The Fat Burning Power of Food

There are certain foods that burn more fat than the calorie content of the food itself and others that promote the release of fat from cells. The effects of these foods will be slightly different in each individual. As each person has a different metabolic rate the benefit from these fat burning foods will vary. The faster your metabolism is to start with the better these foods will work to help your body burn fat.

Foods that contain vitamin C:

Your body needs vitamin C to efficiently burn fat. Eating foods that are high in vitamin C can help to metabolize (break down) fat quicker. Vitamin C reduces the effectiveness of fat. It reduces its content and can liquefy or dilute fat. By diluting the fat, it makes it less effective, and easier to flush out of your system.

Foods high in fiber:

High fiber foods are good because they trick your stomach into thinking it is fuller faster, reducing the overall amount of calories that you eat. Vegetables are a great source of fiber and those that have an outer skin can help you to burn fat as they use up more energy being digested.

Some actually have a negative calorie effect in that your body will use more energy digesting them than it receives. A good example of this is celery, cucumber and beet root.

Dairy foods:

Recent studies have shown that dairy products like milk, cheese and yogurt increase the breakdown of fat in cells. Eating dairy products was shown to be far more effective than taking a calcium supplement alone. Ensure that you stick to low fat dairy products only.

Hot and spicy foods:

Eating hot or spicy foods actually increases your metabolism and therefore your ability to burn fat. Chillies are first-rate fat-burners and some research has found they can increase your calorie burn by up to 8% for as long as three hours after eating. This is because the capsaicin found in them is a super nutrient that speeds up your metabolism and helps you burn off more energy.

Water:

When trying to reduce the fat content of your body, whether it is belly fat or bingo wings it is very important to drink lots of water. Water is the only true zero calorie food that occurs naturally. Drinking water keeps the body hydrated. Lack of proper hydration can dramatically slow down your metabolism and this in turn will reduce the amount of fat your body can burn off.

Most bodily functions require water, so if you are not getting enough your body can not function properly.

Commonly people mistake thirst for hunger and eat when they should be drinking water. Drinking plenty of water helps the body to flush out toxins. As the word suggests, toxins are toxic to your body and if they are not removed the body builds a protective layer of fat around them so that they cannot harm the body, these are generally deposited around your middle. By drinking plenty of water and flushing away the toxins rather than storing them as fat you will reduce the total fat in your body.

Negative Calorie Foods:

While all foods have some calories, they all also require energy by the body to digest them and this is where the negative calorie effect comes in. If a certain food requires the body to burn more energy in the digestion process that it actually produces it will create a calorie deficit; i.e. you will have expended more calories than you received.

We all know that in order to lose weight we have to use up more calories than we eat. Adding some of these negative calorie foods into your daily diet will give you a boost to losing weight!

Some fruits and vegetables are the best negative calorie foods. Spinach, lettuce, cucumber and celery are good examples but there are far more out there! Just be aware of how you prepare these foods and do not add too many calories in the cooking process!

Top 10 Risk Factors For Osteoporosis

Are you at risk for developing osteoporosis?  Over 34 billion Americans currently suffer from low bone density that can lead to osteoporosis and potentially deadly bone fractures.  Now more than ever, we want to live long and healthy lives, and prolong our active and vibrant quality of life.  Knowing whether you are at risk for developing osteoporosis can help you maintain your quality of life well into your senior years.

Anyone can develop osteoporosis, but research has shown that certain people have a higher risk of developing this disabling disease.  Here are the top 10 risk factors:

1. Women have a higher risk of developing osteoporosis.  Once a woman is post-menopausal, her risk increases further.  Women who have an early or surgically-induced menopause are also at higher risk.

2. Women who are Caucasian or Asian are at a higher risk.  If you are thin and have a small frame, your chances of developing osteoporosis increase.

3. Has your mother had a hip fracture or osteoporosis?  If so, your risk of hip fracture is doubled.

4. A diet low in calcium, either as an adult or as a child, can increase your risk of developing osteoporosis. 

5. Vitamin D helps the body absorb calcium.  Lack of vitamin D is another risk factor for developing osteoporosis.

6. Smoking cigarettes interferes with the body’s ability to absorb calcium.

7. Excessive alcohol consumption also makes it difficult for calcium to be absorbed.  Bones will be weaker without sufficient calcium.

8. Lack of weight-bearing exercise, or if you have been unable to walk or exercise for an extended period of time can put you at risk. 

9. Long-term use of certain medications can cause osteoporosis.  If you have taken certain medications for asthma or arthritis, or have had chemotherapy treatments, check with your doctor to see if you are at risk for osteoporosis.

10. Eating disorders can lead to osteoporosis, because nutrients are not properly absorbed.

If you think you are at risk for developing osteoporosis, see your doctor.  Although osteoporosis is a serious disease, there are ways to prevent osteoporosis and the fractures that can result.  Your doctor can recommend changes in diet and exercise, regular bone density screenings, and medications that help increase bone density and prevent fractures.

Once you understand the risks of osteoporosis and can address them, you’ll be on your way to living a healthy, active lifestyle no matter what your age. 

Are you at risk for osteoporosis?  Find out how healthy living and exercise can reduce your risk factors for osteoporosis!

Advance Directive Warning

Approx. 1:30 Saturday morning, Dec. 18, 2010

“I think I need help!”

Mom is standing outside my bedroom door, gasping for breath and writhing in pain. She says she waited an hour before waking me up.

(Backstory: When I arrived last night, Mom told me that she sometimes feels “uncomfortable” at night. Knowing that she’d suffered a major heart attack some months ago, I prayed that I’d be there if it happened again.)

We call 911 and I give them the information. They tell me to make sure that pets are secured and the door is open. I say, “I cannot leave my mother’s side.”

After what seems like 10 minutes, I call 911 again. “They’re at the door,” the dispatcher says.

There are two paramedics and four firefighters, including the captain of the Fire Department. Some give first aid, others ask about Mom’s Advance Directive. I find it and point out that it doesn’t say not to treat her.

We arrive at the hospital, a renowned treatment, research and teaching facility. Dr. C. (a cardiologist) and Dr. N., as well as numerous other staff, attend to Mom.

They are very concerned about her Advance Directive. Again, I point out that it doesn’t say not to treat her unless she’s in a coma, and she isn’t.

“She’s very, very ill,” they say. “What would she want?”

In tears, I tell them, “I know what she wants. She’s a very happy person. She loves life. She’s going to my brother’s for Christmas. Her great-grandkids are coming to visit next month. She doesn’t want to go anywhere.”

I show one of the doctors the part of her Advance Directive that says she doesn’t want to be maintained if in a coma or vegetative state with no hope of recovery. “She’s not in a coma,” I say. He glances meaningfully at her motionless form, hooked up to machines.

If I had my wits about me, perhaps I could say something like, “If they brought in a 20-year-old football player who’d just had a major heart attack and you administered morphine, how sentient do you think he’d be? And would you be so quick to write him off?” But I can’t form these thoughts, let alone express them. I just have a feeling that there’s something wrong with the doctor’s reasoning.

They talk about the possibility of surgery to save her life.

I call my brother, Jamie, and his wife, Shelly (a geriatric nurse). Shelly thinks Mom will die without the surgery. So do the doctors. Jamie and I give permission.

Jamie and Shelly arrive at the hospital.

The doctors decide against surgery. Too risky. We agree.

Dr. N. wants to discuss the options right there, in front of Mom. But I’ve read that comatose–or seemingly comatose–patients sometimes give up and die when they hear a negative prognosis.

I say “Not in front of her,” and we go to the Quiet Room. Dr. C. explains again that surgery is not an option. We agree.

Dr. N. wants to terminate medical treatment (IV medications). He tells us about an experience in medical school when the professor made it hard for the students to breathe, and recounts his terror. He believes she’s suffering and sure that she “will never regain cognitive function.”

I want her to see her grandkids and great-grandkids, some on their way and others here in town. “She won’t know them,” says Dr. N.

“Are you sure?”

He’s sure.

He talks more about how she’s suffering. I don’t remember the wording, but I believe there was some indication that she was already in a vegetative state.

Jamie and I give permission to terminate medical treatment on the grounds that Mom is probably suffering intensely and will never regain cognitive function. Just before giving final permission, I look to Heaven for wisdom and believe that the answer I hear is yes.

They maintain the same dosage of blood thinner but lower the dosage of medication that’s keeping Mom’s blood pressure up.

[I’m calling what happened next a miracle, but may never know, at least not in this life, how it happened. Perhaps Dr. C. didn’t want to disagree with Dr. N. in front of us, but quietly went ahead and did what he knew was right. Or perhaps–and this may be more likely–they maintained the one medication and only lowered the other one in order to give Mom a quiet passing, without another cardiac event that would clearly upset the family. However it happened, I believe that I heard “yes” not because it was the way to go regarding treatment, but because the answer satisfied Dr. N. and made way for what followed.]

Mom’s blood pressure drops. We gather around to sing and pray. Through her mask, Mom says, “I have so much to be thankful for.”

“Thank you for being here with me,” she says to each of us–Jamie, Shelly and me.

“I love you, Mom” I say.

“I love you too,” she answers.

We recite the 23rd Psalm. When we get to “Surely goodness and mercy shall follow me all the days of my life,” Mom joins in. (She remembers this later.)

The chaplain sings “Be Thou My Vision,” Mom’s favorite hymn.

We sing “Amazing Grace” and “Jesus Loves Me.”

I recite John 3:16 (“For God so loved the world… “) and John 1:12 (“As many as received Him… “)

“I can’t speak very clearly,” Mom apologizes through the mask.

“Yes, you can,” I counter. “You just said, ‘I can’t speak very clearly.’ ” She laughs. (Mom remembers this later.)

We watch as Mom’s blood pressure stabilizes, then starts to rise. My nephew comes. Mom thanks him for coming. Her sister comes. She and Mom chat briefly.

Jamie and Shelly’s friend comes. They joke about the last time he came to see her in the hospital, and got her a bed by the window.

The mask is uncomfortable and no adjusting can make it right. Staff replace the mask with prongs.

Mom sits up and chats freely. I crack a joke. She laughs, and the monitor shows deepening respirations.

She wonders why everyone looks so sad (she remembers this later), and… could she have some breakfast?

After tea with toast and jam, Mom is moved upstairs to a cardiac unit. My husband, our daughter and our son arrive. Mom is delighted to see them, but sorry that she worried them. Another of our girls phones and she and Mom have a nice chat. Mom’s happy, but just a little disappointed that my brother can’t get the Nicaraguan connection of the family on Skype.

She will never regain cognitive function… she won’t know them.

Later in the afternoon, she’s moved to another ward. When we leave for the night, Mom says, “I’ve had a wonderful time.”

On Sunday Mom enjoys more visitors and a newspaper crossword puzzle.

On Monday Dr. A, another cardiologist, is making his rounds. I ask him, “If a 90-year-old person had as severe a heart attack as Mom did, would you say she would never regain cognitive function, based solely on her age and the severity of the attack?”

He seems surprised at the question. “A total loss of cognitive function? Did someone tell you that?”

Yes, I answer without elaborating.

No, he answers, he wouldn’t predict that. In fact, Mom could well be home for Christmas, and should be able to continue living in the same situation.

She and I enjoy a Christmas carol concert at the hospital in the afternoon.

That evening, she finishes proofreading her grandson’s introduction to his Honors thesis. She’s found a few minor errors and is looking forward to reading the paper when it’s finished. Mom wonders if a picture of the man my nephew is writing about might be useful. She found one on the Internet last year, but can’t remember the website. I note the suggestion on my nephew’s paper.

Mom writes Christmas checks for the grandchildren and great-grandchildren, and asks Jamie to bring the solution to the crossword puzzle tomorrow.

she won’t know them

On Tuesday a medical student informs us that there was no significant new damage to the heart from this, Mom’s second, heart attack.

Mom is discharged Wednesday afternoon. She delivers thank you cards to the cardiac ward and the Emergency Department.

Pity the poor clerk on Emergency. Even though Mom hands her the card in what is obviously a greeting card envelope, the woman thinks it’s her Health Care card. (Do you think maybe they don’t get many thank you cards on Emergency?)

My concerns with the Advance Directive, at least as we had it written, are as follows:

1. A doctor who favors premature termination of the elderly (my term) may interpret terms such as “in a coma”, “in a vegetative state,” and “no heroic measures” in a way that neither we nor or our loved ones would want.

2. In a somewhat different case, I have a friend who watched helplessly as her father gasped for breath. Apparently staff had interpreted an earlier oral instruction not to use a feeding tube to mean “no intervention”; thus they ignored my friend’s pleadings to give him oxygen. She finally called 911 and paramedics administered oxygen to her father in the hospital. He passed away a week or so later, apparently in relative comfort.

We will never know whether this man was allowed to suffer as he apparently did (there’s no proof, obviously) because staff truly believed no feeding tube also meant no oxygen, or whether they simply felt that he was an old man with advanced Alzheimer’s whose time had come.

My own father passed away at the same palliative care facility. He had specified “no heroic measures” and was given both a feeding tube and oxygen as well as painkillers. I believe he passed away in relative physical comfort. Maybe it depends who’s working that night, or whether the patient has Alzheimer’s, or who’s with them at the time. Dad’s mind remained clear and he was able to communicate orally and in writing until he slipped into the final coma. In addition, his highly vigilant geriatric nurse daughter-in-law was at his side, along with the rest of us.

I once spoke to a nurse who said that she refused oxygen to patients who pointed at the mask, clearly asking for it, because of prior instructions. She said she just held these people and tried to comfort them as they died.

It appears that even a carefully written Advance Directive may result in needless suffering and premature death.

The solution my brother and I are considering is simply a list of agents with full contact information so decisions can be made at the time.

In any case, we need to be very, very vigilant when our loved ones cannot speak for themselves.

Dynamic Face Wrinkle Treatment With Botulinum Toxin

Face wrinkles are of two major varieties. They are dynamic face wrinkles and the static face wrinkles. In this article we are concerned with the causation and treatment of dynamic face wrinkles.

Dynamic face wrinkles occur as a result of excessive muscle activity. The reason the dynamic face wrinkle is labelled thus is because it comes on when the muscle contracts and disappears when the muscles are relaxed. In the face, because the muscle layer is just underneath the skin with a minimum of subcutaneous tissue in between, it is quite easy for face wrinkles to occur whenever the underlying muscles contract. This occurs most commonly and importantly in the forehead (resulting in forehead lines or surprise lines), in between the eyebrows (resulting in frown lines or glabellar lines), and the corners of the eyes (resulting in eye wrinkles or crows feet). There are other areas, of course, on the face where muscular contraction produces dynamic wrinkles. Examples are the under eye wrinkles, the bunny lines on the bridge of the nose, and the smoker’s lines that occur when one purses the lips.

Face wrinkles, both dynamic and static, have the effect of making the sufferer look older and more unpleasant than he or she is. This impacts on the person’s personality and outlook in life, and can affect his job performance as well as that all important first impression when he or she meets clients or potential friends. It is thus very important when one notices the first signs of face wrinkles that there be an aggressive effort made to eliminate that wrinkle, or at the very least, reduce its degree of severity. It is also well known that persistent contraction of muscles will result in the wrinkle being permanent, or static, that is, it does not disappear on relaxation of the muscle, and is then harder to treat.

Treatment of dynamic face wrinkles is, by and large, through the use of a substance that effectively but temporarily weakens or paralyses the facial muscle groups that produce the wrinkle. Although there have been claims of substances that can work when applied to the skin, it is well known that by far the most effective substance that can be used is an injectable item called botulinum toxin.

Botulinum toxin is the purified toxin of a bacterium called Clostridium botulinum. The two most common brands in the world are Botox and Dysport, both of which use a specific variety known as botulinum toxin type A. Botox is produced by Allergan of USA and Dysport is from Ipsen in Britain.

Botulinum toxins such as Botox (also commonly misspelled as Botax) work by blocking the neuromuscular junction of the muscle, thus causing the effect of paralysis or weakening of the muscle, during which time the effect is very positive, being the disappearance of the wrinkles on the part of the face which was injected. This effect is not permanent, lasting 4 to 6 months from the time of injection. After this time period, the affected muscles gradually recover their function, and the face wrinkle will recur. Botox is very safe and specific if used in the proper hands. Thus if one wants to have Botox treatment to remove face wrinkles, one should go to trained practitioners.

Injection of Botox is generally through the use of fine needles which hardly cause any pain, as very small amounts are injected directly into the target muscle. Bleeding is minimal, if any.

The effect of weakening of muscle, resulting in disappearance of the face wrinkle, takes place within 4 days. Generally no side effects are noted if Botox is injected properly. However some people complain of some tightness of the forehead or mild headache a few days after the Botox injection. This is thought to be due to an unconscious reflex contraction of the surrounding untreated muscles as the treated ones are no longer working. This tightness which does not cause any harm wears off after a few days.

Masaoka Shiki: The Great Haiku Master of Japan

Japanese haiku master, poem reformer Masaoka Shiki wrote around 900 Chinese poems, about 2300 tanka and composed over 25,500 haiku in his diminutive life. He is one of the four great masters of haiku along with Matsuo Basho (1644- 1694), Yosa Buson (1716- 1783) and Kobayashi Issa (1763- 1827). Masaoka Shiki (pseudonym Masaoka Tsunenori) was born in Matsuyama, Iyo province (now Ehime prefecture) on 17 September 1867 to a samurai family. He was called Tokoronosuke, later he changed his name to Noboru. In 1872, Shiki lost his father. He entered elementary school in 1873 and studied Chinese classics under his maternal grandfather Ohara Kanzan and calligraphy under an uncle.

Ohara died in 1875 and Shiki’s Chinese studies continued under other tutors. In 1878, he has written his first poem in Chinese. He entered Matsuyama Middle School in 1880 and in 1882, he composed his first tanka. He was withdrawn from school in 1883 and went to Tokyo where he entered Kyoritsu School. In 1884, he passed entrance exam of University Preparatory School (later higher middle school). In 1889, he wrote The Origin and Development of Poetry as essay for school and adopted pen-name Shiki (Japanese cuckoo hototogisu). At this time he begins to suffer from tuberculosis.

After graduation in1890, Shiki entered Japanese Literature department of Imperial University (now Tokyo University). In 1891, he skipped final exam and withdrawn from university. Then he became haiku editor of Nippon and started to reform of the Japanese poetic form. Traditional Japanese literature was attached to yugen (subtle, profound and tranquil beauty) and wabi (quiet refinement). He advocated a realistic, descriptive poetic style and a ‘third literature’ which would be non-imaginary and non-realistic at the same time. He avoided scholarly jargon and advised to use both imaginary pictures and real ones but favored the real ones.

At that time, the traditional seventeen-syllable verse form was considered incapable of expressing the complexities of modern life. Shiki wrote the theoretical text on how to improve haiku, Haiku Taiyo, The Element of Haiku. He introduced the term haiku to replace hokku. He launched the word shasei (delineation from nature or sketching) to describe his methodology of using contemporary language and realistic images. His haiku were characterized by visual description and a concise style.

He attacked on the Literary World and Some Remarks on Basho serialized in Nippon in 1893. In 1895, his illness was severely aggravated while working in China as a war correspondent with the Imperial Japanese Army during the First Sino-Japanese War. On return, he was hospitalized in Kobe. Then he stayed with Natsume Soseki in Matsuyama and leaded a group of young haiku poets. In 1897, he with his disciples founded the literary journal Hototogisu. The Haiku World of 1896 and The Haiku Poet Buson serialized in Nippon. At that time, he has undergone surgery for complications of tuberculosis.

In 1898, series of lecture discussion on Buson held at Shiki’s home. Letters to a Tanka Poet serialized in Nippon; he started to reform tanka. At the beginning of the twentieth century, Shiki with his followers refreshed the old tanka form, replace it 31-mora/syllables waka/poetry. Meetings of Negishi Tanka Society begin at his home. Records of the Little Garden published in Hototogisu and prose movement begin.

In 1900, his essay on Realistic Prose successively published in Nippon.

In spite of ill-health, he maintained a prominent position in the literary world. He frequently mentioned his illness in his poems but maintained an emotional detachment from his physical suffering. In 1902, volume one of Selections from the Haiku Note-book of the Others Den was published and A Six-foot Sickbed serialized in Nippon. He suffered from caries of the spine but he faced his illness and physical pain with dignity and ironic humor. At last, he died on September 19 1902.

Shiki’s most important writings are Dassai Sho-oku Haiwa (1892), Haikai Taiyo (1895) and Haijin Buson (1897). Basho Zatsudan (1894) was a critical examination of the principles of Basho. His two diaries, published in 1901-1902, combine qualities of the classical Japanese poetic diary with the self-revelation of modern autobiography. A volume called Songs from a Bamboo Village (1904) appeared posthumously. His other works are Bokuju Itteki (1901), Byosho Rokushaku (1902), Gyoka-manroku (1902), Take No Sato Uta (1904), Sh. Kushu (1909), Shiki Zenshu, 1975-78 (25 vols.), Masaoka Shiki: Selected Poems (1998) etc.

Renters and Landlords – The New Market

More renters will be looking for rental properties across the country and of course in Cleveland Ohio area with the increase of foreclosures. It's inevitable that with supply and demand, rental property will be critiqued by renters and landlords will be critiquing tenants. There is to a sort of happy medium in this equation. Many new renters will have tarnished credit and rental history as they're just entering or coming out of a foreclosure. Most landlords these days require good credit, past recommendations and references from previous landlords.

So what do you do? How do you ensure getting selected as the new tenant and how do you select good tenants? For both property owners wanting to rent and previous home owners needing a new place to call home, there are things to remember and guidelines to follow.

Landlords: It may be time to scrap your previous application form and make some needed changes for the changing times. Ask if their previous place of residence ended in a foreclosure. If it did, you can contact the current listing brokerage about the condition of the home when they first listed it. This may give you a good indication of how they kept the property and if there was a major damage to the home when they left. You can also find out online using your county auditor website if the rental applicant had previously owned a home and what happened to it.

A more in-depth detailed explanation of why a potential tenant desires to rent your property and relying on references outside of previous homeowners may be necessary. Try focusing on long term references that can vouch for the applicable. Employers are a good resource as well as past employers. You can learn a lot about an applicant's character and responsibleness by talking in detail with their employers and even previous neighbors.

Try being a little more lenient with the credit history and understanding of the potential renter's current situation. Not everyone will fit a standard mold of acceptance and each person / family may need to be considered individually. Remember that just because they lost their home due to foreclosure and not being able to keep up with the mortgage or not being able to refinance a ridiculous loan, does not necessarily mean they're bad renters. Some however will be. You'll need to check employment thoroughly and make sure your lease is complete covering all aspects of fees for late rent, eviction proceedings and damages.

Renters: If you're looking to rent a home now that you've recently lost yours or even if you have not been involved with a foreclosure, remember that the market is a little tougher now for rental property. Selections are a little tighter and finding the perfect home in your price range may require acting fast and dealing with the competition of other renters on the market. When looking for a property to rent, understand that there will be different types of properties and landlords out there.

Type A landlords will likely be a family or individual that can not unload the home due to owed more on it than it's worth. Some of these landlords will have moved out of the state or area due to relocation and are temporarily trying to rent their property. These homes will typically rent for what is owed on the mortgage and may not be in the best condition. Ask this type of landlord why they're renting and if they own other properties. A Type A landlord may not have the ability or means to tend to the property or repairs like a local or more experienced landlord. Make sure your rental agreement spells out who makes repairs and takes care of the exterior and interior upkeep of the property.

Type B landlords are a tad more experienced and often do this for a living. Many own multiple properties and either take care of them personally or have a team and / or property manager involved to take care of any 3am water heater leaks. Remember, not ALL are on top of things just because they're local or do this for their business, but asking them in advance how they maintain the property's needs may give you an indication of their character as a landlord. Many of these type B property owners are also in it for the profit, and rent may be a little higher. Some also buy cheap properties and rehab them for the sole purpose of renting them out for profit. Keep an eye on the competition and make sure you're renting at a fair price for the condition, area and size of the home. Check for quality in the upgrades like carpet, paint, and kitchen and bathroom fixtures and appliances. Remember that you'll be living and using this home. Wear and tear often show more with cheaper rehab jobs. You might get stuck losing your security deposit and / or making certain repairs to these types of rehab homes.

Bottom line: Shop around until you find something or someone that fits you. Rly more on your gut and first impressions to determine if your landlord or potential renter is a good fit. Relying only on the past or credit score numbers may cost you a good renter and falling in love with a property without knowing more about the landlord could give you endless heads.

Prevent Digestive System Cancers

Cancer is the growth of abnormal cells. These changes cells grow and they can form into small tumors. The tumors can place pressure on nerves or blood vessels or they can interfere with the function of organs – such as obstruction the intestines. Some cancers grow slowly and it can take years for them to become life threatening – though others can grow very quickly. Cancers are named according to the type of tissue in which they occur – carcinomas, begin in the tissues of organs (these are the most common gastrointestinal cancers); Lymphomas develop in the immune system, particularly in the lymph nodes; Sarcomas start on the connective tissue such as muscle or bone.

Cancer can be through the digestive tract but the most common sites are the colon and rectum. Symptoms of cancers in the digestive tract include:

O blood in the stool

O difficulty in swallowing

O abdominal pain

O unexplained weight loss

O changes in bowels habits – not related to changes in diet.

You should have any of these symptoms checked by a health professional. If cancers are detected and treated early enough the prognosis is good.

Colorectal cancers begin with changes to the intestinal lining and the development of polyps. While not all polyps become cancerous almost all colon cancers start as polyps.

Some of the factors that increase the risk of colorectal cancer

O A diet that is high in saturated fats, particularly red meat such as beef, pork and lamb and a diet that is low in fruit and vegetables.

O A diet and lifestyle that increases the level of toxins in the bowel. Toxins cause problems for the body – they irritate tissues, cause cells to break and mutagenic changes to occur.

O Inflammatory bowel disease – ulcerative colitis, irritable bowel disease, Crohn's disease all increase the risk of developing colorectal cancer.

O Smoking – colorectal cancer rates are higher among smokers than non-smokers.

O Polyps – nearly all colorectal cancers start as polyps.

O Hereditary – if other members of your family have colorectal cancer then you are at increased risk.

Your hereditary predisposition is a factor over which you have little control but there is a lot that you can do to reduce the risks associated with colorectal cancer – as well as other cancers. Having a healthy lifestyle and reducing the toxins that you are exposed to and in particular those that you ingest will greatly assist.

One of the most important things that you can do is to have a clean colon. So then what is colon cleansing? Proper and safe colon cleansing is the process of enabling the body to remove the stored and harmful substances by re-establishing the normal balance and function of the colon and the rest of the digestive process. Only through this thorough process is the body able to begin healing and repair and only then can there be a restoration of health and vitality.

The colon processes many vital functions but one of its most important is the effective removal of toxins from the body. There are many factors that are capable to interfere with this elimination process. If the process is slowed or the bacterial balance of the colon is destroyed then toxins that are ingested and are a by-product of normal digestion will be absorbed into the bloodstream. The body will attempt to eliminate then through other routes however these can become overwhelmed. When this occurs the body needs to store the toxins. These stored toxins cause damage to tissue and are the basis of many diseases. They need to be eliminated from the body. Effective colon cleansing provides a safe means for achieving the cleansing of the whole body. When the toxins are effectively removed form the colon then the risks associated with the development of colorectal and many other cancers in the body are reduced.

Discover how to properly cleanse internally to gain and maintain your health and reduce your risk of colorectal cancer with safe colon cleansing (at safecoloncleansing.com). Then get on with really enjoying life.

Caring for a Loved One With Cancer

In April 2014 my mom was diagnosed with breast cancer. Even though almost everyone in her family has had cancer it was a strange sensation. It was still one of those things that happened to other people. Not to us. At the time she was diagnosed, she and my sister were not on speaking terms so it was up to me to relay the news. Oh being the middle man. So began my role in my mother's journey towards being cancer free. It's a role many others take on, and it's not an easy one. It is the role of the caregiver.

I grew up in hospitals. I have various depths of illnesses, so I learned at an early age the importance of note-taking, listening carefully, and getting along with doctors. They are the experts. I am not. But I learned a lot from them, and from nurses and how they treated their patients. Caring for a relative with cancer can, at many times, feel like being a nurse. Essentially that's exactly what caregivers are. This article will showcase what I learned not from health care providers, but from my mom as I took care of her.

The most important part to caring for a relative with cancer is knowing the person. When my mom told me her diagnosis, I was stone-faced and factual. I asked questions about staging, had it metastasized, next steps, etc. There was no point worrying about worst cases until we had more information. But my mom needed me to cry. She needed me to show that this was the end of the world. Looking back, I should have done something, even fake emotions I was holding at bay until we got more results. Through the rest of our journey, she appreciated this part of my care but says she just needed something else at the beginning. Do not get me wrong, I cry pretty much all the time. Once when my husband and I went grocery shopping he picked up four boxes of crackers. I started to cry. There were so many boxes of crackers. But my mom is just as emotional. During her appointments and treatment sessions, she needed someone level headed. So I stopped thinking about crackers and started thinking about the enemy, cancer.

The next important part is knowing the enemy. My mom was diagnosed with stage 2B ductal carcinoma in situ (DCIS). M0 T2 / 3 N1 and HER2 positive to be exact. I went over every pathology report and recorded everything for me and my mom. Being armed with this information made it easier to understand the doctor and the treatment plans, and it also helped me explain to my mom next steps. Most of the doctor appointments went over her head or she could not fully concentrate on them, so I would go over my notes with her after step by step. It helped me process everything, too. Knowing the enemy helped us process the fight.

Another important part to all of this is sacrifice. My husband and I were barely married a year when my mom was diagnosed, and we live in a different city than my mom. To top it off, I do not drive. I took a grayhound to be there for every doctor appointment, stayed a few days after she got her port inserted, and stayed with her a week after her mastectomy which included three days sleeping in the hospital with her. I would do it all again in a heartbeat. I'm so thankful I was able to be part of this journey, but it definitely took its toll on all of us. You need to let your loved one know that the sacrifications that are made, by everyone, are not only willing but desired. At the end of her treatment, my mom got back in touch with my sister and she was able to care for my mom at times (which was easier as they live in the same city) but I still wanted to be there. I wanted to be able to take care of my mom. Any sacrifice I grieve nothing compared to what my mom has had to give up.

December 5th, 2014 my mom was declared cancer free. In that time she lost her hair, lost 20 pounds, had double pneumonia (which put her in the hospital for twelve days), six rounds of chemo, 25 rounds of chemo, a mastectomy, and has now developed lymphedema. Through it all, I've had no greater accomplishment in my life so far than being able to take care of my mom. It's not easy being a caregiver, but I would not trade it for anything and I know most others would say the same.

Diagnosis Coding: Ways to Decode Your Doctor's Notes

If the doctor doesn’t circle a diagnosis, the onus may be on you to find one. Do not let an unfinished superbill ruin your chances of submitting a spot-on claim. If the doctor in your office fails to point out to the ICD-9 code for the condition he tended to, you should read through his documentation to find which diagnoses you should go for.

Open the notes when you have to – and even when you don’t have to

Imagine your doctor hands you a superbill with the procedures circled and the diagnosis left blank. You could ask the doctor which diagnosis to report or you could inspect the documentation yourself. If your office has a policy that covers “coding by abstraction” by certified and qualified medical coders, then submitting charges based on what is supported (documented) in the note is apt, according to Barbara J. Cobuzzi, MBA, CPC, CPCH,CPC-P, CENTC, CHCC, with CRN Healthcare Solutions in Tinton Falls, N.J. As part of your internal policy, the physician should be signing off on these charges as part of your internal policy.

Some practices select to review the documentation and compare it against any diagnoses recorded on the superbill, even when they are not required to. This sees to it that the documentation matches the code selection each and every time.

Confirm with the physician when in doubt

If you’re new at coding diagnoses from the physician’s notes, you should double check your code selections with the practitioners prior to submitting your claims.

“Until a medical coder feels at ease with the ICD-9 books and the codes used more often in their office, it is a good idea to run the choices by a clinician,” according to Suzan Berman, CPC, CEMC, CEDC, senior manager of coding & compliance with the Physician Services Division of UPMC in Pittsburgh.

You never want to pass on a patient a disease or symptom they don’t have or one more severe (or less) than what they have. This is also beneficial to the physicians, because if you choose unspecified codes a lot, they may learn how to document better the patient’s condition into their notes.”

Tip: See to it that your office creates a policy in writing that spells out what you should do when you encounter a superbill with no diagnosis listed. Some doctors prefer that you ask them for information, whereas most others rely on their coders to choose an accurate code.

For clues check the notes

Think about this example of a situation in which the coder must fill up the blanks when the physician has not written a diagnosis on the patient’s superbill.

For instance: The physician’s superbill shows a level-three office with a patient wearing a lumbar orthosis. It also shows a date of injury of three days before the date of service and is missing the diagnosis code.

First step: You refer to the dictation, which reads, “The patient happens to be a 13-year-old female being evaluated as a consultation at the request of Dr Jones for lumbar pain. The low back pain began on 12-9-09 when she did splits during cheerleading.” The doctor completes the remaining history, review of systems (ROS), past family and social history (PFSH), and exam.

Going down through the chart note, you see that the patient brought an MRI and x-ray with her, which showed a hairline fracture to the patient’s third lumbar vertebra (L3).

Under a different heading, the physician has given his assessment, which states: Closed L3 fracture, benign.

The next step: When you look up “fracture” in Vol 2 of the ICD-9 code book, the most specific body area listed is “vertebra, lumbar (closed),” which is 805.4 (Fracture of vertebral column without mention of spinal cord injury; lumbar, closed).

You then turn to Vol 1 and read the information under the “fracture of vertebral column” heading to check for exclusions and see that none apply in this particular case. You do a search under 805.4 to see if by chance the book lists codes for benign or traumatic fractures, which it does not.

To add to it, ICD-9 doesn’t instruct you to add a fifth digit to 805.4. As such, you know that 805.4 is the most spot-on code for your physician’s visit.

Determination of Cold and Hot Spot in Stability Chambers

Back in the day, pharmaceutical companies have made a huge leap forward. When storing the drugs in one way or another may be exposed to a variety of factors, affecting the quality and lead to a change of properties. By destroying the main parameters include increased storage temperature, the action of light, moisture content oxygen or carbon dioxide in the air, the impact microorganisms and so the packaging structure etc. Determination of the effect these factors – one of the most important tasks of the service control quality to the pharmaceutical industry. Climate chambers with humidity control allow you to test the stability of pharmaceuticals, cosmetics, and food substances in accordance with international standards of the pharmaceutical industries.

Climate chambers – devices, specially designed for the simulation of complex weather conditions with extremes of temperature and humidity, as well as maintaining constant conditions for long period of time They operate at a temperature from -70C to + 200C. In addition to maintaining the temperature and humidity chamber can be equipped with lighting and CO2 supply systems. The task of any climatic chamber -to create and maintain a climate with given parameters of temperature and humidity. Special attention is paid to these cells equally distribution of temperature and humidity throughout the volume of the working chamber. Each climate chamber must be tested to meet strict standards and be equipped with all the security features.

In these cells maintain a temperature lower than ambient temperature medium (from 0 C to + 70C) is provided by using a Peltier thermoelectric elements. This allows dispensing with the traditional refrigeration systems. Peltier elements consume 2 – 5 times less energy than freon refrigeration systems, and during their operation no noise and vibration.

Not least the fact that these cells are excluded icing and over drying samples. Heating and cooling systems are located in the chamber air jacket that surrounds the working chamber. It provides fast and accurate temperature control.

In testing climatic chambers are created ideal conditions for temperature and climatic tests. Programming by means of profiles, an active moisturizing and drying (10 to 98% relative humidity) in combination with accurate temperature control from -42 to 190C (without humidity control), or from 10C to 95C (with humidity control) provide opportunities test materials and artificial aging tests.

All components of the climate system perfectly interact with each other, it provides a fast, accurate and cost-effective change in temperature. Electronic coolant injection system ensures optimum cooling performance, and thanks to the automatic defrosting stability chamber can conduct long-term trials without interruption.

The high quality of stability chamber confirmed heating and cooling time Thus, the test cells are cooled from 180 C to -40 C for about 95 minutes, and the reverse heating time is only 20 minutes. Thus hot and cold spot in stability chamber has a huge number of advantages as compared: 1) Comfortable design for operation and maintenance; 2) High-precision temperature control system; 3) Easy and intuitive user control; 4) Optimum air flow for cameras of all sizes; 5) Independent protection unit at the maximum/minimum temperature; 6) Minimum noise; 7) The possibility of combining up to 32 cameras in a single computer network (including connecting to the Internet). In our time stability chamber – the very much needed acquisition for each of the pharmaceutical laboratories.

Problems with Our Health Care System

Given the enormous amount of money that is spent on our health care system and the research that has gone into the various diseases we would be excused if we think that there should be able to trust our health care system to deliver quality health care. Sadly, our Western health care system falls well short of what is desired. Instead of healing and health it largely delivers suffering and further disease. Mendelssohn as far back as 1979 (and he wasn’t the first to suggest it) considers that the public has been ‘conned’ about the benefits delivered by ‘scientific medicine’. There is a great deal of myth that surrounds our current system.

A part of the myth is that medical practice has produced an overall increase in health in the past one hundred years. However, historical analysis has found that general improvements in social and environmental conditions provide a more adequate explanation of the changes than the rise of ‘scientific medicine’. Factors such as the improvement in diet and nutrition, sanitation and improved general living conditions have made the greatest difference.

Hospitals are deadly. Mistakes/errors, accidents, infections, medical drug disasters, diagnostic equipment including; X-rays, ultrasounds and mammograms make hospitals very dangerous. Hard technology has taken over the central role in modern medicine as it is considered effective and efficient. This has however been questioned. It is considered uneconomic and it also causes an unnecessary amount of pain and suffering. Accidents in hospitals now occur more frequently than in any other industry except mining and high rise construction. In addition to this are the medical doctor caused diseases. They are so common that they have their own name – iatrogenesis. Again the general public is unaware of how common this disease is. All told, iatrogenesis accounts for 784,000 deaths each year in the United States – more American deaths than all the wars of the 20th century combined. 98,000 deaths a year are caused by medical errors alone, and surgical errors account for another 32,000 deaths. These figures include only deaths. Officials admit that medical errors are reported in official data only 5 percent of the time, so the problem is much greater – exactly how much greater, no one really knows.

Research carried out in Australia showed that the equivalent of a jumbo jet load of people died unnecessarily died each week in Australia because of medical interventions – this information was contained in an official Health Department report. It was substantially hushed up – because of the potential impact of the information on the general public! We talk about and work to reduce road accidents and we ‘ground’ airplanes that are shown to have faults – but the general public is generally unaware of the risks that they take when they come under the care of the medical health care system.

Apart from accidents and medical mistakes adverse drug reactions and infections account for many of the incidences of iatrogenesis. Adverse drug reactions are very common. Some of these reactions can be minor but they can also be deadly. There are five main groups into which these adverse reactions can be placed. Those that:

  • adversely affect the blood cells,
  • cause toxicity in the liver,
  • damage the kidneys,
  • affect the skin, and
  • affect the unborn baby.

The hazardous side effects listed here do not include allergic reactions or medication errors, but rather the effects of the drugs themselves. Out of the 2.2 million cases of serious adverse reactions to drugs each year, authorities have listed four types of drugs as being the worst offenders for adverse reactions. These are antibiotics (17%), cardiovascular drugs (17%), chemotherapy drugs (15%), analgesics/anti-inflammatory drugs (15%). 198 drugs were approved by the FDA from1976 through 1985 and over 50 percent had serious post-approval reactions. Many adverse reactions were discovered during clinical trials and were covered up by pharmaceutical manufacturers in order to get FDA approval. The FDA is also far from blame free when it comes to giving approval for drugs that have serious reactions. The whole drug approval process has many problems and cannot be relied upon to protect the public from dangerous drugs.

Antibiotics are no longer working on many extremely dangerous bacteria or they only work in doses that that cause serious side effects. The development of these antibiotic resistant ‘superbugs’ is in the order of a crisis. In the years following the introduction of antibiotics they were (and still are) used for the treatment of common colds and flu and other complaints. Antibiotics, such as tetracycline were used (and still are) over long periods of time for the treatment of acne. Ampicillin and bactrim were used for the wrong reasons and there has been a reliance on antibiotics to treat recurrent bladder infections, chronic ear infections, chronic sinusitis, chronic bronchitis and non-bacterial sore throats. The UK office of health Economics in 1997 (cited in Chaitow) reported the following statistics:

· 5,000 people are being killed every year (in UK hospitals alone) by infections that they caught in hospital.

· A further 15,000 deaths are being contributed to by the infections that they caught in hospital.

· One in 16 patients who goes to hospital for anything will develop a ‘hospital acquired infection’.

· Many of the infections acquired involve the difficult to treat ‘superbugs’.

· USA figures published more than a decade ago show that 1 in 10 patients develops an infection that they caught in hospital – this involves around 2.5 million people every year.

· Every year 20,000 of these people die from their infections and the deaths of a further 60,000 are contributed to by the hospital acquired infection – a large number of these involve antibiotic resistant ‘superbugs’.

The current approach of our health care system is ineffective and can potentially cause more harm and damage than the original condition. Although undoubtedly many lives have been saved by timely medical intervention much medical intervention is unnecessary and alternatives, which don’t cause the same devastation, are available. Everyone needs to consider the way they interact with the medical system. Try to avoid the health care system if you can and certainly question your medical practitioner very carefully about any intervention they wish to make. Many will not like this questioning and just want to be seen as the ‘all knowing, all wise doctor’ – but this they are not! Do not be conned and do not buy into myths about the medical profession and health care.

Having said this it is important that if you are currently taking medication that you don’t suddenly stop. Seek information, discover alternatives and discuss changing you approach to health care with a health professional. If your current medical practitioner is uninformed about alternatives (as many are) or unwilling to discuss these with you (as many are) then you may need to seek a different health professional who is prepared to help you improve your health rather than just use medical drug prescriptions or surgery!

All about Hand Wrist Pain

Have you been searching the internet for answers to your wrist or hand pain? Did you search for magnet therapy and get many offers to sell you something but not the answers to your questions? Wrist Pain: Our hands, by design, were not intended for weight bearing, so it’s no wonder that many of us experience pain or discomfort when assuming those Pilates or yoga positions that require us to do just that -bear body weight on our hands. Carpal tunnel symptoms develop from repetitive wrist movement, and keeping your hands in awkward positions. Over time, your forearm muscles become overworked. What are the some of the more common hand and wrist pain cases that a typical chiropractor would treat? For one, overuse or repetitive strain syndromes that can manifest either as hand/wrist or elbow pain.Gout is mainly caused by a build up or uric acid in your blood stream. It usually starts in the big toe and becomes advanced gout when it gets into your wrist.

For the most part you will need a doctor for gout, but you can try cherry juice.Reliving your pain depends on what you are willing to do. You should consider just doing some old fashioned regular exercise. This alone can greatly reduce pain in some people.When your wrists are kept in one position for too long, you can develop a Repetitive Stress Injury, or RSI. This is usually caused by repetitive movements due to work or hobbies.It is very noticeable how a short walk taken before beginning a lesson with your guitar can set you up for a really positive and satisfying session. Do try it and you will find yourself to be much more focused and motivated afterwards.Take a lot of breaks when your doing an activity that aggravates the pain. If only for a few moments, it will greatly reduce the amount of pain. As much as possible, do not engage in strenuous activities such as lifting weights while your wrist is still in pain. Doing so may further worsen the condition. One way of knowing if a pinched nerve is causing your problems is by describing your pain. Do your hands fall asleep? Do your arms, hands or wrists get numb, or tingly?

Your arms, wrists, and hands are influenced by your entire body. The muscles in your upper body, especially, play a huge role in wrist health. When your upper-body muscles are tense, they can ‘clamp down’ on sensitive nerves and blood-flow.Primarily the pianist can be looked at as an athlete. Athletes must perform physical movements over and over in the most efficient way, and their bodies must be strong enough to withstand the requirements.A Creative Musician, who was recording her own compositions using a synthesizer keyboard, was so troubled with pains in her arms and wrists that she was unable to continue her recording sessions. Mild to moderate symptoms can be treated with simple, non-surgical therapies. But if symptoms are persistent and getting worse, you may want to consult a doctor for further options.Self Massage: Along those lines, if you don’t have ice around, you can use your other hand, or a massage tool, or the edge of a desk or wall (anything, really) and massage the muscles in your forearm. Over time you will notice more of a balance between the muscle groups in your forearm and, hopefully, lessened pain.

2012 Most Improved NFC Teams

Every year, the NFL sees a cellar dweller from the prior year’s campaign rises up from the ashes and shocks the public with a sudden boon of proficiency. Figuring out who that team might be before it happens is nearly impossible, mostly because team chemistry and confidence don’t show up on paper. Nevertheless, year in and out, we idiots try like hell to wipe the film off our crystal ball and, with careful analysis, get the edge over the random, dart-throwing mouth-breathers.

However, this time around, I’m not going to pronounce my most-likely-to-succeed. Instead, I’ve identified a handful of teams that bettered themselves the most in the off-season and hope that one of them on the list gels so I can finally prove that thorough examination of the facts consistently beats dumb luck and gut feelings.

CHICAGO

Of all the teams on this list, the Bears might have the most upside – and it all started with the staff. Much maligned GM Jerry DeAngelo left along with OC Mike Martz. DeAngelo’s replacement, Phil Emery, brought immediate help to QB Jay Cutler by trading for Brandon Marshall and drafting a younger version of Marshall in WR Alshon Jeffery (South Carolina). Martz’s throw-to-a-spot philosophy coupled with a suspect offensive was a terrible combination and never a good fit for Cutler, whose arm strength is far superior to his accuracy.

With the receiving core shored up, attention moved to the running game. Matt Forte finally received a much deserved payday, despite concerns about his durability. The Bears addressed this by adding a stellar back-up and potential goal line/short-yardage back in Michael Bush. Emery capitalized on the Raiders’ post-Davis era close-out sale and solidified another weak point by acquiring what some say is the best back-up QB in the league, Jason Campbell.

Still a concern is the offensive line, but Rome wasn’t built in a day and with the Martz-system gone, it won’t be necessary for Cutler to hold the ball for an eternity. New offensive coordinator Mike Tice is an ex-offensive line coach and should be able to improve on the existing line’s technique. Also, look for the tight end to play or more prominent role in 2012 under the former TE, Tice. It’s a shame Greg Olsen isn’t still around to reap the benefits of this new scheme, but Kellen Davis could be the benefactor – especially inside the 10.

The defense is aging and feeling a sense of urgency, but the nucleus should be solid for at least another year. This may be the season that the Bears battle with Green Bay for the division.

TAMPA BAY

It’s unlikely that Tampa can right the pirate ship in a single year, but new coach Greg Schiano (Rutgers) has made tremendous headway in the offseason. Schiano’s blue collar mentality should help a team that lacked discipline, drive and direction.

In addition to a solid draft, the team was active in free agency, landing one of the pond’s biggest fish in WR Vincent Jackson. They spent a second round pick on the dynamic RB, Doug Martin (Boise St), to help awaken a plodding run game.

Defensively, the team selected stud safety, Mark Barron (Alabama), as the 7th overall pick. Ronde Barber will return for his 16th season to help mentor Barron. The team is counting on second round pick, LB Lavonte David (Nebraska) to be the second-coming of Derrick Brooks.

To expect a team this young to regain the success they experienced in 2010 is a bit much. When you factor in the strength of the division, it’s unlikely that the Bucs can via for a playoff slot, but they should be much more competitive in 2011. If QB Josh Freeman and Jackson can develop some early chemistry, they could quickly become one of the more productive duos in the league. With Martin as a viable third-down option, you should see Freeman return to the form that had fantasy football owners drooling two years ago.

ST. LOUIS

New Head Coach, Jeff Fisher has done quite a bit of house cleaning in St. Louis and the general consensus among the league pundits is that all changes are for the better. The defense should be immediately improved with strong additions in the secondary. Controversial Courtland Finnegan comes over from Tennessee and will likely work aside highly touted rookies, Janoris Jenkins and Trumaine Johnson. On the line, defensive ends Robert Quinn and Chris Long make up one of the more formidable pass-rushing tandems in the league and make up the strength of the team.

Fisher has been known to run his RBs hard – especially when their worthy of carrying the load. Expect to see Steven Jackson get a glut of activity this year with rookie Isaiah Pead (Cincy) serving as a complementary change-of-pace back.

The receiving core offers lots of options for QB Sam Bradford, yet all come with major “buts”. Rookies Brian Quick and Chris Givens both look promising, but asking them to step into starting roles might be a bit much, as both are unpolished. Fisher has been very high on former Giant, Steve Smith, but, historically, micro-fracture recoveries have been ruinous to a WR’s career. Danny Amendola should return from his dislocated elbow, but his tenacity far exceeds his raw ability. Donario Alexander and Greg Salas are both raw and both coming back from shortened 2011 campaigns. They should compete for first-team time, but it’s anyone’s guess at this point in the season who might surface as Bradford’s go-to guys.

On the less murky side, don’t forget about TE, Lance Kendricks. While he didn’t meet the high expectations fantasy owners had for him in 2011, a new offensive scheme and a year of familiarity with Bradford could pay off – especially with WR position so unsettled.

So who from the list will make the leap to success and be this year’s 49ers? Probably none of the above. The Seahawks have new uniforms, so look out for them. Something preposterous like that will be the difference. And when it happens, I’ll exhale deeply from my mouth and proudly claim, “I told ya so”.

Protecting Ocean Regions With Robotics

1.1 INCREASING BURDEN OF CHRONIC ILLNESS AND EVER-AGING GLOBAL POPULATION

With the ever-aging global population and the growing burden of chronic illness, there is an increased reliance on the healthcare system (particularly the biopharmaceutical industry) in order or one to achieve and sustain a high quality of life. According to the World Health Organization (WHO), the burden of human diseases have been rapidly increasing for decades with this trend predominantly contributed by population growth and environmental degradation.

1.2 DEFINITION OF MARINE BIOPROSPECTING

Marine bioprospecting is the search for novel compounds from natural sources in the marine environment. These activities have increased a great deal in the last few years likely in part due to the continued technological advances enabling further oceanic exploration, acknowledgement of the rich generic diversity in the marine biome, as well as the pressure from industry to produce given various blockbuster drugs going off patent. Today, about 18,000 natural products have been reported from marine organisms belonging to about 4,800 named species. The number of natural products from marine species is growing at a rate of 4% per year. The increase in the rate of discoveries is largely the result of technological advances in exploring the ocean and the genetic diversity it contains. Advances in technologies for observing and sampling the deep ocean, such as submersibles and remotely operated vehicles (ROVs), have opened up previously unexplored areas to scientific research. Since 1999, the number of patents of genetic material from marine species has increased at the rate of 12% per year. Marine species are about twice as likely to yield at least one gene in a patent than their terrestrial counterparts. Bioprospecting typically requires the collection of a very limited amount of biomass for the initial discovery. Although further collections may be required after a promising discovery has been made, bioprospecting generally does not involve threats to biodiversity comparable to the large biomass removals involved in harvesting resources for food or mineral exploitation.

1.3 THE SUCCESS OF NATURAL COMPOUNDS IN DRUG DISCOVERY AND BIOPHARMACEUTICAL BACK DROP

Biopharmaceuticals are one of the most impressive achievements of modern science. Many biopharmaceuticals offer high efficacy and few side effects. And there is much more to come: radically new concepts are making it to the market, and the advances keep coming at a rapid pace. The success of natural compounds in drug discovery is unparalleled: for antimicrobial and anticancer therapies, for example, more than 70% of new chemical entities introduced during the period 1981-2002 originated from natural products. It has been estimated by the US National Cancer Institute (NCI) that 1% of samples from marine animals tested in the laboratory reveal anti-tumor potential (which compares favorably with just 0.01% of samples of terrestrial origin). In the last few decades, advances in informatics, automation and imaging technology have made it possible to screen 100,000s – 1,000,000s of small molecules against a specific biological target or cellular assay per day, compared with 10s-100s of compounds tested on animals over many months previously. Growing awareness of the limitations of historically valuable approaches, and breakthroughs in robotics technologies, such as those used in separation and structure determination, have made screening mixtures of structurally complex natural product molecules easier, and have expanded the potential role of natural chemical diversity in the drug discovery process

2 THE OPPORTUNITY

2.1 AUSTRALIA CONTEXT

Australia is one of only 17 mega-diverse countries in the world and is renowned for the uniqueness of its biota. Australia has several features proving attractive to investors and researchers in the natural products area. This includes, not least, access to a diverse and unique biota. More generally, the features of Australia conducive to research and commercial activity include its robust system of law and stable democratic system of government, its stable and resilient economy, transparent and efficient regulatory environment, comprehensive intellectual property protections and high scientific and technological capacity. Australia has remained relatively isolated over time compared to most countries. Consequently, Australia has a high proportion of endemic species – that is, species not occurring naturally elsewhere. For example, in the case of mammals, approximately 83% are endemic to Australia. Australia’s unique marine environment contains the world’s largest areas and highest diversity of tropical and temperate seagrass species and of mangrove species; some of the largest areas of coral reefs; exceptional levels of biodiversity for a wide range of marine invertebrates; and it is estimated that around 80% of the southern marine species occur nowhere else in the world. With only 0.3% of the world’s population, Australia contributes 2.5% of the world’s medical research and 2.9% of global scientific publications (Invest Australia, 2007, p.6). In 2005, Australia ranked eighth in the OECD in terms of the proportion of researchers in the total labor force. This is above the OECD average. On a per capita basis, Australia has a research output twice the OECD average. In terms of biotechnology research, Australia has several dedicated biotechnology research institutes. Australia’s biotechnology industry is steadily growing, with activity across biotechnology fields including biomedicine, agricultural biotechnology, industrial biotechnology and environmental biotechnology. The Australian Government is a staunch advocate of the domestic pharmaceutical industry and has been very supportive in implementing initiatives to grow this sector. By any measure, Australian Government support for research and development in the biopharmaceutical industry has been and looks to continue to be strong.

2.2 MARINE BIOME REMAINS UNTAPPED/UNDER-INVESTIGATED-THUS PROSPECTS FOR NEW AND MEANINGFUL FINDINGS ARE SIGNIFICANT

Today, biopharmaceuticals generate global revenues of $163 billion, making up about 20 percent of the pharma market. It’s by far the fastest-growing part of the industry: biopharma’s current annual growth rate of more than 8 percent is double that of conventional pharma, and growth is expected to continue at that rate for the foreseeable future. Marine bioprospecting has the potential to further drive these trends. The marine biome remains untapped and under investigated, and thus, perfectly poised to drive both topline and bottom line for multiple stakeholders in the biopharma value chain. Investing in biotech R&D has yielded better returns than the pharma-industry average. The current biologics-development pipeline supports an outlook of continued healthy growth. The number of biotech patents applied for every year has been growing at 25 percent annually since 1995. There are currently more than 1,500 biomolecules undergoing clinical trials, and the success rate for biologics has so far been over twice that of small-molecule products, with 13 percent of biopharma products that enter the Phase I trial stage going on to launch. To date, sampling of marine products has primarily occurred in easy-to-reach coastal waters. As a result, 97% of natural products of marine origin are from eukaryotic sources (organisms with complex cells), with sponges alone accounting for 38% of the products. However, the majority of the Earth’s metabolic diversity resides in prokaryotic organisms (single-celled organisms such as bacteria) and over 99% of the microbial community of the ocean remains to be explored, so it stands to reason that many more genetic sequences valuable for products are yet to be discovered. There is a particular interest in marine species that live in extreme environments, such as hydrothermal vents and seamounts (‘extremophiles’). By the end of 2007, only 10 compounds had been reported from Deep Ocean and ocean trench environments, with a further seven identified in 2010. Fewer than 10 marine natural products have so far been reported from hot vent bacteria. Furthermore, if we break down the various ecosystems of our seas and oceans and compare the chemical dynamics, coral reefs have particularly impressive potential. The corals that we see are actually made up of colonies that build up and thrive in an environment where nutrients are low. Although coral reefs only occupy 0.1% of the world’s ocean surface, they are one of the most diverse ecosystems on earth, hosting ~25% of all marine species. The focus on the coral reef ecosystem as a target place for medicinal purposes is not a new concept. As early as the 14th century, coral reefs were a known source for medicines. One practice at that time is the use of fish gall bladder to treat venomous stings from marine organisms. Today, coral reefs have already contributed its name in the pharmaceutical industry as one of the source of biochemical compounds for new drugs and the possibilities are endless. The opportunity moving forward is substantial.

2.3 SPECIFIC EXAMPLES OF SUCCESSFUL MARINE BIOPROSPECTING

2.3.1 Aplidin

One of the early biochemical compounds derived from the sea is Didemnin, a compound isolated for the treatment of certain cancers. This compound was obtained from the tunicate Trididemnum solidum. Unfortunately, Didemin did not survive in later stages of its clinical trials. However, after a series of further exploration, a relative of the former species was discovered to poses similar traits. The tunicate Aplidium albicans possesses the compound Aplidin® which has a similar structure with Didemnin but far less toxic. Aplidin is an anti-tumor, anti-viral and immunosuppressive drug that has been demonstrated to be effective in pancreatic, stomach, bladder and prostate cancers. After undergoing series of clinical test, Aplidin was granted the classification as an orphan drug that specifically treats multiple myeloma and acute lymphoblastic leukemia. In the United States alone, there are over 45,000 people with multiple myeloma and an estimated 15,000 new cases in the U.S. each year.

2.3.2 Yondelis

Yondelis® was developed by the PharmaMar Pharmaceutical Company and was released in the market in 2003. This compound is now sold by Zeltia and Johnson and Johnson. Yondelis contains the active substance Trabectedin. Trabectedin is derived from coral reefs. Specifically from the filter feeding sacs of the small and immobile plant-like invertebrate called sea squirts. Extracts of this reef associated species has been found to contain a treatment for soft-tissue sarcoma and ovarian neoplasm sarcoma. Yondelis was developed as a result of the National Cancer Institute Screening Program for marine plants and animals. Sea quirts were collected from reefs of West Indies and studied in the laboratory at the University of Illinois. The anti-cancer biosynthetic compound was then discovered to be embedded in the symbiotic microorganism within the sea squirts. Yondelis is produced in a semi-synthetic manner, after the extracts from the sea squirts undergo a patented chemical process. This process is less intrusive and less demanding to the natural marine biome. Moreover, even though the usage of Yondelis is only for rare medical conditions such as sarcoma, there is still potential for this product to add a lot of value to the lives of patients and other stakeholders. More and more adopting Yondelis in their prescribing workflow for sarcomas and there are an increasing number of patients who are sensitive to medicines containing platinum and Yondelis is one of the only alternative anti-cancer medicines.

2.3.3 Pro Osteon

There are many indications for a bone graft implant (e.g. fusion of the spine, joints in arms and legs, fractures or gaps in bones caused by trauma or infection, oral surgery). In a typical bone grafting procedure, a synthetic material is shaped by the surgeon to fit the affected area of the bone while pins or screws are used to hold it in place. This material builds a support structure where bone cells can interlace, regenerate and heal. Pro Osteon Implant 500 has a porous microstructure where new tissues and blood cells can grow, thereby stimulating growth and connects fractured bone segments. Generically called “Bone Void Filler” and approved by the FDA in 1992, Pro Osteon Implant 500 is clinically proven to be safe, strong and cost effective. This material is sterile, thereby minimizing adverse reactions from the patient’s immune system rejecting the implant. The effectiveness of Pro Osteon Implant 500 lies in its source. It uses corals from the sea that has the same porous interconnected structure of a typical bone graft thereby mimicking the internal structure of a human bone. After undergoing a patented chemical process, it converts the coral into hydroxyapatite which is a mineral and the chief structural element of a human bone. At this stage, the implant material is now also osteoconductive which facilitates bone cells to weave into the porous structure. After the procedure and the healing process starts, the Pro Osteon Implant will eventually be covered and replaced by bones creating the mended part as strong as it was before. Pro Osteon has great demonstrated efficacy and a safe side-effect profile. The company manufacturing this product is projecting at least $3 billion in sales by 2017. What’s more, the production of Pro Osteon is not completely dependent on farming and extracting corals from their natural habitat. Special techniques have been developed, which require only a small portion of coral to be extracted, while the balance is grown artificially in the lab-thus promoting sustainability and stability of the marine biome.

3 THE CHALLENGES

3.1 HOW TO CONSERVE AND SUSTAINABLY USE MARINE BIOLOGICAL DIVERSITY

Despite the fact that marine bioprospecting is relatively unimposing and the practice does not impose the sustainability risk of various terrestrial techniques, conservationists and the public still have some concerns. For one, very little is known about the conservation status of many species used as sources of marine genetic resources. Further, many species occur in vulnerable and fragile ecosystems. Many are also concerned with what we don’t know in this relatively nascent sub-industry at this point. For instance, the effect on ecosystems of removal of marine genetic resources is poorly understood.

3.2 FEW NATIONS CAN SUCCESSFULLY DO BIOPROSPECTING ON THEIR OWN

Investment in marine biotechnology is not without risk. Sampling at sea costs a minimum of US$ 30,000 per day or US$ 1 million for a month. It typically takes 15 years overall, and an investment of up to US$ 1billion, to go from research to commercial product, due to the fact that many products fail to deliver on early promises. As a result the field is dominated by relatively few nations. Patent claims associated with marine genetic resources (MGR) originate from only 31 countries. Ninety per cent of these patents originate from 10 countries (USA, Germany, Japan, France, UK, Denmark, Belgium, Netherlands, Switzerland and Norway), with 70% originating from the US, Germany and Japan. Despite the high levels of investment required in R&D, biotechnology is a lucrative and important industry.

3.3 THE CURRENT UNCERTAIN AND UNPREDICTABLE LEGAL AND REGULATORY FRAMEWORK DISCOURAGES INDUSTRY (I.E. BIOPHARM COMPANIES) FROM INVESTING THEIR EFFORTS INTO BIOPROSPECTING

The potential of marine bioprospecting has become the subject of international policy debate (particularly for areas beyond national jurisdiction). One central question is whether the potential benefits from marine bioprospecting ought to be shared by the entire international community or only by the States or individual corporations with the capacity to exploit them. Various groups are looking at this in order to configure the most sensible set of policies to balance the need to promote innovation and technological/biopharmaceutical advances, with the need to make sure all stakeholders in the value chain are appropriately compensated, along with the need to ensure the longevity of these natural marine habitats. Increasingly, individual nation-states are establishing policies that dictate the way in which protected marine habitats in their jurisdiction may be used for bioprospecting and other scientific and commercial pursuits.

3.4 COSTS OF BIOPHARM/BIOTECH DISCOVERY

There are operational and technological challenges to bioprospecting and biopharmaceutical discovery in general. Reproducing large molecules reliably at an industrial scale requires manufacturing capabilities of a previously unknown sophistication. Consider this: a molecule of aspirin consists of 21 atoms. A biopharmaceutical molecule might contain anything from 2,000 to 25,000 atoms (Exhibit 1). The “machines” that produce recombinant therapeutics are genetically modified living cells that must be frozen for storage, thawed without damage, and made to thrive in the unusual environment of a reaction vessel. The necessary sophistication comes at great cost. Large-scale biotech-manufacturing facilities require $200 million to $500 million or more to build, compared with similar-scale small-molecule facilities that may cost just $30 million to $100 million, and they can take four to five years to build. As the number of products rises and new process technologies such as continuous manufacturing are introduced, the complexity of biopharma operations and the biopharma supply chain will increase.

4 THE SOLUTION

4.1 HUMAN/ROBOTICS INTERVENTION

First, activities at sea in support of biotechnology need to be distinguished from processes in the laboratory. Commercial expeditions purely to collect marine genetic resources are rare to non-existent. Typically, sampling is conducted on scientific research cruises, or by using downtime on ROVs used in the offshore oil industry. Ocean-going research vessels are typically owned by national research bodies (e.g. China, UK, US, Brazil, Germany, Japan, France, Russia) or commercial operations, particularly in the offshore oil and gas sector. With the advances in ROVs, less and less direct human disruption of the marine biome is necessary. Leveraging ROV technology allows for minimally invasive tactics that still allows for effective research/discovery/development opportunities while maintaining the balance in the most fragile of habitats. Investing and employing ROV technology is also safer for all parties involved. As the scientific community continues to research more dangerous and less-explored marine habitats, the risk for health and human safety increase. ROVs dramatically reduces this risk while permitting research and commercial societies to explore true frontier regions. For example, Liquid Robotics is a venture-backed firm specializing in this area with their marquee product, the Wave Glider. The Wave Glider is an autonomous, environmentally powered ocean-going platform for gathering and remotely transmitting information about the ocean. Wave Gliders collect data on temperature, winds, humidity, wind gusts, water temperature, water color, and water composition. They can also take pictures. These robots are gathering a lot of observational data about climate change, ocean acidification, fisheries management, hurricane and tsunami warnings, and exploration – but in a green way. This type of technology applied specifically to marine bioprospecting to further drive innovation and efficiency in this space.

4.2 HEALTHY PUBLIC-PRIVATE PARTNERSHIPS, CASE-IN-POINT: GRIFFITH/ASTAZENECA PARTNERSHIP

The Griffith University (an Australian University based in the State of Queensland)/AstraZeneca Partnership represents a multi-year, 100 AUD investment by AstraZeneca, has involved the screening of extracts of flora and fauna by Griffith University’s Eskitis Institute to identify bioactive molecules as potential leads for pharmaceutical discovery and development of novel pharmaceuticals. More than 45,000 samples of regional biota, both marine and terrestrial, have been collected since the start of the partnership. Collections have derived from several jurisdictions within Australia. This partnership should also serve as a grounded example to help inform future initiatives aimed at balancing the various needs to ensure effective and safe marine bioprospecting. This partnership demonstrated that bioprospecting partnerships can yield consistent benefits for provider countries and for biodiversity conservation over time. The collaborative agreement and consequent investment in Queensland has resulted in significant technology transfer. As part of the partnership, AstraZeneca provides funding to Griffith University to participate in their bio discovery and commercialization efforts. Griffith University in turn partners with domestic and overseas collecting institutions to undertake biota collections, make extracts of samples, and then run these samples through high throughput screens (HTS) against targets provided by and of therapeutics interest to AZ. Active compounds are then identified and isolated at Griffith University via bioassay guided fractionation, and structures are elucidated using nuclear magnetic resonance spectroscopy. Benefits accrued to the range of collaborators in the partnership – Astra Zeneca, Griffith University, the Queensland Herbarium, the Queensland Museum, and companies and institutions in China, India, Papua New Guinea, and Tasmania. At the same time, broader benefits were achieved or may still emerge for the State of Queensland, the Australian research community, the Australian public, and the international community. Realized benefits to Australia include monetary remuneration like fees for samples (or to cover the costs of an agreed-upon work plan) and royalties. Non-monetary benefits to Australia included the provision of vehicles, equipment, technology, training, building of a state-of-the-art natural product discovery unit, and increased knowledge of biodiversity. Benefits to AZ include the access to a huge pipeline of potential blockbuster drugs that may yet serve to benefit thousands (if not millions) of patients. Furthermore, new information and data gleaned from the partnerships have gone towards informing more policy around conservation and environmental planning and management throughout the region. Many best practices for similar future partnerships can be established from the AZ/Griffith Partnership.

End Note:

Science has an opportunity now unlike any other time in history to advance mankind utilizing robotics for the betterment of us all.

Why Should We Use Fidget Toys?

Playing with a stress ball, geometric puzzle, tangles or similar toys may seem a lot like idle distraction. In fact, these toys are useful objects to help calm and focus a person, while helping to promote the more creative and clearer thinking. Also, the fidget toys are a practical option for tactile input and movement that is necessary for some people’s ability to learn. They come in a wide range of textures, sizes and shapes for ease of use and comfort.

What are they?

Fidget toys are practical for both adults and children. They are mostly used as therapeutic toys and relatively small in size. Most of the toys can easily sit comfortably in the palm of the hand. This small size means they are easy to carry in a lunch box, pocket, purse, or backpack. The toys are used in all types of environments, such as the office, in school and at home. They are built in a variety of materials from metal to washable nylon material, but no matter the type, it is still intended to increase a person’s attention and focus. The toys are often recommended by counselors and teacher’s doctors for those that lack focus in a learning environment.

Use for children

Children today can be more distracted and less inclined to learn and pay attention to their teacher. Their behavior, diets and entertainment options are completely different to previous generations of children. For the children that are quite restless and often fidget, it is worth trying these toys to see if it can help increase their focus and attention span. The fidget toys are practical to use in the home or school and help in a wide range of situations. Plus, the children are likely to have a lot of fun with these toys and they are very affordable.

Benefits

The benefits of the fidget toys are wide-ranging for both adults and children. They are a useful choice to help improve focus and self-regulation. For those that use them in a school or work environment, there is the potential to see an improvement in academic development or an increase in productivity. The toys held in the hands are very effective at giving a calming influence and can keep a person more alert. A further benefit is the ability to improve the tactile awareness of the hands and fingers. The regular user of this type of toy can see an improvement in strength of the hands and fingers overtime.