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Science Policy Around the Web – June 16, 2017

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By: Emily Petrus, PhD

Source: pixabay

Science and Politics

Politics in Science – It’s Not Just the U.S.!

Romania is a country in eastern Europe that joined the European Union (EU) in 2007. Scientists there are few and far between; research spending only accounts for 0.49% of GDP, the lowest in Europe (the US spent 2.7% in 2016). After joining the EU, Romanian researchers were encouraged to apply for European merit-based grants and sit on international review boards such as the National Research Council and the National Council of Ethics. It seemed that research was making slow but steady progress, but the new administration elected this year has shaken things up in all facets of government, including scientific research.

The new research minister, Serban Valeca, removed the international members appointed to government councils that oversee research funding, ethics, innovation and science policy, and replaced them with city council members, government-loyal union members, researchers from second tier Romanian institutes and even a surgeon being investigated for embezzlement. Grant review panels have been shuffled to remove international scientists and replace them with domestic researchers, but only if they have a certificate saying their university approves of their participation. These changes mark a departure from welcoming international input into Romanian proceedings and a movement towards scientific isolation.

To combat these changes, Romanian scientists have formed an organization, Ad Astra, which calls on researchers to boycott grant evaluations. Combined with the shuffling, the councils have been suspended for 3 months, which delays funding and puts already under-funded researchers in peril. The European University Association calls the policies deeply concerning, and although the current president may disagree with the research minister’s handling of the situation, his political ties ensure he won’t hold much sway over how this plays out. A computer scientist at the University Politehnica in Bucharest, Costin Raiciu, is concerned that the policies will affect talented researchers who have returned to Romania and says, “Without [merit-based] funding, people would either give up research altogether or move out of the country”. This is an all too familiar scenario in which it is apparent that policy and science must cooperate to produce ideal outcomes. (Alexandra Nistoroiu, ScienceInsider)

Mental Health

Clinical Trials Down, Basic Research Up at NIMH

Mental health is a notoriously tricky field. The development of the Diagnostic and Statistical Manual of Mental Disorders (DSM) in the 1950s has historically been a way to diagnose patients with mental health issues, and then give appropriate treatment. This has proved to be an imprecise treatment strategy, because within a category of diagnosis there is a broad spectrum of behaviors, and underlying this behavior there may be multiple causes. The NIH’s Precision Medicine Initiative (PMI) seeks to characterize 1,000,000 people by behavior, genetics, environment, and physiology. Researchers from the NIMH will send questionnaires evaluating behavior to detect mood and reward responses for this group of people. When this mental health evaluation is combined with information about their genetics, lifestyle and environment, scientists can characterize mental health disorders more specifically.

Many clinician researchers are upset by the steep decline in clinical trial research funded by NIMH, which has become higher profile with director Joshua Gordon’s arrival in 2016. NIMH seeks to route funding to study mental disorders using a basic research approach before spending time and money on costly clinical trials which too often lead to inconclusive or disappointing results. In 2011 NIMH launched the Research Domain Criteria (RDoC), which encourages research proposals to include a hunt for the mechanism underlying mental health studies. Since the initial call to include a RDoC perspective in grant applications, the incidence of RDoC appearing in funded applications has increased while mention of the DSM has decreased. Other buzzwords that are present in funded grants include biomarker, circuit, target and mechanism.

These data represent a shift in how funding decisions will proceed in mental health but may have broader reaching implications for other areas of research. In a blog post Dr. Gordon writes, “the idea that RDoC will facilitate rapid, robust and reproducible neurobiological explanations for psychopathology (as observed within and across DSM disorders) represents a hypothesis”. It remains to be seen if RDoC is an effective metric to evaluate successful grants. (Sara Reardon, Nature News)

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Mental Health Policy and its Impact on the American Population

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By: Fatima Chowdhry, MD

           In the last 50 years, the U.S. has seen a migration in which individuals diagnosed with a mental illness, defined by the Diagnostic and Statistical Manual of Mental Disorders as “a syndrome characterized by clinically significant disturbance in an individual’s cognition, emotion regulation, or behavior”, are treated not in a mental health institution but rather in prisons, nursing homes, and outpatient facilities. To understand the implications of this trend, it’s important to frame this issue as a cascade of events. For example, we can start with a member of law enforcement, not adequately trained to recognize someone in the throes of a manic phase or a schizophrenic not on their medication, arresting an individual with a mental illness. We then find that this individual, upon release, did not receive treatment and now has trouble reintegrating into their community and is unable to find gainful employment. The combination of a lack of treatment, stable community, and employment leads them to continuous run-ins with the law, restarting a vicious cycle that had led us to a prison population in which the majority has a mental illness.

The move to deinstitutionalize people with mental illness from mental institutions began in the 1960’s and accelerated with the passage of the Community Mental Health Act of 1963. This bill was an important step forward to improve the delivery of mental health care because it provided grants to states to set up community health centers. In 1981, President Ronald Reagan signed the Omnibus Budget Reconciliation Act, which sent block grants to states in order for them to provide mental health services. Aside from these two bills, and the Mental Health Parity Act of 1996, which ensured insurance coverage parity of mental health care with other types of health care, there has been little in the way of significant mental health legislation. Mental health was put on the backburner and the result is a mental health infrastructure in tatters.

During the Great Recession, states cut billions in funding dedicated to mental health. A vivid example of how decreased state funding affects mental health services can be seen in the state of Iowa. The current Governor has been put in the difficult position of balancing fiscal responsibility with maintaining access to mental health care. At one point, there were four state mental health hospitals that provided care to each corner of the state. The Governor closed down two of the facilities to save the state money. While they were old facilities built in the 19th century and cost millions to maintain, many people in Iowa felt that he moved too quickly before alternative services were in place. In addition to closing these mental health facilities, the governor obtained a waiver from the federal government to modernize the state’s Medicaid program and move from fee-for-service to managed care. Under fee-for-service, health care providers are paid for each service provided to a Medicaid enrollee. Under managed care, Medicaid enrollees get their services through a vendor under contract with the state. Since the 1990s, the share of Medicaid enrollees covered by managed care has increased, with about 72% of Medicaid enrollees covered by managed care as of July 1, 2013. The move can be difficult because hospital networks and providers have to contract with a vendor and Medicaid beneficiaries may have to switch providers. Needless to say, it can be an administrative nightmare. The transition in Iowa, to say the least, has been rocky with the vendors threatening to pull out because of tens of millions of dollars in losses. The vendors and the providers might not get paid as much as they want but the people getting the short end of the stick are people on Medicaid, which includes individuals with mental health illnesses.

Given the patchwork of mental health care across the country and the lack of funding, what can be done? According to NAMI, 43.8 million Americans experience a mental illness in a year. Many don’t receive the treatment they need. It’s a multi-faceted problem facing families, employers, health care providers and community leaders. At the federal level, lawmakers have introduced several bills to address mental health. In the United States Senate, a bipartisan group of four Senators introduced S. 2680, the Mental Health Reform Act of 2016. This bill encouraged evidence-based programs for the treatment of mental illness, provided federal dollars to states to deliver mental health services for adults and children, and created programs to develop a mental health workforce.

It was encouraging to see that many components of S.2680 were included in H.R 34, the 21st Century Cures Act, which was signed into law on December 13th, 2016.  H.R 34 faces some headwinds because some of the funding portions are subject to Congressional appropriations, and if Congress is feeling austere, they can tighten the purse strings. Moving forward, a major issue of concern for mental health is the future of the Affordable Care Act. Under the Affordable Care Act, states were initially mandated to expand their Medicaid rolls. A Supreme Court decision, however, made the decision to expand optional. So far 32 states, including Washington D.C., have expanded. Some red states, like Iowa, Arkansas and Indiana have utilized the waiver process of the ACA to expand their program. If the ACA is repealed, policymakers will have to contend with the effects on the private insurance market as well as Medicaid.

Right now, the crystal ball is murky. Only time will tell.

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Written by sciencepolicyforall

December 22, 2016 at 10:45 am

How Much Neuroscience Funding is the Right Amount?

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By: Brian Russ, PhD

Source: pixabay

       Scientific funding can be a very tricky proposition. Unfortunately, there is a finite amount of money that is put towards science each funding cycle. This means that at any given time funding agencies need to decide where they believe their funds will be best spent. Every funding cycle, one can find different groups lamenting that their favorite topic is “being underfunded” while some other group is getting “too big a piece of the pie”. There is often no right answer to the question of how much is the right amount of funding to provide different topics, and the likelihood is that at the end of the day every group will feel that they are not getting the right amount of respect and funding.

This debate has come to the forefront recently in the fields of psychiatry and neuroscience with a change in the leadership at the National Institute of Mental Health (NIMH). In September, Dr. Joshua Gordon became the new director of the NIMH. Dr. Gordon’s directorship of the NIMH comes after a 13-year period of leadership by Dr. Tom Insel. During the previous administration, there had been an increasing focus on funding neuroscience related work, often at the expense of purely behavioral work, such as cognitive behavioral therapies for psychiatry patients. It is important to point out that the NIMH’s definition of neuroscience research includes basic, translational, and clinical neuroscience research. This direction led to a new research framework for studying mental health disorders termed the Research Domain Criteria (RDoC), which has a very strong neuroscience component. The goal of RDoC is to provide a new framework in which researchers and clinicians can study and treat mental health disorders. The RDoC framework involves neuroscience components of brain circuits and physiology, and cognitive components of behavior and self-reports. The end goal is to provide a more comprehensive description of mental health disorders with the intention of developing cures and treatments. This push toward RDoC, and more neuroscience in general, has led to both praise and criticism of where the NIMH is directing its funding opportunities.

Recently, an opinion piece was published in the New York Times stating that the NIMH needs to reverse their push towards more neuroscience. Specifically, Dr. Markowitz, a research psychiatrist from Columbia University, believes that the NIMH has been funding neuroscience at the expense of clinical psychological research, in the absence of a brain oriented component. His argument is that in the current funding environment only 10% of the NIMH’s research budget is going towards clinical research. From the content of his article the research he is speaking of involves behavioral studies and interventions that contain no neuroscience component. Dr. Markowitz brings up many important points, and his main thesis that we cannot forget about behavioral interventions while pursuing the biological bases of clinical disorders is critical. For example, he makes the strong point that neuroscience research is unlikely to help solve the problem of suicide. And his final argument is for a “more balanced approach to funding clinical and neuroscience research.”

However, one can argue what that balance should actually look like. Is ten percent of the budget actually a small amount? And does that number include the multitude of basic neuroscience studies that are investigating the neural underpinning of a given disease? For example, based on the NIH reporter, schizophrenia research has been funded for approximately 250 million dollars for each of the last three years. A quick look at the total budget (32.3 billion in 2016, with ~25 billion going to research grants) suggests that that would be on the order of about 1% of the total NIH research budget. This is only one disease, and is being calculated from the whole NIH budget, not just from the NIMH budget. Only a portion of that funding is going towards clinical research, as Dr. Markowitz would define it, however the rest of that funding is going to research that will in all likelihood provide clinical benefits to patients down the road, in the form of new physiological targets or potentially new drugs.

So how can one make a determination about the correct of amount of funding that should go towards different mental health fields? Should 25% or 50% of the budget go towards clinical research? It seems that comparing the percent of money going to clinical research versus neuroscience is simply a bad comparison. Neuroscience is not one homogenous topic; it includes tens of, if not over a hundred, different fields. The various mental health fields fighting each other over funding doesn’t help anyone. Both neuroscience and clinical research need to be funded. It seems that the best way to divide the funding from NIMH would not be to specify what field gets priority but instead to fund the best grants regardless of whether there is a specific component involved. This would open the door to more clinical research while not requiring a shift in the priorities of the NIMH, whose mission is to understand and treat mental illnesses though both basic and clinical research. For instance, RDoC already contains both behavioral and self-report components. These components should be given as much priority as the other neuroscience components. If 10% of the budget is given to behavioral work, in this way, that would seem reasonable, possibly even greater than other areas might be getting.

On a final note, while we should always be looking internally at how we are funding different types of science, and if we, the public, are getting our money’s worth out of projects, it is also important for us to ensure that science funding as a whole is increasing. The current funding environment has been relatively static for years. We need, through advocacy and outreach, to get the public and government to provide more funding opportunities to the NIH. As the saying goes “a rising tide raises all boats”.

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Written by sciencepolicyforall

November 17, 2016 at 6:53 pm

Science Policy Around the Web – November 8, 2016

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By: Saurav Seshadri, PhD

Source: pixabay

Mental Health Research

FET Flagships: lessons learnt

The European Commission (EC), the executive body of the European Union, launched two major Future and Emerging Technologies (FET) Flagship projects in 2013, with funding of about 1 billion euros each. Both aim to foster collaboration and scientific innovation over a period of 10 years, in the fields of neuroscience (the Human Brain Project or HBP) and material chemistry (the Graphene Flagship). As these projects transition to the infrastructure construction phase, which has been funded for the next two years, the EC has released a statement reflecting on the first, ‘ramp-up’ phase of these high-level initiatives.

The assessment presented of the Flagships’ success is uniformly positive; the Directors write that they ‘create amazing collaboration opportunities’, ‘mobilis[e]…enthusiastic young researchers’, and ‘spread an innovation mind-set in Europe’. The EC expects this evaluation to be corroborated by an independent review by a panel of experts, due to be published in early 2017. Key insights from the initial phase include the power of flagships to foster international community-building, the importance of balanced and transparent governance and management, and the need to fine-tune the size and composition of the Consortium of funding entities over time.

A driving force behind some of these lessons is the controversy that has faced the HBP almost since its inception: in 2014, a group of leading neuroscientists sent a protest letter to the EC stating that the HBP was ‘not a well-conceived or implemented project’. The letter now has more than 800 signatures, and led to the formation of mediation committee, based on whose recommendations in 2015 the HBP dissolved its executive board and significantly changed its scientific focus. The recent release of long-gestating computational tools has also helped address criticism. In navigating these challenges and moving forward, the HBP merits attention for its similarity to our own BRAIN Initiative in scope, methodology, and scale. (European Commission)

HIV/AIDS

HIV’s patient zero exonerated

Gaetan Dugas was a French Canadian airline steward whose cooperation with CDC researchers helped identify sexual contact as a key step in HIV transmission in 1984. Unfortunately, this contribution earned him the label of ‘Patient Zero’ for HIV in the United States, which, along with an influential book that portrayed him as an unrepentant and malicious spreader of the disease, led to his widespread condemnation. On a larger scale, this characterization of the epidemic was a setback in the fight against homophobia, even at the policy level: in 1988, a Presidential Commission on HIV recommended that behavior among gay men that ‘fail[s] to comply with clearly set standards of conduct’ be criminalized.

However, a recent study in Nature has found ‘neither biological nor historical evidence’ that Dugas was the primary case of HIV in the US. The authors used a highly sensitive method to recover and sequence viral RNA from samples collected in the late 1970s, which revealed that HIV most likely jumped from Africa to the US via the Caribbean in approximately 1971, and that Dugas’ HIV genome was typical of US cases far downstream of ancestral strains. Ignorance may explain how scientists and the public in the 1980s came to scapegoat Dugas: with our current understanding of HIV’s long incubation period, it appears possible that many of Dugas’ partners could have contracted the disease years before they met him.

According to Dr. Anthony Fauci, director of NIAID, “The history of diseases has always been, in part, that someone needs to be blamed.” This study highlights the scientific and ethical pitfalls inherent to this mentality. (Sara Reardon, Nature News)

Schizophrenia

Schizophrenia secrets found hidden in the folds of DNA

Schizophrenia is known to be highly heritable, but the individual genes conferring risk for the disease have remained elusive. Advances in sequencing capabilities have allowed researchers to vastly increase the statistical power of studies aimed at identifying these genes: one such large-scale effort, the Psychiatric Genomics Consortium (PGC), identified over 100 common variants associated with schizophrenia, by using more than 36,000 cases and 100,000 controls. While progress has been made in understanding how some of these mutations contribute to changes in gene expression and brain network development, the majority remain unexplained. One obstacle is the fact that many of the loci are in regulatory regions, often without any obvious nearby target gene.

A recent study from Dr. Daniel Geschwind’s group at UCLA addresses this problem by showing that many non-coding variants identified by the PGC actually do contact genes involved in brain development, when the 3-dimensional structure of chromatin is taken into account. The authors used a cutting-edge technique called chromosome conformation capture to generate high-resolution maps of physical interactions between regulatory regions and genes. This approach revealed that loci of previously indeterminate function may in fact influence pathways linked to schizophrenia, including neurogenesis and cholinergic signaling.

Coming on the heels of another study, which used whole exon sequencing in about 5,000 cases to show that rare variants contribute to risk for schizophrenia, these findings represent significant progress towards understanding the mechanistic implications of genome-scale data in psychiatric disorders. This understanding is a key step towards using such data to develop personalized treatment strategies, which may be a priority for Dr. Geschwind, as he was appointed head of precision medicine efforts in the UCLA Health System in March. The above approach can also be generalized to other neurodevelopmental disorders (a prime candidate is autism, for which Dr. Geschwind helped establish the world’s largest gene bank), and holds great promise for the future of care for these devastating diseases. (Tim Newman, Medical News Today)

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November 8, 2016 at 9:00 am

Science Policy Around the Web – October 28, 2016

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By: Emily Petrus, PhD

Source: Flickr, under Creative Commons

Technology and Health

Can You Please Pass the iPad?

As digital media screens have become more prevalent, doctors have warned parents of its negative impact on developing minds. In 1999, screen time was first addressed, with doctors mandating that no screen time was recommended for children under age 2.   The argument goes that children need parents present in real-time to interact with to develop the ability to read social cues and engage on a personal level.

Now the American Academy of Pediatrics (AAP) has dictated that one hour per day of high-quality educational screen time may be allowed for children between 2 and 5 years of age. For children 18 months to 2 years, some screen time is ok as long as a parent is actively engaged and watching with the child. This is especially relieving for parents of children who have relatives far away who use Skype or FaceTime to communicate. Although this is technically screen time, it does benefit children with those important social interactions and reading facial and vocal cues.

Overall the goal of the AAP is to ensure that media is used in a mindful way, not to replace social interactions but to enhance family discussions and provide supplementary education material for older age groups. They also recommend media-free family time to ensure children develop a healthy relationship with technology. Jenny Radesky, MD, FAAP and lead author for the statement said, “What’s most important is that parents be their child’s media mentor. That means teaching them how to use it as a tool to create, connect and learn.” In relation to screen time rules, it seems the amount of parent involvement and moderation are the keys to success. (AAP)

Mental Health Research

New Director of National Institutes of Mental Health (NIMH)

NIMH has a tall order to fill: bridge the gap from the breakneck speed of basic neuroscience research advances to bring solid and reliable treatments to the clinic. Last month NIMH welcomed a new director, Dr. Joshua Gordon, to take the helm and direct the institute toward a balance between these two priorities. After 19 years as a faculty member at Columbia University, Gordon hopes to bring his experience as both a clinician and a researcher to achieve this delicate result.

NIMH’s strategic plan for research was laid out in September, with four priorities highlighted to combat mental illness. These include describing mechanisms of complex behaviors, at the molecular, cellular, circuit and genetic levels. Second, characterizing mental illness trajectories to determine best intervention procedures and time points, which would include detecting biomarkers and understanding how behavior reflects neuropathology. Third, NIMH strives to marry tried and true existing treatments with new therapies which can be implemented in community settings, thus bringing help to patients. Finally, NIMH funded research must improve public health, with better clinician education about new treatments, and new service delivery models that can be implemented to reach more patients suffering from mental illness.

These are all monumental tasks but Gordon seems up for the challenge. In a recent Q&A session by Meredith Wadman of Science Magazine, he was asked about the op-ed pieces in the Washington Post and the New York Times by NIMH clinical psychiatrists where they accused previous director Thomas Insel of putting too much priority on basic research and letting clinical neuroscience fall by the wayside. Gordon replied by saying, “I think my first priority is good science. Where there are opportunities in psychiatry for short-term effects, we are going to try to take advantage of them. Absolutely. We’d be mad not to. We know so little about the brain, we have so few truly novel treatments in the pipeline that I’m all ears.” (NIH News Release)

Autism

Autism early intervention – help the parents, help their children

The plight of the working parent has become an important and almost bipartisan issue this election season. Politicians are proposing policies that will help families with paid family leave and some help with childcare costs, however there is a growing segment of people who desperately need even more help. Raising a child with autism is increasingly common, currently 1% of children and young people in the US are on the spectrum.

The cost of having an autistic child can be tremendous, with extra health care expenses, special equipment, classes and educational requirements. Often one parent must leave the workforce to care for their child as they require extensive and specialized care. Early interventions such as classes and therapy are thought to be effective for lessening the symptoms of autism, but until now the trials have been small and have had short end points. This week The Lancet published an article demonstrating that interventions aimed at educating parents of autistic children had long-term (up to 6 years) benefits. 152 children aged 2-4 years old were recruited to the study, with half given interventions that included therapy, monthly support and a parent-mediated 20-30 minute daily session of planned activities. The children who received this extra support reported lower levels of severe autism and had better teacher and parent assessed behaviors. However, the study did not find significant reductions in anxiety or depression or a language benefit.

This study demonstrates that providing education and resources for parents of autistic children are a worthwhile endeavor. Government resources are often aimed at providing services for the child, which are equally important. Parents armed with the proper educational tools can become personalized therapists for their children, which could reduce societal costs and improve outcomes. (Heidi Ledford, Nature)

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October 28, 2016 at 10:50 am

Screening for Depression – Why Girls May Benefit

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By: Katherine M. Reding, Ph.D.

Photo source: pixabay.com

Major Depressive Disorder (MDD) is one of the most common mental health disorders in the United States. According to the National Institute of Mental Health, in the year 2014 alone, approximately 7% of the population, or 5.7 million adults, aged 18 or over experienced at least one major depressive episode. Of these adults, women were almost twice as likely to have experienced an MDD episode, such that 8.2% of women compared to 4.8% of men reported an episode in 2014. In general, women are two to three times more likely than men to develop stress-related psychopathology, such as MDD, across their lifetime. Importantly, MDD is also common in adolescents between ages 12 and 18. Approximately 8% of adolescents have been diagnosed with MDD, according to a recent study from the U.S. Preventive Services Task Force (USPSTF), an independent and volunteer panel of experts in disease prevention and evidence-based medicine.

Throughout young adulthood, between the ages of 19 and 31, being female is one of the largest risk factors for developing MDD. Although the USPSTF report identified the ‘female sex’ as a risk factor for developing MDD in adolescents, it lacked any discussion regarding the sex and gender differences in disease onset, screening, and treatment. In fact, sex-differences in MDD onset emerge around the time of puberty, and girls show a spike in onset at age 14, such that the two-fold increase in female prevalence of MDD seen in adulthood is apparent beginning at 15 years of age.

Exactly why sex differences in MDD emerge during adolescence is still in debate. Some researchers suggest that it is the biological process of puberty, or the maturation of the female reproductive system and the production of ovarian hormones such as estrogen and progesterone, that causes the increased susceptibility to depression in adolescent girls. Unfortunately, the correlation between female hormones and teenage mental health is not a simple one to demonstrate. The process of puberty is not isolated to reproductive biology, but is also a time of increased physical, social, and emotional changes.

Another potent predictor for the development of depression in women is a history of exposure to stressful life events. The prevalence of MDD in women may be due to a combination of exposure to stressful or traumatic events coinciding with the production of ovarian hormones leading up to menarche when girls begin menstruating. Dr. Amy Marshall, a clinical psychologist from Pennsylvania State University, suggests that traumatic events such as major disasters, witnessing family violence, physical assault, or sexual assault occurring between 6 years prior to menarche and 2 years afterwards were a significant risk factor for developing depression in young women. Peak risk resulted when traumatic events occurred 2 to 6 years prior to menarche, when ovarian hormones are in the early stages of production.

As an update to their 2009 recommendations, the USPSTF found that there is essentially “no harm” in screening for and treating MDD in adolescents age 12 to 18. Previously, the USPSTF had limited its recommendations for screening to only those adolescents with access to psychotherapy due to concerns regarding the negative side-effects and harms of pharmacotherapy in adolescents. Current recommendations suggest universal screening due to more recent findings that show no significant harm resulting from using pharmacotherapy, psychotherapy, collaborative care, psychosocial support interventions, or complementary and alternative medicine approaches. Instead, the most harm appears to come from not detecting and not treating adolescent onset MDD, as one episode of MDD in adolescence greatly increases the risk of recurrent episodes throughout adulthood.

Despite broadening their screening recommendation, the report unenthusiastically stated that “there is moderate certainty that the net benefit [of screening for MDD] is moderate to substantial,” which does not appear to be a huge vote of confidence on their own findings. This seemingly indifferent review is a direct result of the limited data available on the outcomes of adolescent screenings for MDD. In fact, the USPSTF found no studies directly assessing the benefits or harms of screening for MDD in adolescents, making it impossible to detect actual benefits derived from the screening process. It is also important to note, that the USPSTF could make no recommendations for screening or treating children younger than 11 years of age, as no studies that were found that included children of those ages.

In conclusion, healthcare providers and researchers must begin to collect data on MDD screening and treatment outcomes in teens to determine just how beneficial these screening recommendations might be. The benefits to women’s health, as well as men’s health, across the lifespan may be significant, but only time and data will tell.

Written by sciencepolicyforall

June 8, 2016 at 9:00 am

Science Policy Around the Web – May 31, 2016

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By: Emily Petrus, Ph.D.

Biomedical Research Salaries

Higher Salary for Postdocs Coming Soon

What do a Metrobus driver and a recent biomedical PhD graduate in have in common? Their salary! Although both positions are important to keeping society moving forward, figuratively or literally speaking, one can imagine the disparity between the educational time commitment between these two positions.

New rules set forth by the US Department of Labor dictate that employees with annual salaries falling below $47,476 must be paid overtime for hours they work beyond 40 hours per week.  Research scientists who have recently (typically within 5 years) received a PhD in biomedical sciences will undergo additional training before the next step in their career, similar to residency among medical school graduates.  These highly skilled postdoctoral researchers are called postdocs, and they fall below this threshold, with an average starting salary of $45,000.

This gives research organizations such as academic universities and the National Institutes of Health two options: track the hours their postdocs log at the bench and pay them overtime, or raise the base salary above the threshold.  Because scientific research rarely falls neatly into a 9-5 time table, NIH director Francis Collins is leading the NIH to increase postdoc pay to avoid logging hours for overtime pay.  Most academic research labs follow NIH guidelines for postdoc salary, so the NIH’s commitment to increase their pay should spill over into most other areas of biomedical research.  In a recent article penned by Collins and Thomas Perez, the U.S. Secretary of Labor, they called on the nation to “embrace the fact that increasing the salary threshold for postdocs represents an opportunity to encourage more of our brightest young minds to consider choosing careers in science.”

Although these salary increases will increase the pressure on labs already struggling with tight funding, it may serve as an incentive for future generations to choose biomedical research careers over driving a Metrobus. (Beryl Lieff Benderly, Science Articles)

Chemical Safety

United States poised to approve major chemical safety overhaul

Did you know that companies can use new chemicals in their products without demonstrating their safety for consumers or the environment? How about that the Environmental Protection Agency (EPA) cannot ask them to remove it until they demonstrate toxicity, which requires a costly amount of research and legislative action? If this sounds backwards to you, take heart: the House of Representatives has approved a long overdue overhaul of the Toxic Substances Control Act (TSCA).  This measure is expected to be approved by the Senate and President Obama with the next few months.

The TSCA was originally passed in 1976, and contains wording difficult for environmentalists, consumers, and even industry to follow. The original act required the EPA to consider regulatory costs during safety review, effectively reducing the importance of science-based research into chemical safety for consumers and the environment while favoring regulatory cost saving measures. It also made toxicity testing difficult by the EPA by requiring the minimal (“least burdensome”) amount of testing instead of full-fledged studies. The new TSCA will enable the EPA to order companies to prove chemicals are safe for consumers and/or the environment before introducing them to the marketplace, to hopefully avoid another issue such as the widespread use of asbestos in construction until the 1970’s.

Other components of the revised TSCA include an emphasis on reducing numbers of animals used in toxicity studies by replacing them with other testing methods when possible. The act also aims to identify and increase studies on “cancer clusters,” areas of the country which have higher incidences of cancer which may be due to environmental effects.

The revision of the TSCA is arguably the biggest environmental legislative success since the Clean Air Act amendment of the 1990’s. By containing clearer language, it makes the act “a careful compromise that’s good for consumers, good for jobs, and good for the environment” – said John Shimkus (R-IL). (Puneet Kollipara, ScienceInsider)

Mental Health

Children in Poverty at Risk for Increased Incidence of Mental Health Issues

Is it the chicken or the egg?  When it comes to mental health and poverty, it can be difficult to determine causation versus correlation: are mentally unstable people unable to provide for themselves, or is the stress of poverty causing mental health issues?  A recent study in children has determined a third genetic component to the puzzle, related to how the structure of DNA differs between poor and healthy children.

Although it has long been known that children from families below the poverty line have increased incidences of mental and physical ailments such as depression and diabetes, many have pointed to environmental factors such as relatives smoking or poor nutrition as the main culprits. New evidence suggests exposure to stress in utero and during childhood changes the very DNA of these children. Serotonin is a neurotransmitter important for maintaining “happy” brain chemistry and is often targeted for treating depression. New researchers found that the DNA for a serotonin transporter protein is altered in poor children, which may decrease the amount of serotonin allowed to get into brain cells. This was also correlated with higher levels of stress, indicating that growing up in poverty can change fundamental biological components and create lifetime mental health issues for these children.

Growing up in poverty is stressful for children; however there are ways to attenuate their suffering.  High quality, affordable, preschool and childcare is one way the government can step up to the plate.  “Headstart” is a program which enables children of families below the federal poverty line to enjoy a stimulating, warm environment and may reduce the burden of their families to choose between working and providing for their families or staying home to avoid daycare expenses. There are a multitude of issues creating stressful environments for poor families, but providing high quality child care and healthy meals for kids for part of the day is a small investment towards a big, epigenetic payoff in generations to come. (Sara Reardon, Nature News)

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Written by sciencepolicyforall

May 31, 2016 at 12:00 pm