Ministry of Stories

Ministry of Stories

Ministry of Stories

Would you believe the items above have been created to support literacy? The back story: in 2008, David Eggers gave a TED talk regarding literacy and the 826 literacy program, which is here in the US and appears to be a great program in a slew of cities across the country. He posed the thought of beginning something similar in London. Many meetings and some great thoughts came and went; 2 years later The Ministry of Stories was born. Design firm we made this worked with the Arts Council and the JJ Charitable Trust to create a fun inviting space:

The Ministry follows the model of the 826 centres: a writing centre where kids aged 8-18 can get one-to-one tuition with professional writers and other volunteers; with the centres being housed behind fantastical shop fronts designed to fire the kids’ imaginations (and generate income for the writing centres).

A shop named Horton Street Monster Supplies is the income generator, and boy do I wish I could stop by and do my part. I would really like some canned Mortal Terror or a jar of Organ Marmalade. This is the greatest idea ever, and I sincerely hope it does well.

Favorite Slang for Breasts?

iHeartGuts Breast Exam Ever

Yet another fabulous chart designed by our favorite plush organ designer, iHeartGuts!   This is so much more entertaining (and therefore more likely to be read in a doctor’s office) than those boring anatomical charts.  Just sayin.Ahem, docs.

Doesn’t look like these are for sale at the moment, but hopefully they will be in the future!

I’m curious, what’s your favorite slang for breasts??

 

Medical doctors speak out about why they avoid naked body scanners at airports

For those still contemplating whether or not the radiation emitted from airport naked body scanners is serious enough to avoid, you may be interested to know that many doctors routinely "opt out" and choose the full-body pat down instead because they recognize the inherent dangers associated with any level of radiation exposure. A recent CNN piece explains that for many doctors, avoiding all sources of radiation whenever possible is just the smart thing to do.

Throughout the past year, was covered many stories related to the US Transportation Security Administration's (TSA) controversial naked body scanners, which are now installed and in use at nearly 80 US airports (http://www.tsa.gov/approach/tech/ait/faqs.shtm). Besides representing an unconstitutional invasion of privacy (http://www.tsa.gov/approach/tech/ait/faqs.shtm), the scanners blast passengers with full-body doses of health-destroying radiation (http://www.dreddyclinic.com/forum/viewtopic.php?f=2&t=22309).

So what do medical doctors who fly have to say about the machines? Well, according to CNN's Elizabeth Cohen who recently conducted her own small investigation, many are concerned about the radiation these scanners emit. Read more...

Joint Mender for Joint Care

Are patient characteristics associated with the accuracy of hysterosalpingography in diagnosing tubal pathology? An individual patient data meta-analysis

BACKGROUND

Conventional meta-analysis has estimated the sensitivity and specificity of hysterosalpingography (HSG) to be 65% and 83%. The impact of patient characteristics on the accuracy of HSG is unknown. The aim of this study was to assess by individual patient data meta-analysis whether the accuracy of HSG is associated with different patient characteristics.

METHODS

We approached authors of primary studies reporting on the accuracy of HSG using findings at laparoscopy as the reference. We assessed whether patient characteristics such as female age, duration of subfertility and a clinical history without risk factors for tubal pathology were associated with the accuracy of HSG, using a random intercept logistic regression model.

RESULTS

We acquired data of seven primary studies containing data of 4521 women. Pooled sensitivity and specificity of HSG were 53% and 87% for any tubal pathology and 46% and 95% for bilateral tubal pathology. In women without risk factors, the sensitivity of HSG was 38% for any tubal pathology, compared with 61% in women with risk factors (P = 0.005). For bilateral tubal pathology, these rates were 13% versus 47% (P = 0.01). For bilateral tubal pathology, the sensitivity of HSG decreased with age [factor 0.93 per year (P = 0.05)]. The specificity of HSG was very stable across all subgroups.

CONCLUSIONS

The accuracy of HSG in detecting tubal pathology was similar in all subgroups, except for women without risk factors in whom sensitivity was lower, possibly due to false-positive results at laparoscopy. HSG is a useful tubal patency screening test for all infertile couples.

Chlamydia antibody testing and diagnosing tubal pathology in subfertile women: an individual patient data meta-analysis

BACKGROUND

The Chlamydia IgG antibody test (CAT) shows considerable variations in reported estimates of test accuracy, partly because of the use of different assays and cut-off values. The aim of this study was to reassess the accuracy of CAT in diagnosing tubal pathology by individual patient data (IPD) meta-analysis for three different CAT assays.

METHODS

We approached authors of primary studies that used micro-immunofluorescence tests (MIF), immunofluorescence tests (IF) or enzyme-linked immunosorbent assay tests (ELISA). Using the obtained IPD, we performed pooled receiver operator characteristics analysis and logistic regression analysis with a random effects model to compare the three assays. Tubal pathology was defined as either any tubal obstruction or bilateral tubal obstruction.

RESULTS

We acquired data of 14 primary studies containing data of 6191 women, of which data of 3453 women were available for analysis. The areas under the curve for ELISA, IF and MIF were 0.64, 0.65 and 0.75, respectively (P-value < 0.001) for any tubal pathology and 0.66, 0.66 and 0.77, respectively (P-value = 0.01) for bilateral tubal pathology.

CONCLUSIONS

In Chlamydia antibody testing, MIF is superior in the assessment of tubal pathology. In the initial screen for tubal pathology MIF should therefore be the test of first choice.

Surgical treatment of deeply infiltrating endometriosis with colorectal involvement

BACKGROUND

Treatment of colorectal endometriosis is difficult and challenging. We reviewed the clinical outcome of surgical treatment of deeply infiltrating endometriosis (DIE) with colorectal involvement.

METHODS

Review was based upon a literature search using following search terms: (1) ‘surgery’ and ‘colorectal endometriosis’, (2) ‘bowel’ and ‘endometriosis’ and ‘surgery’. Inclusion criteria: clear explanation of surgical technique and follow-up data on at least one of the following items: complications, pain, quality of life (QOL), fertility and recurrence.

RESULTS

Most of the 49 studies included complications (94%) and pain (67%); few studies reported recurrence (41%), fertility (37%) and QOL (10%); only 29% reported (loss of) follow-up. Out of 3894 patients, 71% received bowel resection anastomosis, 10% received full-thickness disc excision and 17% were treated with superficial surgery. Comparison of clinical outcome between different surgical techniques was not possible. Post-operative complications were present in 0–3% of the patients. Although pain improvement was reported in most studies, pain evaluation was patient-based in <50% (Visual Analogue Scale in only 18%). While QOL was improved in most studies, prospective data were only available for 149 patients. Pregnancy rates were 23–57% with a cumulative pregnancy rate of 58–70% within 4 years. The overall endometriosis recurrence rate in studies (>2 years follow-up) was 5–25% with most of the studies reporting 10%. Owing to highly variable study design and data collection, a CONSORT-inspired checklist was developed for future studies.

CONCLUSIONS

Prospective studies reporting standardized and well-defined clinical outcome after surgical treatment of DIE with colorectal involvement with long-term follow-up are needed.

Cell-free fetal nucleic acids in amniotic fluid

BACKGROUND

Research into cell-free fetal (cff) nucleic acids has primarily focused on maternal plasma; however, cff DNA and RNA are also detectable in other body fluids such as amniotic fluid (AF). In AF, cff DNA is present in much greater concentrations than in maternal plasma and represents a pure fetal sample uncontaminated by maternal- and trophoblast-derived nucleic acids. The aim of this review was to summarize the current knowledge on cff nucleic acids in AF and to outline future research directions.

METHODS

MEDLINE and PREMEDLINE were searched up to August 2010 for original investigations of cell-free RNA or DNA in AF. Sixteen studies were included in the review.

RESULTS

AF cff DNA represents a physiologically separate pool from cff DNA in maternal plasma. The placenta is not a major source of nucleic acids in AF. It is feasible to isolate cff nucleic acids from small volumes of discarded AF supernatant in sufficient quality and quantity to perform microarray studies and downstream applications such as pathway analysis. This ‘discovery-driven approach’ has resulted in new information on the pathogenesis of Down syndrome and polyhydramnios. There is otherwise a paucity of information relating to the basic biology and clinical applications of cff nucleic acids in AF.

CONCLUSIONS

AF supernatant is a valuable and widely available but under-utilized biological resource. Further studies of cff nucleic acids in AF may lead to new insights into human fetal development and ultimately new approaches to antenatal treatment of human disease.

Non-invasive aneuploidy detection using free fetal DNA and RNA in maternal plasma: recent progress and future possibilities

BACKGROUND

Cell-free fetal DNA (cff DNA) and RNA can be detected in maternal plasma and used for non-invasive prenatal diagnostics. Recent technical advances have led to a drastic change in the clinical applicability and potential uses of free fetal DNA and RNA. This review summarizes the latest clinical developments in non-invasive prenatal diagnosis in the context of the latest technical developments.

METHODS

We searched PubMed with the search terms ‘prenatal’, ‘non-invasive’, ‘fetal DNA’, ‘mRNA’ and cross-referenced them with ‘diagnostics’, ‘microRNA’, ‘aneuploidy’, ‘trisomy’ and ‘placenta’. We also searched the reference list of the articles identified by this search strategy.

RESULTS

Genome-wide methods have been, or can be, successfully applied on total DNA (DNA-seq), methylated DNA immunoprecipitation (with tiling array), microRNA (Megaplex) and total RNA (RNA-seq). Chromosome- or gene-specific assays have been successively applied on placenta RNA (allele ratio) or DNA multiplex ligation-dependent probe amplification (MLPA). These methods are reviewed for their merits and pitfalls with consideration of the placental biology. For the purpose of clarity, the technical and clinical characteristics are limited to non-invasive prenatal detection of chromosomal aneuploidies, with emphasis on trisomy 21.

CONCLUSIONS

The technical advances for non-invasive aneuploidy tests based on cff DNA and placental mRNA in maternal plasma have been enormous. Multimarker assays including genome-wide approaches with the option of qualitative information on variation (polymorphism or mutation) besides quantitative information are the preferred methods of choice. The time for population-based, double blind, large-scale clinical cohort trials has come.

The role of mast cells and their mediators in reproduction, pregnancy and labour

BACKGROUND

Mast cells (MCs) are the classical mediators of allergy, however, their importance in the development of innate and adaptive immune responses is increasingly being recognized. Herein, the present MC literature is summarized, with particular focus on studies of MCs in the endometrium and myometrium, and their involvement in fertility, implantation, pregnancy and labour.

METHODS

Recent developments in MC biology were identified by systematic searches of PubMed, Medline and Google Scholar from 2000 to November 2009. To specifically examine the role of MCs in fertility and pregnancy, we then performed a systematic review of English literature cited in the PubMed, Medline and Google Scholar databases, but extended the search period, from 1980 to January 2010

RESULTS

MCs can respond to immunoglobulin E-independent innate immune stimuli and are present within the endometrium, with activation and release of mediators occurring prior to menstruation and in association with endometriosis. With respect to pregnancy, MCs are redundant during blastocyst implantation and although their mediators can induce myometrial contractility, there is no epidemiological link of preterm birth with allergy, suggesting a non-essential role or robust regulation. In males, MCs are present in the testes and are increased in oligo- and azoospermia, with MC mediators directly suppressing sperm motility in a potentially reversible manner.

CONCLUSIONS

MCs are prevalent in the female and male reproductive tract. However, whether MCs are absolutely required for a successful pregnancy or are fundamental to reproductive pathology, and thereby a therapeutic target, remains to be determined.

Epigenetics and the placenta

BACKGROUND

The placenta is of utmost importance for intrauterine fetal development and growth. Deregulation of placentation can lead to adverse outcomes for both mother and fetus, e.g. gestational trophoblastic disease (GTD), pre-eclampsia and fetal growth retardation. A significant factor in placental development and function is epigenetic regulation.

METHODS

This review summarizes the current knowledge in the field of epigenetics in relation to placental development and function. Relevant studies were identified by searching PubMed, Medline and reference sections of all relevant studies and reviews.

RESULTS

Epigenetic regulation of the placenta evolves during preimplantation development and further gestation. Epigenetic marks, like DNA methylation, histone modifications and non-coding RNAs, affect gene expression patterns. These expression patterns, including the important parent-of-origin-dependent gene expression resulting from genomic imprinting, play a pivotal role in proper fetal and placental development. Disturbed placental epigenetics has been demonstrated in cases of intrauterine growth retardation and small for gestational age, and also appears to be involved in the pathogenesis of pre-eclampsia and GTD. Several environmental effects have been investigated so far, e.g. ethanol, oxygen tension as well as the effect of several aspects of assisted reproduction technologies on placental epigenetics.

CONCLUSIONS

Studies in both animals and humans have made it increasingly clear that proper epigenetic regulation of both imprinted and non-imprinted genes is important in placental development. Its disturbance, which can be caused by various environmental factors, can lead to abnormal placental development and function with possible consequences for maternal morbidity, fetal development and disease susceptibility in later life.

Environment and women’s reproductive health

BACKGROUND

There is significant evidence that continuous and prolonged exposure to several endocrine disrupting chemicals (EDC) is a risk factor for reduced fertility and fecundity in women. There is also evidence that ED exposure has trans-generational effects. In this systematic review, we evaluate the evidence for an association between EDC exposure and women's reproductive health.

METHODS

Studies were found by searching the PubMed database for articles published up to 2010. Associations between ED exposure and women's reproductive health reported in the PubMed database are summarized and classified as fertility and fecundity, pregnancy outcomes, transgenerational exposure and effects.

RESULTS

Epidemiological studies on EDCs are not always consistent, in part due to limitations imposed by practical constraints. In order to make progress in this field, we recommend taking advantage of biomonitoring and biobanks, including the development of appropriate biomarkers, and taking into greater consideration modulating factors such as genetic polymorphisms and dietary habits. Further human studies are warranted with particular focus on impaired fertility/fecundity associated with currently widespread ED (e.g. bisphenol A, phthalates and polybrominated flame retardants).

CONCLUSIONS

A detailed appraisal of compounds specifically related to adverse reproductive outcomes is very important for prevention and risk-communication strategies. Besides research needs, the current evidence is sufficient to prompt precautionary actions to protect women's reproductive health.

Chronic pelvic pain and endometriosis: translational evidence of the relationship and implications

BACKGROUND

Many clinicians and patients believe that endometriosis-associated pain is due to the lesions. Yet causality remains an enigma, because pain symptoms attributed to endometriosis occur in women without endometriosis and because pain symptoms and severity correlate poorly with lesion characteristics. Most research and reviews focus on the lesions, not the pain. This review starts with the recognition that the experience of pain is determined by the central nervous system (CNS) and focuses on the pain symptoms.

METHODS

Comprehensive searches of Pubmed, Medline and Embase were conducted for current basic and clinical research on chronic pelvic pain and endometriosis. The information was mutually interpreted by a basic scientist and a clinical researcher, both in the field of endometriosis. The goal was to develop new ways to conceptualize how endometriosis contributes to pain symptoms in the context of current treatments and the reproductive tract.

RESULTS

Endometriotic lesions can develop their own nerve supply, thereby creating a direct and two-way interaction between lesions and the CNS. This engagement provides a mechanism by which the dynamic and hormonally responsive nervous system is brought directly into play to produce a variety of individual differences in pain that can, in some women, become independent of the disease itself.

CONCLUSIONS

Major advances in improving understanding and alleviating pain in endometriosis will likely occur if the focus changes from lesions to pain. In turn, how endometriosis affects the CNS would be best examined in the context of mechanisms underlying other chronic pain conditions.

The role of sex steroid hormones, cytokines and the endocannabinoid system in female fertility

BACKGROUND

Marijuana, the most used recreational drug, has been shown to have adverse effects on human reproduction. Endogenous cannabinoids (also called endocannabinoids) bind to the same receptors as those of 9-tetrahydrocannabinol (THC), the psychoactive component of Cannabis sativa. The most extensively studied endocannabinoids are anandamide (N-arachidonoylethanolamine, AEA) and 2-arachidonoylglycerol. The endocannabinoids, their congeners and the cannabinoid receptors, together with the metabolic enzymes and putative transporters form the endocannabinoid system (ECS). In this review, we summarize current knowledge about the relationships of ECS, sex steroid hormones and cytokines in female fertility, and underline the importance of this endocannabinoid–hormone–cytokine network.

METHODS

Pubmed and the Web of Science databases were searched for studies published since 1985, looking into the ECS, sex hormones, type-1/2 T-helper (Th1/Th2) cytokines, leukaemia inhibitory factor, leptin and reproduction.

RESULTS

The ECS plays a pivotal role in human reproduction. The enzymes involved in the synthesis and degradation of endocannabinoids normalize levels of AEA for successful implantation. The AEA degrading enzyme (fatty acid amide hydrolase) activity as well as AEA content in blood may potentially be used for the monitoring of early pregnancies. Progesterone and oestrogen are involved in the maintenance of endocannabinoid levels. The ECS plays an important role in the immune regulation of human fertility.

CONCLUSIONS

The available studies suggest that tight control of the endocannabinoid–hormone–cytokine network is required for successful implantation and early pregnancy maintenance. This hormone–cytokine network is a key element at the maternal–foetal interface, and any defect in such a network may result in foetal loss.

Sexual Vitality: A Better Approach

Few topics are of greater interest to my patients than sexuality. And why not? A rich and rewarding sex life is something men and women enjoy and appreciate. But today’s advertising paints a pretty weird picture!

Most of you have seen the barrage of ads on TV and in newspapers and magazines for drugs claiming to cure “E.D” – erectile dysfunction. When I see these relentless ads for drugs like Viagra and Cialis, I always laugh at the fast talking disclaimer at the end, where the announcer (reading a script surely written by the Legal Department) says something like, “Be sure to check with your doctor to make sure you are healthy enough for sexual activity.” The purpose of this disclaimer is to protect the company: if you do get over excited and topple over dead while making love, this careful wording ensures that it’s your family doctor who gets sued rather than the multi-billion dollar drug company.

But it also raises a larger and more important issue. I believe that not dropping dead during sex is a triumph of low expectations!

Are you “healthy enough” for the activities you engage in every day? I hope so. Not dropping dead while carrying your groceries up the stairs, or while walking out to get the mail, seems to me to be a pretty modest goal. The same is certainly true in your most intimate relationships (although admittedly your partner will be less distressed if you fall over on the stairs or at the mailbox than if you are with her or him at the time of your demise!). Back in the 1980’s the rock group The Beegees sang a song called “Stayin’ Alive.” Maybe this is what they were singing about.

I may sound facetious, but come on: doesn’t having a great sex life require a whole lot more than simply not dying? Shouldn’t we be learning how to stay healthy and active so that we approach every activity of life, including sex, with energy and vitality? Instead, if you are like all too many Americans, you come home every evening both physically and emotionally spent. You drag yourself into the kitchen or dining room and sit with a sigh of relief. After dinner you make your way into the living room where you sit through the evening watching TV. Then you drag yourself to the bedroom where you collapse into bed, again with a sigh of relief. Sex is far from the minds of most people over 50 because they simply do not have the energy to initiate or respond sexually.  Sexuality is an emotional state requiring high amounts of energy, and that emotional energy is dependent on having enough physical energy to generate the right emotionally-charged sexual mood.

At Longevity Medical Clinic, I want my patients to come home at night with a spring in their step, a song in their heart, and a slightly mischievous twinkle in their eyes. A man should have the physical and emotional energy to come dancing up the stairs, throw open the door, rush into the room and sweep his woman off her feet and into his arms. He should run (not stagger) while he carries her to the bedroom, laying her under the covers and leaping in after her. She should be able to respond in kind. A couple with this sort of emotional and physical energy is able to enjoy their sexual relationship to the fullest, at any age.

But this approach is light years away from the presumptions behind the Viagra advertising. They would have to believe that the key to sexual response is – a pill. You and I know better. Sexuality is about more than prescription drugs, and great sex means far more than simply not dying in the act. Rich, vibrant sexuality requires the sort of strength, energy, and enthusiasm we endeavor to foster in our patients at Longevity Medical Clinic.

I like our approach far better than theirs.

Economics of Seasteading papers to be presented at the Association of Private Enterprise Education Conference Nassau

Patri Friedman and Brad Taylor are presenting what we consider among our most important research papers at the Association of Private Enterprise Education Conference Nassau, The Bahamas, April 10-12, 2011. These updated papers explain why seasteading is a powerful lever to improve government and thus make the world better.

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The Oceans Are Uninhabitable By Humanity…Or Are They?

The oceans are not only the source of life on Earth, they still host over half of all life on our blue planet. Unfortunately, that half does not include humans. Right now, we only use the oceans to extract resources, transport goods, and have the occasional awesome party with 1,000 entrepreneurs. As Robert Ballard, discoverer of the Titanic, pointed out in his TED Talk, it's crazy that we have better maps of Mars than we do of our own oceans - which are 55,000,000 kilometers closer.

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Happy Birdthday April!

HAPPY BIRTHDAY APRIL!!!
I've been looking for an excuse to start introducing the 'Farnes team of 2011' and today is a good time to start, as April celebrates her birthday on the islands. April is no stranger to island life having spent the previous summer out on the islands, successfully completing her Masters degree, having researched Puffin disturbance by visitors.

Having graduated last autumn, April enjoyed the islands so much, she has returned as a fully paid up member of the team. I hope you have a great Birthday and best wishes from everyone concerned.

Fishy Double!

Our second Osprey over this year (Graeme Duncan)

Large Gulls not happy - Osprey over

Tuesday 5th April comments:

Its still all go on the islands, as everything is starting to kick-off. The breeding birds are starting to settle as the urge to nest grows ever stronger, as Puffins have finally returned after a four day absence. Cormorants are now on eggs, whilst Ringed Plover and Oystercatchers have commenced territorial displays.

It wasn't just the breeding birds which have been attracting our attention as yesterday produced our second OSPREY of the year, another being harassed by large Gulls over the inner group - what a year its becoming for large raptors! Sunday brought the biggest influx of migrants including the islands first TREE SPARROW since our long-staying resident of 2007.

As for the team, everyone is settling in and enjoying the great start - long may it continue.

Monday 4th highlights: OSPREY (second of spring) over inner group, Chiffchaff 1

Sunday 3rd highlights: Red-throated Diver 3, Grey Heron, Wigeon pair north, Red-breasted Merganser male north, Canada Goose 8, Greylag Gosee 2 – both species lingering, Teal 2, Woodcock 1 over Brownsman, Sandwich Tern 78, Wheatear 12, Swallow 1N, Black Redstart male (stunning), Chiffchaff 1(first of the year), Blackcap male (first of the year), Goldcrest 2, Jackdaw 3, TREE SPARROW 1 on Brownsman first since 2007!!

Breeding birds Puffins copulating at sea with good numbers back on the islands Guillemots – huge numbers back on the clifftops Kittiwakes collecting nest material across the islands Cormorants on eggs on the East Wideopens

Floating eco-village for Haiti

floating eco homes for HaitiAfter the tragic earthquake in Haiti last year many engineers and designers are looking for ways to prevent this disaster from happening again.  One amazing alternative housing concept that has been proposed comes from world famous architect Vincent Callebaut.  His coral reef design is a floating housing concept designed to house up to  1,000 Haitian families. Built upon seismic piers off the coast of the mainland, the prefabricated, modular units can be fit into a wave-like matrix as space is needed. Each family would have a plot of land to grow their own food, and their passive home would minimize energy usage, while renewable energy sources would make the entire project carbon neutral.

Source: Inhabitat

me and frenchie

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Like many others, MuiMui and Boris decided they needed a break from their ‘cube lives’ in San Francisco. Boris wanted to move to another country and learn a new language. MuiMui had other ideas – traveling around the world. She was very convincing as they have been on the road and in constant motion.


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