First-of-their-kind images could aid in use of DNA to build nanoscale devices


Revealing the fluctuations of flexible DNA in 3-D
In a Berkeley Lab-led study, flexible double-helix DNA segments connected to gold nanoparticles are revealed from the 3-D density maps (purple and yellow) reconstructed from individual samples using a Berkeley Lab-developed technique called individual-particle electron tomography or IPET. Projections of the structures are shown in the background grid. Credit: Berkeley Lab

An international team working at the Department of Energy’s Lawrence Berkeley National Laboratory (Berkeley Lab) has captured the first high-resolution 3-D images from individual double-helix DNA segments attached at either end to gold nanoparticles. The images detail the flexible structure of the DNA segments, which appear as nanoscale jump ropes.

This unique imaging capability, pioneered by Berkeley Lab scientists, could aid in the use of DNA segments as building blocks for that function as nanoscale drug-delivery systems, markers for biological research, and components for computer memory and electronic devices. It could also lead to images of important disease-relevant proteins that have proven elusive for other imaging techniques, and of the assembly process that forms DNA from separate, individual strands.

The shapes of the coiled DNA strands, which were sandwiched between polygon-shaped gold nanoparticles, were reconstructed in 3-D using a cutting-edge electron microscope technique coupled with a protein-staining process and sophisticated software that provided structural details to the scale of about 2 nanometers, or two billionths of a meter.

“We had no idea about what the double-strand DNA would look like between the nanogold particles,” said Gang “Gary” Ren, a Berkeley Lab scientist who led the research. “This is the first time for directly visualizing an individual double-strand DNA segment in 3-D,” he said. The results were published in the March 30 edition of Nature Communications.

Revealing the fluctuations of flexible DNA in 3-D
Gang Ren (standing) and Lei Zhang participated in a study at Berkeley Lab’s Molecular Foundry that produced 3-D reproductions of individual samples of double-helix DNA segments attached to gold nanoparticles. Credit: Roy Kaltschmidt/Berkeley Lab

The method developed by this team, called individual-particle electron tomography (IPET), had earlier captured the 3-D structure of a single protein that plays a key role in human cholesterol metabolism. By grabbing 2-D images of the same object from different angles, the technique allows researchers to assemble a 3-D image of that object. The team has also used the technique to uncover the fluctuation of another well-known flexible protein, human immunoglobulin 1, which plays a role in our immune system.

For this latest study of DNA nanostructures, Ren used an electron-beam study technique called cryo-electron microscopy (cryo-EM) to examine frozen DNA-nanogold samples, and used IPET to reconstruct 3-D images from samples stained with heavy metal salts. The team also used molecular simulation tools to test the natural shape variations, called “conformations,” in the samples, and compared these simulated shapes with observations.

Ren explained that the naturally flexible dynamics of samples, like a man waving his arms, cannot be fully detailed by any method that uses an average of many observations.

A popular way to view the nanoscale structural details of delicate biological samples is to form them into crystals and zap them with X-rays, though this does not preserve their natural shape and the DNA-nanogold samples in this study are incredibly challenging to crystallize. Other common research techniques may require a collection of thousands near-identical objects, viewed with an electron microscope, to compile a single, averaged 3-D structure. But this 3-D image may not adequately show the natural shape fluctuations of a given object.

The samples in the latest experiment were formed from individual polygon gold nanostructures, measuring about 5 nanometers across, connected to single DNA-segment strands with 84 base pairs. Base pairs are basic chemical building blocks that give DNA its structure. Each individual DNA segment and gold nanoparticle naturally zipped together with a partner to form the double-stranded DNA segment with a gold particle at either end.

The samples were flash-frozen to preserve their structure for study with cryo-EM imaging, and the distance between the two gold particles in individual samples varied from 20-30 nanometers based on different shapes observed in the DNA segments. Researchers used a cryo-electron microscope at Berkeley Lab’s Molecular Foundry for this study.

They collected a series of tilted images of the stained objects, and reconstructed 14 electron-density maps that detailed the structure of individual samples using the IPET technique. They gathered a dozen conformations for the samples and found the DNA shape variations were consistent with those measured in the flash-frozen cryo-EM samples. The shapes were also consistent with samples studied using other electron-based imaging and X-ray scattering methods, and with computer simulations.

While the 3-D reconstructions show the basic nanoscale structure of the samples, Ren said that the next step will be to work to improve the resolution to the sub-nanometer scale.

“Even in this current state we begin to see 3-D structures at 1- to 2-nanometer resolution,” he said. “Through better instrumentation and improved computational algorithms, it would be promising to push the resolution to that visualizing a single DNA helix within an individual protein.”

The technique, he said, has already excited interest among some prominent pharmaceutical companies and nanotechnology researchers, and his science team already has dozens of related research projects in the pipeline.

In future studies, researchers could attempt to improve the imaging resolution for complex structures that incorporate more DNA segments as a sort of “DNA origami,” Ren said. Researchers hope to build and better characterize nanoscale molecular devices using DNA segments that can, for example, store and deliver drugs to targeted areas in the body.

“DNA is easy to program, synthesize and replicate, so it can be used as a special material to quickly self-assemble into nanostructures and to guide the operation of molecular-scale devices,” he said. “Our current study is just a proof of concept for imaging these kinds of molecular devices’ structures.”

Best Time To Shower- Morning Or Evening?


A shower rejuvenates and refreshes you! Read on to see the pros of taking a shower in the morning and showering in the evening.
Pros Of A Morning Shower:

Increased Blood Circulation

A morning bath increases blood flow and circulation to your system.
Relieves Muscle Tension

A hot water bath in the morning does wonders for stiff neck and shoulder muscles.

Oily Skin Problems

Wash away the excess grease and dirt often seen more in oily skinned people. Seal open pores with cold water afterwards.

 

Pros Of An Evening Shower:

Ultimate Wind Down

A bath prior bedtime reduces blood pressure and stress after a hard day’s work.
Induces Sleep

A quick rinse in warm water is a sure way to sleep faster.

Cleaner Sheets

Clean sheets are a must for pimple free skin. A rinse before bedtime will ensure that the sheets remain clean and keep away skin infections.

Believe it or not! Scientists created Wormholes! Distant galaxies will be nearer soon!


Wormholes have been an evergreen topic of interest among sci-fi fans. The discoveries of wrinkles in the fabric of space and time, that can warp the two dimension to transport a body instantaneously to an alternate universe. Well, don’t get too excited; it’s all still very theoretical. What has actually been made by scientists, is a wormhole for magnets, which transports magnetic fields through space. The transaction of the magnet will occur without being visible from the outside.

wormhole-lab-660x330

“From a magnetic point of view, this device acts like a wormhole, as if the magnetic field was transferred through an extra special dimension,” lead study author Jordi Prat-Camps of the Autonomous University of Barcelona in Spain told Live Science.

The wormhole device contains an interior spiral of ferromagnetic metal, surrounded by two concentric spheres. The ferromagnet takes care of the magnetic field lines from one end to the other. A shell of yttrium barium copper oxide (a superconducting material, yellow) bends and distorts the magnetic field lines as they travel.

9-5

The outer shell composed of “mu-metals” (used for shielding electronic devices, silver) perfectly cancels out the magnetic distortion of the superconductor, rendering the entire thing “magnetically invisible” from the outside.
This creation is necessary as it could greatly improve the MRI scans we currently use. A strong magnet could take someone’s picture from very far away.

High-Dose Vitamin C As An Adjunct Cancer Treatment


The use of  High-Dose Vitamin C for Cancer mitigation has been studied for years. While there is little evidence to say that Vitamin C by itself will cure cancer, studies have shown it to kill cancer cells, slow the growth of cancers and greatly improve the effectiveness of other cancer treatments. According to the National Institute Of Health:

“Many laboratory studies have been done to find out how high-dose vitamin C may cause the death of cancer cells. The anticancer effect of vitamin C in different types of cancer cells involves a chemical reaction that makes hydrogen peroxide, which may kill cancer cells.

The National Cancer Institute says laboratory studies have shown the following:

  • Treatment with high-dose vitamin C slowed the growth and spread of prostate, pancreatic, liver, colon, malignant mesothelioma, neuroblastoma, and other types of cancer cells.
  • Combining high-dose vitamin C with certain types of chemotherapy may be more effective than chemotherapy alone:
    • Ascorbic acid with arsenic trioxide may be more effective in ovarian cancer
    • Ascorbic acid with gemcitabine may be more effective in pancreatic cancer
    • Ascorbic acid with gemcitabine and epigallocatechin-3-gallate (EGCG) may be more effective in malignant mesothelioma cells.
  • Another laboratory study suggested that combining high-dose vitamin C with radiation therapy killed more glioblastoma multiforme cells than radiation therapy alone.”

 

High-dose vitamin c for cancerThe Cancer Center at CHIPSA Research Hospital in Mexico uses high dose IV Vitamin C in conjunction with their other innovative treatments such as Coley’s Toxins to maximize effectiveness. Chipsa does not  use traditional Chemotherapy or radiation which often causes permanent or even fatal side effects.

To find out if High-Dose Vitamin C is an appropriate treatment for your cancer call 855-624-4772 or simply fill out the form to the right of this blog and one of our patient coordinators will work with you to find the best treatment.

Forget Filling Cavities: Regrow Your Teeth Instead


Forget Filling Cavities: Regrow Your Teeth Instead

Eggshells contain the perfect amount of the ideal substances for healing cavities – massive amounts of calcium and 27 other minerals. The composition of eggshells resembles our teeth. Eggshells provide the necessary amount of calcium to remineralize teeth. Just boil shells from one organic free range egg  for about 5 minutes. You can add them daily into your smoothies or grind them into a fine powder and add it to your food.

Forget Filling Cavities: Regrow Your Teeth Instead

Eggshells have unique beneficial medicinal properties

    • Bone tissue is composed of calcium.  Actually, human bones and teeth are very similar to an eggshell’s composition. One of the benefits of eggshells is the calcium contained in the shell (93 %), the bone marrow is fulfilling its hematopoietic function better.
    • Additionally, eggshells also contain mineral elements: magnesium, phosphorus, silicon,  sodium, potassium, iron, sulfur, aluminum, etc.
    • There are 27 elements found in the eggshells.  Also the protein of a shell is composed of such essential amino acids as methionine, cysteine, lysine, isoleucine. Thus, properly prepared eggshells are the most balanced natural means to obtain calcium.
    • Eggshells are especially beneficial for small children because their bodies experience more intensively involved in the formation of bone tissue, which requires an uninterrupted flow of calcium. Shell’s included in baby food can be beneficial to prevent  rickets and anemia, which usually develops in parallel with rickets. Shell’s promote activation of blood in the bone tissue.
    • Studies also showed accelerated healing when using the shell for treating such orthopedic diseases as congenital dislocation of a hip or osteoporosis (softening of the bones).

    To use  eggshells for medicinal purposes, you need to use organic eggs in order to avoid any chemicals or antibiotics.

How to prepare:
Take eggshells and put them in boiling water for about 5 minutes. The boiling will kill any pathogens. Then, air dry the shells and grind the shells in a coffee grinder. Take a 1/2 teaspoon a day. It is important to note that Vitamin D greatly aids calcium absorption.  So make sure to get enough sunlight or eat organ meats such as liver.

 

Vaccines Do NOT Cause Autism! What Does?


Everyone loves a good conspiracy theory! Even if you don’t believe one, it can still be interesting to learn about. However, sometimes it can lead to some harmful misinformation. Join Trace as he talks about conspiracy theories in the medical world and why they can be harmful for adults and children.

Read More:
Medical Conspiracy Theories and Health Behaviors in the United States
https://archinte.jamanetwork.com/article.aspx?articleid=1835348
“Over the past 50 years, numerous conspiracy theories have materialized around public health matters such as water fluoridation, vaccines, cell phones, and alternative medicine.”

The Risk of Autism Is Not Increased by “Too Many Vaccines”
http://www.jpeds.com/content/JPEDSDeStefano
“Although scientific evidence suggests that vaccines do not cause autism, approximately one-third of parents continue to express concern that they do; nearly 1 in 10 parents refuse or delay vaccinations because they believe it is safer than following the Centers for Disease Control and Prevention’s (CDC) schedule.”

2-14 Recommended Immunizations for Children from Birth Through 6 Years Old
http://www.cdc.gov/vaccines/parents/downloads/parent-ver-sch-0-6yrs.pdf

Pathogenic SYNGAP1 Mutations Impair Cognitive Development by Disrupting Maturation of Dendritic Spine Synapses
http://www.cell.com/abstract/S0092-8674%2812%2901240-8
“Mutations that cause intellectual disability (ID) and autism spectrum disorder (ASD) are commonly found in genes that encode for synaptic proteins.”

Nearly 50% in US Believe in Medical Conspiracy Theories
http://www.livescience.com/44147-medical-conspiracy-theories.html
“About half of Americans agree with at least one medical conspiracy theory, a new study suggests.”

5 Enduring Kennedy Assassination Theories
http://www.livescience.com/41375-enduring-kennedy-assassination-theories.html
“On Nov. 22, 1963, President John F. Kennedy died in Dallas, Texas, the victim of a shot through the head that rung out as his motorcade passed through Dealey Plaza.”

Top Ten Conspiracy Theories
http://www.livescience.com/11375-top-ten-conspiracy-theories.html
“Conspiracy. Just saying the word in conversation can make people politely edge away, looking for someone who won’t corner them with wild theories about how Elvis, John F. Kennedy, and Bigfoot are cryogenically frozen in an underground bunker.”

Study: Why people ignore facts
http://www.upi.com/Health_News/2009/08/25/Study-Why-people-ignore-facts/UPI-95341251179479/
“Many people seek out information confirming what they believe, instead of searching for information that confirms or disconfirms a belief, U.S. researchers say.”

What is Autism? What Causes Autism?
http://www.medicalnewstoday.com/info/autism/
“Autism is known as a complex developmental disability. Experts believe that Autism presents itself during the first three years of a person’s life.”

One Thing we Know About Autism: Vaccines Aren’t to Blame
http://news.nationalgeographic.com/news/2013/07/130716-autism-vaccines-mccarthy-view-medicine-science/
“It all started with bad science.”

What Is Autism?
http://www.autismspeaks.org/what-autism
“Autism spectrum disorder (ASD) and autism are both general terms for a group of complex disorders of brain development.”

Image Credit: Mario Anzuoni/Reuters/Corbis

Watch More:
How We Killed Smallpox
https://testtube.com/dnews/dnews-765-disease-eradication
TestTube Wild Card
http://testtube.com/dnews/dnews-382-what-ancient-wine-tasted-like?utm_source=YT&utm_medium=DNews&utm_campaign=DNWC
Using Science to Save Your Relationship
https://testtube.com/dnews/dnews-889-relationship-tips

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The Cure for All Anxiety


We live in a culture that says that the only way to get what you want is to DO DO DO and then DO some more. Push. Struggle. Make it happen. Put your nose to the grindstone. Work your ass off. Try. And never ever give up.

I once believed this was true. Surrender was something I only did after everything else my ego knew how to do had failed. Once I had exhausted every available option, I would fall to my knees, usually in tears, and surrender to the Divine.

Now I know there’s a whole other way to live, where surrender isn’t a last ditch effort once you’ve given up. It’s a spiritual practice wherein you surrender first, not because there aren’t actions to be taken, but because you trust that living in alignment with Divine Will is more easeful, more gratifying, and ultimately more fulfilling on a deep soul level than constantly chasing after the ego’s ever-grasping, never satisfied desires.

This Is Not the Law of Attraction

Maybe you’ve already realized the insanity of trying to push, strive, and make things happen in the traditional way, and so now you’ve traded it all in by practicing “the law of attraction.” Instead of grinding away trying to get what you want, you’re now visualizing, vision boarding, and affirming that which your ego wants in order to “manifest” what you desires.

But isn’t that just another form of “doership?” Now, instead of pushing and striving, you’re pushing and striving in your efforts to manifest your desires. What if there’s a whole other way of living? What if, instead of attaching to what your ego desires, you’re willing to let the Divine take the lead, allowing whatever is in the highest good come into being, regardless of what your ego desires? What if you’re willing to offer all your desires up to the Divine and then be brave enough to follow the spiritual guidance that directs you to the highest, even if you’re lead away from what you think you want? Would you be willing to trust that something higher than your ego has your best interests at heart? Would you be willing to let your Inner Pilot Light take the lead in your life, instead of keeping your ego in control of your decision-making?

anxiety cure

Outrageous Openness

As Tosha Silver taught in our second retreat with the doctors of the Whole Health Medicine Institute, it’s not only possible to offer up your desires and problems to the Divine; it’s actually a much more magical, miraculous, and fulfilling way to live. But this is not an easy concept for a group of doctors to grok! Try telling doctors that it’s not their job to attach to curing the patient, that it’s not their responsibility to assure a perfect surgical outcome, that they don’t have the power to cure cancer or save someone from heart disease, that instead, they have the opportunity to allow their very skillful hands and minds to be servants of Divine Will, without claiming any credit for a “good” outcome or blaming themselves for a “bad” one! This doesn’t mean these doctors won’t do everything within their power to achieve the best possible outcomes for their patients. But it does mean that instead of praying for a perfect outcome, they pray that whatever is in the highest may come into being. They pray that they may be vessels for Divine will, in whatever form is in the best interest of the soul of the patient.

This year’s graduates of the Whole Health Medicine Institute Physician Training program TOTALLY get this, but it’s such a radical way of practicing medicine—such a radical way of practicing life, for that matter—that we have to make it a daily practice. See if you can sense the peace in living this way . . .

Opportunities for Surrender

If you’re struggling to succeed in your career . . . surrender your desire to achieve and ask instead that you be used in service in whatever way is most aligned.

If you’re sick and in pain . . . let go of your attachment to cure and accept what is, right here, right now, without resistance.

If you’re yearning for true love . . . give your longing over to a power greater than you and trust that the perfect lover is already picked and you will meet this being in Divine timing, when your soul is ready to give and receive unconditional love.

If you’re trying to get pregnant . . . offer your desire to be a parent to the Divine and be willing to mother in whatever way the Divine wants to use you.

If you’re in the midst of a contentious divorce or you’re getting sued or your house isn’t selling . . . trust and let go.

If your computer crashes or the market crashes and your bank account is dwindling, surrender.

If you long for a new car or a new apartment or even just a parking spot, offer it up to the Divine and watch for spiritual guidance that will lead you to whatever is most aligned for you.

Any unmet desire that’s burdening you, any problem you think you have to solve—try surrendering it over to the Divine as an offering of trust.

Banishing “My”

One thing Tosha taught the doctors this weekend is that putting this concept into practice in everyday life gets easier if you banish the word “my” from your vocabulary. If you’re afraid of losing “my” money or having a bad outcome of “my” surgical case, you’re going to grasp and attach. But if you know it’s God’s money and God’s surgery, you trust that it’s safe to let go. If you’re struggling through a divorce, it’s likely because you’re grasping at “my” house and “my” retirement account and “my” child. But what if it’s God’s house, God’s retirement account, and God’s child? As Tosha said to meduring my divorce, “You’re suffering because you think it’s ‘my’ books, ‘my’ business, ‘my’ kid. But you wouldn’t have shit if it weren’t for God’s largess.”

Oy. Busted.

When you realize none of it’s yours, that you don’t get to claim or even keep any of it, when you’re willing to let go of attaching to anything you consider “mine,” you’re suddenly free. There’s no need to grip or grasp. As Tosha says, “The very act of grasping for the feather creates the wind current that pushes it away.” Ironically, very often—but not always—when you let go, that’s the moment you suddenly get exactly what you want. But you can’t choose to live this way for egoic purposes! The motivation must be pure. Let go because you trust, not because your ego is grasping at this spiritual teaching as yet another tool to get what it wants.

Surrender Isn’t Passive

This is such a counter-cultural concept that most people resist letting go. Our culture teaches us that letting go is for sissies. Winners make things happen. Winners hustle. Only lazy people and losers surrender. Surrender sounds so god damn passive, right?

But letting go of attachment to the ego’s desires isn’t lazy or careless or the action of a loser. It’s the bravest risk you’ll ever take because it requires you to trust in something the ego can never quite accept—that it’s actually safer to let the soul lead instead.

Letting go of attachment doesn’t mean doing nothing. Once you’ve offered over your desires and problems to a higher Source, you’ll often find yourself leaping to take inspired action. But this action arises not from the gripping, grasping panic of the ego but from the relaxed, peaceful, creative problem solving and inspiration of the soul. When you’re brave enough to try this, you’re likely to find that everything becomes easier. Your desires become simply preferences, and your only real desire becomes your wish to let the Divine use you however best serves the highest good.

Putting Surrender Into Practice

Part of the beauty of this way of living is that it takes away all the anxiety that might normally accompany something like the launch of a new program. Let me give you an example of how I’m called to practice surrender in practical ways. We announced that we were accepting applications for the Class of 2015 for the next Whole Health Medicine Institute Physician Training program. And just as we launched, our server crashed and the website was inaccessible. My team started to panic. Oh no! Computer problems! Who can sign up if there’s no sales page?

Then we remembered . . . surrender it all. Surrender the computer problem. Surrender our desire to fill the program with twenty perfectly aligned doctors. Surrender any idea that the program is “my” program. Give it up. Let it go . . .

So we did this as a team. If we’re meant to do this program again and fill it with the 20 doctors we hope to attract, the website will come back up. If not, well . . . none of it is “mine,” and I trust that if we’re not meant to do this, we’ll be guided to do whatever else is most aligned. We’ve turned the whole program over the Divine, knowing it doesn’t belong to us anyway, that we are merely the hands being offered in service to whatever is in the highest good for everyone involved. (God willing, if you’re a doctor interested in this program or you know one who is, you’ll be able to read the invitation.

Cave Early

Living this way takes constant practice. I have to remember what I’ve learned from my spiritual teachers at least twenty times a day, because my habit of grasping and doing and pushing to solve problems is so ingrained after years of cultural brainwashing that I have to keep remembering to surrender over and over. But the more I do it, the more quickly I remember to let go. Surrender is no longer something I do as an act of desperation after everything else has failed. It’s something I try to do within minutes of identifying a desire or encountering a problem I think I need to solve. As Martha Beck says, “Cave early.”

When you choose to live this way, a surprising thing happens. Your anxiety goes away. Not always permanently. You may have to be reminded over and over. But when you’re in the zone of trust, anxiety can’t co-exist.

So I challenge you. Are you ready to release anxiety. Are you willing to cave early? Would you be willing to be this brave? I dare you . . . but only if you’re ready to attain inner peace and find yourself awash in joy . . .

 

13 Billion Years Ago, This Was Our Universe


http://www.sciencechannel.com/tv-shows/how-the-universe-works/videos/13-billion-years-ago-this-was-our-universe/

Study Identifies 5 Strategies to Spark Patient Motivation


Primary care physicians increasingly are assessed on patient outcomes even though many outcomes are determined largely by the patient, not the physician. But physicians sometimes struggle with motivating patients to make health-enhancing changes.

A research study(www.annfammed.org) published in the March/April issue of Annals of Family Medicineidentified five strategies that may help. The strategies show promise in supporting patient activation, which has been shown to be associated with outcomes including better self-management and clinical indicators, fewer hospitalizations and lower health care costs.

The study, “Supporting Patient Behavior Change: Approaches Used by Primary Care Clinicians Whose Patients Have an Increase in Activation Levels,” defined patient activation as having the knowledge, confidence and skills to take care of one’s health and health care.

Using data from an accountable care organization, researchers aggregated data on change in the patient activation measure (PAM) scores for 7,144 patients to the primary care clinician level. The patients all had two PAM scores between 2010 and 2012, and were chosen based on their baseline scores being below the highest of four levels of scores.

STORY HIGHLIGHTS
  • A study reported in Annals of Family Medicine identified five promising strategies that may help physicians influence patients to make health-enhancing changes.
  • The five strategies reported by the top-performing physicians were emphasizing that patients own their own health; partnering with patients; identifying small steps to improve health; scheduling frequent follow-up visits to cheer successes and solve problems; and showing care and concern.
  • The researchers will conduct a follow-up study of a larger sample with a goal of developing training for clinicians.

Researchers ranked clinicians based on the change in their patients’ scores. They then conducted in-depth interviews with 10 of the clinicians whose patients’ scores increased the most and 10 of those whose patients’ scores increased the least. The interview transcripts were analyzed to look for strategies the clinicians used to support patient lifestyle behavior change.

“We found the top-performing clinicians most frequently reported using five strategies when they worked with patients on behavior change,” lead researcher Jessica Greene, Ph.D., associate dean for research and a professor at the George Washington University School of Nursing, toldAAFP News.

The five key strategies were:

  • Emphasizing patient ownership. The top-performing clinicians described emphasizing that patients own their health, Greene said. “One clinician told her patients, ‘I’m here to coach you, not to make you better. You make yourself better; I can’t do that for you.'”
  • Partnering with patients. The top performers described working with patients to co-create goals and strategies for behavior change and to solve problems, Greene said. “These clinicians acknowledged that they don’t know their patients’ lives outside the clinic and that patients can best decide which goals and strategies are most appealing or feasible.”
  • Identifying small steps. The top performers helped patients identify small steps toward change, initially setting the bar low so the patient could achieve the goal, said Greene. “The patient then had some confidence when the bar was set a little higher for the next step.” Many of the top performers said they would ask a patient who resisted change to identify just one small change. “The patient almost always could describe one thing they could do to get healthier,” said Greene.
  • Scheduling frequent follow-ups. Following up with patients frequently was part of the coaching role the top performers assumed. Some had patients come in for face-to-face visits, while others used their electronic medical record system to communicate with patients, said Greene. “A few said they felt a tension about asking a patient to make frequent follow-up visits because they didn’t want the patient to have to spend more money.”
  • Showing care and concern. “Some of these top-performing clinicians told patients they wanted them to be healthy enough to play with their grandchildren,” Greene said. “The clinicians wanted patients to make changes so their lives would be better, not just change to please the clinician.”

Very few of the bottom-performing clinicians reported using these five strategies with patients, said Greene. When these clinicians did report one of these strategies, they rarely described it in as much detail as the top-performing clinicians did.

The strategy most of the bottom performers described was telling patients the consequences of bad behaviors. “I think these clinicians were doing this from the right place, trying to help spark change in people,” said Greene. “Since we didn’t hear this strategy from many of the top performers, it’s probably not an effective strategy, but we don’t really know that from this study.”

Most of the clinicians in both groups reported relying on team members, such as hypertension nurses, to support behavior change.

Greene noted that the top performers described counseling and education as a crucial part of their work, while most bottom performers reported that it was a smaller component.

Top performers also seemed more optimistic about their patients, while the less successful clinicians expressed more frustration with their patients, Greene said. “It seems that once you start giving up on patients, it’s hard to get them to be healthier. Maintaining a positive approach and focusing on successes seem to be helpful.”

Greene and her research team will conduct a follow-up study with a larger provider sample. If that study validates the five key strategies, then the next step would be to develop training to help clinicians learn how to apply the strategies, she said.

The current study showed that both the top- and bottom-performing clinicians used trial and error and tweaked their approaches to support behavior change. “This underscores the importance of training in this area, because some folks figure out effective ways to support patients in behavior change while others don’t,” Greene said. “They shouldn’t have to figure it out on their own.”

 

Obama: U.S. opioid epidemic as great a threat as terrorism


President Obama said Tuesday that America’s addiction to pain killers is as great a threat as terrorism.

Here’s why: 78 people die each day from overdoses of opioids, prescription drugs and heroin. No place is immune.

Six minutes. That’s the goal in Plymouth, Massachusetts. Six minutes for EMTs to get a call about an opioid overdose, and get the victim breathing again.

Jocelyn Benvie revived her 22-year-old friend and called 911 after she took heroin and fell unconscious.

“It’s just really scary when you see your friend not breathing with purple lips, and you don’t know what you can do to help,” Benvie said.

Plymouth, population 56,000, is nick-named “America’s hometown.” Twenty-five people there died from heroin overdoses last year.

Across the country, opioid deaths — whether caused by pain pills or heroin — jumped 372 percent from 2000 to 2014.

That’s why President Obama told a heroin summit in Atlanta that the government is distributing $11 million to states for the overdose reversal drug often called Narcan.

In cities like Plymouth, 911 calls for overdoses are up 500 percent in two years. On weekends, it’s as many as four a day.

“The mean age of overdoses is dropping into the low 20’s. We’ve had opioid overdoses as low as 14 years old,” said EMT Jeff Jacobsen.

Davis Owen, a former high school class president, was 20 when he died from a heroin overdose.

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All these kids are dying they’re no different than Davis. They’re high achievers. They’re fun. They’re beautiful kids from exceptional families. And they’re dropping like flies,” his mother said.

In all, the president proposed an additional $1.1 billion to combat this addiction — triple the current funding. But the issue is still, in the president’s words, “grossly under-resourced.”