Several wearable devices on display at CES Unveiled, a sneak peek pre-show press event, intend to aid with both fitness and health. Maura Barrett reports, with additional reporting by Rachel Mccubbin.
By Yasmine Robinson
BU News Service
BU News reporter Yasmine Robinson interviews Partners in Health, Jon Shaffer who is the Strategist for Grassroots Organizing in PIH.
BY David Shultz
BU News Service
There is no such thing as the stomach flu. No doctor has ever diagnosed a patient with it. The Internal Classification of Diseases (ICD), which catalogues every single disease known to man, doesn’t contain a code for it. The stomach flu is a blanket term used by people to describe any number of illnesses. It can describe brief viral infections, food poisoning, or a cold. It’s a catch-all for “I was sick for a day or two.” What it never describes though, is the flu.
The flu, the real flu, is caused by the Influenza virus. If you’ve ever had it, you would remember; most people who get it are sick for more than a week. Common symptoms include fever, body aches, sore throat, head ache, and a dry cough. Most of the time, the real flu does not cause diarrhea or vomiting. If you get the real flu, you’re likely to miss school or work—you’re probably bed ridden. Worst of all, the real flu loves the term “stomach flu.”
The problem with the term stomach flu isn’t just related to its ambiguity. The problem is that the term causes a decreased appreciation for how serious influenza actually is. More specifically, the propagation of the term “stomach flu” makes people less likely to get a flu vaccine. “Oh I had the stomach flu last year, it wasn’t that bad. I don’t need a vaccine.” Furthermore, people who have gotten a flu vaccine will often think their vaccine didn’t work after they get the “stomach flu.” “I’m not getting a flu shot this year! I got one last year and I still got the flu anyway.”
If #vaccine works why do I get the #stomachflu a couple of times a year?
— /home/Monkey!!! (@WSchnes) January 20, 2014
Everybody should get a flu shot. It should be viewed as a civic duty. It’s not about protecting yourself as much as protecting everybody else. There’s a concept called Herd Immunity that describes how if enough of a population is immunized, a disease can’t infect anybody in the population—even the people who aren’t immune to it. The susceptible individuals are shielded by the immunity of the herd because the disease isn’t able to circulate. Using the term “stomach flu” damages our herd immunity. Let’s stop saying it.
by Poncie Rutsch
Dory and Marlin are trapped inside of a whale in the midst of their search for Marlin’s son Nemo. Marlin wants desperately to escape and slams himself into the whale’s baleen. And the whale does spew them out — after a brief Marlin vs Dory struggle…and some excellent footage of the whale’s oral anatomy, complete with a uvula.
If you don’t know what a uvula is, that last sentence probably looked a bit questionable. A uvula is the chandelier of your mouth. It’s a little bit of flesh that hangs down from the roof of your mouth at the opening where your mouth becomes your throat. Say AH and you’ll see it.
[for quality whale uvula footage, fast forward to about 2:00]
But here’s the thing: whales don’t have uvulas. Only a few animals do. And scientists are still trying to figure out whether humans need uvulas in the first place.
In 1992, researchers searched the mouth cavities in a number of animals to see if there was even a trace of something that could have evolved into a uvula – almost like our tailbone shows we may have once had tails. They looked in dogs and horses and cows and apes and sheep. And this is what they found:
“Of all animals in the study, a small underdeveloped uvula was found only in two baboons. We found that the human uvula consists of an intermix of serous and seromucous glandular masses, muscular tissue, and large excretory canals…. Thus, the uvula is a highly sophisticated structure, capable of producing a large quantity of fluid saliva that can be excreted in a short time.”
The researchers also suggested that the uvula lubricates our vocal cords, and could be necessary to make some sounds that are critical for human language. Another camp of researchers disagrees though. They think that it’s just some vestigial trace of our ancestors (again, like your tailbone), without any essential purpose.
Their camp gets a little support from a type of surgery called uvulopalatopharyngoplasty (try saying that five times fast). The surgery doesn’t necessarily remove the entire uvula, but it removes parts of the soft flesh inside the mouth to reduce snoring and sleep apnea. Even those uvula-less patients appear to be communicating just fine.
Look around. Each of the Muppets has a felted uvula so that when they lean back to belt out songs you see a human-like mouth. I bet you’ll see uvulas everywhere now…or at least in every animated movie.
So why bother stuffing uvulas into animals? It’s not like the uvula is an essential part of the human body, let alone one that seems quintessentially human. It would be easy to overlook, except it’s always there. It would seem like the animators just don’t know any better, but when was the first time you even noticed you HAD a uvula?
And on that note, it’s time for some obligatory Muppet uvulas.
By Kasha Patel
BU News Service
More information at pamojatogether.com
Imagine you must visit 100 houses a month in your town. At each house, you spend time with the residents, asking how they are feeling and addressing any of their health issues. Then, you notice that their living conditions are very unhygienic. So, you teach them to wash their hands with clean water before eating and after using the bathroom. You teach them to wash and hang their clothing. You play a critical role in maintaining your residents’ health. Without you, the healthcare system will falter. But, you are not getting paid anything for doing this job.
That is the life of a community health worker in western Kenya.
Kenya is largely affected by HIV and malaria, but also struggles with getting people to go to hospitals and practice good hygiene in their homes. Six years ago, the Kenyan Ministry of Public Health and Sanitation implemented a new healthcare plan called the Community Health Strategy in order to improve the country’s healthcare outcomes. One of the changes from the new health strategy was the implementation of community health workers, which the Kenyans refer to as CHWs.
AUDIO: Jackie Atieno is a community health worker in the Butere district in western Kenya. After finding out she was HIV positive, she decided to publicly announce her status, but did not initially receive a lot of support from her peers. When her CD4 count went down, Atieno began antiretroviral therapies (ARVs) to help suppress the HIV virus. Now, Atieno helps other members of her community in revealing their HIV status to the public, motivating them to keep hope, and encouraging them to get proper treatment.
This past summer, I traveled to a rural town in western Kenya called Bondo and reported on the lives of a few community health workers. The reporting expedition was through a program called PamojaTogether with the Boston University Program on Crisis Response and Reporting. The reporting opportunity was great because it allowed me to actually experience what I learned about community health workers in my class at the BU School of Public Health. The literature told me that the community health workers are overworked, sometimes unhappy with their workload, and are not regularly paid, if paid at all. But I didn’t understand the number, gravity, or importance of their duties until I followed community health worker Millicent Akinyi Odhiambo around for few days.
Millicent is a community health worker in the Ting Wangi district in Kenya. She visits 99 houses a month and takes care of 454 people. She provides a myriad of services including checking the health of her residents, installing water sanitation systems by the bathrooms, and encouraging mothers to give birth in a clinic rather than the unsanitary conditions at home. On one day that I followed her around, she and two other health workers visited elementary schools in the area to administer Vitamin A supplements to pre-school aged children.
They walked to and from each school, which were kilometers apart. Because I was with them, they offered to get a bike to take us from each school. Wanting to experience an authentic day as a community health worker, I said no and walked with them for kilometers, in the blazing sun, with my long pants, for several hours, with no water. I could barely talk because I was tired and wanted to save my energy, but Millicent and her coworkers were walking, laughing, and enjoying the day. When we arrived at one school, the principal informed us that the elementary school children were not there because their teacher is out on maternity leave. They couldn’t find a replacement so they just told the kids to stay at home. We nodded, turned around, and walked back through the hilly, dirt roads for a few more kilometers.
After she completes her community health worker duties at 4:00pm every day, Millicent opens up her cloth store— her only source of revenue. Most community health workers are not paid for their duties as a community health worker. Sometimes, another country will provide foreign aid in the form of a small stipend to the workers, but it’s not consistent. For instance, Millicent is supposed to receive $2,000 a month from USAID (which is not enough to cover her expenses), but hasn’t received any money for months. But she still continue her duties because being a community health worker is an honor bestowed by the community.
Community health workers are either elected or appointed to the position and are members of the community they serve. After they are elected, they receive training and supplies from other countries such as USA, Norway, and Japan to help them carry out their duties. Community health workers are usually people that the community respects and can feel comfortable talking to about sensitive situations, such as their HIV status. For Millicent, as well as many other community health workers, the honor of being a community health worker and a genuine desire to help members of their community is their primary motivation.
And it’s working. In the Ashirembe area in the Butere district, community health workers have motivated eighteen out of twenty two mothers to give birth in hospitals in this past year. The Siaya district has also had measurable success with more mothers attending antenatal clinics (see picture to the right). When I talked to the community members, many were happy with their community health workers. Millicent loves working as a health worker. When she was asked to be a health worker, she was so excited because she’s always wanted to be a nurse.
It’s amazing to me that these community health workers do so much work and expect no pay, but I understand how it works after my brief but valuable time in Kenya. That is the culture in Kenya, at least in the area that I was in. Millicent and her fellow community health workers do the work because it’s an honor in their community. And to have an entire portion of the Kenyan healthcare system be based on volunteerism, well, to me, that’s impressive.
For more in-depth health reporting stories from the PamojaTogether program, visit www.pamojatogether.com
Amid a deep recession and a slow economic recovery, the fertility rate is below the replacement level of two-point-one percent. Withe the baby boomers reaching retirement, the aging of America will have consequences. BUTV’s Sandeep Chandrasekhar investigates in Boston.
By Poncie Rutsch
BU News Service
Many a student spends the summer lifeguarding at the local pool. Swimming without a lifeguard almost feels irresponsible. Yet CPR is only about 10% effective. Even when lifeguards do their best, the odds are not in their favor. WTBU reporter Poncie Rutsch interviews a group of young lifeguards as they train at the BU pool.
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By Angelo Verzoni
Boston University News Service
BOSTON – “Put him in a body bag!” chanted the boisterous, banner-wielding bunch of teenagers, bleeding red, white and black, at a Scarborough High School ice hockey game.
“It’s all in good fun,” Andrew Reichl, a former student at the southern Maine high school, where ice hockey is as popular as L.L. Bean backpacks, said in an email. “It’s all about extremes in high school. If you’re not saying the most outrageous things, you’re not going to get heard.”
But hard hits, especially ones to the head, are no laughing matter. Repetitive blows to the head can lead to chronic traumatic encephalopathy (CTE) in athletes and others, research suggests.
CTE is a progressive brain disease that can result after repetitive concussions, or blows to the head. The Center for the Study of Traumatic Encephalopathy (CSTE), a collaborative effort born out of the Boston University School of Medicine (BUSM) and the Sports Legacy Institute, has been researching CTE since 2008, when BUSM received a $1 million grant from the National Football League (NFL) to fund the project.
CTE is a disease that starts early on as a result of repeated blows to the head, said Dr. Robert Stern, one of the four co-directors at the CSTE, in a telephone interview. It triggers “a cascade of events in the neurons and other brain cells that lead to the accumulation of an abnormal form of the protein called tau,” said Stern. “And that abnormal form clumps together to create what are called neurofibrillary tangles. And that accumulation of neurofibrillary tangles and tau throughout the brain eventually leads to the destruction of brain cells. And as the cells get destroyed, symptoms begin.”
The symptoms are broken into three areas, explained Stern: cognitive, behavioral and emotional. Cognitive symptoms include changes in memory and changes in what are known as executive functions, such as multitasking, organization, judgment and impulse control. Behavioral symptoms include rage, problems with emotional control and changes in personality. Emotional, or “mood symptoms,” include depression, apathy and thoughts of suicide.
As the disease progresses, symptoms in all of these areas can worsen, said Stern. In some people, problems with motor functioning occur, such as loss of balance, falling or difficulty speaking. “In a subset of individuals, there’s the development of a motor neuron disease like ALS, or Lou Gehrig’s disease,” said Stern. “And then, eventually, if someone lives long enough and more brain tissue is destroyed, the person develops a full-blown dementia.”
So, is CTE an alienesque super-disease sprung up in the last decade or so?
Not quite; in fact, the longtime bane of boxers, it is far from it. CTE is the same thing that used to be referred to as “punch drunk,” or dementia pugilistica, said Stern. “We’ve known about the longterm effects of boxing, which is what ‘punch drunk’ and dementia pugilistica are, since 1928, when the first scientific article was published in the Journal of the American Medical Association.”
Exposure to repetitive brain trauma – more or less, blows to the head – is the necessary variable for developing CTE. But it is not sufficient for developing the disease. “In other words, not everyone who hits their head over and over again develops this progressive brain disease,” said Stern.
“Anyone who might have a history of being hit in the head over and over again is at risk for developing CTE, whether it’s a boxer or a football player or a hockey player or a soccer player,” said Stern. But the scope of those at risk is not limited to athletes, he clarified. There is a case of a circus clown, who had been repetitively and, it goes without saying, forcefully shot out of a cannon, who developed CTE, said Stern. “Anything that results in repetitive blows to the head can lead to CTE,” he said.
A lineman in football will hit his head 1,000 to 1,500 times a year, estimated Stern. That is around 20 to 25 g (as in g-force): “The equivalent, each one of those, of running a car into a brick wall at 35 miles per hour. Brain cells are being hurt,” he said, every play of every game and every practice.
“The symptoms of CTE do not usually begin until one’s 30s or 40s or 50s, years or decades after the person stops getting their head hit,” said Stern. And once it starts, it spreads, he said, very much like Alzheimer’s disease.
So what do athletes think?
Nicholas Neugebauer, a sophomore at Castleton State College in Vermont, continues to play football and lacrosse despite having suffered three concussions when he was in high school. “I already suffer from short-term memory loss,” Neugebauer said in a string of text messages, “and I worry about the longterm effects.” But he loves playing too much to give it up, he said.
The NFL is making an effort to increase awareness of the dangers of concussions and prevent them. But many agree that the efforts at the high-school and even college level are lackluster. “They’re making an outreach to coaches in high schools to prevent this type of damage,” William Eldred, a professor of biology at Boston University and expert in neuroscience, said in an interview.
Eldred spoke enthusiastically about the CSTE’s research. The message needs to be clearer, he said. “That’s what they’re establishing. If you have something like [a concussion], depending on the severity, either you don’t come back, or you are out for weeks and then maybe come back.”
At Scarborough High School, efforts to prevent and treat concussions are in full-swing. “The perception of concussions has changed dramatically in the past several years,” Joe Davis, the athletic trainer at Scarborough High, where football, ice hockey, soccer and lacrosse, among other sports, are popular, said in an email. “The biggest thing is to get the word out,” said Davis of the dangers of concussions, “to parents, coaches, and especially athletes.”
Less than a mile from Scarborough High, just down a grassy hill speckled with parking lots, bleachers, an expensive turf field and usually roaming students and past the elementary school and its playground, is Scarborough Middle School. “We’re in the process of creating a protocol for students post-concussion,” Patricia Bolduc, a nurse at the middle school, said in an email. “The football program is still not sanctioned by the school, so we deal directly with parents,” she said, “and have found parents to be very receptive and careful about their children’s well-being.”
As of yet, CTE can only be diagnosed postmortem. Research at the CSTE is moving toward earlier diagnosis, treatment or a cure, said Stern. But until then, awareness and prevention of concussions, especially with regard to contact sports, is key. “Our goal is to try to understand what else, in particular, leads to why one person gets the disease and another person doesn’t, including genetics and possibly specific aspects of the injuries themselves,” said Stern.
Despite efforts by the NFL and forward-thinking schools like Scarborough High and Scarborough Middle School, Stern said he is not content. “I don’t think it’s being given enough attention across all levels of sports,” he said bluntly of CTE and concussions in general.