Consciousness: how the brain chemical ‘dopamine’ plays a key role – new research

We know very little about the human brain. 

Orla/Shutterstock

August 4, 2021

Consciousness is arguably the most important scientific topic there is. Without consciousness, there would after all be no science. But while we all know what it is like to be conscious – meaning that we have personal awareness and respond to the world around us – it has turned out to be near impossible to explain exactly how it arises from the hardware of the brain. This is dubbed the “hard” problem of consciousness.

Solving the hard problem is a matter of great scientific curiosity. But so far, we haven’t even solved the “easy” problems of explaining which brain systems give rise to conscious experiences in general – in humans or other animals. This is of huge clinical importance. Disorders of consciousness are a common consequence of severe brain injury and include comas and vegetative states. And we all experience temporary loss of awareness when under anaesthesia during an operation.

In a study published in the Proceedings of the National Academies of Science, we have now shown that conscious brain activity seems to be linked to the brain’s “pleasure chemical”, dopamine.

The fact that the neural mechanisms that underpin consciousness disorders are difficult to characterise makes these conditions hard to diagnose and treat. Brain-imaging has established that a network of interconnected brain regions, known as the default mode network, is involved in self-awareness. This network has also been shown to be impaired in anaesthesia and after brain damage that causes disorders of consciousness. Importantly, it seems to be crucial to conscious experience.

Listen to ‘Don’t Call Me Resilient,’ a provocative new podcast about raceFind out more

Some patients, however, may seem to be unconscious when they in fact are not. In a landmark study in 2006, a team of researchers showed that a 23-year old woman, who suffered severe brain trauma and was thought to be in a vegetative state following a traffic accident, had signs of awareness. The patient was asked to imagine playing tennis during a brain scan (fMRI)) and the scientists saw that regions of the brain involved in motor processes activated in response.

Similarly, when she was asked to imagine walking through the rooms of her home, regions of the brain involved in spatial navigation, such as the posterior parietal cortex, became active. The pattern of activation that she showed was similar to that of healthy people, and she was deemed to have awareness even though that wasn’t noticeable in classical clinical assessment (not involving brain scans).

Other research has found similar effects in other vegetative state patients. This year, a group of scientists, writing in the journal Brain, warned that one in five patients in vegetative states may in fact be conscious enough to follow commands during brain scans – though there is no consensus on this.
The brain chemical involved in consciousness

So how do we help these people? The brain is more than just a congregation of different areas. Brain cells also rely on a number of chemicals to communicate with other cells – enabling a number of brain functions. Before our study, there was already some evidence that dopamine, well known for its role in reward, also plays a role in disorders of consciousness.

Dopamine, the brain’s pleasure chemical. Andrea Danti/shutterstock

For example, one study showed that dopamine release in the brain is impaired in minimally conscious patients. Moreover, a number of small-scale studies have shown that patients’ consciousness can improve by giving them drugs that act through dopamine.

The dopamine source in the brain is called the ventral tegmental area (VTA). It is from this region that dopamine is released to most areas in the cortex. In our recent study, we showed that the function of this source of the brain’s dopamine is impaired in patients with disorders of consciousness and also in healthy people after the administration of an anaesthetic.

In healthy people, we found that VTA function was restored after withdrawal of sedation. And people with reduced consciousness who improved over time also regained some of their VTA function. In addition, the dysfunction in dopamine was linked with a dysfunction in the default mode network, which we already know is key in consciousness. This suggests that dopamine may really have a central role in maintaining our consciousness.

The study, carried out in the Division of Anaesthesia at the University of Cambridge, also shows that the use of current and future drugs, which act on dopamine, should help improve our understanding of anaesthesia. Surprisingly, although anaesthesia with ether was first used in surgery at Massachusetts General Hospital in 1846, the specific processes as to how general anaesthetics act at multiple sites to produce anaesthetic action remain a mystery.

But the most exciting aspect of this research is ultimately that it gives hope for better treatments of consciousness disorders, using drugs that act on dopamine.

Authors
B

arbara Jacquelyn Sahakian
Barbara Jacquelyn Sahakian is a Friend of The Conversation.
Professor of Clinical Neuropsychology, University of Cambridge

Christelle Langley
Postdoctoral Research Associate, Cognitive Neuroscience, University of Cambridge

Emmanuel A Stamatakis
Lead, Cognition and Consciousness Imaging Group, Division of Anaesthesia, University of Cambridge

Lennart Spindler
PhD Candidate of Neuroscience, University of Cambridge

Disclosure statement

Barbara Jacquelyn Sahakian receives funding from the Wellcome Trust, the Lundbeck Foundation and the Leverhulme Foundation. Her research is conducted within the NIHR Cambridge Biomedical Research Centre (Mental Health and Neurodegeneration Themes) and the NIHR MedTech and Invitro Diagnostic Co-operative (MIC).

Christelle Langley receives funding from the Wellcome Trust.

Emmanuel A Stamatakis receives funding from the Canadian Institute for Advanced Research and the Stephen Erskine Fellowship, Queens’ College, University of Cambridge.

Lennart Spindler receives funding from The Cambridge International Trust, and the Cambridge European Scholarship.

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Neanderthals Hunted with Leaf-Shaped Spears, Archaeologists Say

Archaeologists say they have found a 65,000-year-old leaf point in a cave in the Swabian Jura, Germany.

The 65,000-year-old leaf point from Hohle Fels Cave, Germany. Image credit: University of Tübingen.

“This discovery represents the first time a leaf point has been recovered from a modern excavation, allowing us to study the fresh find with state-of-the-art methods,” said Professor Nicholas Conard, a researcher at the University of Tübingen and the Senckenberg Centre for Human Evolution and Palaeoenvironment.

“The last time archaeologists in the region recovered such artifacts was in 1936.”

The leaf point was found at the archaeological site of Hohle Fels, a cave in the Swabian Jura of Germany.

The artifact is 7.6 cm (3 inches) long, 4.1 cm (1.6 inches) wide, 0.9 cm (0.35 inches) thick, and has a mass of 28 grams.

“Our results document how the tool was made, used and why it was discarded,” Professor Conard said.

“Thanks to a series of four ESR-dates the find is securely dated to over 65,000 years ago.”

“Until now finds of leaf points were interpreted as belonging to the period between 45,000 and 55,000 years ago — the last cultural phase of Neanderthals in Central Europe,” he added.

“The new results demonstrate that our assumptions about the dating of the cultural groups of the late Neanderthals were wrong and need revision.”

Using detailed microscopic analyses, the researchers found that the leaf point was mounted on a wooden shaft.

“Damage to the tip indicates that the artifact was used as a hafted spear point, and that the spear was likely thrust into prey rather than being thrown,” they said.

“Neanderthals used plant-based glue and bindings made from plant fibers, sinew, or leather, to secure the leaf point to the spear.”

“They clearly used the spear for hunting. While they re-sharpened the tool it broke, leading to its discard.”

“Neanderthals were expert stone knappers and knew exactly how to make and use complex technologies combining multiple parts and materials to produce and maintain deadly weapons,” said Dr. Veerle Rots, a researcher at the University of Liège.

“Homo heidelbergensis used sharpened wooden spears for hunting too, but their spears lacked mounted stone points like those used by Neanderthals.”

The team’s results appear in two papers in the journal Archäologische Ausgrabungen in Baden-Württemberg and the journal Mitteilungen der Gesellschaft für Urgeschichte.

Jul 28, 2021 by News Staff / Source

Nicholas J. Conard & Alexander Janas. Ausgrabungen im Hohle Fels: Fundschichten aus dem Mittelpaläolithikum und Neues zur Jagdtechnik der Neandertaler. Archäologische Ausgrabungen in Baden-Württemberg 2020: 60-65

Veerle Rots et al. 2021. A Leaf Point Documents Hunting with Spears in the Middle Paleolithic at Hohle Fels, Germany / Eine Blattspitze belegt die Jagd mit Speeren im Mittelpaläolithikum am Hohle Fels, Deutschland. Mitteilungen der Gesellschaft für Urgeschichte 30: 1-28

Jurassic-Period Crocodile Ancestor Unearthed in Chile
Aug 4, 2021 by Enrico de Lazaro


Paleontologists have identified a new genus and species of small-sized mesoeucrocodylian from the fossilized remains found in the Patagonian mountains of southern Chile.

Burkesuchus mallingrandensis and a group of Chilesaurus diegosuarezi. Image credit: Gabriel L. Lio / de Anatomía Comparada y Evolución de los Vertebrados (LACEV), Museo Argentino de Ciencias Naturales ‘Bernardino Rivadavia.’

The newly-discovered crocodile species roamed Earth during the Late Jurassic epoch, some 148 million years ago.

The ancient creature lived alongside giant titanosaurs and other sauropod dinosaurs as well as smaller herbivorous species such as Chilesaurus diegosuarezi.

Named Burkesuchus mallingrandensis, it was a relatively small animal roughly 70 cm (27.5 inches) long.

It belongs to Mesoeucrocodylia, a group that includes all living crocodiles and their fossil relatives.

“The discovery of Burkesuchus mallingrandensis expands the meagre record of non-pelagic representatives of this clade for the Jurassic period,” said Dr. Fernando Novas, a researcher in the Laboratorio de Anatomía Comparada y Evolución de los Vertebrados (LACEV) at the Museo Argentino de Ciencias Naturales ‘Bernardino Rivadavia’ and CONICET, and his colleagues.

“Previously recorded members of non-pelagic Jurassic Mesoeucrocodylia are the presumably fresh-water Atoposauridae, Goniopholididae and Paralligatoridae.”

“Burkesuchus mallingrandensis expands the taxonomic diversity of Jurassic crocodylomorphs,” they added.

“Nevertheless, its body size falls within the size range (i.e., less than 1 m — or 3.3 feet — in whole length) that was usual for most Triassic and Jurassic terrestrial crocodyliforms.”


The fossilized remains of Burkesuchus mallingrandensis.

 Image credit: Novas et al., doi: 10.1038/s41598-021-93994-z.

The fossilized remains of Burkesuchus mallingrandensis were collected from beds of the Toqui Formation, cropping out in the mountains flanked by the Maitenes and Horquetas rivers in southern Chile.

“We found part of the skull, the vertebral column and the lower extremities of the animal,” Dr. Novas said.

“This was a small crocodile no more than 70 cm long, in clear contrast to the 6-m- (20-foot) long marine crocodiles that were thriving back then in what is now the Chilean province of Neuquén, which was previously covered by the sea.”


Skeletal reconstruction of Burkesuchus mallingrandensis based on holotype and paratype specimens. Image credit: Novas et al., doi: 10.1038/s41598-021-93994-z.

“Although we didn’t find the snout of this species, its small size as well as its small and sharp teeth make us think that Burkesuchus mallingrandensis was a small carnivore that possibly fed on invertebrates such as insects or crustaceans, or small vertebrates such as fish,” said Dr. Federico Agnolin, a paleontologist in the LACEV laboratory at the Museo Argentino de Ciencias Naturales ‘Bernardino Rivadavia,’ CONICET and the Universidad Maimónides.

“What we know about Burkesuchus mallingrandensis that it didn’t have the ability to capture large prey, or tear large chunks of meat as living crocodiles do.”

“Burkesuchus mallingrandensis shows how the radiation of terrestrial crocodiles occured,” Dr. Novas said.

“The shape of its body, its skull and its hind legs also shows us that it was on its way to modern crocodiles that inhabit lagoons and rivers.”

A paper on the findings was published in the journal Scientific Reports.

_____

F.E. Novas et al. 2021. New transitional fossil from late Jurassic of Chile sheds light on the origin of modern crocodiles. Sci Rep 11, 14960; doi: 10.1038/s41598-021-93994-z

 Lava lamp tectonics: How giant blobs of

subducted sediment float up through deep

 Earth

by University of Wyoming

Numerical modeling of sediment subducted beneath North American crust suggests that the sediment may buoyantly rise

 up through the mantle, like a lava lamp blob, and become attached to the base of the crust. Credit: Jay Chapman

A University of Wyoming professor has used computer modeling to propose that sand and mud subducted off the coast of California around 75 million years ago returned to the Earth's crust by rising up through the mantle as enormous diapirs, like blobs in a lava lamp.

These blobs are now found at the surface of the Earth, far inland from the coast, in places including the Mojave Desert and western Arizona.

"These rocks aren't the prettiest to look at, but they went on an extraordinary journey and have an incredible story to tell," says Jay Chapman, an assistant professor in UW's Department of Geology and Geophysics who focuses on tectonics.

Chapman is the author of a new paper, titled "Diapiric relamination of the Orocopia Schist (southwestern U.S.) during low-angle subduction," which was published in the August issue of the journal Geology. 

"The rocks started their lives as sediment eroded from the Sierra Nevada Mountains and carried by rivers and streams down to the ocean, where they ended up deposited in a subduction trench, similar to the modern-day Marianas trench," Chapman says. "Then, they were carried about 20 miles deep into the Earth by a subducting oceanic plate, where the sediments were metamorphosed into a rock called schist. That in and of itself is pretty amazing, but the truly special thing about these rocks is that they didn't stay subducted, but somehow made their way back up to the surface, where you can go stand on them today."

How the subducted sediments returned to the surface of the Earth and the distribution of the sediments in the subsurface are some of the questions Chapman is trying to answer with his research.

"The prevailing theory is that the sediments were smeared against and plastered to the base of the North American tectonic plate, forming a sheet-like layer," Chapman says. "However, the density of these sediments is much lower than rocks in the mantle or lower crust and, over millions of years, computer modeling predicts that the sediments will flow and buoyantly ascend, like hot wax in a lava lamp."

The research has implications for understanding subduction zone processes and the distribution of natural resources.

"Geoscientists around the world are working to understand what gives continental crust its unique composition, and subduction and reincorporation of sediment are a popular hypothesis," Chapman says. "In addition, many researchers are now wondering whether fluids and elements released from the subducted sediments may have contributed to the concentration of economically important minerals and metals."

More information: James B. Chapman, Diapiric relamination of the Orocopia Schist (southwestern U.S.) during low-angle subduction, Geology (2021). DOI: 10.1130/G48647.1

Journal information: Geology 

Provided by University of Wyoming 

What does the Delta variant have in store for the U.S? We asked coronavirus experts

Crowds on Bourbon Street in New Orleans in late July. The coronavirus Delta variant is driving record-breaking case counts in Louisiana and other states. KATHLEEN FLYNN/REUTERS

By Meredith Wadman

Aug. 4, 2021 , 6:50 PM

The United States is standing at a dire inflection point, with pandemic coronavirus cases surging and only 50% of the population fully vaccinated. Driving the latest wave is the highly contagious Delta variant, which according to the Centers for Disease Control and Prevention (CDC) caused between 80% and 87% of all U.S. COVID-19 cases in the last 2 weeks of July — up from 8% to 14% in early June. The variant’s exceptional infectiousness has driven cases from a 7-day average of 13,500 daily cases in early June to 92,000 on 3 August. At the same time, an internal CDC document that leaked last week says the variant may make people sicker, citing published reports from Singapore and Scotland and a preprint from Canada.

The good news is that severe disease and death are highly unlikely among the vaccinated—and U.S. vaccination rates are beginning to increase once again, if modestly.

How bad will the U.S. surge become, and how long will it take to recede? “Anyone saying they know exactly what is happening is overconfident,” says Natalie Dean, a biostatistician at Emory University. “There is a lot of uncertainty about what will happen in the future, even on a relatively short time scale.” With that proviso, here is what Dean and other scientists closely following the pandemic told Science they foresee.

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How many cases and deaths can the United States expect in the Delta-driven surge?

Many computer models predict case counts will peak sometime between mid-August and early September. That peak may bring as many as 450,000 daily cases, according to forecasters at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington. IHME’s models have drawn controversy throughout the pandemic and other groups are more conservative: The COVID-19 Forecast Hub predicts the daily case count on 21 August will be somewhere between 29,000 and 176,000, using a range of estimates from 41 different models.

But all projections rely on assumptions that are moving targets—such as mask wearing and vaccination behavior—and accuracy quickly diminishes the further out the forecast. “We can probably expect to see cases continue to rise for the next 2 or 3 weeks at least. Beyond that, I think it’s challenging to predict,” says David Dowdy, an infectious disease epidemiologist at the Johns Hopkins Bloomberg School of Public Health.

Hospitalizations and deaths will lag behind cases by several weeks and, given the number of people who are now vaccinated, deaths are expected to be lower than their peak of more than 3400 per day in January. Still, IHME researchers forecast a peak of about 1000 deaths a day in mid-September, and a total of 76,000 additional deaths by 1 November. But if 95% of the people in the United States wore masks, their model predicts, 49,000 of those lives would be saved. Americans, including young and healthy people, should not underestimate this variant, warns Ali Mokdad, an IHME epidemiologist. “Delta is a nasty one,” he says.
Can other countries’ Delta surges offer hints about what will happen in the United States?

In India, where the Delta variant was first identified, a massive, Delta-driven wave began in late March and receded by late June, even though mask wearing was spotty and less than 1% of the population was vaccinated as the wave began. In the United Kingdom, a surge that began in early June peaked in mid-July and is now rapidly receding, although daily cases are still many times what they were before the Delta variant took over.

But assuming the U.S. surge will recede as quickly as the one in the United Kingdom did may be a mistake. In that country, vaccine uptake has been much higher than in the United States. Former CDC Director Tom Frieden, president of the nonprofit Resolve to Save Lives, cautioned yesterday in a tweet that the number of unvaccinated Americans could make the U.S. surge “much deadlier” than the United Kingdom’s.

The national case count obscures the record-breaking infection rates in U.S. states with low vaccination rates such as Florida and Louisiana. In Alabama, where just 35% of the population is fully vaccinated, hospitalizations have more than doubled in the past 10 days to nearly 1700—the same number of full beds as at the end of November 2020. The difference: Back then, the doubling took 6 weeks. The amount of time you need to be exposed to someone who has the Delta variant is much less than what it was with that ancestral strain,” says epidemiologist Russell Griffin of the University of Alabama, Birmingham (UAB). What's more, he says, the median age of patients at the UAB hospital has fallen from 65 to 52 since January, and healthy young adults are starting to turn up in the intensive care unit.

Can Delta infect fully vaccinated people?

Yes, although vaccination still protects extremely well against severe disease and death. A study of a recent Delta-driven outbreak in Provincetown, Massachusetts, published in the CDC’s Morbidity and Mortality Weekly Report last week, was pivotal to the agency’s decision to reverse itself and advise fully vaccinated people to wear masks in indoor public places in areas where transmission is high, agency Director Rochelle Walensky said. In the Massachusetts outbreak, fully vaccinated people accounted for 74% of nearly 469 COVID-19 cases. (Four of the five people hospitalized in the outbreak were fully vaccinated; no one died.)

Strikingly, the study found that fully vaccinated people carried just as much virus in their noses and throats as the unvaccinated. Since then, a new, not-yet-peer-reviewed, preprint from the University of Wisconsin, Madison has reported similar findings.

It’s not surprising that, at the time they're diagnosed, fully vaccinated people might carry a large nasal load of a variant that’s known to replicate rapidly, says Sixto Leal, who directs medical microbiology at UAB hospitals. That’s because although vaccines are excellent at generating blood-borne antibodies, they are not as good at generating a form of antibody that occupies the lining of the nose and throat. “There’s a window of time when fast-replicating virus can enter [the cells lining the nose], replicate like crazy in a very high amount, and [cause] symptoms,” Leal says.

But in vaccinated people, the replication soon alerts the immune system to send blood-borne antibodies that neutralize the virus in the nose and throat, Leal says. Another new preprint from scientists in Singapore found that although vaccinated and unvaccinated patients infected with Delta had similar viral loads when diagnosed, those loads declined more rapidly in the vaccinated. “Based on basic immunology, that’s exactly what we would expect—that vaccinated individuals would clear the infection much faster,” says Kristian Andersen, an infectious disease researcher at Scripps Research.
What might happen in the fall and winter, when people move indoors and children are back in school?

“There’s every reason to suspect that SARS-CoV-2 infection rates will be worse in winter as opposed to summertime, because that’s the path we see with other respiratory viruses,” Dowdy says. “[But] we don’t have evidence yet.” And with so much Delta circulating in both vaccinated and unvaccinated people, we are unwittingly exerting selection pressure for new, more dangerous variants to evolve, Andersen cautions. “This fall and winter I am not sure we will be dealing with Delta. I think we will probably be dealing with a variant we haven’t heard about yet,” he says. “From a viral evolution perspective, it would be foolish not to expect that.”
Does Delta’s trajectory influence the debate over whether people should receive booster doses?

Scientists generally agree on the need for immunocompromised people to receive boosters soon, although a go-ahead from U.S. regulators will be needed. Israel is moving ahead with administering a third vaccine dose to people age 60 and older, and the United Kingdom may soon follow with boosters for older people.

But experts disagree on whether Delta’s emergence calls for an urgent focus on boosters in the general population. Pfizer added fuel to the conversation last week, when it posted a preprint showing the efficacy of its vaccine declined from 96.2% to 83.7% more than 4 months after full vaccination.

But because the available U.S. vaccines are still highly effective against Delta and the vast majority of serious illness and death is occurring in people who are unvaccinated, “I would strongly prioritize getting more people fully vaccinated than getting booster shots in people,” Dowdy says.

Dean, adds that a global view is important: “We live in a world where so many people remain unvaccinated. How do you justify that boost to individuals that [already] have a certain amount of protection?”

World Health Organization Director-General Tedros Adhanom Ghebreyesus threw the organization’s moral authority behind that viewpoint today, calling for a moratorium on booster vaccinations through at least September. Confronted with the Delta variant, he said, “We cannot accept countries that have already used most of the global supply of vaccines using even more of it, while the world’s most vulnerable people remain unprotected.”

But Andersen, who is calling for rapid development and distribution of Delta-specific boosters, calls the booster-versus-vaccine question a false choice. “We need to do both,” he says. “And that requires warlike efforts which we are not doing right now.”

What will make the Delta surge fade away?

Although the reasons for Delta receding in India and the United Kingdom remain unclear, increasing population immunity—from either infection with the virus or vaccination—should give the variant increasingly fewer new opportunities to spread. Human behavior plays a role, too. “As cases start to climb … [people] start to think twice about that big party they were going to go to,” Dowdy says. Another factor that may bend the U.S. curve is CDC’s revised recommendation last week that fully vaccinated people again wear masks in public, indoor spaces in areas of high transmission. The decline will take time. “People need to recognize that things are going to get worse before they get better,” Dowdy cautions. “But it’s not time to panic in thinking that this is going to be December [2020] and January all over again.”

Have COVID-19 scientists changed their own behavior since Delta emerged?

“I started wearing a mask again at the grocery store,” says Dean, who lives in Gainesville. “I feel confident in the vaccine. I just am not going out to a bar. But I wasn’t doing that a ton [anyway].”

In San Diego, Andersen, who never stopped wearing a mask in indoor settings with other people, now says he is not frequenting crowded outdoor spaces either—including restaurants. “We get take-out instead.”

At UAB, Leal required masks for his lab’s employees 3 weeks ahead of a new campuswide mandate. “We had experienced 2 months of happiness and [a] return to normal,” he says. “Now we are much more cautious again.”
P

doi:10.1126/science.abl7874


Meredith Wadman

Canada's health system ranked second last among 11 countries: report

Brooklyn Neustaeter

CTVNews.ca Writer
Published Wednesday, August 4, 2021 

TORONTO -- A new report has ranked Canada's health system second last, ahead of the United States, among high-income countries.

The report, released on Wednesday by the Commonwealth Fund, ranked 11 high-income countries on key health-system measures, including equity, access to care, affordability, health-care outcomes, and administrative efficiency.

The report found that the top-performing health systems overall are in Norway, the Netherlands, and Australia, while Switzerland, Canada and the U.S. were the countries with the worst health-care systems, respectively.

However, the report noted that the U.S. performance falls "far below" Switzerland and Canada's, despite these countries being ranked directly above it.

In addition to its overall ranking, the study noted that the U.S. ranks last on access to care, administrative efficiency, equity, and health-care outcomes, but second for preventative care processes, such as screenings and vaccinations.

The report said countries were ranked by an expert advisory panel using Commonwealth Fund international surveys conducted in each country prior to the COVID-19 pandemic, as well as administrative data from the Organisation for Economic Co-operation and Development and the World Health Organization.

CANADA'S RANKING

The report ranked Canada 10th overall, as well as in two major categories: equity and health-care outcomes.

The report found that income-related disparities in accessing health care are largest in the U.S., Canada, New Zealand, and Norway.

"Compared to the other countries, the United States and Canada had larger income-related inequities in patient reported experiences," the study noted.

The inequities include financial barriers to accessing medical and dental care, medical bill burdens, difficulty obtaining after-hours care, and the use of web portals to facilitate patient engagement.

In regards to health-care outcome metrics, defined in the report as those outcomes that can be improved by the delivery of health-care services, Canada ranked 10th after taking into account mortality rates and life expectancy.

Compared to other countries, the report found that Canada spends less on social programs, such as early childhood education, parental leave, and income supports for single parents, which impact health-care services.

Canada also ranked 9th out of the 11 countries for access to care, with the report citing the country's health-care system's affordability and timeliness as reason for its placement.

To improve one's health system, the report says countries need to ensure they provide universal coverage to help remove cost barriers, primary-care services should be expanded to every local community, administrative burdens should be reduced to free up resources, and they need to invest in social services, specifically for children and working-age adults.

While the report acknowledges that no health system is perfect, the panel recommends countries look to one another to see what has worked and what has not.

In doing so, the report says countries may move closer to the "ideal of a health system that achieves optimal health for all its people" at an affordable price.

"International comparisons allow the public, policymakers, and health-care leaders to see alternative approaches to delivering health care, ones that might be borrowed to build better health systems that yield better health outcomes," the report said.

NHS drops from first to fourth among rich countries’ healthcare systems

Thinktank says longer wait for treatment since Covid pandemic is main reason, in study of 11 countries

Denis Campbell 

Health policy editor

THE GUARDIAN
Wed 4 Aug 2021 

The NHS has lost its prestigious ranking as the best health system in a study of 11 rich countries by an influential US thinktank.

The UK has fallen from first to fourth in the Commonwealth Fund’s latest analysis of the performance of the healthcare systems in the nations it studied.

Norway, the Netherlands and Australia now provide better care than the UK, it found. The findings are a blow to the NHS, which had been the top-rated system in the thinktank’s two previous reports in 2017 and 2014. The US had by far the worst-rated system, despite spending the most on care.

The Washington-based Commonwealth Fund blamed the NHS’s slip down its league table on the delays patients face in accessing care and treatment, lack of investment in the service and poverty.

“According to this report, our previously world-beating health service is at risk of moving to the middle of the pack, largely due to growing delays across the system in people’s ability to access care quickly,” said Siva Anandaciva, the chief analyst at the King’s Fund, the leading UK health thinktank.

“We can’t brush this under the carpet as being solely a consequence of the impact of the pandemic on patients, staff and services. Even before Covid, waiting lists for treatment were already sizeable after a decade of stalling funding and a growing workforce crisis.


“As Covid put the NHS under unprecedented pressure, the waiting list for routine NHS care has ballooned to levels not seen since the early 2000s. Whilst the NHS is doing its best to keep services running, increasing demand for hospital, mental health and GP services means the whole health and care system is now facing a capacity crunch,” he added.

Eric Schneider, lead author of the Commonwealth Fund’s Mirror, Mirror 2021 report, said the UK had scored lower marks compared with 2017 on three of the five domains its panel of experts used: access to care; care processes, which look at the co-ordination of treatment and how well patients are involved; and equity, or the ability to obtain healthcare regardless of income.

He pinpointed the time taken to access care in the UK as a key factor in its ranking. “For example, nearly 60% of adults in the UK found it somewhat or very difficult to obtain after-hours care, one of the highest rates among the countries surveyed,” he said.

‘It’s been real mental torture’: one woman’s wait for vital surgery

The study also found that while 78% of Britons in 2017 said that their regular doctor always or often answered a query on the day they posed it, just 65% did so this year. Similarly, while 57% in 2017 said they saw a doctor or nurse on the same or next day the last time they sought care, that has fallen to 52%

In addition, just 33% of patients said that they got counselling or treatment for mental health problems when they sought help from a specialist in psychological or psychiatric illness – a new indicator that the thinktank had not previously analysed. The NHS was the second worst performer of the 11 countries on that criterion, just ahead of

 France.‘

Almost indescribable pain’: life stuck on an NHS waiting list

As well as being ranked fourth overall the UK was also ranked fourth out of 11 for access to care, administrative efficiency and equity, and fifth for care processes but just ninth for health care outcomes, which measures how well patients recover after undergoing medical treatment.

Asked to explain the NHS’s decline relative to the other nations, Schneider added: “We know that reported experiences of access, co-ordination and engagement can deteriorate over time if budgets are cut. The UK has been a remarkably lean spender among high-income countries while nevertheless maintaining a very high ranking.”

NHS England declined to comment. A Department of Health and Social Care spokesperson said: “We are committed to making sure the NHS has everything it needs to continue providing excellent care to the public, as we tackle the backlogs that have built up.

“We gave the NHS a historic settlement in 2018, which will see its budget rise by £33.9bn by 2023/24, and we have provided an extra £92bn to support health and care services throughout the pandemic.”

Long-Lost Fragment of Stonehenge Gives Unprecedented Glimpse Inside Ancient Monument

Pink supermoon over Stone Henge in April 2021. (Finnbarr Webster/Stringer/Getty Images)

MINDY WEISBERGER, LIVE SCIENCE

5 AUGUST 2021

A long-lost piece of Stonehenge that was taken by a man performing restoration work on the monument has been returned after 60 years, giving scientists a chance to peer inside a pillar of the iconic monument for the first time.

In 1958, Robert Phillips, a representative of the drilling company helping to restore Stonehenge, took the cylindrical core after it was drilled from one of Stonehenge's pillars – Stone 58. Later, when he emigrated to the United States, Phillips took the core with him.

A rocky core was removed during restoration work in 1958, and then kept as a souvenir

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The final stone is put in place during the restoration of Stonehenge on July 9, 1958, with the giant lintel laid across the top of upright megaliths 57 and 58. 

(Image credit: PA Images/Alamy Stock Photo) website.

Drilling work at Stonehenge in 1958, during which cores of sarsen stone were extracted from Stone 58. Robert Phillips, who returned one of the cores to the U.K. in 2018, is pictured left. (Image credit: Lewis Phillips)

Because of Stonehenge's protected status, it's no longer possible to extract samples from the stones. But with the core's return in 2018, researchers had the opportunity to perform unprecedented geochemical analyses of a Stonehenge pillar, which they described in a new study.

They found that Stonehenge's towering standing stones, or sarsens, were made of rock containing sediments that formed when dinosaurs walked the Earth. Other grains in the rock date as far back as 1.6 billion years.

Sample of the core from Stone 58 (British Geological Survey)

Related: In photos: A walk through Stonehenge

"We have CT-scanned the rock, zapped it with X-rays, looked at it under various microscopes and analyzed its sedimentology and chemistry," said study lead author David Nash, a professor of physical geography at the University of Brighton in England.

"With the exception of thin-section analyses and a couple of the chemical methods, all of the techniques we used in the study were new both to Stonehenge and the study of sarsen stones in the UK," Nash told Live Science in an email.

Stonehenge's central circle of pillars was erected during the Neolithic period, about 2,500 years ago, according to English Heritage, a nonprofit organization that manages historic monuments in England.

"Sarsens were erected in two concentric arrangements – an inner horseshoe and an outer circle – and the bluestones [smaller monument stones] were set up between them in a double arc," English Heritage said on its website.

When the scientists peered through a microscope at thin slices of sarsen rock from Stone 58, they were surprised to discover that the stone was 99.7 percent quartz. A quartz "cement" held fine-to-medium quartz grains and formed "an interlocking mosaic of crystals," Nash said.

That made the rock more durable, and it may have been why the builders chose that type of rock for their massive monument thousands of years ago.

"These cements are incredibly strong. I've wondered if the builders of Stonehenge could tell something about the stone properties, and not only chose the closest, biggest boulders, but also the ones that were most likely to stand the test of time," Nash said.

(Trustees of the Natural History Museum)
Above: Microscope image from the sarsen sample showing the tightly interlocking mosaic of quartz crystals that cement the rock together. The outlines of quartz sand grains are indicated by arrows.

Older than dinosaurs

The researchers' analysis also revealed clues about the ages of sediments in the rock, Nash said in the email.

"The sandy sediments within which the stone developed were deposited during the Paleogene period, 66 [million] to 23 million years ago, so the sarsens can be no older than this," he explained.

However, when the scientists compared ratios of neodymium isotopes – or atoms of the element with a different number of neutrons in the nucleus – in the samples, they found that certain sediments in the sarsen stone were even more ancient.

Some grains were likely eroded from rocks dating to the Mesozoic era (252 million to 66 million years ago), when they may have been trodden upon by dinosaurs.

And some of the sand grains formed as long ago as 1 billion to 1.6 billion years ago, Nash said.

While this analysis answered some questions about Stonehenge, other unresolved puzzles remain, among them the whereabouts of two more cores that were drilled from Stone 58 during the 1958 restoration, and which also vanished from the record.

Workers at the Salisbury Museum in England discovered part of one of those cores in their collection in 2019, the researchers reported. Museum director Adrian Green contacted a representative at English Heritage, reporting the discovery of a portion of a core from Stone 58 "in a box marked '3x Stonehenge Stones from 'Treasure Box,'" according to the study.

The scientists investigated the Salisbury fragment alongside the Phillips core, and recorded its data in their study. However, "how and when it came to be at the museum was unknown," the authors wrote.

The location of the third core (and the rest of the core found at the Salisbury Museum) "is similarly unknown," the scientists said.

The findings were published August 4 in the journal PLOS One.

VALE SUDBURY

Strike is over: Local 6500 members vote 85% to ratify new deal

Deal includes wage increases of 6% over five years, maintaining post-retirement benefits for new hires 

 By: Sudbury.com Staff

United Steelworkers Local 6500 members on the picket line at the entrance to Clarabelle Mill on Tuesday, June 1.Arron Pickard/Sudbury.com

Steelworkers Local 6500 members voted 85 per cent in favour of a new deal with Vale, ending a strike that began June 1.

Vale announced the deal on its website late last night. Local 6500 members reviewed the deal yesterday and voted last night on whether to accept it.

The new agreement takes effect immediately.

Dino Otranto, Vale’s chief operating officer for its North Atlantic Operations, said the company was pleased an agreement had been reached.

"The past two months have been challenging for everyone," Otranto said in a news release. "We are pleased that the company and the union were able to find common ground and a path forward. We look forward to welcoming everyone. Our task now is to position our business to thrive today and for generations to come. We have many opportunities ahead of us, with the growing electric vehicle market. 

“The nickel, copper and cobalt we produce are critical metals to achieving a low carbon future. What we produce, and how we produce it, matters and our collective success going forward will require collaboration to make this business successful for us all. I’m confident that together, we will find our way."

The company said employees return to work the week of Aug. 9, with production ramping up in the weeks ahead.

The agreement ensures wage increases of six per cent over five years and maintains post-retirement benefits for new hires, one of the key sticking points that led to the strike.

The new five-year tentative agreement comes with a $2,500 recognition payment in recognition for efforts during the pandemic, to be paid this month.

It also comes with a $3,500 signing bonus, to be paid in September.

Wages will increase by a minimum of six per cent over the five year contract, with 1.5 per cent in the first year, plus an 82-cent cost-of-living allowance. Wages will increase by one per cent plus a 41-cent cost-of-living allowance in the second year, another one per cent plus a 41-cent cost-of-living allowance in the third year, another one per cent plus a 41-cent cost-of-living allowance in the fourth year, and another 1.5 per cent plus a 41-cent cost-of-living allowance in the fifth year.

Throughout the duration of the strike, many members said they were fighting for the future, as the Vale wanted to ax post-retirement benefits for all future hires. The union and the company have agreed to keep those benefits in place. Furthermore, over-the-counter drug coverage is being maintained.

The nearly 2,500 Local 6500 members hit the picket line June 1 after rejecting the first contract offer, which the union’s bargaining committee recommended workers accept. On June 14, members rejected a second contract offer. 

In mid-July, a third-party facilitator was brought in to help with negotiations. 

At the time, Local 6500 vice-president Kevin Boyd said the mood among the 2,500 members on the picket line is one of optimism on news negotiators had returned to the table.

“We could not have reached this settlement without your incredible support and principled stand you took throughout this difficult process,” said the bargaining committee in a message to members. We believe this tentative agreement is worthy of your USW Local 6500 solidarity and values, and we are unanimously recommending ratification.”

Local 6500 reveals highlights of new proposed 5-year deal

Steelworkers meeting today to vote on deal with Vale that offers 6% wage increase and to keep post-retirement benefits for new hires

1 d By: Arron Pickard

United Steelworkers retired international president Leo Gerard speaks with striking miner Dave Johns during a visit to striking Local 6500 members on the picket line at the Copper Cliff smelter in June. Arron Pickard / Sudbury.com

Wage increases of six per cent over five years and maintaining post-retirement benefits for new hires are among the highlights of a new tentative agreement reached by Vale and the striking United Steelworkers Local 6500.

In a message to its members, the union said after two weeks of challenging negotiations, a tentative agreement has been reached, one the bargaining team said includes significant monetary improvements for existing members and preserves retiree health benefits for all future hires.

The new five-year tentative agreement comes with a $2,500 recognition payment in recognition for efforts during the pandemic, to be paid this month.

It also comes with a $3,500 signing bonus, to be paid in September.

Wages will increase by a minimum of six per cent over the five year contract, with 1.5 per cent in the first year, plus an 82-cent cost-of-living allowance. Wages will increase by one per cent plus a 41-cent cost-of-living allowance in the second year, another one per cent plus a 41-cent cost-of-living allowance in the third year, another one per cent plus a 41-cent cost-of-living allowance in the fourth year, and another 1.5 per cent plus a 41-cent cost-of-living allowance in the fifth year.

Throughout the duration of the strike, many members said they were fighting for the future, as the Vale wanted to ax post-retirement benefits for all future hires. The union and the company have agreed to keep those benefits in place. Furthermore, over-the-counter drug coverage is being maintained.

Membership meetings are taking place today, and online voting will take place from 4-11 p.m.

The nearly 2,500 Local 6500 members hit the picket line June 1 after rejecting the first contract offer, which the union’s bargaining committee recommended workers accept. On June 14, members rejected a second contract offer. 

In mid-July, a third-party facilitator was brought in to help with negotiations. 

Local 6500 vice-president Kevin Boyd said the mood among the 2,500 members on the picket line is one of optimism on news negotiators had returned to the table.

“We could not have reached this settlement without your incredible support and principled stand you took throughout this difficult process,” said the bargaining committee in a message to members. :We believe this tentative agreement is worthy of your USW Local 6500 solidarity and values, and we are unanimously recommending ratification.”

In an email statement, Vale said the details of the agreement are being reviewed and voted on.

“We will have no further comment until such times as that occurs and the vote is complete,” said Vale spokesperson Danica Pagnutti.

We can confirm we have reached a tentative deal on a new five-year collective bargaining agreement with United Steelworkers (USW) Local 6500. Details of the tentative agreement are being shared directly with Local 6500 membership to review and vote on the offer on Tuesday. We will have no further comment until such time as that occurs and the vote is complete.

Vale warns Canada nickel ramp-up will stretch into next quarter

Bloomberg News | August 4, 2021 | 

Sudbury, Ontario. Photo by P199, Wikimedia Commons.

Vale SA may have finally resolved a strike at its Sudbury complex, but don’t expect it to resume nickel and copper production anytime soon.


After a wage deal with workers ended the two-month stoppage, Vale outlined a return-to-production schedule that won’t see the Canadian facility fully up and running again until next quarter. Maintenance underway at the mines and plants will be completed, with the ramp-up beginning in September, the Rio de Janeiro-based company said Wednesday in an emailed response to questions.

While staff will return to work next week, the complex nature of restarting smelters and refineries may keep pressure on the metals markets. Sudbury is one of the few producers of nickel pellet, which is used to make alloys for the aerospace, electronic and nuclear industries. The disruption has driven consumers to tap battery-grade nickel briquette as an alternative, raising its premium and shortening inventories.

Vale is looking to steady its base metals ship after a poor performance last quarter that prompted the world’s largest commercial producer of nickel to discontinue annual production guidance. On a call with analysts last week, Chief Executive Officer Luciano Siani predicted a “challenging” third quarter at Sudbury even if the strike ended quickly.

Besides monetary sweeteners, the new contract preserves retiree health benefits for future hires as well as paying each worker a $3,500 signing bonus and $2,500 for their efforts in the pandemic.Post-retirement benefits had been a sticking point in the talks as Vale looks to contain costs and overhaul operations with an eye on the demanding battery market.

“We have many opportunities ahead of us, with the growing electric vehicle market,” Dino Otranto, chief operating officer of North Atlantic operations, said in a statement. “The nickel, copper and cobalt we produce are critical metals to achieving a low carbon future.”

(By Mariana Durao and James Attwood)