Better Living Through Well Being

Modern life places extraordinary demands on our brains. Not only do we live longer than ever before, but we must constantly adapt to complex and rapidly evolving personal and professional realities as we get older. These days, we all live under considerable stress in the face of economic challenges, job demands, family tensions, always-on technology and a 24-hour news cycle promoting ceaseless worry. While many have learned to “live with it,” this ongoing stress can, unless properly managed, have a serious negative impact on our ability to think clearly and make good decisions in the short term, and in the long term may even do harm to our brains.

Recent studies have shown that chronic stress can also lead to depression, and even to a higher risk of cognitive decline and Alzheimer’s symptoms. This is because under stress, the brain’s limbic system (responsible for emotions, memory and learning) triggers an alarm that activates the fight-or-flight response, increasing the production of adrenaline and cortisol, which work together to speed heart rate, increase metabolism and blood pressure and lower pain sensitivity. This is all very good when your very survival is on the line, but your body is supposed to reset to normal when the stressful situation has passed. Consequences of a body that does not reset due to sustained stress are blood pressure problems and also blockage of new neural connections in the hippocampus, the part of the brain responsible for encoding new memories. The hippocampus can actually shrink in size, hindering memory. Fortunately, we can learn to master our stress levels and build emotional resilience to not only feel better and perform better on a daily basis, but also to protect our brain from effects of long term stress.

This is because the brain can, and does, change as a result of alterations in neural pathways and synapses caused by changes in behavior, environment and neural processes. This phenomenon is known as neuroplasticity.

Prior to a paradigm shift among neuroscientists in the late 1970s and early 1980s, the consensus was that brain structure is relatively immutable after a critical period during early childhood. Now, studies of how the brain changes throughout life are commonplace, and the role of lifelong neuroplasticity is widely recognized in healthy development, learning, memory, and recovery from brain damage. In fact, now there is so much information available on the subject of brain health in general that it may not be easy to self-assess what really works.

A new book, "The Sharpbrains Guide to Brain Fitness: How to Optimize Brain Health and Performance at Any Age,” offers an independent, engaging analysis of hundreds of scientific studies published over the last decade. The guide provides a window into the research and thinking of dozens of leading neuroscientists who often question conventional wisdom and prevailing brain health care while providing unique perspectives on groundbreaking new approaches. It is a great start for making sense of new brain science and for taking active steps toward smart brain health at the individual and, ultimately, the societal level.

For brain training to be truly effective its results must transfer to daily life. Brain training can be successful if the right conditions are met. It must engage and exercise a core brain-based capacity or neural circuit identified to be relevant to specific real-life outcomes, such as executive attention, working memory, speed of processing and emotional regulation. It must target a performance bottleneck. The choice of a technique or technology should be driven by your specific goal. A minimum “dose” of 15 hours total per targeted brain function performed over 8 weeks or less is necessary for real improvement. The training must adapt to performance, require effortful attention, and increase in difficulty, and continued practice is required for continued benefits. There is no “magic pill” for better brain health.

Other articles of interest in the Summer 2013 TMIS eNewsletter:

* The “Do One Thing” campaign is a partnership between Whole Foods Market, Seattle Cancer Care Alliance, and a Seattle high school student-run radio station aimed at promoting healthy lifestyle choices in an easy and accessible way.

* New research findings suggest that massage therapy may be a helpful pain management strategy for individuals suffering from metastatic cancer and rheumatoid arthritis, in addition to post-cardiac surgery.

* A new ingestible device can sample the gastrointestinal mucosa at pre-determined locations, including the small intestine. This information will open the door to personalized medicine, where diagnostic analysis of the microbiome will provide invaluable information on the likelihood of responses to probiotics and drugs.

* Lumbar epidural steroid injections may lead to increased bone fragility and are not advisable in patients at high risk for fractures associated with osteoporosis.

* A 70-year-old grandmother from Eugene, Oregon has dedicated herself to saving lives in Central America through an organization she founded that helps local people start factories to replace dangerous open fires with a fuel-efficient cook stove.

* A study shows that many older people could benefit from home-based physiotherapy or occupational therapy, potentially leading to fewer hospital admissions and a decreased demand for home care services; yet, despite its benefits, community-based rehabilitation is not adequately funded.

I am grateful to be in a collaborative business with many talented and skilled professionals. Additional feedback and recommendations for our products and services at TM Information Services are always welcome.

- Mary Michele McLaughlin

From the Front Page of TMIS News
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New SharpBrains Book Offers Groundbreaking Guidance to Help Consumers Improve Brain Health
Washington, DC

Just days after the White House's launch of its new BRAIN Initiative, a new how-to guide is shedding much-needed light on a practical approach to preserving and optimizing brain health and performance at any age, tackling this complex topic with refreshing new guidance and personalized lifestyle and brain training tips.

Featuring a foreword by Misha Pavel, Ph.D., Program Director at the National Science Foundation, the new "SharpBrains Guide to Brain Fitness: How to Optimize Brain Health and Performance at Any Age," cuts through the misconceptions, superficial and conflicting media coverage, and aggressive marketing claims with a common sense approach that empowers readers to take control of their own brain health. The book is available today in paperback and e-book in the U.S., Canada and the U.K.

"In today's increasingly high-demand, fast-paced world, we all need to process information faster, boost working memory and resilience and delay age-related problems," said Alvaro Fernandez, CEO of SharpBrains and co-author of the guide, who was also named a Young Global Leader by the World Economic Forum in 2012. "Instead of waiting for the elusive 'magic pill' for cognitive enhancement or Alzheimer's treatment, we need to pay more attention to lifestyle and research-based brain training tools. This book provides an easy-to-follow guide to understanding and harnessing the natural properties of the brain so that more readers can thrive in the 21st century."
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Partners Develop Study of Prevention of Falls Injuries in Older Adults
Washington, DC

The Patient-Centered Outcomes Research Institute (PCORI) has announced an agreement with the National Institute on Aging (NIA), part of the National Institutes of Health (NIH), to form a partnership to fund a major intervention study aimed at preventing injuries from falls in older adults.

The memorandum of understanding supports the formation of the "Falls Injuries Prevention Partnership," which establishes the basis for an NIA-PCORI funding announcement for a large-scale, multi-year clinical trial on preventing injuries due to falls in non-institutionalized older individuals. PCORI plans to commit up to $30 million to this effort; the final amount is yet to be determined.

The intent of this collaborative project is to evaluate a comprehensive, multi-factorial approach to preventing a frequent and often debilitating type of injury among the fast-growing population of older adults. There is extensive evidence that older people who have previously fallen have a significant risk of falling again. Patients, caregivers, and clinicians all want to know the best way to address this problem, but there is uncertainty about the best prevention strategy.
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Local Students Team Up with Seattle Cancer Care Alliance and Whole Foods Market to Challenge the Public to "Do One Thing" for a Healthier Life
Seattle, Washington

In an effort to encourage people of all ages to add one thing to their daily routine to improve their health, Seattle Cancer Care Alliance (SCCA) and Whole Foods Market launched a new partnership with C89.5, Nathan Hale High School's student-run radio station. The "Do One Thing" campaign spotlights student-generated messages about the importance of little steps towards a healthier lifestyle and extends across radio, social media, and events. Through promoting healthy lifestyle choices for people in an easy and accessible way, SCCA hopes to empower people to take charge of their health choices and highlight how everyday habits translate into cancer and other disease prevention.

Initially started as a grassroots movement by Nathan Hale High School students in a journalism class, Do One Thing has developed into a multimedia campaign that faculty predict will inspire regional participation by students as well as adults. As part of the campaign, students have worked with SCCA to produce videos showcasing the "one thing" they do every day to lead a healthier life, in hopes of inspiring others to add one healthy action to their daily routine. Lev Marcus, a high school senior, used his video to encourage other students to add exercising to their daily schedule. Previously overweight and inactive, Lev decided to make a positive change and picked up weight lifting and pole vaulting. He developed a passion for exercise, proving to be a talented athlete and recently won the State competition. As a result he has become an active, athletic, and healthy teenager.
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New Research Suggests Massage Therapy Is a Powerful Tool for Pain Relief
Evanston, Illinois

Pain can negatively affect a person's quality of life and impede recovery from illness or injury. Recent research compiled by the American Massage Therapy Association (AMTA) suggests that massage can be a helpful pain management strategy for manually controlling symptoms in people suffering metastatic cancer and rheumatoid arthritis, among other illnesses, as well as post-cardiac surgery pain.

Massage Therapy for Improved Pain and Sleep in Metastatic Cancer Patients

Research published in The Journal of Alternative and Complementary Medicine found that therapeutic massage at home for metastatic cancer patients can improve their overall quality of life by reducing pain and improving sleep quality. American Massage Therapy Association President Winona Bontrager, says of the study, "These findings suggest that cancer patients can also benefit from professional massage, both physically and mentally, providing the necessary comfort during advanced stages of the disease."

Massage Therapy for Decreased Pain in Rheumatoid Arthritis Patients

Research published in Complementary Therapies in Clinical Practice showed that adults with rheumatoid arthritis may feel a decrease in pain, as well as greater grip strength and range of motion in writs and large upper joins, after receiving regular moderate-pressure massages during a 4-week period. This research demonstrates the potential value of massage therapy for the estimated 1.3 million Americans living with this chronic condition, with women outnumbering men 2.5-14. Rheumatoid arthritis sufferers are encouraged to speak with their health care provider about the possibility of incorporating routine massage therapy into their current treatment plan to help manage painful symptoms, says American Massage Therapy Association President, Winona Bontrager.

Massage Therapy for Reduced Pain, Anxiety and Muscular Tension in Cardiac Surgery Patients

Research published in The Journal of Thoracic and Cardiovascular Surgery indicates that massage therapy can significantly reduce pain, anxiety and muscular tension, as well as enhance relaxation and satisfaction after cardiac surgery. The American Massage Therapy Association acknowledges that cardiac surgery recovery is a very crucial time a patient must endure and this study further suggests that massage therapy can be a useful aid in making the road to recovery an easier journey.
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Micropharma announces timeline to commercial launch of world's first ingestible gastrointestinal sampling device
Montreal, Canada

Micropharma Limited, a pioneer in the development of innovative and effective products based on the human microbiome has announced that after three years of development it has a timeline for launch of its ingestible gastrointestinal sampling technology. The company released its plans to launch the device in late 2014 commercially for research and development use and later for specific clinical applications. Micropharma has been developing the device for three years and in the last year has expedited the project by partnering with StarFish Medical a medical device development company that offers a full complement of design and manufacturing solutions. The partnership will see StarFish Medical improve and finalize the design of the autonomous multiple sample acquisition and localization technologies, design for manufacture, produce initial devices, as well as to engineer for cost effectiveness.

Micropharma's chief scientific officer Dr. Mitchell Jones commented on the advantages of sampling the GI mucosa over the evaluation of fecal samples by saying "our ingestible pill can sample the mucosa at pre-determined locations throughout the GI tract, including the small intestine. The device is programmable, acts autonomously and can take multiple, large, discrete samples that can be evaluated for human genomic, metabolomic and human gut microbiome data; of immediate and specific interest is to improve samples for microbiome research" he commented further that "protecting the intellectual property was an important part of the commercial development process and we are pleased to have recently filed an international PCT patent application" and that "sampling the gastrointestinal tract allows for site-specific analysis of the bacterial populations and metabolites present at the mucosal surface is a distinct advantage over the evaluation of fecal samples for many applications."
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Steroid Injection Therapy May Increase Risk of Spinal Fracture
Rosemont, Illinois

Most aging adults will experience back pain or a spinal disorder at some time in their life. In fact, about 25.8 million visits were made to physicians' offices due to primary back problems. Treatment focuses on pain relief and is available in both non-surgical (medication or physical therapy) and surgical forms.

A retrospective study in the June 5th issue of the Journal of Bone and Joint Surgery (JBJS) looked at one type of back treatment, a lumbar epidural steroid injection (LESI), and whether or not that treatment had an impact on bone fragility and vertebral fractures (spinal fractures). A higher number of injections was associated with increased risk. Authors concluded that LESIs may lead to increased bone fragility over time, and while injection therapy is useful in some cases, it should be approached cautiously for patients at risk for fractures associated with osteoporosis.

Patients at a high risk for vertebral fractures after an epidural injection include older women, those who have had an earlier fracture, those who smoke and those who are underweight. Young and active male patients have a lower risk of vertebral fracture.
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CNN Hero: Oregon Grandmother Addresses Silent Killer
Eugene, Oregon

When Nancy Hughes was volunteering for a medical mission in Guatemala she saw doctors trying to repair lives devastated by the effects of traditional cooking methods. Infants who could not breathe and children with debilitating burns convinced Nancy to dedicate herself to preventing rather than repairing these life-threatening injuries and diseases.

This 70-year-old grandmother from Eugene, Ore., is showing that it's never too late to make a difference. She has been recognized as a "CNN Hero" for founding StoveTeam International, an organization helping local people start factories to replace dangerous open fires with a fuel-efficient cookstove.

Cookstove smoke kills one person every sixteen seconds as half the world's population still cooks by burning wood, animal and agricultural waste and coal in open fires or rudimentary stoves. Those smoky fires are the leading cause of death of children under age five.

Nancy's incredible energy, passion and ability have inspired five year old StoveTeam to help build six factories in five countries helping 280,000 people live healthier lives and improving local ecology and economies.

These stove factories have employed more than 45 individuals and produced and sold over 37,000 portable safe, efficient stoves, protecting the lives of over 280,000 people. This year, StoveTeam is working to start four more factories, three in Mexico and one in Colombia. This effort will continue to bring better health conditions in homes, help the environment, and provide local employment.
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Home-based rehab for seniors improves quality of life, saves money
Waterloo, Ontario

Seniors with musculoskeletal disorders, like arthritis or broken bones, who get rehabilitation at home are less likely to need admission to hospital or long-term care homes, say researchers from the University of Waterloo and University of Toronto.

The study, published in the Archives of Physical Medicine and Rehabilitation, also found that older patients who receive physiotherapy and occupational therapy in their own home are more likely to be discharged from home care services altogether after treatment.

"Fewer hospital admissions and a decreased demand for home care services would represent a significant reduction in the government's overall health costs," said Professor Paul Stolee, of the Faculty of Applied Health Sciences at Waterloo.

"The aging of the population is often seen as the biggest cause of increasing health care costs, which is not true," said Professor Stolee. "This study provides evidence that if older people get the right services at the right time, this can actually reduce their cost to the health system, while improving their quality of life."
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FDA Clears Initiation of a Phase I/2a Clinical Trial Testing Cell Therapy Product, SB623, in Patients with Traumatic Brain Injury
Mountain View, California

SanBio Inc., a California-based regenerative medicine company has announced that the U.S. Food and Drug Administration has approved their Investigational New Drug application for the use of SB623, a novel allogeneic stem cell therapy product, in patients suffering from traumatic brain injuries (TBI's). This approval allows the company to proceed with a Phase 1/2a clinical trial testing the safety and feasibility of the therapy. The clinical trial is expected to be carried out at several major hospitals in the United States.

"This is the second clinical program for SanBio," said Keita Mori, SanBio's Chief Executive Officer, "we see this as a clear validation of our development program and a significant broadening of the therapeutic application of our lead product SB623 for the treatment of unaddressed chronic neurological deficits."

"We measure the responses of TBI patients to physical therapy every day. Progress is often painfully slow and incremental," said Dr. Daniel Lu, Principal Investigator, Neuroplasticity and Repair Laboratory and Director, Neuromotor Recovery Research Center, University of California, Los Angeles, "If this new cell therapy approach improves outcomes it could have a dramatic positive effect on many lives."

About Traumatic Brain Injury: According to the Center for Disease Control and Prevention, more the 1.7 million people in the United States sustain a traumatic brain injury each year, resulting in approximately 50,000 deaths and 275,000 hospitalizations. Many of these more severely injured patients suffer permanent disabilities, including loss of motor function and cognitive impairment. Other than physical rehabilitation there is no effective therapy. Direct medical costs and indirect costs such as lost productivity of TBI totaled an estimated $76.5 billion in the United States in 2000.
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Dr. Isaac Eliaz Awarded Patent for Modified Citrus Pectin and Alginates
Santa Rosa, California

The United States Patent and Trademark Office has awarded Isaac Eliaz, M.D., patent # 8,426,567, on April 23, 2013 for modified citrus pectin (MCP) and modified alginates as: "A method for enhancing mammalian immunological function." Specifically, the patent recognizes that MCP and modified alginate help improve the immune response in mammals, particularly humans.

"I am very excited that this patent has been accepted and that we are increasing awareness about the important benefits of MCP as a powerful, natural therapy," says Dr. Eliaz, an integrative medicine expert who helped research and develop MCP for numerous clinical applications. "In addition to other important pharmacological actions and benefits, we've proven that MCP is an extremely powerful immune modulator which selectively enhances different branches of the immune system," states Eliaz.

A 2011 study published in the journal BMC Complementary and Alternative Medicine, showed that MCP significantly enhanced natural killer (NK) cells' ability to identify and destroy human leukemia cells. MCP activated T-cytotoxic cells and B-cells in a dose-dependent manner, and induced significant dose-dependent activation of NK-cells. Furthermore, MCP-activated NK-cells showed significantly increased functionality in inducing cancer cell death. This research focused on MCP's immunostimulatory properties in human blood samples, resulting in modulation of different arms of the immune system. The MCP tested consists of oligogalacturonic acids with a very low degree of methyl esterification, unsaturated regions and some unsaturated non-reducing ends. The selective immunostimulatory properties are proposed by the USDA-ARS coauthors to be attributed to the presence of these properties. Additional published research has established the immune-modulating effects of alginates as well.
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'Blood Therapy' Has Patients Flocking to Washington DC's Pioneering Pain Doctor
Washington, DC

Platelet-Rich Plasma (PRP) is a little-known treatment discovered by the athletic elite in 2009. A radical treatment for sports related and other chronic injuries, it uses a patient's own blood to aid in the healing of itself. With growing buzz created by former "blood therapy" recipients; pro golfer, Tiger Woods and NBA star, Kobe Bryant, PRP is fast becoming the exciting alternative to surgery that more pain patients are looking for. A handful of doctors in the United States and only a few in the Washington Metropolitan area have extensive experience in this revolutionary procedure, that's why Pain Management Specialist G. Hudson Drakes of Metro Spine is in such high demand. "If more people knew that they could get relief from chronic pain without painful surgery and without drugs using their body's own healing mechanisms, they wouldn't hesitate," says Drakes, "it's a non-invasive alternative worth exploring."
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