Saturday, October 1, 2011

Last week, Nature Genetics carried twin studies into the genetics of bipolar disorder and schizophrenia. This special report examines the month’s research into the illnesses in detail, with Wikinews obtaining comment from experts based in Australia, the United States, and the United Kingdom ahead of the U.S. Mental Illness Awareness Week, which starts tomorrow.

Eleven genetic regions were identified; seven of these were for schizophrenia and five of those were hitherto undiscovered. The parallel studies, conducted separately, examined more than 50,000 people worldwide and identified two genetic loci associated with both diseases.

Little is known about the two illnesses, each of which affects around 1% of people and is treated with strong medication. Bipolar sufferers experience extremes of mood – depression and mania, hence the previous name “manic depression” for the illness. Schizophrenia is associated with hearing voices, chaotic thoughts, and paranoia. There is no known cure.

The latest research examined both the healthy and the afflicted, using computers to scan genomes. Inheritance was thought to be a factor from prior knowledge of the diseases as a familial trait, but the original desire had been to isolate a single faulty gene. Instead it has become apparent that the genetic factors are many; in the case of schizophrenia, at most around 30% of the genetic components are thought to have been identified.

The University of Chicago’s Pablo Gejman, a lead researcher on the schizophrenia study, explained to Wikinews in a telephone interview from Buenos Aires, Argentina that “One of the goals of genetic research is to find druggable targets” – to “find treatments at the root of the problem”.

Whilst noting that there is no guarantee the genetic code identified is druggable, Gejman named calcium-activated neurochemical channels in the brain as candidates for new drugs. The channels were linked to schizophrenia in the study.

Gejman explained that a genetic locus called mir137 “suggests an abnormality of gene regulation.” The diseases are so poorly understood that it is uncertain if they are in fact two components of a single spectrum, or even each comprised of multiple illnesses.

The new and “provocative data” gathered showed the significant loci identified were “not part of the pre-existent hypothesis.” Calling this “interesting”, Gejman added that the team found no evidence that dopamine receptors are involved; current drug treatments target dopamine receptors. The findings are “not related to anything we thought we knew [about schizophrenia],” he told our correspondent.

Quizzed about the possibility variations in the genetic factors involved in expressing the diseases explained the variation seen in symptoms, Gejman was uncertain. “We will have the answer, probably, only when we sequence the whole [human] genome.” He notes that the relationship between genotype and phenotype is unclear, and that “We know very little of the genetic architecture of schizophrenia and” other disorders.At the time the results were published, participating scientist Professor Rodney Scott from the University of Newcastle in Australia said “The strength of this research is in the numbers. The findings are robust and give us a lot of statistical power to identify the genetic determinants of schizophrenia.” Scott told Wikinews that “If any single centre tried to undertake such a study, it would require millions of pounds. Since it was a collection of data from across the world the costs were spread. In this era of financial difficulty it will become increasingly difficult to secure funding for this type of project even though the pay-offs will be significant.”

Gejman expressed similar sentiment. “The research budget is not growing, which makes [funding] difficult,” he said, though he felt the cost “is not prohibitive because of the benefits.” “I think that it was money well invested” and “very well spent for the future,” he said, adding that organisations in Europe and the US were aware of the importance of such research.

Gejman also agreed on reliability – the study is “Very reliable because of the sample size; that should provide robust results… [we] have worked with a much larger sample than before.” Scott told us it was “a highly reliable study” that has the potential to lead to new treatments “in the long run”.

Another point was the two genetic loci identified as common to both – how much support do they lend to the notion the diseases are linked? “Until more information is available it is really only suggestive,” says Scott. “Strong enough to say there may be potentially a common pathway that bifurcates to give rise to two diseases.”

“It is an excellent demonstration,” said Gejman “because you have the same chains that are common to both disorders, in fact not just the same chains but also the same alleles.” He stressed uncertainty in how strong the relationship was, however.

Scott said examining how the variation of genetic factors may translate into varied symptoms being expressed “certainly is a good target for future research”; “It is not known how many genetic factors contribute to either of these diseases but it is likely that not all are necessary to trigger disease.” “New questions will always arise from any major study,” he told our reporter. “Certainly, new questions about bipolar and schizophrenia are now able to be formulated on the basis of the results presented in the two reports.”

These weren’t the only studies to look at the two diseases together in September. The British Medical Journal carried research by a team from the University of Oxford and King’s College London that examined mortality rates in England for schizophrenia and bipolar sufferers. They found both groups continued to suffer higher mortality rates than the general population – whilst these included suicides, three quarters of deaths were down to ailments such a s heart conditions. General death rates dropped from 1999 to 2006, but sufferers below 65 saw their death rate remain stable – and the over-65 saw theirs increase.

“By 2006, the excess risk in these groups had risk to twice the rate of the general population, whereas prior to that it had only been 1.6 times the risk, so it increased by almost 40%,” said Dr Uy Hoang of Oxford. The study looked at every discharged inpatient with a diagnosis of either condition in England in the relevant time.

Hoang said at the time of the research’s release that doctors should devote attention to predicting and preventing physical illness associated with mental disorders. His study comes at a time when the UK has launched a “no health without mental health” strategy which does attempt to screen for physical illnesses coinciding with mental illnesses. The government aims to reduce the death rate of those with mental disorders.

Rodney Scott described this research result to Wikinews as “Possibly” connected to genetic association with other hereditary ailments, such as cardiovascular disease; he told us another possibility is that “The continued raised mortality rates may be associated with the diseases themselves.”

“We believe the NHS [National Health Service] and Department of Health need to do more to support research and service development for people with bipolar disorder,” Wikinews was told by Suzanne Hudson, Chief Executive of London-based British charity MDF The Bipolar Organisation. “The provision of specialist services for bipolar is very limited in the UK and the demand for our services is unprecedented.”

“A genetic test for bipolar would be a useful tool but the science and ethics are very complex,” Hudson told us, referring to the Nature Genetics genetic study. “Just because someone has ‘bipolar genes’ does not mean they might go on to develop it. Family studies of bipolar show that this is a likely outcome of genetics research in this area. Even if it were possible to accurately predict bipolar in this way, questions about how you treat that person are difficult. For example do you start medication that is not necessary at that point in time?”

“Current treatment is not satisfactory” because it does not always work and has “side effects,” Gejman told us. Robert Whitaker, a US medical journalist and book author, told an audience in New Zealand at the end of August that evidence suggests antidepressant drugs may make children and teenagers worse – “You see many become worse and end up with a more severe diagnosis, like bipolar illness,” and the suicide risk may increase.

Whitaker blames commercial interests. “The adult market appeared saturated, and so they began eying children and teenagers. Prior to this, few children and youth were seen as suffering from major depression, and so few were prescribed anti-depressants.”

One possible alternative, raised by a connection between depressive illness and inflammation, is aspirin and similar compounds. “The link between inflammation and mood disorders has been known for sometime and the use of aspirin and other drugs in depression is now becoming more common in the literature,” Hudson says. “Any new treatments for bipolar, which is a very complex and co-morbid illness, has to be a good thing.”

Professor Dr. Michael Berk, chairman of psychiatry at Australia’s Deakin University, recently gave a talk to just this effect. Speaking at this year’s Congress of the European College of Neuropsychopharmacology, held this past month, he also highlighted statins as a treatment. Recognising the link to physical ailments, he told an interviewer “The brain does not exist in isolation, and we need to understand that pathways similar to those that underpin risks for cardiovascular disorders, stroke, and osteoporosis might also underpin the risk for psychiatric disorders, and that other treatments might be helpful.”

Berk also touched upon speed of diagnosis and treatment; “Early interventions can potentially improve the outcome” of bipolar sufferers, he told his audience. MDF The Bipolar Organisation claim an average of ten years is possible before a person is diagnosed. “This clearly is an issue, if we believe that earlier diagnosis and treatment facilitate better outcomes,” Berk told Wikinews. Though he questions the effectiveness of currently-used drugs on advanced bipolar cases, he does not go so far as to say drugs are actively harmful. He told us “it appears that our best treatments work best earlier in the illness course; and that seems to apply to psychotherapy and pharmacotherapy.”

Berk has already performed research using statins which suggests they can form a treatment. He now seeks funding for research involving aspirin. On funding, he tells Wikinews “psychiatric disorders comprise between 16% and 22% of the burden of disability (depending on who measures it), attracts^[sic] just over 6% of the clinical budget at least in Australia and 3% of the research budget. Research as a discretionary spending item is at great risk.”

Berk’s research, in the past, has been funded by companies including GlaxoSmithKline. Hudson told Wikinews this did not concern her charity; in fact, they welcomed it. “We believe it is important pharmaceutical companies continue to invest in the development of new medications for bipolar. This is how it works in all other health specialities and mental health should be no different.”

“There is a need for greater education for mental health professionals and GPs [general practitioners] about bipolar [in the UK],” she told us. “As the national bipolar charity we receive many, many calls and requests from GPs and other health professionals for our leaflets and information sheets which is fantastic. We very much welcome opportunities to work together for the benefit of individuals affected by bipolar.”

Wikinews contacted the UK’s National Institute for Clinical Excellence (NICE) to discuss issues raised in this article, including future treatments, genetic screening, and mortality rates. NICE did not respond.

Might statins and/or aspirin improve treatment – might they be cheaper, perhaps, or safer? “This is an area of research promise,” says Berk, “however it is too early to make any clinical treatment claims; [all] we can say is that this needs to be studied in properly designed trials capable of giving a more definitive answer.” And what of possible explanations for the increased mortality rate observed in England? Should researchers look at whether bipolar influences more than just the brain, or if it is linked to other genetic conditions?

“For sure,” he told us. “There is new evidence that similar pathways contribute to the risk for both medical and psychiatric illness, both in terms of lifestyle factors, and biomarkers of risk.”

Wednesday, April 13, 2005

Tony Blair today launched the Labour Party’s 112 page manifesto for a third term, entitled “Britain: Forward not back”, at London’s Mermaid Theatre this afternoon, promising not to increase income tax or VAT.

Blair, with Chancellor Gordon Brown, described the manifesto, which focused on economic policy, as “radical”, “quintessentially New Labour” and giving people the “chance to succeed and make the most of what they have”.

As well as economic promises, the manifesto pledged better social housing, increased funding and reform of education and the National Health Service and the introduction of community police patrols. The manifesto does not promise a freeze on National Insurance, the income-linked tax which funds the NHS and pensions.

Conservative leader Michael Howard said that the British people had “heard it all before”, and reiterated claims that Labour would have to increase taxes significantly in the third term.

Deputy leader of the Liberal Democrats, Sir Menzies Campbell, whose party was the only mainstream party consistently against the Iraq war, said Labour would “not be judged by their promises, but by what they have done”, adding that Labour have not kept their previous promises.

The Conservative Party and Green Party launched their manifestos yesterday, and the Liberal Democrats launch theirs tomorrow.

Saturday, July 23, 2005

NASA has announced that the Space Shuttle Discovery is due to blast off on Tuesday 26 July at 10.39 am EDT.

The news that the 43 hour countdown will be restarted on Saturday comes after the successful resolution of the problems that forced the aborting of the previous launch attempt.

The countdown includes 28 hours of scheduled “hold time” bringing the total time period up to Tuesday.

The launch had been scrubbed previously due to a faulty main fuel tank sensor which was sufferring from electromagnetic interference. Engineers fixed the problem by improving the electrical grounding of the system to reduce interference.

Wednesday, March 5, 2008

The implosion of a relationship between Wikipedia founder Jimmy Wales and journalist Rachel Marsden has resulted in controversy and international headlines. Associated Press and ABC News have also reported on questionable activity by Wales involving Wikimedia Foundation expenses. The Wikimedia Foundation is a donor-supported non-profit organization which runs Wikipedia.

Marsden had contacted Wales two years ago about concerns she had over the article about her on Wikipedia, and Wales determined the article was not compliant with Wikipedia’s standards. The tech blog Valleywag revealed Wales had a personal relationship with Marsden, and posted supposed transcripts of their instant message conversations on its site, www.valleywag.com. Wales and Marsden met in February, and The Times reported that “An apparent transcript of their conversations before that meeting suggests that, although Mr Wales had withdrawn from the editing process, he was still influencing the editors.” The Times quoted Wales from the chat logs as having stated to Marsden “The truth is of course a much worse conflict of interest than that; but that will do.” — in reference to his conflict of interest regarding Marsden’s article on Wikipedia.

Wales posted a public statement on Saturday on Wikipedia addressing the matter, and stated that his relationship with Marsden was over: “First, while I find it hard to imagine that anyone really cares about my sex life, the facts are: I am separated from my wife. I considered myself single at the time of my one meeting with Rachel Marsden on Feb. 9, 2008 … I am no longer involved with Rachel Marsden. Gossipy stories suggesting that I have been in a relationship with her ‘since last fall’ are completely false … I care deeply about the integrity of Wikipedia, and take very seriously my responsibilities as a member of the board and as a member of the Wikipedia community. I would never knowingly do anything to compromise that trust.” With regard to the conflict of interest in Marsden’s article, Wales had acknowledged to a team of Wikipedia editors in February 2008 that he and Marsden “became friends … and that we would be meeting about that,” and stated “I recused myself from any further official action with respect to her biography.”

On Sunday, The Canadian Press reported that Marsden had posted photos of herself on Ebay, and was selling items that Wales had left at her New York City apartment. In her Ebay posting, Marsden stated: “Hi, my name is Rachel and my (now ex-) boyfriend, Wikipedia founder Jimmy Wales, just broke up with me via an announcement on Wikipedia … It was such a classy move that I was inspired to do something equally classy myself, so I’m selling a couple of items of clothing he left behind, here in my NYC apartment, on eBay. Jimbo was supposed to come visit me in a couple of weeks and pick up some of his stuff, but obviously that won’t be happening now.” Marsden told The Canadian Press “It didn’t really help matters that Jimmy chose to announce the breakup to the entire world via Wikipedia (which apparently now is an online encyclopedia that doubles as a personal soapbox?) rather than to me directly (which he did much later, in an instant message discussion).”

Marsden placed a t-shirt and sweater which she said were left at her apartment by Wales up on Ebay, and started the bidding for each at ninety-nine cents, with the auctions set to end on March 12. By Monday, bidding on the t-shirt had reached US$300, and by Tuesday the highest bid had reached $12,200. In an email to The Globe and Mail, Marsden stated “My only focus right now, to be really honest, is on my career and finding a way to get back into print, TV, or radio here in NYC,” she wrote. “All of this other personal stuff is just an unfortunate distraction.”

Jay Walsh, the Wikimedia Foundation’s head of communications, told the San Jose Mercury News that Wales’ actions in relaying Marsden’s concerns about her Wikipedia article to a team of trusted editors was within his “routine” role. When asked by the San Jose Mercury News if Wales’ actions regarding the Marsden article could compromise his role with the Wikimedia Foundation and Wikipedia, Walsh responded “No, absolutely not.”

On Tuesday, ABC News carried a story by Wired News reporter Megan McCarthy regarding allegations of “excessive spending” by Wales, and Associated Press also reported on questions involving Wikimedia Foundation expenses. McCarthy reported that former Wikimedia executive Danny Wool, who had left the foundation last year, criticized Wales’ use of Wikimedia Foundation expenses in a blog post. Wool stated that Wales had tried to expense $300 bottles of wine, a $1,300 dinner for four at a Florida steakhouse, and visits to Moscow massage parlors to the foundation, and that the foundation rescinded Wales’ corporate credit card in 2006. Wool also stated that Wales paid the foundation $7,000, after being short $30,000 on receipts for expenses.

Wool told EPICENTER that “There were occasions where he used [the Wikimedia Foundation] for personal advancement under the guide [sic] of the mission. And, as someone who was in there for the mission part of it, I found that rather distressful.” Wool commented in an interview with the San Francisco Chronicle: “Originally, it was carelessness … But as things developed, it became more apparent and obvious that he was taking advantage of the foundation credit card. It was almost like his personal piggy bank.”

In an instant message exchange with Associated Press, Wales denied that the Wikimedia Foundation had taken away his corporate credit card, and asserted that he had made the decision to stop expensing business travel for the foundation. Wales highlighted a statement by the foundation’s executive director Sue Gardner: “Jimmy has never used Wikimedia money to subsidize his personal expenditures. Indeed, he has consistently put the foundation’s interests ahead of his own.” In an email to Associated Press, Brad Patrick, a former attorney for the Wikimedia Foundation, stated “Danny seems interested in blogging his way straight to a lawsuit”.

Florence Devouard, who chairs the Wikimedia Foundation, told Associated Press that Wales had been “slow in submitting receipts,” and that the foundation had rejected Wales’ expense at the Florida steakhouse. Devouard told fellow foundation board members in a private email that she had convinced Associated Press that “the money story was a no story,” and told Wales “I find (it) tiring to see how you are constantly trying to rewrite the past. Get a grip!” Wales told Associated Press: “The board, the current executive director, the previous executive director, and independent auditors have reviewed our books and publicly agree that all of my expenses were appropriate and fully accounted for.”

Media reports speculated on how the controversy would end up being represented in Wikipedia itself. On Wednesday, the St. Petersburg Times wrote: “Wales’ Wikipedia page said only this about Marsden: ‘Wales had a brief relationship with Canadian journalist Rachel Marsden.'” An article in The Australian surmised: “History will decide whether Mr Wales broke his own principles, but before that happens there may well be a Wikipedia page devoted to the controversy.”

Saturday, March 10, 2012

The Kenyan government has dismissed 25,000 striking health workers, mostly nurses, citing failure to heed government orders to recommence work and concern for the welfare of hospital patients. Speaking on behalf of the government, Alfred Mutua stated the workers were dismissed “illegally striking” and “[defying] the directive … to report back to work”, which he called “unethical”. The government asks that “[a]ll qualified health professionals, who are unemployed and/or retired have been advised to report to their nearest health facility for interviews and deployment”, Mutua stated.

The workers, who had been on strike for four days, were wishing to have improvements made to their wages, working conditions, and allowances. The strikes have caused a significant number of Kenyan hospitals to cease operations. According to Kenya Health Professionals Society spokesperson Alex Orina, the average monthly wage plus allowances for health workers in Kenya is KSh25,000 (£193, US$302 or €230) approximately. With an increasing number of reports of patients neglected in hospitals emerging, two trade unions met with the Kenyan government yesterday and negotitated a return to work, although a significant proportion of demonstrators defied the agreement, The Guardian reported.

Orina told Reuters the dismissals were “cat-and-mouse games, you cannot sack an entire workforce. It is a ploy to get us to rush back to work, but our strike continues until our demands are met”. Frederick Omiah, a member of the same society, believed the government’s actions would “make an already delicate and volatile situation worse”, expressing concern that demonstrations may continue in the capital Nairobi, amongst other locations. Kenya Medical Practitioners, Pharmacists and Dentists Union chairperson Dr. Victor Ng’ani described government actions as “reckless”.

Mutua said the health workers were “no longer employees of the government” and had been eliminated from the payroll. While Ng’ani told the BBC of difficulties with finding other workers as skilled and experienced, Mutua reportedly stated that this would not be an issue. “We have over 100,000 to 200,000 health professionals looking for work today,” Mutua commented. “There will be a lag of a day or two … but it is better than letting people die on the floor, at the gate, or suffer in pain”.

Wednesday, February 18, 2009

On Tuesday, the US state of California announced it is ready to notify approximately twenty thousand state workers that they are being laid off. The announcement was made by a spokesman for California’s governor Arnold Schwarzenegger. The cuts would begin at the start of the fiscal year on July 1.

This comes after California lawmakers voted down a budget worth US$40 billion last weekend.

“In the absence of a budget, the governor has a responsibility to realise state savings any way he can,” said Aaron McLear, Schwarzenegger’s spokesman. “This is unfortunately a necessary decision.”

The state is also planning to put all remaining public work projects on hold, which could cost thousands of construction workers their jobs.

California has the world’s eighth largest economy. It has suffered from unemployment and the housing crisis, with Schwarzenegger declaring a fiscal emergency last December.

“We are dealing with a catastrophe of unbelievable proportions,” said Alan Lowenthal, a Democratic state senator from Long Beach.

The budget plan consisted of $11.4 billion in borrowing, $14.4 billion for temporary increases in taxes, and $15.1 billion dedicated for program cuts. The package initially appeared to have enough support to reach the two-thirds majority needed to make the bill a law, but fell short by a single vote. The Assembly was at one point in session for thirty hours, breaking the record for the longest legislative session in the history of the state.

Many Republican lawmakers say they disagree with the tax increases that are included as part of the budget package.

“People don’t realize where California is at — people are losing homes, people are losing jobs,” said Republican state senator Abel Maldonado.

“You’re not going to go back to the people’s pocketbooks to fuel that spending,” added Republican state senator Dennis Hollingsworth from Temecula.

Senate leader Darrell Steinberg wants another session on Tuesday, saying that he would put up the tax provisions of the budget proposal for a vote. “Bring a toothbrush, bring any necessities you want to bring, because I will not allow anyone to go home to resume their lives […] as long as we know […] that 20,000 people will be laid off,” he warned.

Wednesday, February 20, 2008

The battle between the two high definition optical disc formats, Blu-ray and HD DVD has ended after sole HD DVD manufacturer Toshiba has announced it will no longer produce HD DVD players.

In a press conference yesterday, Toshiba president Atsutoshi Nishida announced and confirmed that Toshiba will terminate the R&D plan on HD-DVD products. The key issue to force Toshiba terminating their HD-DVD R&D plan was Warner Bros., who changed their R&D plan from HD-DVD to Blu-ray on January 4.

In what is a reverse of the VHS vs Betamax format war, Sony‘s Blu-ray has come out on top with the backing of major studios and retailers such as Warner Bros. but also Wal-Mart, Best Buy, Netflix, and Blockbuster who announced they would only support Blu-ray exclusively this past month.

Even though Toshiba is currently about to change their R&D plan from HD-DVD to NAND flash drives and micro drives and plan to build two factories in Iwate, Japan, the company will provide the maintenance service on discs and players in the future 8 years.

Sony bundled Blu-ray into their PlayStation 3 game system. Microsoft’s competing Xbox 360, comes with a $200 HD DVD add-on player, whose fate is now undetermined with the demise of HD DVD. Microsoft has said they will wait for what Toshiba has to say.

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