Placebo rivals paracetamol in study

Paracetamol, the first-choice lower-back pain killer, worked no better than dummy drugs administered in a trial of more than 1600 people suffering from the condition, researchers say.

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In fact, the median recovery time for those on placebo was a day shorter than that for trial subjects given real medicine, they wrote in The Lancet medical journal.

“Our findings suggest that … paracetamol does not affect recovery time compared with placebo in low-back pain, and question the universal endorsement of paracetamol in this patient group,” the Australian team concluded.

“Paracetamol also had no effect on pain, disability, function, global symptom change, sleep or quality of life.”

Lower-back pain is the leading cause of disability in the world, and paracetamol is “universally” recommended as the treatment of first choice, said a statement carried by The Lancet on Wednesday.

The Paracetamol for Low-Back Pain Study (PACE) divided 1652 individuals with acute pain from 235 clinics in Sydney into three trial groups.

One received regular paracetamol doses, the other used the drug as needed, and the third was given placebo pills.

Recovery was defined as seven consecutive days of 0 or 1 pain intensity on a 0-10 scale.

“Median time to recovery was 17 days in the regular paracetamol group, 17 days in the as-needed paracetamol group, and 16 days in the placebo group,” said the statement.

All patients were given high-quality advice and reassurance, and the findings suggest these may be more important in lower-back pain management than drug therapy, said the authors.

“Our results convey the need to reconsider the universal endorsement of paracetamol in clinical practice guidelines as first-line care for low-back pain.”

A potential limitation of the study was that some participants used other treatments.

In a comment also carried by The Lancet, Bart Koes and Wendy Enthoven from the Universal Medical Center in Rotterdam applauded the team “for tackling this research question on a topic that has been without debate and evidence for such a long time”.

But they cautioned that guidelines should not be changed on the basis of a single trial.

Scientists have discovered how to make people care about climate change

A woman peers through goggles embedded in a large black helmet.

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 Forest sounds emanate from various corners of the room: a bird chirping here, a breeze whispering there. She moves slowly around the room. On the wall, a flat digital forest is projected so observers can get a rough idea of her surroundings, but in her mind’s eye, this undergrad is no longer pacing a small, cramped room in a university lab. Thanks to that black helmet, she’s walking through the woods.

In a minute, she’s handed a joystick that looks and vibrates like a chainsaw, and she’s asked to cut down a tree. As she completes the task, she feels the same sort of resistance she might feel if she were cutting down a real tree. When she leaves this forest, and re-enters the “real” world, her paper consumption will drop by 20% and she will show a measurable preference for recycled paper products. Those effects will continue into the next few weeks and researchers hypothesize it will be a fairly permanent shift. By comparison, students who watch a video about deforestation or read an article on the subject will show heightened awareness of paper waste through that day—but they will return to their baseline behavior by the end of the week.

The tree-cutting study is one of many that Stanford University has conducted in its Virtual Human Interaction Lab over the last several years in an attempt to figure out the extent to which a simulated experience can affect behavior. And it’s part of a growing body of research that suggests virtual experiences may offer a powerful catalyst for otherwise apathetic groups to begin caring about issues and taking action, including on climate change. That’s important because while time spent in nature has been proven to be quite beneficial to human health, whether or not humans repay the favor tends to rely on the type of nature experiences they have in their youth. In a 2009 study published in the journal PLoS ONE, researchers from the University of Pretoria in South Africa found that while people who spent time hiking and backpacking were more willing to support conservation efforts a decade or more later, those who had visited national parks or spent time fishing as kids were actually less inclined to do anything to support the environment. An earlier (2006) study (pdf) on the relationship between nature experiences and environmentalism found that while those who had spent their youth in “wild” nature, defined as hiking or playing in the woods, were more likely to be environmentalists as adults, those who had been exposed to “domesticated” nature—defined as visits to parks, picking flowers, planting seeds, or tending to gardens—were not. Given the unlikelihood of every child having a “wild” nature experience, researchers are on the hunt for other ways to cultivate environmentally responsible behavior.

The latest work with virtual reality builds upon roughly half a century of behavioral studies that indicate humans’ willingness to shift behavior is directly correlated to our sense of control.

Climate change, like many large-scale environmental issues, is a problem over which few people feel they have a direct impact—for better or worse. As researchers Sun Joo (Grace) Ahn and Jeremy Bailenson wrote in a forthcoming paper in the journal Computers and Human Behavior, individual actions taken at a micro-scale, like failing to recycle paper or support certain policies, can contribute over time to negative environmental consequences, like deforestation, which in turn affects climate trends over many years. But the long time frames and vast scale create a dangerous disconnect. While 97% of peer-reviewed scientific research points to human activities as a primary contributor to climate change, only half of Americans see the link.

Proponents of virtual reality think it could help drive home the impacts of climate change and make people feel empowered to do something about it. “When individuals feel that their behaviors directly influence the well-being of the environment, they are more likely to be concerned about and actively care for the environment,” Ahn and Bailenson wrote.

Bailenson, a cognitive psychologist and founding director of Stanford’s Virtual Human Interaction Lab, sees particular value in virtual reality related to climate change because it allows for a combination of real experience with boundless possibilities: The brain treats the virtual experience as real but, at the same time, knows that anything is possible in the simulation.

“Understanding complicated issues like climate change requires a shift in perspective in terms of how you’re willing to see the problem,” said Amy Kamarainen, co-director of Harvard’s EcoMOBILE and EcoMUVE projects. “We’re trying to do that by immersing kids in environments that have elements similar to real-world systems but are somewhat simplified to meet kids where they are. We put them in complex worlds but give them the tools to be able to unpack what’s happening.”

EcoMUVE, a multi-user, desktop computer-based virtual environment that features a simulated pond ecosystem, was developed by Harvard University to teach students basic biological processes like photosynthesis and decomposition as well as systems thinking about complex environmental issues. The Harvard team recently launched EcoMOBILE, a corresponding augmented reality app, which enables students to take the EcoMUVE experience with them, collect data out in the field, and “see” what’s going on below the surface and what happened in an ecosystem in the past. EcoMUVE was initially piloted in schools in Massachusetts and New York, but is now available for download by any school, and is being used across the United States and in other countries as well, including India and Mexico. EcoMOBIL is currently being piloted at schools in Massachusetts and New York.

A handful of Massachusetts high schools have also piloted an MIT-developed augmented reality app called Time Lapse 2100, which requires users to set various policies that would affect the environment and then shows them what would happen if those policies were enacted. This fall, Bay Area schools will be pilot-testing Stanford’s Coral Reef, a virtual reality game in which participants become a piece of coral in a reef affected by ocean acidification. All three universities are also working with museums and science learning centers to deploy their technology in learning experiences.

“I was initially not sold on the idea of augmented reality,” said cognitive scientist Tina Grotzer, a professor in Harvard’s graduate school of education and the co-principal investigator for both the EcoMUVE and EcoMobile projects. Grotzer spent several years as a teacher herself before heading to Harvard to research how kids learn, particularly how they learn science. Grotzer said it was the technology’s potential to drive home environmental science lessons that won her over. “With physics, you can do an experiment, and kids can see instantly what you’re talking about. With environmental science, we tried to do a decomposition experiment, but you set the experiment up and then 12 weeks later something happens. By then the kids have completely lost interest.”

“I’ve tagged along on these field trips and have seen how the technology actually immerses them more in the surroundings, rather than distracting them,” Grotzer said. Students use smartphones to take photographs and notes, documenting what they’re seeing: the clarity of the pond water, the weather, descriptions of their samples, different species of bugs and birds. And they can learn at their own pace too. “On a regular field trip, if a student had a question they’d have to leave that moment that spurred the question and go ask the teacher,” Grotzer said. “The teacher would be facilitating the needs of 30 kids. This way they can find the answer themselves and stay in the moment, stay engaged with what they’re looking at.”

In Stanford’s Coral Reef students embody a tall piece of purple coral off the coast of Italy, near Ischia. Over the course of a 14-minute lesson, they are taken through the experience of being coral in a body of water affected by ocean acidification. At first, the surrounding ocean is filled with an abundance of sea life. Waves around the reef are simulated by floor vibrations and ocean sounds. A lab technician periodically touches the participant with a stick in synchronized motions to coincide with what he sees as a fishing net hitting the reef. Then acidification sets in. Sea life begins to die off all around. The reef begins to lose its color, as does the piece of coral the participant has embodied.

Still, despite an increasing variety of options and declining prices, schools looking to put these technologies to use in the classroom face a number of challenges.

If virtual and augmented reality are to have a measurable impact on how future generations understand and approach climate change, access across all socioeconomic classes will be key. Kamarainen said that in some higher-income school districts students could use their own devices.

In many school districts around the country, however, the majority of students do not have smartphones. Mobile phone company Kajeet has begun to address this issue by offering schools data packages that provide WiFi with school-managed filtering so they can set time limits for usage, enabling kids to take home school-provided tablets for only school-related work.

“There are clashes all the time between the reality of what goes on in a classroom and what researchers would like to see happen in a classroom,” said Paul Olson, an outreach specialist at the Games Learning Society, or GLS, at the University of Wisconsin at Madison, who taught seventh grade for more than three decades. He said that a lot of his time these days is spent explaining to researchers what life is like “in the trenches” and encouraging teachers to experiment with GLS games to motivate those students who “really don’t respond to a lecture or a chapter in a book but are all over programming something.”

This is where museums incorporating these technologies might fill some gaps. “A museum has the freedom to step outside the rigid guidelines and requirements that schools are held to,” said Dan Wempa, vice president of external affairs for the New York Hall of Science in Queens, which sees roughly 1,200 students per day on field trips during the school year. The museum’s latest exhibit Connected Worlds, created with input from Kamarainen, will immerse visitors in a digital, interactive world that shows how their actions affect the environment. In one part of the exhibit, visitors add water to the environment and a plant flourishes. In another, they add too much and cause flooding. Taken together, the exhibit puts nature into fast forward to help students see how their individual and communal actions hurt or sustain plant and animal life, clean water, and fresh air.

“Students have a germ of knowing that water is important, but they say ‘I didn’t realize that it’s THAT important, and I didn’t realize that what I do over here affects someone way over there,’” Wempa said.

Karydes’ concerns are common among parents. “There are two ways that parents tend to look at these games,” said Eric Klopfer, who directs MIT’s Scheller Teacher Education Program, developed Time Lapse 2100, and has been researching the use of augmented reality in education since 2009. “One is, ‘Great. My kid is outside, but he still has the phone in his hand,’ and the other is that the mobile device and the game are actually getting their kid outside.”

Kamarainen and Grotzer have also heard parental concerns about technology interrupting kids’ experience of nature, and they have worked hard to design games that they feel complement a relationship with nature rather than detract from it.

The EcoMOBILE pilot has included around 1,000 students so far, and Kamarainen said they consistently talk about how the augmented reality piece helps them to see things going on in their communities that they never paid attention to before. “They say this helps open their eyes about the environment that’s around them,” Kamarainen said. “They’re more aware and conscious of it, and they’re paying closer attention to the natural world.”

Ultimately, proponents say that these games not only complement and improve students’ relationship with nature but also teach them how to think systematically and to see their own roles in harming or improving their world.

“The younger kids say, ‘I get to create a world!’” Wempa said, “and the older kids say, ‘I like this because it felt like I was in control and, as a kid, I’m never in control of anything.’ That carries over. They understand that actions have consequences and that they can affect outcomes.”

Amy Westervelt is an environmental journalist who lives in Truckee, California. She is a co-founder of reporting project Climate Confidential.

This article was originally published on Quartz. Click here to view the original. © All rights reserved. Distributed by Tribune Content Agency.

 

Whale freed from shark net in Qld

A marine expert has renewed calls to review the use of shark nets off Gold Coast beaches after a young whale became trapped.

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The exhausted humpback calf was freed by a rescue team mid-morning on Thursday after struggling for hours in the net off Kirra beach.

Sea World director of marine sciences Trevor Long said the calf, about five to eight years old, probably became stuck the previous evening.

“By the time we arrived in the morning, it was very tired and very, very sore,” he told AAP.

“It actually worked in our favour.

“The animal was calm during the rescue and we were able to work fairly close to the animal and slowly cut the nets free.”

Using special knives, the rescue team took 90 minutes to release the struggling mammal after being alerted to its plight by beach walkers.

The whale, which has been independent for some years, suffered muscle and tail damage but was able to swim away, Mr Long said.

However, a baby whale that became trapped off a southern Gold Coast beach on Sunday was not so lucky.

Mr Long said the newborn hit the bottom of a shark net, was unable to free itself and drowned.

He said many inexperienced mammals ran into trouble on their first southern migration because they did not know where the “traps” were.

“We’ve got about 20,000 animals on the east coast of Australia now, so certainly we would like to see some review of the shark nets,” Mr Long said.

“Maybe the shark nets are removed during the whale season in winter because the beaches are not as popular because it’s cold.”

Mr Long said drum lines could be used to protect bathers instead.

Brumbies unchanged for Sydney semi against Waratahs

The Canberra-based side have been able to stick with the same 23 who dethroned the double defending champion Waikato Chiefs 32-30 in Canberra.

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The Brumbies are looking to get to the final for the second successive year – they lost to the Chiefs last season – and will face the Canterbury Crusaders or South Africa’s Sharks on Aug. 2 if they can get past the strongly-favoured Waratahs.

“To have got through last weekend injury free, it’s great for us to be playing again this weekend to maintain momentum,” Brumbies director of rugby Laurie Fisher said.

“The result won’t be determined by who’s favourite. The result will be decided by who is the better team on the night.

“There’s an intense rivalry which has been there since the competition started and I’m expecting a fierce clash of bodies this weekend.”

Henry Speight and Robbie Coleman retain their places on the wing after performing well against the Chiefs, the former busting a competition-high 12 tackles and the latter scoring the second try.

Wallabies Joe Tomane and Pat McCabe will offer back three cover from the bench meaning there is no place in the side for winger Clyde Rathbone, the sole survivor of the Brumbies’ last Super Rugby title in 2004.

Team: 15-Jesse Mogg, 14-Henry Speight, 13-Tevita Kuridrani, 12-Christian Lealiifano, 11-Robbie Coleman, 10-Matt Toomua, 9-Nic White, 8-Ben Mowen (captain), 7-Jarrad Butler, 6-Scott Fardy, 5-Sam Carter, 4-Leon Power, 3-Ben Alexander, 2-Josh Mann-Rea, 1-Scott Sio.

Replacements: 16-Ruaidhri Murphy, 17-Ruan Smith, 18-Allan Alaalatoa, 19-Fotu Auelua, 20-Tom McVerry, 21-Michael Dowsett, 22-Joe Tomane, 23-Pat McCabe.

(Reporting by Nick Mulvenney, editing by Amlan Chakraborty)

When hearing voices is a good thing

As a child, Joe Holt constantly thought he heard people hurling savage insults at him.

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When he would confront them, they would deny having said anything, enraging him further. Holt’s angry outbursts eventually cost him dozens of jobs and relationships. Years later, a diagnosis explained the years of pain and paranoia: Holt had schizophrenia.  

Holt’s story, reported in a 2011 New York Times article, is typical of the way many Americans experience schizophrenia. Auditory hallucinations are one of the illness’s telltale signs. The imagined voices torment sufferers throughout the day, jeering them or nudging them toward violence.

But a new study suggests that the way schizophrenia sufferers experience those voices depends on their cultural context. Surprisingly, schizophrenic people from certain other countries don’t hear the same vicious, dark voices that Holt and other Americans do. Some of them, in fact, think their hallucinations are good—and sometimes even magical.

“I have a companion to talk to … I need not go out to speak. I can talk within myself!”

Doctors “sometimes treat the voices heard by people with psychosis as if they are the uninteresting neurological byproducts of disease which should be ignored,” Stanford anthropologistTanya Luhrmann says. “Our work found that people with serious psychotic disorders in different cultures have different voice-hearing experiences. That suggests that the way people pay attention to their voices alters what they hear their voices say.” 

For the study, which was recently published in the British Journal of Psychiatry, Luhrmann and her colleagues interviewed 60 adults diagnosed with schizophrenia—20 each in San Mateo, California; Accra, Ghana; and Chennai, India. The patients were asked how many voices they heard, how often they heard them, and what the voices were like.

There were a number of cross-cultural similarities: Everyone from the Ghanians to the Californians reported hearing both good and bad voices and hearing unexplained hissing and whispering.

But there was one stark difference, as Stanford News points out: “While many of the African and Indian subjects registered predominantly positive experiences with their voices, not one American did. Rather, the U.S. subjects were more likely to report experiences as violent and hateful—and evidence of a sick condition.”

The Americans tended to described their voices as violent—”like torturing people, to take their eye out with a fork, or cut someone’s head and drink their blood, really nasty stuff,” according to the study.

Meanwhile, the Indians and Africans were more likely to say that their hallucinations reminded them of friends and family, and that the voices were playful or even entertaining. “Mostly, the voices are good,” said one Ghanian participant. 

A Chennai participant said, “I have a companion to talk [to] . . . [laughs] I need not go out to speak. I can talk within myself!”

Luhrmann and her colleagues chalked up the differences in how the voices were perceived to distinct societal values. Americans desire individuality and independence, and the voices were seen as an intrusion into a self-made mind. Eastern and African cultures, meanwhile, tend to emphasize relationships and collectivism. There, a hallucination was more likely to be seen as just another point in the schizophrenic person’s already extensive social network. In fact, the participants were sometimes so sympaticowith their hallucinations that they didn’t even see themselves as mentally ill:

“Many in the Chennai and Accra samples seemed to experience their voices as people: the voice was that of a human the participant knew, such as a brother or a neighbor, or a human-like spirit whom the participant also knew. These respondents seemed to have real human relationships with the voices—sometimes even when they did not like them.”

Luhrmann says she thinks her insights might help in the development of new therapies for schizophrenia sufferers the world over. There’s no cure for schizophrenia, but some therapies urge patients to develop relationships with their hallucinated voices and to negotiate with them.

In an article for the American Scholar, Luhrmann describes one such patient, a 20-year-0ld Dutch man named Hans, whose inner voices were urging him to study Buddhism for hours each day. He cut a deal with his demons, telling them he’d say Buddhist prayers for one hour per day, no more, no less. And it worked—the voices subsided and he was able to taper his dose of psychosis medications.

At one support group for schizophrenic patients, Hans said a new, “nice” voice he had been hearing recently threatened to get mean. 

“This new voice seemed like it might get nasty,” Luhrmann writes. “The group had told [Hans] that he needed to talk to it. They said that he should say, ‘We have to live with each other and we have to make the best of it, and we can do it only if we respect each other.’ He did that, and this new voice became nice.” 

This article was originally published on The Atlantic. Click here to view the original. © All rights reserved. Distributed by Tribune Content Agency.