Against the backdrop of health care reform and a controversial medical device tax, medical technology companies are focusing more than ever on products that deliver cheaper, faster, more efficient patient care. They are also making inroads with U.S. Food & Drug Administration regulators to re-engineer the complex review and approval process for new medical devices.
Many in the industry have long felt overly burdened by what they consider to be an unnecessarily complex approval process. Critics claim it impedes innovation and delays the availability of better health care. To change that perception, the FDA last year announced a new Medical Device Innovation Consortium (MDIC) charged with simplifying the process of designing and testing new technologies. With input from industry, government, and other nonprofit organizations, public-private MDIC will prioritize the regulatory science needs of the medical device community and fund projects to streamline the process.
"By sharing and leveraging resources, MDIC may help industry to be better equipped to bring safe and effective medical devices to market more quickly and at a lower cost," says Jeffrey Shuren, M.D., J.D., director of the FDA's Center for Devices and Radiological Health.
As the regulators, politicians, and corporate executives hash out these details, industry engineers and scientists continue to push through new ideas for improving and managing human health. Every year, industry observers like the Cleveland Clinic and the medical device trade press single out their favorite technology trends. These thought leaders agree that today's best technologies strike a balance between reducing the overall cost of medical care and increasing safety and survival rates—and isn't that what health care reform is all about?
Here are five emerging technologies to watch in the year ahead.
With the most deadly form of skin cancer, melanoma, a huge number of dangerous-looking moles are actually harmless, but has always been impossible to know for sure without an invasive surgical biopsy. Today dermatologists have new help in making the right call — a handheld tool approved by the FDA for multispectral analysis of tissue morphology. The MelaFind optical scanner is not for definitive diagnosis but rather to provide additional information a doctor can use in determining whether or not to order a biopsy. The goal is to reduce the number of patients left with unnecessary biopsy scars, with the added benefit of eliminating the cost of unnecessary procedures. The MelaFind technology (MELA Sciences, Irvington, NY) uses missile navigation technologies originally paid for the Department of Defense to optically scan the surface of a suspicious lesion at 10 electromagnetic wavelengths. The collected signals are processed using heavy-duty algorithms and matched against a registry of 10,000 digital images of melanoma and skin disease.
The MelaFind optical scanner from MELA Sciences. Image: MelaFind.com
The ATI Neurostimulator from Autonomic Technologies. Image: ATI-SPG.com
For people who suffer from migraines, cluster headaches, and other causes of chronic, excruciating head or facial pain, the "take two aspirins and call me in the morning" method is useless. Doctors have long associated the most severe, chronic forms of headache with the sphenopalatine ganglion (SPG), a facial nerve bundle, but haven't yet found a treatment that works on the SPG long-term. A technology under clinical investigation at Autonomic Technologies, Inc., (Redwood City, CA) is a patient-powered tool for blocking SPG signals at the first sign of a headache. The system involves the permanent implant of a small nerve stimulating device in the upper gum on the side of the head normally affected by headache. The lead tip of the implant connects with the SPG bundle, and when a patient senses the onset of a headache, he or she places a handheld remote controller on the cheek nearest the implant. The resulting signals stimulate the SPG nerves and block the pain-causing neurotransmitters.
Diabetes self-care is a pain—literally. It brings the constant need to draw blood for glucose testing, the need for daily insulin shots and the heightened risk of infection from all that poking. Continuous glucose monitors and insulin pumps are today's best options for automating most of the complicated daily process of blood sugar management – but they don't completely remove the need for skin pricks and shots. But there's new skin in this game. Echo Therapeutics (Philadelphia, PA) is developing technologies that would replace the poke with a patch. The company is working on a transdermal biosensor that reads blood analytes through the skin without drawing blood. The technology involves a handheld electric-toothbrush-like device that removes just enough top-layer skin cells to put the patient's blood chemistry within signal range of a patch-borne biosensor. The sensor collects one reading per minute and sends the data wirelessly to a remote monitor, triggering audible alarms when levels go out of the patient's optimal range and tracking glucose levels over time.
The Symphony tCGM biosensor from Echo Therapeutics. Image: EchoTX.com
The Telemedicine System from InTouch Technologies. Image: InTouchHealth.com
A pillar of health reform is improving access to the best health care for more people. Technology is a cost-effective and increasingly potent means to connect clinics in the vast and medically underserved rural regions of the United States with big city medical centers and their specialists. Telemedicine is well established as a tool for triage and assessment in emergencies, but new medical robots go one step further—they can now patrol hospital hallways on more routine rounds, checking on patients in different rooms and managing their individual charts and vital signs without direct human intervention. The RP-VITA Remote Presence Robot produced jointly by iRobot Corp. and InTouch Health is the first such autonomous navigation remote-presence robot to receive FDA clearance for hospital use. The device is a mobile cart with a two-way video screen and medical monitoring equipment, programmed to maneuver through the busy halls of a hospital.
The Sapien transcatheter aortic valve is a life-saving alternative to open-heart surgery for patients who need new a new valve but can't endure the rigors of the operation. Manufactured by Edwards Life Sciences (Irvine, CA), the Sapien has been available in Europe for some time but is only now finding its first use in U.S. heart centers—where it is limited only to the frailest patients thus far. The Sapien valve is guided through the femoral artery by catheter from a small incision near the grown or rib cage. The valve material is made of bovine tissue attached to a stainless-steel stent, which is expanded by inflating a small balloon when correctly placed in the valve space. A simpler procedure that promises dramatically shorter hospitalizations is bound to have a positive effect on the cost of care.
The Sapien transcatheter aortic valve from Edwards Lifesciences. Image: Edwards.com
Michael MacRae is an independent writer.
At Mobility Designed we believe the status quo is not good enough. We believe you can have a better quality of life through improved mobility, and our mission is to create mobility devices that provide a painless experience and are made to fit you.
If you work in the tech industry, it’s easy to forget that older people exist.Most tech workers are really young, so it’s easy to see why most technology is designed for young people. But consider this: By 2030, around19% of people in the US will be over 65.Doesn’t sound like a lot? Well it happens to be about the same number of people in the US who own an iPhone today. Which of these two groups do you think Silicon Valley spends more time thinking about?
This seems unfortunate when you consider all of the things technology has to offer older people. A great example isSpeaking Exchange, an initiative that connects retirees in the US with kids who are learning English in Brazil. Check out the video below, but beware — it’s a tear-jerker.
CNA – Speaking Exchange（watch the video onYoutTube）
While the ageing process is different for everyone, we all go through some fundamental changes. Not all of them are what you’d expect. For example, despite declining health, older people tend to besignificantly happier and better atappreciating what they have.
But ageing makes some things harder as well, and one of those things is using technology. If you’re designing technology for older people, below are seven key things you need to know.
(How old is old? It depends. While I’ve deliberately avoided trying to define such an amorphous group using chronological boundaries, it’s safe to assume that each of the following issues becomes increasingly significant after 65 years of age.)
From the age of about 40, the lens of the eye begins to harden, causing a condition called “presbyopia.” This is a normal part of ageing that makes it increasingly difficult to read text that is small and close.
Color vision also declines with age, and we become worse at distinguishing between similar colors. In particular, shades of blue appear to be faded or desaturated.
Hearing also declines in predictable ways, and a large proportion of people over 65 havesome form of hearing loss. While audio is seldom fundamental to interaction with a product, there are obvious implications for certain types of content.
Our motor skills decline with age, which makes it harder to use computers in various ways. For example, during some user testing at a retirement village, we saw an 80-year-old who always uses the mouse with two hands. Like many older people, she had a lot of trouble hitting interface targets and moving from one thing to the next.
In the general population, a mouse is more accurate than a finger. But in our user testing, we’ve seen older people perform better using touch interfaces. This is consistent with research that shows that finger tapping declines later than some other motor skills.
If you want to predict the future, just look at what middle-class American teens are doing. Right now, they’re using their mobile phones for everything.
It’s safe to assume Dustin has never watched a 75-year-old use a mobile phone. Eventually, changes in vision and motor control make small screens impractical for everyone. Smartphones are a young person’s tool, and not even the coolest teenager can escape their biological destiny.
In our research, older people consistently described phones as “annoying” and “fiddly.” Those who own them seldom use them, often not touching them for days at a time. They often ignore SMS’ entirely.
Examples of technology used by the elderly (Image: Navy Design）（View large version）But older people aren’t afraid to try new technology when they see a clear benefit. For example, older people are the largest users of tablets. This makes sense when you consider the defining difference between a tablet and a phone: screen size. The recent slump in tablet sales also makes sense if you accept that older people have longer upgrade cycles than younger people.
Older people have different relationships than young people, at least partly because they’ve had more time to cultivate them. For example, we conducted some research into how older people interact with health care professionals. In many cases, they’ve seen the same doctors for decades, leading to a very high degree of trust.
I regard it like going to see old pals.… I feel I could tell my GP almost anything.
– George, 73, on visiting his medical team
But due to health and mobility issues, the world available to the elderly is often smaller — both physically and socially. Digital technology has an obvious role to play here, by connecting people virtually when being in the same room is hard.
During a user testing session, I sat with a 66-year-old as she signed up for an Apple ID. She was asked to complete a series of security questions. She read the first question out loud. “What was the model of your first car?” She laughed. “I have no idea! What car did I have in 1968? What a stupid question!”
It’s natural for a 30-year-old programmer to assume that this question has meaning for everyone, but it contains an implicit assumption about which life stage the user is at. Don’t make the same mistake in your design.
I once sat with a man in his 80s as he used a library interface. “I know there are things down there that I want to read” he said, gesturing to the bottom of the screen, “but I can’t figure out how to get to them.” After I taught him how to use a scrollbar, his experience changed completely. In another session, two of the older participants told me that they’d never used a search field before.
Generally when you’re designing interfaces, you’re working within a certain kind of scaffolding. And it’s easy to assume that everyone knows how that scaffolding works. But people who didn’t grow up with computers might have never used the interface elements we take for granted. Is a scrollbar a good design for moving content up and down? Is its function self-evident? These aren’t questions most designers often ask. But the success of your design might depend on a thousand parts of the interface that you can’t control and probably aren’t even aware of.
The science of cognition is a huge topic, and ageing changes how we think in unpredictable ways. Some people are razor-sharp in their 80s, while others decline as early as in their 60s.
Despite this variability, three areas are particularly relevant to designing for the elderly: memory, attention and decision-making. (For a more comprehensive view of cognitive change with age, chapter 1 of Brain Aging: Models, Methods, and Mechanisms is a great place to start.)
There are different kinds of memory, and they’re affected differently by the ageing process. For example, procedural memory (that is, remembering how to do things) is generally unaffected. People of all ages are able to learn new skills and reproduce them over time.
But other types of memory suffer as we age. Short-term memory and episodicmemory are particularly vulnerable. And, although the causes are unclear, older people often have difficulty manipulating the contents of their working memory.This means that they may have trouble understanding how to combine complex new concepts in a product or interface.
Prospective memory (remembering to do something in the future) also suffers. This is particularly relevant for habitual tasks, like remembering to take medication at the right time every day.
How do people manage this decline? In our research, we’ve found that paper is king. Older people almost exclusively use calendars and diaries to supplement their memory. But well-designed technology has great potential to provide cues for these important actions.
It’s easy to view ageing as a decline, but it’s not all bad news. In our research, we’ve observed one big advantage: Elderly people consistently excel in attention span, persistence and thoroughness. Jakob Nielsen has observed similar things, finding that 95% of seniors are “methodical” in their behaviors. This is significant in a world where the average person’s attention span has actually dropped below the level of a goldfish./p>
It can be a great feeling to watch an older user really take the time to explore your design during a testing session. And it means that older people often find things that younger people skip right over. I often find myself admiring this way of interacting with the world. But the obvious downside of a slower pace is increased time to complete tasks.
Older people are also less adept at dividing their attention between multiple tasks. In a world obsessed with multitasking, this can seem like a handicap. But because multi-tasking is probably a bad idea the first place, designing products that help people to focus on one thing at a time can have benefits for all age groups.
Young people tend to weigh a lot of options before settling on one. Older people make decisions a bit differently. They tend to emphasize prior knowledge （(perhaps because they’ve had more time to accumulate it). And they give more weight to the opinions of experts (for example, their doctor for medical decisions).
The exact reason for this is unclear, but it may be due to other cognitive limitations that make comparing new options more difficult.
A lot of people in the tech industry talk about “changing the world” and “making people’s lives better.” But bad design is excluding whole sections of the population from the benefits of technology. If you’re a designer, you can help change that. By following some simple principles, you can create more inclusive products that work better for everyone, especially the people who need them the most.
Payment for this article was donated to Alzheimer’s Australia.
The American Association of Clinical Endocrinologists and the American College of Endocrinology have updated their 2013 algorithm for managing patients with type 2 diabetes. Available free of charge at the link below, the new algorithm advocates for glycemic control, offers recommendations for blood pressure and lipid targets, and emphasizes obesity and prediabetes as risk factors for diabetes and related complications.
In addition, the document includes a new section on lifestyle optimization (emphasizing diet, exercise, adequate sleep, smoking cessation, and behavioral support) as an adjunct to medical therapy, and it reviews all classes of FDA-approved obesity, antihyperglycemic, lipid-lowering, and antihypertensive medications.
A cash-only, house call practice enabled this physician to earn more while spending less.
Fam Pract Manag. 2006 Feb;13(2):67-68.
Two years ago I traded my salaried position in a traditional practice – with an office, exam rooms, staff, multiple health plan contracts, fringe benefits, not to mention a regular paycheck – for a cash-only, house call practice that relies mostly on a car, a doctor's bag, paper charts, a simple fee structure and cash, which I collect at the time of service.
I'm earning less per year than I did in salaried practice (because I work fewer hours now), but my hourly income is much higher – about $150 to $200 before expenses. My overhead was as high as 30 percent during my startup year, but it continues to decline. My patient visits have increased 18 percent in my second year, and I expect this to continue. Here's how my practice works.
I arrive at the patient's home carrying a solar-powered portable scale and a medical bag with the essentials: blood pressure cuffs of all sizes, stethoscope, otoscope, ophthalmoscope, thermometer, pulse oximeter, folding ruler, gloves, reflex hammer, tape measure, chart forms and personal digital assistant, which I use to access medical reference material electronically. Should I need them, an EKG machine, mobile lab, nebulizer, halogen light source and an assortment of drug samples are in the trunk of my car. With these tools, I can do 95 percent of what I used to do in an office setting for about 30 percent of the overhead, and I don't have to hurry through the visit. My patients and I sit comfortably in the living room or share tea at the kitchen table during the visit. The medical office creates many physical and emotional barriers between doctors and patients; the house call removes them.
My practice is low volume by design, and this allows me to provide better service than what I could offer in traditional office practice – with its high overhead, declining reimbursement and increasing productivity demands – and it attracts new patients to my practice. I offer same-day service and aim to do today's work today. Imagine a patient's reaction when you answer the phone and say, “I can be there within the hour.” I give patients my cell phone number so they can reach me easily. They respect my time and call me only when appropriate. I open my own mail and check the fax machine myself, and I call patients with their test results as soon as I receive them. I call every patient I have seen in the last 24 to 48 hours to see how he or she is feeling. Patients are delighted by this attention. I also offer online consultations for established patients, for a fee. This is a great way to help patients with diabetes, hypertension and high cholesterol to manage their health between visits.
The financial success of a cash-based house call practice hinges on having low overhead. I deliver care for a fraction of the cost of a traditional medical office, and I share the savings with the patient in the form of lower fees.
A budget of $5,000 will cover start-up expenses, including the basic equipment mentioned earlier and the fee you'd pay a practice management consultant, if you hire one. I elected to use paper records, but the house call model is ideal for using electronic medical records. Ongoing expenses include cell phone, fax line, Internet access, auto maintenance, license renewal fees and malpractice insurance, if you carry it. I don't. Malpractice insurance is especially high in my state, and my risk is relatively low because I have a low-volume practice, do ambulatory care only and actively follow up on my patients. So my “insurance” consists of a risk-reduction plan, asset protection and a commitment to making the visit a good experience for the patient.
I developed my fee schedule with my expenses in mind, as well as the fees charged by area practices, the number of hours per day I'd be able to see patients and the amount of time needed for a typical level-III visit in the home setting. I charge a flat fee for visits lasting up to 30 minutes. During business hours, this is $100 for a new patient or an established patient with a new problem. I have different fees for evening, weekend and holiday visits, as well as phone and online consultations.
I collect fees at the time of service, offering family discounts or waiving fees when I feel it's appropriate. I don't accept credit cards for home visits, but online consultations are paid this way. I bill patients for telephone consultations. I supply insured patients with a completed 1500 form that they can submit to their insurer for reimbursement. I opted out of Medicare, so I see Medicare beneficiaries under the terms of a private contract that prohibits submitting any charges to Medicare.
Because I am the only employee of the practice, I am a sole proprietor. This means I can use my Social Security number for reporting income to the IRS. There is no corporation to set up – another expense I was able to avoid.
The key to attracting patients to my new practice is to show them why they should choose me as their doctor. Here are some strategies:
Send a letter to existing patients and to colleagues that explains what you are doing and why. Describe your unique service – same-day service in their home or office. Explain your policy concerning insurance and how you will help them by supplying the necessary form for reimbursement.
Offer to write an article for your local newspaper about a new way to deliver high-quality health care, and mention your practice.
Offer to speak on a local TV news show and at community events.
The best way by far to promote your practice is through happy patients, and you will have them. At the end of my first visit with new patients, I surprise them with a T-shirt that reads “Dr. Brand – House calls on LBK!” [Longboat Key]. Visits with established patients usually start with the patient saying, “Thank you for coming,” and they often end with a hug.
In more than two years, I have never looked back. I can deliver high-quality medical care to patients in comfort and privacy at a reasonable cost to them and with a reasonable income for me. It could work for you too. Just step out of the office, leave the stress behind and ring the doorbell.
Older individuals face many challenges as their bodies age, but one of the biggest challenges at hand for aged adults has to do with their minds: cognitive health. Keeping the mind healthy and clicking like a well-oiled machine is a top priority for those who grow old, and researchers from the University of Texas at Dallas have addressed the issue firsthand, claiming that by taking up a mental challenge like quilting or digital photography can help maintain brain health in older individuals.
The team of researchers, led by Ian McDonough, performed a study that found that tasks that involve a sustained mental effort or challenge can promote positive cognitive function, the underlying mechanism of which has been previously misunderstood, according to a news release. Evidence has shown that many enriching activities and enjoyable lifestyle tasks are associated with mental vitality.
"The present findings provide some of the first experimental evidence that mentally-challenging leisure activities can actually change brain function and that it is possible that such interventions can restore levels of brain activity to a more youth-like state," coauthor Denise Park said. "However, we would like to conduct much larger studies to determine the universality of this effect and understand who will benefit the most from such an intervention."
McDonough and Park examined the brain activity of 39 individuals before and after the experiment, and retested the participants a year later. The individuals were split into three groups, one performing high-challenge activities and one performing low-challenge activites, along with a placebo group. The high-challenge activities required learning a new skill and exertion of mental effort, whereas the low-challenge activities that did not. The participants were subject to use of fMRI to measure their brain activity.
The high-challenge group spent 14 weeks learning new skills that progressed in difficulty for 15 hours per week, in digital photography, quilting, or a combination of the two. The low-challenge group also participated for 15 hours a week, socializing and engaging in travel and cooking related subjects that yielded no learning challenge. The placebo group spent time watching classic movies, listening to music, or playing simple games.
Not only did the high-challenge group show better memory performance, but they showed a completely increased ability to modulate their brain activity to challenge word-meaning judgements in three areas of the brain - the medial frontal, lateral temporal, and parietal cortex - all of which are associated with semantic processing and attention. Even a year later, the enhanced activity was still maintained.
"The study clearly illustrates that the enhanced neural efficiency was a direct consequence of participation in a demanding learning environment," McDonough said. "The findings superficially confirm the familiar adage regarding cognitive aging of 'Use it or lose it.'"
Before participation, the individuals showed their brains performing at maximum activity levels during activities that required difficult word-meaning judgement similarly high levels during easy judgement. After participation, neural efficiency was shown to increased, as the individuals were able to modulate activity to the demands of the task at hand - meaning easy tasks required lower levels and difficult activities higher.
"Although there is much more to be learned, we are cautiously optimistic that age-related cognitive declines can be slowed or even partially restored if individuals are exposed to sustained, mentally challenging experiences," Park said.
Dementia patients admitted to hospital in England play "Russian roulette" with their health, a charity is warning. The Alzheimer's Society said it had found "shocking" evidence of poor and variable care during its review.
The report, based on Freedom of Information (FOI) requests, found problems with falls, night-time discharges and readmissions, and said standards needed to improve urgently.
The Department of Health said the disease was a key priority.
One in four hospital beds is believed to be occupied by a person with dementia.
The Alzheimer's Society called for all hospitals to publish an annual statement of dementia care, to include information on satisfaction, falls, readmissions and staff training as part of its campaign to improve standards.
The charity received responses to their FOI request from half of the 163 hospital trusts in England; however, for some of the questions the figures were based on a fifth of trusts as not all hospitals could provide answers to all the questions.
Its report showed:
The Alzheimer's Society also carried out a survey of dementia patients. It found examples of patients being treated with excessive force, not being given enough help with meals and drinks and being left in wet or soiled sheets.
Nine in 10 said hospitals were frightening and only 2% felt all staff understood the needs of people with dementia.
The charity described these findings as unacceptable and a sign that dementia patients were not getting the standard of care they should.
Alzheimer's Society chief executive Jeremy Hughes said: "In the worst cases, hospital care for people with dementia is like Russian roulette. People with dementia and their carers have no way of knowing what's going to happen to them when they are admitted.
"In many cases they are well looked after but, as our investigation shows, too often people with dementia fall and injure themselves, get discharged at night or are marooned in hospital despite their medical treatment having finished."
A Department of Health spokesman said the disease was a key priority and in recent years £50m had been spent on making hospitals and care homes more "dementia friendly", while 500,000 staff had received extra training.
"People with dementia and their carers deserve the very best support," he added.
The Avegant Glyph is not a virtual reality device. I was told this over and over during my demo of the hardware. It's a media player, designed to give you a private screen for your existing devices. It doesn't offer an experience that engulfs you. The experience of wearing the glyph is more like sitting in a dark movie theater.
The fact that reality doesn't disappear is a feature, not a bug. I was able to watch movie clips and play games from an iPhone while still seeing the room above and below my eye line. It was comfortable to interact with people around me, and they were able to speak with me without feeling like I was closed off.
The screen itself also stood well above what other products in this space are offering. I took my glasses off to use the Glyph and was able to see the screens perfectly after spending a moment or two adjusting the focus and the interpupillary distance. The screen presented a beautiful image, with deep colors and no noticeable pixels.
"The Glyph recreates natural sight —there’s no screen," the official site states. "Avegant’s patented Retinal Imaging Technology uses advanced optics and microscopic mirrors to project images directly to the eyes. It’s more like seeing than watching."
You can learn a bit more about the technology in the video above, but the important thing to know is that the Glyph offers a wonderful image. I was able to plug the hardware into a standard laptop and comfortably read even small text. The detail and clarity of the image is very striking, and there's no proprietary software needed; if your console, laptop, phone or other device can output an image using HDMI, you can use the Glyph to view it. This makes it versatile, without requiring any extra work to view your content.
The hardware will provide around four hours of video on a single charge, and the built-in headphones handle the sound. You can even flip the device up on your head after flattening the screens and use the hardware as a standard set of headphones.
I was invited to hook my own phone up to the hardware to try any game or video file I may have brought with me, and the Glyph was able to handle everything from mobile games to Fallout 4 in my demos. The screen included in the Glyph was a delight to use, and the demos of 3D films using the headset was one of the most pleasant surprises of CES.
It's a portable media player, not a VR device. But as a portable media player, the performance and quality of the sound and visuals were outstanding. I could see using the Glyph on the subway in a way that wouldn't be possible with the Gear VR due to the loss of situational awareness.
The price is a bit steep: Pre-orders are $599.99 until the 15th and then the price goes up to $699.99, but the Glyph is, in many ways, a remarkable product. In a show filled with me-too VR devices, the Glyph knows exactly what it wants to be, and based on my demo with the hardware, it lives up to its own promise.
It takes just one-tenth of a second for our brains to begin to recognize emotions conveyed by vocalizations, according to researchers from McGill. It doesn't matter whether the non-verbal sounds are growls of anger, the laughter of happiness or cries of sadness. More importantly, the researchers have also discovered that we pay more attention when an emotion (such as happiness, sadness or anger) is expressed through vocalizations than we do when the same emotion is expressed in speech.
The researchers believe that the speed with which the brain 'tags' these vocalizations and the preference given to them compared to language, is due to the potentially crucial role that decoding vocal sounds has played in human survival.
"The identification of emotional vocalizations depends on systems in the brain that are older in evolutionary terms," says Marc Pell, Director of McGill's School of Communication Sciences and Disorders and the lead author on the study that was recently published in Biological Psychology. "Understanding emotions expressed in spoken language, on the other hand, involves more recent brain systems that have evolved as human language developed."
Of nonsense speech and growls
The researchers were interested in finding out whether the brain responded differently when emotions were expressed through vocalizations (sounds such as growls, laughter or sobbing, where no words are used) or through language. They focused on three basic emotions: anger, sadness and happiness and tested 24 participants by playing a random mix of vocalizations and nonsense speech, e.g. The dirms are in the cindabal, spoken with different emotional intent. (The researchers used nonsense phrases in order to avoid any linguistic cues about emotions.) They asked participants to identify which emotions the speakers were trying to convey and used an EEG to record how quickly and in what ways the brain responded as the participants heard the different types of emotional vocal sounds.
They were able to measure:
Anger leaves longer traces—especially for those who are anxious
The researchers found that the participants were able to detect vocalizations of happiness (i.e., laughter) more quickly than vocal sounds conveying either anger or sadness. But, interestingly, they found that angry sounds and angry speech both produced ongoing brain activity that lasted longer than either of the other emotions, suggesting that the brain pays special attention to the importance of anger signals.
"Our data suggest that listeners engage in sustained monitoring of angry voices, irrespective of the form they take, to grasp the significance of potentially threatening events," says Pell.
The researchers also discovered that individuals who are more anxious have a faster and more heightened response to emotional voices in general than people who are less anxious.
"Vocalizations appear to have the advantage of conveying meaning in a more immediate way than speech," says Pell. "Our findings are consistent with studies of non-human primates which suggest that vocalizations that are specific to a species are treated preferentially by the neural system over other sounds."
LONDON — Malaria-carrying parasites in parts of Cambodia have developed resistance to a major drug used to treat the disease in South-east Asia, according to research published yesterday (Jan 7) in The Lancet Infectious Diseases journal.
The drug piperaquine, used in combination with the drug artemisinin, has been the main form of malaria treatment in Cambodia since 2008.
The combination is also one of the few treatments still effective against multi drug-resistant malaria which has emerged in South-east Asia in recent years, and which experts fear may spread to other parts of the world.
“(Treatment) failures are caused by both artemisinin and piperaquine resistance, and commonly occur in places where dihydroartemisinin-piperaquine has been used in the private sector,” researchers said.
Artemisinin resistance has been found in five countries in South-east Asia — Cambodia, Laos, Myanmar, Thailand and Vietnam.
Resistance to both artemisinin and drugs used in combination with it has developed in parts of Cambodia and Thailand.
Experts are particularly concerned that artemisinin resistance will spread to sub-Saharan Africa where about 90 per cent of malaria cases and deaths occur.
“Because few other artemisinin combination therapies are available, and because artemisinin resistance will probably accelerate resistance to any partner drug, investigations of alternative treatment approaches are urgently needed,” the researchers said.
They suggest an alternative treatment should be tested, comprising artesunate, a form of artemisinin, combined with mefloquine, a different long-acting partner drug.
“The intensive spread of artemisinin resistance in Cambodia is rapidly threatening to reduce the efficacy of all artemisinin combination therapies used in this country and in bordering areas of Vietnam, Laos, and Thailand,” the article said.
Malaria patients in areas with drug-resistant malaria should be treated in hospital, the researchers said.
“... intensified efforts are needed to discourage what appears to be a highly ineffective approach of self-treatment in the private sector.”
The research was produced by the US National Institute of Allergy and Infectious Diseases.
About 3.2 billion people — almost half the world’s population — are at risk of malaria, according to the World Health Organization. REUTERS