Stem cells located in the bone marrow generate and control the production of blood and immune cells. Researchers from EMBL, DKFZ and HI-STEM have now developed new methods to reveal the three-dimensional organization of the bone marrow at the single cell level. Using this approach the teams have identified previously unknown cell types that create specific local environments required for blood generation from stem cells. The study, published in Nature Cell Biology, reveals an unexpected complexity of the bone marrow and its microdomains at an unprecedented resolution and provides a novel scientific basis to study blood diseases such as leukemias.

Lithium-ion batteries are notorious for developing internal electrical shorts that can ignite a battery’s liquid electrolytes, leading to explosions and fires. Engineers at the University of Illinois have developed a solid polymer-based electrolyte that can self-heal after damage — and the material can also be recycled without the use of harsh chemicals or high temperatures.

A team of Florida researchers and their collaborators created a first-of-its-kind computer model that tracks where sea turtle hatchlings go after they leave Florida’s shores, giving scientists a new tool to figure out where young turtles spend their “lost years.”

Some people look forward to the festive season. Others, not so much. According to the South African Depression and Anxiety Group (SADAG), the holidays can be tougher than usual for those with depression. It can be a time of loneliness, despair or relapsing into bad habits.

In South Africa, the month of December has the highest suicide rate of the year, says Zane Wilson, founder of SADAG.

Here are some ways to take care of your mental health during the holidays.

1. Don’t ignore the tell-tale signs and symptoms

Sometimes, a bout of depression can hit so fast without you realising. Symptoms might manifest differently in every individual – therefore it’s important to truly take note of what you are feeling and acknowledging when going through a rough patch. Here are some signs of depression over the festive season.

The festive season may also trigger sadness in some, especially when family is far away, when you had to deal with the loss of a loved one, or when you are simply reflecting over the past year. But know when it’s depression or simply situational sadness with this article.

2. Get moving

We are not saying that exercise is an instant miracle cure for depression, but studies have shown that exercise could have significant benefits for even those who are high at risk. Even small amounts of exercise may help. You don’t need to go to the gym over the festive season at all – go for walks, do short home workouts or do some yoga.

3. Give screen time a break

Social media can be linked to a higher risk of depression, especially in teenagers, according to a previous report on Health24. Take time out from social media over the festive season, especially if you are permanently glued to your phone. You don’t have to go cold turkey or cut all contact with friends – simply create windows of social media-free time during the holidays.

Make a conscious effort of leaving your phone in the bedroom while you read that book you always wanted to finish during the year.

4. Be mindful of family members who might be suffering

Even if you are not affected by a mental health issue such as depression or anxiety, you should know how to support someone in your house who might go through a rough patch. This article gives helpful tips on how to support a loved one.

5. Pay attention to eating disorders

The festive season and all the social eating that goes with it may be your worst nightmare if you suffer from any issue relating to eating or body dysmorphia. Be kind to yourself and ask for help if you feel like endless family dinners may take its toll on your health. 

This guide may help you identify the signs of an eating disorder and how to support a loved one who might be suffering.

6. Minimise stress as much as possible

The rush and stress that comes with the festive season can trigger mental health issues. We change our routines over the holidays, deal with year-end deadlines and holiday preparations, or have to contend with large crowds in public spaces.

Keep your expectations reasonable, plan ahead for what you can, don’t overspend and create financial troubles in the new year and let go of what you can’t control. This article contains more tips.

7. Be prepared for January

Speaking of the new year – know that many people take a bit of a mental dip during January after the highs of the festive season. Be mindful of this and take inventory of any possible signs and symptoms of depression during this period.

Make January a bit less stressful by tying up all loose ends in December (even if you don’t have the energy right now) and by keeping your finances in check over the holiday season. Here are some more mental adjustments that may help you during this time.  

8. Take stock of your current treatment plan

Now may be a good time to check in with your therapist or doctor before everyone takes a break for your holiday. They may help you reassess your current medication. A session with a therapist might also help prepare you for any lows that you might experience during the festive season. They may also help you come up with a plan to help you manage depression or anxiety over the new year.

Do you suspect you might be suffering from depression but hesitant to ask for help? These are the signs that you may need a psychologist.

9. Bust low self-esteem

A low self-esteem can be a big sign of depression, anxiety, eating disorders or any other mental health condition and it may have a crippling effect on your overall health. During the festive season, low self-esteem can soar when we compare ourselves to siblings, more successful family members or friends having a great time on an expensive holiday. But ultimately, this will not do you any favours. This article may be able to help.

10. Understand the grieving process

Whether you are dealing with the loss of a loved one, the loss of a job, the diagnosis of a terminal illness, or a family member moving far away, know that mourning is a normal process. This article explains the four so-called tasks of mourning, which may guide you through the process.

Marelize Wilke

Seven-year-old Olly can now get Orkambi after the NHS struck a deal with the manufacturer.

Hundreds of parents allege Shrewsbury and Telford NHS Trust provided poor maternity care.

The amount of food needed to feed the world’s population by the end of the century could increase by almost 80%, a study suggests.

When you eat and how often you eat can make a big impact on your weight and insulin needs if you have type 2 diabetes, new research suggests.

The study found that people who ate three meals a day instead of six smaller meals, and moved the timing of those meals to earlier in the day, needed less insulin, improved their blood sugar and lost about 5kg to boot.

Six small meals not effective

“Shifting calories and carbs to the early hours of the day and less eating occasions is an effective strategy for the achievement of better diabetes control and outcomes with less total daily insulin dose,” said study author Dr Daniela Jakubowicz. She is a professor of medicine from Tel Aviv University, in Israel.

Jakubowicz said a traditional diet recommended for type 2 diabetes has been to eat six small meals distributed evenly throughout the day.

But this type of eating plan hasn’t been effective for blood sugar control and leads to the need for more insulin, and weight gain, she said.

Jakubowicz said this becomes “a vicious cycle, with continuous weight gain, increased blood sugar and progressive increases in insulin doses”.

The study included 28 people with type 2 diabetes who were taking insulin, with an average body mass index in the obese category. The average age was between 68 and 69.

Half of the group was randomly assigned to three meals a day (3M diet), and the other half to six meals a day (6M diet).

Reduced need for insulin

The composition of the meals was consistent: 35% fat, 25% protein and 40% carbohydrates. What differed were the calories and the timing of the meals.

The 3M diet included a large breakfast of 700 calories, a medium lunch with 600 calories and a small dinner of just 200 calories, according to the study. The 6M diet included breakfast, lunch and dinner and three snacks, all with fairly uniform calorie amounts.

Study volunteers were asked to eat breakfast before 9:30 a.m., lunch between noon and 3 p.m., and dinner between 6 p.m. and 8 p.m. The people in the 6M diet also had a snack at 11 a.m., 5 p.m. and 10 p.m.

Those on the 6M diet didn’t see any weight loss or improvement in their blood sugar levels, the findings showed.

Meanwhile, the folks on the 3M diet lost nearly 12 pounds and significantly improved their blood sugar levels. In fact, they improved so much that people were able to reduce their need for insulin.

Jakubowicz thinks these improvements occurred because those on the 3M diet were eating to their biological clock. The body is “optimized for eating in the early hours of the day and for fasting and sleeping in the evening and night,” she said. A slice of bread eaten in the evening is more fattening and leads to higher blood sugar than a slice of bread eaten in the morning, she added.

Jakubowicz said she thinks the 3M diet would also be helpful for people with type 1 diabetes and those with type 2 who don’t require insulin to manage their disease.

Keep track of what you’re eating

Dr Minisha Sood, an endocrinologist with Lenox Hill Hospital in New York City, said that the improvement in blood sugar control was equivalent to what might be seen from taking diabetes medication.

“More awareness should be raised around the power of lifestyle change in persons with diabetes in general,” she said. “Though this study includes only 28 participants, this data is a powerful example of what can be accomplished with front-loading calories and avoiding large meals and excess calories later in the day.”

Registered dietitian Maureen Franklin, from Upstate University Hospital in Syracuse, New York, isn’t convinced that the exact timing of meals plays as much of a role in blood sugar control as making sure your carbohydrate intake is consistent and that you’re eating a balance of foods, such as protein and carbohydrates.

Franklin said it’s also important not to focus so much on the clock that you start eating when you’re not hungry. “Ask yourself, ‘Am I really hungry?’ before you eat. Sometimes, the reason we eat is more a psychological issue.”

It’s really important for people with diabetes to keep track of what they’re eating, she added. “Keep a food diary for a week, including what time you’re eating,” Franklin suggested. “You need to know what you’re actually doing before you can make a change.”

The findings were published in Diabetes Care.

^{Image credit: iStock}

The days of old-fashioned house calls may be over, but there is a growing trend toward providing some hospital care in the comfort of patients’ homes. Now, a new study suggests it might end up being cheaper and, in some respects, better than traditional hospital care.

The study, done at Brigham and Women’s Hospital in Boston, tested a “hospital at home” programme – where patients with certain medical conditions are eligible to receive “hospital-level” care at home.

Concept still in infancy

Researchers found that compared with similar patients admitted to the hospital, those in the home programme were less likely to return to the hospital within 30 days of their discharge. And their health care costs were, on average, 38% lower.

The study was small, with only 91 patients, and the home-hospital concept is still in its infancy in the United States.

But the results are “exciting”, because they point to one way that health care can be “reimagined”, said lead researcher Dr David Levine, a physician at Brigham and Women’s.

“In day-to-day practice,” he said, “we look at certain [hospital] patients and think, ‘You don’t really need to be here.'”

That is, they could receive the care they need at home – where they could likely sleep better, move around more and almost certainly eat better food.

Home hospital care is already offered in a few countries, such as Australia and Spain, according to Levine’s team. And some academic health systems in the United States have launched projects, including Johns Hopkins in Baltimore and Mount Sinai in New York City.

A certain amount of mobility

But the new study, published in the Annals of Internal Medicine, is the first randomised trial of a home programme in the United States. Patients arriving in the ER were randomly assigned to either be admitted to the hospital or to the home programme (with patients’ informed consent).

Patients were eligible for home care if they had select conditions – such as an infection or an exacerbation of a chronic disease like asthma, heart failure or emphysema.

“A critical point is that we knew exactly what the diagnosis was,” Levine said.

If there was doubt – a patient arriving in the ER with chest pain, for example – home care was not an option.

Patients also had to have a certain amount of mobility – needing no more than one person to help them to a bedside commode. And, Levine said, “They were all considered to be low risk for clinical deterioration.”

The programme involved at least one daily visit from a doctor and at least two visits from a nurse. If necessary, patients received services from a home health aide, physical therapist or social worker. Their vitals were monitored by a skin patch that could send alarms to their doctors’ and nurses’ smartphones, and any blood tests and imaging were done in their homes.

An impact on readmissions

Overall, the study found, home patients underwent far fewer lab tests – typically around three, versus 15 among hospital patients.

In the end, only 7% of home patients needed to be admitted to the hospital within 30 days of their discharge. In contrast, 23% of hospital patients were readmitted.

“We were frankly surprised there was such an impact on re-admissions,” Levine said.

Dr John Wong, of Tufts University Medical Center in Boston, co-wrote an editorial published with the study.

He said that a bigger-picture question is how well the results at Brigham and Women’s – a top academic medical centre – could be translated to other, smaller hospitals. The logistics – including educating staff and partnering with a home health care company – can be challenging even for a large hospital, Wong noted.

Payment is a major area that has to be worked out, too, he said: Currently, there is no “payment model” in place for insurance companies and Medicare/Medicaid to reimburse for home hospital care.

More beds free in hospitals

And then there are the family caregivers. Is it a help or a burden to have their loved one cared for at home?

“Some families would probably welcome this opportunity,” Wong said, “while others might find it stressful.”

But all of these questions are worth digging into, according to Wong.

One possibility, he noted, is that by caring for certain patients at home, hospitals would have more beds free for those with more-complicated or rare conditions.

“As a country,” Wong said, “we should explore more opportunities to provide patients with the care they need, in the place they’d prefer to have it.”

^{Image credit: iStock}