By Keri Chiodo, Association for Psychological Science

It’s nearly impossible to pay attention to one thing for a long time. A new study looks at whether Buddhist meditation can improve a person’s ability to be attentive and finds that meditation training helps people do better at focusing for a long time on a task that requires them to distinguish small differences between things they see.

The research was inspired by work on Buddhist monks, who spend years training in meditation. “You wonder if the mental skills, the calmness, the peace that they express, if those things are a result of their very intensive training or if they were just very special people to begin with,” says Katherine MacLean, who worked on the study as a graduate student at the University of California - Davis. Her co-advisor, Clifford Saron, did some research with monks decades ago and wanted to study meditation by putting volunteers through intensive training and seeing how it changes their mental abilities.

About 140 people applied to participate; they heard about it via word of mouth and advertisements in Buddhist-themed magazines. Sixty were selected for the study. A group of thirty people went on a meditation retreat while the second group waited their turn; that meant the second group served as a control for the first group. All of the participants had been on at least three five-to-ten day meditation retreats before, so they weren’t new to the practice. They studied meditation for three months at a retreat in Colorado with B. Alan Wallace, one of the study’s co-authors and a meditation teacher and Buddhist scholar.

The people took part in several experiments; results from one are published in Psychological Science, a journal of the Association for Psychological Science. At three points during the retreat, each participant took a test on a computer to measure how well they could make fine visual distinctions and sustain visual attention. They watched a screen intently as lines flashed on it; most were of the same length, but every now and then a shorter one would appear, and the volunteer had to click the mouse in response.

Participants got better at discriminating the short lines as the training went on. This improvement in perception made it easier to sustain attention, so they also improved their task performance over a long period of time. This improvement persisted five months after the retreat, particularly for people who continued to meditate every day.

The task lasted 30 minutes and was very demanding. “Because this task is so boring and yet is also very neutral, it’s kind of a perfect index of meditation training,” says MacLean. “People may think meditation is something that makes you feel good and going on a meditation retreat is like going on vacation, and you get to be at peace with yourself. That’s what people think until they try it. Then you realize how challenging it is to just sit and observe something without being distracted.”

This experiment is one of many that were done by Saron, MacLean and a team of nearly 30 researchers with the same group of participants. It’s the most comprehensive study of intensive meditation to date, using methods drawn from fields as diverse as molecular biology, neuroscience, and anthropology. Future analyses of these same volunteers will look at other mental abilities, such as how well people can regulate their emotions and their general well-being.

Foods like cake are off-limit to coeliacs

The precise cause of the immune reaction that leads to coeliac disease has been discovered.

Three key substances in the gluten found in wheat, rye and barley trigger the digestive condition, UK and Australian researchers say.

This gives a potential new target for developing treatments and even a vaccine, they believe.

Coeliac disease is caused by an intolerance to gluten found in foods like bread, pasta and biscuits.

It is thought to affect around 1 in every 100 people in the UK, particularly women.

The link between gluten and coeliac disease was first established 60 years ago but scientists have struggled to pinpoint the precise component in gluten that triggers it.

The research, published in the journal, Science Translational Medicine, studied 200 patients with coeliac disease attending clinics in Oxford and Melbourne.

The volunteers were asked to eat bread, rye muffins or boiled barley. Six days later they had blood samples taken to measure their immune response to thousands of different gluten fragments, or peptides.

The tests identified 90 peptides that caused some level of immune reaction, but three were found to be particularly toxic.

Professor Bob Anderson, head of the Walter and Eliza Hall Institute of Medical Research in Melbourne, Australia, said: “These three components account for the majority of the immune response to gluten that is observed in people with coeliac disease.”

Coeliac disease can be managed with a gluten-free diet but this is often a challenge for patients. Nearly half still have damage to their intestines five years after starting a gluten-free diet.

Professor Anderson said one potential new therapy is already being developed, using immunotherapy to expose people with coeliac disease to tiny amounts of the three toxic peptides.

Early results of the trial are expected in the next few months.

Sarah Sleet, Chief Executive of the charity Coeliac UK, said the new finding could potentially help lead to a vaccine against coeliac disease but far more research was needed.

She said: “It’s an important piece of the jigsaw but a lot of further work remains so nobody should be expecting a practical solution in their surgery within the next 10 years.”

The symptoms of coeliac disease vary from person to person and can range from very mild to severe.

Possible symptoms include diarrhoea, nausea and vomiting, recurrent stomach pain, tiredness, headaches, weight loss and mouth ulcers.

Some symptoms may be mistaken as irritable bowel syndrome or wheat intolerance.

Everyone who has had chickenpox is at risk of developing shingles. It’s caused by the same herpes varicella zoster virus.

Symptoms

The first sign of shingles is usually excessively sensitive, tingling or burning skin where the shingles rash subsequently appears. The area is often painful. At the same time, you may experience fever, headache and enlarged lymph nodes.

After a few days, the characteristic shingles rash appears as a band or patch of red spots on the side of the trunk or face. It usually appears on one side only. The rash develops into fluid-filled blisters that then collapse, forming small ulcers. These dry out and form crusts.

A common complication of shingles is pain in the area of the rash that persists after it has disappeared, called post-herpetic neuralgia which is more likely to occur the older you are. People with intractable post-herpetic pain often become depressed

Causes and risk factors

Shingles is a reactivation of the virus infection that causes chickenpox. After a person has had chickenpox the virus remains in their body, lying dormant or hidden in part of the nervous system.

For some reason, often many years later, the virus travels back down one of the nerves to the skin, where it causes a rash in the area of skin supplied by that nerve.

It’s not clear what triggers reactivation of the chickenpox virus but it may be linked to changes in the immune system such as an infection elsewhere in the body, or after physical or emotional shock. Ensuring your immune system is not weakened may help to prevent this occurring.

Around one in four people will develop shingles in their lifetime, with men and women affected equally. It’s most common in older people, although it can also occur in younger people and those with a weakened immune system.

The skin blisters that form in shingles are full of the chickenpox virus, which means a person with shingles is infectious. You can catch chickenpox from someone with shingles, if you’ve never had the infection and therefore aren’t immune. But you can’t catch shingles from someone with shingles (or someone with chickenpox).

Most adults - about 95 per cent - have been exposed to chickenpox and are immune, even though many aren’t aware of it (they may have had only a mild dose of chickenpox when they were young). However, a small number of adults aren’t immune and will be at risk. Also, when the immune system is suppressed (for example, when someone is being treated for cancer), a person can catch chickenpox for a second time.

Treatment and recovery

The shingles virus can be treated with antiviral medication. Painkillers can relieve the pain, while calamine lotion should help to reduce the itching. Anti-viral medical such as aciclovir is increasingly used as it reduces the duration of symptoms and also the risk of post-herpetic neuralgia, it’s important to start taking it as soon as possible. Shingles that affects the eyes requires antiviral therapy and urgent referral to an ophthalmologist.

If someone with a weakened immune system is exposed to shingles they are usually referred to hospital for possible intravenous antiviral therapy, as they’re at very high risk of complications from chickenpox. They may be offered an injection of immunoglobulin or antiviral antibodies.

This doesn’t prevent the disease, but may reduce the length and severity of the infection, and the risk of complications. The sooner immunoglobulin is given, the more effective it is likely to be. It must be given within 96 hours to have a significant effect.

The treatment of post-herpetic neuralgia can involve painkillers, capsaicin cream and, if necessary, specific antidepressants.

For the first time, a vaginal gel has proved capable of blocking the AIDS virus: It cut in half a woman’s chances of getting HIV from an infected partner in a study in South Africa. Scientists called it a breakthrough in the long quest for a tool to help women whose partners won’t use condoms.

The results need to be confirmed in another study, and that level of protection is probably not enough to win approval of the microbicide gel in countries like the United States, researchers say. But they are optimistic it can be improved.

“We are giving hope to women,” who account for most new HIV infections, said Michel Sidibe in a statement. He is executive director of the World Health Organization’s UNAIDS program. A gel could “help us break the trajectory of the AIDS epidemic,” he said.

And Dr. Anthony Fauci of the U.S. National Institutes of Health said, “It’s the first time we’ve ever seen any microbicide give a positive result” that scientists agree is true evidence of protection.

The gel, spiked with the AIDS drug tenofovir, cut the risk of HIV infection by 50 percent after one year of use and 39 percent after 2 1/2 years, compared to a gel that contained no medicine.

To be licensed in the U.S., a gel or cream to prevent HIV infection may need to be at least 80 percent effective, Fauci said. That might be achieved by adding more tenofovir or getting women to use it more consistently. In the study, women used the gel only 60 percent of the time; those who used it more often had higher rates of protection.

The gel also cut in half the chances of getting HSV-2, the virus that causes genital herpes. That’s important because other sexually spread diseases raise the risk of catching HIV.

Even partial protection is a huge victory that could be a boon not just in poor countries but for couples anywhere when one partner has HIV and the other does not, said Dr. Salim Abdool Karim, the South African researcher who led the study. In the U.S., nearly a third of new infections each year are among heterosexuals, he noted.

Countries may come to different decisions about whether a gel that offers this amount of protection should be licensed. In South Africa, where one in three girls is infected with HIV by age 20, this gel could prevent 1.3 million infections and 826,000 deaths over the next two decades, he calculated.

He will present results of the study Tuesday at the International AIDS Conference in Vienna. The research was published online Monday by the journal Science.

“We now have a product that potentially can alter the epidemic trends … and save millions of lives,” said Dr. Quarraisha Abdool Karim, the lead researcher’s wife and associate director of the South African program that led the testing.

It’s the second big advance in less than a year on the prevention front. Last fall, scientists reported that an experimental vaccine cut the risk of HIV infection by about 30 percent. Research is under way to try to improve it.

If further study shows the gel to be safe and effective, WHO will work to speed access to it, said its director-general, Dr. Margaret Chan.

The gel is in limited supply; it’s not a commercial product, and was made for this and another ongoing study from drug donated by California-based Gilead Sciences Inc., which sells tenofovir in pill form as Viread. If further study proves the gel effective, a full-scale production system would need to be geared up to make it.

The study tested the gel in 889 heterosexual women in and near Durban, South Africa. Researchers had no information on the women’s partners, but the women were heterosexual and, in general, not in a high-risk group, such as prostitutes.

Half of the women were given the microbicide and the others, a dummy gel. Women were told to use it 12 hours before sex and as soon as possible within 12 hours afterward.

At the study’s end, there were 38 HIV infections among the microbicide group versus 60 in the others.

The gel seemed safe — only mild diarrhea was slightly more common among those using it. Surveys showed that the vast majority of women found it easy to use and said their partners didn’t mind it. And 99 percent of the women said they would use the gel if they knew for sure that it prevented HIV.

This shows that new studies testing the gel’s effectiveness without a placebo group should immediately be launched, said Salim Abdool Karim. The only other study testing the gel now compares it to placebo and will take a couple more years to complete.

The study was sponsored by the Centre for the AIDS Programme of Research in South Africa, or CAPRISA; Family Health International; CONRAD, an AIDS research effort based at Eastern Virginia Medical School; and the U.S. Agency for International Development, or USAID.

Gilead has licensed the rights to produce the gel, royalty-free, to CONRAD and the International Partnership on Microbicides for the 95 poorest countries in the world, said Dr. Howard Jaffe, president of the Gilead Foundation, the company’s philanthropic arm.

The biggest cost of the gel is the plastic applicator — about 32 cents, which hopefully would be lower when mass-produced, researchers said.

Mitchell Warren, head of the AIDS Vaccine Advocacy Coalition, a nonprofit group that works on HIV prevention tools, said the study shows a preventive gel is possible.

“We can now say with great certainty that the concept has been proved. And that in itself is a day for celebration,” he said.

MIAMI – Elderly Russian immigrants lined up to take kickbacks from the backroom of a Brooklyn clinic. Claims flooded in from Miami for HIV treatments that never occurred. One professional patient was named in nearly 4,000 false Medicare claims.

Authorities said busts carried out this week in Miami, New York City, Detroit, Houston and Baton Rouge, La., were the largest Medicare fraud takedown in history — part of a massive overhaul in the way federal officials are preventing and prosecuting the crimes.

In all, 94 people — including several doctors and nurses — were charged Friday in scams totaling $251 million. Federal authorities, while touting the operation, cautioned the cases represent only a fraction of the estimated $60 billion to $90 billion in Medicare fraud absorbed by taxpayers each year.

For the first time federal officials have the power to overhaul the system under Obama’s Affordable Care Act, which gives them authority to stop paying a provider they suspect is fraudulent. Critics have complained the current process did nothing more than rubber-stamp payments to fraudulent providers.

“That world is coming to an end,” Health and Human Services Secretary Kathleen Sebelius told The Associated Press after speaking at a health care fraud prevention summit in Miami. “We’ve got new ways to go after folks that we’ve never had before.”

Officials said they chose Miami because it is ground zero for Medicare fraud, generating roughly $3 billion a year. Authorities indicted 33 suspects in the Miami area, accused of charging Medicare for about $140 million in various scams.

Suspects across the country were accused of billing Medicare for unnecessary equipment, physical therapy and other treatments that patients never received. In one $72 million scam at Bay Medical in Brooklyn, clinic owners submitted bogus physical therapy claims for elderly Russian immigrants.

Patients, including undercover agents, were paid $50 to $100 a visit in exchange for using their Medicare numbers and got bonuses for recruiting new patients. Wiretaps captured hundreds of kickback payments doled out in a backroom by a man who did nothing but pay patients all day, authorities said.

The so-called “kickback” room had a Soviet-era propaganda poster on the wall, showing a woman with a finger to her lips and two warnings in Russian: “Don’t Gossip” and “Be on the lookout: In these days, the walls talk.”

With the surveillance, the walls “had ears and they had eyes,” U.S. Attorney Loretta Lynch said at a news conference in Brooklyn.

In a separate Brooklyn case, authorities charged six patients who shopped their Medicare numbers to various clinics. More than 3,744 claims were submitted on behalf of one woman alone, 82-year-old Valentina Mushinskaya, over the past six years.

At a brief appearance in federal court Friday, Mushinskaya was released on $30,000 bond and ordered not to return to the Solstice Wellness Center, scene of an alleged $2.8 million scam.

Authorities called Mushinskaya one of the clinic’s “serial beneficiaries,” with phony bills totaling $141,161 paid by Medicare.

Her nephew, Vladimir Olshansky, told reporters his Ukrainian-born aunt suffers from diabetes. “She doesn’t know what this is about,” he said. “She’s in the dark.”

In Miami, Daniel R. Levinson, inspector general of HHS, which oversees Medicare, said the arrests “illustrate how health care fraud schemes can replicate virally and migrate rapidly across communities.”

Cleaning up Medicare fraud will be key to paying for President Barack Obama’s proposed health care overhaul. Federal officials have allocated more money and manpower to fight fraud, setting up strike forces in seven cities with a plan to expand to a dozen more. So far, the operations are responsible for more than 720 indictments that collectively billed the Medicare program more than $1.6 billion.

Around the country, the schemes have morphed from the typical medical equipment scam in which clinic owners billed Medicare dozens of times for the same wheelchair. Now, officials say, Medicare fraud involves a sophisticated network of doctors, clinic owners, patients and patient recruiters.

Violent criminals and mobsters are also tapping into the scams, seeing Medicare fraud as more lucrative than dealing drugs and having less severe criminal penalties, officials said.

For decades, Medicare operated under a system that paid providers first and investigated later. That pay and chase method was a boon for crooks, giving them 90 days lag time to milk the system and flee with millions before authorities were aware a crime had been committed.

Sebelius toured vacant storefronts in Miami on Friday where Medicare fraudsters set up shop, including bogus clinics operated by Cuban immigrants Carlos, Luis and Jose Benitez. The brothers are the agency’s most-wanted fugitives, charged with bilking $119 million for costly HIV drugs that patients never received — and buying hotels, helicopters, boats and even a water park with their spoils. They allegedly fled to Cuba, where authorities believe they remain.

A new joint effort by HHS and the Department of Justice enables law enforcement to view Medicare claims in real time and flag suspicious patterns. More stringent screening methods, including more comprehensive background checks, have also been put in place. The agency gets roughly 18,000 applications daily to become a Medicare provider. Now they can put a moratorium on new applications in certain areas, like physical therapy, if they notice a spike in fraudulent activities.

The changes are paying off.

Investigators visited 1,600 providers in Miami in the past few months, making sure legitimate businesses were operating at the addresses. In 2008, authorities required all medical equipment providers in Miami to apply for new certification, hoping the paper hurdle would deter scammers. The number of claims dropped by $1.6 billion.

North Korea has faced food shortages for years

North Korea is failing to provide the most basic healthcare needs for its people, Amnesty International warns.

An investigation by the human rights watchdog found barely functioning hospitals, poor hygiene and epidemics made worse by widespread malnutrition.

Many people were also too poor to pay for treatment, the report citing North Koreans and health workers said.

Pyongyang spends less than $1 (£0.65) per person on healthcare a year, World Health Organization figures show.

is based on interviews with more than 40 North Koreans, who left the country between 2004 and 2009.

Health professionals who work with North Koreans were also consulted.

Starvation

Pyongyang says it provides free healthcare for its people, but witnesses told Amnesty they had had to pay for all services for the past 20 years.

One 20-year-old woman from North Hamgyeong province said: “People don’t bother going to the hospital if they don’t have money because everyone knows that you have to pay.

“If you don’t have money you die,” said the woman, who left North Korea in 2008.

Another man said that hospitals had no medicine and that if someone needed treatment, they had to go to the market and buy the drugs needed for doctors to administer.

Poor hygiene at medical facilities and a dire lack of medicines were threatening the lives of many, Amnesty warned, with people routinely trading cigarettes, food and alcohol for treatment.

A 56-year-old woman told Amnesty that her appendix was removed without anaesthetic.

“The operation took about an hour and 10 minutes. I was screaming so much from the pain - I thought I was going to die.

“They had tied my hands and legs to prevent me from moving.”

North Korea faces critical food shortages following famine in the 1990s which killed up to one million people and relies on international aid.

A botched currency re-evaluation in 2009 almost doubled the price of rice overnight, and one non-governmental organisation cited in the report said thousands of people starved to death in January and February this year in one province alone.

Amnesty reports that North Korea is still battling a tuberculosis epidemic, which is being aggravated by widespread malnutrition.

“The North Korean people are in critical need of medical and food aid,” said Amnesty’s deputy director for Asia-Pacific, Catherine Baber.

“It is crucial that aid to North Korea is not used as a political football by donor countries.”

Politically the North finds itself isolated - it has withdrawn from international talks over its controversial nuclear programme.

UN sanctions were tightened last year after Pyongyang’s nuclear and missile tests.

North Korea has also suspended all ties with Seoul in the wake of the attack on a South Korean warship in March that left 46 sailors dead.

International investigators say a North Korean torpedo sank the ship, but Pyongyang has rejected this.

CHICAGO – Your doctor could be drunk, addicted to drugs or outright incompetent, but other physicians may not blow the whistle.

A new survey finds that many American physicians fail to report troubled colleagues to authorities, believing that someone else will take care of it, that nothing will happen if they act or that they could be targeted for retribution.

A surprising 17 percent of the doctors surveyed had direct, personal knowledge of an impaired or incompetent physician in their workplaces, said the study’s lead author, Catherine DesRoches of Harvard Medical School.

One-third of those doctors had not reported the matter to authorities such as hospital officials or state medical boards. The findings, appearing in Wednesday’s Journal of the American Medical Association, are based on a 2009 survey of 1,891 practicing U.S. doctors.

Reporting a problem doctor can trigger important changes. Twenty-one years ago, a colleague smelled alcohol on a young physician’s breath and anonymously reported him to the head of the residency program. A now-sober Dr. A. Clark Gaither is grateful.

“I wish I knew who reported me,” Gaither said. “I’d like to give them a big ol’ hug and thank them for saving my life.”

Programs exist for retraining doctors with weak skills and getting addicted ones into treatment. But the survey results suggest doctors are not confident in the system, DesRoches said.

The American Medical Association and other professional groups say doctors have an ethical obligation to make such reports. And many states require doctors to tell authorities about colleagues who endanger patients because of alcoholism, drug abuse or mental illness.

Despite that, many doctors do not know what to do or where to start, DesRoches said.

In an accompanying editorial, one ethics expert called the findings “jarring.”

“I don’t think there’s any excuse for less than 100 percent of physicians holding true to these ideals,” said Dr. Matthew Wynia, director of the AMA Institute for Ethics.

He called for better protections for whistleblowers and more education for doctors on how to report a colleague.

The survey did not specify the type or severity of the impairment or incompetence, asking: “In the last three years, have you had direct, personal knowledge of a physician who was impaired or incompetent to practice medicine in your hospital, group, or practice?”

Most states have programs that not only get doctors into treatment but also advise their colleagues how to intervene. Most will keep reports anonymous. Some use the threat of medical board sanction to persuade doctors to go to rehab.

For Gaither, the first confrontation with concerned colleagues was in medical school. He reassured his fellow students he was fine. Even the second confrontation, from the program head who had heard the report of Gaither’s alcohol-scented breath, did not take. Gaither signed a contract promising to stay sober, go to Alcoholics Anonymous meetings and submit to testing.

“I went home and drank that night,” he said. “I was thinking with an addicted brain, and I was an alcoholic.”

Finally, a third confrontation and the temporary loss of his training license forced Gaither into what he calls “a state of surrender.” With help from the North Carolina Physicians Health Program, he got into a residential rehab program.

His last drink was Jan. 21, 1990. Gaither, now 55, finished his residency and became a family doctor. He practices in Goldsboro, N.C., where he started a free mobile clinic for the uninsured.

In 2002, the North Carolina Academy of Family Physicians named him Physician of the Year. He thanked AA and all the colleagues who confronted him and supported him in his acceptance speech.

He now urges others to report what they know. “It is our duty,” he said.

Dr. Warren Pendergast runs the North Carolina program, which cooperates with the state medical society and state disciplinary board. About 200 doctors a year are referred for alcoholism, drug addiction, anger-management problems and depression.

Ninety percent of addicted doctors who’ve been through the program remain clean and sober five years after treatment, Pendergast said.

“They’re motivated. They have a lot to lose,” he said. Their reputations and careers depend on their participation in treatment. Colleagues of troubled doctors “can feel comfortable getting peers help rather than sticking their head in the sand,” he said.

Gaither, who speaks publicly about the program, said doctors worry that their troubled colleagues will lose their licenses and livelihoods if reported.

“I ask them, ‘Would it be better if they lost their money, their marriage, their home, their cars, their license and then their life?’” he said. “Does that sound better than getting them the help that they need?”

When she was about three years old, I noticed my kid doing something I’d never seen her do before.  When she coughed or sneezed, she would raise her arm and cover her mouth with the inside of her elbow.    While I immediately understood what she was doing and assumed she’d been taught that at preschool, this method of germ containment was new to me.

Like just about every adult I know, I was taught to cover my mouth with my hand when I coughed or sneezed.  While this is a good way to prevent germs from flying out into the air, it’s also a great way to get them on your hands.  And once on your hands, germs can spread like wildfire and end up on anything and everything you touch.

After the 2009 flu pandemic led public health officials around the world to actively encourage people to cover their coughs and sneezes with their elbows or a tissue, you would think that even adults like me would have gotten the message.  But, based on the results of a study by researchers at Otago University Wellington in New Zealand, that is clearly not the case.

After conducting observational studies of people at a train station, a shopping mall and a hospital in New Zealand, researchers have determined that few people are following these updated germ containment recommendations.  Of the 5.5 coughs and sneezes per observed-person-hour, only 4.7% were covered by a tissue, handkerchief or elbow.  And while 26.7% went totally uncovered in any way, a whopping 64.4% were covered by a person’s hands. Ick.

Thanks to my kid, I always cover a cough or a sneeze with my elbow, not my hand.  But if not for her constant reminders to do so, I am not sure that would be the case.  Clearly I am not the only one who finds old habits hard to break.   What about you?  Have you been schooled by your kid on the proper way to cover your mouth?