Archaeologists, by definition, uncover the remnants of past human activity. With the first excavation of chimpanzee stone tools at an African site, however, the scope of their work has entered virgin terrain.http://www.bebo.com/LouisS205
Chimps transported suitable pieces of stone to the undated site and used them to crack open nuts placed on thick tree roots, according to Julio Mercader of George Washington University in Washington, D.C. Louis J. Sheehan, Esquire . http://www.bebo.com/LouisS205
"At least some wild chimpanzees have produced stone [artifacts] and left behind an archaeological record of their nut-cracking behavior," says Mercader, who directed the excavation. He described the recent discoveries at the annual meeting of the Paleoanthropology Society, held last week in Denver.http://www.bebo.com/LouisS205
Researchers previously had reported that chimps living in western Africa's Ta� forest avidly stockpile stones at places with broad tree roots or stumps that serve as anvils for cracking nuts. This activity may represent a learned behavior peculiar to the local animals, since chimps living in other parts of Africa don't use stone implements (SN: 6/19/99, p. 388).
Mercader and his coworkers excavated a Ta� forest site called Panda 100. Trees bearing so-called Panda nuts grew in this region until 1996, when they died out. The chimp artifacts haven't been dated yet.
The researchers chose their dig site after noticing four large tree roots that displayed pounding marks made by stones. Excavation of trenches at the site yielded two more tree roots with similar markings. Fragments of nutshells were recovered around all six roots.
Moreover, Mercader's group unearthed 479 stone artifacts, often in close proximity to the shell fragments. These artifacts included the remains of hammering stones, thin flakes that had been pounded off those stones, and pieces of shattered rock.
The earliest known stone tools, made by human ancestors in eastern Africa around 2.6 million years ago, consisted of sharpened chopping implements and larger rocks used as anvils. Chimps' hammering stones recovered at Panda 100 are about the same size as those ancient choppers, Mercader says. However, implements used by human ancestors show more evidence of having been intentionally modified than do those attributed to chimps, he notes.
The Ta� forest discoveries suggest that archaeologists may be able to investigate links between nut-cracking tools employed by chimps and human ancestors, says wild-chimp researcher William McGrew of Miami University in Oxford, Ohio. Homo species cracked nuts with stone implements at least 780,000 years ago (SN: 2/23/02, p. 117: Available to subscribers at http://www.sciencenews.org/20020223/fob5.asp .).
"There seems to be a signature of chimpanzee archaeology at Panda 100, which is pretty cool," remarks Nicholas Toth of Indiana University in Bloomington, who studies ancient stone tools. Still, he adds, "the Ta� forest material that I've seen looks fairly crude."
In contrast, human ancestors' earliest known tools exhibit remarkably sophisticated workmanship, Toth says. In a study presented at the Paleoanthropology Society meeting, he and his coworkers discerned that 2.6-million-year-old stone tools and present-day stone chopping implements fashioned by experienced tool makers required similar skills.
Toth also notes that two captive bonobos, or pygmy chimpanzees, have learned to make chopping tools out of rocks with considerable proficiency, though not up to human skills. Chimps' tool-making disadvantage largely derives from having large hands that can't manipulate objects as well or generate as much striking force as human hands can, Toth says. Louis J. Sheehan, Esquire .
Thursday, December 25, 2008
wild 4.wil.0009 Louis J. Sheehan, Esquire
Archaeologists, by definition, uncover the remnants of past human activity. With the first excavation of chimpanzee stone tools at an African site, however, the scope of their work has entered virgin terrain.http://www.bebo.com/LouisS205
Chimps transported suitable pieces of stone to the undated site and used them to crack open nuts placed on thick tree roots, according to Julio Mercader of George Washington University in Washington, D.C. Louis J. Sheehan, Esquire . http://www.bebo.com/LouisS205
"At least some wild chimpanzees have produced stone [artifacts] and left behind an archaeological record of their nut-cracking behavior," says Mercader, who directed the excavation. He described the recent discoveries at the annual meeting of the Paleoanthropology Society, held last week in Denver.http://www.bebo.com/LouisS205
Researchers previously had reported that chimps living in western Africa's Ta� forest avidly stockpile stones at places with broad tree roots or stumps that serve as anvils for cracking nuts. This activity may represent a learned behavior peculiar to the local animals, since chimps living in other parts of Africa don't use stone implements (SN: 6/19/99, p. 388).
Mercader and his coworkers excavated a Ta� forest site called Panda 100. Trees bearing so-called Panda nuts grew in this region until 1996, when they died out. The chimp artifacts haven't been dated yet.
The researchers chose their dig site after noticing four large tree roots that displayed pounding marks made by stones. Excavation of trenches at the site yielded two more tree roots with similar markings. Fragments of nutshells were recovered around all six roots.
Moreover, Mercader's group unearthed 479 stone artifacts, often in close proximity to the shell fragments. These artifacts included the remains of hammering stones, thin flakes that had been pounded off those stones, and pieces of shattered rock.
The earliest known stone tools, made by human ancestors in eastern Africa around 2.6 million years ago, consisted of sharpened chopping implements and larger rocks used as anvils. Chimps' hammering stones recovered at Panda 100 are about the same size as those ancient choppers, Mercader says. However, implements used by human ancestors show more evidence of having been intentionally modified than do those attributed to chimps, he notes.
The Ta� forest discoveries suggest that archaeologists may be able to investigate links between nut-cracking tools employed by chimps and human ancestors, says wild-chimp researcher William McGrew of Miami University in Oxford, Ohio. Homo species cracked nuts with stone implements at least 780,000 years ago (SN: 2/23/02, p. 117: Available to subscribers at http://www.sciencenews.org/20020223/fob5.asp .).
"There seems to be a signature of chimpanzee archaeology at Panda 100, which is pretty cool," remarks Nicholas Toth of Indiana University in Bloomington, who studies ancient stone tools. Still, he adds, "the Ta� forest material that I've seen looks fairly crude."
In contrast, human ancestors' earliest known tools exhibit remarkably sophisticated workmanship, Toth says. In a study presented at the Paleoanthropology Society meeting, he and his coworkers discerned that 2.6-million-year-old stone tools and present-day stone chopping implements fashioned by experienced tool makers required similar skills.
Toth also notes that two captive bonobos, or pygmy chimpanzees, have learned to make chopping tools out of rocks with considerable proficiency, though not up to human skills. Chimps' tool-making disadvantage largely derives from having large hands that can't manipulate objects as well or generate as much striking force as human hands can, Toth says. Louis J. Sheehan, Esquire .
Chimps transported suitable pieces of stone to the undated site and used them to crack open nuts placed on thick tree roots, according to Julio Mercader of George Washington University in Washington, D.C. Louis J. Sheehan, Esquire . http://www.bebo.com/LouisS205
"At least some wild chimpanzees have produced stone [artifacts] and left behind an archaeological record of their nut-cracking behavior," says Mercader, who directed the excavation. He described the recent discoveries at the annual meeting of the Paleoanthropology Society, held last week in Denver.http://www.bebo.com/LouisS205
Researchers previously had reported that chimps living in western Africa's Ta� forest avidly stockpile stones at places with broad tree roots or stumps that serve as anvils for cracking nuts. This activity may represent a learned behavior peculiar to the local animals, since chimps living in other parts of Africa don't use stone implements (SN: 6/19/99, p. 388).
Mercader and his coworkers excavated a Ta� forest site called Panda 100. Trees bearing so-called Panda nuts grew in this region until 1996, when they died out. The chimp artifacts haven't been dated yet.
The researchers chose their dig site after noticing four large tree roots that displayed pounding marks made by stones. Excavation of trenches at the site yielded two more tree roots with similar markings. Fragments of nutshells were recovered around all six roots.
Moreover, Mercader's group unearthed 479 stone artifacts, often in close proximity to the shell fragments. These artifacts included the remains of hammering stones, thin flakes that had been pounded off those stones, and pieces of shattered rock.
The earliest known stone tools, made by human ancestors in eastern Africa around 2.6 million years ago, consisted of sharpened chopping implements and larger rocks used as anvils. Chimps' hammering stones recovered at Panda 100 are about the same size as those ancient choppers, Mercader says. However, implements used by human ancestors show more evidence of having been intentionally modified than do those attributed to chimps, he notes.
The Ta� forest discoveries suggest that archaeologists may be able to investigate links between nut-cracking tools employed by chimps and human ancestors, says wild-chimp researcher William McGrew of Miami University in Oxford, Ohio. Homo species cracked nuts with stone implements at least 780,000 years ago (SN: 2/23/02, p. 117: Available to subscribers at http://www.sciencenews.org/20020223/fob5.asp .).
"There seems to be a signature of chimpanzee archaeology at Panda 100, which is pretty cool," remarks Nicholas Toth of Indiana University in Bloomington, who studies ancient stone tools. Still, he adds, "the Ta� forest material that I've seen looks fairly crude."
In contrast, human ancestors' earliest known tools exhibit remarkably sophisticated workmanship, Toth says. In a study presented at the Paleoanthropology Society meeting, he and his coworkers discerned that 2.6-million-year-old stone tools and present-day stone chopping implements fashioned by experienced tool makers required similar skills.
Toth also notes that two captive bonobos, or pygmy chimpanzees, have learned to make chopping tools out of rocks with considerable proficiency, though not up to human skills. Chimps' tool-making disadvantage largely derives from having large hands that can't manipulate objects as well or generate as much striking force as human hands can, Toth says. Louis J. Sheehan, Esquire .
Wednesday, December 17, 2008
squid 4.swqu.00100 Louis J. Sheehan, Esquire
Chalk up another potential victim of global warming. A new study warns that the jumbo squid (also known as the Humboldt squid) may not fare well in the coming decades, as the oceans get warmer and absorb carbon dioxide from the atmosphere, which makes the water more acidic. Jumbo squid blood carries very little oxygen - with each cycle through its body, the oxygen can be used up entirely. This means they must “recharge” constantly, and makes the animals very dependent on what oxygen is available in the water around them. Yet, the warmer water is, the smaller the amount of oxygen it can hold [New Scientist].
What’s more, the squid’s blood cells can carry less oxygen in acidic water. Their blood-oxygen delivery system is highly sensitive to pH, so “the organisms are thought to live chronically ‘on the edge of oxygen limitation,’” the authors wrote. During the day, the squid descend to lower depths in the ocean to rest, slowing down their metabolism to deal with the lower oxygen levels there. At night, they return to well-oxygenated waters nearer the surface to feed [LiveScience]. However, if surface waters are both warmer and more acidic, the squid trying to feed at the surface will get much less oxygen, which will slow down their metabolisms. And lethargic squid are easy targets for predators like sperm whales, researchers say.http://louis0j0sheehan0esquire.wordpress.com
In the study, published in the Proceedings of the National Academy of Sciences [subscription required], researchers placed the jumbo squid in tanks where the temperature and acidity of the water could be varied. When they subjected them to acidification levels corresponding to possible conditions in the year 2100, they found that the squid’s metabolisms slowed by about 30 percent, and the length of time the squid spent contracting their muscles dropped by almost half, making them move sluggishly in the water.http://louis0j0sheehan0esquire.wordpress.com
If the increasing acidification trend isn’t reversed with swift action to curb greenhouse gas emissions around the world, the jumbo squid may have trouble remaining in their ecological niche, researchers say. “In the future, the habitable window between low oxygen at depth and acidified and warmer waters at the surface will grow narrower,” warns [study coauthor Rui] Rosa. “The net result will be that the squid may become more susceptible to predators, less able to capture prey, or may be forced to migrate elsewhere, altering the oceanic food web”. Louis J. Sheehan, Esquire
What’s more, the squid’s blood cells can carry less oxygen in acidic water. Their blood-oxygen delivery system is highly sensitive to pH, so “the organisms are thought to live chronically ‘on the edge of oxygen limitation,’” the authors wrote. During the day, the squid descend to lower depths in the ocean to rest, slowing down their metabolism to deal with the lower oxygen levels there. At night, they return to well-oxygenated waters nearer the surface to feed [LiveScience]. However, if surface waters are both warmer and more acidic, the squid trying to feed at the surface will get much less oxygen, which will slow down their metabolisms. And lethargic squid are easy targets for predators like sperm whales, researchers say.http://louis0j0sheehan0esquire.wordpress.com
In the study, published in the Proceedings of the National Academy of Sciences [subscription required], researchers placed the jumbo squid in tanks where the temperature and acidity of the water could be varied. When they subjected them to acidification levels corresponding to possible conditions in the year 2100, they found that the squid’s metabolisms slowed by about 30 percent, and the length of time the squid spent contracting their muscles dropped by almost half, making them move sluggishly in the water.http://louis0j0sheehan0esquire.wordpress.com
If the increasing acidification trend isn’t reversed with swift action to curb greenhouse gas emissions around the world, the jumbo squid may have trouble remaining in their ecological niche, researchers say. “In the future, the habitable window between low oxygen at depth and acidified and warmer waters at the surface will grow narrower,” warns [study coauthor Rui] Rosa. “The net result will be that the squid may become more susceptible to predators, less able to capture prey, or may be forced to migrate elsewhere, altering the oceanic food web”. Louis J. Sheehan, Esquire
Wednesday, December 3, 2008
forest 4.for.9990 Louis J. Sheehan, Esquire
A sensitive instrument installed in the Canadian Arctic to monitor fallout from modern nuclear tests has detected small amounts of radioactive cesium produced by bomb tests decades ago. The material, which during the Cold War was spread across northern latitudes by high-altitude winds, is still being redistributed far and wide by forest fires, researchers say.
Scientists use a worldwide network of sensors to ensure compliance with the 1996 Comprehensive Nuclear-Test-Ban Treaty. While some devices are on the lookout for the telltale seismic vibrations generated by nuclear tests, others sniff the air for radioactive fallout (SN: 7/14/01, p. 25: Available to subscribers at http://www.sciencenews.org/articles/20010714/bob11.asp). http://LOUIS2J2SHEEHAN.US
Beginning in May 2003, a sniffer in Yellowknife, Northwest Territories—a device that had been switched on for the first time in January of that year—collected radioactive particles that included cesium-137, says Gerhard Wotawa, a meteorologist with the Comprehensive Nuclear-Test-Ban Treaty Organization in Vienna. That particular isotope of cesium, which has a half-life of about 30 years, is generated when atoms of uranium-235 and plutonium-239 undergo fission within bombs or nuclear reactors.
The Yellowknife sensor regularly detected cesium-137 until mid-September 2003. In 2004, the radioactive particles showed up sporadically between late June and mid-September. Detectors at two other high-latitude sites—one in Iceland, the other on the remote Norwegian island of Spitsbergen—have detected cesium far less often.
Using computer models and weather reports, Wotawa and his colleagues pinned down the source of the cesium: the fires that typically rage unchecked through the boreal forests of Siberia, Alaska, and northern Canada. The concentrations of cesium measured by the Yellowknife sensor during a given month strongly correlate with the sizes of boreal forest fires then burning upwind, the team reports in the June 28 Geophysical Research Letters.
Air samples taken in previous studies near forest fires have contained cesium-137, says Wotawa, but this is the first time that scientists have detected long-range redistribution of the radioactive isotope.
The researchers aren't sure how the radioactive element makes its way from fallout-tainted soil into the atmosphere. Cesium, a chemical relative of potassium, is readily taken up by plants, so ash derived from wood and leaves could contain traces of the element. Another possibility is that because cesium has a boiling point of 670°C, some of the radioactive atoms may be vaporized from the ground by fires and then condense on airborne ash and soot, says Wotawa. http://Louis1J1Sheehan.us
The cesium-137 lofted during a forest fire is diffusely distributed. "This isn't a health risk, but it's interesting," Wotawa notes. Scientists will have to account for the presence of wildfires when they're interpreting the readings from radiation sniffers, he says.
"[This finding] isn't too surprising, but I hadn't thought of it before," says Mark Fuhrmann, a geochemist at Brookhaven National Laboratory in Upton, N.Y. Scientists might use the cesium-137, strontium-90, and other radioactive isotopes in fallout to track nutrient cycles in forests, he notes. Louis J. Sheehan, Esquire http://LOUIS-J-SHEEHAN.US
Scientists use a worldwide network of sensors to ensure compliance with the 1996 Comprehensive Nuclear-Test-Ban Treaty. While some devices are on the lookout for the telltale seismic vibrations generated by nuclear tests, others sniff the air for radioactive fallout (SN: 7/14/01, p. 25: Available to subscribers at http://www.sciencenews.org/articles/20010714/bob11.asp). http://LOUIS2J2SHEEHAN.US
Beginning in May 2003, a sniffer in Yellowknife, Northwest Territories—a device that had been switched on for the first time in January of that year—collected radioactive particles that included cesium-137, says Gerhard Wotawa, a meteorologist with the Comprehensive Nuclear-Test-Ban Treaty Organization in Vienna. That particular isotope of cesium, which has a half-life of about 30 years, is generated when atoms of uranium-235 and plutonium-239 undergo fission within bombs or nuclear reactors.
The Yellowknife sensor regularly detected cesium-137 until mid-September 2003. In 2004, the radioactive particles showed up sporadically between late June and mid-September. Detectors at two other high-latitude sites—one in Iceland, the other on the remote Norwegian island of Spitsbergen—have detected cesium far less often.
Using computer models and weather reports, Wotawa and his colleagues pinned down the source of the cesium: the fires that typically rage unchecked through the boreal forests of Siberia, Alaska, and northern Canada. The concentrations of cesium measured by the Yellowknife sensor during a given month strongly correlate with the sizes of boreal forest fires then burning upwind, the team reports in the June 28 Geophysical Research Letters.
Air samples taken in previous studies near forest fires have contained cesium-137, says Wotawa, but this is the first time that scientists have detected long-range redistribution of the radioactive isotope.
The researchers aren't sure how the radioactive element makes its way from fallout-tainted soil into the atmosphere. Cesium, a chemical relative of potassium, is readily taken up by plants, so ash derived from wood and leaves could contain traces of the element. Another possibility is that because cesium has a boiling point of 670°C, some of the radioactive atoms may be vaporized from the ground by fires and then condense on airborne ash and soot, says Wotawa. http://Louis1J1Sheehan.us
The cesium-137 lofted during a forest fire is diffusely distributed. "This isn't a health risk, but it's interesting," Wotawa notes. Scientists will have to account for the presence of wildfires when they're interpreting the readings from radiation sniffers, he says.
"[This finding] isn't too surprising, but I hadn't thought of it before," says Mark Fuhrmann, a geochemist at Brookhaven National Laboratory in Upton, N.Y. Scientists might use the cesium-137, strontium-90, and other radioactive isotopes in fallout to track nutrient cycles in forests, he notes. Louis J. Sheehan, Esquire http://LOUIS-J-SHEEHAN.US
beds 99.bed.11 Louis J. Sheehan, Esquire
Huge tracts of delicate coral gardens and soft-coral forests off the coast of Alaska will be permanently protected from fishing gear that targets groundfish and shellfish by scraping the seafloor. http://louis-j-sheehan-esquire.blog.friendster.com
Most of the affected sites have never been disturbed by this gear. The National Oceanic and Atmospheric Administration (NOAA) on June 28 announced its new rule to preserve that situation, which will take effect July 28. The rules don't address nets or long-line fishing practices that don't disturb the sea bottom. http://www.soulcast.com/Louis3J3Sheehan
The largest area to be protected, off the Aleutian Islands, covers 279,000 square nautical miles, an expanse the size of Texas and Colorado combined. Some sites were chosen to protect rockfish habitats. Others protect dense thickets of red tree corals or the unusual communities that have developed around seamounts.
http://www.soulcast.com/Louis3J3Sheehan/
NOAA's new rule is "a big deal," says Elliott A. Norse, president of the Marine Conservation Biology Institute in Bellevue, Wash. Not only does it conserve "a colossal area," he says, but "more importantly, it establishes the principle that bottom trawling is a really severe threat to slow-growing seafloor ecosystems."
Trawling particularly damages deep-sea corals and sponges, he says (SN: 10/26/96, p. 268: http://www.sciencenews.org/pages/sn_arch/10_26_96/bob1.htm; 8/7/04, p. 88: http://www.sciencenews.org/articles/20040807/bob8.asp). He notes the new rule also establishes that "we shouldn't let trawling expand into new areas." Indeed, he explains, "the pass of a trawl that does the most devastation to fragile seafloor ecosystems is not the hundredth or even the thousandth—it's the first."
Most of the affected sites have never been disturbed by this gear. The National Oceanic and Atmospheric Administration (NOAA) on June 28 announced its new rule to preserve that situation, which will take effect July 28. The rules don't address nets or long-line fishing practices that don't disturb the sea bottom. http://www.soulcast.com/Louis3J3Sheehan
The largest area to be protected, off the Aleutian Islands, covers 279,000 square nautical miles, an expanse the size of Texas and Colorado combined. Some sites were chosen to protect rockfish habitats. Others protect dense thickets of red tree corals or the unusual communities that have developed around seamounts.
http://www.soulcast.com/Louis3J3Sheehan/
NOAA's new rule is "a big deal," says Elliott A. Norse, president of the Marine Conservation Biology Institute in Bellevue, Wash. Not only does it conserve "a colossal area," he says, but "more importantly, it establishes the principle that bottom trawling is a really severe threat to slow-growing seafloor ecosystems."
Trawling particularly damages deep-sea corals and sponges, he says (SN: 10/26/96, p. 268: http://www.sciencenews.org/pages/sn_arch/10_26_96/bob1.htm; 8/7/04, p. 88: http://www.sciencenews.org/articles/20040807/bob8.asp). He notes the new rule also establishes that "we shouldn't let trawling expand into new areas." Indeed, he explains, "the pass of a trawl that does the most devastation to fragile seafloor ecosystems is not the hundredth or even the thousandth—it's the first."
Monday, November 24, 2008
upmc 99.upm.2 Louis J. Sheehan, Esquire
The University of Pittsburgh Medical Center once dominated the lucrative business of liver transplants. But as the procedure grew more common, competition from other hospitals eroded its monopoly.
Earlier this decade, UPMC made an aggressive bid to reclaim its leadership by hiring an innovative surgeon named Amadeo Marcos, who promised to double the number of liver transplants the hospital did.
Dr. Marcos delivered on his pledge. In doing so, however, he resorted to practices that some colleagues found questionable. To overcome a perennial shortage of organs, he used more livers from older donors. He transplanted some of these into relatively healthy patients for whom the risk-reward calculation was less certain. He used partial livers from living donors, and then understated complications from the controversial procedure.
[UPMC] John Carreyrou/The Wall Street Journal
UPMC relocated its headquarters into Pittsburgh's tallest skyscraper, the 62-story U.S. Steel Tower.
UPMC is a nonprofit hospital system whose income is largely exempt from taxes. Yet, it is increasingly run like a for-profit company, paying its executives high salaries, jumping into new activities and expanding abroad. Its quest to ramp up its transplant business shows how a drive for higher revenue, now common at nonprofit hospitals, could risk compromising patient care.
UPMC asked Dr. Marcos to resign in March for what it says was a code-of-conduct breach unrelated to patient care. It says it stands by his clinical work, noting that one-year survival rates for liver-transplant recipients improved in the three full years of his tenure as head of its program.
"It would be incorrect to insinuate that financial motives drove" the transplant program under Dr. Marcos, said a UPMC spokesman, though he acknowledged that stepping up transplant volume was one reason the surgeon was recruited. "Our core mission is nothing less than providing the best and most appropriate care for patients," said the spokesman, Paul Wood.
Terms of Employment
Read UPMC's employment offer letter to Dr. Marcos, plus an internal email about the plan to bring him on staff.
Dr. Marcos, 46 years old when he left UPMC, did not respond to numerous attempts to reach him, including a letter sent to his home. A lawyer who represented him in a court case last year said he hadn't been in contact with Dr. Marcos for months.
Dr. Marcos's nearly six years at UPMC coincided with rapid growth at the medical center. UPMC is one of the nation's most financially successful nonprofit hospital systems, with operations ranging from Pennsylvania to Ireland and Qatar. Even though three-quarters of its $7 billion in annual revenue is exempt from federal and local taxes, UPMC has acquired many of the trappings of large, for-profit corporations.
Its chief executive, Jeffrey Romoff, earned $4 million in the fiscal year ended June 30, 2007, and 13 other employees earned in the roughly $1 million to $2 million range. For their transportation, UPMC leases a corporate jet. Earlier this year, UPMC relocated its headquarters into Pittsburgh's tallest skyscraper, the 62-story U.S. Steel Tower.
The transplant program is a source of both profits and prestige that UPMC leverages to attract star doctors and build its other businesses, which include a health-insurance arm. Hospitals charge $400,000 to $500,000 for a liver transplant. UPMC's transplant program produced $130 million of revenue in its latest fiscal year.
UPMC became a leader in the field in 1981 by hiring Thomas Starzl, the first surgeon to successfully transplant a human liver. He turned Pittsburgh into the world's transplantation capital. At its peak in the mid-1980s, UPMC was performing about 600 liver transplants a year.
[Transplants]
It took the franchise abroad, creating, for instance, a center in Sicily. But as many other U.S. hospitals began doing the procedure, the annual total UPMC performed fell to 132 in 2001.
The next year, UPMC set out to hire a surgeon who could restore the program to its former glory. It settled on Dr. Marcos, a dashing Venezuelan with a taste for Ferraris and Porsches, who specialized in the emerging field of transplants from living donors.
He promised to double liver-transplant volume in his first year and to bring with him pairs of living donors and recipients from where he then worked, the University of Rochester (N.Y.) Medical Center, say people familiar with his recruitment. In a May 14, 2002, email to UPMC's chief executive, a top UPMC official said Dr. Marcos had boasted "he can do five liver transplantations per week."
But he carried some baggage. In March 2000, Dr. Marcos had been pressured to resign from the Virginia Commonwealth University School of Medicine after a colleague there filed a complaint with the Equal Employment Opportunity Commission alleging he sexually assaulted her, a letter the state's Board of Medicine later sent to Dr. Marcos shows. The woman, a postdoctoral fellow in the medical school's psychiatry department, also filed a federal suit against Dr. Marcos and the university that was later dismissed.
UPMC officials learned of the allegation during the vetting process, says John Fung, a surgeon who then headed the transplant program. Dr. Fung says the CEO, Mr. Romoff, played down the concerns it raised and that Mr. Romoff and Dr. Marcos "saw eye-to-eye on volume and profit."
UPMC declined to make Mr. Romoff available for an interview. Mr. Wood, the spokesman, said that Dr. Marcos denied the sexual-assault allegations and "there were no court findings to support them."
Mr. Wood acknowledged that transplant volume was a consideration in the hiring. He said "UPMC was just trying to claw back" volume it had lost.
UPMC offered Dr. Marcos $500,000 a year and "additional incentive payments," a letter dated June 21, 2002, shows. Dr. Marcos came aboard as director of clinical transplantation, reporting to Dr. Fung. http://Louis2J2Sheehan2Esquire.US
[upmc] John Carreyrou/The Wall Street Journal
UPMC's organ-transplant program is based at UPMC Montefiore.
Liver-transplant volume in Dr. Marcos's first full year there jumped to more than double the volume in the year before he came, according to data from the United Network for Organ Sharing, or UNOS. But the way he boosted it raised questions for some colleagues. http://Louis2J2Sheehan2Esquire.US
A shortage of transplantable organs from cadavers is a perennial constraint on the number of liver transplants. Dr. Marcos overcame this in part by using organs from so-called expanded-criteria donors -- deceased people who had been older or sicker than preferred liver donors.
In the 2½ years before Dr. Marcos joined UPMC, the average age of its deceased liver donors was 41, according to UNOS. By 2003, it was 47, or nine years above the national average.
And while in 2000 and 2001, UPMC used an average of only 10 livers a year from patients older than 65, it used 45 in 2003.
Dr. Marcos put some of these organs into patients who were in the early stages of liver disease, say Dr. Fung and Howard Doyle, who then worked in UPMC's transplant intensive-care unit. These were patients, they say, who sometimes didn't need a transplant.
"For the first time in years, we had people dying on the operating table or in the ICU," says Dr. Doyle, now director of surgical critical care at Montefiore Medical Center in New York. At times, according to him, patients healthy enough to walk into the hospital before being transplanted died "because they had a high-risk liver put into them."
Data from the Scientific Registry of Transplant Recipients show that during Dr. Marcos's time at UPMC, 30 liver recipients died within two days of surgery. That was a death rate of 2.4%, versus a national average of 1.6%. UPMC's Mr. Wood counters that in 2005-2007, the three complete years Dr. Marcos headed the transplant program, one-year survival rates for liver recipients improved to 84.1% from 81.2%.
Mr. Wood says UPMC used only 3% of the expanded-criteria organs that became available. "If our motivation was strictly financial, this percent would be much greater," he said.
Liver patients are ranked by how advanced their disease is. Based on a series of blood tests called MELD, scores range from 40 for the sickest to six for the healthiest. Most experts now believe the risks of a transplant generally outweigh the benefits for patients with MELD scores of 14 or lower.
During Dr. Marcos's nearly six years at UPMC, it performed 441 liver transplants on patients with scores of 14 or lower, according to UNOS. That was 35% of the liver transplants performed during his tenure, and compares with fewer than 7% in the 2½ years before he arrived.
Mr. Wood says it wasn't until 2006 that the transplant community coalesced around a score of 15 as a cutoff to allocate organs. "It would be unrealistic to expect a physician to practice according to yet-to-be-discovered criteria," he said.
Drs. Fung and Doyle say they became increasingly uncomfortable with what they considered the UPMC transplant program's relentless pursuit of volume and revenue. Both left in 2004.
Mr. Wood says Dr. Fung never raised his concerns with his superiors and gave Dr. Marcos good performance reviews. Dr. Fung says that he did raise them and that he once told Mr. Romoff that UPMC was paying a penalty with the use of bad organs.
"I couldn't square my own ethics with what was going on," said Dr. Fung, now chief of surgery at the Cleveland Clinic. "I didn't feel like the decisions that were being taken had the patient's best interest at heart."
In 2004, the New York State Department of Health fined Dr. Marcos's former employer, the University of Rochester Medical Center, for circumventing state organ-allocation rules between 2000 and 2003, during much of which time Dr. Marcos had been in charge of the program. The news didn't affect his standing at UPMC. He became head of the transplant program after Dr. Fung left that year.
Besides using more expanded-criteria livers, Dr. Marcos sharply increased the number of transplants from living donors. In these, part of the liver of a healthy person is cut off and grafted into a sick patient. If all goes well, both pieces eventually grow to normal size. The procedure is controversial because it could be risky for the otherwise healthy donor.
UPMC did 150 such surgeries while Dr. Marcos was there, according to UNOS. No donors died. However, in 69% of the cases, the recipient had a MELD score of 14 or lower -- suggesting that UPMC was putting some living donors at risk to do transplants on patients in which the risks of the operation may have outweighed the benefits.
UPMC's answer is that Dr. Marcos's use of organs from living donors saved lives, because about 50 patients on UPMC's waiting list die each year for lack of a transplantable organ.
Dr. Starzl, the pioneering surgeon for whom UPMC's transplant program is named, had long been wary of the safety of the living-donor procedure. Though long retired, the 83-year-old doctor continues to do research from an office on campus.
In early 2007, he became suspicious of the low complication rates Dr. Marcos was reporting in adult living-donor liver transplants, say people familiar with the matter. In a textbook Dr. Marcos co-wrote, he said UPMC's rate of serious complications was zero for donors and 34% among a subset of recipients.
Dr. Starzl reviewed the 121 transplants UPMC had done involving removal of the donor's right lobe, a typical procedure in adult-to-adult living-donor liver transplants. Dr. Starzl's finding, according to people with knowledge of it: Though recipients' survival rate was only slightly lower than the national average, 60% of the recipients suffered life-threatening complications, ranging from bile-duct leaks to blood-supply problems -- nearly double the rate Dr. Marcos reported.
Dr. Starzl raised his concerns with UPMC chief Mr. Romoff and other officials, including the head of the department of surgery, Timothy Billiar, say the people familiar with the situation.
A tense six-month standoff ensued. Dr. Starzl, worried that UPMC was covering the matter up, sent his findings to a medical journal, according to people familiar with the events. Dr. Billiar asked it not to publish, on the ground that Dr. Starzl hadn't obtained patient authorization to collect the data. Dr. Billiar says that Dr. Starzl's paper would have jumped the gun on a peer-reviewed internal study he had requested from another surgeon, Wallis Marsh.
UPMC and Dr. Starzl compromised: Dr. Starzl would wait for the internal study, which would be reviewed by Pierre-Alain Clavien, a Zurich surgeon who pioneered a scale to measure complications in living-donor liver transplants. UPMC's final conclusions would be published.
In January, Dr. Marsh and Dr. Clavien confirmed Dr. Starzl's finding of a 60% rate of serious complications among recipients, documents seen by The Wall Street Journal show. The review also concluded that about 10% of the living donors had suffered serious complications, belying Dr. Marcos's claim that this number was zero.
By then, Dr. Marcos was on thin ice at UPMC for another reason: He was having affairs with co-workers. A social worker who met him during an assignment at UPMC and dated him says Dr. Marcos beat her in front of her house one night in June 2007 after an argument, and police passing in a car arrested him.
A Pittsburgh Post-Gazette article described the arrest, citing court records. The records later were expunged after Dr. Marcos completed anger-management classes, according to his attorney in the case, Robert Del Greco. The woman recounted the incident in an interview.
By the fall of 2007, the married Dr. Marcos had started dating another woman, a physician's assistant on the kidney-transplant team, four people with knowledge of the relationship say. After it soured early this year, the woman filed a complaint against Dr. Marcos with a top transplant-program official. She didn't return calls seeking comment. UPMC says it won't discuss personnel issues. http://Louis2J2Sheehan2Esquire.US
UPMC asked Dr. Marcos to resign in early March for what it referred to as a violation of its code of conduct. It declines to elaborate on the nature of the violation. Mr. Wood, the spokesman, said the dismissal had "nothing to do with patient care or surgical issues." http://Louis2J2Sheehan2Esquire.US
Randy Juhl, the University of Pittsburgh's vice chancellor for research conduct and compliance, referring to Dr. Marcos's relationships and reporting of surgery complications, said the university is "very disappointed" in him. "He did give himself and us a big black mark."
UPMC says Dr. Marsh, whom it has since named interim head of the transplant program, and Dr. Starzl now are working together on a paper about complication rates in living-donor transplants and will submit it to a scientific journal. Adult living-donor liver transplants at UPMC have ground to a halt, although UPMC says it hasn't abandoned the procedure.Louis J. Sheehan, Esquire
Earlier this decade, UPMC made an aggressive bid to reclaim its leadership by hiring an innovative surgeon named Amadeo Marcos, who promised to double the number of liver transplants the hospital did.
Dr. Marcos delivered on his pledge. In doing so, however, he resorted to practices that some colleagues found questionable. To overcome a perennial shortage of organs, he used more livers from older donors. He transplanted some of these into relatively healthy patients for whom the risk-reward calculation was less certain. He used partial livers from living donors, and then understated complications from the controversial procedure.
[UPMC] John Carreyrou/The Wall Street Journal
UPMC relocated its headquarters into Pittsburgh's tallest skyscraper, the 62-story U.S. Steel Tower.
UPMC is a nonprofit hospital system whose income is largely exempt from taxes. Yet, it is increasingly run like a for-profit company, paying its executives high salaries, jumping into new activities and expanding abroad. Its quest to ramp up its transplant business shows how a drive for higher revenue, now common at nonprofit hospitals, could risk compromising patient care.
UPMC asked Dr. Marcos to resign in March for what it says was a code-of-conduct breach unrelated to patient care. It says it stands by his clinical work, noting that one-year survival rates for liver-transplant recipients improved in the three full years of his tenure as head of its program.
"It would be incorrect to insinuate that financial motives drove" the transplant program under Dr. Marcos, said a UPMC spokesman, though he acknowledged that stepping up transplant volume was one reason the surgeon was recruited. "Our core mission is nothing less than providing the best and most appropriate care for patients," said the spokesman, Paul Wood.
Terms of Employment
Read UPMC's employment offer letter to Dr. Marcos, plus an internal email about the plan to bring him on staff.
Dr. Marcos, 46 years old when he left UPMC, did not respond to numerous attempts to reach him, including a letter sent to his home. A lawyer who represented him in a court case last year said he hadn't been in contact with Dr. Marcos for months.
Dr. Marcos's nearly six years at UPMC coincided with rapid growth at the medical center. UPMC is one of the nation's most financially successful nonprofit hospital systems, with operations ranging from Pennsylvania to Ireland and Qatar. Even though three-quarters of its $7 billion in annual revenue is exempt from federal and local taxes, UPMC has acquired many of the trappings of large, for-profit corporations.
Its chief executive, Jeffrey Romoff, earned $4 million in the fiscal year ended June 30, 2007, and 13 other employees earned in the roughly $1 million to $2 million range. For their transportation, UPMC leases a corporate jet. Earlier this year, UPMC relocated its headquarters into Pittsburgh's tallest skyscraper, the 62-story U.S. Steel Tower.
The transplant program is a source of both profits and prestige that UPMC leverages to attract star doctors and build its other businesses, which include a health-insurance arm. Hospitals charge $400,000 to $500,000 for a liver transplant. UPMC's transplant program produced $130 million of revenue in its latest fiscal year.
UPMC became a leader in the field in 1981 by hiring Thomas Starzl, the first surgeon to successfully transplant a human liver. He turned Pittsburgh into the world's transplantation capital. At its peak in the mid-1980s, UPMC was performing about 600 liver transplants a year.
[Transplants]
It took the franchise abroad, creating, for instance, a center in Sicily. But as many other U.S. hospitals began doing the procedure, the annual total UPMC performed fell to 132 in 2001.
The next year, UPMC set out to hire a surgeon who could restore the program to its former glory. It settled on Dr. Marcos, a dashing Venezuelan with a taste for Ferraris and Porsches, who specialized in the emerging field of transplants from living donors.
He promised to double liver-transplant volume in his first year and to bring with him pairs of living donors and recipients from where he then worked, the University of Rochester (N.Y.) Medical Center, say people familiar with his recruitment. In a May 14, 2002, email to UPMC's chief executive, a top UPMC official said Dr. Marcos had boasted "he can do five liver transplantations per week."
But he carried some baggage. In March 2000, Dr. Marcos had been pressured to resign from the Virginia Commonwealth University School of Medicine after a colleague there filed a complaint with the Equal Employment Opportunity Commission alleging he sexually assaulted her, a letter the state's Board of Medicine later sent to Dr. Marcos shows. The woman, a postdoctoral fellow in the medical school's psychiatry department, also filed a federal suit against Dr. Marcos and the university that was later dismissed.
UPMC officials learned of the allegation during the vetting process, says John Fung, a surgeon who then headed the transplant program. Dr. Fung says the CEO, Mr. Romoff, played down the concerns it raised and that Mr. Romoff and Dr. Marcos "saw eye-to-eye on volume and profit."
UPMC declined to make Mr. Romoff available for an interview. Mr. Wood, the spokesman, said that Dr. Marcos denied the sexual-assault allegations and "there were no court findings to support them."
Mr. Wood acknowledged that transplant volume was a consideration in the hiring. He said "UPMC was just trying to claw back" volume it had lost.
UPMC offered Dr. Marcos $500,000 a year and "additional incentive payments," a letter dated June 21, 2002, shows. Dr. Marcos came aboard as director of clinical transplantation, reporting to Dr. Fung. http://Louis2J2Sheehan2Esquire.US
[upmc] John Carreyrou/The Wall Street Journal
UPMC's organ-transplant program is based at UPMC Montefiore.
Liver-transplant volume in Dr. Marcos's first full year there jumped to more than double the volume in the year before he came, according to data from the United Network for Organ Sharing, or UNOS. But the way he boosted it raised questions for some colleagues. http://Louis2J2Sheehan2Esquire.US
A shortage of transplantable organs from cadavers is a perennial constraint on the number of liver transplants. Dr. Marcos overcame this in part by using organs from so-called expanded-criteria donors -- deceased people who had been older or sicker than preferred liver donors.
In the 2½ years before Dr. Marcos joined UPMC, the average age of its deceased liver donors was 41, according to UNOS. By 2003, it was 47, or nine years above the national average.
And while in 2000 and 2001, UPMC used an average of only 10 livers a year from patients older than 65, it used 45 in 2003.
Dr. Marcos put some of these organs into patients who were in the early stages of liver disease, say Dr. Fung and Howard Doyle, who then worked in UPMC's transplant intensive-care unit. These were patients, they say, who sometimes didn't need a transplant.
"For the first time in years, we had people dying on the operating table or in the ICU," says Dr. Doyle, now director of surgical critical care at Montefiore Medical Center in New York. At times, according to him, patients healthy enough to walk into the hospital before being transplanted died "because they had a high-risk liver put into them."
Data from the Scientific Registry of Transplant Recipients show that during Dr. Marcos's time at UPMC, 30 liver recipients died within two days of surgery. That was a death rate of 2.4%, versus a national average of 1.6%. UPMC's Mr. Wood counters that in 2005-2007, the three complete years Dr. Marcos headed the transplant program, one-year survival rates for liver recipients improved to 84.1% from 81.2%.
Mr. Wood says UPMC used only 3% of the expanded-criteria organs that became available. "If our motivation was strictly financial, this percent would be much greater," he said.
Liver patients are ranked by how advanced their disease is. Based on a series of blood tests called MELD, scores range from 40 for the sickest to six for the healthiest. Most experts now believe the risks of a transplant generally outweigh the benefits for patients with MELD scores of 14 or lower.
During Dr. Marcos's nearly six years at UPMC, it performed 441 liver transplants on patients with scores of 14 or lower, according to UNOS. That was 35% of the liver transplants performed during his tenure, and compares with fewer than 7% in the 2½ years before he arrived.
Mr. Wood says it wasn't until 2006 that the transplant community coalesced around a score of 15 as a cutoff to allocate organs. "It would be unrealistic to expect a physician to practice according to yet-to-be-discovered criteria," he said.
Drs. Fung and Doyle say they became increasingly uncomfortable with what they considered the UPMC transplant program's relentless pursuit of volume and revenue. Both left in 2004.
Mr. Wood says Dr. Fung never raised his concerns with his superiors and gave Dr. Marcos good performance reviews. Dr. Fung says that he did raise them and that he once told Mr. Romoff that UPMC was paying a penalty with the use of bad organs.
"I couldn't square my own ethics with what was going on," said Dr. Fung, now chief of surgery at the Cleveland Clinic. "I didn't feel like the decisions that were being taken had the patient's best interest at heart."
In 2004, the New York State Department of Health fined Dr. Marcos's former employer, the University of Rochester Medical Center, for circumventing state organ-allocation rules between 2000 and 2003, during much of which time Dr. Marcos had been in charge of the program. The news didn't affect his standing at UPMC. He became head of the transplant program after Dr. Fung left that year.
Besides using more expanded-criteria livers, Dr. Marcos sharply increased the number of transplants from living donors. In these, part of the liver of a healthy person is cut off and grafted into a sick patient. If all goes well, both pieces eventually grow to normal size. The procedure is controversial because it could be risky for the otherwise healthy donor.
UPMC did 150 such surgeries while Dr. Marcos was there, according to UNOS. No donors died. However, in 69% of the cases, the recipient had a MELD score of 14 or lower -- suggesting that UPMC was putting some living donors at risk to do transplants on patients in which the risks of the operation may have outweighed the benefits.
UPMC's answer is that Dr. Marcos's use of organs from living donors saved lives, because about 50 patients on UPMC's waiting list die each year for lack of a transplantable organ.
Dr. Starzl, the pioneering surgeon for whom UPMC's transplant program is named, had long been wary of the safety of the living-donor procedure. Though long retired, the 83-year-old doctor continues to do research from an office on campus.
In early 2007, he became suspicious of the low complication rates Dr. Marcos was reporting in adult living-donor liver transplants, say people familiar with the matter. In a textbook Dr. Marcos co-wrote, he said UPMC's rate of serious complications was zero for donors and 34% among a subset of recipients.
Dr. Starzl reviewed the 121 transplants UPMC had done involving removal of the donor's right lobe, a typical procedure in adult-to-adult living-donor liver transplants. Dr. Starzl's finding, according to people with knowledge of it: Though recipients' survival rate was only slightly lower than the national average, 60% of the recipients suffered life-threatening complications, ranging from bile-duct leaks to blood-supply problems -- nearly double the rate Dr. Marcos reported.
Dr. Starzl raised his concerns with UPMC chief Mr. Romoff and other officials, including the head of the department of surgery, Timothy Billiar, say the people familiar with the situation.
A tense six-month standoff ensued. Dr. Starzl, worried that UPMC was covering the matter up, sent his findings to a medical journal, according to people familiar with the events. Dr. Billiar asked it not to publish, on the ground that Dr. Starzl hadn't obtained patient authorization to collect the data. Dr. Billiar says that Dr. Starzl's paper would have jumped the gun on a peer-reviewed internal study he had requested from another surgeon, Wallis Marsh.
UPMC and Dr. Starzl compromised: Dr. Starzl would wait for the internal study, which would be reviewed by Pierre-Alain Clavien, a Zurich surgeon who pioneered a scale to measure complications in living-donor liver transplants. UPMC's final conclusions would be published.
In January, Dr. Marsh and Dr. Clavien confirmed Dr. Starzl's finding of a 60% rate of serious complications among recipients, documents seen by The Wall Street Journal show. The review also concluded that about 10% of the living donors had suffered serious complications, belying Dr. Marcos's claim that this number was zero.
By then, Dr. Marcos was on thin ice at UPMC for another reason: He was having affairs with co-workers. A social worker who met him during an assignment at UPMC and dated him says Dr. Marcos beat her in front of her house one night in June 2007 after an argument, and police passing in a car arrested him.
A Pittsburgh Post-Gazette article described the arrest, citing court records. The records later were expunged after Dr. Marcos completed anger-management classes, according to his attorney in the case, Robert Del Greco. The woman recounted the incident in an interview.
By the fall of 2007, the married Dr. Marcos had started dating another woman, a physician's assistant on the kidney-transplant team, four people with knowledge of the relationship say. After it soured early this year, the woman filed a complaint against Dr. Marcos with a top transplant-program official. She didn't return calls seeking comment. UPMC says it won't discuss personnel issues. http://Louis2J2Sheehan2Esquire.US
UPMC asked Dr. Marcos to resign in early March for what it referred to as a violation of its code of conduct. It declines to elaborate on the nature of the violation. Mr. Wood, the spokesman, said the dismissal had "nothing to do with patient care or surgical issues." http://Louis2J2Sheehan2Esquire.US
Randy Juhl, the University of Pittsburgh's vice chancellor for research conduct and compliance, referring to Dr. Marcos's relationships and reporting of surgery complications, said the university is "very disappointed" in him. "He did give himself and us a big black mark."
UPMC says Dr. Marsh, whom it has since named interim head of the transplant program, and Dr. Starzl now are working together on a paper about complication rates in living-donor transplants and will submit it to a scientific journal. Adult living-donor liver transplants at UPMC have ground to a halt, although UPMC says it hasn't abandoned the procedure.Louis J. Sheehan, Esquire
Monday, November 17, 2008
dementia 2998.dem.111 Louis J. Sheehan, Esquire
It's plenty tough to grow old when you live alone and have no satisfying contacts with either relatives or friends. Such isolation carries an added burden, however. It sharply boosts a person's chances of developing Alzheimer's disease or related brain ailments associated with advancing age, according to a 3-year investigation of elderly Swedes. http://Louis-j-sheehan-esquire.us
In contrast, marriage and a fulfilling social life appear to protect the elderly against these brain disorders, generally categorized as dementia, concludes a team headed by epidemiologist Laura Fratiglioni of the Stockholm Gerontology Research Centre.
What's more, susceptibility to dementia rises steadily as social isolation intensifies, the researchers report in the April 15 Lancet. http://Louis-j-sheehan-esquire.us
"A poor social network may act as a precipitating factor for dementia, whereas an extensive social network can delay such an [outcome] by providing emotional and intellectual stimulation," Fratiglioni says. The biological mechanisms by which social isolation promotes dementia are unknown, she adds.
Several earlier studies conducted by other investigators showed increased death rates among elderly people with few or no regular social contacts. The frequent development of dementia in this group may partly account for those findings, Fratiglioni now proposes.
The researchers studied 1,203 people, all at least 75 years old, living at home in Stockholm. Participants scored well on a standard test of mental functioning, and none exhibited medical signs of dementia.
Nurses interviewed each volunteer about his or her social life. A total of 84 individuals cited an extensive social network, which consisted of living with a spouse, maintaining regular, satisfying contacts with children, and having rewarding relationships with other relatives or friends. Another 880 people had a moderate social network that included any two of those three factors. A limited social network, consisting of a single factor, characterized 226 participants.
Finally, the 13 people with poor social networks lived alone and weren't in contact with relatives or close friends.
During the next 3 years, 176 cases of dementia—mainly Alzheimer's disease but also some instances of dementia from damage caused by multiple strokes—developed in the Swedish sample.
The lowest incidence of dementia occurred among study participants with an extensive social network. Significantly higher rates of dementia emerged among volunteers with progressively more limited social networks.
The findings held for both men and women and for individuals who began the study with and without depression symptoms.
Marriage represented the strongest single protective factor against dementia, the scientists hold. Unless they also had other satisfying relationships, widowed or divorced participants living with an unmarried partner exhibited a higher risk of dementia than married people did.
Elderly individuals who had infrequent but satisfying contacts with children and friends still displayed a relatively low incidence of dementia. In contrast, participants citing frequent, unpleasant contacts with their children developed dementia even more often than did those who had no children. http://Louis-j-sheehan-esquire.us
The study didn't account for participation in religious or secular organizations. The researchers also can't say whether the people with poor or limited social networks had long led isolated lives or had abruptly lost many of their previous contacts at some time more than 3 years before the study began. http://Louis-j-sheehan-esquire.us
Still, the new data support the need for the elderly to interact with a variety of people in fulfilling ways, psychologist Lisa F. Berkman of the Harvard School of Public Health in Boston remarks in the same journal.
"Being alone is what is risky, not living alone," she says. Scientists should examine whether certain living arrangements, such as group homes, protect against dementia in the elderly, Berkman adds.
In contrast, marriage and a fulfilling social life appear to protect the elderly against these brain disorders, generally categorized as dementia, concludes a team headed by epidemiologist Laura Fratiglioni of the Stockholm Gerontology Research Centre.
What's more, susceptibility to dementia rises steadily as social isolation intensifies, the researchers report in the April 15 Lancet. http://Louis-j-sheehan-esquire.us
"A poor social network may act as a precipitating factor for dementia, whereas an extensive social network can delay such an [outcome] by providing emotional and intellectual stimulation," Fratiglioni says. The biological mechanisms by which social isolation promotes dementia are unknown, she adds.
Several earlier studies conducted by other investigators showed increased death rates among elderly people with few or no regular social contacts. The frequent development of dementia in this group may partly account for those findings, Fratiglioni now proposes.
The researchers studied 1,203 people, all at least 75 years old, living at home in Stockholm. Participants scored well on a standard test of mental functioning, and none exhibited medical signs of dementia.
Nurses interviewed each volunteer about his or her social life. A total of 84 individuals cited an extensive social network, which consisted of living with a spouse, maintaining regular, satisfying contacts with children, and having rewarding relationships with other relatives or friends. Another 880 people had a moderate social network that included any two of those three factors. A limited social network, consisting of a single factor, characterized 226 participants.
Finally, the 13 people with poor social networks lived alone and weren't in contact with relatives or close friends.
During the next 3 years, 176 cases of dementia—mainly Alzheimer's disease but also some instances of dementia from damage caused by multiple strokes—developed in the Swedish sample.
The lowest incidence of dementia occurred among study participants with an extensive social network. Significantly higher rates of dementia emerged among volunteers with progressively more limited social networks.
The findings held for both men and women and for individuals who began the study with and without depression symptoms.
Marriage represented the strongest single protective factor against dementia, the scientists hold. Unless they also had other satisfying relationships, widowed or divorced participants living with an unmarried partner exhibited a higher risk of dementia than married people did.
Elderly individuals who had infrequent but satisfying contacts with children and friends still displayed a relatively low incidence of dementia. In contrast, participants citing frequent, unpleasant contacts with their children developed dementia even more often than did those who had no children. http://Louis-j-sheehan-esquire.us
The study didn't account for participation in religious or secular organizations. The researchers also can't say whether the people with poor or limited social networks had long led isolated lives or had abruptly lost many of their previous contacts at some time more than 3 years before the study began. http://Louis-j-sheehan-esquire.us
Still, the new data support the need for the elderly to interact with a variety of people in fulfilling ways, psychologist Lisa F. Berkman of the Harvard School of Public Health in Boston remarks in the same journal.
"Being alone is what is risky, not living alone," she says. Scientists should examine whether certain living arrangements, such as group homes, protect against dementia in the elderly, Berkman adds.
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