What Happens When One Man’s Genome Is Revealed
Stanford University School of Medicine’s Michael Snyder has learned firsthand how gene sequencing can change a person’s daily life.
Stanford University School of Medicine’s Michael Snyder has learned firsthand how gene sequencing can change a person’s daily life.
The FDA says the only oral multiple-sclerosis drug on the market shouldn’t be used in patients with a recent history of stroke or some heart problems.
A new method for performing a “virtual” colonoscopy was shown to accurately detect larger precancerous polyps—and was a better experience for patients.
Editor's note: CNN contributor Amanda Enayati ponders the theme of seeking serenity: the quest for well-being and life balance in stressful times. Last week we responded to your questions about some of life’s most stressful circumstances. Is it any surprise that the themes running through our experts’ advice read like a laundry list of wisdom from the elders? If you do not care for yourself, you will not be able to care for others. Figure out what’s truly important and do not look for perfection. Do your best to remain in the present moment, free of the shackles of the past and fear for what the future holds. All of these are far easier said (and written), of course. It is the execution that's most difficult. The first step is awareness. With that in mind – here are some more of your stress questions answered: Once again, our panel of experts included UC Davis professor Jay Belsky, a developmental psychologist and an internationally recognized expert on the role of nature and nurture in shaping children and families; Dr. Judith Orloff, professor of psychiatry at UCLA and bestselling author of “Emotional Freedom”; and Dr. Rajita Sinha, professor of psychiatry, neurobiology and child study at Yale University and director of the Yale Stress Center. Done in by single parenting My husband’s always traveling so I’m effectively a single parent. I’m overwhelmed with too much to do and not enough time. Balancing is an art form, observes Orloff. It’s important to be able to take time out to center and replenish yourself. Build energy through meditating, laughing or engaging in something other than your tasks. Get beyond the to-do list and make time for yourself. “Go hide in the bathroom, if you must!” According to Belsky, it is critical to prioritize what is more and less important. If the house is messy, that’s not the end of the world. “Sometimes people have to lower their standards and expectations,” he says. “You are better off being sane mom than super mom.” Sinha suggests that single parents strategize about organization and time management. Rethink and moderate children’s often-hectic schedules. She also stresses the importance of keeping oneself regulated: “Eat enough, and get enough sleep and exercise.” When money is tight How do I better handle financial stresses that limit how much money I have to spend on all the things we need, like childcare and home maintenance? The key, says Belsky, is to distinguish between wants and needs. We live in a day and age where the media and advertising want you to believe that your wants are your needs. They are not. Less is often more. A good first strategy is to stop looking at advertisements. Turn the sound down; skip over them in newspapers and magazines. When it comes to services, is it possible to do non-monetary exchanges with friends and family for things like childcare and home maintenance? Belsky points out that using your money thoughtfully and frugally is one of the best lessons you can teach children. Just because everyone has something doesn’t mean everyone needs it. This can serve as an opportunity to figure out what has value and what does not. Internalizing stress I’m stressed daily and I internalize it. It manifests in skin issues (I have psoriasis). I can’t meditate very well and I don’t feel like I have the time or patience to learn. What else can I do? Learn to focus on positive things in your life, says Belsky. This takes discipline and practice, because it’s often easier to focus on the stressful. You have to build up the psychological muscle to focus on the good. “Have a place you can go to in your mind: the beach, your child’s first steps. Close your eyes and go there during stressful moments. Use it as a place to move away from the wallowing and dwelling.” Orloff also recommends writing in a journal to “get out all the raw feelings, your anger and frustration, so you don’t hold them in.” If you don’t feel like writing, confiding in a trusted friend can work equally well. Evolution of stress Why is the fight or flight instinct still so strong? It’s not like we’re running into tigers in the jungle anymore; we’re sitting in traffic jams! Why can’t our bodies adapt and stop wreaking havoc when we get stressed? Evolution, says Belsky, isn’t forward-looking. It’s backward-looking. It prepares us for the things we have encountered in the past, not necessarily for what we will encounter in the future. That is, you may be dealing with modern-day problems, but your instincts are still somewhere back in the jungle. The survival instinct is very basic in all living organisms, says Sinha. And even though we are not facing tigers in the jungle, we still may have crises – natural disasters or violence – for which we need our fight or flight response. Nonetheless, our regulatory system has undergone a great deal of cognitive and emotional adaptation. Our prefrontal cortex has become more complex and sophisticated. But since those regions of the brain are more sensitive to high levels of chronic and repeated stress, it’s vulnerable to not functioning well under certain everyday types of situations, like stressful commutes. Orloff says it’s important to take control and consciously turn off the stress and negative emotions. “Stop and expressly remind yourself that more than likely your life is not in danger, that you are just sitting in traffic.” One simple way to take control? “Listen to mellow music during your commute,” suggests Orloff. Caretaker blues My father is suffering from dementia and I have had to drop my whole life to take care of him. I feel stuck, like there’s no way out, and then I also feel guilty for feeling that way, which makes me more stressed. The first thing you can do, says Belsky, is forgive yourself and accept those feelings of resentment, frustration and anger. “By having unreasonable standards and expectations, you risk draining the tank and beating up on yourself all at the same time.” Orloff believes that though it is a sacred duty to care for our loved ones when they are in need, you also have to take care of yourself. “There’s no reason to feel guilty about the feelings of anger and helplessness. It’s natural. There is never enough time and you can’t do enough work.” Join a support group of others who are coping with the same issue, she recommends. This will allows you to gain perspective and realize you are not alone. And if it’s at all possible, hire an occasional caregiver or helper so that you can take time off for yourself. “If you don’t practice self-care,” observes Orloff, “you will never be able to give quality time to others. You will just be run down and miserable.” According to Sinha, caretaker anxiety is another form of pernicious, uncontrollable stress, similar to financial stress. “The person feels stuck and cannot meet his or her own needs.” Sinha suggests seeking out the help of a mental health professional and agrees that it’s critical for caretakers to take time out for themselves. “Positive activities on an ongoing basis will build optimism and give caretakers strength. This should be part of their routine. Once here and there is not enough.” Information overload The news makes me panic. Even things like Facebook and Twitter and TV that are not meant to be bad make me panic. But it’s not like you can go off the grid and live your life without any technology, so what do I do? Orloff recommends taking periodic technology fasts. “Give yourself a dark period, like 3 to 6 hours where you are not focused on any type of technology.” She also cautions against watching the news before you go to bed because it may disrupt your sleep. “You will risk having insomnia, restlessness and bad dreams.” Build activities that don’t involve technology into your schedule. Take a walk mindfully. Get back to your break. Validate what’s going on inside. “Facebook will always be there,” says Sinha. “But this moment is never going to be there again. It is fleeting.” Follow @amandaenayati on Twitter or on Facebook Filed under: Living Well , Stress Tagged: Amanda Enayati — Special to CNN
Editor's note: This post is part of the Overheard on CNN.com series, a regular feature that examines interesting comments and thought-provoking conversations posted by the community. When we woke up this morning, “Time breast feeding cover” was the top trending topic on Google. Throughout the day, variations of that search have taken up four more of the top 10 spots. What is it about the photo of a 3-year-old breastfeeding on the cover of Time magazine this week that’s caused such uproar? CNN.com readers had a lot to say about the subject. Breastfeeding: Too much of a good thing? Readers debated the proper age to wean a child off breastfeeding. JungleQueen I breastfed exclusively all three of my babies for 9 months, and then they started to wean themselves. I was able to breastfeed all three for 2 years (my twins and my oldest are a year a part) before they finally weaned themselves for good. Unfortunately, too many people are worried about what everyone else is doing instead of what they should be doing. Different children have different needs P.J. What would people say to a 3, 4 or 5 year old drinking formula from a bottle? mab18 My baby was formula fed from day one – not by my choice, but because of health complications (to me) … Fast forward 2 1/2 years – my daughter is completely healthy, happy all the time, ahead in height and weight, and ahead of most of her "classmates" in daycare mentally. Yes breast is best, but that does not mean that formula fed babies are only going to "survive.” Kate Just because a toddler is breastfeeding doesn't mean it's exclusive. When my boys were toddlers, nursing was saved for before naps/bed, and a few other private times at home when they wanted the comfort. They were drinking out of sippy cups an eating table food by 6 months. It's not all or nothing, and my boys learned the boundaries of when/where it's appropriate. thisplanethasgonenuts I am of the belief that when your child is old enough to go outside and play and socialize with other children – the breastfeeding stops. I mean, no breastfeeding mother wants to deal with the question: "Can Bobby stay for dinner?" Scott I think we need to listen to nature on this one. Why would we think we are different than any other mammal that stops breastfeeding when their offspring have teeth? That's why the teeth come in, so they can eat food! Some readers said the problem wasn’t breastfeeding but the photo itself. Ohioan Let's all just cut to the chase. I'm all for breastfeeding. But the TIME cover was totally inappropriate. If the mother wanted to get her point across there are other ways. The child is the victim here. maeflowersdoulaservices I am 100% for extended breastfeeding if that's what you choose for your family. But I have to say that this photo does not portray what real extended breastfeeding is. The sweetness of breast feeding is not in the photo. If anything I think that with a cover photo like this it will make people want to not breastfeed at all. Breastfeeding is about the snuggles and love between a mother and her child and that doesn't happen with a child standing on a chair. Others disagreed. Watch: 'Attachment parenting' doc speaks out Molly I cannot believe that so many people are so uncomfortable with the idea of a woman providing the most natural, nutritional and perfectly balanced food for the child… Please stop alienating women for doing the most natural thing since the dawn of man. For some, it was an example of America’s unique culture. Tom Globally the average age of weaning is 4 to 5, meaning that some stop older, some younger. So 3 isn't too old to be breastfeeding. Seems we are the backwards culture. Theresa What most of the people commentating fail to recognize is that what we call "extended" breastfeeding was (and STILL is throughout most of the world) "civilized" and traditional, [and] is actually the norm and what is best for children's immune systems, bonding maturation, self esteem… Americans are prudes who only see the breast as a sex object. Pathetic. Others took issue with the debate as a whole. CMax37 So breastfeeding is the only way to become close to your child? By this equation, fathers are nothing more than sperm donors because we clearly can't have a strong bond with our children. @casdesummer At a time when children are becoming obese, in a country with rampant child sex abuse, this is an issue? Jenny EXCUSE ME! I am an adopted child, my mother could not breastfeed me. I turned out just fine, thank you very much. I have two boys neither of whom were breastfed. They are both in college and doing great. Breast feeding does not make you a mother. Love, nurturing, compassion are what makes a good mother. What's your opinion of the cover? Share your opinion in the comments area below, or sound off on video via CNN iReport. Filed under: Breastfeeding , Living Well , Parenting Tagged: Jacque Wilson — CNN.com writer/producer
Editor's note: Gary Marcus is a cognitive psychologist and author of the book "Guitar Zero ." He is the director of the New York University Center for Language And Music. The idea that learning a new skill – say juggling, cooking, or playing guitar – can be like an addiction is no joke. I should know. As a college professor/scientist, who has written about the dynamics of narcotics and self-control, I have spent the last 3 1/2 years all but addicted to learning to play guitar. Despite lacking anything that might remotely resemble musical talent, I find no day is complete without at least a little bit of time on the guitar. Even listening to music can be a little like a drug. A brain imaging study that came out last year proved what many scientists long suspected: Listening to music can lead the brain to release the neurotransmitter dopamine. Dopamine is the brain's universal signal for pleasure, an internal system that tells the brain (sometimes rightly, sometime wrongly) that it is doing the right thing. Drugs elicit dopamine artificially by fooling the brain, while activities like sex and eating elicit dopamine naturally. Listening to music taps into the dopamine system in part because hearing something new is a signal that the brain is learning something, and we have evolved to enjoy acquiring new information. Shortcuts like drugs, however are fleeting. Although narcotics can elicit dopamine fairly directly, over time it takes a bigger and bigger dose to get the same rush, and can lead people to destroy families, risk their health and even lose their lives. Learning new things is a lot safer, and ultimately a lot more satisfying. There is a myth that children (and for that matter adults) don’t really enjoy learning new things, but as every video game maker has realized, the truth is just the opposite. From "Space Invaders" to "Halo," "Grand Theft Auto" and "Zelda," practically every video game is in part about mastering new skills. As video game designers realized long ago, if you can keep a player poised on the knife’s edge of conquering new challenges, neither too easy and too hard but square in what the cognitive psychologist Vygotsky called the Zone of Proximal Development, you can keep gamers engaged for hours. As long as we constantly feel challenged but never overwhelmed, we keep coming back for more and constantly sharpen new skills. The trouble, though, with most video games lies in what they teach, which often stays with the game when the game is complete. A game that makes you good at shooting aliens may have little application in the real world. Learning a more lasting new skill – be it playing guitar or learning to speak a foreign language – can equally harness the brain’s joy of learning new things, but leave you with something of permanent value, in a way that neither drugs nor video games ever could. It leaves you with a sense of fulfillment, which goes back to what pioneering psychologist Abraham Maslow called "self-actualization." As Aristotle realized, there is a difference between the pleasures of the moment (hedonia), and the satisfaction that comes from constantly developing and living one’s life to the fullest (eudaimonia). In recent years, scientists have finally begun to study eudaimonia. Research suggests that the greater sense of purpose and personal growth associated with eudaimonia correlates with lower cortisol levels, better immune function and more efficient sleep. From the strict "Selfish Gene" perspective – in which all that we do is driven by the self-perpetuating interests of our individual genes – hobbies like playing music rarely make sense, especially for mere amateurs. But maybe the art of reinvention and acquiring new skills, even as adults, can give us a sense of a life well-lived. According to a 2009 Gallup Poll, 85% of Americans who don't play a musical instrument wish that they could. Why not start today? As it happens, this week is National Wanna Play Music Week , a perfect time to pick up a new skill that will bring satisfaction throughout life. What stops many people from learning something new is the thought that they are too old, not good enough or just plain busy. If my own experience is any guide, none of these matter much. Taking up an instrument (starting at age 38) has been one of the most challenging but rewarding things I've ever done. So long as your goal is growth rather than stardom, learning something new may just turn out to be one of the most rewarding things you ever do. Your brain will thank you for it. Filed under: Brain , Psychology Tagged: Gary Marcus – Special to CNN
MIAMI (CBSMiami) – The University of Miami medical school is set to layoff 800 workers, according to CBS4 news partner the Miami Herald. UM hasn’t officially announced the layoffs, but filed a notification with the state that the layoffs would happen July 31. The move comes just weeks after UM president Donna Shala told employees that “significant” cuts were being planned at the medical school, according to the Herald. The move comes as Jackson Memorial Health System has reduced payments to UM as it deals with debt during the Great Recession. According to the Herald, payments to UM from Jackson have dropped by $16 million in the last two years. Both sides were trying to put together a new annual operating agreement. Originally the plan was set to be in place by June 1, but according to the Herald, the date has been pushed back indefinitely as Jackson studies the issue. Combined, Jackson and UM will layoff 1,720 workers by the time all of the restructuring is complete.
With Type 1 diabetes on the rise, researchers are stepping up efforts to screen patients’ family members, who are at higher risk of also getting the disease, the Informed Patient column reports . More than 100,000 relatives have been screened through a free program offered by Diabetes Type 1 TrialNet , a research network of 18 centers world-wide seeking volunteers to participate in its studies of ways to prevent, delay and cure Type 1, long known as juvenile diabetes. TrialNet Chairman Jay Skyler , a professor and diabetes expert at the University of Miami, tells the Health Blog that the program has grown to about 200 sites and aims to expand testing sites further. “We’ve been broadening our base and the aim is to convince all medical practices to participate,” he says. The goal is to screen at least two to three relatives of patients diagnosed with Type 1 “so we can really make progress” with research. Distinct from the far more prevalent Type 2 diabetes, which is linked to obesity, Type 1 is an autoimmune disease that inhibits the body from producing the hormone insulin needed to convert food into energy. It requires lifelong insulin injections. iStockphoto TrialNet uses a simple blood test to determine if patients have antibodies that indicate a risk for developing Type 1. Close blood relatives of people with Type 1 diabetes have 10-to-15-times-greater risk of developing the disease than others in the population. Nevertheless, about 80% of those with the disease have no family history. JDRF , formerly called the Juvenile Diabetes Research Foundation, helps fund TrialNet and hosts mobile-screening units at its fundraising walks. Richard Insel , JDRF’s chief scientific officer, says that new ways to score a patient’s risk can identify those with the highest chance of developing the disease within a couple of years, and can also be used to monitor the disease’s progression. TrialNet provides family members who qualify for the screening testing kits on request and asks for a signed consent form. The kits can then be taken to a local doctor or lab. In addition to grassroots efforts like mobile testing units, TrialNet teams also offer screenings at diabetes summer camps and has even sent a team to test one extended family. If a group asks for a screening, “we will get a team out there to do it,” Dr. Skyler says. Among TrialNet studies underway is the Natural History Study, which is observing people at increased risk for Type 1 diabetes to learn more about the immune and metabolic events that precede actual symptoms. Another is testing whether one insulin capsule a day can prevent or delay Type 1 diabetes in a specific group at risk, after an earlier clinical trial suggested that it might delay the disease for about four years in certain people. Yet a third study is testing whether treatment with the drug teplizumab can prevent or delay the disease in high-risk relatives of people with type 1 diabetes. Earlier studies in people newly diagnosed suggest that the drug reduces the loss of insulin production during the first year of type 1 diabetes. For Type 1 patients with a family history, participation in the study includes close monitoring and the potential to prevent or delay the onset of the disease, says Henry Rodriguez , a principal investigator at the University of South Florida. If diabetes can be delayed, even for a few years, those at risk may be able to postpone the difficult challenges of trying to control their disease and the development of potentially serious complications. “We have the ability to identify those who are at that precipice before developing diabetes and start them on therapy before they get very ill,” Dr. Rodriguez says.
iStockphoto More adults went without needed medical treatment, a dental visit or routine check-ups in 2010 than a decade earlier, according to a new study . In 2010, some 21% of adults under the age of 65 told a government survey that they had an unmet health-care need, 20% said they hadn’t been able to get into a doctor’s office and 39% said they hadn’t had a dental visit. Those numbers were all higher than responses in 2000, researchers at the liberal Urban Institute think tank found after analyzing National Health Interview Survey questionnaires that asked adults under the age of 65 about their health. The latest numbers are likely to add further fuel to the debate over the future direction of health costs. National health-spending growth was at a near-historic low in 2010, as WSJ reported , but experts are divided over whether the trend is a good thing or not. As the Health Blog explained in January , many observers attribute the decline in spending to people cutting back on care because of the weak economy. But they also say the long-term cost implications depend on whether the people postponed necessary treatments for conditions that will worsen, or put off unnecessary treatments that they would be better off skipping. In the study, adults without health insurance were much more likely to say they didn’t have access to care or didn’t see a doctor or a dentist. In 2010, 46% of these people said they had had unmet medical needs, 48% said they had seen a doctor in the previous year, and 28% said they had seen a dentist.
Roche Drug to Raise ‘Good’ Cholesterol Fails (WSJ): The drug’s failure in a large human trial spelled a setback for pharmaceutical companies that see an opportunity in medicines that seek to ward of heart disease by raising so-called “good” cholesterol. Competitors Merck and Eli Lilly said they remain confident in late-stage drugs in their pipelines that work similarly. Study Examines Depression and Aging Brain (WSJ): The onset of depression late in life can be an early warning of Alzheimer’s disease and other dementia later, according to a new study of 13,535 Kaiser Permanente members. A Regime’s Tight Grip on AIDS (New York Times): Cuba’s AIDS rate is only one-sixth that of the U.S., thanks in part to aggressive tactics taken in the early years of the epidemic, such as forced quarantines for people who tested positive for HIV. F.D.A. Staff Raises Concerns About Arthritis Drug (New York Times): Documents released ahead of a Food and Drug Administration review Wednesday show regulators are concerned a new Pfizer treatment for rheumatoid arthritis raised concerns of significant side-effects. Court Dismisses Vets’ Suit on Mental Health Care (San Francisco Chronicle): A San Francisco appeals court dismissed a five-year-old suit by veterans groups accusing the Department of Veterans Affairs of delaying needed mental health services. Drug-Defying Germs from India Speed Post-Antibiotic Era (Bloomberg): The widespread use of antibiotics in India is helping cultivate new breeds of drug-resistant bacteria bred from otherwise benign microorganisms.