Human reproduction is the basic requirement for life on Earth. But what if pregnancy was really rare?
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Appointments of black, Asian and minority ethnic candidates to senior roles has fallen, a report says.
The Trump Administration announced yesterday that it was discontinuing all research at the National Institutes of Health (NIH) involving the use of human fetal tissue obtained from elective abortions. It also chose not to renew a long-running contract with the University of California, San Francisco (UCSF)—which expired yesterday—to provide funding for such research being conducted at the university.
In a statement provided to Health and published online, UCSF Chancellor Sam Hawgood said that the university "strongly opposes” the administration’s decision to discontinue fetal tissue research at the NIH. “The efforts by the administration to impede this work will undermine scientific discovery and the ability to find effective treatments for serious and life-threatening disease,” he added.
The decision to cut funding to UCSF and ban fetal tissue research within the NIH is being praised by anti-abortion groups but criticized by many science and health organizations. What exactly is research involving human fetal tissue, and why is it considered so important for modern medicine? Here are the facts doctors and scientists want you to know.
As early as the 1930s, scientists discovered that cells and tissue from human fetuses and embryos could be useful for medical studies—to test new drugs or to understand how human tissue might react to certain stimuli, for example. Because fetal cells are often still undifferentiated (which means they haven’t developed into certain types of cells, like nerve cells or blood cells), they can be used broadly in many different fields of research.
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“Researchers use fetal tissue to produce cell cultures, also called cell lines, which can be maintained in a laboratory environment for very long periods of time, in some cases indefinitely,” explains a 2015 report from the Congressional Research Service. “Cultured cells mimic many of the properties that they have in a living body, and therefore can be used as a model for researchers studying basic biological processes.”
In some cases, researchers perform experiments on fetal tissue itself (to study potential causes of birth defects, for example). In others, they inject fetal cells into mice to make their bodies and immune systems behave more human.
The NIH has supported this type of research since the 1950s, according to the Congressional report, and was slated to spend $77 million on fetal tissue research in 2016. People who oppose this research claim that scientists don’t have to use fetal tissue, and that computer models or animal tissue can be acceptable alternatives. But supporters disagree.
“If we want to study a process, it’s best to study the real thing,” Akhilesh Pandey, MD, a researcher at Johns Hopkins University School of Medicine, told the Baltimore Sun in 2015. “Models can be insufficient in mimicking what we want to study, Even today we don’t understand all the biological processes.”
“Fetal tissue is a flexible, less-differentiated tissue,” Carrie Wolinetz, the NIH associate director for science policy, told Nature in 2015. “It grows readily and adapts to new environments, allowing researchers to study basic biology or use it as a tool in a way that can’t be replicated with adult tissue.”
According to STAT News, fetal tissue was involved in the discovery of treatments for rheumatoid arthritis, cystic fibrosis, and hemophilia. Recently, research on fetal tissue has helped scientists learn how the Zika virus might cause birth defects, and how it might be prevented.
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Certain vaccines, including those for polio, measles, chickenpox, and rabies, were also developed with the use of stem cells derived from human fetal tissue. (Despite this, the Catholic Church—which is strongly opposed to abortion—has said that the benefits of vaccination outweigh the ethical issues involved.)
Last year, when the Trump administration temporarily halted the acquisition of new fetal tissue for government research, Science magazine reported that studies being conducted by the National Eye Institute, the National Institute of Allergy and Infectious Diseases, and the National Cancer Institute were affected.
And in his statement, UCSF Chancellor Hawgood said that “fetal tissue is used in important research aimed at discovering cures for illnesses that affect the lives of millions of Americans, including Alzheimer’s, spinal cord injury, eye disease, and HIV.” He also noted that UCSF had been working with specially designed models “that could be developed only through the use of fetal tissue to find a cure for HIV.”
The primary source by which research institutions obtain fetal tissue is through hospitals and clinics that perform abortions. It is illegal for those organizations to profit off the sale of that tissue (hence the controversy that ensued when Planned Parenthood was falsely accused of “selling baby parts” in 2015), or for providers to discuss donating fetal tissue for medical research with a woman before she decides to have an abortion.
Some states have even stricter laws that prohibit research on fetal tissue entirely. The American Medical Association also has a Code of Medical Ethics that physicians are advised to follow when involved with research that uses human fetal tissue.
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Hagwood said in his statement that “UCSF exercised appropriate oversight and complied with all state and federal laws,” but that their contract was terminated anyway. “We believe this decision to be politically motivated, shortsighted, and not based on sound science,” he added.
As for UCSF’s ongoing research, Hagwood’s statement says the university “will continue to collaborate with the UC Office of the President, as well as with other universities, science associations, and affiliated organizations, to advocate for sustained federal funding of fetal tissue research with Congress and the Administration.”
A statement from the Department of Health and Human Services (HHS) notes that no other research being conducted outside the NIH, even those receiving NIH funding, will be affected “during their currently approved project period.” Newly proposed projects, however, or those reapplying for grants, will be considered by a new ethics advisory board to determine whether they should be funded.
The statement also notes that HHS is continuing to search for "adequate alternatives” to the use of human fetal tissue obtained from elective abortions. Last year, the NIH announced a $20 million grant opportunity for researchers who could develop and implement such alternatives.
“Promoting the dignity of human life from conception to natural death is one of the very top priorities of President Trump’s administration,” the HHS statement reads.
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Bedwetting in young children is common, but mostly stops when they start gaining control over their bladders.
However, when the condition persists, it could be due to an underlying medical condition such as incontinence or urinary tract infection, and may go undiagnosed because of a number of myths parents believe about bedwetting.
Common problems that may cause bedwetting are:
Here are the most common myths about bedwetting:
1. Children wet the bed because they are not properly toilet trained
Bedwetting is not a sign that a child is not toilet trained. A child might be perfectly able to control his or her bladder during the day but will still wet the bed at night.
2. Bedwetting should be waited out and requires no treatment
Many parents assume that their children simply wet the bed because they don’t have full control over their bladders yet and that they should wait it out. While this is often the case, it isn’t always true.
According to a study done by the University of Bristol, there are several factors that can cause bedwetting at a later stage, where a “watch-and-wait approach” may not be successful. In fact, it may mask an underlying medical problem such as faulty bladder mechanism, or a urinary tract infection.
The study also mentioned that many parents do not consider treatment for bedwetting until it’s too late and has a knock-on effect on the child’s quality of life.
Our verdict: If your child has had a period of not wetting the bed and suddenly starts again, especially after the age of five, medical intervention might be necessary to uncover the reason why.
3. Children who wet the bed are simply lazy
This view may be extremely harmful to the child’s wellbeing. Children do not wet the bed on purpose and may feel embarrassed and ashamed if a parent chooses to punish them for it, according to the ERIC Children’s Bladder and Bowel Charity.
It’s important to reassure your child that it’s not their fault, and to rule out and consider possible underlying causes.
4. Bedwetting is always linked to emotional stress
While emotional stress can be linked to bedwetting in children, this is not always the reason, according to paediatrician Dr Alanna Levine. It’s more likely to be because of a delay in bladder development.
5. Your child needs medication for bedwetting
While there are some instances where medication is prescribed for bedwetting, it should always be the last resort. If you think your child’s bedwetting could be caused by an underlying medical condition, it’s important to see a doctor.
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Need another reason to take that vacation? It’s probably good for your heart and mind.
Research over the years has suggested that holidays – and breaking away from a stressful daily routine – reap more than just scenic photos and souvenirs.
Better overall well-being
One of the most-cited studies, the Multiple Risk Factor Intervention Trial published in 2000, tracked middle-aged men for nine years and concluded those who had taken more annual vacations were less likely to die from cardiovascular causes, including heart attacks. Other surveys and studies have linked vacations to less depression, decreased stress and better overall well-being.
Dr Anand Rohatgi, a preventive cardiologist and associate professor of medicine at UT Southwestern Medical Center in Dallas, said more research is needed on the subject, but the idea makes sense.
“These are mostly observational studies, but people who take less vacation are typically more stressed and have more health issues,” he said. “If you don’t take the time to recover and restore, you’re not going to perform as well, and you may be more prone to injury and inflammation and illness.”
One barrier to drawing definitive conclusions, he said, is the difficulty in separating the vacation issue from every other factor affecting health.
“People who choose to have or are able to have more vacation may be different from people who can’t,” Rohatgi said. “It may be related to job status or financial status, not just about the vacation itself.”
Clear cardiovascular implications
Nevertheless, the cardiologist said he counsels patients, especially those with heart problems, to reduce their stress, with time off as part of that strategy.
“Stress can raise your blood pressure, it can raise your pulse, it can lead to arrhythmia or make any of those conditions worse, and make them harder to manage,” Rohatgi said. “There are clear cardiovascular implications of maintaining balance and diminishing stress. You need to do that on some level on a daily basis, but vacations are a nice way to fully unplug and disengage.”
Fully unplugging is the key.
“You need to use that vacation properly,” Rohatgi said. “Even when you do take time off, you can still be on your screen with constant phone calls and email. Spending time somewhere else but still checking in all the time may diminish the value you think you’re getting.”
What you do and how you eat can make a difference. A sabbatical with lots of fresh air and vigorous hikes may have a healthier impact than an unlimited food-and-drink cruise or replenishing the cola and chips at every gas stop.
“Sometimes we have a tendency to go away and feel it’s all or nothing,” said Andrea D’Ambrosio, a dietitian and nutrition coach in Kitchener, Ontario. “We tell ourselves, ‘I can’t have it at home but when I go away there’s unlimited drinks and buffets so I’m just going to gorge myself.’
Part of the total holistic package
“The goal is to try to make your vacation similar to your normal eating habits.” For example, she said, maintain regularly scheduled meals four to six hours apart and pack healthy snacks “so you’re not over-hungry at any given time”.
Even so, D’Ambrosio knows food is a cherished part of any vacation.
“If you go to Italy, enjoy the pasta and the wine,” she said. But she also advises keeping a healthy balance and limiting liquid calories “because they’re sneaky. We’re more likely to consume liquid calories like alcohol and sugary beverages than food calories.”
Home or away, experts agree moderation should be the theme.
“Vacations are just part of the total holistic package” for health, Rohatgi said. “Managing stress and diet and exercise are always going to be key.”
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Stroke is a leading cause of death and disability in the US, and women make up nearly 60% of all stroke deaths.
Why?
In part, experts say, women may have symptoms subtle enough to be missed or brushed off in the daily juggle of work-life balance. That can lead to delays in getting time-sensitive, lifesaving treatments.
Understated symptoms
Men and women who have strokes often experience a similar set of symptoms that can be remembered using the mnemonic F.A.S.T.: face drooping, arm weakness, speech difficulty, time to call 911. Other signs include problems seeing out of one or both eyes and balance or coordination problems.
But some women experience other, more understated symptoms they may hesitate to bring to a doctor’s attention – or to a 911 operator.
“Women more frequently have atypical, vague symptoms. They might start with fatigue, confusion or maybe general weakness, as opposed to weakness on one side of the body,” said Dr Pooja Khatri, a neurology professor at the University of Cincinnati.
Khatri advised taking note of any sudden change or unusual body function.
She said many women may disregard something like a sudden, unusually bad headache if they’re generally used to getting headaches. Or, they may dismiss difficulty walking, exhaustion, brain fog or an overall malaise and instead blame it on stress or being overworked. Nausea or vomiting often gets explained away to viral illnesses.
Key to getting treatment
It’s critical to zero in on “any sudden symptom or loss in function that you can’t explain. The key is that it’s sudden,” said Khatri, director of the University of Cincinnati Stroke Team.
Studies suggest women are just as knowledgeable as men, if not more, about recognising the more typical stroke symptoms. Yet because women are more likely than men to minimise their symptoms, they’re also more likely to reach out to their primary doctor or drive themselves to the hospital instead of calling 911, said Dr Amytis Towfighi, director of neurological services for Los Angeles County Department of Health Services.
“The key to getting the treatments we have available is having the ambulances alert the hospitals that they’re coming with a stroke patient, so that the whole team is activated and ready to give the medication,” said Towfighi, an associate professor of neurology and preventive medicine at the University of Southern California’s Keck School of Medicine.
“Whereas if you just walk into the ER, you might be stuck in triage waiting to be seen. And since women in particular may have non-traditional symptoms, the staff may not figure out right away that they’re having a stroke, and there could be delays in getting seen and getting treatment.”
Worth taking a risk
Minutes matter during a stroke, which happens when the brain is deprived of oxygen after blood flow is cut off by a clot or a ruptured vessel. Treatment is extremely time-sensitive, and delays can increase the risk of death or permanent brain damage.
When deciding whether to seek help, Khatri said women – and men – should be comfortable with the idea of a potential false alarm.
“It’s not worth the risk of it being a true stroke that you failed to get treated for quickly,” she said.
“Time is brain, and the longer you take to get definitive treatment, the more brain (tissue) that’s going to die, and the less well you’re going to be in the long run. In fact, fast treatment can even completely reverse the stroke. It’s worth taking that risk of being wrong. You want to err towards being seen.”
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