Monday, December 2, 2013

Naps and Caffeine as Countermeasures to Sleep Problems of Night-Shift Work

               As a person who has worked the night shift before, I can attest to how difficult it is to stay awake and perform duties on the same efficacy of day time work. Performance in regards to skills, reaction time, logical reasoning, and spatial orientation are heavily reduced, to approximately 10-35% of the mean level of performance in the daytime. Therefore, research into potential countermeasures for sleep problems associated with the night-shift is increasingly popular to those who suffer from reduced mean performance. In this examined study, napping and caffeine as a combined treatment was observed, with the goal of increasing work performance.

               Most of the causes for reduced work performance originate from the circadian rhythm and homeostatic sleep pressure preceding work time.  Night work inherently disrupts the critical temporal relationship of the circadian and homeostatic factors that mediate sleep and alertness; it does not allow for the circadian rhythm to counteract increasing homeostatic drive for sleep during work hours, while also interfering with attempted sleep during daytime. Furthermore, the ability of the body to adapt to such patterns of sleep does not occur even after two or three weeks of night time working. While napping and caffeine usage were previously studied before, no previous studies had combined the two measures and observed their effects before.


               The procedure involved 4 experimental groups: 1) A 2.5 hour nap prior to two of the four consecutive night shifts plus a caffeine placebo taken prior to all four nights (NAP); 2) Ingestion of 4 mg/kg of caffeine prior to all 4 night shifts (CAF); 3) A combination of the two prior groups (NAP+CAF); 4) A caffeine placebo prior to all 4 night shifts with no naps (PBO). Statistical analysis of the tests of executive functioning showed that caffeine, napping, and a combination of caffeine and napping improved both alertness and performance during all four night shifts, with the combination treatment being the most effective. Furthermore, the countermeasures were able to reduce sleep pressure during the sleep time after the night work, thus decreasing sleep deprivation by preventing disruptions to sleep during the daytime. Much of the study, however, contains methodological discrepancies, such as the varying ages of the participants. It does serve to show that combining naps and caffeine may be the optimal way to improve performance during night work. 

Schweitzer, P., Randazzo, A., Stone, K., Erman, M., Walsh, J. (2006). Laboratory and Field Studies of Naps and Caffeine as Practical Countermeasures For Sleep-Wake Problems Associated With Night Work. SLEEP. 29(1): 39-50. 

It Can Be As Simple As Thinking

Who knew that the way you think can impact your life and overall health? You can change your outlook on life and how your see others and yourself by simple changing how you think. Positive self-talk is a way to approach situations with a positive mind set, and helps solve problems in a productive manner; it can bring out an optimism that allows people to see life in a “better light”.
There are also health benefits to positive self-talk because it reduces stress by eliminating negative self-talk. Negative thinking and self-talk bring about a pessimistic mindset that forces you to think about the worst is going to happen. It places your body in a fight-or-flight mode that can be detrimental individual systems and the all in all functions of the body, especially while chronically stressed. According to the staff at the Mayo Clinic, positive thinking and self-talk can provide: lower rates of depression, lower levels, of distress, increased life span, greater resistance to the common cold, better psychological and physical well-being, reduced risk of cardiovascular disease, and better coping skills with stress.
From persona experience, I truly believe positive self-talk can influence all aspect of life, including school, sports, work, and health. During the time I played volleyball at Regis, we had someone come in and help us with positive self-talk and affirmations that helped us during the game and practices. On a weekly basis, we made individual and team affirmations based on the goals we wanted to achieve during that week of practices and games. We were required to say out loud, rewrite, and visualize our affirmations each day. The positive self-talk and affirmations helped me during the week because they kept me focused and positive even though I had a hard week in school or practice. An example of an affirmation I had included, “I am a great passer because I can pass 9 out of 10 ‘perfect’ service receive passes.” When I focused on the positive self-talk, it gave me confidence in practices and games because I believed whole-heartedly that I was a great passer.

Positive thinking and self-talk is a great and easy way to relieve stress. You can do with yourself or with others. It helps open many opportunities because it allows you to think with an open and optimistic mind set.

References

http://www.mayoclinic.com/health/positive-thinking/SR00009

It's Stressful Being Intelligent!

I’m sure that the majority of us have wondered what it’s like to be a dog. They have a balanced life of exercise, fun, and rest. Though dogs are smart, Sapolsky states that intellectual capacity is positively correlated with the amount of stressors (“Why do humans,” 2007; Sapolsky, 2007). So, it’s either live a relaxed and unattached life with minimal stressors, or be intelligent, emotionally connected, and possibly develop high blood pressure, gastrointestinal diseases, and diabetes from stress (“Why do humans,” 2007). Great.


Stress hormones are apart of the evolutionarily ancient stress response that are excreted in humans, as well as a variety of other animals such as fish, birds, and reptiles. These glucocorticoids are well adapted to alter our bodily systems in order to raise our chances of survival; they mobilize energy to your thighs, increase blood pressure, and turn off digestion, growth, and reproduction (“Why do humans,” 2007). However, these brilliantly adapted hormones are not well adapted for chronic psychosocial stress that more intellectual animals experience such as elephants, whales, and baboons (“Why do humans,” 2007). According to Wemmer and Christen, elephants experience stress, pain, and suffering just like humans (2008). You simply don’t see depression and other stress related disorders in fish and reptiles because they are not emotionally complex like the animals with higher levels of intelligence. Wonderful. So the reward for our survival is depression?


Sapolsky states that Baboon’s only concern is getting enough calories during the day (2007). As a college student living in America, I don’t even have to worry about that! Because we have nothing else to worry about, baboons and humans extend our emotions and find other things to worry about (whether I will finish this blog on time, children in Africa, the effects of global warming in the next 10 years, whether I will have a job when I graduate, etc).


But there’s hope! We could put our well earned intelligence to good use if we apply Sapolsky’s baboon research to our lives. Sapolsky states that social connectedness is highly correlated with the level of stress that baboons and humans experience (“Why do humans,” 2007; Sapolsky, 2007). Low-ranking baboons have a higher prevalence of stress related diseases because they are socially isolated and are constantly surrounded by higher ranking baboons. However, humans have more social flexibility than baboons (“Why do humans,” 2007; Sapolsky, 2007). Though we may be “low-ranking” in our family, we have the opportunity to be “high-ranking” in other aspects of life such as school, church, and athletics.


Looking back on my question that I asked my grandparents, I understand why they would want to be a dog. But, a dog’s intellectual capacity does not enable them to overcome their “hierarchy” if they are placed in a shelter or an abusive household. Humans are capable of overcoming stressful barriers by becoming more socially connected, active, and aware of the stressors in our lives.


Why do humans and primates get more stress-related diseases than other animals?. (2007, February 25). Retrieved from http://www.sciencedaily.com/releases/2007/02/070218134333.htm


Wemmer, C., & Christen, C. A. (2008). Elephants and ethics: Toward a morality of coexistence. Baltimore, MD US: Johns Hopkins University Press.


Sapolsky, R. M. (2007). Why zebras don't get ulcers. (3 ed.).

Fungus Among us.


When you think of fungus what’s the first thing that comes to mind?  Is it perhaps a scratchy rash on your foot?  A popular video game with fungus based Zombies?  What about Cryptococus Gattii, a form of yeast fungus.  This fungus was relatively unknown until a few years back when it began to infect dolphins, dogs, koalas, and finally people.  The strange thing, this fungus didn’t show up in the humid and hot south (as most fungal infections do) but instead Canada.  That’s right, Canada.

This fungus loves to live in the lungs of infected people, proliferating and reducing the amount of surface area available for gas exchange.  Roughly ¼ of the people infected with this disease die from respiratory failure.  C. Gattii hits those with compromised immune systems the hardest. 

You may be asking yourself, why do you care?  If it kills those with bad immune systems I should be fine.  Well, typically you will be.  Assuming you don’t smoke, have cancer, get a transplant, or contract HIV.   Granted, if you’re immune system is damaged then you probably have bigger things to worry about than a relatively uncommon fungus, but still it’s important to know what’s out there.

That being said,  I find it fascinating that there’s a fungus that not only thrives up north, but also is capable of being a deadly, and virulent pathogen to mammals.  Most of the time, between our immune system, temperature, and various other factors, fungi have a hard time maintaining an internal hold over us and typically infect easier/less defended creatures, such as ants.  It’s fascinating that this fungus has found such a hospitable environment in our lungs.  I wonder why such an infectious route isn’t more common.  What do you think?

References.

Datta K, Bartlett K, Baer R, Byrnes E, Galanis E, Heitman J, Hoang L, Leslie M, Macdougal L, Magill S, et al. 2009 August. Spread of Cryptococcus Gattii into pacific northwest region of the United States. Emerging Infectious Diseases.  15(8):1185-1191

Frazer J. 2013 December. Strange fungi now stalk healthy people. Scientific American [Internet]. [cited 2013 Dec 2].  Available From: http://www.scientificamerican.com/article.cfm?id=strange-fungi-now-stalk-healthy-people

What's your kidney worth?



What’s your kidney worth?

Thinking about all the things our bodies are capable of it is hard to put a price tag onto the form and function of the parts that make up our bodies.  Some of the most visible body parts such as an arm or a leg enable us to function as evolution intended, however losing one of these extremities will not directly threaten our ability to sustain life.  That being said, the Federal Employee Compensation Act, FECA, values the arm 8% above the leg, where the complete loss of function or amputation of the arm will land an individual 312 weeks of compensation (lawers.com).  That means that if you were making $44,322, the average wage index for 2012 (Official Social Security website), you would be entitled to $265,932.  That is assuming that some kind of negligence could not be proven which could quickly add large settlement payouts for the injury.  When it comes to internal organs, such as calculating the cost of a kidney, it might get a little trickier. 

Most people are born with two functioning kidneys that perform a wide range of functions within the renal system, which also includes the ureters that connect the kidney to the bladder and the urethra that drains the bladder to the external environment.  The main function of the kidney is filtration of body fluids, maintaining the composition, pH, osmotic pressure, and amount of the fluids within our body.  The kidney also shares responsibility in regulating blood pressure, the production of red blood cells, producing some of the glucose found in our bodies, and activating Vitamin D.  The kidney may be the most efficient organ within our body; the functioning of one kidney at 75% of its normal functioning is enough to properly filter the body’s fluids for many decades (Andrews 2002).

The kidney receives about 20% of the blood flow coming from the heart and nearly 120 liters of blood are filtered every day through the 1.2 million functioning nephrons.  Each nephron is made up of a Bowman’s capsule that encloses a glomerulus made up of a tuft of capillaries, a proximal convoluted tubule, the loop of Henle, a distal convoluted tubule and a collecting duct that drains about eight nephrons.  Filtration occurs nondiscriminately followed by selective tubular reabsorption and secretion. Kidney functioning is typically measured through glomerular filtration rate, GFR, with a normal rate of 100 mL per minute.  Chronic kidney disease is considered to be present when the GFR falls below 90 mL per minute along with proteinuria or hematuria, a genetic diagnosis of kidney disease, or structural abnormalities (The Renal Association).  

When the kidney fails to properly function only a few options for treatment exist.  Extremely minute kidney failure may be treated with a strictly prescribed diet limited in proteins, but most cases of kidney failure are treated through dialysis, a kidney transplant, or both.  Dialysis is available in two different forms, both of which require a minor surgery to gain access into the body.  Hemodialysis is performed through the use of a machine that filters your blood pumped through a dialyzer outside of your body.  Peritoneal dialysis utilizes a catheter placed inside of the peritoneal cavity of the abdomen and a dialysate is pumped into the abdomen and replaced several times a day removing extra solutes each time it is emptied.  Kidney transplants require a donor kidney that replaces the damaged kidney of the effected individual in a major organ transplant surgery.

It is when things go wrong that allows a price tag to be put on the kidney through the costs of dialysis or a kidney transplant.  When the kidney is not filtering the body’s fluids properly and dialysis is required a single emergency room visit for dialysis could run $9,900 for a single treatment, but outside of emergency room visits a typical peritoneal dialysis treatment will cost roughly $53,000 annually and hemodialysis will cost about $72,000 annually (How much does dialysis cost).   Americans have an average life span of 78.7 years (Hoyert D and Xu D 2011) and figuring an annual cost of dialysis at $72,000 means that throughout a person’s lifetime their kidneys will perform $5,666,400 worth of filtering the body’s fluids, but because this functioning could be performed by one kidney that cost could be split in half to a value of $2,833,200 per kidney.  A kidney transplant will cost the recipient of the kidney about $262,900 which covers treatment and medications before and after the surgery, the hospital transplant admission, the price of the surgeon, immunosuppressants, and the procurement of a kidney valued at $67,200 (transplantliving.org).  One final price for the kidney to be considered is the black-market, where in the United States a kidney could land a donor $25,000 and the person buying the donated kidney might be able to resell it for $150,000 if an illegitimate buyer and doctor can be found (Postrel 2012).

In summary a few different prices are found to exist for the kidney.  A lifetime of dialysis in lieu of at least one functioning kidney will cost more than $5.5 million in a lifetime.  Buying a legitimate kidney through an organ transplant bank will run $67,000 plus roughly another $200,00 for the surgery.  The black market could produce a value of $150,000 for a sold kidney where the donor may see $25,000 of that amount.   Averaging all these numbers, the price of a kidney transplant, the price a donor would receive on the black-market, the price a seller on the black-market would get, and splitting the cost of a lifetime of dialysis in half to determine a per kidney cost produces a mean value of  $818,800.  Despite a large potential for profit I would not recommend the black market route.  However if a close friend or family member is in need of a new kidney and you are determined to be a match I would recommend considering donating your kidney to them since we really only need one to survive, but if that situation arises talk to the professionals to ensure that you are aware of all the risks and benefits.

Works Cited

Andrews M.A.  2002 Apr.  How can you live without one of your kidneys.  Scientific American.  [Internet].  [cited 2013 Dec 1].  Available from: http://www.scientificamerican.com/article.cfm?id=how-can-you-live-without

How much does dialysis cost [Internet].  c2013.  San Jose (CA): CostHelper Inc. [cited 2013 Dec 2]. Available from: http://www.costhelper.com/about.html.

Life expectancy [Internet]. c2013.  Atlanta: Center for Disease Control; [updated 2013 May 30, cited 2013 Dec 2].  Available from: http://www.cdc.gov/nchs/fastats/lifexpec.htm

Lost limb award schedules [Internet].  c2013.  Lawyers.com.  Miamisburg (OH): Lexis Nexus. [cited 2013 Dec 2].  Available from: http://workers-compensation.lawyers.com/Lost-Limb-Award-Schedules.html

National Average Wage Index.  2012.  Social security: official social security website.  [cited 2013 Dec 2].  Available from:  http://www.ssa.gov/oact/cola/AWI.html

Normal GFR [Internet]. c2013.  London: The Renal Association.  [cited 2013 Dec 2]. Available from: http://www.renal.org/whatwedo/InformationResources/CKDeGUIDE/NormalGFR.aspx

Postrel V: How much is your kidney worth? [Internet].  c2013.  New York City: Bloomberg. [cited 2013 Dec 2].  Available from: http://www.bloomberg.com/news/2012-07-16/how-much-is-your-kidney-worth-.html

Transplant living: your prescription for transplant living [Internet].  c2013.  Richmond (VA): UNOS.  [cited 2013 Dec 1].  Available from:



Depression and Grey Hair

      You are going to be old one day. Yes, it's true. In time, your skin will wrinkle, your vision will worsen, your bones will grow frail, and your hair color will change to white or grey. You feeling sad yet? Well, you may want to think twice before you dwell on that sadness. In other words, don't let yourself fall into depression. Unfortunately, sometimes we have about as much a choice of whether we become depressed as we do of whether we get old. However, that doesn't mean we can't try our best to avoid one unfortunate happening in order to avoid the other.
      Let me explain. According to an article by the Huffington Post, a recent study performed in the Netherlands tested 1,900 individuals who experienced major depressive disorders at some point in their lives (and 500 individuals who had not), to find that people who had depression had shorter telomeres. Experts at the University of Utah reveal that telomeres, located at the ends of chromosomes, are stretches of DNA that are analogous to the plastic tips on the ends of our shoelaces; they keep our DNA from "fraying". When we are born, our telomeres are long, with about 8,000 base pairs made of the nucleic acid bases guanine, adenine, thymine, and cytosine. Over time, though, as our cells undergo cell division multiple times, our telomeres shorten. Long story short, if telomeres become too short, a cell will die, and cells getting closer to death over time essentially leads to organisms aging. Going back to the Netherlands study, researchers found that individuals who had experienced depression had shorter telomeres than their counterparts in the control group. Moreover, a higher severity of depression, along with a longer duration of symptoms tended to correlate with shorter telomeres, even when researchers controlled for weight, age, smoking, drinking, and other lifestyle-related factors. It was also suggested that telomere shortening could result from an impairment in the body's stress system. This, to me, would be reasonable, given that individuals with major depressive disorder may have experienced some huge stressful event or psychological stressor and not been able to handle it well enough, which could ultimately lead to depression; thus, an impaired stress system may be to blame for both the short telomeres and the depression (uh oh).
      Overall, the shorter your telomeres are, technically, the older your cells are and the closer they are to dying. When our cells die, we die. The question has been raised, then, whether this aging caused by telomeres progressively shortening can be stopped or reversed. Research is currently being performed on the enzyme, telomerase, that adds nucleotides to the ends of telomeres in order to reverse their shortening. There has not yet been a clear solution to this problem of stress and/or depression potentially increasing the rate of telomere shortening besides living a healthy lifestyle. Eating right, abstaining from abuse of alcohol and drugs, not smoking, and exercising may be even more important for depressed individuals than others. Gotta protect those telomeres!

References:
 Gholipour, B. (2013, Nov 12). Depression linked with shorter telomeres, a sign of cell aging. Huffington post. Retrieved from http://www.huffingtonpost.com/2013/11/12/depression-aging-cell-telomeres-shorter_n_4260476.html
Siegel, L. (2013). Are telomeres the key to aging and cancer?. Retrieved from http://learn.genetics.utah.edu/content/begin/traits/telomeres/

How reliable are animal studies?

When new animal studies come out reporting that they have found  the cure for a disability or disease, many rush to excitement because they believe it to be true. Its a published research article so it must be true right? Most people would be inclined to say yes because many do not look closely to the details or simply do not research into it farther. I'm guilty of that every time. From an article that I found, it turns out that many times a lot of information is left out of research articles simply because it didn't correspond to the researchers objectives. 

In the article When Mice Mislead, described an experiment that was done that resulted in a new drug that helped protect a rodent's brain after a stroke. At the beginning of the study 10 mice were accounted for. At the end only 7 were reported in the results. What happened to the other 3 mice? The editor of the paper said that they died after experiencing a massive stroke so the authors just left them out. Are they allowed to do that? 

Well according to Couzin-Frankel this is what the editor told her,"This isn't fraud...Dropping animals from a research study for any number of reasons is an entrenched, accepted part of the culture...You look at your data, there are no rules...People exclude animals at their whim, they just do it and they don't report it."

This definitely makes it hard for me to believe in any animal research study now which alters my hope in studies that are being done now for new cures. 

Reference:

Couzin-Frankel J. 2013. When mice mislead. Science. 342: 922-925