Long-term health effects of Vietnam-era military service: "Hearing and mental health appear to be particularly affected."

J Health Econ. 2015 Dec 2;45:12-26. doi: 10.1016/j.jhealeco.2015.11.003. [Epub ahead of print]

Long-term health effects of Vietnam-era military service: A quasi-experiment using Australian conscription lotteries.

Johnston DW1, Shields MA1, Siminski P2.

Author information

• 1Centre for Health Economics, Monash University, Melbourne, Australia.
• 2School of Accounting, Economics and Finance, University of Wollongong, Wollongong, Australia; IZA, Bonn, Germany. Electronic address: siminski@uow.edu.au.

Abstract

This paper estimates the long-term health effects of Vietnam-era military service using Australia's National conscription lotteries for identification. Our primary contribution is the quality and breadth of our health outcomes. We use several administrative sources, containing a near-universe of records on mortality (1994-2011), cancer diagnoses (1982-2008), and emergency hospital presentations (2005-2010). We also analyse a range of self-reported morbidity indicators (2006-2009). We find no significant long-term effects on mortality, cancer or emergency hospital visits. In contrast, we find significant detrimental effects on a number of morbidity measures. Hearing and mental health appear to be particularly affected.

Biomed Res Int. 2015;2015:569235. doi: 10.1155/2015/569235. Epub 2015 Nov 26.

Strong Public Health Recommendations from Weak Evidence? Lessons Learned in Developing Guidance on the Public Health Management of Meningococcal Disease.

Hanquet G1, Stefanoff P2, Hellenbrand W3, Heuberger S4, Lopalco P5, Stuart JM6.

Author information

• 1Consultant Epidemiologist (Independent), 1081 Brussels, Belgium ; Department of Vaccinology, University of Antwerp, 2000 Antwerp, Belgium.
• 2Division of Epidemiology, Norwegian Institute of Public Health, 0403 Oslo, Norway ; National Institute of Public Health-National Institute of Hygiene, 400-791 Warsaw, Poland.
• 3Department of Infectious Disease Epidemiology, Immunization Unit, Robert Koch Institute, 13086 Berlin, Germany.
• 4Meningococcal Reference Laboratory, Austrian Agency for Food and Health Safety, 8010 Graz, Austria.
• 5Vaccine-Preventable Diseases Programme, European Centre for Disease Prevention and Control, 171 83 Stockholm, Sweden.
• 6School of Social and Community Medicine, University of Bristol, Bristol BS8 2BN, UK ; Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK.

Abstract

The evidence underpinning public health policy is often of low quality, leading to inconsistencies in recommended interventions. One example is the divergence in national policies across Europe for managing contacts of invasive meningococcal disease. Aiming to develop consistent guidance at the European level, a group of experts reviewed the literature and formulated recommendations. The group defined eight priority research questions, searched the literature, and formulated recommendations using GRADE methodology. Five of the research questions are discussed in this paper. After taking into account quality of evidence, benefit, harm, value, preference, burden on patient of the intervention, and resource implications, we made four strong recommendations and five weak recommendations for intervention. Strong recommendations related not only to one question with very low quality of evidence as well as to two questions with moderate to high quality of evidence. The weak recommendations related to two questions with low and very low quality of evidence but also to one question with moderate quality of evidence. GRADE methodology ensures a transparent process and explicit recognition of additional factors that should be considered when making recommendations for policy. This approach can be usefully applied to many areas of public health policy where evidence quality is often low.

Exercise Found Less Helpful for the Obese

Benefit concentrated in normal-weight individuals in Swedish study.

"The new findings suggest it's more important to be a normal weight at a young age than it is to be fit, said senior author Peter Nordstrom, of Umea University in Sweden."

From the CAP: Template for Reporting Results of Biomarker Testing of Specimens From Patients With Myeloproliferative Neoplasms

Todd W. Kelley, Daniel A. Arber, Christine Gibson, Daniel Jones, Joseph D. Khoury, Bruno C. Medeiros, Dennis P. O'Malley, Keyur P. Patel, Monika Pilichowska, Mohammad A. Vasef, Jeremy Wallentine, James L. Zehnder, and for the Members of the Cancer Biomarker Reporting Committee, College of American Pathologists (2015) Template for Reporting Results of Biomarker Testing of Specimens From Patients With Myeloproliferative Neoplasms. Archives of Pathology & Laboratory Medicine In-Press.

Early Online Release

Template for Reporting Results of Biomarker Testing of Specimens From Patients With Myeloproliferative Neoplasms

Todd W. Kelley, MD; Daniel A. Arber, MD; Christine Gibson, CTR; Daniel Jones, MD, PhD; Joseph D. Khoury, MD; Bruno C.Medeiros, MD; Dennis P. O'Malley, MD; Keyur P. Patel, MD, PhD; Monika Pilichowska, MD; Mohammad A. Vasef, MD; JeremyWallentine, MD; James L. Zehnder, MD; for the Members of the Cancer Biomarker Reporting Committee, College of American Pathologists

Am J Public Health. 2015 Dec 21:e1-e6. [Epub ahead of print]

Ethics and Childhood Vaccination Policy in the United States.

Hendrix KS1, Sturm LA1, Zimet GD1, Meslin EM1.

Author information

• 1Kristin S. Hendrix, Lynne A. Sturm, and Gregory D. Zimet are with the Department of Pediatrics and Eric M. Meslin is with the Center for Bioethics, Indiana University School of Medicine, Indianapolis.

Abstract

Childhood immunization involves a balance between parents' autonomy in deciding whether to immunize their children and the benefits to public health from mandating vaccines. Ethical concerns about pediatric vaccination span several public health domains, including those of policymakers, clinicians, and other professionals. In light of ongoing developments and debates, we discuss several key ethical issues concerning childhood immunization in the United States and describe how they affect policy development and clinical practice. We focus onethical considerations pertaining to herd immunity as a community good, vaccine communication, dismissal of vaccine-refusing families from practice, and vaccine mandates. Clinicians and policymakers need to consider the nature and timing of vaccine-related discussions and invoke deliberative approaches to policymaking. 

"Positioning invented diseases prior to product launch, convincing physicians of ‘unmet needs’, expanding populations eligible for treatment..."

J Med Ethics. 2015 Dec 16. pii: medethics-2015-103131. doi: 10.1136/medethics-2015-103131. [Epub ahead of print]

CME stands for commercial medical education: and ACCME still won't address the issue.

Fugh-Berman A1, Hogenmiller A1.

Author information

• 1Department of Pharmacology and Physiology, Georgetown University Medical Center, Washington, DC, USA.

"These exceptions cover just about everything that industry needs from CME, which is important to marketing precisely because it never directly promotes products.3 ,6 ,14–18 Positioning invented diseases prior to product launch, convincing physicians of ‘unmet needs’, expanding populations eligible for treatment (pre-diabetes, pre-hypertension), exaggerating adverse effects of competing therapies, minimising concerns about targeted drugs and identifying ‘emerging’ (ie, unproven or disproven) uses of drugs are all classic ways by which CME is used for marketing. Basic science presentations create buzz about new mechanisms of action—especially important for marketing when a new drug has no actual clinical advantages. And ‘processes/methodologies of research’ talks can be used against evidence-based medicine."

Byron York: What if Democrats had a national security debate?

"Anyone not in the room might find it astonishing that in the midst of highly publicized terror attacks around the world and in the United States, not a single Democrat in the New Hampshire town hall brought up the subject. But that's what happened."

"Astrology relies so heavily on confirmation bias—the odds that you’ll identify enough with your sign to overlook its contradictions — that it’s hard to imagine getting anything out of it that you didn’t have going in."

Stars—They’re Just Like Us!

"BUT TOOLS FOR WHAT? Self-knowledge? Astrology relies so heavily on confirmation bias—the odds that you’ll identify enough with your sign to overlook its contradictions — that it’s hard to imagine getting anything out of it that you didn’t have going in. A better question might be why people like it, or whether it’s a problem to subscribe to something in which you don’t believe."

Await further prospective peer-reviewed studies: DNA Testing for Your Fitness Level

DNA Testing for Your Fitness Level: The Next Health Craze?

• Sharon Feiereisen

The Oceanside Post: Obesity is as bigger threat to United Kingdom women as TERRORISM

Obesity is as bigger threat to United Kingdom women as TERRORISM 

The Oceanside Post 



"The Chief Medical Officer Professor Dame Sally Davies has asked the government to treat obesity in women as a national risk, effectively placing it on the same level as terror and cyber attacks."





http://oceansidepost.com/2015/12/17/obesity-is-as-bigger-threat-to-united-kingdom-women-as.html

Psychol Trauma. 2015 Dec 14. [Epub ahead of print]

Deployment Stress, Tobacco Use, and Postdeployment Posttraumatic Stress Disorder: Gender Differences.

Japuntich SJ, Gregor K, Pineles SL, Gradus JL, Street AE, Prabhala R, Rasmusson AM.

Abstract

OBJECTIVE:

Epidemiological research has demonstrated that tobacco use and posttraumatic stress disorder (PTSD) frequently co-occur and are highly prevalent among Veterans; research with female Veterans is limited. Given the increasing numbers of women deployed to combat zones in recent conflicts, the objective of the current study was to examine gender-specific associations between deployment stress, tobacco use and postdeployment PTSD symptoms.

METHOD:

Two thousand thirteen Veterans deployed to Afghanistan and Iraq (50.9% female; mean age = 35.53) completed a postdeployment, mailed survey that assessed tobacco use before, during, and after deployment, deployment stressors, and postdeployment PTSD symptoms.

RESULTS:

Warfare stress was associated with initiation and increases in tobacco use during deployment in both men and women, whereas harassment stress was associated with initiation and increases in tobacco use in women only. Only among women was continued postdeployment tobacco use associated with postdeployment PTSD symptoms.

CONCLUSIONS:

We found a dose-dependent relationship between deployment stress and adoption and escalation of tobacco use; the stressors that provoked initiation and escalation of tobacco use differed by gender. Continued tobacco use after deployment was associated with PTSD in women suggesting that women used tobacco more selectively than men to regulate negative affect. Implications of this work are that training before combat and during combat on healthy means of coping with deployment stress is needed to prevent tobacco use. For women, reducing harassment stress during deployment and early treatment of acute stress and PTSD during and soon after deployment may prevent intractable tobacco use.

Cancer. 2015 Dec 15. doi: 10.1002/cncr.29827. [Epub ahead of print]

The rise of concurrent care for veterans with advanced cancer at the end of life.

Mor V1,2, Joyce NR1,3, Coté DL1, Gidwani RA4,5,6, Ersek M7,8, Levy CR9, Faricy-Anderson KE1,10, Miller SC1,2, Wagner TH4,5,6, Kinosian BP7,11, Lorenz KA5,6,Shreve ST12,13.

Author information

• 1Center of Innovation, Providence Veterans Health Administration (VA) Medical Center, Providence, Rhode Island.
• 2Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island.
• 3Department of Health Policy, Harvard Medical School, Boston, Massachusetts.
• 4VA Health Economics Resource Center, VA Palo Alto Healthcare System, Palo Alto, California.
• 5Center for Innovation to Implementation, VA Palo Alto Healthcare System, Palo Alto, California.
• 6School of Medicine, Stanford University, Stanford, California.
• 7Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania.
• 8National Performance Reporting and Outcomes Measurement to Improve the Standard of Care at End-of-Life (PROMISE) Center, US Department of Veterans Affairs, Washington, DC.
• 9Eastern Colorado VA Healthcare System, Denver, Colorado.
• 10Warren Alpert Medical School of Brown University, Providence, Rhode Island.
• 11Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania.
• 12Hospice and Palliative Care Program, US Department of Veterans Affairs, Washington, DC.
• 13Penn State College of Medicine, Hershey, Pennsylvania.

Abstract

BACKGROUND:

Unlike Medicare, the Veterans Health Administration (VA) health care system does not require veterans with cancer to make the "terrible choice" between receipt of hospice services or disease-modifying chemotherapy/radiation therapy. For this report, the authors characterized the VA's provision of concurrent care, defined as days in the last 6 months of life during which veterans simultaneously received hospice services and chemotherapy or radiation therapy.

METHODS:

This retrospective cohort study included veteran decedents with cancer during 2006 through 2012 who were identified from claims with cancer diagnoses. Hospice and cancer treatment were identified using VA and Medicare administrative data. Descriptive statistics were used to characterize the changes in concurrent care, hospice, palliative care, and chemotherapy or radiation treatment.

RESULTS:

The proportion of veterans receiving chemotherapy or radiation therapy remained stable at approximately 45%, whereas the proportion of veterans who received hospice increased from 55% to 68%. The receipt of concurrent care also increased during this time from 16.2% to 24.5%. The median time between hospice initiation and death remained stable at around 21 days. Among veterans who received chemotherapy or radiation therapy in their last 6 months of life, the median time between treatment termination and death ranged from 35 to 40 days. There was considerable variation between VA medical centers in the use of concurrent care (interquartile range, 16%-34% in 2012).

CONCLUSIONS:

Concurrent receipt of hospice and chemotherapy or radiation therapy increased among veterans dying from cancer without reductions in the receipt of cancer therapy. This approach reflects the expansion of hospice services in the VA with VA policy allowing the concurrent receipt of hospice and antineoplastic therapies. Cancer 2015. Published 2015. This article is a U.S. Government work and is in the public domain in the USA.

J Med Philos. 2015 Dec 14. pii: jhv037. [Epub ahead of print]

Conjoined Twins: Philosophical Problems and Ethical Challenges.

Savulescu J1, Persson I2.

Author information

• 1University of Oxford, Oxford, UK University of Oxford, Oxford, UK julian.savulescu@philosophy.ox.ac.uk.
• 2University of Oxford, Oxford, UK University of Oxford, Oxford, UK.

Abstract

We examine the philosophical and ethical issues associated with conjoined twins and their surgical separation. In cases in which there is an extensive sharing of organs, but nevertheless two distinguishable functioning brains, there are a number of philosophical and ethicalchallenges. This is because such conjoined twins: 1. give rise to puzzles concerning our identity, about whether we are identical to something psychological or biological;2. force us to decide whether what matters from an ethical point of view is the biological life of our organisms or the existence of our consciousness or mind;3. raise questions concerning when, if ever, it is morally acceptable to sacrifice one of us to save another;4. force us to reflect on the conditions for ownership of organs and the justification of removal of organs for transplantation which causes the death of the donor;5. raise questions about who should take decisions about life-risking treatments when this cannot be decided by patients themselves. We examine and suggest answers to these questions.

Cancer kills Kentuckians at highest rate in nation

“It’s really been driven by three major things: obesity, smoking and lack of screening,” said Louisville gastroenterologist Dr. Whitney Jones. “Our state is completely inundated with risk factors.”

Cracking the Code of Human Diseases Using Next-Generation Sequencing

Biomed Res Int. 2015;2015:161648. Epub 2015 Nov 19.

Cracking the Code of Human Diseases Using Next-Generation Sequencing: Applications, Challenges, and Perspectives.

Precone V1, Del Monaco V1, Esposito MV2, De Palma FD1, Ruocco A1, Salvatore F3, D'Argenio V1.

Author information

• 1CEINGE-Biotecnologie Avanzate, Via G Salvatore 486, 80145 Naples, Italy ; Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Ed. 19, Via Sergio Pansini 5, 80131 Naples, Italy.
• 2CEINGE-Biotecnologie Avanzate, Via G Salvatore 486, 80145 Naples, Italy.
• 3CEINGE-Biotecnologie Avanzate, Via G Salvatore 486, 80145 Naples, Italy ; Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Ed. 19, Via Sergio Pansini 5, 80131 Naples, Italy ; IRCCS-Fondazione SDN, 80143 Naples, Italy.

Abstract

Next-generation sequencing (NGS) technologies have greatly impacted on every field of molecular research mainly because they reduce costs and increase throughput of DNA sequencing. These features, together with the technology's flexibility, have opened the way to a variety of applications including the study of the molecular basis of human diseases. Several analytical approaches have been developed to selectively enrich regions of interest from the whole genome in order to identify germinal and/or somatic sequence variants and to study DNA methylation. These approaches are now widely used in research, and they are already being used in routine molecular diagnostics. However, some issues are still controversial, namely, standardization of methods, data analysis and storage, and ethical aspects. Besides providing an overview of the NGS-based approaches most frequently used to study the molecular basis of human diseases at DNA level, we discuss the principal challenges and applications of NGS in the field of human genomics.

Less than 7 hours sleep a night could be linked to obesity

Less than 7 hours sleep a night could be linked to obesity, according to new study

"The study also found that poor sleeping habits can lead to poor eating habits, with those sleeping less snacking more between mealtimes, and particularly at night when tiredness sets in, leading to cravings for sugary foods to boost energy. This snacking is also partly due to the hormonal disturbances that lack of sleep causes."

EGEMS (Wash DC). 2015 Nov 23;3(1):1190. doi: 10.13063/2327-9214.1190. eCollection 2015.

Consumer Engagement in Health IT: Distinguishing Rhetoric from Reality.

Gold M1, Hossain M1, Mangum A1.

Author information

• 1Mathematica Policy Research.

Abstract

RATIONALE:

Policymakers want health information technology (health IT) to support consumer engagement to help achieve national health goals. In this paper, we review the evidence to compare the rhetoric with the reality of current practice.

CURRENT REALITY AND BARRIERS:

Our environmental scan shows that consumer demand exists for electronic access to personal health information, but that technical and system or political barriers still limit the value of the available information and its potential benefits.

CONCLUSIONS AND POLICY IMPLICATIONS:

There is a gap between current reality and the goals for consumer engagement. Actions that may help bridge this gap include: (1) resolving technical barriers to health information exchange (HIE); (2) developing more consumer-centric design and functionality; (3) reinforcing incentives that attract provider support by showing that consumer engagement is in their interest; and (4) building a stronger empirical case to convince decision makers that consumer engagement will lead to better care, improved health outcomes, and lower costs.

"Above all, Paglia, who some have called the anti-feminist feminist, has remained a staunch defender of individual freedom."

FEMINIST TROUBLE

"Above all, Paglia, who some have called the anti-feminist feminist, has remained a staunch defender of individual freedom. She has argued against laws prohibiting pornography, drugs and abortion. And, when political correctness was cutting a swathe through a host of institutions during the 1990s, she stood firmly on the side of free speech. So, what does she make of the political and cultural state of feminism today?" 

Bioessays. 2015 Dec 10. doi: 10.1002/bies.201500102. [Epub ahead of print]

The dawn of active genetics.

Gantz VM1, Bier E1.

Author information

• 1Section of Cell and Developmental Biology, University of California, San Diego, La Jolla, CA, USA.

Abstract

On December 18, 2014, a yellow female fly quietly emerged from her pupal case. What made her unique was that she had only one parent carrying a mutant allele of this classic recessive locus. Then, one generation later, after mating with a wild-type male, all her offspring displayed the same recessive yellow phenotype. Further analysis of other such yellow females revealed that the construct causing the mutation was converting the opposing chromosome with 95% efficiency. These simple results, seen also in mosquitoes and yeast, open the door to a new era of genetics wherein the laws of traditional Mendelian inheritance can be bypassed for a broad variety of purposes. Here, we consider the implications of this fundamentally new form of "active genetics," its applications for gene drives, reversal and amplification strategies, its potential for contributing to cell and gene therapy strategies, and ethical/biosafety considerations associated with such active genetic elements.

Donald E. Henson and Philip M. Grimley (2015) Pathology Education: Moving On. Archives of Pathology & Laboratory Medicine: December 2015, Vol. 139, No. 12, pp. 1480-1481.

EDITORIALS

Pathology Education: Moving On

Donald E. Henson, MD; Philip M. Grimley, MD

From the Departments of Preventive Medicine and Biometrics (Dr Henson) and Pathology (Dr Grimley), The Uniformed Services University of the Health Sciences, F. Edward Hebert Medical School, Bethesda, Maryland.

"We emphasize that image integration based in pathology and radiology should occur concurrently with convergent images specifically selected to highlight pathogenesis and natural history."

Chunyan Liu, Kristi Pepper, Heather Hendrickson, Philip T. Cagle, and Bryce P. Portier (2015) Clinical Validation of a Novel Commercial Reverse Transcription–Quantitative Polymerase Chain Reaction Screening Assay for Detection of ALK Translocations and Amplifications in Non–Small Cell Lung Carcinomas. Archives of Pathology & Laboratory Medicine In-Press.

Early Online Release

Clinical Validation of a Novel Commercial Reverse Transcription–Quantitative Polymerase Chain Reaction Screening Assay for Detection of ALK Translocations and Amplifications in Non–Small Cell Lung Carcinomas

Chunyan Liu, MD, PhD; Kristi Pepper, MB (ASCP); Heather Hendrickson, MB (ASCP); Philip T. Cagle, MD; Bryce P. Portier, MD, PhD

Reprints: Bryce P. Portier, MD, PhD, Roche Tissue Diagnostics/Ventana Medical Systems (ROCHE Group), 1910 E Innovation Park Dr, Tucson, AZ 85755 (e-mail: portierbp@gmail.com).

Context.— EGFR mutations and Anaplastic lymphoma kinase (ALK) translocations have significant biologic and therapeutic implications in lung cancers, particularly lung adenocarcinomas. ALK translocations are less frequent compared with EGFRmutations; interestingly, these two abnormalities are most commonly mutually exclusive. The 2013 College of American Pathologists/Association for Molecular Pathology/International Association for the Study of Lung Cancer molecular testing guideline for lung cancers recommend a testing algorithm in which detection of ALK translocations using fluorescence in situ hybridization (FISH) is to be performed following testing for EGFR mutations. Such an algorithm is cost-effective but potentially slows down turnaround time; and as a secondary test, ALK FISH assay may not be completed because it requires the use of additional tissue, and the small biopsies or cytology specimens may have been exhausted in the extraction of nucleic acid for EGFR mutation screening.

Objective. —To provide efficient testing of both EGFR and ALK genetic alterations in small biopsies and cytology specimens.

Design.— We validated a highly sensitive ALK reverse transcription–quantitative polymerase chain reaction (RT-qPCR) assay as a screening tool for ALK translocations and amplifications.

Results. —We performed a retrospective review of cases previously tested by FISH and found that all FISH ALKtranslocation–positive specimens were RT-qPCR positive, and all FISH ALK translocation–negative cases were RT-qPCR negative (the sensitivity and specificity of the ALK RT-qPCR assay were 100%).

Conclusion.— This assay allows rapid identification of ALK alterations, can be performed in conjunction with EGFR testing, and does not require use of valuable additional tumor tissue.

Reducing Portion Sizes Cited as Key to Obesity Control

Pam Harrison

December 14, 2015

"We consistently found that 14% to 33% of customers accepted the downsizing offer, and they did so whether or not they were given a nominal 25% discount."

"It sounds a bit counterintuitive because we think of fast-food consumers as 'value maximizers' — they are there to get as much food as possible," Dr Schwartz told Medscape Medical News.

"But people recognize that portions are too big, and if you just offered people smaller portions, I think some percentage of customers would really welcome this change, and they might be more willing to come into a fast-food restaurant because they know they can get smaller portions and not feel sick about overeating."

Updates Surg. 2015 Dec 9. [Epub ahead of print]

Consequences of defensive medicine, second victims, and clinical-judicial syndrome on surgeons' medical practice and on health service.

Pellino IM1, Pellino G2.

Author information

• 1, Via Giotto 60, 81031, Aversa, CE, Italy. liapellino@gmail.com.
• 2Unit of General Surgery, Department of Medical, Surgical, Neurologic, Metabolic and Ageing Sciences, Second University of Naples, Naples, Italy. gipe1984@gmail.com.

Abstract

Increased knowledge in disease causes and progression, along with technological and technical advancements in their diagnosis and treatment, have led to increased expectations from physicians by patients and their relatives. The condition of "second victim" is known to affect caregivers that commit an error, and seriously impairs private life and subsequent practice. Besides, a condition has been described, the clinical-judicial syndrome, affecting caregivers at any moment during a medical litigation. In this scenario, physicians have started to practice "defensive medicine", aimed at protect themselves from liability rather than actually advancing care of patients. This paper represents the first review on defensive medicine with specific focus on surgery in an Italian setting. We reviewed the literature on the topic, with particular focus on surgeons and Italian current status, and provide the readers with a snapshot on these relevant issues, proposing strategies to prevent and reduce the practice of defensive medicine, and to support patients and physicians suffering from medical errors.

Melisma

Jingle Hell

The debasement of Christmas songs

Dec 21, 2015 | By ANDREW FERGUSON

"To convey her depth of religious feeling, Christina borrows her mentor's signature vocal trick, using several notes to sing a single syllable. Musicologists call it melisma. It is an old technique, common to Gregorian chants from long ago, but it's more familiar to contemporary audiences through the vein-popping exertions of the late Whitney Houston and countless singers who have kneecapped our national anthem before televised sporting events. As the singer slides around in search of the note to match the syllable, melisma can sound to the amateur ear—mine anyway—like someone handed a pennywhistle to a meth-head."