Rates of benzodiazepine (Valium) use are the highest for this group for the psychoactive drugs.
So, one can see that drug abuse problems are by no means unique to the young.
REFERENCE
Kuerbis, A., P. Sacco, D. Blazer, and A. Moore. Substance abuse among older adults. Clinics in GeriatricMedicine, vol. 30, no. 3, 2014, pp. 629–654.
27 CAN LISTENING TO CLASSICAL MUSIC MAKE US SMARTER?
A SIZABLE INDUSTRY has built up around the concept that listening to classical music will make us smarter. CDs, DVDs, and promotional materials from Baby Einstein, Baby Mozart, and Baby Beethoven multimedia musical products have grown across five continents, based on a belief that listening to classical music will make children more intelligent.
The same theory has circulated on college and university campuses over the past 20 years or so. Could it be true? Or could it be that our taste in music reveals how smart (or not smart) we are?
The term “Mozart Effect” is used to describe a theory that both children and adults can improve their IQ by listening to classical music. This has led to the trend of pregnant mothers playing sonatas to their unborn children.
Why would people believe this? The idea that music benefits the brain and results in improvement in human behaviour is not a new concept. However, a paper published in 1993 in the international science journal Nature described a group of 36 college students who had listened to a Mozart sonata scoring better in part of an IQ test compared to those students who didn’t listen to the music. The other group of students listened to a relaxation track or to nothing. The benefit lasted for 15 minutes.
An IQ test measures several areas of intellectual function. In this instance, only one area showed a short-term improvement in score. This was the skill of spatial reasoning. In layperson terms, the students did better in a task of paper folding! The improvement was 8.5 percent spatial IQ points.
It was never the intent of the author of the study to infer that paper folding equals general intelligence. Neither were the study results meant to transfer to children or fetuses. However, the cat was out of the bag, and people liked this theory and wanted to run with it.
The governor of Georgia, Zell Miller, mandated in 1998 that mothers of newborns in that state be given classical music CDs. In the state of Florida, daycares were required to pump symphonies through their sound systems.
Six years later, psychologist Christopher Chabris set about analyzing the data supporting the validity of the Mozart Effect. He looked at 16 studies related to its effectiveness, finding a benefit of 1.5 points solely related to the paper-folding task. This finding was probably due to chance alone.
The Ministry of Education and Research in Germany then published a second review done by “musically inclined scientists” and declared the phenomenon non-existent.
It seems that Frances Rauscher, the psychologist who published the original study, was horrified by the runaway response to her article. She does, however, still advocate piano lessons for pre-schoolers to raise their intelligence.
REFERENCES
Rauscher, F.H., G.L. Shaw, K.N. Ky. Music and spatial task performance. Nature, vol. 365, no. 6447, 1993, p. 611.
White-Schwoch, T., K.W. Carr, S. Anderson, D.L. Strait, N. Kraus. Older adults benefit from music training in early life: Biological evidence for long term training-driven plasticity. Neuroscience 33, no. 45, 2013, pp. 17667–17674.
A POTPOURRI OF MEDICAL MYTHOLOGY
28 HEAD LICE: SIGN OF POOR SOCIAL CONDITIONS?
OF COURSE OUR children couldn’t possibly have head lice. Our home is so clean!
Head lice have been around for upwards of 100,000 years. DNA technology has detected head lice on mummies in Egypt and in Aztec burial sites in South America.
Our culture acknowledges the familiarity of head lice in words woven through our everyday language.
After all, the weather is lousy, isnt it?
We wish others would stop nit-picking.
And now we have to go through everything with a fine-tooth comb.
But are head lice in fact a problem of poor hygiene or lower socio-economic groups? We now know that the human parasite Pediculus humanus capitis has no preference for dirty hair, and may in fact prefer clean hair. This parasite lives on the blood of humans and cannot live longer than 48 hours off a human body. The lice suck blood from the scalp and leave saliva behind under the skin. This saliva causes severe itching.
Poor hygiene is not a risk factor, but clustering is. Schools and daycares are thus common sources of outbreaks. Head lice are found in particularly large numbers in children aged three to eleven. Girls, because many have longer hair, are more likely to spread lice by having hair touching hair. Three to four girls are affected for every boy.
Studies in Belgium found a prevalence of head lice in 8 percent of school-aged children but did not observe any higher incidence in schools in lower socio-economic areas. However, there were more treatment failures in lower socio-economic groups, possibly because of poorer compliance with treatment related to cost.
So stay calm if you get the dreaded note home from school announcing that your child has head lice. Unlike its cousin the body louse (Pediculus humanus corporis), the head louse does not cause disease in humans. Treatment is readily available and should be continued until the problem is eradicated.
REFERENCES
Williams, S., H. Lapeere, N. Haedens, I. Pasteels, J.M. Naeyaert, J. De Maeseneer. The importance of socioeconomic status and individual characteristics on the prevalence of headlice in schoolchildren. Eur J Dermatol, vol. 15, no. 5, 2005, pp. 387–392.
29 TEETHING AND FEVER: DO THEY GO HAND IN HAND?
PARENTS AND DOCTORS — but particularly parents — have long ascribed fevers in infants to teething. Other behaviours and signs including facial rashes, drooling, and insomnia have also been blamed on the eruption of teeth. Hippocrates in the fourth century BC described teething in infants as causing fever, diarrhoea, and convulsions.
While it is sometimes convenient to blame vague symptoms in young children on tooth eruption, there may be reasons why your doctor may not want you to believe that teething is a source of fever. What if the fever were really due to a more serious illness, such as meningitis or pneumonia?
If we are to believe that teething causes fever, then by definition all infants would develop fever, as all infants eventually have teeth. A few efforts have been made to establish scientific support for these claims. But infants can teethe at any time between three and nine months, so how would studies determine the time of teething?
In recent years, several studies have managed to capture this phenomenon. This research was done in three different sites: in Israel, Michigan, and Cleveland, Ohio. The methodology was important. In one study, 125 children were enrolled and their temperatures were measured twice daily. Researchers completed symptom data on 475 tooth eruptions for 19,422 child days. In the eight-day window of four days before to three days after tooth eruption, low-grade temperatures of greater than one standard deviation were significantly associated with teething. Temperatures above 38.8 degrees Celsius or 102 degrees Fahrenheit were not.
What these studies tell us is that low-grade fevers at the time of tooth eruption are common. However, what your pediatrician wants you to know is that it is not a myth that teething causes fever, but that fever in this age group can potentially be serious and may need to be treated. Don’t assume that it’s just teething!
REFERENCES
Jaber, I., I.J. Cohen, A. Mor. Fever associated with teething. Arch Diss Child, vol. 67, 1992, pp. 233–234.
Macknin, M.L., M. Piedmonte, J. Jacobs, C. Skibinki. Symptoms associated with infant teething: A prospective study. Pediatrics, vol. 105, no. 4, pt. 1, 2000, pp. 747–752.
30 RED HAIR SKIPS GENERATIONS
RED HAIR IS THE RAREST natural hair colour found in humans. Only 2 percent of the world’s population is known to have red hair. Yet many eminent people have be
en blessed with this shade. Vincent Van Gogh, Winston Churchill, and Queen Elizabeth I are prominent examples. Vivaldi, Florence Nightingale, and George Washington were redheads as well.
Many of these persons arrived de novo — that is, they were apparently the first infants to be born in their family with the ginger gene. Explanations for the seemingly erratic appearance of red hair ranged from a belief that somehow the trait just skips generations to observations that the milkman (when there were milkmen) also had red hair.
In the 1990s, the MC1R gene was identified as the recessive gene determining red hair. Approximately 50 percent of Scots and Irish people carry this gene. Recessive genes are passed from parent to child, but two such genes are needed to express a recessive trait. Therefore, two parents with black hair could be carriers and have a child with red hair. Clearly, if one parent already had red hair, that parent was carrying both copies of the gene. If that parent’s partner was a carrier, then 50 percent of their offspring would manifest the ginger gene.
Oliver Cromwell (himself a ginger) deported many thousands of Irishmen to the West Indies in 1649 after the Battle of Drogheda. The purpose was to provide labour for the Caribbean colonies. Many generations later, in the twentieth century, a Canadian dentist reported that some of his black patients had red hair. This trait had apparently taken many generations to appear.
Therefore red hair doesn’t skip generations. It simply takes two MC1R carriers to make a redhead.
REFERENCE
Flanagan, N., E. Healy, A. Ray, S. Phillips, C. Todd, I. Jackson, M. Birch-Machin, J. Rees. Pleitropic effects of MC1R gene on human pigmentation. Human Mol Genet, vol. 9, no. 17, 2000, pp. 2531–2537.
31 WILL MARIJUANA HELP YOUR CHILD'S SEIZURES?
IT IS COMMONLY BELIEVED that the use of marijuana as a medicinal plant started in the 1960s. In fact its medicinal use dates back five millennia, having begun in India and moved west much later. The list of conditions treated with marijuana include glaucoma, spasticity, asthma, nausea, depression, anxiety, and anorexia.
The first attempts to treat epileptic seizures with marijuana date back to 1881. Even today, 30 percent of epilepsy patients have uncontrolled seizures, so it can’t be a surprise that patients and their loved ones still seek alternative treatments, marijuana being one of them.
Marijuana has two active ingredients, THC and CBD. Both have been shown to have anticonvulsant properties in animal models with epileptic seizures. But these are animal models.
In humans, evidence exists of benefit of cannabis for treatment of spasticity and pain in multiple sclerosis.
In children, there is a severe form of epilepsy called Dravet Syndrome, or severe myoclonic epilepsy of infancy, which is refractory to anticonvulsant treatment. Surveys of parents who used cannabis to treat these children reported a reduction in seizures in 84 percent of cases. The children were between two and 16 years of age. The use of CBD-enriched cannabis was well tolerated.
Based on these reports, a number of families moved to Colorado where marijuana was legal and easily accessible. The American Epilepsy Society, however, felt that the reports did not constitute sufficient scientific evidence and called for more research. All the media hype may have led to increased expectations on the part of parents, which may have biased some of the reports.
There seems little doubt, experimentally, that THC and CBD both have anticonvulsant properties. These properties are dose-dependent in animal models. However, scientific studies need to be undertaken to quantify these effects and also to determine the safety of cannabinoids, particularly for children.
Most studies to date show very good tolerance of CBD in humans. But THC, the psychoactive component of marijuana, does have addictive properties. Most of our data on side effects of cannabis use comes from recreational users. These side effects include impaired short-term memory, decreased motor coordination, altered judgment, paranoia, and psychosis. While poor school performance has been documented in adolescents using marijuana recreationally, we have very little data on cannabis effects on the developing brain — especially for children under the age of five.
And if cannabis is going to be smoked, there will be concerns regarding bronchitis, airway infections, and perhaps cancer.
Yet another concern is the potential for interaction with other drugs. However, there is no evidence that these interactions would be any more complex than the interactions of existing drugs. Moreover, the side effects of marijuana need to be measured against the high burden of side effects from traditional anti-epileptic medications.
So while the majority of patients who have used cannabis are convinced of its benefit in reducing seizures, neurologists do not yet feel there is sufficient evidence to recommend these substances without further studies.
Although your child may not be prescribed a joint for seizure control any time soon, it is not a total myth that marijuana has a beneficial effect for at least some young epilepsy patients.
REFERENCE
Detyniecki, K., and L. Hirsch. Marijuana use in epilepsy: The myth and the reality. Current Neurology and Neuroscience Reports, vol. 15, 2015, p. 65.
32 ARE BILINGUAL CHILDREN SMARTER CHILDREN?
PEOPLE ONCE BELIEVED that knowing more than one language confused the mind, and thus the consequences of bilingualism were detrimental. That belief now looks to be a myth.
More than half the world speaks a second language. This tends to be more the case in Europe than in North America. In Europe, 56 percent of residents are bilingual (in Luxembourg, 99 percent). Interestingly, in Los Angeles, 60 percent of people speak a language at home additional to English.
Interest has risen among parents in having their young children learn a second language. This isn’t just good for international relations; it’s also based on a belief that there are other benefits to acquiring an additional language, including cognitive flexibility and possibly reduced chances of dementia.
Studies in Holland comparing unilingual and bilingual teaching programs indicate that children who are sent to bilingual or immersion schools do better academically than their monolingual counterparts, and perhaps socially as well. So, are these just smart kids of preppy parents who would do well anyway? No! When testing was corrected for childhood intelligence, gathered at age 11, and retested in later adult life, the results were consistent: learning a second language is beneficial.
Are all those benefits all linguistic, or are there other cognitive benefits as well? A growing number of studies indicate that lifelong bilinguals outperform monolinguals on a number of cognitive tests that have nothing to do with language. These tests involve reaction time and speed of processing.
Fundamentally, the bilingual brain is not just a better storehouse of vocabulary: bilinguals at all ages demonstrate better executive control. These are the skills that are tied to working memory, inhibition, and switching attention. As such, these skills support high level thought, multi-tasking, and sustained attention.
Executive control is central to academic achievement. It also declines early in the aging process. These insights therefore, imply a protective effect of bilingualism against age-related cognitive decline. The benefits were further enhanced when third and even fourth languages were added.
Is it true that there is a lower incidence of Alzheimer's in bilinguals? It would seem so. This resilience is based on the theory of “cognitive reserve,” which refers to the mind’s ability to maximize performance through the recruitment of brain networks or alternative strategies. Learning another language enriches the brain’s networks, giving it extra protection against cognitive decline.
Clearly, learning more than one language makes us smarter, longer. Does it matter whether these language skills are learnt in bilingual Montreal, in a chaotic refugee camp, or at an expensive private school? Does it matter if a language is learned in infancy (la langue maternelle), in teen or adult life, at university, or after emigrating?
Not necessarily. Benefits have been seen in
people who acquired an additional language, regardless of how, where, or when.
REFERENCES
Bialystock, E., F. Craik, G. Luk. Bilingualism: Consequences for mind and brain. Trends in Cognitive Sciences, vol. 16, 2012, pp. 240–250.
Kristoffels, I., A. DeHaan, L. Steenbergen, W. Van Den Wildenbergen, L. Colzato. Two is better than one: Bilingual education promotes the flexible mind. Psychological Research, vol. 79, 2015, pp. 371–379.
Bak,T., J. Nissan, M. Allerhand, I. Deary. Does bilingualism influence cognitive aging? Ann Neurol, vol. 75, 2014, pp. 959–963.
33 ARE BLOOD TRANSFUSIONS UNSAFE?
DONATING BLOOD has long been viewed as a noble gesture. If you lived in Dublin, you were often rewarded with a pint of Guinness for your trouble!
Back in 1818, a British obstetrician, James Blundell, successfully transfused human blood into a patient who had hemorrhaged during childbirth. It was 100 years on before blood groups were identified, allowing safer matching of donor to recipient. This discovery unfolded four different groups in humans: A, B, AB, and O. For simplicity’s sake, group O has been identified as “universal donors” — a valuable commodity, particularly in wartime. Group AB, on the other hand, are “universal recipients” — they can be given blood from any of the other types of donors. All of this was learned in time for the slaughter on Flanders Fields.
Before surgery, all interns had the responsibility of cross-matching each patient for one or more units of blood the night before the surgery in case of blood loss.
In my early years of neonatology, we identified hospital porters who were blood group O to serve as last-minute donors for our sick “prems — extremely premature infants. This source was safe (we thought), could be given at short notice, and did not have to be warmed. No porter was going to miss 20 to 30 ccs of blood each shift.
Of Plagues and Vampires: Believable Myths and Unbelievable Facts from Medical Practice Page 8