Casting for the Cure

The great innovators of our time are said to be the titans of technology - the inventors of the microchip, the founders of Microsoft, the guys behind Google. But far from Silicon Valley another great thinker and innovator is changing the world with far less fanfare. His name is Dr. Paul Farmer.

As Byron Pitts reports, more than 20 years ago Dr. Farmer and a few other great minds created a charity called “Partners In Health.” In the years since, they revolutionized the delivery of healthcare worldwide, saving millions of lives in places where no one thought there was any reason for hope.

“The idea that because you’re born in Haiti you could die having a child. The idea that because you’re born in you know Malawi your children may go to bed hungry. We want to take some of the chance out of that,” Farmer tells Pitts.

Farmer invited 60 Minutes to central Haiti, where he discovered his life’s work 25 years ago. The invitation meant a three-hour, jaw clenching, teeth rattling ride on an unpaved road from the capital city to the hospital.

If the ride doesn’t break your back, what you see when you arrive will break your heart: the squatter settlement of Cange is one of the poorest parts of the poorest country in the Western Hemisphere.

lanjut →

A cognitive behavioral intervention for insomnia delivered via the Internet can significantly improve insomnia in adults, according to a research abstract presented at SLEEP 2008, the 22nd Annual Meeting of the Associated Professional Sleep Societies (APSS).

The study, authored by Lee Ritterband, PhD, of the University of Virginia, focused on 44 participants (mostly female) with an average age of 45 years. The participants were randomly selected to either the cognitive behavioral intervention for insomnia via the Internet or a wait list control. Measures of sleep, mood, cost, and cognitive functioning were collected at pre- and post-treatment, while additional measures of sleep were collected throughout treatment.

According to the results, sleep improved significantly for those who received a cognitive behavioral intervention for insomnia via the Internet over the six-week intervention, whereas control participants showed no change during the treatment period. Sleep efficiency also significantly improved for the experimental group from pre- to post- assessment, with no change for the controls. The experimental group increased total sleep time by 80 minutes and the control group increased by nine minutes.

“We believe these types of Web-based treatment programs have the potential to impact countless individuals around the world,” said Dr. Ritterband. “Specifically related to insomnia, the availability of non-pharmacological help is significantly lacking. The Internet has already become a critical source of health-care and medical information. The Internet may prove an effective tool to more broadly disseminate cognitive behavioral therapy for insomnia.”

Insomnia is a classification of sleep disorders in which a person has trouble falling asleep, staying asleep or waking up too early. It is the most commonly reported sleep disorder. About 30 percent of adults have symptoms of insomnia. It is more common among elderly people and women.

Cognitive behavioral therapy (CBT) helps you change actions or thoughts that hurt your ability to sleep well. It helps you develop habits that promote a healthy pattern of sleep. CBT is most often used for people who suffer from insomnia.

The American Academy of Sleep Medicine (AASM) offers the following tips on how to get a good night’s sleep:

• Follow a consistent bedtime routine.
• Establish a relaxing setting at bedtime.
• Get a full night’s sleep every night.
• Avoid foods or drinks that contain caffeine, as well as any medicine that has a stimulant, prior to bedtime.
• Do not bring your worries to bed with you.
• Do not go to bed hungry, but don’t eat a big meal before bedtime either.
• Avoid any rigorous exercise within six hours of your bedtime.
• Make your bedroom quiet, dark and a little bit cool.
• Get up at the same time every morning.

Those who suspect that they might be suffering from insomnia, or another sleep disorder, are encouraged to consult with their primary care physician or a sleep specialist.

A group of Swiss investigators has reported on a new conceptualization of the effects of behavioral conditioning in allergic rhinitis in the fourth 2008 issue of Psychotherapy and Psychosomatics.

Allergic symptoms can be induced by behavioral conditioning. However, the conditionability of antiallergic effects has not yet been studied. Thus, in this study the Authors investigated whether the effects of a histamine 1 (H1) receptor antagonist are inducible in patients suffering from house-dust mite allergy using a behavioral conditioning procedure. During the association phase, 30 patients with allergic house-dust mite rhinitis received a novel-tasting drink once daily, followed by a standard dose of the H1 receptor antagonist, desloratadine, on 5 consecutive days. After 9 days of drug washout, the evocation trial commenced: 10 patients received water together with an identically looking placebo pill (water group), 11 patients were re-exposed to the novel-tasting drink and received a placebo pill [conditioned stimulus (CS); CS group] and 9 patients received water and desloratadine (drug group). During the association phase, desloratadine treatment decreased the subjective total symptom scores, attenuated the effects of the skin prick test for histamine and reduced basophil activation ex vivo in all groups. During the evocation trial, the water group, in which subjects were not re-exposed to the gustatory stimulus, showed a reduction in subjective total symptom scores and skin prick test results, but no inhibition of basophil activation. In contrast, re-exposure to the novel-tasting drink decreased basophil activation, the skin prick test result and the subjective symptom score in the CS group to a degree that was similar to the effects of desloratadine in the drug group.