Research, advocacy, education urged to address chronic disease through Food Is Medicine programs

American Heart Association Presidential Advisory calls for building on existing research and implementing cross-sector approaches to Food Is Medicine

Peer-Reviewed Publication

AMERICAN HEART ASSOCIATION

DALLAS, September 28, 2023 — Creating a stronger body of research on the efficacy and value of clinical Food Is Medicine programs is critical to improving the treatment and prevention of many serious chronic health conditions, according to a new American Heart Association Presidential Advisory published today in the Association’s flagship scientific journal Circulation. Given the significant role that food and nutrition play in supporting health, the American Heart Association, a global force for healthier lives for all, recommends approaches to close gaps in research and build a robust evidence base for increasing adoption of clinical Food Is Medicine programs in the U.S.

An estimated 90% of the $4.3 trillion annual cost of health care in the U.S. is spent on medical care for chronic diseases. Unhealthy food intake is a major risk factor for many of these diseases. Healthy food is not accessible or affordable for many people in the U.S., making it difficult to apply clinical food-based interventions that treat and prevent disease. Recent research demonstrates that health care systems may be able to help patients access healthy foods, resulting in improved health, reduced need for health care and better cost-effectiveness.

Food Is Medicine (FIM) may be defined as providing healthy food resources to treat, manage and prevent specific chronic conditions in coordination with the health care sector. FIM programs can be prescribed by a health care professional, health care organization or health insurance plan, and can include interventions such as medically tailored meals, medically tailored groceries and produce prescriptions. FIM represents a paradigm shift focused on incorporating food and nutrition programs into health care systems.

“To unlock the potential of Food Is Medicine and make it a regular and reimbursable component of health care, we need an ambitious and coordinated research approach,” said Kevin G. Volpp, M.D., Ph.D., FAHA, American Heart Association volunteer, chair of the Presidential Advisory writing group, director of the Center for Health Incentives and Behavioral Economics at the University of Pennsylvania and research lead of the Association’s Food Is Medicine Initiative. “By addressing research gaps and integrating research efforts in collaboration with stakeholders nationwide, we will fuel cross-sector efforts that ensure Food Is Medicine programs improve health costs effectively and are feasible in practice.”

FIM programs are not new; however, the study of these interventions in health care has been limited by factors including small sample sizes, non-randomized comparisons and broad differences in data collection and measurement. The advisory proposes a coordinated research approach to compare how well nutrition-based interventions treat and prevent disease compared to standard medical care. This approach is the foundation of the Food Is Medicine Initiative announced at the White House Conference on Hunger, Nutrition and Health in September 2022. Earlier this month, the Association announced the Initiative’s first Request for Proposals for groundbreaking research projects. RFP applications are open through Nov. 6. A webinar will be held Oct. 4 to answer questions from researchers considering submitting proposals.

“Food Is Medicine holds the promise to improve health outcomes for millions of patients living with or at risk for cardiovascular disease and other serious chronic health conditions,” said Mitchell S.V. Elkind, M.D., M.S., FAHA, FAAN, chief clinical science officer of the American Heart Association, past volunteer president of the Association, a member of the Presidential Advisory writing committee and a tenured professor of neurology and epidemiology at Columbia University. “Too many patients lack access to healthy foods, and they may have limited ability to prepare those foods into healthy meals, but Food Is Medicine programs can help change that.”

The advisory outlines key principles to guide research on Food Is Medicine, aligned with the highest standards of clinical research, and emphasizes equity and lived experiences of people in communities across the U.S. The advisory also proposes concurrent efforts to strengthen public policy, ensure quality, standardize professional education, educate the public and prioritize FIM programs at all levels of government.

Food Is Medicine is particularly important within the broader context of the Association’s efforts to improve health equity by enhancing food systems and related policies that support improvements in health.

The advisory concludes with a call to action on the steps needed for multi-sector partnerships to develop evidence on efficacy and value that will inform decisions by health insurers to cover FIM as a medical benefit.

The advisory was prepared by a volunteer writing group on behalf of the Association. American Heart Association Presidential Advisories promote greater awareness about cardiovascular diseases and stroke issues and help facilitate informed health care decisions. Presidential Advisories outline what is currently known about a topic and what areas need additional research. While these advisories inform the development of guidelines, they do not make treatment recommendations. American Heart Association guidelines provide the Association’s official clinical practice recommendations.

Additional members of the volunteer writing committee are Seth A. Berkowitz, M.D., M.P.H., co-vice chair; Shreela V. Sharma, Ph.D., R.D., L.D., co-vice chair; Cheryl A.M. Anderson, Ph.D., M.P.H., M.S., FAHA; LaPrincess C. Brewer, M.D., M.P.H., FAHA; Christopher D. Gardner, Ph.D., FAHA; Julie E. Gervis, Ph.D.; Robert A. Harrington, M.D., FAHA; Mario Herrero, Ph.D., M.Sc.; Alice H. Lichtenstein, D.Sc., FAHA; Mark McLellan, M.D., Ph.D; Jen Muse, R.D.; Christine A. Roberto, Ph.D.; and Justin P.V. Zachariah, M.D., M.P.H., FAHA. Authors’ disclosures are listed in the manuscript.

Additional Resources:

• VIDEO: Clips with Dr. Volpp offering insight into the FIM program (closed captioning and transcripts provided) are available on the right column of this release link.
• After Sept. 28 at 4 a.m. CT / 5 a.m. ET, view the manuscript online.
• American Heart Association Food is Medicine initiative
• American Heart Association Scientific Statements and Advisories:
  • American Heart Association’s 2024 Impact Goal (2021): Every Person Deserves the Opportunity for a Full, Healthy Life
  • Science Advisory (2019): Innovation to Create a Healthy and Sustainable Food System
  • Scientific Statement (2021): Dietary Guidance to Improve Cardiovascular Health
  • Scientific Statement (2020): Rapid Diet Assessment Screening Tools for Cardiovascular Disease Risk Reduction Across Healthcare Settings
• Follow AHA/ASA news on X (formerly known as Twitter) @HeartNews  

About the American Heart Association

The American Heart Association is a relentless force for a world of longer, healthier lives. We are dedicated to ensuring equitable health in all communities. Through collaboration with numerous organizations, and powered by millions of volunteers, we fund innovative research, advocate for the public’s health and share lifesaving resources. The Dallas-based organization has been a leading source of health information for nearly a century. Connect with us on heart.org, Facebook, X or by calling 1-800-AHA-USA1.

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JOURNAL

Circulation

DOI

10.1161/CIR.0000000000001182 

ARTICLE TITLE

Food Is Medicine: A Presidential Advisory From the American Heart Association

 

New free-to-read collection shares research into academic freedom and censorship

Business Announcement

SAGE

Sage has launched a new collection of free-to-read research highlighting the effects of academic censorship on democracy, social-emotional learning, higher education, and more. Categories in the collection include: 

• academic freedom 
• banned content 
• cultures in the classroom 
• intellectual freedom 
• social emotion learning 

 

Sage’s guaranteed independence means that we are free to focus on our mission and values for the long term, including supporting intellectual freedom. The Banned Books and Academic Freedom microsite is part of Sage’s larger commitment to supporting academic freedom: 

• Publishing Index on Censorship, a nonprofit that campaigns for and defends free expression worldwide. They publish work by censored writers and artists, promote debate, and monitor threats to free speech.

• A co-sponsor of the Downs Intellectual Freedom Award, Sage celebrated the 2022 winners, the New College of Florida faculty, librarians, student reporters of The Catalyst, and the Defend New College and Save New College student and alumni organizations. The group took a stand against a Florida mandate to overhaul the school toward a “more traditional liberal arts institution.”  
• Putting together a “Banned Books Week Webinar: Navigating Threats to Academic Freedom: Experiences and Needs,” which will feature researchers and higher-ed faculty highlighting the threats to academic freedom and discussing the necessary support needed.   
• Affirming a joint commitment to the landmark 1953 Freedom to Read statement, on June 25th, Sage joined ALA and others as a signatory.    

 

Ancient plant wax reveals how global warming affects methane in Arctic lakes

Warming led to an intensified methane cycle, lasting thousands of years, study finds

Peer-Reviewed Publication

NORTHWESTERN UNIVERSITY

 

IMAGE: A SECTION OF SEDIMENT CORE MATERIAL FROM WAX LIPS LAKE IN NORTHERN GREENLAND. view more 

CREDIT: JAMIE MCFARLIN

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• New study makes novel use of plant biomarkers preserved in sediment to reconstruct methane cycling over the past 10,000 years
• Plant waxes hold an isotopic signature of ancient methane
• As planet warmed due to slow changes in Earth’s orbit, lakes produced increased amounts of methane, which is a potent greenhouse gas
• Researcher: ‘Living on a warming planet, we can look to these signs from the past to predict our future’

EVANSTON, Ill. — By studying fossils from ancient aquatic plants, Northwestern University and University of Wyoming (UW) researchers are gaining a better understanding of how methane produced in Arctic lakes might affect — and be affected by — climate change.

In a new study, the researchers examined the waxy coatings of leaves preserved as organic molecules within sediment from the early-to-middle Holocene, a period of intense warming that occurred due to slow changes in Earth’s orbit 11,700 to 4,200 years ago. These wax biomarkers — which were once a part of common aquatic brown mosses — were preserved in sediment buried beneath four lakes in Greenland.

By studying these biomarkers, the researchers discovered that past warming during the middle Holocene caused lakes across a wide range of Greenland’s climates to generate methane. Because methane is a more potent greenhouse gas than carbon dioxide, any changes in methane production with warming are important to understand.

Currently, researchers have incomplete knowledge of how much methane is produced in Arctic lakes and how ongoing warming will affect methane production. The new study suggests that warming potentially could lead to a previously under-appreciated flux in methane emissions from lakes.

The study will be published on Friday (Sept. 29) in the journal Science Advances.

“Last time Greenland lakes experienced major warming, we were coming out of the last ice age, and it took some time for the conditions to develop for lake methane cycling to increase,” said Jamie McFarlin, who led the study. “But once it developed, the lakes in our study maintained an intensified methane cycle for thousands of years until the onset of the naturally driven late Holocene cooling. This supports a climate dependence on lake methane cycling in some Arctic lakes.”

“These data show increased periods of methane cycling during past warm periods,” added Magdalena Osburn, the study’s senior author. “Living on a warming planet, we can look to these signs from the past to help predict our future. We suspect this process is going to become more and more important in the future of these lakes.”

When the research began, McFarlin was a Ph.D. student at Northwestern; now she is an assistant professor at UW. Osburn is an associate professor of Earth and planetary sciences at Northwestern’s Weinberg College of Arts and Sciences. Osburn co-advised McFarlin with Yarrow Axford, William Deering Professor in Geological Sciences at Weinberg College and the paper’s second author.

Lakes act as significant natural sources of methane, but exactly how much methane production will change with ongoing warming within Arctic lakes is not fully quantified. And because Arctic and boreal landscapes are the fastest warming regions on Earth, it is imperative for researchers to better understand the dynamics between warming temperatures and methane production in these lakes.

To explore these dynamics, the researchers produced new data at two lakes (Wax Lips Lake and Trifna Sø) and reviewed published data from two additional lakes on Greenland (Lake N3 and Pluto Lake). They compared the hydrogen isotopic composition of aquatic plant waxes within the sediment to biomarkers from terrestrial plants and other sources. The isotopic composition of biomarkers from aquatic plants revealed a signature from methane during the early-middle Holocene at most sites.

Because these plants absorb methane, they might mitigate some of the methane produced in lakes before it is emitted into the atmosphere.

“In the lakes in our study, some methane was taken up by aquatic mosses living in the lakes — likely through a symbiotic association with a type of bacteria that eats methane,” McFarlin said. “We do not know yet how much methane was produced versus consumed in these lakes during the time period of our study, so the overall effect on the atmosphere remains unclear. The uptake of methane into plants is likely restricted to very specific types of aquatic mosses, however, so not all lakes or even all Arctic lakes will have these same dynamics.”

“The Arctic has huge areas covered in lakes,” Axford said. “Not every lake has mosses that will record methane dynamics, but our study also highlights that those vast swaths of Arctic lakes are vulnerable to climate-driven changes in methane cycling, whether mosses are on site to witness those changes or not. This is yet another way that rapid warming in the Arctic could affect global climate.” 

The study, “Aquatic plant wax hydrogen and carbon isotopes in Greenland lakes record shifts in methane cycling during past Holocene warming,” was supported by the National Science Foundation (NSF) Division of Polar Program awards, an NSF Graduate Research Fellowship, Northwestern’s Paula M. Trienens Institute for Sustainability and Energy and a Geological Society of America Graduate Research Award.

A 2014 field photo from Wax Lips Lake on northwest Greenland with the Greenland Ice Sheet in the background and three of the study authors (Jamie McFarlin, Everett Lasher, Yarrow Axford)

CREDIT

Alex P. Taylor

JOURNAL

Science Advances

DOI

10.1126/sciadv.adh9704 

METHOD OF RESEARCH

Experimental study

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Aquatic plant wax hydrogen and carbon isotopes in Greenland lakes record shifts in methane cycling during past Holocene warming

ARTICLE PUBLICATION DATE

29-Sep-2023

 

Scientists figured out what causes Earth’s strongest lightning

When a storm's charging zone sits close to the Earth's surface, the resulting “superbolts” can be 1,000 times stronger than regular lightning.

Peer-Reviewed Publication

AMERICAN GEOPHYSICAL UNION

 

IMAGE: 

GLOBAL DISTRIBUTION OF ALL SUPERBOLTS FROM 2010-2018, WITH RED POINTS INDICATING THE STRONGEST LIGHTNING STROKES. THE THREE REGIONS IN POLYGONS HAVE THE HIGHEST CONCENTRATION OF SUPER-CHARGED LIGHTNING MAKING THEM SUPERBOLT HOTSPOTS. SUPERBOLT STRIKES TEND TO CLUSTER IN REGOINS WHERE STORMS' ELECTRICAL CHARGING ZONES ARE CLOSEST TO THE EARTH'S SURFACE, ACCORDING TO A NEW STUDY IN THE JOURNAL OF GEOPHYSICAL RESEARCH: ATMOSPHERES.

view more 

CREDIT: EFRAIM ET AL (2023), ADAPTED FROM HOLZWORTH ET AL. (2019)

American Geophysical Union
28 September 2023
AGU Release No. 23-37
For Immediate Release

This press release and accompanying multimedia are available online at:
https://news.agu.org/press-release/scientists-figured-out-what-causes-earths-strongest-lightning

Scientists figured out what causes Earth’s strongest lightning
When a storm's charging zone sits close to the Earth's surface, the resulting “superbolts” can be 1,000 times stronger than regular lightning.

AGU press contact:
Liza Lester, +1 (202) 777-7494, news@agu.org (UTC-4 hours)

Contact information for the researchers:
Avichay Efraim, The Hebrew University of Jerusalem, avichay.efraim@mail.huji.ac.il (UTC+3 hours)

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WASHINGTON — Superbolts are more likely to strike the closer a storm cloud’s electrical charging zone is to the land or ocean’s surface, a new study finds. These conditions are responsible for superbolt “hotspots” above some oceans and tall mountains.

Superbolts make up less than 1% of total lightning, but when they do strike, they pack a powerful punch. While the average lightning strike contains around 300 million volts, superbolts are 1,000 times stronger and can cause major damage to infrastructure and ships, the authors say.

“Superbolts, even though they’re only a very, very tiny percentage of all lightning, they’re a magnificent phenomenon,” said Avichay Efraim, a physicist at the Hebrew University of Jerusalem and lead author of this study.

A 2019 report found that superbolts tend to cluster over the Northeast Atlantic Ocean, the Mediterranean Sea and the Altiplano in Peru and Bolivia, which is one of the tallest plateaus on Earth. "We wanted to know what makes these powerful superbolts more likely to form in some places as opposed to others," Efraim said.

The new study provides the first explanation for the formation and distribution of superbolts over land and sea worldwide. The research was published in the Journal of Geophysical Research: Atmospheres, AGU’s journal dedicated to advancing the understanding of Earth’s atmosphere and its interaction with other components of the Earth system.

Storm clouds often reach 12 to 18 kilometers (7.5 to 11 miles) in height, spanning a wide range of temperatures. But for lightning to form, a cloud must straddle the line where the air temperature reaches 0 degrees Celsius (32 degrees Fahrenheit). Above the freezing line, in the upper reaches of the cloud, electrification takes place and generates the lightning’s “charging zone.” Efraim wondered whether changes in freezing line altitude, and subsequently charging zone height, could influence a storm’s ability to form superbolts.

Past studies have explored whether superbolt strength could be affected by sea spray, shipping lane emissions, ocean salinity or even desert dust, but those studies were limited to regional bodies of water and could explain at most only part of the regional distribution of superbolts. A global explanation of superbolt hotspots remained elusive.

To determine what causes superbolts to cluster over certain areas, Efraim and his co-authors needed to know the time, location and energy of select lightning strikes, which they obtained from a set of radio wave detectors. They used these lightning data to extract key properties from the storms’ environments, including land and water surface height, charging zone height, cloud top and base temperatures, and aerosol concentrations. They then looked for correlations between each of these factors and superbolt strength, gleaning insights into what causes stronger lightning — and what doesn’t.

The researchers found that contrary to previous studies, aerosols did not have a significant effect on superbolt strength. Instead, a smaller distance between the charging zone and land or water surface led to significantly more energized lightning. Storms close to the surface allow higher-energy bolts to form because, generally, a shorter distance means less electrical resistance and therefore a higher current. And a higher current means stronger lightning bolts.

The three regions that experience the most superbolts — the Northeast Atlantic Ocean, the Mediterranean Sea and the Altiplano — all have one thing in common: short gaps between lightning charging zones and surfaces.

“The correlation we saw was very clear and significant, and it was very thrilling to see that it occurs in the three regions,” Efraim said. “This is a major breakthrough for us."

Knowing that a short distance between a surface and a cloud’s charging zone leads to more superbolts will help scientists determine how changes in climate could affect the occurrence of superbolt lightning in the future. Warmer temperatures could cause an increase in weaker lightning, but more moisture in the atmosphere could counteract that, Efraim said. There is no definitive answer yet.

Moving forward, the team plans on exploring other factors that could contribute to superbolt formation, such as the magnetic field or changes in the solar cycle.

“There is much more unknown, but what we’ve found out here is a big piece of the puzzle,” Efraim said. “And we’re not done yet. There’s much more to do.”

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Notes for Journalists:

This study is published with open access in the Journal of Geophysical Research: Atmospheres. View and download a pdf of the study here. Neither the paper nor this press release is under embargo.

Paper title:

“A possible cause for preference of super bolt lightning over the Mediterranean Sea and the Altiplano”

Authors:

• Avichay Efraim, (corresponding author) The Hebrew University of Jerusalem
• Daniel Rosenfeld, The Hebrew University of Jerusalem
• Robert Holzworth, University of Washington, Seattle
• Joel A. Thornton, University of Washington, Seattle

Related research:

“Global distribution of superbolts,” Holzworth et al. (2019), JGR: Atmospheres

*** 
Visit the AGU Newsroom to read about the latest science from AGU’s 23 journals, get updates about our organization, register for complimentary press access to AGU journals, and find topical experts. Visit eos.org to read Research Spotlights and Editors’ Highlights.

***

AGU (www.agu.org/) is a global community supporting more than half a million advocates and professionals in Earth and space sciences. Through broad and inclusive partnerships, AGU aims to advance discovery and solution science that accelerate knowledge and create solutions that are ethical, unbiased and respectful of communities and their values. Our programs include serving as a scholarly publisher, convening virtual and in-person events and providing career support. We live our values in everything we do, such as our net zero energy renovated building in Washington, D.C. and our Ethics and Equity Center, which fosters a diverse and inclusive geoscience community to ensure responsible conduct.

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JOURNAL

Journal of Geophysical Research Atmospheres

DOI

10.1029/2022JD038254 

ARTICLE PUBLICATION DATE

19-Sep-2023

Sexy Instagram images can affect body image

Influencers set bar high for followers

Peer-Reviewed Publication

FLINDERS UNIVERSITY

Viewing sexualised Instagram posts by online influencers increases the negative mood and body dissatisfaction of young female adults who view them, and promotes negative effects among viewers beyond striving for thinness and attractiveness. 

A new study by Flinders University researchers highlights the negative impact of sexualised images on social media and the need for enhanced regulation in relation to influencer advertising. 

“Some Influencers endorse lingerie and bikini products, and there is growing concern about the overtly sexualised nature of the imagery they post to social media,” says body image expert Associate Professor Prichard, who leads the Embrace Impact Lab at Flinders University. 

“This problem is amplified by the popularity of Instagram among young adults aged 18-34 years, with more than two billion active users monthly.” 

The study investigated the effect of viewing both standard fashion and sexualized imagery (in lingerie/bikini garments and posed in a suggestive manner) posted by the same female influencers on young women’s mood and body dissatisfaction.  

Females aged 17–25 years were recruited online and completed pre- and post-viewing measurements of mood and body dissatisfaction, as well as measures of appearance comparison and self-objectification. 

“Exposure to influencer imagery led to greater negative mood, body dissatisfaction, appearance comparison and self-objectification than exposure to control images,” says Associate Professor Prichard. 

“Furthermore, exposure to sexualised images led to an even greater negative mood, body dissatisfaction and appearance comparison than exposure to standard fashion images of influencers – and this was with images chosen as being only moderately sexualised (for ethical reasons) rather than hypersexualised, which depict more lewd poses. 

“The most obvious implication is that women should be advised to limit their exposure to such images and to unfollow the accounts of influencers who post this type of material. There is growing evidence that even a short break from Instagram can have considerable benefit.” 

At a policy level, a new code of ethics for Australian advertisers that came into effect on February 1, 2021, prohibits the use of overtly sexualised images in advertising. However, this does not apply to user-generated material, and therefore does not apply to images posted by Influencers on Instagram.  

Associate Professor Prichard says it could be argued that Influencers, who gain considerable financial benefit from their endorsements, should be held to the same standards as other advertisers. 

“Our study findings highlight the detrimental impact of exposure to sexualised imagery, which is an increasingly common part of contemporary social media, and the role of social comparisons to such imagery,” she says. 

“We have clearly shown that the effects of sexualisation extend beyond those of attractiveness. These findings illustrate the need for more research and enhanced regulation regarding advertising by influencers on social media.” 

The research – “Comparing and self-objectifying: The effect of sexualised imagery posted by Instagram influencers on women’s body image,” by Ivanka Prichard, Brydie Taylor and Marika Tiggemann – has been published by Body Image journal. https://doi.org/10.1016/j.bodyim.2023.07.002 

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JOURNAL

Body Image

DOI

10.1016/j.bodyim.2023.07.002 

METHOD OF RESEARCH

Survey

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Comparing and self-objectifying: The effect of sexualised imagery posted by Instagram influencers on women’s body image

Standing on the shoulders of punk: the early years of dance

Reports and Proceedings

UNIVERSITEIT VAN AMSTERDAM

 

IMAGE: RISE OF DANCE, FALL OF PUNK view more 

CREDIT: RENS WILDEROM

The pre-existing network of labels, record stores, venues and organisers related to the declining punk scene gave dance music a solid base from which to break through in the United Kingdom, and later in the Netherlands. In the United States, the cradle of house music, the lack of those important network relationships was the reason that dance only became popular years later. These were among the conclusions of Rens Wilderom’s investigation into why house, techno and other dance genres became enormously popular in the UK and Netherlands in the late 1980s, but did not in the US. Wilderom defended his PhD at the University of Amsterdam (UvA) on 27 September.

In the late 1980s, many dance enthusiasts lived it up every weekend in clubs such as the Roxy in Amsterdam, Shoom in London or the Hacienda in Manchester. House and techno paved the way , other dance genres would soon follow them up the charts. But while the Netherlands and the UK fell in love with dance, its popularity in the US lagged behind. The first mainstream house hit - Love Can't Turn Around by two American producers - was a hit in Europe, but not in the US.

‘I conduct research into the development of new genres in art and culture,’ says Wilderom. 'Dance has a relatively short, but very interesting history. An important factor in a music genre becoming popular is the (decreasing) popularity of related, existing genres within music. In addition, the media and even the government are important for the institutionalisation of a new genre, helping it become a part of society.'

In his research, Wilderom analysed data on the establishment of dance labels, the commercial success of dance records, and reporting by traditional newspapers and the specialised music press, among other things.

From beginnings in the US to mainstream in the UK

Dance music originally comes from the US. In the 1980s, certain disco scenes were experimenting with drum machines. One of those scenes was in Chicago, at a club called The Warehouse (from which house music allegedly takes its name). While early dance genres such as house and techno thrived in these scenes, they did not achieve much in the way of mainstream success.

Wilderom: 'It was different in the UK. The popularity of (post-)punk declined in the early 1980s. However, the infrastructure of punk labels, punk record stores, punk venues was still there. A number of cultural entrepreneurs in the punk scene wanted something new, something that was still 'authentic' and untouched, and they saw this new scene in the US that met that requirement.'

In the UK, people invested in creating value from the new genre. House was seen as the new punk. In its early days, house attracted a large number of people who had previously been active in punk. Influential people within the music field such as BBC Radio DJs were also involved right from the beginning.

'One reason why dance was able to break through in the UK was the proactive search for the undiscovered, and the benefit of having those labels, shops and stages still existing from the days of punk. Switching to a new genre allowed the former (post-)punk-affiliates to survive in the market,' says Wilderom.

Trance benefits from hardcore's downfall

The developments surrounding dance in the UK were probably also important for the rise and popularity of dance in the Netherlands. For example, a significant number of the first dance hits in the Netherlands were released by British record labels such as 4AD and a number of Britons such as Maz Weston and Paul Jay were involved in organising the first dance parties in Amsterdam. Almost from the beginning, dance (then mainly house) was picked up in the Netherlands by mainstream media. This was a marked difference from the US, where that kind of attention was lacking.

'The theory of genres - that the relationship with existing genres and other facets from the environment are important for the development of a new genre - can also be applied within clusters of related genres. Here in the Netherlands, for example, you see that trance could quickly become popular due to the demise of hardcore,' says Wilderom.

'Trance made use of the existing network and infrastructure of hardcore, in a similar way to how house had made use of the punk network. When hardcore declined in popularity, some of the artists, labels and festival organisers converted from hardcore to trance. It is not a coincidence that famous trance DJs such as Ferry Corsten and Tiësto also have a history in hardcore.'

 

Quarterly number of hits

CREDIT

Rens Wilderom

 

University of Cincinnati research shows widespread naloxone distribution not enough to impact overdose death rate

UC researchers hope study helps reduce the stigma of opioid use disorder

Peer-Reviewed Publication

UNIVERSITY OF CINCINNATI

The highest ever number of opioid-related overdose deaths in the United States was recorded in 2020 at 68,630, a 68% increase in just two years. Naloxone is a medicine that can rapidly reverse an opioid overdose, but a new study out of the University of Cincinnati finds that widespread community distribution of naloxone through a take-home naloxone (THN) program did not significantly impact the median monthly opioid overdose rates.

The study was published in PLOS ONE.

The Naloxone Distribution Collaborative (NDC) was facilitated from October 2017 through December 2019 by Hamilton County Public Health (HCPH). Opioid overdose mortality was compared between the period before (Oct. 2015-Sep. 2017) and during (Oct. 2017-Sep. 2019) the program. Prior to the start of the program, there was little distribution of THN to individuals in Hamilton County.

“Our goal with the naloxone distribution collaborative was to see what happens if we could saturate an entire community and see what impact that might have on the opioid overdose rates,” says Caroline Freiermuth, MD, Endowed Chair to Benefit the Acute Treatment of Mental Health and Substance Use Disorder in the Department of Emergency Medicine at the UC College of Medicine. “We looked to see what impact broad distribution of naloxone had on the community and what we found that it held opioid overdose death rates steady.”

HCPH managed naloxone inventory, recruited distribution sites and distributed cartons directly through community events and health department service locations such as a syringe service program or local jail. Partnering sites were chosen based on their interactions with persons at risk for opioid overdose, people who may interact with those at risk for opioid overdose, community involvement and willingness to participate. To be included in the study, naloxone cartons had to have documentation of either distribution to an individual from a site in Hamilton County, or distribution to an individual with a reported residence within Hamilton County.

Freiermuth says after seeing the study results showing no significant change in the opioid overdose death rate, they went back and modeled what would have happened had that level of naloxone supply been available to the community to predict the opioid death rate to be.

“If you do that prediction modeling, we would have thought the opioid death rate would keep climbing,” she says. “We saw that throughout the country and throughout Ohio, whereas here in Hamilton County we pretty much held steady. Granted there were many other things going on in our county that probably contributed to that, but we like to think that at least a piece of that was naloxone was more broadly available.”

The THN effort in Hamilton County ended at the conclusion of 2019, and Freiermuth says the availability of naloxone has been evolving since then. Project DAWN (Deaths Avoided with Naloxone) is a network of opioid overdose education and naloxone distribution programs through the Ohio Department of Health that attempts to get naloxone out in the community as widely as possible by distributing it to community agencies who then distribute it to individuals. Plus, she says, naloxone is being made available over the counter, so that is another way people who want to have it on hand can obtain it.

The NDC was a successful effort to increase access to Narcan in the community, according to Darci Smith, director of harm reduction for HCPH.

“Increasing the amount of Narcan available in the community increases opportunities to save lives and helps reduce the stigma associated with substance use disorder and carrying Narcan,” she says. “The NDC helped lay the foundation for our current naloxone education and distribution efforts.”

With the backdrop of September being National Recovery Month, Freiermuth says one of the biggest hopes with the study is that it continues to help combat the stigma.

“There is still a lot of stigma around opioid use disorder and people who use drugs,” she says. “If you talk to people who use drugs, they don’t want to carry naloxone because there’s a stigma associated with that. It’s interesting because people will recognize that they are at risk for overdose yet still not always carry the medication because of that external symbol. We hope for people to ask for this medication, for people to be more aware that they may need to use it and that it’s not just homeless people or those with mental health disease who are using drugs.”

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JOURNAL

PLoS ONE

DOI

10.1371/journal.pone.0289959 

METHOD OF RESEARCH

Data/statistical analysis

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Evaluation of a large-scale health department naloxone distribution program: Per capita naloxone distribution and overdose morality

The greatest secret of the Soviet Union

What we can learn about today’s most secretive states

Book Announcement

UNIVERSITY OF WARWICK

Twenty-five years ago, after the fall of the Soviet Union, an academic at the University of Warwick began work in the Russian archives to map the sophisticated regime that made the Soviet Union the most secretive state that ever existed.

A new book, based on decades of research, describes the complex layers of secrecy within the Soviet Union, what secrecy hid, what the state gained and lost because of it, and what we can learn about how secrecy is used in Russia today.

Emeritus Professor of Economics Mark Harrison at the University of Warwick and author of Secret Leviathan: Secrecy and State Capacity under Soviet Communism says: “The Soviet Union’s archives hold many millions of secret documents. Their volume is far greater than the government information that was released into the public sphere. But the biggest secret was the huge gap between the appearance and reality of the communist party dictatorship. To all appearances, the Soviet state was decisive, all-knowing, and all-powerful. Behind the scenes, the state was ruled by procrastination, indecision, groupthink, mistrust, fear, and disinformation. This gap was hidden by secrecy.

“The communists were the most diligent state-builders of the twentieth century. The political leaders valued secrecy because it bought them security of tenure. But secrecy was extremely costly. The price they paid was in a state machine that was far less capable than the one they pretended to deploy. There was a secrecy/capacity trade-off.”

“Ordinary people who had no direct connection to power also paid the price of secrecy. Not only were they denied the freedoms of an open society. In addition, they knew that the secret police held information about their background and lives. You didn’t know what that information was or how it affected your life. A promotion might be mysteriously blocked, or an application to travel abroad that was refused without reason. You would never know why. You could only suspect that there was something in your past that the state knew about. And there was no appeal process.”

A measure of the scale of the Soviet Union’s secret state compares the number of US and Soviet  secret informants at the height of the Cold War:

“In 1976 the FBI had around 1500 undercover informants. In a slightly earlier year, 1968, the KGB had 165,000 informants. Given that the Soviet population was slightly larger than the American population at the time, the difference was 1:100.”

What we can learn about Russia’s secrecy today

The digital age we are now living in is more adapted to disinformation than to censorship. Yet, the secrecy /capacity trade-off continues to operate, explains Professor Harrison:

“President Putin chose to plan and launch the invasion of Ukraine in complete secrecy, to preserve his freedom of action and achieve surprise. But in doing so he sacrificed a large part of his invasion force. With more transparent decision making, Russia’s soldiers would not have invaded Ukraine thinking they were on an exercise, and President Putin would not have sent them into battle believing that he could win the war in three days.”

Secret Leviathan: Secrecy and State Capacity under Soviet Communism by Mark Harrison, published by Stanford University Press (2023), is out now.

ENDS