’s the key. You’ve said that you don’t make time for exercise the way you do for reading because it’s not as pleasurable. I’d so love you to reach the point I’ve reached: I do enjoy the exercise in and of itself, but what most motivates me is the desire not to feel like crap on a given day. It’s harder to face the torpor and irritability of not doing it than the brief sweaty effort of doing it. Continue reading

Control: Why We Get Sucked Into Insanity (And Other Intense Workout Programs)

My insanity workout in my recycling bin, waiting for regifting (Carey Goldberg/WBUR)

“Insanity” workout in the recycling bin, waiting for regifting (Carey Goldberg/WBUR)

Veronica Thomas
CommonHealth intern

It’s time to come clean: Like my colleague, Carey, I too am an “Insanity” dropout.

Some people may say we’re weak or wimpy or quitters—in fact, many commenters declare just that—but a new study suggests that we fell into a very common marketing trap. We were bored by the same old exercises and hungry for something new—something intense. What we didn’t realize was that we might well be looking to intensity as a way to reassert control.

The new study, published in the Journal of Consumer Research, found that when a person’s sense of control is jeopardized, they are more likely to buy products that require hard work.

And man, are those workout programs hard. My first time trying Insanity—a high-intensity interval training program—I thought the 9-minute warmup was the actual workout. But Sean T, my glistening TV trainer, encouraged me to dig deeper. While simultaneously cursing his existence, I also managed to convince myself that somewhere deep, deep inside me I did have the strength to finish.

Turns out, my need to complete the workout every day for a month may have been about something more than just a boost to my usual fitness routine. According to the study, I may have been using ski jumps and burpees to regain some sense of control over my life.

From the press release:

“Intuitively, it would seem that feeling a loss of control might cause consumers to seek out a product that does NOT require them to exert very much effort. But we find that consumers actually look to products that require hard work to restore their belief that they can drive their own positive outcomes,” write authors Keisha M. Cutright (Wharton School of the University of Pennsylvania) and Adriana Samper (Arizona State University).

By looking across five smaller studies, the authors assessed how people’s feelings of control over health or fitness influenced their selection of products demanding either high or low effort. Those who felt a low sense of control were likelier to choose tougher programs and mantras. For instance, one study found that basketball players just defeated in a game were more likely to purchase shoes with the tagline, “Work harder, Jump higher.” Continue reading

Winning The Lottery: Study Links School Quality To Teen Health

 

(Compfight)

(Compfight)

Veronica Thomas
CommonHealth Intern

Successful high schools don’t just mean higher academic achievement, a new study finds. They may also mean healthier behaviors among teens.

The study, published in the journal Pediatrics, compared students from highly rated charter high schools with those from regular public high schools—all located in low-income Los Angeles neighborhoods.

The researchers found that students from the charter schools not only performed much better on math and English standard tests. These students also reported less very risky health behaviors, including unprotected sex, carrying a weapon, and gang membership, compared to district school students.

Retention in the same school may be the most important factor, they found.

However, the effects were much less dramatic when it came to more moderate health risks. In fact, when the researchers looked at recent use of alcohol, tobacco and drugs, there was virtually no difference between the two groups.

To select the two groups of students, the researchers took advantage of the lottery admissions system used by many charter schools. Continue reading

Inspired By Family Illness, Philanthropist Gives $650 Million For Psychiatric Research

The Broad Institute of Harvard and MIT  summer student Lydia Emerson and aesearch associate Aldo Amaya. (Courtesy/Kelly Davidson Photography)

Researchers at the Broad Institute plan to use Ted Stanley’s money to catalog all the genetic variations that contribute to severe psychiatric disorders. (Courtesy/Kelly Davidson Photography)

In the largest-ever donation to psychiatric research, Connecticut businessman Ted Stanley is giving $650 million to the Eli and Edythe Broad Institute of MIT and Harvard. The goal — to find and treat the genetic underpinnings of mental illnesses — was inspired by a family experience.

Ted Stanley made his fortune in the collectibles business. He founded The Danbury Mint, a company (later MBI, Inc.) whose first product was a series of medals commemorating the biggest scientific achievement of its time: the moon landing in 1969. While his business grew, his son Jonathan Stanley grew up as a normal Connecticut kid. Until, at age 19, Jonathan came down with bipolar disorder with psychosis, which got worse over the next three years.

“We’ll call it the epiphany from my dad’s standpoint at least,” Jonathan Stanley remembered of the turning point in his illness. “I went three days straight running through the streets of New York, no food, no water, no money, running from secret agents. And not surprisingly, after I stripped naked in a deli, ended up in a psychiatric facility.”

Jonathan was a college junior at the time.

“My dad came to visit, and he got to see his beloved son in a straitjacket,” Jonathan Stanley said.

The Stanleys were lucky. Jonathan responded well to the lithium, then a newly-approved drug. He went on to graduate from college and law school, too. Yet along the way, his father had met other fathers whose sons did not respond to treatment. He met other families who had to keep living with uncontrolled mental illness.

Ted Stanley said that gave him a focus for his philanthropy.

There was something out there that our son could take, and it made the problem go away,” he said. “And I’d like to see that happen for a lot of other people. And that’s why I’m doing what I’m doing.”

Continue reading

Boston Doc At AIDS Conference Reports Shock, Grief For Colleagues

A pro-Russian fighter inspects the site of a crashed Malaysia Airlines passenger plane near the village of Hrabove, Ukraine, eastern Ukraine Friday, July 18, 2014. (AP Photo/Dmitry Lovetsky)

A pro-Russian fighter inspects the site of a crashed Malaysia Airlines passenger plane near the village of Hrabove, Ukraine, eastern Ukraine Friday, July 18, 2014. (AP Photo/Dmitry Lovetsky)

Veronica Thomas
CommonHealth Intern

The 20th International AIDS Conference began Sunday in Melbourne, Australia, as attendees mourned the loss of colleagues in last week’s plane crash in Ukraine. Yesterday, the International AIDS Society released a statement confirming that at least six delegates traveling to the conference were onboard the Malaysian Airlines flight.

Dr. Dan Barouch, director of the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center and a professor at Harvard Medical School who is attending the conference, said the attendees are reeling in disbelief.

“The mood is somber, people are in shock,” he told WBUR’s Kassandra Sundt. “And it’s certainly not the type of discussions that people were planning to have here.”

Despite the tragedy, he said there was no discussion of canceling the conference, which is scheduled to continue through Friday.

‘A lot of people’s lives are saved because of his work.’

“There are clearly statements of sorrow and condolences and moments of silence throughout the scientific sessions, throughout the conference dinners, and privately,” he says. “But from the start everyone acknowledged that it would be the desire of all those who died tragically in this plane crash to have the work go on.”

Continue reading

Medical Marijuana 101: 10 Things You Should Know Before Using The Drug

As medical marijuana is introduced in Massachusetts, here are 10 things to know about using it.

Whether you are using marijuana for the first time, or trying it for a new ailment, those who praise its benefits say you should be prepared for a period of trial and error. Because:

1) What works for one patient may not work for you. The difference may be in the marijuana, but patients also respond to drugs differently based on age, race, gender, genetics and other factors. (The Food and Drug Administration takes many of these factors into account when testing legal drugs.)

2) All pot is not alike. Every strain of marijuana has a different balance of cannabinoids, the chemical compounds that are unique to marijuana, some of which have medicinal value. The two most common are THC, which can make people high, and CBD, which offsets the effects of THC and is believed to prevent muscle spasms and seizures.

3) Even within the same strain, the intensity of cannabinoids will vary. Take Blue Dream, one of the more popular strains these days. Blue Dream from one grower might have 5 percent THC, but if you change buyers, your next batch of Blue Dream might have 25 percent THC and produce a strong high. Continue reading

Medical Marijuana 101: What’s In Your Drug?

Jack Boyle reaches across the marble island in his kitchen for a small blue glass bottle with a black rubber cap. He holds it to the light, shaking the liquid, a marijuana concentrate.

“The person who made this didn’t make it properly,” Boyle says.

Boyle’s wife Susan Lucas uses the marijuana concentrate, or tincture, to prevent epileptic seizures. The first batch helped, so Boyle went back for more.

But then, “Sue started seeing her symptoms coming back,” he says. “We immediately took [the new batch] to the lab, had it tested. It didn’t have the CBD in it.”

The second batch, it seems, wasn’t heated enough to activate CBD, one of the compounds in marijuana that supporters say helps with muscle spasms and seizures.

Now Boyle is learning how to make a perfect concentrate on his own, in his kitchen in Stow. He bought a Crock-pot and found a recipe for marijuana tinctures online.

“I’ll make a batch and have Michael Kahn test it again, and if [it] matches up to at least as strong as the first batch then we’re good to go for six months to a year,” Boyle says. “It’s my wife, I just want to do the best I can.”

Michael Kahn is an analytical chemist and president of Massachusetts Cannabis Research, or MCR Labs, in Framingham. It’s the first marijuana testing lab to open in Massachusetts.

“We provide quality control,” Kahn says.

With all the attention to dispensaries that will grow and sell marijuana for medical use, the question of who will test the drug has been largely overlooked. The state Department of Public Health (DPH) is expected to issue testing protocols soon, but they may be a work in progress — at least for the first few years — as this industry takes shape across the country.
Continue reading

Mourning The AIDS Researchers Killed In Ukraine Plane Crash

A pro-Russian fighter inspects the site of a crashed Malaysia Airlines passenger plane near the village of Hrabove, Ukraine, eastern Ukraine Friday, July 18, 2014. (AP Photo/Dmitry Lovetsky)

A pro-Russian fighter inspects the site of a crashed Malaysia Airlines passenger plane near the village of Hrabove, Ukraine, eastern Ukraine Friday, July 18, 2014. (AP Photo/Dmitry Lovetsky)

With an estimated 100 HIV/AIDS researchers believed to have been on the Malaysian Airlines flight that went down in Ukraine, the official mourning has begun and will surely grow as names and details emerge. This just in from James Friedman, executive director of the American Academy of HIV Medicine:

It is with heavy heart we learn many of those that perished in the crash of Malaysia Airlines Flight 17 were leading HIV/AIDS researchers traveling to the International AIDS Conference scheduled to begin on Sunday in Australia. While all names have not yet been released, the passing of Dr. Joep Lange, a leading HIV/AIDS researcher, has been confirmed.

It is due to their continued dedication to HIV/AIDS patients worldwide that they were making this journey. Not only did this tragedy take the lives of these researchers, but also robbed the world of their future discoveries and contributions to the HIV/AIDS patients they served.

The HIV/AIDS community mourns the loss of these talented and compassionate researchers and HIV care providers. Our condolences to the families of all those affected by the Malaysia Airlines Flight 17 tragedy.

The New York Times profiles Dr. Lange here, and the Australian Broadcasting Corporation reports that Canadian HIV researcher Trevor Stratton said the crash was a huge loss to the AIDS research world.

“What if the cure for AIDS was on that plane? Really? We don’t know,” he said.

“There were some really prominent researchers that have been doing this for a very long time and we’re getting close to vaccines and people are talking about cures and the end of AIDS.