Os Washingtonianos

 

Na tarde de 02 de abril de 1840, quase cem anos antes do nascimento de A.A., seis companheiros de bebedeiras se reuniram em um botequim da cidade de Baltimore, Estado da Virgínia, nos Estados Unidos da América.

Quanto mais bebiam, mais falavam sobre o tema da temperança, que era um dos assuntos mais populares da época. Essa reunião, assim como os encontros posteriores, deram origem à formação, para a curta mas espetacular existência do Movimento dos Washingtonianos, que chegou a contar com mais de 400.000 membros "alcoólicos recuperados", para poucos anos depois, da noite para o dia, desaparecer totalmente.

A história do Movimento dos Washingtonianos demonstra nitidamente, a importância das Doze Tradições de A.A. como guia de comportamento para os nossos grupos e organismos de Serviço, montadas que foram para proteger-nos de um destino semelhante. O hábito de desprezar nossas Tradições, ou de ignorá-las, nos legou, pelo menos, alguma marca negativa em nosso inventário.

Até a já mencionada reunião de 1840, prevalecia a opinião de que nada era possível fazer pelos doentes do alcoolismo e, mesmo as palavras "alcoólico" ou "alcoolismo", não era de uso comum. Os poucos casos conhecidos de recuperação de alcoólicos, não influíam no pessimismo geral sobre as
possibilidades de recuperação. E, como se acreditava que o álcool era a causa do alcoolismo, muitos movimentos de temperança, então existentes, orientavam sua atuação no sentido de evitar que os não-alcoólicos no alcoolismo ingressassem. Seu lema era:

"Mantenhamos sóbrios os sóbrios; os bêbados que morram e nos deixem em paz".

Em 05 de abril de 1840 os seis companheiros já referidos, novamente sereuniram no mesmo botequim, ao redor de uma garrafa de bebida alcoólica e, alegremente, brindaram as virtudes da temperança, enquanto condenavam a maldição do alcoolismo.

Embora existisse um bom número de Grupos de Temperança, nenhum deles parecia interessar a esses seis companheiros. Como bons bebedores que eram, decidiram formar seu próprio grupo; elegeram-se diretores e firmaram uma promessa de total abstinência, com o seguinte texto:

"Nós, cujas assinaturas aqui constam, com o propósito de constituir, para o nosso próprio benefício e para proteger-nos de costumes perniciosos que são prejudiciais à nossa saúde, à nossa reputação, às nossas famílias, nos comprometeremos, como cavalheiros, a não ingerir qualquer bebida alcoólica, nem licores, nem vinhos de cidra".

Escolheram o nome Sociedade de Temperança Washington, em homenagem a George Washington, estabelecendo uma cota de inscrição em dinheiro, junto com uma contribuição mensal. Com calorosos abraços se despediram, ficando combinado que, cada um deles, traria um novo sócio ao botequim para a próxima reunião. E se mantiveram sóbrios.

Como resultado do crescimento do número de associados e, devido às solicitações desesperadas do dono do botequim, o grupo decidiu alugar uma sala e, ao mesmo tempo, tornar habitual as reuniões semanais.

Nessas reuniões desenvolveram um método único de procedimento, onde cada orador contava sua própria história, calcada no seguinte:

"Como era eu; o que me aconteceu e, como sou agora".

Esta idéia obteve sensacional aceitação, contribuindo para enorme e rápido crescimento ao Movimento. A abstinência total parecia um milagre.

Em novembro de 1840, realizaram sua primeira reunião pública. Os jornais deram ampla cobertura ao acontecimento nas reportagens incluindo o nome completo dos fundadores. A quantidade de público fora tão grande, que só havia poucos lugares de pé. Tanto aos alcoólicos, como os não-alcoólicos; a todos os que se comprometiam à total abstinência; deu-se boas-vindas ao Grupo.

Uns cinco meses mais tarde, o Movimento Washingtoniano declarava constar de seus quadros mais de 1000 alcoólicos recuperados e uns 5000 membros indecisos quanto à conclusão se eram, ou não, alcoólicos, mas que já haviam se comprometidos a manter uma abstinência absoluta, bem como outros 1000 que defendiam uma temperança total, em todos os sentidos e que viam com muito entusiasmo o crescimento da cruzada dos Washingtonianos.

Como bons e entusiasmados propagandistas que eram, os membros organizaram e participaram de um espetacular desfile, com banda de música, balizas, estandartes, que foi presenciado por mais de 40.000 pessoas em Baltimore. Após o desfile, houve uma grande reunião ao ar livre para pulgação de sua mensagem do "12º Passo". Diziam;

"Alcoólico, venha até nós. Você pode se recuperar. Ainda esta manhã estivemos com um homem que se recuperou já faz 4 semanas e estava feliz com a sua abstinência. Não desprezamos os alcoólicos, amamo-nos, guiamos, assim como uma mãe guia seus filhos nos primeiros passos".

As lágrimas caíam copiosamente sobre a mesa da secretária, na medida em que centenas de pessoas subiam ao palanque para assinar seus compromissos de total abstinência. A atmosfera emocional estava saturada de uma contagiante esperança. Os grupos religiosos aceitaram seu programa.

Samuel F. Holbrook, o primeiro Presidente da Sociedade, explodia em altas palavras, com relação ao papel desempenhado por Deus na recuperação dos alcoólicos. Dizia:

Ao cambaleante alcoólico que encontramos na sarjeta, ou retiramos de seu meio, damos apoio, falamos como amigos, levamos às nossas reuniões. Em nosso grupo ele se encontra rodeado por novos amigos, não do que mais temia, a polícia. Todos lhe estendem as mãos; começa a recuperar-se e, quando já se sente sóbrio, assina o compromisso de manter-se abstêmio e volta à rua como um homem recuperado. E seu caso não termina aí, ele cumpre a sua promessa e, dentre seus companheiros de bebedeiras, logo trás outros que, de sua parte, assinarão o mesmo compromisso, trarão outros. Esses são fatos positivos que se pode constatar.

Então pergunto: - Pode algum movimento da humanidade demonstrar isso por si só? A minha resposta é um redondo "NÃO". Nós temos o testemunho invariável de um vasto número de homens recuperados que dizem publicamente que dizem publicamente que haviam deixado de beber persas vezes para, logo a seguir, recair nas bebedeiras e, entendem que, seu atual comportamento, deriva da total confiança da força desta nova decisão, sem qualquer preocupação de olhar um pouco mais alto. Depois, sentem que, necessitam da ajuda de Deus que, uma vez conseguida torna a recuperação completa. Louvado seja Deus".

Não foi possível manter os milagres dos Washingtonianos dentro de seus limites geográficos. Seus membros estavam convencidos de que deles dependiam o socorro para os mais aflitivos casos; os alcoólicos recuperados e em atividade dentro do Movimento comprovaram, com seus exemplos, que
podiam ajudar aos alcoólicos e estavam possuídos de uma extraordinária disposição de levar sua mensagem. Depois, essa campanha se ampliou no sentido de evitar o mesmo sofrimento, pela persuasão, aos ainda não atingidos pelo alcoolismo, objetivando que prosseguissem com a sobriedade através de uma total abstinência. Os líderes mais influentes do Movimento eram de opinião de que necessitavam de bons "vendedores" para espalhar a mensagem de prevenção e, os membros dos Grupos Washingtonianos, proporcionaram uma vasta relação de pessoas disponíveis.

A cidade de Nova Iorque lhes serviu de cenário. Em março de 1842, Washingtonianos e espectadores se reuniram na igreja da Rua Gren; no transcurso do primeiro discurso, um jovem que estava no auditório se levantou cambaleando e disse: - "Não haverá alguma esperança para mim? Deus do céu, não haverá esperança? Vocês podem me ajudar?". O ajudaram a chegar até o palco e, ali mesmo, manifestou sua vontade de assumir o compromisso, partir de então, de absoluta abstinência.

Outros o seguiram; uns jovens como ele; outros, de cabeças grisalhas. Os Washingtonianos receberam a todos eles e, uma organização paralela feminina, conhecida como Sociedade Martha Washington, alimentava e vestia os mais necessitados, enquanto buscava apoio e adeptos dentro do próprio sexo.

Em menos de quatro anos da relatada reunião no botequim, o número de Washingtonianos chegava ao máximo.

Nessa época, se estimava que o Movimento incluía, no mínimo 100.000 "alcoólicos recuperados"; 300.000 "bebedores normais" que, também, se mantinham em total abstinência, bem como incontável número de admiradores entre os membros dos Movimentos de Temperança.

Mas logo chegaria ao esquecimento total. Pelo ano de 1848, tudo o que restava da espetacular e poderosa organização como método original de tratamento do alcoolismo, era o Asilo dos Decaídos, em Boston. Essa organização, assim mesmo, sofreu numerosas modificações, no nome e na orientação e, atualmente funciona com o nome de Hospital Washingtoniano, se dedicando ao tratamento do alcoolismo mediante sistemas médicos modernos e técnicas sociais. Nos demais aspectos o Movimento se autodestruiu por completo. Com ele, desapareceu a esperança de milhares de alcoólicos de sua época.Tendo a breve história anterior por exemplo, é possível efetuar uma limitada comparação entre o Movimento Washingtoniano e Alcoólicos Anônimos e, meditar sobre as possibilidades de A.A. ter um destino semelhante.

As semelhanças são as seguintes:

• Alcoólicos se ajudando mutuamente;
• Reuniões semanais;
• Experiência compartilhada;
• Permanente disponibilidade para ajudar os grupos e seus membros;
• Confiança em um Poder Superior e,
• Total abstinência ao álcool.

Embora seja óbvio que o programa dos Washingtonianos fosse incompleto, contendo limitadas possibilidades para a modificação da personalidade se comparado aos Doze Passos de Alcoólicos Anônimos, nasceu da experiência dos que conseguiram a sobriedade; mesmo que por pouco tempo; de milhares de alcoólicos. Porém, falhou em não oferecer um método de conduta, para membros e grupos, que fosse comparável às Doze Tradições de Alcoólicos Anônimos. Como não existiam garantia de salvaguarda para o Movimento em seu conjunto, este morreu. A maioria dos problemas dos Washingtonianos se situaram em áreas que estão amplamente protegidas em nossas Tradições:

• O preâmbulo e nossa 5ª Tradição nos aconselham a proteger nosso único objetivo; a 1ª Tradição nos aconselha cautela, para conservar nossa Unidade. Sem essas orientações, o Movimento Washingtoniano se converteu em um monstro de 3 cabeças: a primeira, o programa para atingir a recuperação dos alcoólicos; a Segunda, o convite ao público em geral para conseguir a temperança através da persuasão moral e, a terceira, a exigência de total temperança nacional pelos meios legais. Homens de enorme influência controlavam a ação de cada uma das cabeças e, não levou muito tempo, as cabeças lutavam entre si.
• As táticas carnavalescas de promoção e a absoluta falta de qualquer princípio de anonimato criaram uma atmosfera de crescimento espetacular; porém, conduziram ao mesmo tempo, às lutas entre as personalidades que buscavam prestígio e poder. Cem anos depois Alcoólicos Anônimos adotou as 11ª e 12ª Tradições que indicam que devemos basear nossas relações com o público na atração, no lugar da promoção; a manter o anonimato pessoal ao nível da imprensa; a considerar o anonimato como "fundamento espiritual..." que nos recorda que devemos sempre que os princípios estão acima das personalidades.
• Não há nada que possa pidir um grupo com maior rapidez do que a controvérsia política ou religiosa. A 10ª Tradição diz que: "Alcoólicos Anônimos não tem qualquer opinião sobre assuntos alheios às suas atividades" e que o membro de Alcoólicos Anônimos nunca deve envolver-se em polêmicas públicas. Sem possuir esta Tradição, os Washingtonianos ingressaram nesse campo. Chegou ao conhecimento de alguns líderes religiosos que, alguns alcoólicos recuperados, proclamavam publicamente que, "eles, entre outras coisas, é que estavam praticando verdadeiramente o Cristianismo, não alguns pastores que conheciam e que apenas falavam em Cristo". Em represália o Reverendo Hiram Mattison, ministro da Igreja Metodista Episcopal de Watertown, N.Y., tornou pública a seguinte comunicação: - "Nenhum cristão tem liberdade para selecionar ou adotar algum sistema, organização, agência ou métodos de reforma moral da humanidade, com exceção daqueles prescritos e reconhecidos por Jesus Cristo".
  Acrescentava que sua igreja havia sido escolhida junto com o seu Evangelho, como o sistema da verdade e único para reformar a humanidade. Isto era a guerra. Outras igrejas reagiram da mesma forma, até fecharem suas portas aos Grupos Washingtonianos.
• E como se esse fato grave fosse pouco, alguns membros do Movimento se tornaram oradores profissionais, por não contar com a orientação de uma 8ª Tradição. Dessa forma, sua mensagem de "alcoólico para alcoólico", perdeu toda força de atração.

O ponto final da destruição aconteceu quando, alguns influentes líderes de movimentos não-alcoólicos, decidiram que a necessidade de os ex-bebedores recuperarem outros alcoólicos já havia sido Ultrapassada e, agora, se deveria concentrar todo esforço na criação de novas leis destinadas a promover a temperança. Enquanto efetuava as investigações para escrever este artigo, várias vezes me ocorreu o seguinte pensamento: - "Depois que os Washingtonianos se autodestruíram, o que teria ocorrido com os seus milhares de membros?" E, esse pensamento se converteu numa indagação pessoal: - "O que aconteceria comigo?"

Durante os primeiros tempos do programa, especialmente antes de elaboradas as Doze Tradições, Alcoólicos Anônimos passou por muitos dos problemas que destruíram os Washingtonianos. O fato de havermos sobrevivido aos mesmos perigos, é um dos milagres de Alcoólicos Anônimos.

This Is What We Don’t Know About The Universe

 

By Caleb A. Scharf | March 12, 2014 |  

 

You may experience some temporary disillusionment

In recent days I’ve had some interesting conversations. There’s a giddiness going around, related to an outpouring of science love – the kind you get from President Obama introducing TV science shows, the kind that has wonderful visuals, but is, well, a wee bit simplistic (a sin that none of us could ever, ever be accused of, naturally). It’s all very positive, commendable, and perfectly reasonable. But it leaves me feeling a little askew. You see, the thing is, it’s relatively easy to focus on what we know, yet to me the wonder of the cosmos, the awesomeness, is never greater than when we contemplate all that we don’t know.

It’s true that when we take note of the impossibly brief sliver of time that our entire species has inhabited compared to the billions of years before, and the untold billions ahead, one can feel refreshingly small. Or, if we contemplate the billions of trillions of other worlds that must exist across the observable universe, we can grasp momentarily at just how tiny our daily existence is. But for me nothing compares to the perspective, the shock, or the excitement, of being reminded of what we don’t know.

We don’t know why the universe exists: This is really quite unfair, and could be grounds for doubting that the cosmos knows what its doing. But in terms of physics, although there are some really very appealing, very promising, theoretical frameworks that begin to answer the question, the simple truth is that we’re not sure which might be right. It may be that the universe springs from an inherently unstable ‘nothingness’. The most void-like void, prone to spontaneous generation of matter and energy in proportions that always balance out to zero (yep, really, read Lawrence Krauss’s great book on this). Furthermore, this may not be the only universe (a terrible linguistic fail, I know), but rather one of a vast array, part of a multiverse of more than 10 to the power of 10 to the power of 16 distinguishable realities. But a big piece of the problem is that we’re still waiting for the next generation of cosmic measurements to chip away at the models, and we’re still waiting for theories that provide more readily testable hypotheses, not just mathematical elegance. So we don’t know why the heck all of this exists. Sorry.

We don’t know what dark matter, or dark energy, is: Big problem, honking big problem. Normal matter, the stuff of you, the stuff of me, planets, stars, and cheese sandwiches, amounts to only about 4.9% of the total matter and energy content of the universe. 26.8% of matter is ‘dark’, we know it’s there because on large, cosmic, scales stuff moves around faster than it should and because the way that galaxies strew themselves across space is consistent with the existence of vast amounts of slow-moving gravitating ‘stuff’ that never turns into stars or planets or anything, just stays as diffuse, invisible, incredibly antisocial particles. Except we really have no idea what these particles truly are – a situation beautifully summarized recently by Mario Livio and Joe Silk. That’s nasty, but perhaps nastier is dark energy. Something is causing the expansion of the universe to accelerate. It didn’t used to. Until about 5 or 6 billion years ago the stretching of space following the Big Bang was in decline, but then something started to counter that, another unseen component, perhaps a type of vacuum energy density that fills up space as space itself grows. What exactly is it? We do not know. We have lots of ideas though, which is great, always good to have ideas about 68.3% of the universe.

We don’t know whether life exists anywhere else: This one is close to my heart. Here we are, sentient beings on a planet seething with life (although perhaps not as seething as it could be) that’s been busy sculpting and re-sculpting the physical and chemical environment for much of the past 5 billion years. And now we’re confident that there are lots of planets out there, and that many of them could have an equal shot at playing host to life. But we still don’t know whether or not we’re alone. No clue. That’s quite a problem. Don’t get me wrong, it’s a good problem, a juicy problem, one of the best. But even when the President of the United States introduces a lovely glossy TV series all about science, science that addresses the question of life in the universe, that doesn’t mean that governments or industry give a fig about paying to solve the problem. As Lee Billings writes in his recent, wonderful, book, the lack of a sense of urgency is a little bewildering. So we continue to bumble along in splendid isolation, with only our towels for comfort.

We probably haven’t really figured out the quantum world: What!? While it’s true that our present mathematical framework of quantum mechanics can do wonders, from describing atoms and molecules to the bizarre nature of entanglement and qubits, that doesn’t mean that we’ve nailed the case shut. Quite the contrary. One need only cast a look over the literature to see that the most fundamental aspects of the quantum nature of the universe are still causing headaches and disagreements. People are still reformulating the ways in which we cope with the quantum nature of reality (yes, they are) so it’s clearly too soon to call this fully understood. Not only that, but the possibility of pure quantum effects reaching into the realm of soft, wet, and warm biology has also raised its head (although admittedly it depends on who’s talking) – a rather unnerving notion. . Oh, and don’t get me started on black holes and quantum firewalls…

We don’t understand our own biology: It’s not too radical to say this, after all, if we did understand every detail of how we worked we’d presumably be able to eliminate disease (assuming that’s actually better for us, which it clearly is individually, but perhaps not as a species). We’d also be able to customize ourselves by reaching into to those 3 billion or so nucleic acids in our DNA and doing a spot of molecular engineering, getting those purple earlobes we’ve always wanted. But we’re not close to doing this any better than we can come up with ‘engineered’ crops -  lots of misses and a few hits. Want a good example of our pitiful lack of knowledge? It’s the microbiome. Our ten trillion human cells are augmented, exploited, nurtured, by a hundred trillion microbial cells – a couple of pounds of bacteria and archaea that we all carry around and can’t live without. They’re in our guts, our lungs, up our noses and in every other dank corner. We’re just cruise ships for the ultimate microbial Club-Med, and we simply don’t know what that all means.

We don’t know how the Earth works: Let’s lurch back to a grander scale. No human, or robot, has ever physically traveled deeper than a few miles into the Earth’s crust, everything else is extrapolation and interpolation from ‘remote sensing’ and clever physical analyses. It took us a ridiculously long time to figure out that the outer planetary skin is moving and sliding around; plate tectonics was not generally accepted until the mid-20th century! We’re still not sure exactly how the inner dynamo works, how rolls of convecting, conducting material in the outer core generate our planetary magnetic field. There’s also so much mess after 4.5 billion years of geophysics that some of our best information about the planet’s origins come from meteorites and the cratering of other worlds – outsourced. Speaking of other worlds, we’re not even sure we understand where the Moon came from, maybe it was a giant impact, maybe not. For an allegedly clever species on a small rocky planet this is a bit of an epic fail.

We can’t prove or solve many of our own mathematical conjectures and problems: Ouch. Lest mathematics thinks it can escape this festival of ignorance, just remind yourself that there’s a long list of unproven, unsolved problems and unproven conjectures. Here, take a look. All in all, best kept firmly brushed under the carpet. Another glass of sherry professor?

We don’t know how to make an artificial intelligence: I’m putting this here because it’s a perennial problem, and one that speaks to both our desire to understand ourselves (if you can make an artificial being you may find the secret sauce behind your own intelligence, even if ultimately it’s just an emergent phenomenon) as well as to understand what might be ‘out there’ in the vastness of the cosmos, wrought by billions of years of alien evolution, and really quite depressed by it all. Although we’ve come a long way with our machines, it’s not clear that predictive text or automated suggestions for shopping and movie streaming are really assembling information in any way that resembles how our minds generate ideas. This is truly a frontier.

The conclusion? There’s an awful lot we don’t know (far more than just the examples here). But the point is not to get despondent, because this ignorance is a beautiful thing. It’s what ultimately drives science, and it’s what makes the universe truly awe-inspiring. After the hundreds of thousands of years that Homo sapiens has loped around, the cosmos can still elude our fidgety, inquisitive minds, easily outracing our considerable imaginations. How wonderful.

Bacteria cells used as secure information storage device

 

Cambridge - A technique for encryption/ compression/decryption of data and the use of bacteria as a secure storage device was successfully produced by a team of Chinese biochemistry students as an alternative solution for storing electronic data.

A team of instructors and students of the Chinese University of Hong Kong (CUHK) have managed to store enormous amounts of data in bacteria. The system is based on a novel cryptographic system for data encoding and the application of a compression algorithm which reduces its size dramatically. Following the reduction in size, the researchers were able to enter the information into bacteria in the form of modified DNA sequences. They used the DH5-alpha strain of Escherichia coli, a bacterium normally found in the intestines of most animals. This bacterium is often used as a model organism in microbiology and biotechnology. Modified E. coli has also been used in bioengineering for the development of vaccines, bio-remediation and the production of certain enzymes. Two research groups have already conducted unsuccessful experiments in 2001 and 2007 aiming to the use of biological systems as data storage devices. The researchers of the Chinese University of Hong Kong used encoded E. coli plasmid DNA (a molecule of DNA usually present in bacteria that replicate independently of chromosomal DNA) to encrypt the data and store it in the bacteria. Then, by using a novel information processing system they were able to reconstruct and recover the data with error checking. Another advantage of the system is that the bacteria cells abundantly replicate the data storage units thereby ensuring the integrity and permanence of the data by redundancy. Based on the procedures tested, they estimate the ability to store about 900000 gigabytes (GB) in one gram of bacteria cells. That is the equivalent of 450 hard drives, each with the capacity of 2 terabytes (2000 GB).

Igor I. Solar

Several "traditional" data storage devices. The one with the largest storage capacity in this group is the portable hard-drive (320 GB). One gram of bacteria cells can store 900000 GB.

As an example of the potential for storage they explain that the text of the Declaration of Independence of the United States (8047 characters) could be stored in just 18 bacteria cells. One gram of bacteria cells contains approximately 10 million cells. "We believe this could be an industry standard for large-scale manipulation of data storage in living cells" said the researchers responsible for the project on their website where they describe the potential of data bio-encryption and storage. The researchers envision a wide range of applications for this technology. The capabilities of what they describe as a “bio-hard-disk” include the storage of text, images, music and even movies, or the insertion of barcodes into synthetic organisms as part of security protocols to discriminate between synthetic and natural organisms. The team of researchers was integrated by 3 instructors and 10 undergraduate biochemistry students of CUHK. They carried out their study as part of a worldwide Synthetic Biology competition called The International Genetically Engineered Machine (iGEM) organized by the Massachusetts Institute of Technology (MIT) of the USA. The CUHK team obtained a gold award in the iGEM competition. “Biology students learn engineering approaches and tools to organize, model, and assemble complex systems, while engineering students are able to immerse themselves in applied molecular biology.” declared iGEM organizers. The iGEM competition started in 2003. The 2010 version included over 1,900 participants in 138 teams from around the world. They were required to specify, design, build, and test simple biological systems made from standard, interchangeable biological parts. The achievements of the iGEM research teams often lead to important advances in medicine, energy, biotechnology and the environment.

 

How to increase serotonin in the human brain without drugs

 

Simon N. Young

This article has been cited by other articles in PMC.

Notice: The numbers within the article are references. (links)

For the last 4 decades, the question of how to manipulate the serotonergic system with drugs has been an important area of research in biological psychiatry, and this research has led to advances in the treatment of depression. Research on the association between various polymorphisms and depression supports the idea that serotonin plays a role, not only in the treatment of depression but also in susceptibility to depression and suicide. The research focus here has been on polymorphisms of the serotonin transporter, but other serotonin-related genes may also be involved.^1–5 In the future, genetic research will make it possible to predict with increasing accuracy who is susceptible to depression. Much less attention has been given to how this information will be used for the benefit of individuals with a serotonin-related susceptibility to depression, and little evidence exists concerning strategies to prevent depression in those with such a susceptibility. Various studies have looked at early intervention in those with prodromal symptoms as well as at population strategies for preventing depression.^6–11 Obviously, prevention is preferable to early intervention; moreover, although population strategies are important, they are ideally supplemented with preventive interventions that can be used over long periods of time in targeted individuals who do not yet exhibit even nonclinical symptoms. Clearly, pharmacologic approaches are not appropriate, and given the evidence for serotonin's role in the etiology and treatment of depression, nonpharmacologic methods of increasing serotonin are potential candidates to test for their ability to prevent depression.

Another reason for pursuing nonpharmacologic methods of increasing serotonin arises from the increasing recognition that happiness and well-being are important, both as factors protecting against mental and physical disorders and in their own right.^12–14 Conversely, negative moods are associated with negative outcomes. For example, the negative mood hostility is a risk factor for many disorders. For the sake of brevity, hostility is discussed here mainly in relation to one of the biggest sources of mortality, coronary heart disease (CHD). A meta-analysis of 45 studies demonstrated that hostility is a risk factor for CHD and for all-cause mortality.¹⁵ More recent research confirms this. Hostility is associated not only with the development of CHD but also with poorer survival in coronary artery disease (CAD) patients.¹⁶ Hostility may lead to decreased social support and social isolation,¹⁷ and low perceived social support is associated with greater mortality in those with CAD.¹⁸ Effects are not just limited to CHD. For example, the opposite of hostility, agreeableness, was a significant protective factor against mortality in a sample of older, frail participants.¹⁹

The constitution of the WHO states “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”²⁰ This may sound exaggerated but positive mood within the normal range is an important predictor of health and longevity. In a classic study, those in the lowest quartile for positive emotions, rated from autobiographies written at a mean age of 22 years, died on average 10 years earlier than those in the highest quartile.²¹ Even taking into account possible confounders, other studies “found the same solid link between feeling good and living longer.”¹² In a series of recent studies, negative emotions were associated with increased disability due to mental and physical disorders,²² increased incidence of depression,²³ increased suicide²⁴ and increased mortality²⁵ up to 2 decades later. Positive emotions protected against these outcomes. A recent review including meta-analyses assessed cross-sectional, longitudinal and experimental studies and concluded that happiness is associated with and precedes numerous successful outcomes.²⁶ Mood may influence social behaviour, and social support is one of the most studied psychosocial factors in relation to health and disease.²⁷ Low social support is associated with higher levels of stress, depression, dysthymia and posttraumatic stress disorder and with increased morbidity and mortality from a host of medical illnesses.²⁷

Research confirms what might be intuitively expected, that positive emotions and agreeableness foster congenial relationships with others.^28,29 This in turn will create the conditions for an increase in social support.

Several studies found an association between measures related to serotonin and mood in the normal range. Lower platelet serotonin₂ receptor function was associated with lower mood in one study,³⁰ whereas better mood was associated with higher blood serotonin levels in another.³¹ Two studies found that greater prolactin release in response to fenfluramine was associated with more positive mood.^32,33 The idea that these associations indicate a causal association between serotonin function and mood within the normal range is consistent with a study demonstrating that, in healthy people with high trait irritability, tryptophan, relative to placebo, decreased quarrelsome behaviours, increased agreeable behaviours and improved mood.³⁴ Serotonin may be associated with physical health as well as mood. In otherwise healthy individuals, a low prolactin response to the serotonin-releasing drug fenfluramine was associated with the metabolic syndrome, a risk factor for heart disease,³⁵ suggesting that low serotonin may predispose healthy individuals to suboptimal physical as well as mental functioning.

Nonpharmacologic methods of raising brain serotonin may not only improve mood and social functioning of healthy people — a worthwhile objective even without additional considerations — but would also make it possible to test the idea that increases in brain serotonin may help protect against the onset of various mental and physical disorders. Four strategies that are worth further investigation are discussed below.

The article by Perreau-Linck and colleagues³⁶ (page 430 of this issue) provides an initial lead about one possible strategy for raising brain serotonin. Using positron emission tomography, they obtained a measure of serotonin synthesis in the brains of healthy participants who underwent positive, negative and neutral mood inductions. Reported levels of happiness were positively correlated and reported levels of sadness were negatively correlated with serotonin synthesis in the right anterior cingulate cortex. The idea that alterations in thought, either self-induced or due to psychotherapy, can alter brain metabolism is not new. Numerous studies have demonstrated changes in blood flow in such circumstances. However, reports related to specific transmitters are much less common. In one recent study, meditation was reported to increase release of dopamine.³⁷ The study by Perreau-Linck and colleagues³⁶ is the first to report that self-induced changes in mood can influence serotonin synthesis. This raises the possibility that the interaction between serotonin synthesis and mood may be 2-way, with serotonin influencing mood and mood influencing serotonin. Obviously, more work is needed to answer questions in this area. For example, is the improvement in mood associated with psychotherapy accompanied by increases in serotonin synthesis? If more precise information is obtained about the mental states that increase serotonin synthesis, will this help to enhance therapy techniques?

Exposure to bright light is a second possible approach to increasing serotonin without drugs. Bright light is, of course, a standard treatment for seasonal depression, but a few studies also suggest that it is an effective treatment for nonseasonal depression³⁸ and also reduces depressed mood in women with premenstrual dysphoric disorder³⁹ and in pregnant women suffering from depression.⁴⁰ The evidence relating these effects to serotonin is indirect. In human postmortem brain, serotonin levels are higher in those who died in summer than in those who died in winter.⁴¹ A similar conclusion came from a study on healthy volunteers, in which serotonin synthesis was assessed by measurements of the serotonin metabolite 5-hydroxyindoleacetic acid (5-HIAA) in the venous outflow from the brain.⁴² There was also a positive correlation between serotonin synthesis and the hours of sunlight on the day the measurements were made, independent of season. In rats, serotonin is highest during the light part of the light–dark cycle, and this state is driven by the photic cycle rather than the circadian rhythm.^43,44 The existence of a retinoraphe tract may help explain why, in experimental animals, neuronal firing rates, c-fos expression and the serotonin content in the raphe nuclei are responsive to retinal light exposure.^44–48 In humans, there is certainly an interaction between bright light and the serotonin system. The mood-lowering effect of acute tryptophan depletion in healthy women is completely blocked by carrying out the study in bright light (3000 lux) instead of dim light.⁴⁹

Relatively few generations ago, most of the world population was involved in agriculture and was outdoors for much of the day. This would have resulted in high levels of bright light exposure even in winter. Even on a cloudy day, the light outside can be greater than 1000 lux, a level never normally achieved indoors. In a recent study carried out at around latitude 45° N, daily exposure to light greater than 1000 lux averaged about 30 minutes in winter and only about 90 minutes in summer⁵⁰ among people working at least 30 hours weekly; weekends were included. In this group, summer bright light exposure was probably considerably less than the winter exposure of our agricultural ancestors. We may be living in a bright light–deprived society. A large literature that is beyond the scope of this editorial exists on the beneficial effect of bright light exposure in healthy individuals. Lamps designed for the treatment of seasonal affective disorder, which provide more lux than is ever achieved by normal indoor lighting, are readily available, although incorporating their use into a daily routine may be a challenge for some. However, other strategies, both personal and institutional, exist. “Light cafes” pioneered in Scandinavia have come to the United Kingdom,⁵¹ and an Austrian village that receives no sunshine in the winter because of its surrounding mountains is building a series of giant mirrors to reflect sunlight into the valley.⁵² Better use of daylight in buildings is an issue that architects are increasingly aware of. Working indoors does not have to be associated with suboptimal exposure to bright light.

A third strategy that may raise brain serotonin is exercise. A comprehensive review of the relation between exercise and mood concluded that antidepressant and anxiolytic effects have been clearly demonstrated.⁵³ In the United Kingdom the National Institute for Health and Clinical Excellence, which works on behalf of the National Health Service and makes recommendations on treatments according to the best available evidence, has published a guide on the treatment of depression.⁵⁴ The guide recommends treating mild clinical depression with various strategies, including exercise rather than antidepressants, because the risk–benefit ratio is poor for antidepressant use in patients with mild depression. Exercise improves mood in subclinical populations as well as in patients. The most consistent effect is seen when regular exercisers undertake aerobic exercise at a level with which they are familiar.⁵³ However, some skepticism remains about the antidepressant effect of exercise, and the National Institute of Mental Health in the United States is currently funding a clinical trial of the antidepressant effect of exercise that is designed to overcome sources of potential bias and threats to internal and external validity that have limited previous research.⁵⁵

Several lines of research suggest that exercise increases brain serotonin function in the human brain. Post and colleagues⁵⁶ measured biogenic amine metabolites in cerebrospinal fluid (CSF) of patients with depression before and after they increased their physical activity to simulate mania. Physical activity increased 5-HIAA, but it is not clear that this was due to increased serotonin turnover or to mixing of CSF from higher regions, which contain higher levels of 5-HIAA, with lumbar CSF (or to a combination of both mechanisms). Nonetheless, this finding stimulated many animal studies on the effects of exercise. For example, Chaouloff and colleagues⁵⁷ showed that exercise increased tryptophan and 5-HIAA in rat ventricles. More recent studies using intracerebral dialysis have shown that exercise increases extracellular serotonin and 5-HIAA in various brain areas, including the hippocampus and cortex (for example, see^58–60). Two different mechanisms may be involved in this effect. As reviewed by Jacobs and Fornal,⁶¹ motor activity increases the firing rates of serotonin neurons, and this results in increased release and synthesis of serotonin.⁶² In addition, there is an increase in the brain of the serotonin precursor tryptophan that persists after exercise.⁶³

The largest body of work in humans looking at the effect of exercise on tryptophan availability to the brain is concerned with the hypothesis that fatigue during exercise is associated with elevated brain tryptophan and serotonin synthesis. A large body of evidence supports the idea that exercise, including exercise to fatigue, is associated with an increase in plasma tryptophan and a decrease in the plasma level of the branched chain amino acids (BCAAs) leucine, isoleucine and valine (see^64,65 for reviews). The BCAAs inhibit tryptophan transport into the brain.⁶⁶ Because of the increase in plasma tryptophan and decrease in BCAA, there is a substantial increase in tryptophan availability to the brain. Tryptophan is an effective mild hypnotic,⁶⁷ a fact that stimulated the hypothesis that it may be involved in fatigue. A full discussion of this topic is not within the scope of this editorial; however, it is notable that several clinical trials of BCAA investigated whether it was possible to counter fatigue by lowering brain tryptophan, with results that provided little support for the hypothesis. Further, exercise results in an increase in the plasma ratio of tryptophan to the BCAAs before the onset of fatigue.^64,65 The conclusion of these studies is that, in humans, a rise in precursor availability should increase serotonin synthesis during and after exercise and that this is not related to fatigue, although it may be related to improved mood. Whether motor activity increases the firing rate of serotonin neurons in humans, as in animals, is not known. However, it is clear that aerobic exercise can improve mood.

As with exposure to bright light, there has been a large change in the level of vigorous physical exercise experienced since humans were hunter-gatherers or engaged primarily in agriculture.⁶⁸ Lambert⁶⁸ argued that the decline in vigorous physical exercise and, in particular, in effort-based rewards may contribute to the high level of depression in today's society. The effect of exercise on serotonin suggests that the exercise itself, not the rewards that stem from exercise, may be important. If trials of exercise to prevent depression are successful, then prevention of depression can be added to the numerous other benefits of exercise.

The fourth factor that could play a role in raising brain serotonin is diet. According to some evidence, tryptophan, which increases brain serotonin in humans as in experimental animals,⁶⁹ is an effective antidepressant in mild-to-moderate depression.^67,70 Further, in healthy people with high trait irritability, it increases agreeableness, decreases quarrelsomeness and improves mood.³⁴ However, whether tryptophan should be considered primarily as a drug or a dietary component is a matter of some dispute. In the United States, it is classified as a dietary component, but Canada and some European countries classify it as a drug. Treating tryptophan as a drug is reasonable because, first, there is normally no situation in which purified tryptophan is needed for dietary reasons, and second, purified tryptophan and foods containing tryptophan have different effects on brain serotonin. Although purified tryptophan increases brain serotonin, foods containing tryptophan do not.⁷¹ This is because tryptophan is transported into the brain by a transport system that is active toward all the large neutral amino acids and tryptophan is the least abundant amino acid in protein. There is competition between the various amino acids for the transport system, so after the ingestion of a meal containing protein, the rise in the plasma level of the other large neutral amino acids will prevent the rise in plasma tryptophan from increasing brain tryptophan. The idea, common in popular culture, that a high-protein food such as turkey will raise brain tryptophan and serotonin is, unfortunately, false. Another popular myth that is widespread on the Internet is that bananas improve mood because of their serotonin content. Although it is true that bananas contain serotonin, it does not cross the blood–brain barrier.

α-Lactalbumin, a minor constituent of milk, is one protein that contains relatively more tryptophan than most proteins. Acute ingestion of α-lactalbumin by humans can improve mood and cognition in some circumstances, presumably owing to increased serotonin.^72,73 Enhancing the tryptophan content of the diet chronically with α-lactalbumin is probably not practical. However, increasing the tryptophan content of the diet relative to that of the other amino acids is something that possibly occurred in the past and could occur again in the future. Kerem and colleagues⁷⁴ studied the tryptophan content of both wild chickpeas and the domesticated chickpeas that were bred from them in the Near East in neolithic times. The mean protein content (per mg dry seed) was similar for 73 cultivars and 15 wild varieties. In the cultivated group, however, the tryptophan content was almost twice that of the wild seeds. Interestingly, the greater part of the increase was due to an increase in the free tryptophan content (i.e., not part of the protein). In cultivated chickpeas, almost two-thirds of the tryptophan was in the free form. Kerem and colleagues⁷⁴ argue that there was probably selection for seeds with a higher tryptophan content. This is plausible, given another example of an early strategy to increase the available tryptophan content of an important food source. Pellagra is a disorder caused by niacin deficiency, usually owing to poverty and a diet relying heavily on corn (maize), which has a low level of niacin and its precursor tryptophan. Cultures in the Americas that relied greatly on corn used alkali during its processing (e.g., boiling the corn in lime when making tortillas). This enhanced the nutritional quality of the corn by increasing the bioavailability of both niacin and tryptophan, a practice that prevented pellagra.⁷⁵ The Europeans transported corn around the world but did not transport the traditional alkali-processing methods, thereby causing epidemics of pellagra in past centuries. Breeding corn with a higher tryptophan content was shown in the 1980s to prevent pellagra⁷⁶; presumably, it also raised brain serotonin. In a recent issue of Nature Biotechnology, Morris and Sands⁷⁷ argue that plant breeders should be focusing more on nutrition than on yield. They ask, “Could consumption of tryptophan-rich foods play a role in reducing the prevalence of depression and aggression in society?” Cross-national studies have reported a positive association between corn consumption and homicide rates⁷⁸ and a negative association between dietary tryptophan and suicide rates.⁷⁹ Although the idea behind such studies is interesting, any causal attribution must remain speculative, given the possible confounds. Nonetheless, the possibility that the mental health of a population could be improved by increasing the dietary intake of tryptophan relative to the dietary intake of other amino acids remains an interesting idea that should be explored.

The primary purpose of this editorial is to point out that pharmacologic strategies are not the only ones worthy of study when devising strategies to increase brain serotonin function. The effect of nonpharmacologic interventions on brain serotonin and the implications of increased serotonin for mood and behaviour need to be studied more. The amount of money and effort put into research on drugs that alter serotonin is very much greater than that put into non-pharmacologic methods. The magnitude of the discrepancy is probably neither in tune with the wishes of the public nor optimal for progress in the prevention and treatment of mental disorders.

 

The New York Academy of Sciences

 

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• 

  Overview

  More than two billion people are affected by malnutrition—both undernutrition and overnutrition—in developed and developing countries. It is well documented that those who struggle with poor nutrition suffer from cognitive development problems, are sick more often, are more prone to disease, and die younger than their nutritionally-secure counterparts.

  There is near-universal support for a high-level, coordinated effort to identify core areas of nutrition science research and strategically apply work in these areas to remedy the global crisis in malnutrition. Many organizations are performing cutting-edge research to understand the physiological basis of nutrition-related problems, designing behavioral interventions, and working to advance policy. However, stakeholders across functional and geographic sectors agree that there is a need for a prioritized nutrition science research agenda that is easily accessible and can be translated into application and public policy changes.

  To respond to this challenge, the New York Academy of Sciences, in partnership with The Mortimer D. Sackler Foundation, has established The Sackler Institute for Nutrition Science. The Sackler Institute is dedicated to advancing nutrition science research and knowledge, mobilizing communities, and applying this work in the field.

  Objectives

  Three overarching goals for the Sackler Institute are:

  • To develop an agenda for nutrition science research.
  • To build communities around important areas of nutrition science through public-private partnerships and public outreach with conferences, webinars, podcasts, e-briefings, and other publications.
  • To stimulate research in nutrition science.

  The Institute is generating a coordinated network across sectors, disciplines, and geographies that promotes open communication; encourages exchange of information and resources; nurtures the next generation of scientists; and drives community intervention design and public policy changes.

  Contact Us

  For more information about The Sackler Institute for Nutrition Science, contact nutrition@nyas.org.

  Stay Connected

  If you would like to receive regular email updates from The Sackler Institute for Nutrition Science, please visit www.nyas.org/Subscribe, create an email profile, and be sure to tick the "Nutrition Topical eNewsletter" box.

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  • The Mortimer D. Sackler Foundation

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Education Resources

 

• Connect A Million Minds

  Time Warner Cable's Connect a Million Minds program allows parents and community members to pledge to connect young people with the wonders of science.

• Intel International Science and Engineering Fair

  The Intel International Science and Engineering Fair, a program of Society for Science & the Public, is the world's largest precollege science fair competition.

• NBC Learn

  NBC Learn is the educational arm of NBC News that makes the global resources of NBC News and historic film and video archive available to teachers, students, schools and universities.

• The Conrad Foundation Spirit of Innovation Awards

  The Conrad Foundation's Spirit of Innovation Awards is a rich program that combines science, education and entrepreneurship in a revolutionary model of incentivized competition.

• New York Academy of Science: Pathways to Science

  The NYAS Science Teachers Program is designed to build a community of science educators in and beyond New York City and to provide a space where science education professionals can convene, learn and collaborate about exciting scientific topics, education policy, curriculum, and best practices in the classroom.

• Scitable by Nature Education

  Scitable is a free science library and personal learning tool brought to you by Nature Publishing Group. ( Scientific American is part of Nature Publishing Group.)

• National Science Teachers Association

  For over 60 years, NSTA has been a beacon for science education, providing ways for science teachers to connect with one another.

• Macmillan's Children

  Macmillan Children's Publishing Group is home to some of the most highly acclaimed and noteworthy children's imprints in the publishing industry and features tools for parents and educators.

• HowtoSmile.org

  SMILE is collecting the best educational materials on the Web and creating learning activities, tools and services-all designed especially for those who teach school-age kids in nonclassroom settings.

• The Lawrence Hall of Science: 24/7 Science

  It's science and it's fun! These interactive activities let you use hands, feet, eyes, ears, brain, imagination and cool tools to experiment, design, test and discover amazing things about the world around you.

• Intel Science Talent Search

  Intel Science Talent Search, a program of Society for Science & the Public, is the U.S.'s oldest and most prestigious precollege science competition.

• National Lab Network

  National Lab Network is a nationwide initiative to build local communities of support that will foster ongoing collaborations among volunteers, students and educators.

• 

Big Climate Danger Could Arrive as Soon as 2036

 

By Mark Fischetti | March 27, 2014 |  

 

Climate change is changing. In three days we will find out how much, and how rapidly. The Intergovernmental Panel on Climate Change (IPCC), which is meeting in Yokohama, Japan, will release the second report of its massive assessment on Sunday, March 30 EDT (March 31 in Japan). The report will weigh the impacts of climate change today and into the future, as well as how vulnerable people and places are to those impacts. A draft of the report, leaked last year, indicated that major risks such as drought, flooding, hunger, disease and stunted economic growth would begin sooner than previously estimated.

The IPCC won’t necessarily tell us when, exactly, we will cross the line into major trouble. But I’ll have an answer to that in a moment.

A lot is riding on this meeting because it marks a clear change in strategy for the IPCC. Despite increasingly dire warnings it has issued for 24 years, various polls show that as many as half of Americans still are not sure that the science is certain. So the hundreds of scientists from around the world who are involved in this report will present the ongoing findings in terms of risks, rather than data and error bars. The spread ranges from risks that are highly likely but may have modest implications, to those that may be unlikely but have severe consequences, such as runaway melting of Greenland, which could raise sea levels dramatically.

The report will also present a variety of possible solutions, such as better disaster planning, the breeding of drought-resistant crops and technologies that can save energy.

Talking about risk and how to lessen it is also a strong attempt by the IPCC to put climate-change denial to rest. The IPCC is no longer focusing on defending the science; it is moving on, trying to advise cities, states and countries about the regional risks that will confront them, and what can be done.

Another major report released last week by the American Association for the Advancement of Science upholds this strategy, as well as the expected IPCC findings. AAAS billed the report, called What We Know, as an initiative to increase dialogue on the risks of climate change. Rather than needlessly arguing over the science, “We can debate the policies,” said James McCarthy, an oceanographer at Harvard University and co-chairman of the report. “And that’s the debate we should be having.”

Policies are needed soon because the new IPCC report is expected to show that climate change impacts are happening on every continent, that people in all nations are vulnerable to extreme climate events, and that if the world does not begin to act soon it will miss the chance to limit global warming to less than 2 degrees Celsius—a goal that leaders of almost 200 countries support.

What IPCC seems unlikely to say, however, is when the world will cross that two-degree line. The AAAS report does not give a date either. Part of the reason is that being so specific requires scientist to settle on just how sensitive the atmosphere is to a rising level of greenhouse gases. This level is usually expressed as a concentration of CO2, which has been mounting steadily for decades. Estimated at roughly 280 parts per million when the Industrial Revolution began, it briefly hit 400 ppm last May—the first time it reached 400 ppm since humans have been on Earth. This year it hit 400 ppm on March 12, and will linger there longer, until plants and trees grow their spring leaves and absorb some of it, bringing the number down into the 390s. The levels will continue to ratchet up annually if nations everywhere do not begin to reduce CO2 emissions.

As CO2 levels rise, so does the average global temperature. It has already risen 0.8 degrees C since pre-industrial times. But when will it cross the 2-degree-C threshold, if nations do not change? The answer comes from Michael Mann, and it’s very soon: 2036.

Mann, a professor of meteorology at Pennsylvania State University, was a key contributor to the third IPCC assessment in 2001 (the latest is the IPCC’s fifth, since 1990). That work resulted in the so-called hockey stick: a curve that shows a global average temperature that is roughly steady for 1,000 years but then turns abruptly upward in recent times. Mann is not involved the current IPCC assessment. But he knows the numbers from the latest science that IPCC is using, so he did some calculations and published them in the current issue of Scientific American.

Mann first settled on the two most likely numbers for the “equilibrium climate sensitivity.” ECS is a common measure of the heating effect of greenhouse gases. He then plugged those ECS values into the so-called energy balance model, which scientists use to investigate possible climate scenarios.

The model showed that if the world continues to burn fossil fuels at the current rate, the planet will cross the dangerous warming threshold of 2 degrees C in 2036, only 22 years from now, when using the higher sensitivity number, which Mann thinks is most realistic. When he entered the lower ECS value—very conservative, in his view—the world crossed the threshold in 2046, just 10 years later (see the graph above). The truly tough news revealed by these and further calculations is that to reliably avoid 2 degrees C of warming, the world should hold CO2 levels below 405 ppm, barely above where they are now.

You can see his numbers, graphs and conclusions. And you can even do the calculations yourself, if you like.

Mann’s projections are probably bolder than what we will hear from the IPCC, because he doesn’t have to get scores of nations to settle on wording for a report. But the IPCC and AAAS have the same message as he does: nations everywhere will have to act fast if they want the planet to stay below the danger threshold. IPCC will reveal its language on Sunday night. Scientific American will be reporting it, so stay tuned.

About the Author: Mark Fischetti is a senior editor at Scientific American who covers energy, environment and sustainability issues. Follow on Twitter @markfischetti.

The Quest: Practical Advice for Online Medical Searches

 

By Christine Gorman | March 27, 2014 |  

 

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Credit: CDC/Debora Cartagena

Being an informed patient is, in many ways, tougher than ever. A tsunami of material is freely available on the Internet nowadays, from medical datasets to research papers to instructive videos. But when you’re searching for something specific for yourself or a loved one, the most relevant streams of data are often hard to find or decipher.

I am spending the next several weeks writing up some of the tips and tricks for online medical searches that I’ve picked up over the years. I also plan to include a bunch of other people’s hard-won habits for finding just the right study, clinical trial or care-giving guide.

Let me be clear, I’m not talking about playing doctor here, trying to match up symptoms to a particular disease or condition. Rather, I’m seeking to explain some of the best ways to look up the information you need, after you’ve been given a definitive diagnosis, to help you better understand your options.

By gathering these pointers in one place, I hope these blog posts will help people get up to speed faster if they suddenly find themselves needing to research a health condition or understand treatment options. Going forward, I’ll tag the posts “how-to-search-medical-info” so you can see what else has been covered and find other installments in the series.

If you have something meaningful to contribute, please use the comments section below. If this project starts gaining momentum, we’ll figure out a more efficient way to collect and rate your tips and ideas.

Getting Started

The first place to check if you need to learn a lot in a hurry is MedlinePlus. The site was launched just over 15 years ago by the National Library of Medicine (NLM) to help consumers find and make better use of authoritative medical information. It provides a quick overview of more than 900 medical topics, expertly curated by information specialists on a daily basis. As an added bonus, MedlinePlus is also available in Spanish.

Why am I such a fan of MedlinePlus? Because the medical librarians at the NLM have already done a lot of the heavy lifting for you.

Let’s say, as an example, you’re helping a friend with throat cancer. You start typing “throat cancer” into the MedlinePlus search box and even before you can finish typing, the entry auto-completes, giving you a sense that at least you’ve picked a meaningful key word (very important). See screenshot below.

Right at the outset, MedlinePlus gives you a definition with—and this is key—some of the more technical names (more key words) for various kinds of throat cancers. You learn that “the different parts of the throat are called the oropharynx, the hypopharynx, and the nasopharynx.” And maybe this jogs your memory that the doctor told you this was an “oropharyngeal cancer.” So now you know you’re talking about the back of the tongue going down into the throat.

What I didn’t realize, until I spent a week at the NLM last fall, is that this page is the result of some medical librarians having created a complex search algorithm that finds and ranks the material you see on the page. For example, even though I did not enter a search term about “human papilloma virus (HPV),” some of the information that the search produces very high up in the list on the right includes links to HPV and throat cancer.

It turns out that while most throat cancers are caused by alcohol or smoking, infection with HPV has also recently been linked to throat cancer. And I didn’t have to know that before typing in my search.

In this case, I have an option to refine my search by the HPV-keyword (on the lower left). And I can see in the detailed results on the right that “head and throat cancer survival may be longer if tumor is caused by HPV.”