McLEOD REGIONAL MEDICAL CENTER 8 JULY 2021

A graduation for the 39th McLeod Family Medicine Residency Program was held on June 25. The Class of 2021 included Dr Caitlin Basnight, Dr. Aria Behrouzi, Dr. Eric Hart, Dr. James Johnson, Dr. Narjah Martin, Dr. Brice Morey, Dr. Yorke Reynolds and Dr. Brandon Washington.

This class represents the 39th class to graduate from our program, said Dr. Gerard Jebaily, McLeod Family Medicine Residency Program Director. At 60 percent, we have the highest retention rate of Residents who have remained in South Carolina to practice, the highest rate in the state. We are very proud of our program and its graduates.

During the graduation ceremony, Dr. Eric Hart was presented with the 2021 Society of Teachers of Family Medicine Residents Teacher Award for exemplifying skills and interests in teaching. The recipient of this award, chosen by program faculty, excels in precepting medical students, community and peer teaching, patient education, and presentations given at regional family medicine meetings. Dr. Hart will join the McLeod Medical Staff as a Hospitalist at McLeod Regional Medical Center starting in August.

Dr. Richard R. Howell was also named the 2021 recipient of the Halford Award for Leadership in Humane Education by South Carolina AHEC and McLeod Health. The award was presented to Dr. Howell by Dr. Jebaily and Dr. Allan Macdonald, Associate Program Director. Since 1984, Dr. Howell has been an integral part of the Family Medicine Residency Program at McLeod Regional Medical Center serving as the Director of Geriatric Education. Recently, Dr. Howell was named Program Director for the McLeod Family Medicine Rural Residency Program. The Halford Award is presented to a Family Medicine Residency Training Program Faculty Member in recognition of outstanding leadership in providing humane education. The award is named for Dr. James Halford, who was the founding director of the AnMed Health Family Medicine Residency Program. Award winners demonstrate a caring attitude and respect for patients, residents and students; value human dignity; demonstrate a passion and joy for teaching, learning and working with others and participating in community service activities.

Additionally, Dr. Susan Robins was honored with the Faculty of the Year award. Dr. Robins serves as the Site Director for the McLeod Family Medicine Rural Residency Program in Cheraw and cares for patients at McLeod Primary Care Cheraw. Chief Resident Dr. James Johnson presented the award to Dr. Robins. Since my classes arrival three years ago, Dr. Robins has always cared deeply for each individual residents education as well as their personal well-being. She is a shining example of why our residency program is so very fortunate to have the faculty that we do to help guide us to becoming the best possible doctors that we can be, said Dr. Johnson.

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Residents and Faculty Honored During McLeod Family Medicine Residency Graduation - McLeod Health

Magic mushroom, computer-enhanced composite image.

Psychedelic agents are experiencing a veritable renaissance. And this time not as illicit mind-expanding drugs that helped give shape to the 1960s counterculture. In recent years a slew of psychedelic agents have filled the drug development pipeline. These therapeutics are being investigated for treating conditions, such as major depressive disorder, severe anxiety, and substance abuse. Psychedelic therapeutics have moved from the fringes of medicine to the mainstream.

In May, the journal Nature Medicine published findings from a study on MDMA - Methylenedioxymethamphetamine - commonly known as Ecstasy or Molly. The first Phase 3 clinical trial conducted with psychedelic-assisted therapy found that MDMA combined with psychological counseling yielded marked relief to patients with severe post-traumatic stress disorder.

In April, a study published in the New England Journal of Medicine highlighted the benefits of treating depression with psilocybin, the psychoactive ingredient in magic mushrooms, have excited scientists, psychotherapists and entrepreneurs in the rapidly expanding field of psychedelic medicine. Other studies suggest substantial rapid and enduring antidepressant effects of psilocybin-assisted therapy among patients with major depressive disorder. The Food and Drug Administration (FDA) granted psilocybin breakthrough therapy designation.

And, esketamine was approved by the FDA on March 5th, 2019, for treatment-resistant depression. It is sold under the trade name, Spravato. Esketamine became the first FDA-approved psychedelic treatment for a psychiatric disorder. In August of last year, the FDA extended its approval for esketamine to adults with major depressive disorder with acute suicidal ideation or behavior.

In a disease area such as mental health, with a significant amount of unmet need, any increase in promising treatment options is welcome. Major depressive disorder affects approximately 17 million Americans, many of whom currently suffer from a lack of adequate treatment alternatives. However, there are possible pitfalls associated with each of the aforementioned drugs where the precautionary principle may apply. In each instance, risks of abuse and diversion must be considered.

There is the potential for abuse and possible long-term negative effects related to MDMA, an amphetamine derivative. Research hasnt definitively answered whether MDMA is addictive, although data suggest that regular MDMA use yields adaptations in the serotonin and dopamine pathways in the brain and central nervous system that may be connected to substance use disorder as well as increased impulsivity. Clearly this is an important factor to consider as medical uses for MDMA are being pursued.

In the case of psilocybin, in the span of a couple of years, the drug has gone from being a completely prohibited Schedule I drug, defined by the Drug Enforcement Administration as a controlled substance having no currently accepted medical use and a high potential for abuse, to a what some researchers recommend should be a Schedule IV controlled substance drug with a relatively low potential for abuse.

Yet, psilocybin is considered to have abuse potential. While advocates assert that psilocybin is not addictive, chronic abuse and misuse can lead to hallucinogen use disorder.

The FDA is the focal point for abuse potential assessment, and works with sponsors of agents with possible abuse potential to determine the studies required to establish approval endpoints, scheduling recommendations, and all aspects of labeling. Psilocybin has not yet been examined in an abuse potential study that would meet the criteria recommended by the FDA in its 2017 Guidance: Assessment of the Abuse Potential of Drugs.

Furthermore, abuse and misuse are not the only problems that require investigating. However rare the risks appear to be from initial reports, possible adverse events must be looked into thoroughly, particularly since clinical trial and real-world settings are vastly different. Persistent use of psilocybin may lead to long-term psychosis, alter a persons personality and perception of reality, and produce hallucinations.

Dr. Bogenschutz, a professor of psychiatry at New York University, said that until now the majority of clinical studies on psilocybin have been conducted with relatively small numbers of individuals in clinical settings designed to exclude those with schizophrenia and other serious mental problems. It is precisely these subgroups that could be predisposed to psychotic episodes, exacerbated by possibly psychosis-inducing psilocybin.

And then theres the case of esketamine, which is the S-enantiomer of ketamine, a similar (in molecular structure) but more potent agent than ketamine.The FDA label for esketamine includes a black box warning of the potential for misuse.

The experience with off-label use of ketamine for clinical depression is a sobering reminder of the importance of close monitoring for the purpose of preventing abuse and misuse from occurring. As noted in several clinical studies, ketamine drug-seeking behavior has appeared as a clinical issue, with some patients shopping infusion clinics to obtain repeated injections for mood elevation. In 2017, the American Psychiatric Association issued a consensus statement on ketamine for mood disorders: Considering the known potential for abuse of ketamine and recent reports of abuse of prescribed ketamine for the treatment of depression, clinicians should be vigilant about assessing the potential for patients to develop ketamine use disorder.

Classified as a Schedule III substance, esketamines safety profile based on real-world data includes possible dissociation, sedation, and suicidal ideation. Mark Horowitz of University College London, asserted that what the sponsor demonstrated very clearly in the trials that theyve done is that esketamine gets you a bit high for a few hours and has little effect on depression scores at 4 weeks. Horowitz maintains that esketamine is an ineffective medication. On top of that, its also a reasonably dangerous medication.

Ignoring or downplaying possible downsides or risk factors isnt going to make these issues go away. The experience with prescription opioids and other drugs, such as benzodiazepines, should give pause. Despite the benzodiazepine clonazepam being the most commonly diverted pharmaceutical in the U.S., it remains the drug most prescribed by psychiatrists to Medicare beneficiaries.

Regulators are proactively establishing a strict set of protocols for psychedelic medications. Several regulatory barriers have already been erected for the approved drug esketamine. Presumably, a similar set of restrictions would be put in place for MDMA and psilocybin. With respect to psilocybin, it appears that only licensed therapists and manufacturers will be allowed to grow the mushrooms or extract psilocybin from them, or to synthetically produce the drug, set up a psilocybin therapy center or provide therapy. Importantly, individuals being treated with the drug may only ingest it at a licensed facility with a certified therapist present.

These safeguards will help, along with systematically implemented post-marketing surveillance plans. Still, regulators and treatment providers will need to work out safe ways of administering these powerful substances in the real world, which will be different from the highly circumscribed and controlled conditions of clinical trials.

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Psychedelic Drugs Are Moving From The Fringes Of Medicine To The Mainstream - Forbes

LONDON & STRASBOURG, France--(BUSINESS WIRE)--Stallergenes Greer, a global healthcare company specialising in allergen immunotherapy (AIT), and Alyatec, a contract research organisation based in Strasbourg University Hospital (France), today announced that they have entered into a collaboration to advance precision medicine in AIT.

With this collaboration, Stallergenes Greer aims to strengthen its precision medicine-based approach and the management of patients with allergies by expanding its knowledge of allergy pathophysiology and endotypes, AIT mode of action and clinical validation.

This research collaboration brings together the longstanding expertise of Stallergenes Greer in AIT and Alyatecs competencies in research and clinical services as well as its state-of-the-art technology, including a new generation environmental exposure chamber.

We are excited about the collaboration with Alyatec which will support Stallergenes Greers ambition to advance the practice of allergology. With Alyatec and its team of distinguished key opinion leaders, Stallergenes Greer will continue to build on precision medicine and personalised healthcare to significantly improve patient disease outcomes, declared Amer Jaber, Executive VP Operations Europe and International and President of Stallergenes SAS.

This collaboration is a remarkable opportunity for Alyatec to develop precision medicine in AIT. The field of allergology is the oldest form of precision medicine as patient phenotypes are directly related to specific results provided by skin tests. We are convinced that adapting immunotherapy to the phenotype of each patient, in other words finding the right immunotherapy for the right patient, is the future of AIT, stated Professor Frdric de Blay, Principal investigator and Medical expert of Alyatec.

ABOUT ALLERGEN IMMUNOTHERAPY

Allergies are the most prevalent and fastest growing chronic disease in the industrialised world, affecting over one billion people worldwide1. Allergen immunotherapy is an allergy treatment designed to alter the natural course of respiratory allergies by treating the underlying cause of the disease. Allergen extracts are modifying disease by inducing tolerance in the immune system2,3.

ABOUT STALLERGENES GREER

Headquartered in London (UK), Stallergenes Greer Ltd is a global healthcare company specialising in the diagnosis and treatment of allergies through the development and commercialisation of allergy immunotherapy products and services. Stallergenes Greer Ltd is the parent company of Greer Laboratories, Inc. (whose registered office is in the United States) and Stallergenes SAS (whose registered office is in France).

ABOUT ALYATEC

Alyatec is a contract research organisation based in Strasbourg University Hospital (France) which performs clinical studies related to respiratory allergies. Thanks to its specific knowledge and medical expertise Alyatec can evaluate the effect of solutions against asthma, rhinitis and conjunctivitis caused by environmental factors such as cat allergens, pollens and house dust mites. To perform these clinical trials, Alyatec has an environmental exposure chamber which enables the assessment of the mode of action of allergy treatment solutions in an innovative and efficient way. The company provides a full range of clinical services in the area of respiratory allergies with all the benefits related to the use of Alyatecs allergen exposure unit.

1.World Health organisation, Ambient Air Pollution: Health Impacts2.Global Atlas of Allergy, EAACI 20143.Halken 2017: EAACI guidelines on allergen immunotherapy: Prevention of allergy

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Stallergenes Greer and Alyatec Announce Research Collaboration to Advance Precision Medicine in Allergen Immunotherapy - Business Wire

BALTIMORE (WJZ) As the Covid-19 pandemic wanes in the United States, hospitals nationwide may not be prepared for the next pandemic, according to a new study from the University of Maryland School of Medicine and the University of Maryland Medical Center. The study was published last month in the Journal of Healthcare Management.

The studys lead author, Dr. David Marcozzi, professor of emergency medicine at the school of medicine and the chief clinical officer and hospital senior vice president, and his colleagues developed and published a surge index tool that linked standard reported hospital information to healthcare preparedness elements.

The tool, called the Hospital Medical Surge Preparedness Index (HMSPI), used data from 2005 to 2014 to produce a score designed to predict how well a hospital can handle a sudden influx in patients due to a mass shooting or infectious disease outbreak. Such data included the size of the medical staff, the number of hospital beds, and the amount of equipment and supplies.

Medical surge capacity is an important measure to assess a hospitals ability to expand quickly beyond normal services to meet increased demand for healthcare, according to a statement from the school of medicine.

The Las Vegas mass shooting in 2017, for example, sent more than 500 concertgoers to local hospitals. During the early weeks of the COVID-19 pandemic, New York City hospitals were under siege with 4,000 patients hospitalized. To calculate the HMSPI, researchers input data from four important metrics:

Marcozzi and his colleagues used data from the American Hospital Associations annual surveys of more than 6,200 hospitals nationwide that were collected from 2005 to 2014. They also employed data from the U.S. Census Bureau to determine population estimates in cities and the Dartmouth Atlas Project to establish the geographic service area of each hospital. They combined the hospital metrics gleaned from the AHAs annual surveys with the geographic data to calculate HMSPI composite scores for hospitals in each state.

Their evaluation found varying levels of increases in HMSPI scores from 2005 to 2014 in every state, which could indicate that states are becoming better prepared to handle a medical surge. The scores also indicated that ideal readiness had not yet been achieved in any state before the COVID-19 pandemic.

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University Of Maryland School Of Medicine, Medical Center Joint Study Says U.S. Not Ready For Next Pandemic - CBS Baltimore

E! You have really rallied around Dr. Contessa. What is your hope for her and her marriage going forward?

Dr. Heavenly: I think that I speak for everyone when we say Contessa is one of the most beautiful, educated, most compassionate people that we know. Our hearts go out to her because we just want her to be happy. I know she is all about family and her kids. But like Toya and so many other people said, your kids want to see you happy so at the end of the day, I want my friend to be happy. That's all.

E!: Can we talk a little bit about Lisa Nicole and Kari returning this season?

Dr. Heavenly: I don't give a damn about them so really, no. They did not come to the reunion. There is no reason to talk about them. I can't think of anything about them. They weren't in the reunion so what is there to talk about?

E! Are you happy that Quad is still part of the show after her divorce?

Dr. Heavenly: Absolutely. I say it all the time. I think there is a youthful energy she brings to the show and I love her. We love her. The show would not be the same without her. And I just think that she's so intelligent. She's so well spoken and I missed her the first half, but the second half she came with fire. She should be, if I had anything to do with it, she should be cast in this season, next season and seasons to come.

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Married to Medicine's Dr. Heavenly Answers Your Burning Reunion Show Questions - E! NEWS

The National Museum of Health and Medicine in Silver Spring has reopened following a pandemic-related closure, officials announced today (July 7).

The museum, established during the Civil War as the Army Medical Museum, strives to preserve, inspire, and inform the history, research, and advancement of military and civilian medicine through world-class collections, digital technology, and public engagement, according to its vision statement.

Its collections include historical and anatomical items, along with historical archives, among other items. The museum also conducts guided group tours and sponsors formal and informal educational programs when fully open.

The museum is reopening to the public under COVID-19 guidelines. Those include a screening questionnaire, temperature checks, mandatory masks for anyone more than 2 years old, and no outside food and drinks, except water, will be permitted.

In addition, access will be limited to no more than 40 people at one time, and visitors will be expected to maintain social distancing.

The museum is open from Wednesday to Sunday, 10 a.m.5:30 p.m., and closed on Monday and Tuesday. It is located at 2500 Linden Lane in Silver Spring.

Photo courtesy National Museum of Health and Medicine

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National Museum of Health and Medicine in Silver Spring Reopens Today - Source of the Spring

The MedCOPTER X4 is one of the drones being trialled by the Bengaluru-based Throttle Aerospace Systems. They are currently conducting tests in Gauribidanur, in Karnatakas Chikkaballapur district. (Courtesy: Throttle Aerospace Systems)

One of the consortiums selected is led by the Bengaluru-based drone company Throttle Aerospace Systems, which has partnered with technology company Honeywell and Swiss firm Involi, the consortiums UTM, or unmanned traffic management, partner. They are currently conducting tests in Gauribidanur, in Karnatakas Chikkaballapur district.

We started with the pre-flight checks towards the end of June, followed by long-range flights daily, says Nagendran Kandasamy, founder and director of Throttle Aerospace, which has created customised software, called RANDINT, for the tests. We spend eight-nine hours in the field and have to continue these flight tests for at least 35-40 days. Using a database of medicines, blood groups and other information from Narayana Health, the consortiums use case and health partner, the software creates a mock, on-demand order for medical packages.

Throttle is testing within an airspace bubble predetermined by the Airports Authority of India. Within this 20-22km area, it has created more than 20 mock sectors, or delivery locations. When the software raises a delivery order for a specific sector, Throttles ground staff prepares the payload and attaches it to the drone. Its like feeding the right information and algorithms to Artificial Intelligence software.

In future real-life scenarios, demand for medicines could come from individual users or hospitals, says Kandasamy. Interestingly, in one of its early tests, a Throttle drone not only matched, but handsomely beat,the time it took an ambulance to deliver a package over a distance of around 4km. The ambulance reached its destination in 26 minutes. The drone took four minutes.

The MedCOPTER X8 drone has a secured, locked boxonce the drone lands, the user receives an OTP to unlock it. (Courtesy: Throttle Aerospace Systems)

The machines

The MedCOPTER X4 and X8the two drone models being tested by Throttleuse a winch mechanism and a secured box system, respectively. These are designed specifically for deliveries. The X4 drone can hover at a fixed altitude while a tether lowers the package slowly. The user can unclasp the package from the tether. Or, once the package touches the ground, the tether is released automatically and the drone reels it back in, Kandasamy explains on the phone. The X8 has a secured, locked boxonce the drone lands, the user receives an OTP to unlock it.

Internationally, Zipline, a US-based drone delivery startup founded in 2014, has changed the way blood and medical supplies are delivered to remote communities in Rwanda. These high-speed drones, powered by lithium ion batteries and electric motors, are propelled into the air through a catapult mechanismthey can go from 0-70 mph in less than a second. Recently, Zipline raised around $250 million (around 1,800 crore) in new funding. It is now valued at $2.75 billion.

A key challenge, says Kandasamy, is operating the drones in high wind speeds. The other issue is that we are operating in a bad internet connectivity region. We use 4G networks to send commands to the drones, he explains, adding that the consortium is consulting network providers to get access to better bandwidths of internet data.

Both the models they are trying out can carry payloads of up to 1-2kg. While their nominal cruise speed is around 9m/second, they can reach speeds of up to 24m/second. They are also designed to withstand light drizzle.

The Non-profit Public Health Foundation of India is currently running pilot trials for its 'Sky Bridge' platform in Telanganas Vikarabad area. (Courtesy: PHFI)

The temperature challenge

Apart from weather and network constraints, the trickiest logistical challenge in medicine delivery is temperature control. Just the way a food delivery drone is expected to get you hot and fresh food, medicine delivery drones will need temperature-control mechanisms to maintain the shelf life of supplies. Take, for instance, the covid-19 vaccines: Vials of both Covishield and Covaxin need to be kept at a storage temperature range of 2-8 degrees Celsius.

Earlier this year, Zipline announced that it was partnering with the government of Ghana to deliver covid-19 vaccines. Crucially, the startup used specialised packaging to maintain the right temperatures for the vaccines. Volansi, another American drone startup specialising in the medical logistics space, partnered with pharma major Merck to deliver temperature-sensitive vaccines to parts of North Carolina, US.

There are challenges on several levels. There have to be a lot of modifications to the drone if you have to carry medical payloads, says Suresh Munuswamy, who heads health informatics and technology innovations at the non-profit Public Health Foundation of India (PHFI). Medical payloads in most cases are temperature-controlled. There are certain medicines that need to be kept at 15-24 degrees Celsius. Blood samples have to be kept at very specific temperatures as well.

Dr Munuswamy explains the active and passive temperature control methods that can be used. In the active method, an electric-powered mini-compressor is added to the drone to maintain the temperature. The passive method involves precooling certain liquids and fluids to ensure the right payload temperature. Throttle, for example, is testing dry ice or icing gel pads in its payloads. In both these cases, the temperature control takes more space and weight compared to the payload itself, says Dr Munuswamy.

The Sky Bridge platform uses a combination of a four-wheeler vehicle and a drone. The vehicle carries the drones and payloads (10-15kg) , covering large parts of the distance to a location. The drone is used for last-mile delivery. (Courtesy: PHFI)

Drones as a bridge

The PHFI, along with the Health Informatics Rapid Design Lab at the Indian Institute of Public Health (IIPH), Hyderabad, has been working on a medicine drone delivery project since 2015, with the aim of using drones as a bridge between medical warehouses and government primary health centres, or PHCs.

The non-profit is currently running pilot trials for its Sky Bridge platform in Telanganas Vikarabad area. This platform uses a combination of a four-wheeler vehicle and a drone. The vehicle carries the drones and payloads (10-15kg) , covering large parts of the distance to a location. The drone is used for last-mile delivery.

The trials will showcase the drones ability to carry different kinds of medical payloads, and temperature-controlled boxes with realistic data for evaluation. They might not be cost-effective but drones bring in extreme time efficiency, says Dr Munuswamy.

At present, the rules around BVLOS and VLOS flights allow only a certain class of drones. Dr Munuswamy believes India must look beyond the current regulations. Once there is enough regulatory support for long-range drones that can fly up to a range of 100km, for example, and bigger payloads, trucks and four-wheelers will become redundant. There have been many ups and downs in this area but the pace of progress has improved now, with better guidelines, he says.

The next three-six months could see some actual results from the existing class of drones, he adds. Drone technology is also quite mature now and there is actual need on the ground for such innovation in India at the moment. What we need is to create a favourable ecosystem where things can actually go forward.

Also read: Drone company Wingcopter gets more firepower in vaccine delivery race

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Will drones change the way we deliver medicine? - Livemint

FOR decades Westminster ran Scotland the way a tired old GP manages a fraught, but largely misunderstood, patient by making ample use of placebos. (You may know that the placebo effect occurs when positive expectations improve an outcome.)

For instance, the Scottish budget is cut but the prevailing narrative on the BBC and other Unionist organs is that these reductions are no big deal and anyway will probably bring about efficiencies in the longer term. Trust doctor Westminster and all will be well. The Scottish patient generally received its medicine sugar coated.

Actually, this nonsense worked rather well. Indeed, so effective was it, there was little need to change.

After all, the Scottish patient even spurned an attempt to ween itself of placebos in 2014. Scottish Tories of old rather liked this patrician approach. It enabled them to be Scots in Edinburgh and British in London. So, what changed?

Doctor Westminster changed thats what. The relatively benign old medical man was replaced by someone who believed in a more muscular treatment. This new medic knew nothing of the Scottish patient and cared even less. For him, the English patient came first and foremost. Energy spent on others was largely wasted effort. No longer was there was there any need to sell the medicine.

So, the Placebo has now been junked. It has been replaced by the Nocebo. Whats that, I hear you ask? A nocebo is when negative expectations of the patient regarding a treatment cause the treatment to have a more negative effect than it otherwise would have. Put briefly, it means the doctor decides youll get whats coming and he will make no attempt to sugar coat or downplay the consequences. In fact, he will go out of his way to tell you how bad things will get for you.

Look at the Latin roots for these words. The term placebo comes from I will please. By contrast, nocebo stems from I will harm. What harm?

Here are a few examples.

N Neglect. The UK Government has moved from unintentional neglect to deliberate mistreatment of the Scottish patient. They do not like you, and they do not want to hear from you. This will soon become even more evident, as Holyrood is neutered and bypassed.

O Overweening arrogance. The British Government increasingly represents only part of this island. And is now happy to make this plain. When challenged they simply shrug. And say, what are you going to do about it?

C Crude, muscular Unionism. Democracy in the UK is dead, in most respects. Without the constraints of a written constitution, Westminster will more and more reward those who agree and condone; but punish severely anyone who displeases. The BBC got this message loud and clear and responded early by surrendering its management to Tory control.

E England trumps all. As the UK Government transforms itself into the BNP in power, nothing that does not aid and support its power base, mostly in England, will be allowed.

B Bloody-mindedness. The doctor does not give a damn about how the Scottish patient feels. He says openly the medicine will be bad. Who cares? Few it seems. Scottish inaction will likely be rewarded with even greater excesses from Doctor Westminster. Dominic Cummings, the former adviser to the PM, has described Johnson as an unthinking Unionist.

O Organised evil. The typical Tory administration was ever engaged in one of mans oldest exercises in moral philosophy, that is the search for a superior ethical justification for selfishness. Now this pursuit will be conducted red in tooth and claw.

Please be under no illusions. The British Government does not care for you and is coming for you. The Scottish Government really needs to get beyond vain hopes that this administration is going to change. It will not. And it has said so on numerous occasions.

Ask yourself this: what would any sensible patient do if they thought their doctor was intent on harming them and had indeed said so? A rational patient would change their medical supervision. Inaction and soothing words are no protection against someone with declared malign intentions.

Also, right-wing voters in Scotland need to take a good look at this new treatment. They, like the Scottish Government, harbour the notion that with Johnson gone, the world will return to normal. Here is an uncomfortable truth. The new Unionist doctor despises you too. Stick with Johnson, then right-wing politics in Scotland is dead for a generation. Better to condemn the UK administration and form an independent Scottish Tory party.

Scotland is watching. The nation wants and deserves action, not words.

SNP president Michael Russell is the guest on the TNT show at 7pmon Wednesday

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Changing the medicine - The move from the benign Placebo to the malignant Nocebo - The National

Many doctors suffer from overwhelm and burn-out in the workplace, most unable to find a healthy work-life balance. Melbourne based doctor, Olivia Ong, is looking to change this and help others become the best they can be.

Olivia is the founder and CEO of The Heart-Centred Doctor and is a medical leadership coach who helps busy, high achieving heart-centred doctors avoid burnout and exhaustion, to achieve balanced energy and time flexibility through her Life Transformation for Doctors program.

In 2008 as a junior doctor, Olivia was hit by a car at high speed. She was told that she would be 'in it for the long haul' by her treating physician and he ended up being right. But Olivia never gave up on her goal to walk again. She travelled to Project Walk at The Centre for Spinal Cord Injury Recovery in San Diego in 2010 to pursue her goal and eventually did walk again with two sticks and a limp after four agonizing years. Her spinal cord injury taught her a very important life lesson, self-compassion. This is the premise behind her creative business, Dr. Olivia Lee Ong, The Heart-Centered Doctor as an inspirational speaker, sharing her story with others.

When Olivia returned home to Melbourne, Australia in 2012, she continued her studies and managed to advance her career as a dual-trained rehabilitation medicine and specialist pain medicine physician. Olivia stepped up as a clinical leader at work using her compassionate leadership skills. She became a mother to two beautiful children, whom she adores, and a very supportive husband, close family, and friends.

However, the combination of living with a spinal cord injury, motherhood, full-time work, and studying for fellowship exams became exhausting. Olivia ignored the warning signs and just kept pushing through until she was eventually burned out.Deep down Olivia knew that there had to be a way where she could build a career while growing her family and become the leader and mother she envisioned herself being without the burnout. She took the determination she had applied in learning how to walk again and applied it to transform her life.

Olivia wrote her book 'The Heart-Centredness of Medicine' because she had not only seen and heard about way too many doctors on the verge of burning out due to stress and overwork, but she had also been one of them.

In 2020 Olivia wanted to rediscover the passion in her work, restore her mental and emotional wellbeing and reconnect with her family, her inner self, and her identity beyond the physician.

Now, she offers 1 on 1 and group coaching, workshops, and speaking engagements on burnout, compassion fatigue and vicarious trauma in doctors so they can stay in the game longer as compassionate leaders, and leave a positive legacy for the upcoming generation of young doctors.

She discovered self-compassion and creative development tools that helped her thrive at home and at work. Olivia also learned how she could take ownership of her thoughts to gain a whole new perspective. Not only was she not willing to live with fatigue and overwhelm, but she knew that if she could change, so could others.

Olivia has seen many of her medical colleagues burn out. More than 40% of doctors and almost 50% of female physicians feel exhausted and drained. Olivia realised she could help other medical peers discover these heart-based tools so that they can rediscover their self-worth and lead the heart-centred life they truly deserve. Olivia wants to help others find their 'spark of joy' and creativity outside of medicine, so she became a career and advancement coach for medical doctors so she could teach them the skills that helped save her life.

Olivia believes that the world needs more heart-centred doctors in medicine and has made this her driving force and her why.

To find out more about Olivia and The Heart-Centred Doctor, connect with her on LinkedIn.

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The Power of Heart-Centred Medicine - International Business Times, Singapore Edition

PHOTO ILLUSTRATION: THE GLOBE AND MAIL. SOURCE IMAGES: ISTOCK

Susan Pinker is a psychologist and columnist whose most recent book, The Village Effect, explores the science of social interaction.

By May of last year, the number of research papers on COVID-19 was doubling every two weeks. This steady churn has unleashed more than 200,000 journal articles on the coronavirus so far, more than 30,000 of them as preprints, meaning studies that are not yet peer-reviewed. Most are also too fresh to have been replicated by other scientists.

Still, many of these findings are cited by scientists and journalists alike and have been shared with millions of people. Indeed, the human brain seems to be the perfect growing medium for untested, often too-good-to-be-true ideas.

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Just one example: A year ago, a preprint, followed by a published scientific paper, reported that an anti-parasitic drug, Ivermectin, used to treat river blindness in sub-Saharan Africa and head lice everywhere else, could suppress SARS-CoV-2. If this were true, it would be a godsend, as Ivermectin is cheap, FDA-approved as an anti-parasitic, and widely available.

The Ivermectin study did not succeed when replicated, however, and theres no clear evidence that it has any effect on humans with the disease. Like hydroxychloroquine a malaria drug that was touted as a cure by Donald Trump when he was the U.S. president Ivermectin has no clinical effects on COVID-19 in the real world.

But the cat video is out of the bag, so to speak. Ivermectin has become an internet meme; dozens of so-called scientific talks have received millions of views on YouTube, each one promoting Ivermectins anti-COVID benefits, with the backstory that pharmaceutical companies are suppressing this information lest it staunch the flow of profits from vaccines. In a short time, a single, non-replicated study has become the new bleach, or in medical history terms, the new snake oil.

Over the past 18 months, two pandemics have collided. On one hand, the SARS-CoV-2 virus was novel, terrifying and constantly evolving; there was a push for quick answers. On the other hand, science and medicine were in the throes of a replication crisis.

Many iconic studies, especially in my own field, psychology, were being repeated by other scientists and found to be wanting; their findings could not be duplicated. In other words, science was in the process of examining itself when COVID-19 struck. There was a desperate thirst for information and a glut of new studies. But there was also little time or patience for a basic due diligence step replication, simply repeating an experiment to see whether it produces the same results.

Now that COVID-19 infection rates are slowing down, its a good time to step back and look at what types of studies seem impossible to reproduce yet have remarkable staying power. Once launched, they continue to breathe new life into what are essentially rumours; they promote misinformation while giving it the patina of science.

Many of us think that science progresses in a straight line. But it zigzags. One hypothesis emerges, changing our outlook for a moment; if it fails to be confirmed by further evidence, it drops out of sight and another one takes its place. Onward and upward, in infinitesimal steps.

Recently, though, the fact-finding trajectory seems to have changed course. Attention-grabbing studies are briskly published. The press and other researchers latch on; a TED talk and a book contract often follow. Social media help turn it into a meme, one that is often surprising, easy to grasp and sticky, like an ear-worm or gossip. If the information hits a sensitive spot, such as a latent fear of hypodermic needles, contamination or public speaking, and also presents a tidy way to dispatch those anxieties, so much the better.

Somewhere along the way, though, another research team has repeated the experiment and couldnt get the same results. But a non-finding is usually non-newsworthy, and in any case, the surprising fact has already made a dent on our collective psyches. Thats just one way splashy findings like Ivermectin as a cure for COVID-19 continue to get attention, even after having been debunked.

Now, a fascinating new study out of University of California San Diego, led by behavioural economists Uri Gneezy and Marta Serra-Garcia, shows that experiments that could not be repeated have a bigger influence over time than the ones that could. In other words, the more interesting and novel-sounding the idea, the more it is cited by other scientists and the media, and the less likely it can be replicated.

There seems to be a trade-off between the wow factor of a study and its ability to be reproduced which should affect its credibility but does not. In Nature and Science, two high-profile and high-status journals, the non-replicable papers were cited 300 times more than the replicable ones.

Published in May in the journal Science Advances, the Gneezy-Serra-Garcia study analyzed the findings from three massive replication projects, two of them led by psychology professor Brian Nosek, from the Center for Open Science at the University of Virginia, and the third directed by behavioural economist Colin Camerer at the California Institute of Technology. All three focused on social science experiments that have been published in highly reputable journals. Volunteer scientists from the same field then repeated the experiment and hoped to get the same results, much as a cookbook author might test her recipes by baking the same torte in a different kitchen, with different utensils, to see if it looked and tasted the same.

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To test a studys replicability alongside its popularity, Prof. Gneezy and Prof. Serra-Garcia matched each original studys outcomes to its citations on Google Scholar, starting roughly in 2008 and ending in 2019. Although they didnt cherry-pick the wow studies, they still found that just 39 per cent of psychology studies replicated, as did 61 per cent in economics, and 62 per cent of those published in Nature and Science.

Yet over a decade, studies that failed to replicate were cited 16 times more often a year than reproducible ones, with no significant change after it was shown that they couldnt be replicated. Papers that failed to replicate were cited much more than papers that were reproducible, Prof. Gneezy told me. If citations are just a proxy for how sexy an idea is, then the findings that are more interesting and get the most attention are the least likely to be true.

Some of the social science findings that havent been replicated include one showing that gripping a pen between your teeth, thus forcing a smile, makes you feel happy. Only one out of 18 attempts by other labs could reproduce this effect (it only works if no one is watching, apparently). Not just facial expression but body posture, too, is supposed to elicit emotions, according to a well-known study of power-posing. The idea that striking a victory stance legs braced, arms in a V can boost ones confidence and alter ones hormone levels (not to mention attenuate ones jitters before public speaking or a job interview) has become the poster child for the replication crisis, mainly because it was such an easy fix for the universal fear of failure. Even if the power-posing study didnt replicate, it continues to top the charts in scientific citations; a TED talk on the topic has garnered 61 million views.

The notion of stereotype threat which is a fancy way of saying that believing stereotypes about your gender, race or ethnic group becomes self-fulfilling prophecy has also largely failed to replicate. For example, the belief that they are bad at math necessarily hampers girls math performance has been studied extensively and is now widely accepted. Yet systematic replications of the phenomenon cant reproduce it. Still, stereotype threat has influenced educational policy, training programs and even admission practices at some universities.

Studies on growth mindset, implicit bias research and ego depletion have faltered in replications thus showing their findings to be exquisitely sensitive to context and statistical nuance. To extend the cooking metaphor, these findings might be like souffls that only rise when the weather is right. Or, they might simply be false. Either way, they persist in the scientific literature, in corporate and educational trends, and in the public imagination.

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The Gneezy-Serra-Garcia study focused on social science. But the phenomenon of non-replicability has hit the worlds of natural science, economics and medicine as well. Heres just a small sampling: A paper published in the journal Nature last year reported that a small inhibitory molecule could tamp down the formation of tau, a sign of Alzheimers disease. Though the study could not be reproduced, it has been cited 605 times in papers published by other scientists. Similarly, animal studies showing successful treatment of Type 1 diabetes based on combining two existing drugs, a neurotransmitter and a malaria medication, raised hopes when published in the journal Cell in 2017. Two other prestigious teams tried and failed to reproduce the results. Still, the research has been cited 238 times.

Other findings that didnt pass muster include a 21 percentage-point boost for the soccer player who kicks first in penalty shots, published in 2010 in American Economic Review. The finding couldnt be coaxed out of a larger sample two years later. Yet the first-mover advantage has been cited 483 times in research, not to mention innumerable soccer broadcasts.

Why is this happening? The researchers who authored the Science Advances study speculate that journal editors perhaps unconsciously might overlook methodological problems in studies with intuitive appeal. These findings may be surprising, or they might provide an easy fix to a complex problem. Ivermectin for COVID-19, power-posing, stereotype threat and first-mover advantage in soccer all fit both bills. Once published, such findings take on a life of their own, gaining currency and momentum. Extraordinary claims require extraordinary evidence, Carl Sagan, the American astronomist, said. When our expectations are high, the burden of proof should be high, as well.

Still, its likely an overstatement to call this a crisis. Enthusiasm for replication and attempts to confirm catchy findings have been growing, and thats a good thing. Having studied the problem for years, Prof. Nosek, the executive director of the Center for Open Science, seems unconcerned.

This is about the scientific community self-scrutinizing, he said. Its not surprising that the things that push the boundaries fail to replicate. Thats how it should be. We should be trying things that are not likely to be true. Then we investigate to see if they are.

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Too good to be true? Why science and medicine are in the throes of a replication crisis - The Globe and Mail