In children and teens, depression doesn ’t always look like sadness
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When we think of a depressed person, we tend to think of someone who, well, acts sad. The picture we have in our head is of someone who doesn’t want to get off the couch or out of bed, who is eating much less or much more than usual, has trouble sleeping or wants to sleep all the time, who has trouble with usual daily activities, and doesn’t talk much.
Children and teens with depression can certainly look like that. But depression can play out in different ways, too. Numbers are hard to come by in younger children, but among 12-to-17-year-olds, almost 13% have had a major depressive episo...
Source: Harvard Health Blog - March 13, 2018 Category: Consumer Health News Authors: Claire McCarthy, MD Tags: Anxiety and Depression Children's Health Mental Health Parenting Source Type: blogs
Trial By Error: The Dutch Review; My Trip; Bristol ’ s Silence
By David Tuller, DrPH And now some potentially good news from the Netherlands. Two years ago, the Dutch parliament asked the Health Council—an independent scientific advisory body—to review the state of evidence related to the illness generally called chronic fatigue syndrome in the Netherlands. That review was to include the evidence for rehabilitative treatments like […] (Source: virology blog)
Source: virology blog - March 12, 2018 Category: Virology Authors: David Tuller Tags: Uncategorized Source Type: blogs
Dr. Google: The top 10 health searches in 2017
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Ever wonder what other people are wondering about? I know I do.
So, here are the top 10 health searches in Google for 2017. And just so you don’t have to look each one up, I’ve provided a brief answer. You’re welcome.
1. What causes hiccups?
I was surprised this one made it to the top 10 list of health searches. Maybe this search is common because hiccups are as mysterious as they are universal. I’ve written about hiccups before, but let’s just say the cause in any individual person is rarely known or knowable. Then again, the reason hiccups stop is also unknown.
Some triggers...
Source: Harvard Health Blog - February 21, 2018 Category: Consumer Health News Authors: Robert H. Shmerling, MD Tags: Health Source Type: blogs
Trial By Error: Letter to British Journal of Sports Medicine from CPET Experts
By David Tuller, DrPH Last October, the British Journal of Sports Medicine published a short paper that was essentially a summary of Cochrane’s systematic review of graded exercise for chronic fatigue syndrome (as Cochrane calls the illness). This systematic review is problematic for a number of reasons—not least of which is that it includes the […] (Source: virology blog)
Source: virology blog - February 5, 2018 Category: Virology Authors: David Tuller Tags: Uncategorized Source Type: blogs
Her Chronic Pain Was a Medical Mystery. Was It an Unexplained Condition? - The Daily Beast
Leslie Levine's searing pains started the day after Thanksgiving in 2006. They began in her toes, which turned strangely dark. Then the agony crept upward."It felt like my legs were being dipped in boiling oil 24/7," she said.The emergency room and a series of doctors could do little but scratch their heads and offer her painkillers."I was living on oxycodone and very grateful for it," Levine said, then Harvard University's chief patent attorney. But it wasn't enough."By January, I was on disability, because I was in such pain and could hardly walk."Her internet search for answers ...
Source: Psychology of Pain - December 7, 2017 Category: Anesthesiology Source Type: blogs
Trial By Error: My Brief Encounter with Professor Crawley
By David Tuller, DrPH
At noon last Friday, at the University of Exeter’s Mood Disorders Centre, Professor Esther Crawley gave a talk called “What is new in paediatric CFS/ME research.” When I saw a notice about the event the day before, I felt it might be my one chance to ask her directly about her concerns regarding my work and her accusation that I was writing “libellous blogs.” (If she were American, she would presumably have accused me of writing “libelous–one L–blogs”).
I also hoped to gain insight into some other issues that have troubled me: why she still believes PACE was a “gre...
Source: virology blog - November 20, 2017 Category: Virology Authors: David Tuller Tags: Uncategorized Source Type: blogs
Trial By Error: What ’ s Going On, BMJ Best Practice?
By David Tuller, DrPH
Something’s weird over at BMJ Best Practice, a resource for clinical decision-making and an arm of the BMJ Publishing Group. Two days ago, Steven Lubet and I posted a blog praising the new guide written by Dr. James Baraniuk and apparently reviewed by Peter White, along with two other experts.
First, I want to acknowledge that many patients disagreed with us about the merits of the guide. We assessed this document based on how much better it was than previous terrible U.K. guidelines, like those from NICE–not based on how far it was from perfection. It was our understanding as well that t...
Source: virology blog - November 15, 2017 Category: Virology Authors: David Tuller Tags: Uncategorized Source Type: blogs
Trial By Error: The Surprising New BMJ Best Practice Guide
This report puts the National Institute for Health and Care Exellence (NICE) to shame. NICE develops clinical guidelines that are widely followed in the U.K, and in other countries as well. A NICE surveillance team had the opportunity to review the same recent literature available to Dr. Baraniuk and recommended in June that the agency should make no changes to its 2007 guidance—which of course highlights CBT and GET as effective treatments.
In September, after patient organizations expressed overwhelming opposition to this recommendation, NICE rejected it and announced that the 2007 guidance would instead undergo a comp...
Source: virology blog - November 13, 2017 Category: Virology Authors: David Tuller Tags: Uncategorized Source Type: blogs
Trial By Error: Another Letter to NICE ’ s Sir Andrew Dillon
By David Tuller, DrPH
First, for those who might have missed it, here’s a conversation from This Week in Virology (TWiV), posted a few days ago. Dr. Racaniello and I discuss the CDC, NICE, Esther Crawley’s ethically challenged behavior, the CMRC, and other stuff.
Second, earlier today, I sent the following e-mail to Sir Andrew Dillon, the NICE chief executive:
Dear Sir Andrew:
I would like to congratulate NICE on its decision to pursue a full update of CG53, the CFS/ME guidance, rather than accept the surveillance report’s recommendation to leave it as is. The Guidance Executive made the right call, b...
Source: virology blog - October 17, 2017 Category: Virology Authors: David Tuller Tags: Uncategorized Source Type: blogs
Leaky gut: What is it, and what does it mean for you?
Before the medical community had better understanding of the mechanisms that cause disease, doctors believed certain ailments could originate from imbalances in the stomach. This was called hypochondriasis. (In Ancient Greek, hypochondrium refers to the upper part of the abdomen, the region between the breastbone and the navel.) This concept was rejected as science evolved and, for example, we could look under a microscope and see bacteria, parasites, and viruses. The meaning of the term changed, and for many years doctors used the word “hypochondriac” to describe a person who has a persistent, often inexplicable fear ...
Source: Harvard Health Blog - September 22, 2017 Category: Consumer Health News Authors: Marcelo Campos, MD Tags: Digestive Disorders Health Source Type: blogs
Study shows how online mindfulness interventions can reduce work-related rumination and fatigue, and improve sleep quality
This study aimed to extend our theoretical understanding of how mindfulness-based interventions exert their positive influence on measures of occupational health. Employing a randomized waitlist control study design, we sought to (a) assess an Internet-based instructor-led mindfulness intervention for its effect on key factors associated with “recovery from work,” specifically, work-related rumination, fatigue, and sleep quality; (b) assess different facets of mindfulness (acting with awareness, describing, nonjudging, and nonreacting) as mechanisms of change; and (c) assess whether the effect of the intervention was m...
Source: SharpBrains - September 14, 2017 Category: Neuroscience Authors: Greater Good Magazine Tags: Cognitive Neuroscience Health & Wellness Technology cognitive-functioning depression fatigue Internet-based mental energy Mental Health Foundation Mental-Health mindfulness occupational health psychological well-being rumination Source Type: blogs
Trial By Error: The NICE “ Topic Expert ” Reports
By David Tuller, DrPH
My first recent freedom of information request to the National Institute for Health and Care Excellence (NICE) was for information about the experts consulted in the current process of reviewing CG53, the 2007 guidance for the illness the agency calls chronic fatigue syndrome/myalgic encephalomyelitis. In its response, the agency explained that seven topic experts had been consulted in the process of preparing the surveillance document, which recommended leaving the guidance as is.
(I have previously written about the NICE review process on CG53 here, here and here. My e-mail exchange with Sir Andrew...
Source: virology blog - September 11, 2017 Category: Virology Authors: David Tuller Tags: Uncategorized Source Type: blogs
Trial By Error: Seeking More Details on Crawley School Absence Study
In this study, schools identified students with unexplained absences and invited them and their families to meet with Professor Crawley to discuss the matter. The study authors did not seek ethical review for this study on the grounds that it only involved “service evaluation,” even though it was piloting a new method of identifying previously undiagnosed patients for Professor Crawley’s CFS/ME clinical service.
Under the circumstances, we were interested in reviewing the letters sent to the families, as well as any other information they were provided about the study. We did not send the request directly to Professo...
Source: virology blog - August 30, 2017 Category: Virology Authors: David Tuller Tags: Uncategorized Source Type: blogs
Trial By Error: No Ethical Review of Crawley School Absence Study
By David Tuller, DrPH
This is a complicated post. Here are the key points. The rest is details:
*Professor Esther Crawley and co-authors claimed a 2011 study in BMJ Open was exempt from ethical review because it involved the routine collection of data for “service evaluation.” Yet the 2011 study was not an evaluation of routine clinical service provision–it was designed to road-test a new methodology to identify undiagnosed CFS/ME patients among students with records of chronic absence.
*To support the claim that the study was exempt from ethical review, Professor Crawley and co-authors cited a 2007 research ethi...
Source: virology blog - August 28, 2017 Category: Virology Authors: David Tuller Tags: ME/CFS Source Type: blogs
Women are flocking to wellness because modern medicine still doesn ’t take them seriously - Quartz
The wellness movement is having a moment. The more luxurious aspects of it were on full display last weekend at the inaugural summitof Gwyneth Paltrow's lifestyle brand Goop, from crystal therapy to $66 jade eggs meant to be worn in the vagina. Meanwhile, juice cleanses,"clean eating," and hand-carved lamps made of pink Himalayan salthave all gone decidedly mainstream. I myself will cop to having participated in a sound bath —basically meditating for 90 minutes in a dark room while listening to gongs and singing bowls. (I felt amazingly weird afterward, in the best possible way.)It seems that privileged wom...
Source: Psychology of Pain - August 20, 2017 Category: Anesthesiology Source Type: blogs
