Writing in the Disciplines

Category: Blog (Page 2 of 2)

The Real Cost of Sleep Loss

You know the feeling when you are lying cozy in your bed watching your latest Netflix binge. You know you are exhausted, but when it automatically plays the next episode, you feel powerless to stop it. You are drawn in by the captivating start of the next episode, you ignore your body’s call for sleep, and decide that yawning your way through tomorrow’s day will not be that bad. Before you know it, the sun is rising. It can be easy to allow sleep to fall low on your priority list but the consequences of sleep deprivation stretch far beyond feeling a little sleepy the next day. Sleep deprivation has extensive effects from memory to brain cell growth and may even lead you to admit to something you didn’t do.

 

False Confessions

It is bad enough to be blamed for something you did not do, but even worse when you are the one blaming yourself. One of the most shocking effects of sleep deprivation is that when you are extremely tired, you are more likely to admit guilt for something that you did not do. A recent study conducted by Michigan State University asked participants if they were guilty of an action that they had in fact not done and found that those who had been up for 24 hours were 4.5 times more likely to admit to the action than participants with 8 hours of sleep. This startling statistic raises questions about our society’s current judicial procedures, which often include the interrogation of sleep deprived suspects, especially when considering those false confessions make up between 15 and 20 percent of all wrongful convictions (Frenda et al. 2015).

Although the judicial issue seems complex, the solution is quite simple. The team of Michigan State researchers who conducted the experiment recommend that all interrogations be videotaped so that the mental state of the suspect can evaluated thoroughly. Additionally, they recommend that suspects should be issued a test measuring how tired they are, such as the Stanford Sleepiness Scale; before being interrogated (Frenda et al. 2015). If you’re concerned about making false confessions in your life, the easiest answer is just to get more sleep.

Scientists have not yet uncovered the definitive link between sleep deprivation and false confession. However, they have hypothesized it may have something to do with sleep deprivation’s impairment of memory.

 

Worsened Memory

For years scientists have known that sleep deprived people have a worse memory, however, it was not until recently that they uncovered the biological basis for this phenomenon. Sleep deprivation causes a loss of connectivity between neurons, which transmit signals to the brain, and a region of the brain known as the Hippocampus, which is responsible for learning and memory. This loss of connectivity is caused by increased activity of the protein collin which causes a decrease in the length and density of neurons called dendrites. These neurons are the parts of neurons that receive the signals from other neurons so when they are shrunk messages are less effectively communicated to the Hippocampus, therefore impeding the formation of memories (Havekes et al. 2016).

There are two main types of memory, declarative and nondeclarative. Nondeclarative memory has to do with skills and abilities, such as riding a bike, whereas declarative memory encompasses anything factual and is divided into two subsections episodic, which includes facts about your personal life and semantic, which includes facts about the world in general. Declarative memory, both episodic and semantic, is more affected by sleep deprivation (Alhola & Polo-Kantola 2007). Therefore, if you are not well rested, it will be more challenging to remember specific facts for a test or even to remember what you ate for breakfast that morning.

If the fear of forgetfulness is not enough to get you to bed at a reasonable hour, you may want to consider the loss of brain growth that occurs as a result of sleep loss.

 

Decline of Neurogenesis

Neurogenesis, which is the proliferation, or growth of cells in the brain, is facilitated through sleep. When you are sleep deprived, your brain experiences elevated levels of glucocorticoids, stress-causing hormones, which along with causing stress-related side effects such as headaches, impede the growth of brain cells (Mirescu et al. 2006).

Psychologists Christian Mirescu, Jennifer D. Peters, Liron Noiman, and Elizabeth Gould conducted a study to examine the effects of sleep deprivation on neurogenesis. Their findings regarding sleep deprivation can be illustrated by imagining a closed empty cardboard box. You can place a few items on top of the box and it will support them easily; However, as you load more and more things on top of the box, it will begin to approach its maximum capacity, sinking lower in the middle and losing its ability to support the weight. Similarly, after only 24 hours of sleep deprivation, there has not been evidence suggesting a decline in neurological cell proliferation. However, when examining the effects of 72 hours of sleep deprivation, researchers found that not only was brain cell proliferation substantially lower but stress hormone levels had increased (Mirescu et al. 2006). The compounded effect of several nights of sleep deprivation is decreased rate of neurogenesis, meaning you’ll have less brain cell growth.

 

Changing your Mindset

Feeling sleepy the next day may not be enough to motivate you to catch some extra shuteye. However, hopefully the effects of sleep deprivation on your innocence, memory,  and potential brain cells have been very convincing. So the next time you are considering watching that extra episode of your latest Netflix binge, you may want to consider all that is at stake. Is it really worth one more?

 

Works Cited.

Alhola P, & Polo-Kantola, P. (2007, October 3). Sleep deprivation: Impact on cognitive performance. Neuropsychiatric Disease and Treatment, 3(5), 553–567. Retrieved 2016, Sept 1 from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2656292/

Frenda R, Berkowitz SR, Loftus EF, & Fenn KM. (2015, December 2). Sleep deprivation and false confessions. Proceedings of the Natural Academy of Sciences, Retrieved 2016, Sept 16, from: http://www.pnas.org/content/113/8/2047

Havekes R, Park AJ, Tudor JC, Luczak VC, Hansen RT, Ferri SL, Bruinenberg VM, Poplawski SG, Day JP, Aton SJ, Radwańska K, Meerlo P, Houslay MD, Baillie GS, & Abel T. (2016, Aug 26). Sleep deprivation causes memory deficits by negatively impacting neuronal connectivity in hippocampal area CA1. eLife, DOI:10.7554/eLife.13424 Retrived 2016, Sept 11 from: https://elifesciences.org/content/5/e13424/article-info

Mirescu C, Peters JD, Noiman L, & Gould E. (2006, June 6). Sleep deprivation inhibits adult neurogenesis in the hippocampus by elevating glucocorticoids. Proceedings of the Natural Academy of Sciences vol. 103 no. 50. Retrieved 2016, Sept 11 from: http://www.pnas.org/content/103/50/19170.full

 

The Future of Physical Rehabilitation

Robots in Physical Therapy

The United States, as well as many other countries, have a rising population of older people. Unfortunately, they can have many complications with their health including strokes; which can be a common occurrence. Strokes are the leading cause of disability in the United States, totaling nearly 750,000 cases annually (Kwakkel et al.). In fact, a person dies every four minutes because of complications related to a stroke (CDC). For survivors the physical and mental effects can often become permanent disabilities. Only about 5%- 20% of patients recover completely, meaning a large majority of this population is left with permanent disability(Kwakkel et al.). Survivors typically have a multitude of issues regarding motor skills that result in the inability to continue to live self-sufficiently. It seems wrong that with such a large number of people affected by strokes there is so little we can do about it. Luckily, the implementation of robotics in the treatment process may be the key to solving this issue.

CASE STUDY ONE:
With the help of Stanford University, researchers from the Palo Alto VA set out to develop, “a single general-purpose system that could assist a disabled individual to achieve independence in activities of daily living”(Burgar et al.). This is a difficult task to carry out because little is known about stroke recovery, and there are no methods of treatment that can be conducted with much confidence. The researchers achieved their goal by conducting a multitude of trials and experiments. This daunting process lead to the creation of five different generations of robots (Burgar et al.). Despite subtle differences and variables, most experiments were conducted in the same way. Generally, the experiments would consist of a patients being seated at an adjustable table. The patient’s arm is strapped to the machine where the movements of the robotic arm and the patient’s arm are recorded and measured. Patients respond to the stimulation by, “either remaining passive, or actively attempting to contribute to the movement”(Burgar et al.). Essentially, minute sensors are able to analyze progress or lack there of.

CASE STUDY TWO:
The second case study is a collection of clinical trials exhibited by a number of qualified scientists with the help of a number of universities and organizations such as the Faculty of Human Movement Science, University of Amsterdam, Yale University, and the VA of West Haven. Hundreds of trials were conducted on a broad range of stroke patients in order to determine whether or not robotic physical therapy is an effective form of treatment. These trials consisted of similar conditions to the aforementioned case study. This means that the testing process was quite similar and the variables used were, once again, patient variety and equipment. The data is difficult to quantify and compare simply because these case studies were carried out independently. The MIT-MANUS, the ARM-GUIDE, the MIME, and the Bi-Manu-Track were all robots created and tested with different modes of measurement (Kwakkel et al.). Some parties opted to focus on very specific improvements as acute as muscle tendons. Others looked at improvements as a whole to large sections of the afflicted patient’s bodies .

RESULTS:
Measurements come from the therapists and computers operating the robot. The results of these trials have some range, Depending of how the scientists decide to analyze a successful therapy period.

Specific Improvements:
Data from the 20+ groups studied shows that, “robot-assisted therapy may have advantages over conventional… therapy techniques”(Burgar et al.). The study of Volpe et al. showed improvements on motor recovery of the upper paretic limb, which is very specific. In almost every case progress, although be it incremental, was made . Meticulous and Habitual robotic rehabilitation resulted in changes in patient’s motor abilities. Although not all patients achieve full recovery, a statistically significant amount of positive change was found.

Broad Improvements:
Despite improvement, there still obviously is no 100% way to regain full functionality after a stroke. The study of Fasoli et al. reported on outcome of functional ability, which is regarding overall improvements holistically. The results of this study we far less convincing as the percentage of patients improved little from the aforementioned 5%-20% recovery window (Kwakkel et al.).

CONCLUSION:
Improvements to a large percentage of the patient’s health are often minimal. However, research strives to continue to find a way to help more stroke patients retain their former mobility. Robots in physical therapy are needed. If there is a device that will help stroke patients, no matter how small the percentage, it should be utilized and developed further in order to benefit as many people as possible. This is incredibly important because as the elderly population of the USA grows, the demand for stroke therapy will only continues to grow. These robots are not designed as replacements for therapists, but rather a mean to improve motor performance and allow for stroke patients to regain mobility and more importantly, their lives.

 

 

 

Annotated Bibliography

Burgar, Charles G., Peter Lum S., Peggy Shor C., and Machiel Van Der Loos. “Development of Robots for Rehabilitation Therapy: The Palo Alto VA/Stanford Experience.” VA Research Development, Nov.-Dec. 2000. Web. 09 Sept. 2016.

-With the help of Stanford University, a team of medical professionals and scientists set out to determine whether or not robots could have an impact on patients in need of rehabilitation. Typically stroke patients tend to have issues with their motor control. Additionally, in many stroke patients there is a window of time where treatment can be done before physical therapy’s effects are less helpful. Findings have shown that, “ robot-aided therapy has therapeutic benefits,”(Burgar et al.). These benefits can be very minuscule for some patients while others experience,” increased strength, as well as more appropriate activation of muscle groups,”(Burgar et al.).

Kwakkel, Gert, Boudewijn J. Kollen, and Hermano I. Krebs. “Effects of robot-assisted therapy on upper limb recovery after stroke: a systematic review.” Neuro-rehabilitation and neural repair (2007). Web. 08 Sept. 2016.

-The authors of this systematic review intended to utilize research to identify if robotics played a part in physical therapy. Many studies involving hundreds of patients were conducted and analyzed by the PHD professors from a multitude of Universities around the world including MIT. Robotics play a role in many different aspects of physical therapy. Research has ranged from sports injuries to stroke recovery. In many cases it has been successful. In fact tests have shown, “a significant improvement in upper limb motor function after stroke for upper arm robotics”(Kwakkel et al.).

Volpe, B. T., H. Krebs I., N. Hogan, L. Edelsteinn, C. Diels M., and M. Aisen L. “Robot Training Enhanced Motor Outcome in Patients with Stroke Maintained over 3 Years.” Neurology.org. N.p., n.d. Web. 08 Sept. 2016.

-Robotics don’t only provide relief on a short term basis. The studies done by these medical trained professionals at the University of Cornell has shown evidence of a “significant decreases in impairment [in] the affected limb,” (Volpe et al.). Their consensus is that the addition of a robot was the turning point in ensuring progress and healing (Volpe et al.).

“Stroke Facts.” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 24 Mar. 2015. Web. 11 Sept. 2016.

-The CDC provided a multitude of simple and effective facts that I intend to use throughout my argument to quantify it.

Patient Using the IPAM System to Undertake Upper Limb Therapeutic Exercise. N.d. National Instruments. Web. 2 Oct. 2016.

-This is a cited image depicting a similar robot to the robots that are referred to throughout my work.

Tackling the “Tortured Artist”: The Link Between Psychosis and Creativity

by Jordan Smith

Limber bristles push thick strokes of indigo into a swirling sky as Vincent Van Gogh breathes kinetic energy into The Starry Night (1889). The rolling sky juxtaposing modest houses, a cypress tree and a steeple is renowned worldwide for conveying unparalleled turbulent emotion. Interestingly enough, the piece is a depiction of Van Gogh’s view from his asylum room window at Saint-Rémy-de-Provence. Just a year before, suffering from psychotic episodes and depression, Van Gogh had taken off his ear with a razor. Just a year later, Van Gogh would take his own life with a revolver. Regardless, Van Gogh is still revered today as one of the greatest artists to ever influence Western art.

The coining of the term and durability image of the “tortured artist” has endured; it is not difficult to think of creative geniuses who were mentally unstable. Famed poet and writer Sylvia Plath took her own life after struggling with depression, author and winner of the 1954 Novel Prize in Literature, Ernest Hemingway did the same. Is there a link between psychopathology and creative genius? Curious, scientists are determined to find out.

Neural Patterns
Research has proven a similarity in the mental processes of creative persons and persons measuring high in schizotypy. Schizotypy describes a spectrum of traits associated with symptoms of schizophrenia that to a degree, all individuals possess. Creative individuals and individuals with high schizotypy both share a unique filtration of information, causing them to keep less relevant information in conscious awareness. The inability to “filter out” is conceived as “cognitive disinhibition” by Harvard psychologist Shelley Carson, explaining how both groups exercise flexible thought, connecting ideas in unordinary ways. Illustrative of this activity is a pattern found in brain scans between schizophrenic and creative subjects, concluding failure to suppress the brain area called the precuneus (Hikaru Takeuchi, 2011). The precuneus is located in the parietal lobe, necessary for collection of information, self- consciousness, retrieval of memories, and mental representations. Thus both groups experience a higher neurological exposure to information. Similarly, both groups have been observed to employ reduced latent inhibition (Shelley Carson, 2011). Latent inhibition describes how one filters their experiences, giving certain meanings between new and familiar stimuli. Reduced latent inhibition thus is demonstrated by a tendency to treat familiar stimuli as novel despite previous experience with it. In other words, it makes sense that acclaimed artists readily reinvent objects or connect abstract things, as the ability to uniquely relate ideas is more accessible to them.

Interestingly enough, the processes behind latent inhibition are tied to dopamine regulation in the brain, the systems of which, in both schizophrenic and creative individuals, is also incredibly alike. Dopamine is a neurotransmitter released by the brain, playing a role in an
individual’s reward system and emotional response. The density of dopamine D2 receptors was found to be low in the thalamus of creative individuals, similar to that of schizophrenics, suggesting a link (Fredrik Ullén, 2010). Since the thalamus filters signals before they reach brain regions for reasoning, the low density of receptors is more evidence of the unique information flow. Asked to speak in regard to his discovery, Dr. Fredrik Ullén concludes, “Thinking outside the box might be facilitated by having a somewhat less intact box.”
Those with psychosis or creative genius demonstrate connectivity across unrelated parts of the brain. Neural hyperconnectivity describes an unusual connectivity in the brain caused by irregular synaptic pruning during development. Neural hyperconnectivity has been recognized frequently in schizophrenic individuals and their first-degree relatives (Whitfield-Gabrieli, 2009). At the same time, brain-imaging depicted similar unusually high levels of neural network across and within brain hemispheres of creative persons. Increased connectivity appears to mediate remote, unique associations.

Risk and Genetic Building Blocks
Beyond similarities in brain activity, a link between creative genius and mental illness is further advanced by genetic and risk patterns. Work in the past sets precedence for modern study, observing inheritance patterns and the susceptibility of creative persons to mental illness. In one of the earliest influential experiments regarding the subject, a sample of creative writers from the University of Iowa was selected and researched from a writing program, along with each subjects’ first-degree relatives and a control group. The study shows that 80% of the writers experienced a mood disorder and both creative interest and psychosis consistently endured in certain families (Nancy C. Andreasen, 1987). More recently, in the largest study ever conducted of the possible link, 300,000 individuals were selected using Swedish registries and were assessed for relation to psychopathology and their type of occupation. The only positive association between psychopathology and creative occupation was for bipolar disorder; however, first-degree relatives of diagnosed bipolar, schizophrenic, and anorexic patients, showed great representation in creative profession (Simon Kyaga, 2011). All in all, research offers evidence that creative individuals have a higher risk for psychosis, specifically bipolar disorder, creativity and mental illness proneness run in families, and relatives to psychotic individuals show high representation in creativity (Shelley Carson, 2011).

In terms of the genetics existing as our human building blocks, molecular studies have determined sets of variants of alleles that are associated with psychosis and creative cognition (Shelley Carson, 2011). Results emphasize variants of genes, most of which code for dopamine and serotonin function. Serotonin is linked to mood, state of consciousness, and certain levels are implicated in psychosis. Absorption of serotonin even more, is associated with creativity. Scientists stress that how these gene variants offer shared genetic vulnerability depends on whether or not there are complex interactions with each other, with other genes, and the individual’s experience in their environment.

The Fine Line
A model of shared vulnerability has been proposed as a result of neurological research. The model illustrates determinant factors relating creativity and psychopathology.

Hyperconnectivity, reduced latent inhibition, and novelty- seeking attitudes are all similar traits. These factors are shared, putting one at risk for psychopathy while also offering opportunity for creative exercise. The three other determining factors have to do with one’s ability to process information rather than become overwhelmed and confused. One with higher IQ can better perceive their novel ideas, recognizing what is extrinsically versus intrinsically experienced; one with flexible cognition can healthily interpret and move between altered states of consciousness, or different perspectives; finally, one with strong working memory can interpret multiple stimuli at the same time.

All in all, these experiments demonstrate that psychosis and creativity are linked genetically, evident by similar mental processes. Traits apparent in both identities place people almost on spectrums for shared vulnerability. Perhaps psychosis has persisted because creativity has been chosen for. This article now begs the question: how do both exist and interact in one individual? Of course, we would all welcome more Van Goghs.

Citations:

Simon Kyaga, Paul Lichtenstein, Marcus Boman, Christina Hultman, Niklas Långström, Mikael Landén. “Creativity and mental disorder: family study of 300,000 people with severe mental disorder.” The British Journal of Psychiatry, vol. 199, no. 5, 2011, pp. 373-379.

Ullén, Fredrik; Cervenka, Simon; Karabanov, Anke; Farde, Lars. “Thinking Outside a Less Intact Box: Thalamic Dopamine D2 Receptor Densities Are Negatively Related to Psychometric Creativity in Healthy Individuals.” PLOS, 2010.

Brisch, Ralf. “The Role of Dopamine in Schizophrenia from a Neurobiological and Evolutionary Perspective: Old Fashioned, but Still in Vogue.” Frontiers in Psychiatry, vol. 5, no. 47, PMC, 2016.

Kaufman, Scott Barry. “The Real Link Between Creativity and Mental Illness.” Scientific American, 2013.
Takeuchi, Hikaru. “Failing to deactivate: the association between brain activity during a working memory task and creativity.” NueroImage, 2011.

Andreason, Nancy. “The relationship between creativity and mood disorders.” Dialogues in Clinical Neuroscience, 2008.

Carson, Shelley. “Creativity and Psychopathology: A Shared Vulnerability Model”. The Canadian Journal of Psychiatry, 2011.

Whitfield-Gabrieli, S. “Hyperacrivity and hyperconnectivity of the default network in schizophrenia and in first degree relatives of persons with schizophrenia.” Proc Natl Acad Sci, 2009.

What’s the Big Deal About Zika?

“Are American parents likely to have children with severely shrunken heads?”

Every year our world is plagued with some health crisis or another. Some years there’s a newly discovered super-bug, others it’s just a particularly bad flu season. Regardless of actual risk, our news media sensationalizes the outbreak and, in so doing, terrorizes the unwitting public. This past year was no exception. Ever since first reports of the Zika virus in the United States surfaced, there’s been a media circus around the epidemic. But is this new threat as dangerous as the public is being led to believe? Are American parents likely to have children with severely shrunken heads like we’ve seen in Brazil? Before we delve too deeply, here’s a brief overview of the outbreak, in case you missed all the media buzz. If you’re already caught up on the background, go ahead and skip down to paragraph four.

 

What is it?

Far from being a brand new virus, Zika was first discovered in 1947 in Ugandan monkeys and was only found to have jumped to humans five years later. The virus is most often transmitted by mosquito, making it a blood borne illness (so also, technically, a sexually transmitted disease), and the first outbreak occurred in 2007 on the Island of Yap. Over the next ten years, other outbreaks throughout the south Pacific and Brazil prompted the World Health Organization (WHO) to declare Zika a Public Health Emergency of International Concern in 2016.

 

Click here to read a more full history of Zika  on the WHO website, as well as some helpful info-graphics! 

 

But the virus itself usually only causes mild flu symptoms as well as a rash, and not all infected patients are even symptomatic. So why was it a Public Health Emergency? Microcephaly: micro, meaning extremely small, and cephalic, meaning of or relating to the head. After the Brazil outbreak, there followed a media frenzy of images of infants with severely shrunken heads born to mothers who had been infected with Zika while pregnant.

 

How bad is it? (aka, paragraph four)

Despite the impression of impending epidemiological doom caused by this media onslaught, data on the outbreak is relatively scarce. There are several reasons for this, the foremost of which being that microcephaly has been observed to occur in a very small number of cases; less than one percent during the French Polynesia outbreak of 2013 (Johansson, 2016), and anywhere from 0.40% and 2.10% during the more recent Brazilian outbreak (Alfaro-Murillo, 2016). Clinicians also estimate that most cases of Zika infection go unreported (Johansson, 2016). Both of these points make it pretty difficult to accurately predict actual risk. Microcephaly itself is even more difficult to diagnose, as most physicians, lacking the MRI equipment necessary to confirm such a diagnosis, tend to report microcephaly pre-maturely and excessively (Teixeira, 2016).

In addition to the myriad graphic images of infants with severe microcephaly just a Google search away, this limited data gives the media plenty of fear factor to run with. Whenever something harmful, and which we have little knowledge of, is discovered, the realities of said danger are easily exaggerated by the public. Additionally, the situation is only exacerbated by its exploitation in the news.

 

“A dryly written article…will not sell enough papers to put food on the writer’s table.”

 

Why all the hype?

Perhaps this is just the nature of mass media; the more ambiguous the topic, the more creative a journalist can be about its coverage. Which of these articles are you most likely to read; one titled Microcephaly in Newborns with Zika or Can Zika Cause Mutant Babies? Obviously, this second option has more clout. Such hyperbole is a necessary evil in an industry which thrives on viewership. A well-meaning but dryly written article on an uninteresting subject will not sell enough papers (or, if you live in the twenty first century, generate enough internet traffic to entice third parties to pay for ads on the author’s site) to put food on the writer’s table. As a result, there becomes a need on the part of the author to bypass the more grounded evidence and just go straight for the click bait title.

Even so, part of what makes irrational fear such a powerful evolutionary advantage is the simple fact that most of the time it works. One would be prudent to approach conception of a child in a Zika infected area of the world with exaggerated caution. Regardless of what the statistics might suggest at first glance, there is a definite risk to the unborn child of a mother infected with Zika, particularly if the mother exhibited symptoms during her first trimester (Turchi Martelli, 2015).

 

“Women…would be well advised to take preventative measures during the first trimester.”

 

What should I do?

I have asked you to be skeptical of what you read in articles here on the internet (articles like this one), so I can’t blame you for having doubts about the efficacy of any preventative tactics I might suggest here. Don’t worry; there’s a study for that! A 2016 study of the cost effectiveness of treating and containing Zika found that campaigns funded in Costa Rica and Brazil were quite effective (Alfaro-Murillo, 2016). Additionally, the release of genetically modified mosquitoes into the environment has been shown to be generally effective depending upon implementation standards (Alfaro-Murillo, 2016). The World Health Organization also recommends mosquito nets and any other traditional forms of prevention against mosquito borne illnesses.

Women planning to have children would be well advised to take preventative measures in avoiding and killing mosquitoes to minimize the chance of infection during the first trimester. Or, more cautiously still, one could simply wait for a vaccine to be developed against the disease before conceiving.

 

In conclusion, I think that Frederick Douglass is a true American hero.

***(sorry about that last bit, I lost a bet with my editor) ***

 

 

References:

 

Alfaro-Murillo, J. A., Parpia, A. S., Fitzpatrick, M. C., Tamagnan, J. A., Medlock, J., Ndeffo-Mbah, M. L., & … Galvani, A. P. (2016). A Cost-Effectiveness Tool for Informing Policies on Zika Virus Control.Plos Neglected Tropical Diseases10(5), 1-14. doi:10.1371/journal.pntd.0004743

 

Johansson, M.A., Mier-y-Teran-Romero, L., Reefhuis, J., Gilboa, S. M., & Hills, S. L. (2016). Zika and the Risk of Microcephaly. New England Journal of Medicine [Web Edition], doi: 10.1056/NEJMp1605367

 

Teixeira, M. G., Costa, M. N., de Oliveira, W. K., Nunes, M. L., & Rodrigues, L. C. (2016). The Epidemic of Zika Virus–Related Microcephaly in Brazil: Detection, Control, Etiology, and Future Scenarios.American Journal Of Public Health106(4), 601-605. doi:10.2105/AJPH.2016.303113

 

Turchi Martelli, C. M., Albuquerque, M. M., Araújo, T. B., Barkokebas, A., Bezerra, L. A., Braga, C., & … Miranda-Filho, D. B. (2016). Microcephaly in Infants, Pernambuco State, Brazil, 2015. Emerging Infectious Diseases22(6), 1090-1093. doi:10.3201/eid2206.160062

Sleep Deprivation; Threatening the Advancement of Modern Medicine – Josh Merrill

Sleep Deprivation; Threatening the Advancement of Modern Medicine

Grey’s Anatomy, Private Practice, and Scrubs and other wildly popular medical television shows have held a vast number of faithful viewers on the edge of their seats.  Writers of these hit television shows exploit sleep deprivation in medical residents and its effects on patient care to boost ratings. But sleep deprivation and its effects are not just a strategic move in the television industry; sleep deprivation in medical residents is proven to have negative effects, such as slowed motor skills and lack of concentration. Without being in the industry, one would assume sleep deprivation is not a pressing issue in the medical field, but that could not be farther from the truth.  The magnitude of sleep deprivation’s consequences will leave a lasting impact on the medical field if action is not taken.

 

Impact on the Human Body

Sleep Deprivation can simply be classified as going without an adequate amount of sleep each night for a long period of time.  Given that sleep is necessary in order for the body to function properly, lack of sleep can lead to major consequences.  Studies have proven that sleep deprivation can significantly hinder a person’s memory and learning abilities (Havekes, 2016).  Essentially, sleep connects neurons with the part of the brain that controls memory and learning; without that connectivity the brain will not function normally (Havekes, 2016).  Against popular belief, sleep deprivation shows no favoritism.  Just because someone is considered a “night owl” or other synonymous nicknames, it does not mean they are immune to sleep deprivation and its lasting effects.

 

Effect on the Medical Field

As you begin to connect the dots, you realize the impact that sleep deprivation is having on the medical field.  The majority of individuals that perform surgeries, prescribe medication, and diagnose diseases are the same people that are suffering from learning deficiencies and memory loss.  Medical faculty must realize they’re self-imposing neglect into their own line of work, right?  And when they first recognize the effects of sleep deprivation they must have the wherewithal to stop this dangerous trend, correct?  You would be shocked to know that this is not true for a majority of medical residents.  In a study conducted by a team of researchers at the University of Toronto, a survey was given to both surgical and nonsurgical medical residents at the university’s six hospitals to assess the current state of their sleep habits.  The vast majority of those who responded to the survey identified as sleep deprived, while the majority of the sleep deprived medical residents claim to knowingly be sleep deprived and accept it as part of the job (Woodrow, 2008).  Essentially, this is allowing new residents of the medical field to create an environment in which sleep deprivation is something you tolerate, not prevent.  If sleep deprivation becomes commonplace in medical residents, the future of our medical field is extremely bleak.

 

Do not think for one second that surgeons are too knowledgeable or have enough experience that they do not suffer from sleep deprivation either.  In an article by Drs. Noni MacDonald, Paul Hébert, Ken Flegel and Matthew Stanbrook, sleep deprivation is acknowledged in all facets of the medical field and a desire to make a change is evident.  MacDonald, Hébert, Flegel, and Stanbrook are not only doctors, but are also editors of the Canadian Medical Association Journal.  These four have a vast understanding of both the medical and journalism fields and are using one field to try to save the other.  They suggest that doctors should take the initiative to police their own hours much more responsibly, and if this is not done then government intervention may be the next step (MacDonald, 2011).  Realizing there is a problem in the medical field and actively trying to do something about it, like these four doctors have done, is very commendable; we can salvage our medical system, but we must begin to reverse this trend and do so in a timely manner.

 

Sleep Deprivation in Medicine as a Social Issue

It feels ridiculous that a major issue in our country is that medical employees will not get a responsible amount of sleep that would allow them to do their jobs successfully.  I can understand and even appreciate one’s desire to do their job and make a difference, but if you act in the medical field while sleep deprived, you are making a difference in a negative way.  Doctors, nurses, medical residents and many more occupations are more likely to make a mistake or act negligibly when sleep deprived, and there is really no way around it.  It is true that many people love their job so much that they deprive themselves of sleep because of it, but it is also true that those people are responsible for another person’s life and wellbeing on a daily basis.  Sure, it could be considered a double standard that being a sleep deprived doctor is worse than another occupation that is sleep deprived, but is it not rightfully so?  It is my belief that the root of most doctors’ desire to work in the medical field is to help others. Working sleep deprived only hurts themselves and the patients, which is contrary to their reason for entering the field in the first place.

 

Plan of Action

It is a popular belief in the medical field that sleep deprivation will continue and will require drastic measures to see a significant change.  I am hopeful that the attention and coverage that this issue receives will result in hospitals delegating their employees’ hours more strictly.  After all, it is the hospital’s responsibility to ensure proper patient care from all employees in regards to legality.  If all else fails, legislation could be pushed and passed, more strictly enforcing weekly work hours, but I do not see that as being a positive change.  Government oversight and impact already handcuffs a large portion of the medical field and even more government limitations could be seen as government’s attempt to prevent medical breakthroughs.  Medicine, deservingly so, holds a top priority of importance in our society and is one of the most remarkable innovations in human history.  By eliminating sleep deprivation, surgeons, doctors, nurses, and all other integral occupations of the medical field can get back to advancing medicine and begin to lessen the public’s doubts regarding patient care.

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