Thursday, July 29, 2010

PAQ Paper Now Published

My paper entitled ""Mind the Gap": Beneficence and Senescence" is now published in the latest issue of Public Affairs Quarterly.

This paper is my latest effort to help establish the case for viewing age retardation as a pressing moral imperative.

A sample from the paper:

To help narrow the gap (hence the title “Mind the Gap”) between science policy and philosophical debates in ethics and distributive justice, I invoke a foundational principle of ethics- beneficence- and apply this principle to the topic of senescence (or biological aging). I address some of the ethical and social issues that arise in the field of biogerontology which studies the complex biological processes of aging in the hopes of extending the human healthspan. Well-ordered science, argue Flory and Kitcher, must inevitably be selective. However, the current “disease-model” approach to health extension, which is the strategy of tackling each specific disease of aging one at a time, is unsatisfactorily selective because it neglects the reality that “age is by far the biggest risk factor for a wide range of clinical conditions that are prevalent today”. Many different kinds of cellular and molecular damage contribute to aging, such as DNA damage (like telomere shortening and chromosome rearrangements), protein damage, oxidation and cell migration and cell death. However, unlike specific diseases of aging, like cancer, heart disease, and Alzheimer’s disease, aging research currently receives very little public funding.

.... The principle of beneficence is a foundational principle of ethics. In its simplest form, the principle states that we ought to perform those actions which, from the menu of options available to us, will create the best outcomes. Beneficence underpins many of the other-regarding actions we take to be integral to morality and justice- such as performing acts of mercy, altruism and charity. When applied to science and medical research, the principle of beneficence requires society to pursue the knowledge and innovation necessary to prevent avoidable harms. These harms include pain and suffering, disability, disease and death.

.... Unlike the topics of multiculturalism, or the primacy of individual rights, or the distribution of wealth and income, science policy receives little attention from moral and political philosophers. This is unfortunate as many of the most pressing challenges facing societies this century are complex, long-term problems that require new scientific knowledge and innovation. The amount of support and funding which a government devotes to different areas of scientific inquiry can have a profound impact on the health and economic prospects of a society. In their recent study on the economic benefits of health and longevity in the United States, Murphy and Topel estimate that the gains in health and longevity made in the last thirty years of the twentieth century added approximately $3.2 trillion per year to national wealth, equal to about half of GDP. Making further health gains will be a challenge given the reality of co-morbidity. Age retardation offers a novel and plausible strategy for making substantial gains against the chronic diseases of aging. And with unprecedented numbers of humans living longer this century, the imperative to protect them from late-life morbidity and mortality becomes even more pressing.


Wednesday, July 28, 2010

Social Relationships Good For Health

So concludes this study in PLOS Medicine. A sample:

Data across 308,849 individuals, followed for an average of 7.5 years, indicate that individuals with adequate social relationships have a 50% greater likelihood of survival compared to those with poor or insufficient social relationships. The magnitude of this effect is comparable with quitting smoking and it exceeds many well-known risk factors for mortality (e.g., obesity, physical inactivity). These findings also reveal significant variability in the predictive utility of social relationship variables, with multidimensional assessments of social integration being optimal when assessing an individual's risk for mortality and evidence that social isolation has a similar influence on mortality to other measures of social relationships. The overall effect remained consistent across a number of factors, including age, sex, initial health status, follow-up period, and cause of death, suggesting that the association between social relationships and mortality may be general, and efforts to reduce risk should not be isolated to subgroups such as the elderly.

To draw a parallel, many decades ago high mortality rates were observed among infants in custodial care (i.e., orphanages), even when controlling for pre-existing health conditions and medical treatment [201]–[204]. Lack of human contact predicted mortality. The medical profession was stunned to learn that infants would die without social interaction. This single finding, so simplistic in hindsight, was responsible for changes in practice and policy that markedly decreased mortality rates in custodial care settings. Contemporary medicine could similarly benefit from acknowledging the data: Social relationships influence the health outcomes of adults.

Physicians, health professionals, educators, and the public media take risk factors such as smoking, diet, and exercise seriously; the data presented here make a compelling case for social relationship factors to be added to that list. With such recognition, medical evaluations and screenings could routinely include variables of social well-being; medical care could recommend if not outright promote enhanced social connections; hospitals and clinics could involve patient support networks in implementing and monitoring treatment regimens and compliance, etc. Health care policies and public health initiatives could likewise benefit from explicitly accounting for social factors in efforts aimed at reducing mortality risk. Individuals do not exist in isolation; social factors influence individuals' health though cognitive, affective, and behavioral pathways. Efforts to reduce mortality via social relationship factors will require innovation, yet innovation already characterizes many medical interventions that extend life at the expense of quality of life. Social relationship–based interventions represent a major opportunity to enhance not only the quality of life but also survival.

I believe this study is very significant, and ought to lead all of us, as individuals, educators, etc., to re-think what the constituents of a good society (and good life) are. How can we better ensure we have the opportunity to live flourishing lives? We can start by replacing the current obsession with consumption and economic growth, which is premised on a vision of humans as "homo economicus", with a greater focus on the social (and natural) determinants of health and happiness. Thus we ought to take Aristotle's contention that we are a "political animal" much more seriously than we have.

The Globe has the scoop on the study here.


Friday, July 23, 2010

Cell PaperFlick on Cancer and Environment

The latest issue of Cell has this study on cancer and environment.

The video above is the PaperFlick report on the study.

Applying the study's findings to humans, we ought to design "enriched environments" for human populations if we want to promote our health!


Friday, July 16, 2010

Fighting Malaria with Genetically Modified Mosquitos

This study in the latest issue of PLOS Pathogens suggest this might not sound as bizarre as it appears. Here is the abstract:

Malaria (Plasmodium spp.) kills nearly one million people annually and this number will likely increase as drug and insecticide resistance reduces the effectiveness of current control strategies. The most important human malaria parasite, Plasmodium falciparum, undergoes a complex developmental cycle in the mosquito that takes approximately two weeks and begins with the invasion of the mosquito midgut. Here, we demonstrate that increased Akt signaling in the mosquito midgut disrupts parasite development and concurrently reduces the duration that mosquitoes are infective to humans. Specifically, we found that increased Akt signaling in the midgut of heterozygous Anopheles stephensi reduced the number of infected mosquitoes by 60–99%. Of those mosquitoes that were infected, we observed a 75–99% reduction in parasite load. In homozygous mosquitoes with increased Akt signaling parasite infection was completely blocked. The increase in midgut-specific Akt signaling also led to an 18–20% reduction in the average mosquito lifespan. Thus, activation of Akt signaling reduced the number of infected mosquitoes, the number of malaria parasites per infected mosquito, and the duration of mosquito infectivity.

And the Globe has the scoop here. A sample:

Scientists have developed the first genetically modified mosquito (GMM) that is completely immune to the disease the insects so efficiently spread. An estimated 250 million people worldwide contract the deadly blood-borne disease a year; one million of them die.

The GMM mosquitoes will still bite; they just won't leave behind the malaria-causing parasite, called Plasmodium.

“Hopefully, down the road this will play a part in controlling malaria,” says lead researcher, entomologist Michael Riehle. The research was published Thursday afternoon in the journal Public Library of Science Pathogens.

Although releasing the new mosquito into the wild is a long way off, Dr. Riehle says that given the drawbacks of other malaria-fighters, especially the mosquito's growing resistance to various insecticides and vaccines, it is a method worth investigating.


Tuesday, July 13, 2010

New Vitamin D Recommendations

The latest issue of the CMAJ has this article on the new guidelines for the (adult) daily supplements of vitamin D.

For adults who are at a low risk of osteoporsis, the recommended daily intake of vitamin D is 400–1000 IU.

EurekAlert! also has the scoop here.


Thursday, July 08, 2010

Deliberative Democracy and Bioethics

NatureNews has this interesting interview with the new chair of the President's Council of Bioethics, political philosopher Amy Gutmann. Here is a sample:

What led you to take the job as chair of the commission?

I'm a political philosopher and a scholar of ethics and public policy by training. I have a long-standing interest in the importance of deliberating on complex issues of health care, science and technology. So when President Obama asked me to chair the commission, first of all I had to say "yes" because the President was asking me to serve. Second, it hit the sweet spot of my scholarly and professional interests.

In this era of sound-bite democracy, we need to recognize the importance of making democracies more deliberative. Deliberative democracy is about engaging: listening to competing points of view, considering opposing arguments and coming to a decision that ideally finds common ground — or at least respects competing points of view.

You can watch the meeting on synthetic biology live, today and tomorrow, at this site here.


Wednesday, July 07, 2010

Timely Study

This scientific study on bias in calling fouls in soccer is timely. The abstract:

Distinguishing between a fair and unfair tackle in soccer can be difficult. For referees, choosing to call a foul often requires a decision despite some level of ambiguity. We were interested in whether a well documented perceptual-motor bias associated with reading direction influenced foul judgments. Prior studies have shown that readers of left-to-right languages tend to think of prototypical events as unfolding concordantly, from left-to-right in space. It follows that events moving from right-to-left should be perceived as atypical and relatively debased. In an experiment using a go/no-go task and photographs taken from real games, participants made more foul calls for pictures depicting left-moving events compared to pictures depicting right-moving events. These data suggest that two referees watching the same play from distinct vantage points may be differentially predisposed to call a foul.


Thursday, July 01, 2010

Genetics of Longevity

The latest issue of Science has this important study on the importance of genetics for healthy aging. Here is the abstract:

Healthy aging is thought to reflect the combined influence of environmental factors (lifestyle choices) and genetic factors. To explore the genetic contribution, we undertook a genome-wide association study of exceptional longevity (EL) in 1055 centenarians and 1267 controls. Using these data, we built a genetic model that includes 150 single-nucleotide polymorphisms (SNPs) and found that it could predict EL with 77% accuracy in an independent set of centenarians and controls. Further in silico analysis revealed that 90% of centenarians can be grouped into 19 clusters characterized by different combinations of SNP genotypes—or genetic signatures—of varying predictive value. The different signatures, which attest to the genetic complexity of EL, correlated with differences in the prevalence and age of onset of age-associated diseases (e.g., dementia, hypertension, and cardiovascular disease) and may help dissect this complex phenotype into subphenotypes of healthy aging.

CNN has the scoop here. A sample:

If celebrating triple-digit birthdays sounds appealing, scientists may be able to determine if you're likely to live that long.

Researchers from the Boston University Schools of Public Health and Medicine and the Boston Medical Center have identified genes associated with living longer. They also predicted using genetics alone many of those among study participants would be a centenarian. Their results will be published in the journal Science.

"Could these signatures tell a physician and their patient who's going to be at increased risk for a particular disease sooner, and can this lead perhaps to interventions that might help them? I think that's a possibility down the road," said co-author Dr. Thomas Perls of Boston Medical Center, in a press conference.

....Using their genetic model, researchers found they could predict with 77 percent accuracy who would live to be 100 or higher based on genetics alone in the sample.

"This is very important information that should make anybody aware that if we are going to find genes that are protecting us from aging, it is not an impossible mission," said Dr. Nir Barzilai, director of the Institute for Aging Research at Albert Einstein College of Medicine in the Bronx, New York, who was not involved in the study.