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This Thursday, Join The “Great American Smoke-Out”

Are you a smoker who’s thinking about quitting? There’s no better day to start than Thursday.

That’s the day of the Great American Smoke-Out, a national event held every year by the American Cancer Society.

The Smoke-Out “encourages people who smoke or use tobacco to quit for 24 hours,” says Barbara Silver, the program manager for employee wellness at UNC Family Medicine and the Town of Chapel Hill. “And then if they’re successful, to quit for another 24 hours – and just do it one day at a time, as a prelude to being able to quit altogether.”

If you’re one of the 42 million Americans who smoke, and you’re looking to quit, UNC’s Nicotine Dependence Program is setting up booths around town on Thursday from 11 to 3 as part of the Great American Smoke-Out.

“We’ll have information tables at the (UNC) hospital outside of Starbucks (and) at UNC Family Medicine by the patient entrance,” Silver says. “And then CVS also has been partnering with us because they’re not selling tobacco anymore – (so) we’re going to have some pharmacy students helping us down there on Franklin Street.”

And if you can’t make it to the booths, there’s also a statewide quit line, 1-800-QUIT-NOW. You can call that number at any time – but if you call on Thursday, as part of the Great American Smoke-Out, you can receive even more support.

“If you call 1-800-QUIT-NOW, on Thursday, the Quit Line will give you eight weeks of free (nicotine) patches,” says Silver.

Silver says nicotine patches and other forms of medication can double your chances of quitting successfully.

It’s a hard road to quitting, and there may be stumbles along the way – but Silver says those stumbles are just “bumps on the road to progress.” And it is possible to quit – you just have to take it one day at a time.

Matt Englund of UNC Health Care has been smoke-free for a year.

“(I did it by) spreading out my cravings,” he says. “When you want a cigarette, you just take an extra 15 minutes and try to hold off – then try 30 minutes, then an hour, and eventually you train yourself to realize that you don’t – though you think you need it at that moment – you don’t need it at that moment…

“And work up to the moment when you can take a day. Take two days. Take a week. Do as much as you can – and keep trying until you’re successful.”

England and Silver joined Aaron Keck on WCHL this week.

 

The Great American Smoke-Out is held every year on the third Thursday in November. For more information, visit the American Cancer Society’s website, Cancer.org – and for more information on programs here in our area, visit the Nicotine Dependence Program’s page, NDP.UNC.edu.

http://chapelboro.com/news/health/thursday-join-great-american-smoke/

Of Minerals And Men

I recently read a report from the journal Nature noting that the concentration of mercury dissolved in the oceans has more than tripled since the beginning of the Industrial Revolution. A number of questions immediately came to mind, such as, “How did this happen?” and “How concerned should we be?” And thus a Common Science® column was born. However, in the process of writing about mercury, I got off on a bit of a tangent on the critical importance of metals in maintaining good health and in the functioning of biological processes. That tangent eventually grew into this week’s column, which will serve as a prelude to the column on mercury next week.

To understand why metals are biologically important, we first need to review some chemistry. You should remember from high school chemistry that molecules are formed when atoms share electrons as part of a chemical bond.(1) In order for a molecule to participate in a chemical reaction, at least one of its chemical bonds must first be broken. In order for a bond to break, two molecules have to smash into each other with enough energy to break the bond – known as the activation energy barrier.

If you want to encourage a chemical reaction to occur or to make it go faster, there are two strategies that can be employed to overcome the activation energy barrier. The simplest approach is to heat up the reactants. Hot reactants move around faster, and thus smash into one another with greater enthusiasm. The other approach is to use a catalyst. Catalysts help chemical reactions to occur by reducing the amount of energy required for them to occur. Catalysts can be particularly useful if you want to induce a chemical reaction to occur but, due to some constraints, cannot add heat.

In both industrial and biological processes, catalysts often include metal atoms. The reason for this stems from the electrical properties of metals which allow them to either accept or donate electrons. As an example, let’s consider what is perhaps the most famous industrial reaction of all (at least to geeks like me): the reaction of nitrogen (N2) with hydrogen (H2) to make ammonia (NH3), the key component of industrial fertilizers, via the Haber-Bosch Process.(2) Nitrogen molecules consist of two nitrogen atoms bound together with a triple bond, making it one of the most stable and therefore unreactive molecules in the entire universe. Without the use of a catalyst, nitrogen will not react with hydrogen even at extremely high temperatures. Haber and Bosch found that if nitrogen molecules were first allowed to absorb on (stick to) osmium metal, they could be converted to ammonia at a high, but not unreasonable, temperature. The reason this works is that when nitrogen absorbs on osmium, some of the electrons in the nitrogen-nitrogen triple bond are pulled towards the metal, which weakens the bonds between the two nitrogen atoms. Now that this bond has been weakened by the catalyst, the activation energy barrier required to induce nitrogen to react with hydrogen is much lower. The development of the Haber-Bosch process, which today provides the fertilizer to generate approximately half of the food calories produced on Earth, is often rated as the greatest scientific achievement of the 20th century.

Now that we have finished our primer on how metals can catalyze chemical reactions, let’s turn to how that applies to people. The functioning of the human body involves a staggering number of chemical reactions, including the digestion of food, the repair of wounds and injuries, and the formation of new blood cells. Since the temperature of the human body hovers around 98.6 ºF, the only practical way to encourage chemical reactions in the body to go faster is to use a catalyst (3). In order to make sure that all of these needed chemical reactions occur, your body produces over 55,000 different catalysts. Catalysts in biologic systems are called enzymes. Many of the enzymes that your body produces include one or more metal atoms, such as iron, magnesium, manganese, zinc, and selenium. The metal atoms in these enzymes function in an analogous way to the osmium in the Haber-Bosch process. The need for your body to produce metal-containing enzymes is a primary reason that you need to eat a diet that contains a wide range of minerals in sufficient quantities and in the proper ratios. If your diet becomes deficient in minerals, a number of rather bad things can happen to you, including nerve damage, kidney stones, anemia, muscle weakness, birth defects, and, in the extreme, death.

If you have made it this far, you now have an understanding of how a catalyst functions, why metals make good catalysts, and that many processes in the human body rely on metal-containing enzymes. That information alone would constitute a reasonably complete Common Science® column. But I have yet to share with you the basis of my fascination with this topic. So pour yourself another cup of coffee and let’s delve into evolutionary development and biology.

The evolution of our species has occurred over the last 500,000 years. During this time, our bodies have evolved to respond to an impressive array of challenges, including wild swings of climate, devastating plagues, changes in food sources, and competition with other hominid species. While these past challenges were certainly significant, even events like the onset and retreat of ice ages occurred slowly over the course of thousands of years, which gave our ancestors time to react both strategically and biologically. Successful human evolution over the millennia proceeded in equilibrium with the available metal-containing minerals in our diets, which allowed us to create just the right balance of enzymes and go on to become the dominant species on Earth.

Over the last two hundred years, with the advent of fossil fuel use, the growth of industrial agriculture, and the explosion of the human population, we have introduced environmental changes at a rate which is unprecedented in the history or our species. This includes some dramatic shifts in the mineral content of our diets. I have written several times about that fact that the mineral content in the U.S. food supply has fallen by around 30% since the 1940s. While it can be difficult to tease out all of the direct mechanisms, we know that these changes in the American diet over the past several decades have led to dramatic increases in tooth decay, heart disease and diabetes, processes which are all intertwined with the proper or improper functioning of metal-containing enzymes.

The dramatic rise in mercury concentration in the oceans represents a different sort of challenge to the human-metal interplay in our environment and diets. This time, rather than a developing deficiency, we are introducing an excess amount of a metal into our diets, a metal which, far from being essential for good human health, is poisonous to us. This is a development which deserves further exploration. But that will have to wait until next week.

Have a comment or question? Use the interface below or send me an email to commonscience@chapelboro.com. Think that this column includes important points that others should consider? Send out a link on Facebook or Twitter. Want more Common Science? Follow me on Twitter on @Commonscience.

(1) I am aware that in many school districts (including, sadly, the Chapel Hill Carrboro City Schools) it is possible to receive a high school diploma without taking chemistry. This knowledge makes me sad, so I choose to repress it and continue to assume that all of you had chemistry in high school.

(2) If you want to know more about the Haber-Bosch process and its role in driving the human population explosion, please follow this link to Fun with Fritz and Carl.

(3) As you know, when the body is threatened by viruses and bacteria, it will respond by raising its temperature. This strategy is designed to make a number of disease-fighting chemical reactions go faster to defeat the intruder. However, if the body over-corrects and raises its temperature to 104 °F, it can start to cause collateral damage to other body systems by damaging beneficial enzymes. This is why fever of this magnitude requires intervention with medicine and/or physical cooling of the body. In a display of evolutionary solidarity, beneficial enzymes in plants also shut down at this temperature. Sadly, there is no aspirin for basil plants.

http://chapelboro.com/columns/common-science/minerals-men/

How To Help Family Members With Mental Illness

Do you have a close family member struggling with mental illness?

The National Alliance on Mental Illness (NAMI) is offering a 12-week series of free classes beginning this Thursday, for family members of people living with major depression, bipolar disorder, schizophrenia, schizoaffective disorder, panic disorder, OCD, or borderline personality disorder.

It’s called the “Family-to-Family Education Program,” co-taught by Dana Greenwood and Tana Hartman-Thorn.

Visit this link for information about the class.

Classes take place at the Seymour Center in Chapel Hill, from 6:00-8:30 p.m. on Thursdays beginning September 4.

Dana Greenwood and Tana Hartman-Thorn joined Aaron Keck on “Aaron in the Afternoon” earlier this week to discuss the class – and the importance of the issue.

For more information – or to register for the class – contact Dana Greenwood at 919-622-3795 or by email at dana.greenwood412@gmail.com.

http://chapelboro.com/news/health/help-family-members-mental-illness/

Parents Aging? Remember The “40-70 Rule”

As your parents grow older, it becomes more and more important to have those tough conversations about aging – but most American families put off those discussions, often until it’s too late.

That’s why senior caregiving experts are promoting the “40-70 Rule” – a new program that’s designed to help seniors and their children and caregivers through the process.

“40-70″ gets its name from a very simple rule: experts say the time to start talking with your parents about aging-related issues is when you’re getting close to 40 and your parents are getting close to 70. That will give you enough time to discuss tough issues calmly and thoughtfully, well in advance of any health crisis or other emergency.

Those issues may include living arrangements, finances, when and when not to drive, health care and end-of-life decisions – and even dating, when your parent is divorced or widowed.

Stephen Lair, of the Home Instead Senior Care branch in Chapel Hill, spoke with Aaron Keck last week on “Aaron in the Afternoon.”

Visit HomeInstead.com for more information about how to get started with the 40-70 program.

Click here for seven tips on how to communicate with your aging parents. (Key tips: start early, before a problem arises; put yourself in your parents’ shoes; try to find solutions that maximize your parents’ independence; and don’t be afraid to ask for help when you need it.)

And for a longer discussion of the “40-70″ plan, visit this link.

http://chapelboro.com/news/health/parents-aging-remember-40-70-rule/

Another Chapel Hillian To Help Fight Ebola?

Another medical professional with ties to Chapel Hill may be heading to Africa to help in the fight against the Ebola virus.

Chapel Hill native Anna Freeman is a nurse with Doctors Without Borders, which says its mission is to serve areas where there is the greatest need.

Freeman was a nurse at UNC Hospitals before applying to work with DWB. She worked in post-surgical care of children with heart defects.

“One thing that I find very rewarding about nursing work—working as a bedside nurse—is working with somebody who finds themselves in a situation often out of their control that can be very difficult to deal with either physically or emotionally, or often both,” Freeman says.

Freeman says she felt drawn to areas known as conflict, post-conflict, and intermittent-conflict zones, or areas struggling with epidemic diseases. She says there was an urge to help those who couldn’t always help themselves.

“Very often, people who find themselves in these circumstances are civilians, are women and children who live in very poor areas,” Freeman says. “I find that very unjust that people don’t have access to health care as a result or have very poor health care. There’s a lot of suffering that goes along with that.”

She says working to help alleviate suffering is very rewarding and that she’s fascinated experiencing new things in places that, when you first arrive, you might not know what awaits you.

Freeman may be heading to Africa in the next few weeks to help in the fight against Ebola. This is the largest outbreak of the disease on record. As of Tuesday, the Centers for Disease Control reported the suspected and confirmed case count was nearing 1,900; the suspected number of deaths had just surpassed 1,000.

WCHL spoke with UNC physician William Fischer upon his return to the states from Africa where he treated people who had contracted Ebola. He said he left feeling like there was more he could do, and that he would certainly be willing to return.

Freeman’s comments were made on a recent edition of Who’s Talking with D.G. Martin, heard weekends on WCHL. Click here to listen (August 2, 2014 edition).

http://chapelboro.com/news/health/another-chapel-hillian-help-fight-ebola/

As The Epidemic Worsens, A UNC Doctor Details The Battle Against Ebola

In the three and a half weeks Dr. William Fischer spent in Gueckedou, Guinea, he encountered between thirty and fifty patients suffering from Ebola. Only seven survived.

“It’s hard. It’s really hard work. It’s really intense work,” says Fischer. “But I’m totally sold on this idea that we can improve mortality with even just basic mechanisms right now.”

Fischer is a pulmonary and critical care physician at UNC Hospitals. He traveled to Guinea in May with the World Health Organization to help battle the latest outbreak of Ebola.

The current outbreak is the largest and deadliest on record. More than 1,200 have been infected and at least 670 have died in the past four months.

Unlike past outbreaks, which were located in remote regions in Central Africa, this began in West Africa, starting in Guinea before spreading to Liberia, Sierra Leone and Nigeria.

“It’s so easy for infection and infected patients to cross international borders, but it’s much more difficult for resources to follow that path,” says Fischer. “Increasingly we’re becoming a much more interconnected world. People are much more mobile. This is a very nice reminder of that interconnectedness, as this population is incredibly mobile and that mobility is sustaining this epidemic.”

The Ebola virus produces a hemorrhagic fever that is spread by contact with bodily fluids. The mortality rate among those infected can reach as high as 90 percent. There’s currently no cure, no vaccine, and no specific treatment, but Fischer says aggressive rehydration can help victims fight off the virus.

“I initially was skeptical about what care we could provide, but in fact, what I saw was that we can have a dramatic effect on reducing Ebola-related mortality with aggressive critical care.”

Yet Fischer said in his three weeks treating patients only a handful recovered, and when they did, the doctors were often happier than the survivors.

“One of the most difficult things about Ebola is that it doesn’t just kill people- it wipes out their families,” says Fischer. “This gentleman we were able to get through, but he lost his mother-in-law, his mother, and his wife and their unborn child. So you can imagine the despair that permeated every inch of that room when he heard that his wife had passed shortly after delivering their child.”

One of the biggest challenges facing doctors battling this current outbreak is convincing communities and individuals to seek medical treatment at the first sign of infection.

Western medical resources flood into the region only when an outbreak occurs, forming an association between doctors and death that’s hard for residents in the affected areas to ignore.

“They don’t understand that their best chance for survival is to come to a treatment facility early and that their best chance at preventing transmission to their loved ones is to go to the treatment facility,” says Fischer. “There’s an incredible amount of distrust between the people and the healthcare providers because they see their loved ones go to these facilities and then 90 percent of them return in a body bag. Facing those statistics, I’d be skeptical of those treatment facilities.”

Fischer says medical personnel need to reach out to community leaders to help stem the spread of the virus and build trust.

“This is a challenge. This is a major, major challenge. But it’s also an opportunity. If we can empower local community leaders to spread the word about the benefits of presenting early to a treatment facility- the benefits being it increases your chance of survival and decreases the chance of transmission- then we can have patients present earlier. If we can reduce that mortality we’re going to improve the trust between the community and the healthcare providers.”

This latest outbreak began in March and continues unabated. Fischer notes that with a twenty-one day incubation period and an increasingly mobile populace, this disease is poised to spread.

“I don’t see this ending any time soon, unfortunately. I do think that we are going to have to dedicate and we should dedicate a tremendous amount of resources, both from a material perspective as well as from a human infrastructure perspective in order to stop this outbreak before it gets even worse.”

Just last week a seemingly healthy man boarded an airplane in Liberia, only to arrive in Lagos, Nigeria with symptoms of Ebola. He later died. Officials are still trying to track other passengers on that plane.

The disease takes a toll on healthcare workers too, as they are often in contact with the bodily fluids that spread Ebola. Top doctors in Liberia and Sierra Leone have succumbed to the disease, and two Americans, a doctor and an aid worker, are currently in quarantine suffering symptoms. This has prompted two North Carolina-based charities to call for an evacuation of all non-essential staff from Liberia.

Nonetheless, Fischer says he is eager to return to the region.

“I’d like to go back. I think, for me, leaving was just as difficult as going. It was the thought that I was leaving in the midst of the epidemic as opposed to the end of the epidemic. I feel a strong draw to go back. My hope would be that I could, through aggressive critical support, reduce the mortality and then improve community trust.”

You can read Dr Fischer’s dispatches from Guinea here.

http://chapelboro.com/news/international/epidemic-worsens-unc-doctor-details-battle-ebola/

Fracking Concerns Blue Ridge Environmental Defense, NC Citizens

With the rising concern of the dangers associated with fracking, many North Carolinians are deeply uncertain about what lies ahead for the state relying on the questionable method of obtaining fuel and energy.

WCHL’s Ron Stutts spoke with Therese Vick of the Blue Ridge Environmental Defense League, and with Martha Girolami, a citizen of northeast Chatham County that has found out recently that she lives atop of what is known as the “Triassic basin,” which is one of the potential locations that fracking companies may take advantage of.

The Blue Ridge Environmental Defense League is a “regional, community-based, non-profit environmental organization.” They focus on issues including “industry’s dependence on toxic chemicals, utilities’ refusal to adopt sound energy alternatives, industrial development and highway construction at the expense of public health, intensive livestock operations’ effects on agriculture and the environment, and huge waste dumps.”

When asked what she personally found so dangerous about fracking, Girolami says that her two biggest issues come from the health risks and how quickly the practice of fracking is being accepted despite a lack of real preparatory analysis.

“Fracking so bad because it’s so polluting,” says Girolami. “It’s so polluting to ground water, surface water, air, air health, and it’s been so rushed. So rushed we haven’t done a health study, we’ve done no air rules. The Energy and Mining Commission has been meeting for two years, but there are big gaps in the rules they put together.”

Vick reminds of the recent legislation created that states it is a misdemeanor to disclose what chemicals are used for digging. She says that this is not how the community should be treated when it comes to this form of resource gathering.

“The community has the right to know what is being injected into the ground under their feet,” says Vick. “Our organization just passed a resolution on chemical disclosure that we hope to share with other folks, but my feeling is that the reason they don’t want people to know is because of that potential liability.”

***Listen to the full interview here***

Part 1

Part 2

Part 3

For more on the Blue Ridge Environmental Defense League, click here.

http://chapelboro.com/news/health/anti-fracking-response-interview/

Four New Flu Deaths In NC Last Week, Three Additional Found

Four people died from the flu last week and three additional flu deaths from previous weeks have been discovered, according to the North Carolina Department of Health and Human Services.

At the last report, 74 people had been killed by the flu in North Carolina this flu season. The total is now up to 81, which is 22 more than last season’s total of 59.

Four deaths is the lowest reported total since the first full week in January showing a continued downward trend since the peak of 12 in late January. This time period also marked just the second week since January 12 that a pediatric death has not been reported.

To see more statistics of flu-reported deaths in North Carolina, click here.

http://chapelboro.com/news/health/four-new-flu-deaths-nc-last-week-three-additional-found/

Flu Season Putting Stress On Vaccine Supply

NORTH CAROLINA – Flu season is still a month or so away from its peak, and health officials are urging people to get their flu shots with the number of cases continuing to rise.

Because of the uptick in cases, all Duke University Health System hospitals began restricting visitation rules on Monday, including ambulatory surgery patients being limited to immediate family or designated care givers, 18 and older, those who are not sick with the flu, and patients can’t have more than two adult visitors at once.

The restrictions are only temporary; Duke put similar restrictions in place last year.

Health officials are still stressing to the public to get flu shots. It takes about two weeks for the vaccine to kick in once administered. Some pharmacies have noticed an increase in demand and therefore a decrease in supply.

Eight people have died from the flu in North Carolina this season.

For information about Health Department clinics in Orange County, click here.

http://chapelboro.com/news/health/flu-season-putting-stress-vaccine-supply/

FDA Funds Two Tobacco Centers At UNC

CHAPEL HILL – The Food and Drug Administration is funding 14 tobacco centers of regulatory science, and out of the 40 universities that applied, UNC was the only school to receive two.

The two research teams combined will receive nearly $40 million from the FDA.

Associate professor, Robert Tarran, is leading one of the teams and four of the projects at UNC. Tarran has experience doing tobacco research on COPD (Chronic Obstructive Pulmonary Disease) for several years.  He says he thinks UNC received funding because of the expertise at the school.

“So UNC has an expertise in airway biology, and so we were able to put together a whole bunch of different researchers who have complimentary research experience to put together this comprehensive project,” Tarran says.

Tarran says that his team will receive $20 million over the next five years for a flexible range of tobacco products.  Currently, Tarran says he’s focusing on the effects of hookah and “little cigars,” but in the future may research other new tobacco products.

The money from the grant will not only employ researchers here at UNC but will provide a training component for graduate students.

“There’s an actual separate component on this for training grad students, and then part of that gives them the advantage, so there’s like a mechanism for a grad student to come into this and then go and get experience at other centers as well,” Tarran says. “And so we get to train the next generation of scientists who look at tobacco research.”

Professor in the School of Public Health at UNC, Kurt Ribisl leads the other research team that looks at how to communicate the facts about tobacco products to smokers.   Having researched in this area for 19 years and involvement in the Surgeon General’s report last year, Ribisl says he has high goals for his project.

“The ultimate goal of all of this work is to reduce the public health burden of tobacco use, design research that will help inform and guide what the FDA does when they regulate tobacco products,” Ribisl says.

The new FDA funded research will allow for studies to be conducted on subjects where there is very little data.  Tarran says the funds will allow for precise, fact-driven research that hasn’t been done.

“Well see it’s going to be interesting, I think its nice now that we can sort of have a better debate about whether or not these new products are dangerous or not, I think the precise research hasn’t been done so this gives us opportunity to do that and then to better help the FDA on governing these products,” Tarran states.

Ribisl says that one of the new aspects they will look at is warning labels for E-Cigarettes.

“We really need to understand what consumers think about the risks of these projects, and when we find if they have really distorted views of the risks, then we want to more properly align what the consumer believes with the actual risk of the product;” Ribisl says “so we are thinking about testing new labels for E-Cigarettes.”

With a combined $40 million for research over the next five years, UNC will produce new data related to cigarettes and other tobacco products. A mix of health studies on the lungs and how to effectively communicate the risks of tobacco products will dovetail nicely for the FDA.

http://chapelboro.com/news/health/fda-funds-two-tobacco-centers-at-unc/