Brainstorm Health Daily: February 14, 2017
In the 1950s, Harry Harlow conducted some remarkable, if heartbreaking, studies on infant rhesus monkeys at the University of Wisconsin. The neonatal macaques were separated from their mothers shortly after birth and then, in several different experiments, placed in cages with two surrogate “mother-machines” on which they could nurse through a bottle: the first, a structure made of wire-mesh; the second, a doll made of wood, covered with sponge rubber, then “sheathed in tan cotton terry cloth,” and placed in front of a light bulb radiating heat.
The babies, no surprise, spent most of their time clinging to the soft, warm mother. But this was true even when the bottle of milk was offered on the wire doll only: The newborns would drink from the hard structure and then quickly return to their soft mother. When the monkeys were separated into two groups, one with each type of surrogate, the wire-mothered macaques developed skittishly, responding in terror when a new stimulus—a teddy bear drummer—was introduced in the cage. Those “reared” by the cloth mother were nervous at first, but then playfully explored the foreign object. They were even secure and confident enough to challenge the stranger after a while.
“The wire mother,” concluded Harlow, was “biologically adequate but psychologically inept.” One offered at least a facsimile of connection, the other merely nutrition. True sustenance required both.
Explorers across the spectrum of scientific disciplines have probed and poked at every aspect of the mysterious power of connectivity between beings in an effort to understand the link between social bonding and health and well-being.
Researchers have found that frequent hugging from a partner, for instance, lowers blood pressure and heart rate; that physical stroking increases levels of oxytocin, a hormone associated with maternal behavior and one known to even hard-edged scientists as the “cuddle chemical.” Social touch, as a gajillion studies have suggested, is essential for many species in the kingdom of animals—including we awkward, two-legged kind. It’s fundamental to being part of (and protected by) a clan. It’s a sign of kinship, a “stress buffer,” and may reduce pain in cancer patients.
Connection to another being—be it physical, emotional, or merely proximal—is associated with longer survival. Pet owners appear to live longer after being discharged from a cardiac care unit; spouses survive longer after a serious illness when there is a partner caring for them, or waiting for them after a hospitalization.
Touch even has the power to tell both the dying and the living that they are connected, that each remains a part of the human fabric even as the tide of life changes.
I was moved to read this passage from a 2009 JAMA article that described the “self-care” of physicians tending to terminally ill patients.
Said one doctor: “I always try to figure out some way to touch the patient during the visit . . . shake hands, do even a small part of the physical exam. When I check the blood pressure, I hold the patient’s arm in between my side and my arm, which is both an accurate and intimate technique that helps me feel really connected.”
Yes, connection is an essential part of what makes us human beings. It may even be the most essential part.
Happy Valentine’s Day. May you all feel connected today.
Sam's Club harnesses digital health with new high-tech kiosks. Big box retailer Sam's Club has teamed up with digital health firm higi to make screening health kiosks available at 622 stores (most of the ones with a pharmacy). The kiosks can provide customers with basic, but key, biometric data such as Body Mass Index (BMI), blood pressure, and pulse. But, as with many digital health outfits, higi also wants to make the experience a bit more social. So the firm's online platform can aggregate data from users' various wearable devices and activity trackers and share this map of their health over time with others. "We believe understanding and tracking your personal biometric data is key to living a healthy life, so we make it as easy as possible for people to do just that with our unique screening technology and digital platforms that interface with leading health devices, fitness trackers or apps that people are already using," said higi CEO Jeff Bennett in a statement.
Researchers were able to get mice to resist cocaine. Cocaine is one of the most addictive controlled substances out there. But a tweak of brain chemistry was able to get mice to resist the drug's allure, according to a team of researchers from the University of British Columbia, Vancouver. The scientists modified mice by inducing them to create more of a protein type called cadherins in their brains. These proteins play an intimate role in both learning and the brain's pleasure center by acting as a "glue" that better fosters neural connections (and can thereby "teach" someone to become addicted to an euphoria-inducing substance). But although one would think having more of these proteins in the brain would actually make mice more susceptible to addiction, it turned out that the excess of biological adhesive actually gummed up the works and didn't let those connections get made. Consequently, the mice with modified cadherin levels were able to ingest cocaine without ever getting addicted to it. (NPR)
Marathon CEO: Let's wait a second on that Duchenne drug price hike. Marathan Pharmaceuticals CEO Jeffery Aronin is hitting the pause button on launching a decades-old, cheap steroid at an $89,000 list price to treat an awful rare disorder in the U.S. The temporary timeout comes on the heels of widespread outrage over the drug price hike and a new Congressional inquiry into the decision by Sen. Bernie Sanders and Rep. Elijah Cummings. "Marathon did not develop [the drug] deflazacort," wrote the lawmakers in a letter to Aronin. They added that they believe the firm is "abusing our nation's 'orphan drug' program" and demanding answers for what they describe as an "outrageous plan" to gouge prices. (Marathon was able to get away with its carte blanche pricing because the treatment wasn't already approved in the U.S. and the company pursued an indication to treat the symptoms of Duchenne muscular dystrophy. Since DMD is a rare disease, the company also landed a coveted "priority review voucher" that it can either sell for hundreds of millions or use to hasten the regulatory process on another product.) "Since last week's approval, we have heard both support from the community, and concerns about how the pricing and reimbursement details will affect individual patients and caregivers, such as how it effects coverage of other Duchenne products," wrote Aronin in a blog post for a Duchenne patient advocacy site. "Based on these questions, today we are announcing: We are pausing our launch which has not taken place yet... We have not sold any new product, and we will pause that process." (Fortune)
Older Americans are using cocktails of psychotropic drugs. The number of elderly Americans taking multiple powerful psychiatric drugs has risen sharply, according to a new study published in the journal JAMA Internal Medicine. Researchers found that 3.68 million doctor's office visits by retirement age Americans in 2013 eventually led to the prescription of three or more psychotropic drugs to treat conditions like depression, anxiety, trouble sleeping, and pain; in 2004, that number was 1.5 million (elderly population growth has had some effect on those numbers, but mostly it's an increase in prescriptions). What's truly concerning about the figures is that about half of the patients didn't even have a diagnosed mental health condition. The study raises all sorts of red flags, from the possibility of risky (and unnecessary) drug-drug interactions that can have an outsize effect on old people to a dearth of alternative treatment options in rural areas which may be driving an over-reliance on medication. (New York Times)
Sabin Vaccine Institute names HHS vet as new president. Sabin, a nonprofit striving to get vaccines to the regions that most need them around the world, has enlisted 15-year Department of Health and Human Services (HHS) vet Dr. Bruce Gellin as its President of Global Immunization. Gellin, who's led the U.S. National Vaccine Program Office since 2002, has an extensive background in immunization deployment and access programs. He tells me that he hopes to use his mix of domestic and international experience in the field to address the fundamental barriers to widespread immunization. In the first years of his new role, he hopes to "look at the issues that managers [of vaccination programs] are having on the ground and figure out some of the best ways to help them deal with those issues," he says. Much of that involves tackling the "last mile" issues that plague health care in underdeveloped areas. "Financing is obviously a big issue. Another is vaccine hesitancy... But the bigger problem is making sure the vaccine gets where it needs to go." During a panel on global pandemics for our inaugural Brainstorm Health conference last November, Gellin emphasized the need to far more aggressively prevent the outbreaks from occurring in the first place. He begins his new position at Sabin on March 1.
THE BIG PICTURE
Melinda Gates says she wouldn't be where she is today without contraceptives. The Bill & Melinda Gates Foundation released its annual letter on Tuesday. And in a separate commentary piece for Fortune, Melinda Gates details the critical role that access to contraceptives has played in her life and success, and makes a stirring case for boosting their availability to women in developing nations. "Even as I write this, there are 225 million women in the world who do not want to get pregnant but do not have access to modern contraceptives. A recent change to U.S. global health policy will soon drive that number up even higher," she writes, referencing President Donald Trump's executive order restoring the so-called "global gag rule" that denies funding to nonprofits which even discuss certain reproductive health treatment options. "Last year alone, family planning tools helped avert the deaths of 124,000 women. Healthier women have healthier children, so the impact of contraceptives ripples across generations," she continued, adding that contraceptive access is deeply correlated with a household's ability to escape poverty. (Fortune)
The Aetna-Humana deal is dead, Humana to get $1 billion breakup fee. Valentine's Day has already seen its first major breakup: a scuttling of the $34 billion corporate marriage between insurers Aetna and Humana, which would have created a health insurance behemoth. The U.S. Justice Department sued to block the merger and won their case in federal court, where a judge ruled that the combination would stifle competition in the private Medicare Advantage market. Unlike rival Anthem, which is appealing its own court loss over a proposed merger with Cigna, Aetna and Humana have decided to let the judge's decision stand. "While we continue to believe that a combined company would create greater value for health care consumers through improved affordability and quality, the current environment makes it too challenging to continue pursuing the transaction," said Aetna CEO Mark Bertolini in a statement. Humana will receive a $1 billion breakup fee. (Fortune)
Two Senators Grill Yahoo Over Hacking, by Jonathan Vanian
|Produced by Sy Mukherjee|
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