"... alcohol/drug testing in isolation does not appear to be related to reduced employee substance use."

Int J Drug Policy. 2015 Sep 3. pii: S0955-3959(15)00253-4. doi: 10.1016/j.drugpo.2015.08.017. [Epub ahead of print]

Do workplace policies work? An examination of the relationship between AOD policies and workers' substance use.

Pidd K1, Kostadinov V1, Roche A2.

Author information

• 1National Centre for Education and Training on Addiction, Flinders University. GPO Box 2100, Adelaide, SA 5001, Australia.
• 2National Centre for Education and Training on Addiction, Flinders University. GPO Box 2100, Adelaide, SA 5001, Australia. Electronic address: ann.roche@flinders.edu.au.

Abstract

BACKGROUND:

There is growing interest in workplace policies as a strategy to prevent or manage alcohol and other drug (AOD) problems. This study is the first to explore the prevalence and impact of AOD policies in Australian workplaces using a nationally representative dataset.

METHODS:

A secondary analysis of the 2010 National Drug Strategy Household Survey was conducted (n=13,590). Descriptive analyses explored the prevalence of AOD policies. Multinomial and logistic regression assessed the relationship between policies and health behaviours.

RESULTS:

Workplace AOD policies were associated with reduced employee substance use. Having any AOD policy in place was associated with significantly decreased odds of high risk drinking (OR: 0.61). In terms of specific policy types, policies on 'use' and 'use plus assistance' were associated with significantly decreased odds of high risk drinking (OR: 0.64 and 0.43, respectively). 'Comprehensive' policies were associated with significantly decreased odds of drug use (OR: 0.72). AOD policies were not significantly related to absence due to AOD use, attending work under the influence, or usually consuming AOD at work.

CONCLUSION:

These findings provide empirical support for the value and efficacy of policies to reduce alcohol and drug problems. While basic policies on 'use' were associated with a reduction in high risk drinking, more comprehensive policies were required to impact drug use. Notably, alcohol/drug testing in isolation does not appear to be related to reduced employee substance use. Scope exists for Australian workplaces to implement effective AOD policies. This could result in considerable benefits for both individuals and workplaces.

Simple fidgeting a helpful, beneficial habit: new study

"Researchers asked the participants to answer a survey to rate their “fidgeting habits” from a scale of 1 as “no fidgeting at all and 10 as “constant fidgeting.” Other lifestyle factors like alcohol consumption, smoking, diet and exercise schedule were also asked.

Results showed that after the adjustment considering other factors, those who sat for more than 7 hours a day have 30% more risk for death from severe health problems compared to women who sat for just 5 hours a day or even less. Interestingly, those in sedentary lifestyle only showed increased risk if they were known to only fidget rarely.

“Our results support the suggestion that it’s best to avoid sitting still for long periods of time, and even fidgeting may offer enough of a break to make a difference.” explained co-lead author Dr. Gareth Hagger-Johnson of the University College London."

Obesity: "...the problem has been getting worse, not better despite many millions spent on national campaigns..."

It’s official: Every state in America is too fat

"Today, all of them do -- and new numbers released this week show the problem has been getting worse, not better despite many millions spent on national campaigns by the likes of public health officials, the American Heart Association, and first lady Michelle Obama to get Americans to eat better and exercise more."

At least 717 people killed in Saudi Arabia hajj stampede

"Many of the victims were crushed and trampled to death as they were on their way to perform a symbolic stoning of the devil by throwing pebbles against three stone columns in Mina."

J Clin Diagn Res. 2015 Mar;9(3):HD01-2. doi: 10.7860/JCDR/2015/11677.5667. Epub 2015 Mar 1.

Lorazepam: a weapon of offence.

Singh SP1, Kaur S2, Singh D3, Aggarwal A4.

Author information

• 1Senior Resident, Department of Forensic Medicine, Post Graduate Institute of Medical Education and Research , Chandigarh, India .
• 2Demonstrator, Department of Biochemistry, Government Medical College and Hospital , Sector 32, Chandigarh, India .
• 3Professor and Head, Department of Forensic Medicine, Post Graduate Institute of Medical Education and Research , Chandigarh, India .
• 4Associate Professor, Department of Forensic Medicine, Government Medical College , Patiala, Punjab, India .

Abstract

The use of knock out drugs for perpetuation of crime has significantly increased in recent years. These drug facilitated crimes mainly involve robbery and sexual offences. Most of the drugs employed for these purposes affect the nervous system and bring a state of incapacitation and amnesia. The miscreants exploit these properties of drugs to commit such crimes. The unsuspecting travellers on public transport vehicles and women in disco parties are most vulnerable to such crimes. The unrestricted and unregulated sale of prescription drugs and general ignorance of such incidents is a challenge that needs to be addressed promptly.

Life Expectancy Of UK Women Second Worst In Europe Says WHO

"The life expectancy of UK women has been ranked as the second worst among 15 European countries, according to the European Health Report 2015 released by the World Health Organization (WHO).

The report stated that the life expectancy of British women born in 2011 is 82.7 years old, falling behind that of Denmark's, which had the worst rank. Lives for women living in Spain, Portugal, France, Germany, Sweden, Italy, Greece and Netherlands, among many others were all assumed to be longer compared to those who hail from the UK."

A New Caption That Works for Every New Yorker Cartoon

A New Caption That Works for Every New Yorker Cartoon

HT:AP

ICD-10: "...one of the largest and most technically challenging changes that the medical community has experienced in the past several decades."

Ann Intern Med. 2015 Sep 22. doi: 10.7326/M15-1933. [Epub ahead of print]

Health Policy Basics: Implementation of the International Classification of Disease, 10th Revision.

Outland B, Newman MM, William MJ.

Abstract

The International Classification of Diseases (ICD) standardizes diagnostic codes into meaningful criteria to enable the storage and retrieval of information regarding patient care. Whereas other countries have been using ICD, 10th Revision (ICD-10), for years, the United States will transition from ICD, Ninth Revision, Clinical Modification (ICD-9-CM), to ICD-10, on 1 October 2015. This transition is one of the largest and most technically challenging changes that the medical community has experienced in the past several decades. This article outlines the implications of moving to ICD-10 and recommends resources to facilitate the transition.

Laws. 2015 Sep;4(3):352-376.

Regulating Gamete Donation in the U.S.: Ethical, Legal and Social Implications.

Sabatello M1.

Author information

• 1Center for Research on Ethical, Legal and Social Implications of Psychiatric, Neurologic & Behavioral Genetics, Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, NY 10032, USA; Tel.: +1-646-774-8632.

Abstract

This article explores the practice of gamete donation in the U.S. having in mind the larger question of what do we as a society owe children born as a result (donor-conceived children). Do recipient-parents have a duty to tell their donor-conceived child about his/her genetic origins? Should the identity of the donor be disclosed or remain anonymous? Does the child have a right to know her conception story and to receive information, including identifying information, about the donor? Furthermore, if a donor-conceived child has a right to know, who has the duty to tell her/him about it? The Article underscores the ethical, legal and social dilemmas that arise, comparing and contrasting with international developments in this arena. It highlights the market-based and more specific medical justifications for regulating this field, explores the emerging so-called right of the child to know his/her genetic origins ("the right to know"), and considers the challenges such a right evokes to existing legal culture and principles of medical ethics in the U.S. as well as other broader societal implications of such a right.

"Europe has the world's highest rates of drinking and smoking, and more than half its people are too fat..."

Europe Has 'Alarming' Rates Of Smoking, Drinking And Obesity: WHO

"LONDON, (Reuters) - Europe has the world's highest rates of drinking and smoking, and more than half its people are too fat, putting them at high risk of heart disease, cancer and other deadly illnesses, health officials warned on Wednesday."

"...most people will receive at least one inaccurate or delayed diagnosis in their lifetime."

Urgent change needed to improve diagnosis, says new IOM report

"A new report from the Institute of Medicine of the National Academies of Sciences, Engineering, and Medicine asserts that most people will receive at least one inaccurate or delayed diagnosis in their lifetime."

Front Neurosci. 2015 Aug 26;9:295. doi: 10.3389/fnins.2015.00295. eCollection 2015.

Effects of anabolic-androgens on brain reward function.

Mhillaj E1, Morgese MG2, Tucci P2, Bove M1, Schiavone S2, Trabace L2.

Author information

• 1Department of Physiology and Pharmacology, Sapienza University of Rome Rome, Italy.
• 2Department of Clinical and Experimental Medicine, University of Foggia Foggia, Italy.

Abstract

Androgens are mainly prescribed to treat several diseases caused by testosterone deficiency. However, athletes try to promote muscle growth by manipulating testosterone levels or assuming androgen anabolic steroids (AAS). These substances were originally synthesized to obtain anabolic effects greater than testosterone. Although AAS are rarely prescribed compared to testosterone, their off-label utilization is very wide. Furthermore, combinations of different steroids and doses generally higher than those used in therapy are common. Symptoms of the chronic use of supra-therapeutic doses of AAS include anxiety, depression, aggression, paranoia, distractibility, confusion, amnesia. Interestingly, some studies have shown that AAS elicited electroencephalographic changes similar to those observed with amphetamine abuse. The frequency of side effects is higher among AAS abusers, with psychiatric complications such as labile mood, lack of impulse control and high violence. On the other hand, AAS addiction studies are complex because data collection is very difficult due to the subjects' reticence and can be biased by many variables, including physical exercise, that alter the reward system. Moreover, it has been reported that AAS may imbalance neurotransmitter systems involved in the reward process, leading to increased sensitivity toward opioid narcotics and central stimulants. The goal of this article is to review the literature on steroid abuse and changes to the reward system in preclinical and clinical studies.

‘BLADE RUNNER’: A GAME-CHANGING SCIENCE-FICTION CLASSIC

‘BLADE RUNNER’: A GAME-CHANGING SCIENCE-FICTION CLASSIC


"Ridley Scott’s vision, craft and use of special effects have passed the test of time. Still equally captivating, still as magical as it was when we first saw it as kids, Blade Runner is a game-changing science-fiction classic that deservedly entered film history books and is there to stay. And all the criticism will be lost in time. Like tears in rain. Time to watch it again."

HT:RW

Real time patient management--and patient involvement--in oncology and beyond

Real time patient management--and patient involvment--in oncology and beyond

IOM's report: Improving Diagnosis in Healthcare

IOM's report: Improving Diagnosis in Healthcare

Most Americans will get a wrong or late diagnosis at least once in their lives

Most Americans will get a wrong or late diagnosis at least once in their lives

"The report said health-care organizations need to put systems in place to identify diagnostic errors and near misses. They also need to adopt a non-punitive culture so open discussion and feedback can take place. That could be empowering for frontline workers like medical assistants to act as a check and balance, looking for gaps and raising flags, even if it's "something doctors won't like but will appreciate when they avoid a near miss," she said."

Everyone hit by wrong or delayed medical diagnosis

"A report published Tuesday by the Institute of Medicine finds that most people will experience a significant diagnostic error in their lifetime. What's more, physicians are well aware that mistakes are made, but the medical community has done little about it."

Front Psychol. 2015 Aug 24;6:1250. doi: 10.3389/fpsyg.2015.01250. eCollection 2015.

Music and literature: are there shared empathy and predictive mechanisms underlying their affective impact?

Omigie D1.

Author information

• 1Music Department, Max Planck Institute for Empirical Aesthetics , Frankfurt am Main, Germany.

Abstract

It has been suggested that music and language had a shared evolutionary precursor before becoming mainly responsible for the communication of emotive and referential meaning respectively. However, emphasis on potential differences between music and language may discourage a consideration of the commonalities that music and literature share. Indeed, one possibility is that common mechanisms underlie their affective impact, and the current paper carefully reviews relevant neuroscientific findings to examine such a prospect. First and foremost, it will be demonstrated that considerable evidence of a common role of empathy and predictive processes now exists for the two domains. However, it will also be noted that an important open question remains: namely, whether the mechanisms underlying the subjective experience of uncertainty differ between the two domains with respect to recruitment of phylogenetically ancient emotion areas. It will be concluded that a comparative approach may not only help to reveal general mechanisms underlying our responses to music and literature, but may also help us better understand any idiosyncrasies in their capacity for affective impact.

Cyberpsychol Behav Soc Netw. 2015 Sep 18. [Epub ahead of print]

Hooked on Facebook: The Role of Social Anxiety and Need for Social Assurance in Problematic Use of Facebook.

Lee-Won RJ1, Herzog L2, Park SG3.

Author information

• 11 School of Communication, The Ohio State University , Columbus, Ohio.
• 22 Computing and Information Technology, Hope College , Holland, Michigan.
• 33 Department of Communication, Seoul National University , Seoul, Korea.

Abstract

There is a growing concern that excessive and uncontrolled use of Facebook not only interferes with performance at school or work but also poses threats to physical and psychological well-being. The present research investigated how two individual difference variables-social anxiety and need for social assurance-affect problematic use of Facebook. Drawing on the basic premises of the social skill model of problematic Internet use, we hypothesized that social anxiety and need for social assurance would be positively correlated with problematic use ofFacebook. Furthermore, it was predicted that need for social assurance would moderate the relationship between social anxiety and problematic use. A cross-sectional online survey was conducted with a college student sample in the United States (N = 243) to test the proposed hypotheses. Results showed that both social anxiety and need for social assurance had a significant positive association with problematic use of Facebook. More importantly, the data demonstrated that need for social assurance served as a significant moderator of the relationship between social anxiety and problematic Facebook use. The positive association between social anxiety and problematic Facebookuse was significant only for Facebook users with medium to high levels of need for social assurance but not for those with a low level of need for social assurance. Theoretical and practical implications of these findings were discussed.

Obesity: the new smoking

Obesity Is Now A Bigger Killer Than Smoking

"A new study by Public Health England shows that obesity has now eclipsed smoking as the number one cause of death in the UK. Smoking-related illnesses account for 10.7% of deaths, but those relating to obesity now stand at 10.8%."

Sci Eng Ethics. 2015 Sep 19. [Epub ahead of print]

The Risks of Revolution: Ethical Dilemmas in 3D Printing from a US Perspective.

Neely EL1.

Author information

• 1Department of Philosophy and Religion, Ohio Northern University, Ada, OH, 45810, USA. e-neely@onu.edu.

Abstract

Additive manufacturing has spread widely over the past decade, especially with the availability of home 3D printers. In the future, many items may be manufactured at home, which raises two ethical issues. First, there are questions of safety. Our current safety regulations depend on centralized manufacturing assumptions; they will be difficult to enforce on this new model of manufacturing. Using current US law as an example, I argue that consumers are not capable of fully assessing all relevant risks and thus continue to require protection; any regulation will likely apply to plans, however, not physical objects. Second, there are intellectual property issues. In combination with a 3D scanner, it is now possible to scan items and print copies; many items are not protected from this by current intellectual property laws. I argue that these laws are ethically sufficient. Patent exists to protect what is innovative; the rest is properly not protected. Intellectual property rests on the notion of creativity, but what counts as creative changes with the rise of new technologies.

PLoS One. 2015 Sep 16;10(9):e0137422. doi: 10.1371/journal.pone.0137422. eCollection 2015.

Twitter Language Use Reflects Psychological Differences between Democrats and Republicans.

Sylwester K1, Purver M1.

Author information

• 1Cognitive Science Research Group, Queen Mary University of London, School of Electronic Engineering and Computer Science, Mile End Road, London, United Kingdom.

Abstract

Previous research has shown that political leanings correlate with various psychological factors. While surveys and experiments provide a rich source of information for political psychology, data from social networks can offer more naturalistic and robust material for analysis. This research investigates psychological differences between individuals of different political orientations on a social networking platform, Twitter. Based on previous findings, we hypothesized that the language used by liberals emphasizes their perception of uniqueness, contains more swear words, more anxiety-related words and more feeling-related words than conservatives' language. Conversely, we predicted that the language of conservatives emphasizes group membership and contains more references to achievement and religion than liberals' language. We analysed Twitter timelines of 5,373 followers of three Twitter accounts of the American Democratic and 5,386 followers of three accounts of the Republican parties' Congressional Organizations. The results support most of the predictions and previous findings, confirming that Twitter behaviour offers valid insights to offline behaviour.

Int J Law Psychiatry. 2015 Aug 31. pii: S0160-2527(15)00146-6. doi: 10.1016/j.ijlp.2015.08.036. [Epub ahead of print]

'What on earth can this possibly mean'? French reentry courts and experts' risk assessment.

Herzog-Evans M1.

Author information

• 1University of Reims, Law faculty, 57 bis rue Pierre Taittinger, CS 80005, 51096 REIMS Cedex, France. Electronic address: martineeevans@gmail.com.

Abstract

Against the backdrop of ten years of punitive criminal justice policies, the number of cases in which risk assessments by psychiatrist experts are mandatory has considerably increased in France. Because of complex and deeply ingrained cultural factors, most experts and academics oppose the use of actuarial or other structured judgement tools, which they assimilate to these policy changes. Parallel to this, the reentry judges in charge of making release and other community sentence decisions have maintained a strong rehabilitative and desistance-focused culture. Drawing on interviews with these judges and experts, the author wanted to assess the judges' expectations of experts' reports, their opinion on actuarial tools, and how they perceived experts and their aptitude to assess risk. The study showed that French reentry judges manage to keep experts' conclusions at bay when they do not fit with their desistance goals, as they can draw upon their own expertise and that of probation services. They do not have much faith in the professionalism and methodology of experts, and would like them to better demonstrate how they reach their conclusions. Moreover, criminogenic needs assessment would be much more useful to them than static risk assessment, which raises the issue as to why this is not the French probation services' role. Reentry judges who never encountered a report which uses a structured tool are influenced by the French ideological debate; those who have read such reports are unanimously in favour of such tools. It thus seems clear that they would like experts to be more strongly guided by science, but are not yet fully aware of what this entails.

Obese mothers might hurt babies' brains

Obese mums might hurt babies' brains

"We've found evidence that suggests the blood-brain barrier - that barrier that separates compounds in your blood from getting access to your brain - we've found there appear to be some changes to the way that forms in the foetuses who develop in obese mums," she said.

As a result, she said, the blood-brain barrier was letting in chemicals similar to those released by a hungry body.

"That might very well be a mechanism that can explain a little bit more about the obesity risk in the offspring later in life."

"It is not for nothing that the Kellogg Company renamed Sugar Smacks to Honey Smacks."

Honey is just as bad as high-fructose corn sweetener

"When it comes to consumer perceptions, the trouble for corn sweetener arises at least in part from its name -- "high fructose" may suggest that it contains much more fructose than the other sweeteners, though it doesn't.

Honey, meanwhile, maintains a halo. It is not for nothing that the Kellogg Company renamed Sugar Smacks to Honey Smacks."

Ger Med Sci. 2015 Jul 9;13:Doc07. doi: 10.3205/000211. eCollection 2015.

Chances and risks in medical risk communication.

Hoffrage U1, Koller M2.

Author information

• 1Faculty of Business and Economics, University of Lausanne, Lausanne, Switzerland.
• 2Centre for Clinical Studies, University Hospital Regensburg, Regensburg, Germany.

Abstract

in English, German

Communication between physicians and patients in everyday life is marked by a number of disruptive factors. Apart from specific interests, mistakes, and misunderstandings on both sides, there are main factors that contribute to the risk in risk communication. Using the example ofmammography screening, the current work demonstrates how the meaning of test results and the informative value of measures taken to reduce risk are often misunderstood. Finally, the current work provides examples of successful risk communication.

Time To End Free Drug Samples

Time To End Free Drug Samples 

J Bioeth Inq. 2015 Sep 1. [Epub ahead of print]

Devotion, Diversity, and Reasoning: Religion and Medical Ethics.

Dahnke MD1.

Author information

• 1Department of Health Administration, Division of Graduate Nursing, College of Nursing and Health Professions, Drexel University, Mail Stop MS 71043, 1601 Cherry St., Room 771, Philadelphia, PA, 19102, USA, dahnke.michael@gmail.com.

Abstract

Most modern ethicists and ethics textbooks assert that religion holds little or no place in ethics, including fields of professional ethics like medical ethics. This assertion, of course, implicitly refers to ethical reasoning, but there is much more to the ethical life and the practice of ethics-especially professional ethics-than reasoning. It is no surprise that teachers of practical ethics, myself included, often focus on reasoning to the exclusion of other aspects of the ethical life. Especially for those with a philosophical background, reasoning is the most patent and pedagogically controllable aspect of the ethical life-and the most easily testable. And whereas there may be powerful reasons for the limitation of religion in this aspect of ethics, there are other aspects of the ethical life in which recognition of religious belief may arguably be more relevant and possibly even necessary. I divide the ethical life into three areas-personal morality, interpersonal morality, and rational morality-each of which I explore in terms of its relationship to religion, normatively characterized by the qualities of devotion, diversity, and reasoning, respectively.

Interact Cardiovasc Thorac Surg. 2013 Apr;16(4):533-7. doi: 10.1093/icvts/ivs542. Epub 2013 Jan 17.

What is the survival after surgery for localized malignant pleural mesothelioma?

Gelvez-Zapata SM1, Gaffney D, Scarci M, Coonar AS.

Author information

• 1Department of Thoracic Surgery, Papworth Hospital NHS Foundation Trust, Papworth Everard, Cambridge, UK.

Abstract

A best evidence topic in thoracic surgery was written according to a structured protocol. This was with the purpose of assisting our management of patients with localized malignant mesothelioma of the pleura (LMM). Although the terminology is used inconsistently, this variant has been formally defined by the WHO as a distinct entity defined as localized disease histologically identical to the diffuse form but without any evidence of pleural spread. Treatments for LMM include different combinations of surgery, chemotherapy and radiotherapy. There is an impression that LMM may have a better outcome than the commoner diffuse form of malignant mesothelioma that has been reported to have a survival between 8 and 14 months. In order to advise our patients on prognosis, we studied the duration of survival after surgical resection of LMM. A total of 150 papers were found, of which 16 represented the best evidence to answer the question. The authors, journal, date, country of publication, study type, relevant outcomes and results of these papers are tabulated. It is difficult to combine the results of these 16 papers because both treatments and results are reported differently. Some report median survival (range: 11.6-36 months) and others disease-free survival (range: 0 months to 11 years). Median survival to the longest follow-up was 29 months when calculated by pooling data from informative papers using the Kaplan-Meier method. Our review suggests that survival in LMM is longer than that generally quoted for the more common diffuse form of malignant mesothelioma. Hence, aggressive treatment of LMM may be reasonable in appropriate patients.

N Engl J Med. 2015 Sep 16. [Epub ahead of print]

Politics and Universal Health Coverage - The Post-2015 Global Health Agenda.

Gupta V1, Kerry VB, Goosby E, Yates R.

Author information

• 1From the Department of Politics and International Studies, University of Cambridge, Cambridge (V.G.), and the Royal Institute of International Affairs, Chatham House, London (R.Y.) - both in the United Kingdom; the Department of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital (V.G.), the Department of Pulmonary and Critical Care, Massachusetts General Hospital (V.B.K.), the Department of Global Health and Social Medicine, Harvard Medical School (V.B.K.), the Center for Global Health, Massachusetts General Hospital (V.B.K.), and Seed Global Health (V.B.K.) - all in Boston; and the Center for Implementation Sciences, University of California, San Francisco, San Francisco (E.G.).

Abstract

When the United Nations summit for the adoption of the post-2015 development agenda begins on September 25, the attainment of universal health coverage (UHC) is expected to garner substantial attention. Bolstered by increasing evidence that UHC improves health outcomes,1 countries are seeking to build health-related goals around the concept of health care for all. Yet many lower- and middle-income countries (LMICs) have not created UHC systems (see map). How can the global community translate vision into policy, especially in the face of complicated politics? 

Ageing Res Rev. 2015 Sep 2. pii: S1568-1637(15)30020-9. doi: 10.1016/j.arr.2015.08.007. [Epub ahead of print]

microRNAs: Modulators of the underlying pathophysiology of sarcopenia?

Brown DM1, Goljanek-Whysall K2.

Author information

• 1Medical Research Council-Arthritis Research UK Centre for Integrated Research into Musculoskeletal Ageing (CIMA), Department of Musculoskeletal Biology, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK. Electronic address: David.Brown@Nottingham.ac.uk.
• 2Medical Research Council-Arthritis Research UK Centre for Integrated Research into Musculoskeletal Ageing (CIMA), Department of Musculoskeletal Biology, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK. Electronic address: K.Whysall@Liverpool.ac.uk.

Abstract

Skeletal muscle homeostasis depends on an intricate balance between muscle hypertrophy, atrophy and regeneration. As we age, maintenance of muscle homeostasis is perturbed, resulting in a loss of muscle mass and function, termed sarcopenia. Individuals with sarcopenia exhibit impaired balance, increased falls (leading to subsequent injury) and an overall decline in quality of life. The mechanisms mediating sarcopenia are still not fully understood but clarity in our understanding of the precise pathophysiological changes occurring during skeletal muscle ageing has improved dramatically. Advances in transcriptomics has highlighted significant deregulation in skeletal muscle gene expression with ageing, suggesting epigenetic alterations may play a crucial and potentially causative role in the skeletal muscle ageing process. microRNAs (miRNAs, miRs), novel regulators of gene expression, can modulate many processes in skeletal muscle, including myogenesis, tissue regeneration and cellular programming. Expression of numerous evolutionary conserved miRNAs is disrupted in skeletal muscle with age. Given that a single miRNA can simultaneously affect the functionality of multiple signaling pathways, miRNAs are potent modulators of pathophysiological changes. miRNA-based interventions provide a promising new therapeutic strategy against alterations in muscle homeostasis. The aim of this review is two-fold; firstly to outline the latest understanding of the pathophysiological alterations impacting the deregulation of skeletal muscle mass and function with ageing, and secondly, to highlight the mounting evidence for a role of miRNAs in modulating muscle mass, and the need to explore their specific role insarcopenia.

"Obesity is a disease" redux: Tommy Thompson--Policymakers must take obesity seriously

Policymakers must take obesity seriously

By Tommy G. Thompson

"Obesity is a disease that we would be wise to treat early and often, because the other conditions that often afflict obese patients carry painfully high costs, in terms of both dollars and lives. If we are serious about improving the health and wellness of the American people, while also reducing the costs of chronic care, we have to stop waiting for people to get sick before providing care. Whenever possible, we have to take decisive steps earlier in disease progression to stop patients from worsening.

A great first step in the right direction – one that already has bicameral, bipartisan support – would be to allow Medicare Part D to cover obesity medicines."