Saturday, January 19, 2008

Swarming With Bloggers

Bloggers to the left of me, bloggers to the right. Tap. Tap. Tap. Click. Click. Click.

At the 2008 North Carolina Science Blogging Conference, the explosion of science blogging is immediately manifest. Despite an official winter storm alert -- Oh, no, it’s supposed to snow! Rush out and buy toilet paper! -- some 200 science bloggers and fellow travelers gathered Jan. 19 at the research society Sigma Xi in Research Triangle Park, N.C., to discuss their meat and potatoes (or, in N.C. parlance, barbecue and hush puppies).

After grabbing coffee and rolls, along with a bag of science-and-blogging goodies provided by conference sponsors, we’re breaking into groups to get insiders’ views on an array of topics. Among the early items on the cornucopian agenda: blogging ethics. Do bloggers discussing published scientific papers have an obligation to send people to the journal articles? Can a discussion be based on an institution’s news release on the paper? Is there a need for a “code of ethics” for science bloggers? How about a list of “best practices”?

Other sessions will cover such issues as overcoming obstacles to open science in the developing world, building interactivity into blogs, student blogging from K to Ph.D., dealing with public scientific data, and various practical issues and experiences in blogging about a number of specific areas of science.

As a new blogger coming to this world from too many years in print communications, my mind boggles at the level of enthusiasm and degrees of skills collectively represented here. My hope is to bring away some lessons -- learning by osmosis, if nothing else -- that will help flavor future postings.

Wednesday, January 16, 2008

A Close Encounter With Epigenetics

It was a bit like watching 15-Minute Hamlet, a time-warped version of Shakespeare’s work that includes all of the well-known scenes without the detailed action.

Facing a standing-room-only crowd of students and faculty at a Jan. 15 meeting at the Duke Institute for Genome Sciences & Policy, genetics researcher Randy Jirtle (photo) covered in short order the background, current events and possible directions of epigenetics -- billed for this occasion as “The New Genetics of Biology.”

Shorn of most details, epigenetics is the study of heritable changes in gene function that occur without a change in the DNA sequence within cells. The field has emerged only in recent years, and Jirtle has proved a marquee player. (For his efforts, he was nominated by a top federal health official to be Time magazine’s 2007 Person of the Year, but lost the part to Vladimir Putin of Russia.)

In particular, Jirtle studies genetic “imprinting,” a form of gene regulation that doesn’t follow the usual genetic rules. Imprinting is proving to be important in determining whether infants exposed to certain environmental or nutritional agents in the womb or during the early postnatal period go on to become susceptible to a number of adult-onset diseases, including cancer, diabetes and asthma. His group’s website offers more.

Among their latest achievements, Jirtle and his colleagues identified 156 imprinted genes in humans -- the largest such list to date. Now the challenge is to determine what roles, if any, the genes play in disease.

Heady stuff -- and often above my head. But I got cut some slack: “This field is not for the faint of heart,” Jirtle told his audience. “It’s not easy to work in, but it’s incredibly exciting and important.”

Aspirin: Small Dose, Big Benefits

In today's world of skyrocketing health care costs, it's nice to be reminded that cheaper sometimes is just as good -- or even better -- than expensive.

Duke medical center researchers have shown this to be true when it comes to using aspirin to prevent heart attacks, stroke or death among patients with cardiovascular disease. They found that using low doses of the 100-plus-year-old drug is just as effective as higher doses.

Moreover, low-dose aspirin -- commonly in the 81 milligram "baby aspirin" range -- worked just as well as several newer drugs.

"When you put aspirin up against newer medications like the cholesterol-lowering statins or blood pressure-reducing ACE-inhibitors -- which can be very expensive -- you see a similar pattern of benefit," says study investigator Dr. Jeffrey Berger, a cardiologist at the Duke Clinical Research Institute (photo above).

Results of the study, published in the January 2007 issue of the American Journal of Medicine, are described in a medical center news release.

The study also has had another result: it reminded me that many people at risk of developing heart problems -- including, in my case, men over 40 -- can benefit by taking a low dose of aspirin each day.

Of course, aspirin can cause side effects, such as serious bleeding, in some patients. So, as they say in the ads, consult your doctor -- but do keep in mind the potential health benefits of the lowly, often overlooked aspirin tablet.

Monday, January 14, 2008

Listen to Cancer Patients


For many people, this diagnosis is as scary as it gets. At once, their world -- their future -- shifts tectonically. Yet when cancer patients express their fears and other negative emotions, their doctors often don't listen closely enough.

A Duke study, published in the Dec. 20, 2007, issue of the Journal of Clinical Oncology, concludes that physicians need to learn to demonstrate greater empathy in communicating with cancer patients -- and medical training should be adjusted to provide the necessary skills.

This cautionary tale for physicians, detailed in a medical center news release, has been reported widely in the media. See New York Times story from Jan. 8, 2008.

Effective communication between oncologists and their patients, especially those with advanced cancer, is essential to good care, says James Tulsky, M.D., director of Duke's Center for Palliative Care and senior investigator on the study (photo above).

"However, many oncologists have never been trained to respond to patients' emotions and concerns in a matter that shows their empathy," he says. "By teaching physicians to use explicit emphatic language when communicating with distressed patients, we have a chance to improve patient quality of life."

Toward this goal, the researchers produced personalized CD-Roms for the doctors in their study that highlight examples of when the clinicians responded emphatically to their patients, as well as examples of areas for improvement.

This study seems to dovetail with other research I’ve read about which suggests that when people first hear their cancer diagnosis, they immediately stop hearing anything else their physicians are saying.

Clearly, communicating about cancer is hard for everyone -- and any clues about how to make matters better are sorely needed.