Republican Senator Chambliss has taken some flak for saying he opposes gay marriage because he's 'not gay.' But it's another sign that GOP opposition is moving from doctrinaire to personal.
By Liz Marlantes / March 21, 2013
Senate Intelligence Committee Chair Sen. Dianne Feinstein (D) of California (l.) and the committee Vice-Chairman Sen. Saxby Chambliss (R) of Georgia listens to testimony on Capitol Hill in Washington, last week. Sen. Chambliss is getting some flak online for remarks he made to Politico about gay marriage.
Susan Walsh/AP
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Georgia Sen. Saxby Chambliss is getting some blowback online for remarks he made to Politico about gay marriage. Asked if he might ever reconsider his opposition to marriage equality, Senator Chambliss is quoted as saying: "I'm not gay, so I'm not going to marry one."?
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Predictably, this has sparked a slew of mocking headlines and comments.
The Atlanta Journal Constitution, Chambliss's hometown paper, went with "Gay Marriage? Saxby Chambliss says he's taken." Talking Points Memo's Josh Marshall posted simply: "Tough Hurdle: So Sen. Saxby Chambliss has to become gay apparently before he'll support marriage equality." New York Magazine's Jon Chait joked: "Given that personal experience seems to be how Republican senators change their minds on the issue, I would urge gay-rights groups to introduce some handsome, charming guys to Senator Chambliss and see if sparks fly."
What's interesting to us about Chambliss's "quip," however inartful, is that it doesn't really sound like strident opposition. Unlike previous election cycles, when most Republicans were actively promoting legislative measures to prevent gay marriage, these days they seem to be taking pains to emphasize that their opposition to it is strictly personal.
Policy-wise, they're no longer pushing for a constitutional amendment banning gay marriage, but increasingly arguing that it is an issue that should be left up to the states. And more and more?GOP officials like Chambliss are describing their views with lines that sound almost like "this old dog can't learn new tricks." The implication: they're not really trying to fight the tide of history. They're just asking to be allowed to maintain their own views.
We heard the same kind of tone in House Speaker John Boehner's comments on the subject last weekend on ABC's "This Week." Asked about Ohio Sen. Rob Portman's recent announcement that he now supports gay marriage, Mr. Boehner said he could not envision himself having a similar change of heart. "Listen, I believe that marriage is the union of one man and one woman," Boehner said. "It's what I grew up with. It's what I believe. It's what my church teaches me. And I can't imagine that position would ever change." Asked how he could justify denying Portman's son, who is gay, the right to marry, Boehner added: "Listen ? I think that Rob can make up his ? his own mind, take his own position."
This rhetorical shift seems in line with the conclusion in the Republican National Committee's recent "autopsy report" that Republicans must offer a more inclusive posture on issues like gay marriage, which, it said, is causing many young people to view the GOP as "totally intolerant of alternative views." According to the report: "there is a?generational difference within?the conservative movement about issues?involving?the treatment and the rights of gays ? and for many younger voters, these issues are a gateway?into whether the Party is a place they want to be. If?our Party is not welcoming and inclusive, young people and increasingly other voters will continue?to tune us out."
This week a new Washington Post/ABC poll found a record 58 percent of Americans now believe gay marriage should be legal, including 52 percent of Republicans between the ages of 18 and 29.
Still, actually supporting gay marriage remains a dicey stand for GOP elected officials. For many social conservatives ? who play an active role in Republican primary contests ? opposition to gay marriage is a strongly held plank. As The Family Research Council's Tony Perkins told The Hill this week, if the GOP abandons its opposition to gay marriage, "evangelicals will either sit the elections out completely ? or move to create a third party. Either option puts Republicans on the path to a permanent minority."
So it's not surprising to see most Republican elected officials still saying they oppose gay marriage ? while trying in general to shift focus away from the issue, and couching their opposition in increasingly personal, and far less political terms.
CAIRO (AP) ? Thousands of Egyptian protesters clashed with riot police and backers of the president's Muslim Brotherhood on Friday, ransacking several offices nationwide as anger over allegations of beatings and power-grabbing boiled over into the largest and most violent demonstrations yet on the doorstep of the powerful group.
As night fell, streets surrounding the Brotherhood headquarters were littered with shattered glass, charred vehicles, stones and gloves stained with blood. The number of injured reached nearly 100 from the two sides.
"We came to the stronghold of the Brotherhood. No more protests in front of the presidential palace because those ruling Egypt are here," said 50-year-old Hamat Awat, a female protester while running away from volleys of tear gas fired by black-clad riot police guarding the headquarters.
Anger erupted a week ago when Brotherhood members beat journalists and liberal and secular activists during a protest outside the group's Cairo headquarters. Journalists were there to cover a meeting. Protesters demand an apology, but the fundamentalist movement said its guards were provoked and acted in self-defense.
After smaller demonstrations since last weekend outside the headquarters, thousands of activists thronged to the building and battled Brotherhood supporters with birdshot, rocks, knives, sticks and their fists Friday. Gunshots were heard ringing in the neighborhood.
Three Brotherhood offices were ransacked by mobs in another Cairo neighborhood, in the second-largest city of Alexandria and in the Nile Delta city of Mahalla.
Egypt has faced near-constant turmoil in the more than two years since longtime, authoritarian leader Hosni Mubarak was overthrown in a revolt. His successor Mohammed Morsi, the country's first democratically elected leader, has faced increasing frustration over what many see as attempts by his group to monopolize power and the slow pace of his efforts to reform the state and fulfill the revolution's promises of better living standards and justice.
Thousands of policemen, meanwhile, have gone on strike, refusing to confront protesters, and in some provinces, Egyptians have taken to vigilante violence and killings to fight crime. The unrest has badly hurt the economy, with foreign investors and tourists largely staying away, and a diesel crisis that has crippled life for millions.
Morsi's opponents ? led by many of the activists who were at the forefront of the mass protests leading to Mubarak's ouster ? charge that he has done little to improve the country in the nine months since he took office. They accuse the Brotherhood, which rose in power after years of repression under the former secular regime, of seeking to monopolize power, a charge the group denies.
The anti-Brotherhood protesters demanding the resignation of the attorney general and the interior minister, both presidential appointees. They also accuse the interior minister of authorizing security forces to use excessive force against protesters. More than 70 people have been killed in protests with police since Mohammed Ibrahim was appointed in January.
Muslim Brotherhood spokesman Yasser Mehres blamed opposition parties for calling Friday's protest outside the group's headquarters. He said it gave way for "thugs" to infiltrate and attack Brotherhood offices.
"Right now, Brotherhood buses are being burnt and there are serious injuries with people in critical condition," he said. "It is not acceptable that Egyptians watch TV and see this farce taking place as Egyptians fight one another."
Young men threw stones and wielded tree branches and broken bottles as they chanted against Morsi near the Brotherhood's headquarters in Cairo. One sign held aloft by a protester outside the headquarters read: "Who is ruling Egypt?"
Riot police stood guard around the building but initially didn't interfere to break up the two sides fighting a few blocks away. Later in the evening, the police fired volleys of tear gas at protesters who tried to approach the headquarters.
Black plumes of smoke billowed after protesters torched buses that had ferried Brotherhood members to the site, and security officials said at least 100 people were injured.
Fatima Khalifa, 30, said she was demonstrating to send a message to the Brotherhood that they are the aggressors.
"Morsi must be tried for killings of protesters just like Mubarak," she said.
The Brotherhood spokesman said the group's headquarters was the wrong place to demand change.
"The protesters' demands should be delivered to the government and president, not the Brotherhood office because even though the president came from the group, he makes decisions that are separate from the group," Mehres told The Associated Press.
In another Cairo neighborhood, young protesters broke into the Brotherhood party's office in Manial and stole some items, according to security officials.
In Alexandria, an AP cameraman saw protesters attack the Brotherhood party's office, leaving with computers, files and other objects. The attack took place near the site where unknown assailants fought protesters demanding the resignation of Morsi, who is a member of the party.
They also torched a Brotherhood office in the Nile Delta city of Mahalla, a security official said.
All security officials spoke on condition of anonymity because they weren't authorized to release the information.
The scenes were reminiscent of clashes that took place late last year and left 10 people dead outside the presidential palace in Cairo between the two sides. More than a dozen Brotherhood offices were torched or ransacked at the time.
The opposition's demands are wide-ranging, including immediate cessation of violence against protesters and the amendment of articles in the constitution that was passed in a contentious referendum last year. They also want the formation of a more representative and inclusive Cabinet.
The clashes in Cairo erupted at a nearby square after a large pro-Brotherhood march approached the Brotherhood's main headquarters In the sprawling Cairo neighborhood of Muqattam. The protesters moved a few blocks away to Fountain Square after being hit with rocks from rooftops of nearby buildings. The square lies at the entrance of Muqattam, which overlooks the city.
An AP correspondent saw members of the anti-Brotherhood camp beating people in the crowd suspected of being members of the Islamist group.
The Brotherhood's website also reported the incident, characterizing the anti-Brotherhood side as "thugs" and "counter-revolutionaries".
Ahmed Abdel-Hai rushed one of the injured Brotherhood members to an ambulance.
He said the man was beaten after protesters allegedly saw him firing birdshot.
"Today will be a massacre," he said, as his hands and face were stained with blood from the wounded Brotherhood man, whose face and half naked body were covered with blood and bruises.
Several anti-Brotherhood protesters were also seen bloodied and being rushed to ambulances. Some covered their faces with black masks.
Anti-Brotherhood protester Hussein el-Sayyid said he saw three people with their faces slashed, suggesting some blades or knives were being used in the fighting.
"We are Egyptians eating one another when we should be one hand," he said.
__
Associated Press writer Aya Batrawy contributed to this report.
Australian hardware startup and Kickstarter success story LIFX has good news for people who missed out on backing the initial project: it's opening up a second round of pre-orders, with a new production run of 100,000 units, sold directly through its website. LIFX sold out its pre-order allotment on Kickstarter in just six days, blowing past $1M, which is 10 times its original funding target.
The UK isn't the only country that's just seen a fresh influx of Nexus 4 stock at its Google Play Store. Today the official +Nexus Google+ page sends word that the coveted handset is now back in stock in Germany. The phone is available in 8GB and 16GB flavors for €299 and €349 respectively, and set to ship in 3 to 5 days.
(Incidentally, the phone's still in stock in the UK and shipping within the same timeframe)
A group of tiny RNA molecules with a big role in regulating gene expression also appear to have a role in causing insulin resistance in woman with polycystic ovary syndrome and, perhaps, in all women, researchers report.
Research in the journalDiabetes, indicates that high activity levels of a microRNA called miR-93 in fat cells impedes insulin's use of glucose, contributing to PCOS as well as insulin resistance, said Dr. Ricardo Azziz, reproductive endocrinologist and PCOS expert at the Medical College of Georgia at Georgia Regents University.
"This is one of the first reports of a defect that may occur both in women who are insulin resistant and, in particular, in women with PCOS," said Azziz, the study's corresponding author. "Identifying this molecular mechanism helps us understand these common conditions better and points us toward targeted therapies to correct these problems in women."
PCOS affects about 10 percent of women and is characterized by excess male hormone, irregular ovulation and menstruation and is associated with an increased risk for insulin resistance, which can lead to diabetes and heart disease.
Researchers looked at fat cells from the lower abdomen of 21 women with PCOS and 20 controls. In all the women with PCOS, they found over expression of miR-93 and decreased expression of GLUT4, a key protein that regulates fat's use of glucose for energy. Fat, a large organ in even a thin individual, is where a lot of glucose usage via insulin occurs.
GLUT4 expression was lowest in the women with PCOS who also were insulin resistant. They also found the expression was low in members of the control group who were insulin resistant.
"Low levels of GLUT4 in fat appear to be affecting insulin resistance in general and to have a more dramatic impact in PCOS," Azziz said. MiR-93 was known to impact GLUT4 in other cell types and to have a role in reproduction, infertility and lipid metabolism. "There has been no clear mechanism to describe insulin resistance in PCOS and we believe this is one of the pathways," said Dr. Yen-Hao Chen, cell biologist at MCG and the study's first author.
Interestingly, the investigators found that two other microRNAS - miR-133 and miR-223, which are known to regulate GLUT4 expression in heart muscle cells - also were over expressed but only in the fat cells of PCOS patients, Chen said. This exclusivity implicates the tiny molecules in the underlying condition of PCOS, Chen said. The researchers don't know yet if the two are related to miR-93. "We are just beginning to understand the role of these small molecules in PCOS and insulin resistance and much work remains to be done," Azziz said.
Follow up studies include better understanding just how microRNAs impact GLUT4, identifying other microRNAS that do ? including looking further at miR-133 and 223 ? and identifying what factors impact the tiny RNA molecules.
Humans use both insulin and non-insulin related mechanisms to use blood sugar, or glucose, as an energy source.
Azziz and his colleagues recently showed in Journal of Clinical Endocrinology & Metabolism that women with PCOS have defects in both mechanisms. In fact, PCOS women who had the most difficulty controlling glucose via insulin were also the ones with the greatest declines in their ability to use non-insulin approaches. More typically, when insulin resistance increases, the body's non-insulin dependent usage increases, apparently to help compensate.
###
Medical College of Georgia at Georgia Regents University: http://www.mcghealth.org
Thanks to Medical College of Georgia at Georgia Regents University for this article.
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Stayin' alive -- delivering resuscitation messages to the publicPublic release date: 21-Mar-2013 [ | E-mail | Share ]
Contact: Jacqueline Partarrieu press@escardio.org 33-492-947-756 European Society of Cardiology
Encouraging bystander intervention
Teaching bystander Cardiac Pulmonary Resuscitation (CPR) strategically to the general public offers the greatest potential to make the biggest overall impact on survival in out of hospital cardiac arrests in Europe, reported a main session on Resuscitation Science at the European Society of Cardiology's EuroHeart Care Congress, which took place in Glasgow, 22 to 23 March, 2013.
"The reality is that four out of five cardiac arrests happen at home, and unless the public are trained in resuscitation many people die before emergency services get to them," said Mary Hannon. "The good news is that CPR is an important life saving technique that can be effectively taught to most people."
The European Resuscitation Council estimates that around 500,000 people suffer a sudden cardiac arrest every year in Europe. While bystander CPR increases survival rates by two to three times, it however is only delivered in one in five out of hospital cardiac arrests. Optimizing this rate, the European Resuscitation Council has estimated, could save 100,000 lives in Europe each year.
"We want to get the message across that anyone, whether First Aid trained or untrained can help someone in an emergency and that doing something is better than not doing anything at all," said Hannon.
It is estimated that a victim's chance of survival slips away by 7% to 10% each minute before CPR is started. "So it's vital not to procrastinate. The challenge is to persuade everyone to roll up their sleeves and get stuck in as quickly as possible," she said.
While in emergency situations everyone should be prepared to have a go, studies have suggested that people who have formally learnt CPR are ten times more likely to respond than those who have not. And training makes a big difference to survival. Statistics from the American Heart Foundation show that in cities such as Seattle and Washington where CPR training is widespread, the survival rate for cardiac arrest is around 30%, where as in cities such a New York city, were training is less, survival rates averages 1-2%.
Ireland's CPR success story
In her presentation Hannon, who works as Resuscitation Training Officer at the Connolly Hospital Blanchardstown (CHB), Dublin, described Ireland's success story, where the "National First Responders campaign" set out to teach resuscitation to the general public.
The campaign, launched in 2005, was a joint initiative from The Irish Heart Foundation (IHF), Pre Hospital Emergency Care Council (PHEC), National Ambulance Service (NAS), and others. The initiative, which involved integrations of the statutory and voluntary services, aimed to train as many people from the community as possible in bystander CPR. In the campaign the Heart Saver AED course was taken out into the community, with members of the public taught the basic techniques of CPR, how to use an automated external defibrillator (AED) and the relief of choking for adults, children and infants.
Overall 65,000 people are now trained in CPR annually in Southern Ireland, and the campaign has resulted in the number of people surviving out of hospital cardiac arrests in Southern Ireland rising from just 1% in 2005, to 6.5% in 2012.
Perhaps the most innovative part of the programme was the introduction of CPR training into the school curriculum. In the "CPR 4 Schools Programme", which ran in 2009, all Transition Year students (aged 16 years), amounting to around 27000 people, were issued with self training kits containing a DVD, booklet and inflatable manikin, which together create and easy to follow lesson in CPR. Teachers acted as facilitators to the training, rather than instructors.
In an evaluation of the programme, 76% of school children who took part said that they would be likely to give CPR if they were present when a person collapse; 90% felt more confident to perform CPR after training; and 68% said they would show their family and friends how to do CPR.
"We showed that by targeting school children there was a real potential that they'll take the knowledge home and teach the rest of the family," said Hannon.
Although the initiative was unfortunately discontinued due to monetary constraints, she said, some schools have continued, and there are future plans to incorporate CPR into the school curriculum.
Future moves to establish a registry of automatic external defibrillators (AEDs) in Southern Ireland, she said, should further increase survival. "Once we know exactly where defibrillators are based we hope to link them to the ambulance services so that lay rescuers can be contacted to take them directly to the victim," said Hannon. An additional advantage, she added, would be that such knowledge would enable strategies to be put in place to ensure good maintenance of the devices.
Can music help achieve the correct rate and depth in CPR?
One of the big challenges in CPR has been to train members of the public and health care professional to achieve the correct rate and depth of chest compressions. In the session Dr Lettie Rawlins gave an overview of the research she undertook at Coventry University, while a medical student, using music as a prompt to help people achieve the correct tempo of chest compressions.
"It's really important to use the correct amount of force to compress the heart sufficiently to push the blood out, and at the same time you need the correct rate of compressions to enable sufficient blood to reach the brain," said Rawlins, now a junior doctor at the Great Western Hospital, Swindon, UK.
"It's quite difficult to get the right rate even if someone shows you, and really easy to deskill if you haven't practiced for a while. The idea behind using popular music is that songs stay longer in your head," she said.
In a study published in the BMJ in 2009 , Rawlins and colleagues showed that using "Nellie the Elephant" as background music significantly increased the number of people getting the right rate of compressions on a manikin, but that there was a drop in those hitting the correct depth.
A second study, published in the Emergency Medical Journal in 2012 , found that the proportion of paramedics who maintained compressions within the optimal range of 100 to 120 a minute was significantly higher when listening to "Disco Science" by Mirwais (82%) than when listening to "Achy Breaky Heart" by Billy Ray Cyrus (64%) or no music at all (65%). But over a third of compressions were still too shallow, irrespective of the music used. "We found that "Achy Breaky Heart" was actually harmful because it made people compress too fast, so that the heart didn't have a chance to fill properly," said Rawlins. They did not, however, investigate "Stayin' Alive", by the Bee Gees, which the British Heart Foundation used in their 2012 "Hard and Fast" ad campaign.
At the end of the studies the investigators remained unconvinced that music provided any additional benefits in improving the quality of CPR compared with using a metronome. "We think the problem may be that music distracted people from focusing on the force of the compressions," explained Rawlins.
In future, she said, it might be more effective to develop manikins with sensors for pressure and rate that could be attached to Wii Fit type devices to deliver real time feedback, and also to have smart phone aps that could be used to provide a metronome in emergency situations.
Appendix
The latest guidelines from the European Resuscitation Council (ERC)4 and the American Heart Association, both updated 2010, emphasize that chest compressions are the most important action in resuscitation. The new drill goes that if someone is unresponsive and their breathing is noisy, infrequent or doesn't seem normal, after calling for an ambulance you should start hands only CPR. Here the technique involves pushing hard and fast at the centre of the casualty's chest, at a rate of two pushes per second to a depth of 5 to 6 cm (two inches).
The idea behind the simplified guidelines, said Hannon, is to aid the retention and acquisition of life support skills by lay people. It has been found that for untrained members of the public having to perform mouth to mouth resuscitation can get in the way of crucial chest compressions. Furthermore rescuers are more willing to give resuscitation if they don't have to provide ventilation.
While CPR alone is unlikely to restart the heart (treatment with high voltage electrical shocks, defibrillation, is needed to restore the normal heart rhythm), its main purpose is to restore flow of oxygenated blood to the brain and heart and extend the brief window for a successful resuscitation without permanent brain damage. Typically, blood contains five to seven minutes worth of oxygen and the effect of constant fast chest compressions is to keep that oxygen moving to the brain and other vital organs. "The idea of CPR is to buy valuable time before the defibrillator arrives," said Hannon.
Guidelines additionally state that bystanders who are trained and willing should combine chest compressions with rescue breathing at a ratio of 30 compressions to two breaths. In children, since 70% of out of hospital cardiac arrests are asphyxia in origin, survival rates are better if they are provided with both chest compressions and ventilations. "But even here hands only CPR is better than nothing," stressed Hannon.
###
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Stayin' alive -- delivering resuscitation messages to the publicPublic release date: 21-Mar-2013 [ | E-mail | Share ]
Contact: Jacqueline Partarrieu press@escardio.org 33-492-947-756 European Society of Cardiology
Encouraging bystander intervention
Teaching bystander Cardiac Pulmonary Resuscitation (CPR) strategically to the general public offers the greatest potential to make the biggest overall impact on survival in out of hospital cardiac arrests in Europe, reported a main session on Resuscitation Science at the European Society of Cardiology's EuroHeart Care Congress, which took place in Glasgow, 22 to 23 March, 2013.
"The reality is that four out of five cardiac arrests happen at home, and unless the public are trained in resuscitation many people die before emergency services get to them," said Mary Hannon. "The good news is that CPR is an important life saving technique that can be effectively taught to most people."
The European Resuscitation Council estimates that around 500,000 people suffer a sudden cardiac arrest every year in Europe. While bystander CPR increases survival rates by two to three times, it however is only delivered in one in five out of hospital cardiac arrests. Optimizing this rate, the European Resuscitation Council has estimated, could save 100,000 lives in Europe each year.
"We want to get the message across that anyone, whether First Aid trained or untrained can help someone in an emergency and that doing something is better than not doing anything at all," said Hannon.
It is estimated that a victim's chance of survival slips away by 7% to 10% each minute before CPR is started. "So it's vital not to procrastinate. The challenge is to persuade everyone to roll up their sleeves and get stuck in as quickly as possible," she said.
While in emergency situations everyone should be prepared to have a go, studies have suggested that people who have formally learnt CPR are ten times more likely to respond than those who have not. And training makes a big difference to survival. Statistics from the American Heart Foundation show that in cities such as Seattle and Washington where CPR training is widespread, the survival rate for cardiac arrest is around 30%, where as in cities such a New York city, were training is less, survival rates averages 1-2%.
Ireland's CPR success story
In her presentation Hannon, who works as Resuscitation Training Officer at the Connolly Hospital Blanchardstown (CHB), Dublin, described Ireland's success story, where the "National First Responders campaign" set out to teach resuscitation to the general public.
The campaign, launched in 2005, was a joint initiative from The Irish Heart Foundation (IHF), Pre Hospital Emergency Care Council (PHEC), National Ambulance Service (NAS), and others. The initiative, which involved integrations of the statutory and voluntary services, aimed to train as many people from the community as possible in bystander CPR. In the campaign the Heart Saver AED course was taken out into the community, with members of the public taught the basic techniques of CPR, how to use an automated external defibrillator (AED) and the relief of choking for adults, children and infants.
Overall 65,000 people are now trained in CPR annually in Southern Ireland, and the campaign has resulted in the number of people surviving out of hospital cardiac arrests in Southern Ireland rising from just 1% in 2005, to 6.5% in 2012.
Perhaps the most innovative part of the programme was the introduction of CPR training into the school curriculum. In the "CPR 4 Schools Programme", which ran in 2009, all Transition Year students (aged 16 years), amounting to around 27000 people, were issued with self training kits containing a DVD, booklet and inflatable manikin, which together create and easy to follow lesson in CPR. Teachers acted as facilitators to the training, rather than instructors.
In an evaluation of the programme, 76% of school children who took part said that they would be likely to give CPR if they were present when a person collapse; 90% felt more confident to perform CPR after training; and 68% said they would show their family and friends how to do CPR.
"We showed that by targeting school children there was a real potential that they'll take the knowledge home and teach the rest of the family," said Hannon.
Although the initiative was unfortunately discontinued due to monetary constraints, she said, some schools have continued, and there are future plans to incorporate CPR into the school curriculum.
Future moves to establish a registry of automatic external defibrillators (AEDs) in Southern Ireland, she said, should further increase survival. "Once we know exactly where defibrillators are based we hope to link them to the ambulance services so that lay rescuers can be contacted to take them directly to the victim," said Hannon. An additional advantage, she added, would be that such knowledge would enable strategies to be put in place to ensure good maintenance of the devices.
Can music help achieve the correct rate and depth in CPR?
One of the big challenges in CPR has been to train members of the public and health care professional to achieve the correct rate and depth of chest compressions. In the session Dr Lettie Rawlins gave an overview of the research she undertook at Coventry University, while a medical student, using music as a prompt to help people achieve the correct tempo of chest compressions.
"It's really important to use the correct amount of force to compress the heart sufficiently to push the blood out, and at the same time you need the correct rate of compressions to enable sufficient blood to reach the brain," said Rawlins, now a junior doctor at the Great Western Hospital, Swindon, UK.
"It's quite difficult to get the right rate even if someone shows you, and really easy to deskill if you haven't practiced for a while. The idea behind using popular music is that songs stay longer in your head," she said.
In a study published in the BMJ in 2009 , Rawlins and colleagues showed that using "Nellie the Elephant" as background music significantly increased the number of people getting the right rate of compressions on a manikin, but that there was a drop in those hitting the correct depth.
A second study, published in the Emergency Medical Journal in 2012 , found that the proportion of paramedics who maintained compressions within the optimal range of 100 to 120 a minute was significantly higher when listening to "Disco Science" by Mirwais (82%) than when listening to "Achy Breaky Heart" by Billy Ray Cyrus (64%) or no music at all (65%). But over a third of compressions were still too shallow, irrespective of the music used. "We found that "Achy Breaky Heart" was actually harmful because it made people compress too fast, so that the heart didn't have a chance to fill properly," said Rawlins. They did not, however, investigate "Stayin' Alive", by the Bee Gees, which the British Heart Foundation used in their 2012 "Hard and Fast" ad campaign.
At the end of the studies the investigators remained unconvinced that music provided any additional benefits in improving the quality of CPR compared with using a metronome. "We think the problem may be that music distracted people from focusing on the force of the compressions," explained Rawlins.
In future, she said, it might be more effective to develop manikins with sensors for pressure and rate that could be attached to Wii Fit type devices to deliver real time feedback, and also to have smart phone aps that could be used to provide a metronome in emergency situations.
Appendix
The latest guidelines from the European Resuscitation Council (ERC)4 and the American Heart Association, both updated 2010, emphasize that chest compressions are the most important action in resuscitation. The new drill goes that if someone is unresponsive and their breathing is noisy, infrequent or doesn't seem normal, after calling for an ambulance you should start hands only CPR. Here the technique involves pushing hard and fast at the centre of the casualty's chest, at a rate of two pushes per second to a depth of 5 to 6 cm (two inches).
The idea behind the simplified guidelines, said Hannon, is to aid the retention and acquisition of life support skills by lay people. It has been found that for untrained members of the public having to perform mouth to mouth resuscitation can get in the way of crucial chest compressions. Furthermore rescuers are more willing to give resuscitation if they don't have to provide ventilation.
While CPR alone is unlikely to restart the heart (treatment with high voltage electrical shocks, defibrillation, is needed to restore the normal heart rhythm), its main purpose is to restore flow of oxygenated blood to the brain and heart and extend the brief window for a successful resuscitation without permanent brain damage. Typically, blood contains five to seven minutes worth of oxygen and the effect of constant fast chest compressions is to keep that oxygen moving to the brain and other vital organs. "The idea of CPR is to buy valuable time before the defibrillator arrives," said Hannon.
Guidelines additionally state that bystanders who are trained and willing should combine chest compressions with rescue breathing at a ratio of 30 compressions to two breaths. In children, since 70% of out of hospital cardiac arrests are asphyxia in origin, survival rates are better if they are provided with both chest compressions and ventilations. "But even here hands only CPR is better than nothing," stressed Hannon.
###
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?
AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.
Migraines and other forms of headache disorders can cause debilitating pain, disrupt lives and lead to?large economic and societal costs. At the Stanford Headache Clinic, director Robert Cowan, MD, who has suffered migraines his entire life, works with colleagues to relieve patients? pain through a treatment approach focusing on prevention and integrating medical, physical, psychological and complementary medicine.
This month we asked Cowan to respond to questions about headache disorders, recent?improvements in managing them, and the use of?a multifaceted approach to treating symptoms. In the following Q&A, he answers a selection of questions submitted via our @SUMedicine Twitter feed and the Scope?comments section.
As a reminder, these answers are meant to offer medical information, not medical advice. They?re not meant to replace the evaluation and determination of your doctor, who will address your specific medical needs and can make a diagnosis and provide appropriate care.
@ryderexpress34 asks: Are there any studies to see if migraines are physiological?
If, by your question, you mean are migraines ?psychological,? then the answer is certainly that migraines are physiological. Migraine is a genetic disease and, as a result, it usually runs in families. There are distinct biochemical and anatomic abnormalities in the brains of people who have migraine. It is definitely not a ?psychological condition.?
@mutterp asks: Why do doctors have a difficult time diagnosing migraines?
The problem is that most doctors do not receive proper training in the diagnosis and treatment of migraine. Fortunately, that is beginning to change. Today, there are just over 300 board certified headache specialists in the United States. While this is still not many when compared to the 60 million headache sufferers, we are moving in the right direction.
Terri asks: What?s your opinion of a holistic approach to migraine treatment where behavioral therapies are included in the treatment plan?
I think a holistic approach is far and away the best approach to managing headaches. When we combine ?traditional? and ?complementary? approaches, we call it ?integrative? medicine. It is the approach we use here at Stanford and it is becoming the standard in many headache centers across the country.
Erin Digitale?asks:? I?m wondering if any research has been done to show how acupuncture or acupressure techniques prevent migraines. What do we know about the mechanism?
There have been a number of studies exploring acupuncture for migraine and several theories offered, but the truth is we still don?t know what the mechanism is. It probably has something to do with release of tiny molecules from nerve endings at the acupuncture sites. These molecules, called neurotransmitters, then modulate pain messages going to a part of the brain called the brainstem, where pain messages en route to the brain are modulated.
Kerrie Smyres?asks:? Can you summarize the research on migraine and histamine and why researchers hypothesize a connection between the two?
There are volumes on the relationship between histamine and headache ? far too much to summarize here. But suffice to say histamine and other immune responses are part of the body?s response system to a perceived threat from the environment, and how the brain responds to environment is at the heart of migraine.
Kim asks: Do you recommend that migraine patients get tested for food allergies?
As a rule, I do not. There is no strong evidence that food allergies trigger migraines. But everyone?s triggers are different and if you find a food that seems to be a trigger, it makes good sense to avoid it. In other words, just because something you ingest gives you a migraine, it does not mean you are ?allergic? to it, and vice versa.
Carolyn B?asks: What are your thoughts on surgery for migraine?
This is a complicated issue. The surgery recommended as a ?migraine cure? has not been well-studied and I have personally seen some disastrous outcomes. I have also heard of some excellent outcomes as well. So I think the jury is still out. Before going to a surgeon, I would suggest you discuss?your case with a headache specialist to make sure all medical options have been explored.
Dean asks: How concerned should people be about migraines as a precursor to strokes?
In general, people with migraine are not at greater risk for stroke than anyone else. There are a couple of exceptions in people who have other risk factors along with a particular kind of migraine. This is a complicated topic and should be discussed with a headache specialist. There are several medical conditions that are more common among migraine sufferers, and again, this is a conversation to have with a headache specialist.
L asks: I have been diagnosed with migraines that come in clusters, but cluster headaches have been ruled out. Melatonin in high doses seems to quell them and kick them out of the cluster period. Is there a genetic component to this type of migraine?
While no gene for this particular type of migraine has been identified, most migraine is, in fact, genetic. As for the role of melatonin, there are two (potentially more) possible explanations. The first is that melatonin facilitates sleep and the sleep ?resets? the brain. Most migraines can be broken by sleep. The second, and perhaps more compelling, explanation is that melatonin is active at the hypothalamus where many of our rhythmic activities are modulated and the ?reset? occurs there. Without knowing a lot more about your particular headaches, it is hard to say more about both the ?inheritability? of your headaches and the rhythmicity.
Giuliana Scarano asks:? I live in Italy, what books, or other resources, could help me learn how lifestyle changes many relieve my symptoms?
A couple of years ago, I wrote a book about this approach. It is called ?The Keeler Migraine Method.? I am not sure where you are in Italy, but you might contact Dr. Bussone, a world-renowned headache specialist there. He may be able to guide you to someone who can help.
Previously: Ask Stanford Med: Director of Stanford Headache Clinic taking questions on headache disorders, Managing headache disorders during the holidays and New Stanford headache clinic taking an interdisciplinary approach to brain pain Photo by Eunice
Australian hardware startup and Kickstarter success story LIFX has good news for people who missed out on backing the initial project: it's opening up a second round of pre-orders, with a new production run of 100,000 units, sold directly through its website. LIFX sold out its pre-order allotment on Kickstarter in just six days, blowing past $1M, which is 10 times its original funding target.
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Migraines and other forms of headache disorders can cause debilitating pain, disrupt lives and lead to?large economic and societal costs. At the Stanford Headache Clinic, director Robert Cowan, MD, who has suffered migraines his entire life, works with colleagues to relieve patients? pain through a treatment approach focusing on prevention and integrating medical, physical, psychological and complementary medicine.