Tag: 14/5/21

Categories : Injury & Trauma Mental HealthTags :

Head Injuries Widespread Among Female Prisoners

On By ModernMedia
Photo by RODNAE Productions from Pexels

New research has found that 78% of women prisoners in Scotland have a history of significant head injury – most of which occurred in the context of years of domestic abuse.

The University of Glasgow-led study also found 66% of women prisoners had suffered repeat head injuries for many years. The majority of the study participants were from the most deprived 20% of the population. One US study of male prisoners found 63.7% of at least one traumatic brain injury, and 32.5% had experienced multiple such injuries.

Of those with a history of head injury, the most common cause (89%) of repeat head injury was domestic violence. Only five women had experienced a single incident of moderate-severe head injury. Of those with a history of significant head injury, a first head injury before the age of 15 was reported by 69% of women.

For the study, researchers interviewed around a quarter of women in Scottish prisons, 109 women in total, between 2018 and 2019. They were assessed for a history of head injury, including its causes, a history of abuse, as well as for disability and mental and physical health conditions.

Of the 78% with a history of significant head injury, 40% also had an associated disability. Previous research has reported that many women in prison have a history of head injury, but none looked at disability.

Those with a history of significant head injury were three times more likely to have violent criminal behaviour, and also spent three times longer in prison.

Nearly all participants (95%) reported a history of abuse, with over half reporting sexual abuse in childhood and 46% reporting sexual abuse in adulthood. Physical abuse in childhood was reported by 39%, while 81% of participants reported physical abuse in adulthood.

Alcohol or drug misuse history was common, with substantially higher rates in the group who reported significant head injuries. Almost all, 92%, complained of mental health difficulties, with anxiety and depression the most commonly reported. Although the participants had 12 years of education on average, schooling was often disrupted by exclusion or truanting and many required special schooling or support.

Professor Tom McMillan, Professor of Clinical Neuropsychology at the University of Glasgow and lead author of the study, said: “It is already recognised that women in prison are vulnerable because of histories of abuse and substance misuse. However, this research shows that a history of significant head injury is also a vulnerability and needs to be included when considering mental health needs and in developing criminal justice policy given the relationships with associated disabilities, abuse and violent crime’’.

“Our findings suggest that interventions to reduce mental health morbidity, and assessment and management of risk of violent offending should include history of significant head injury. There is a need to recognise these vulnerabilities at an early stage, including at the first contact with the criminal justice system, to assess these women and provide long term support.”

Common persistent effects of significant head injury include impairments in information processing and emotional changes associated with impulsivity, irritability and egocentricity. These effects can impair judgement and self-control, increase the risk of offending. Significant head injury can also impair the maturation of the developing brain if occurring before adulthood.

The characteristics of significant head injury in women in prison differ from women with significant head injury in the general population. Domestic violence was the most common cause of these injuries in women in prison, whereas  in the general population falls are most common. In addition head injury occurred repeatedly in around two-thirds of women in prison with significant head injury, whereas single incident head injury from an accident is more common in the general population.

Source: University of Glasgow

Journal information: Tom M McMillan et al. Associations between significant head injury and persisting disability and violent crime in women in prison in Scotland, UK: a cross-sectional study, The Lancet Psychiatry (2021). DOI: 10.1016/S2215-0366(21)00082-1

Categories : HospitalsTags :

Cyber Attack Cripples Ireland’s Health Services

On By ModernMedia
Photo by Nahel Abdul Hadi on Unsplash

A “significant ransomware attack” caused widespread disruption to Ireland’s health service, forcing cancellations and blocking services.

Paul Reid, Ireland’s Health Service Executive chief executive, told RTÉ there had been a “human-operated” attempt to access data for a likely ransom. “There has been no ransom demand at this stage. The key thing is to contain the issue. We are in the containment phase.”

Reid said the HSE was working with police, the defence forces and third-party cybersecurity experts to respond to the cyber attack. He apologised to patients and the public for the disruption.

The attack has affected national and local systems that provide core services. However COVID vaccinations and ambulance services were unaffected.

Several hospitals cancelled outpatient visits or asked patients with appointments to not attend. The Rotunda, a Dublin maternity hospital, said it was experiencing a “critical emergency”, cancelling all outpatients visits save for women over 35 weeks pregnant.

At Cork university hospital, the oncology department was reportedly brought to a halt. The child and family agency Tusla said its IT systems, including the portal through which child protection referrals are made, were offline.

In the US earlier this week, the Colonial petrochemical pipeline was crippled in a major cyberattack by a cybercriminal group called Darkside, resulting in fuel shortages and states of emergency being declared. The pipeline company reportedly paid a ransom fee of $5 million to get control back of their systems.

Master of the Rotunda Hospital Professor Fergal Malone told Morning Ireland that accessing patient records and data was the reason for the cancellations.

There was a backup plan to use an “old-fashioned” paper-based system, he said, but added that “throughput would be much slower” this way.

Malone said the hospital discovered unusual activity in its IT systems at about 2am and later detected what appeared to be a ransomware virus. “We use a common system throughout the HSE in terms of registering patients and it seems that must have been the entry point or source,” he told RTÉ. “It means we have had to shut down all our computer systems.”

However, all patients were safe. “We have systems in place to revert back to old-fashioned record-keeping.” Lifesaving equipment was not affected. “Patients will come in in labour over the weekend and we will be well able to look after them.”

Source: The Guardian

Categories : Cancer Metabolic DisordersTags :

Rise in Obesity Impeding Cancer Fight

On By ModernMedia

Though cancer death rates have fallen dramatically in the United States, those from obesity-related cancers are falling much more slowly.

In a study published this week in JAMA Network Open, researchers found that obesity-related cancer deaths are improving, but at a slowing pace.

Researchers at the University of North Carolina Gillings School of Global Public Health drew on mortality data for 50 million people, cancer deaths not associated with obesity — such as lung or skin cancer – are declining at a rate almost three times faster than obesity-related cancers, such as stomach, colorectal, uterine, thyroid and postmenopausal breast cancer.

“These are cancers where we could see even larger mortality improvements with creative and practical tools to combat obesity,” said study senior author Hazel B Nichols, PhD, associate professor in the Department of Epidemiology at the UNC Gillings School.

Most Americans are over the recommended body weight, and being overweight or obese puts them at risk for certain cancers.  

Extra body fat can lead to changes in the body that can contribute to cancer development, such as long-lasting inflammation and higher than normal levels of insulin and hormones that can fuel cell growth, according to the U.S. Centers for Disease Control and Prevention.

Discordant progress

Researchers use cancer death rates to track progress against cancer over time. The study authors set out to find out if obesity was stalling progress against cancer the way it did against heart disease. After 2011, heart disease mortality rates slowed their decline, a phenomenon which may be due to obesity.

“What was puzzling was that we didn’t see the same pattern of slower improvements when looking at cancer overall, which is surprising because obesity contributes to both cancer risk and heart disease risk,” said Dr Nichols. “When we focused on the differences between obesity-related cancers and non-obesity related cancers, we saw that improvements for obesity cancers were not as impressive — consistent with the pattern for heart disease.”

For example, the study showed that in 2011, 110 people out of 100 000 died from cancers not related to obesity. In 2018, the mortality rate for those cancers fell to 93.8 deaths per 100 00 people — a 2.29% annual decline.

During the same period, the decline for obesity-related cancers was much slower, changing from 58.4 to 54.9 deaths per 100 000 people, a rate of .83% — a rate one-third the decrease in non-obesity related cancers.

Obesity may also be contributing to more of the cancer deaths in the US. The study found that cancers not associated with obesity accounted for 66.8% of cancer deaths in 1999, decreasing to 62.6% in 2018.
The good news is that if we’re able to make these changes as a society, we will be able to improve the health of a nation. Christy Leigh Avery, PhD

Falls in cancer deaths are the result of fewer smokers, along with better screening and treatments, according to the American Cancer Society.

But the findings by UNC researchers reinforce the impact of obesity on cancer. 

“Obesity is a risk factor for many, but not all, types of cancer,” Nichols Dr said. “We need to make maintaining a healthy weight an obtainable goal for everyone in terms of safe public spaces, the availability and affordability of nutritious foods, and other structural factors. The good news is that if we’re able to make these changes as a society, we will be able to improve the health of a nation.”

Source: University of North Carolina

Journal information: Avery CL, Howard AG, Nichols HB. Comparison of 20-Year Obesity-Associated Cancer Mortality Trends With Heart Disease Mortality Trends in the US. JAMA Netw Open. 2021;4(5):e218356. doi:10.1001/jamanetworkopen.2021.8356

Categories : Medical Research & Technology NeurologyTags :

Brain-computer Interface Lets Paralysed People Write Letters

On By ModernMedia
Image by Gerd Altmann from Pixabay

Researchers have developed a new brain-computer interface (BCI) that can let paralysed people write by mentally writing letters by hand.

Working with a participant with paralysis who has sensors implanted in his brain, the team used an algorithm to identify letters in real time as he attempted to write them, putting the results on a screen.

This technology could be further developed to allow people with paralysis type rapidly without using their hands, said study coauthor Krishna Shenoy, a Howard Hughes Medical Institute Investigator at Stanford University who jointly supervised the work with Jaimie Henderson, a Stanford neurosurgeon.

By attempting handwriting, the study participant was able to ‘type’ 90 characters per minute — more than double the previous record for typing with such a brain-computer interface.

Thought-powered communication

Even if injury or disease the ability to move, the brain’s neural activity for being able to do so remains. By making use of this activity, researchers can help people with paralysis or amputations regain lost abilities.

In recent years, Shenoy’s team has decoded the neural activity associated with speech in the hopes of reproducing it. Patients with implanted sensors mentally pointed at and clicked on letters on a screen to type at about 40 characters per minute, the previous speed record for typing with a BCI.
Wanting to try something new and different, Frank Willett, a neuroscientist in Shenoy’s group, wondered if it might be possible to harness the brain signals evoked by writing by hand “We want to find new ways of letting people communicate faster,” he said. 

The team worked with a participant enrolled in a clinical trial involving BCIs. Henderson implanted two tiny sensors into the part of the brain that controls the hand and arm, making it possible for the person to, for example, move a robotic arm or a cursor on a screen by attempting to move their own paralysed arm.
The participant, who was 65 years old at the time of the research, had a spinal cord injury that left him paralysed from the neck down. A machine learning algorithm recognised the patterns his brain produced when he attempted to write each letter.

With this system, the man could copy sentences and answer questions at a rate similar to that of someone his age typing on a smartphone. The reason why this so-called “Brain-to-Text” BCI is so fast is because each letter elicits a highly distinctive activity pattern, making it relatively easy for the algorithm to distinguish one from another, Willett explained.

A new system

Shenoy’s team envisions using attempted handwriting for text entry as part of a more comprehensive system that also includes point-and-click navigation, much like that used on current smartphones, and even attempted speech decoding. “Having those two or three modes and switching between them is something we naturally do,” he said.
The team intends to next work with a participant who cannot speak, such as a person with amyotrophic lateral sclerosis, a degenerative neurological disorder leading to loss of movement and speech.

The new system could potentially help those suffering from paralysis caused by a number of conditions, Henderson added. Those include brain stem stroke, which afflicted Jean-Dominique Bauby, the author of the book The Diving Bell and the Butterfly. “He was able to write this moving and beautiful book by selecting characters painstakingly, one at a time, using eye movement,” Henderson said. “Imagine what he could have done with Frank’s handwriting interface!”

Source: Howard Hughes Medical Institute

Categories : Cardiovascular DiseaseTags :

Overweight in Adolescence Linked to Strokes in Later Life

On By ModernMedia

Having a higher body mass index (BMI) in adolescence is linked to greater risk of first ischaemic stroke in adults under age 50 — regardless of whether they had Type 2 diabetes.

The research was published in Stroke, a journal of the American Stroke Association, a division of the American Heart Association.

Although the prevalence of adolescent obesity and stroke among adults under the age of 50 years continue to rise around the world, the precise link between the two conditions is still not fully understood.

“Adults who survive stroke earlier in life face poor functional outcomes, which can lead to unemployment, depression and anxiety,” said study co-author Gilad Twig, MD, MPH, PhD, an associate professor in the Medical Corps of the Israel Defense Forces and the department of military medicine, Faculty of Medicine of The Hebrew University in Jerusalem, Israel. “The direct and indirect costs attributed to stroke prevention and care are high and expected to keep increasing since the rate of stroke continues to rise.”

This study examined adolescent BMI and first stroke before the age of 50 among 1.9 million participants (ages 16 to 20; 58% male) from two nationwide databases: the Israel Defence Forces and the Israeli National Stroke Registry. All the participants in the database had undergone one complete medical exam between 1985 and 2013.

Standard BMI groups are underweight (less than 5th percentile), low-normal BMI (5th to 49th percentile), high-normal BMI (50th to 84th percentile), overweight (85th to 94th percentile), and obese (greater than 95th percentile). Details on percentile BMI measures by gender are in the article.

Overall, 1088 strokes occurred (921 ischaemic strokes, 167 haemorrhagic strokes) during the follow-up period, a mean age of 41 when the stroke occurred. Adolescent BMI was directly related to the risk of first ischaemic stroke. Compared to participants in the low-normal BMI group, overweight adolescents had a 2-times higher risk of stroke before age 50, and obese adolescents had a 3.4-times higher risk.

Even adolescents with BMIs in the high-normal range were more likely to have a stroke before age 50 compared to those in the low-normal BMI group. Adolescents who were either overweight or obese still had a higher risk of stroke (1.6-times and 2.4-times, respectively) after accounting for Type 2 diabetes, compared to those with normal BMI.

Even though overweight and obesity during adolescence is a common problem, researchers were surprised to find that Type 2 diabetes did not explain the higher risk for ischaemic stroke, which in some cases occurred even before age 30.

Dr Twig noted that current literature shows that a stroke early in life may lead to recurrent stroke, heart attack, long-term care and premature death.

“Our findings underscore the importance of effective treatment and prevention of high normal and excessively high BMI during adolescence,” Dr Twig said. “Our study is also the first to show that the risk of stroke associated with higher BMI values is the same for both men and women.”

A major limitation of the study is that BMI data at follow-up were not available for all participants, meaning that researchers could not assess the contribution of obesity over time to stroke risk and to separate out the risk of BMI during adolescence.

Source: American Heart Association

Journal information: Bardugo A, Fishman B, Libruder C, et al. Body Mass Index in 1.9 Million Adolescents and Stroke in Young Adulthood. Stroke. 2021;STROKEAHA120033595. doi:10.1161/STROKEAHA.120.033595

Categories : COVIDTags :

Third Wave Hits Gauteng as Indian Variant Detected in Durban

On By ModernMedia
Photo by Clodagh Da Paixao on Unsplash

Earlier today, Gauteng Premier David Makhura has announced that the third wave of COVID has hit the province, home to 15 million people.

The province had been recording over 1 000 positive cases for the past two days. In particular, there had been a spike in the number of new COVID cases over the last three weeksthe in the Vaal’s Emfuleni region.

“Having seen over 1000 cases a day we cannot afford to close down the provinces economy but definitely we want to see an increase in restrictions,” said Makhura. Businesses meanwhile had been warning of lockdowns ahead of a third wave.

He made the remarks during the official opening of a refurbished mining hospital in Carletonville, west of Johannesburg.

Test positivity rate had risen to 7.45% on Wednesday, the highest in five days and for a month the rate had hovered close to or above the 5% threshold of what is considered too high.

On Thursday, the health department reported that COVID cases had increased by 3 221 in the last 24 hours, further evidence that a third wave was imminent.

Health Minister Dr Zweli Mkhize said in a statement that the national tally of confirmed cases to date now stood at 1 605 252, with 29 362 of these being active cases. Meanwhile, the recovery rate now stands at 94.7% after 1.52 million patients beat COVID.

Meanwhile, eight new cases of B.1.617.2, known as the Indian variant, have been detected in South Africa.

Professor Tulio de Oliveira, the director of the KZN Research Innovation and Sequencing Platform, said that these were found in crew members of a commercial vessel that arrived in Durban Port from India.

De Oliveira tweeted: “The Network for Genomic Surveillance in South Africa, confirmed detection of eight more genomes B.1.617.2 (Indian variant) and two community transmission of B.1.1.7 (UK variant) in South Africa.”

Source: IOL News