1 . Months ago, researchers at UCLA published a study that showed using a specific type of yoga to engage in a brief, simple daily meditation reduced the stress levels of people who care for those stricken by Alzheimer’s and other forms of dementia. Now they know why.

As previously reported, practicing a certain form of chanting yogic meditation for just 12 minutes daily for eight weeks led to a reduction in the biological mechanisms responsible for an increase in the immune system’s inflammation response. Inflammation, if constantly activated, can contribute to a multitude of chronic health problems.

Reporting in the current online edition of the journal Psychoneuroendocrinology, Dr. Helen Lavretsky, senior author and a professor of psychiatry at the UCLA Semel Institute for Neuroscience and Human Behavior, and colleagues found in their work with 45 family dementia caregivers that 68 of their genes responded differently after Kirtan Kriya Meditation (KKM), resulting in reduced inflammation.

Caregivers are the unsung heroes for their yeoman’s work in taking care of loved ones that have been stricken with Alzheimer’s and other forms of dementia, said Lavretsky, who also directs UCLA’s Late-Life Depression, Stress and Wellness Research Program. But caring for a frail or demented family member can be a significant life stressor. Older adult caregivers report higher levels of stress and depression and lower levels of satisfaction, vigor and life in general. Moreover, caregivers show higher levels of the biological markers of inflammation. Family members in particular are often considered to be at risk of stress-related disease and general health decline.

“We know that chronic stress places caregivers at a higher risk for developing depression,” she said “On average, the incidence and prevalence of clinical depression in family dementia care givers approaches 50 percent. Caregivers are also twice as likely to report high levels of emotional distress.” What s more, many caregivers tend to be older themselves, leading to what Lavretsky calls an “impaired resilience” to stress and an increased rate of cardiovascular disease and mortality.

Research has suggested for some time that psychosocial interventions like meditation reduce the adverse effects of caregiver stress on physical and mental health. However, the pathways by which such psychosocial interventions impact biological processes are poorly understood.

“The goal of the study was to determine if meditation might alter the activity of inflammatory and antiviral proteins that shape immune cell gene expression,” said Lavretsky. “Our analysis showed a reduced activity of those proteins linked directly to increased inflammation.”

“This is encouraging news. Caregivers often don’t have the time, energy, or contacts that could bring them a little relief from the stress of taking care of a loved one with dementia, so practicing a brief form of yogic meditation, which is easy to learn, is a useful tool.”

2 . This website is designed to explore how the experience, diagnosis and treatment of illness has changed over time, and to show some of the many ways illness has been understood by humans. It is our hope that you will leave the site with a broader appreciation of the relationship of medicine to culture, and an understanding that our own medical practices look different when seen in a historical context.

In exploring this site, we ask you to think of this fundamental idea: that illness, the feeling and experience of being sick, is itself a historical object. Illness and medicine are not static(静止的) phenomena. Different people in different time periods can experience, understand and treat similar groups of symptoms very differently. Cycles of fevers and chills may be identified as being a particular disease, part of a general pattern of seasonal health or an internal struggle of opposing yet complementary forces. These are more than just descriptions; they influence the actual experience of having illness, and strongly influence the treatment. A body that is out of balance feels pain in manner that is subjectively different from a body fighting a battle against an external attacker. We believe that illness changes over time. Thus, to fully understand illness, we need not just biological explanation, but also historical explanation. We need both medicine and the history of illness.

Related to this idea is a second. This is the concept that illness, and the medical responses to illness, are related to cultural worldviews. How we see the world structures how we experience and shape the world we live in. What makes particular responses seem reasonable emerges from specific cultural values. The judgements about what medical practices are effective and sensible are value judgements made in the context of broader cultural beliefs about how the world works, our place in that world, and what is morally good and bad. Our aim is to help you understand why blood-letting for instance, now considered unacceptable, was a sensible healing activity in the early 19^th century.

Finally, it is easy to read the history of medicine as one of constant progression leading from barbaric (野蛮的) roots to a scientific approaches embodied in current medical practice. We believe that this understanding is problematic. First, a lack of knowledge that we have today did not mean that medicine in other time periods and cultures was wrong. Based on cultural values and contemporary knowledge, other cultures developed advanced treatments that were effective and sensible for their people, although they may be considered barbaric nowadays. Similarly in a century or two, our own medical practices may seem backward and nonsensical, it is not the case that former practices have led simplistically to our own superior knowledge.

3 . Crowdfunding (众筹) campaigns to help people with cancer pay for ineffective alternative treatments are becoming more common. They often come with six-figure targets to meet the cost of debatable therapies. ________, headlines are almost guaranteed.

The BMJ (British Medical Journal) reports ________ over this, based on information I gathered working for the charity Good Thinking. By sorting fundraising sites like JustGiving and GoFundMe, I identified appeals from people in the UK who sought money for unproven or disproven treatments, finding 400 in the past three years. Those have raised £7 million, the money destined for ________clinics.

Although the treatments, such as extreme diets, aren’t backed by scientific evidence, people who are desperate and vulnerable are often ________by remarkable testimonials(证明书) provided by the clinics themselves. However, for those who see such stories in the media, and who care about following good scientific evidence, the natural reaction is to try to ________people from possible physical, emotional and financial harm.

________ these appeals isn’t easy. People with cancer often view these therapies as ________, and their supporters don’t want to consider that their efforts to help may cause harm.

However, journalists must review the role they play in promoting the ________. Their influence is powerful. As I sorted through appeals and the heartbreaking stories of desperately ill people, I was ________ by just how many cited success stories they had read in newspapers as their reason for trusting questionable treatments.

Most concerning of all were the frequent cases where someone had died—sometimes just months after eye-catching ________of their treatment. While the uplifting story of a community helping fund someone’s “cure” is attractive, the subsequent reality when that hope proves fruitless seems far less ________.

This leaves the public with a ________ view of the effectiveness of such treatments, and serves as an advertising tool for clinics which, under UK law, wouldn’t be able to directly promote their therapies.

If journalists wish to avoid promoting ineffective treatments, they would do well to view such stories not just as human-interest ones, but as ________ and health stories. This means ________the evidence behind treatments, seeking expert opinion on their efficacy, and choosing not to run stories that fail such a careful examination.

I’m certain no journalist would want their work to be used as a recruitment tool for therapists whose treatments offer nothing but heartbreak and false hope, yet until reports of miraculous cancer cures in questionable clinics are approached with an appropriate level of skepticism(怀疑), I fear such places will continue to ________.

4 . Delivering life-saving drugs directly to the brain in a safe and effective way is a challenge for medical providers. One key reason: the blood-brain barrier, which protects the brain from tissue-specific drug delivery. Methods such as an injection or a pill aren't as precise or immediate as doctors might prefer, and ensuring delivery right to the brain often requires invasive, risky techniques.

A team of engineers from Washington University in St. Louis has developed a new nano-particle generation-delivery method that could someday vastly improve drug delivery to the brain, making it as simple as a sniff.

“This would be a nano-particle nasal spray, and the delivery system could allow medicine to reach the brain within 30 minutes to one hour,” said Ramesh Raliya, research scientist at the School of Engineering & Applied Science.

“The blood-brain barrier protects the brain from foreign substances in the blood that may injure the brain,” Raliya said. “But when we need to deliver something there, getting through that barrier is difficult and invasive. Our non-invasive technique can deliver drugs via nano-particles, so there's less risk and better response times.”

The novel approach is based on aerosol science and engineering principles that allow the generation of mono-disperse nano-particles, which can deposit on upper regions of the nasal cavity via spread. The nano-particles were tagged with markers, allowing the researchers to track their movement.

Next, researchers exposed locusts' antenna to the aerosol, and observed the nano-particles travel from the antennas up through the olfactory nerve, which is used to sense the smell. Due to their tiny size, the nano-particles passed through the brain-blood barrier, reaching the brain and spreading all over it in a matter of minutes.

The team tested the concept in locusts because the blood-brain barriers in the insects and humans have similarities. “The shortest and possibly the easiest path to the brain is through your nose,” said Barani Raman, associate professor of biomedical engineering. “Your nose, the olfactory bulb and then olfactory cortex: two steps and you've reached the cortex.”

To determine whether or not the foreign nano-particles disrupted normal brain function, Saha examined the physiology response of olfactory neurons in the locusts before and after the nano-particle delivery and found no noticeable change in the electro-physiological responses was detected.

This is only a beginning of a set of studies that can be performed to make nano-particle-based drug delivery approaches more principled, Raman said. The next phase of research involves fusing the gold nano-particles with various medicines, and using ultrasound to target a more precise dose to specific areas of the brain, which would be especially beneficial in brain-tumor cases.

6 .

Mini-Biographies Help Clinicians Connect with Patients

Bog Hall was recovering from yet another surgery in March 2014 when a volunteer walked into his hospital room.

The volunteer wasn't there to check on his lungs or breathing. Instead, she asked Hall     1     he wanted to tell his life story.

The interview was part of a program     2    （call）My Life, My Story. Volunteer writers seek out veterans（老兵）at the hospital like Hall, and ask them all about their lives. Then they write up a thousand-word biography, and go over it with the patient,     3    can add more details or correct any mistakes.

When the story is finished, it     4    （attach）to the patient's electronic record, where a doctor or nurse     5    （work）anywhere in the Veterans Affairs medical system can read it.

Today more than 2,000 patients at the Madison VA     6    （share）their life stories.

Project organizers say it could change the way providers interact with patients.     7     clinicians can access a lot of medical data through a patient's electronic medical record,   there's nowhere to learn about a patients' personality or learn about his career, passion or values, said Thor Ringler, who has managed the My Life, My Story project     8    2013.

    9    idea for My Life, My Story came from Dr. Elliot Lee, a medical resident who was doing a training programme at the Madison VA in 2012. The typical programme for medical residents lasts only about a year, so Lee wanted to find a way to bring new, young doctors up to speed on the VA patients. He wanted a way for them     10    （absorb）not just their health histories, but more personal pieces of knowledge.