TIME Health Care

Physicians Avoid Conversations About Religion in the ICU

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Even though it's important to patients and their families

Religion and spirituality are not common topics of discussion in intensive care units (ICUs), and doctors often go out of their way to avoid them—even though religion is often very important to patients and their medical surrogates during end-of-life care, a new study shows.

In the study, published Monday in the journal JAMA Internal Medicine, researchers listened to audio recordings of 249 meetings between surrogates of critically ill patients and health care professionals in 13 different ICUs across the country. The goal was to investigate the religious or spiritual content in these talks. The researchers found that although religion was considered important to 77.6% of the surrogates (a surrogate is a family member or another person responsible for making medical decisions for a patient), conversations about religious and spiritual topics occurred in less than 20% of the goals-of-care conversations. Health care professionals rarely “explored the patient’s or family’s religious or spiritual ideas.”

When conversations about spirituality did occur in some of these end-of-life care conversations, the researchers found that 65% of the time the topic was initiated by the surrogate. Health care professionals raised the issue of spirituality only 5.6% of the time.

The types of religious conversations surrogates would bring up fell into categories such as: referencing their religious or spiritual beliefs, having the notion that the physician is God’s tool to aid in the healing of their loved one, and the idea that the end of life would be a new beginning. For example, surrogates said things like, “All I can do is pray for her to continue to get better and maybe one o’ these days, she can walk outta here.” Or, “I’m very, very optimistic because I know our faith is strong.”

The most common response among health care providers when a surrogate brought up religion or spirituality was to change the subject. In only eight conferences did a health care professional try to understand the beliefs of the surrogate by doing things like asking about the patient’s religious beliefs. “Our findings suggest that religious considerations—viewed as important to a large proportion of Americans—are often absent from end-of-life conversations,” the authors wrote. “This may signal a need for changes in health care delivery in ICUs.”

The study authors concluded that one potential solution would be to “redesign” health care processes so that spiritual care providers were a larger part of end-of-life care discussions for patients who value spirituality and religion.

In a corresponding editorial, health care professionals who were not involved in the study wrote: “Although we health care professionals struggle to connect spirituality and medicine as evidenced by the many and mounting articles that refute or explicate their connection, our patients and families typically do not struggle. For most, thoughts of what is most sacred, of what transcends the finitude of human life, come flooding in the moment the physician shares the news of the serious illness or the telephone call comes urging the listener to the bedside of a critically ill loved one.”

The new study suggests that religion and spirituality may be a conversation that people want to have at the end of life, and they are not getting it from their health care providers. Finding a solution for this discrepancy could be in patients’ and health care professionals’ best interest, the editorial said.
TIME Infectious Disease

Blue Bell Ice Cream Slowly Returns to Stores

The ice cream is making its way back into select markets after spurring a listeria outbreak

Blue Bell Creameries resumed delivering ice cream to select regions on Monday, several months after shutting down production when Blue Bell products were identified as the source of a multi-state listeria outbreak.

The first deliveries of ice cream were made early Monday morning in Brenham, Texas, where a local NBC News station says freezers were well stocked with Blue Bell ice cream.

Blue Bell production was shut down earlier this year after it was determined that Americans were getting sick with listeriosis from consuming Blue Bell products. The multi-state outbreak hospitalized 10 people, and three people died. In April, Blue Bell recalled all of its products.

MORE: How Ice Cream Gets Contaminated—and Sometimes Kills

In early August, Alabama approved Blue Bell’s request to resume production and delivery. Since the company still only has limited production capacity, it plans to re-enter 15 states in five phases. Monday began the first phase, which includes distribution to the Brenham, Houston and Austin, Texas areas and Birmingham and Montgomery, Ala.

“Over the past several months we have been working to make our facilities even better, and to ensure that everything we produce is safe, wholesome and of the highest quality for you to enjoy,” Ricky Dickson, vice president of sales and marketing for Blue Bell, said in a statement.

You can see where Blue Bell will be distributing next, here.

TIME Food

Lawsuit Accuses Nestlé of Using Slave-Caught Fish in Fancy Feast

Fancy Feast cat food
Elise Amendola—AP Fancy Feast cat food cans are photographed in Boston on March 19, 2015.

California residents brought a class-action lawsuit

A class-action lawsuit filed by California residents claims that Nestlé purchases fish from a Thai supplier known to use slave labor—and uses that fish in Fancy Feast cat food.

The suit was brought by consumers who say they would not have bought the product if they had known it had ties to slave labor, according to Bloomberg. Their lawyer says that “By hiding this from public view, Nestlé has effectively tricked millions of consumers into supporting and encouraging slave labor on floating prisons.”

Nestlé would not comment specifically on the suit, but told Bloomberg that it was working with an NGO “to identify where and why forced labor and human rights abuses may be taking place” in the region, and that forced labor “has no place in our supply chain.”

[Bloomberg]

TIME Diet/Nutrition

How to Tell If Your Grass-Fed Beef Is Real

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A range of practices and labels persist amid lack of regulation

When you buy a pound of hamburger in the grocery store, you’re likely to be bombarded by an incredible assortment of labels. With all-natural, grass-fed, free-range, pastured, sustainably sourced, and certified organic options to choose from, it’s not easy to parse which beef is actually the best.

In recent years, demand for grass-fed beef has grown rapidly, thanks to the popularity of high-protein diets and growing consumer awareness about the overuse of antibiotics on farms and other related concerns. Grass-fed beef is also seen as nutritionally superior to its corn-fed counterparts, thanks to the omega-3 fatty acids that cows ingest when they graze on clover and other grasses. Grass-fed burger chains are popping up all over the country, and even Carl’s Jr. began offering a grass-fed burger earlier this year.

But what exactly do we mean when we say “grass-fed”? And is all grass-fed beef the same?

It’s All in the Finishing

“All cattle are grass-fed at one time in their life, until most end up in a feedlot where they’re finished on grain,” says Texas rancher Gerry Shudde. Indeed, most cows spend at least six months eating grass, before they are “finished,” or fattened up, with grain.The National Cattlemen’s Beef Association puts that number at 12 months, but most grain-finished beef cows don’t live beyond 18 months.

According to rancher and the author of Defending Beef Nicolette Hahn Niman, the real number likely falls somewhere in the middle. “On average, the cattle in the U.S. that is going through feedlots is slaughtered at 14-16 months,” she says. “They do grow fatter and faster if they’re being fed grain, so they’re going into feedlots at younger ages to shorten that time as much as possible.” In a feedlot environment, grain causes cows to put on about one pound for every six pounds of feed they eat. In contrast, grass-fed cows are slaughtered anywhere between 18-36 months.

“When you keep cattle on grass their whole lives, and truly have them forage for a diet that their bodies have evolved to eat, you allow them to grow at a slower pace,” says Niman. Not surprisingly, caring for the animal for so long can be expensive for ranchers and consumers.

Many informed eaters will tell you that this slower process results in a signature flavor and distinct leanness that sets it apart from its corn-fed counterpart, but the fact is that beef producers can label their product “grass-fed,” even if the animal is fed grain over the course of its lifetime. Unlike the lengthy auditing process involved in U.S. Department of Agriculture’s (USDA) organic certification, the use of “grass-fed” is only regulated under the agency’s “marketing claim standards.

According to these standards, grass-fed cows are supposed to be given continuous access to rangeland, and they cannot be fed grains or grain by-products. In the event of drought or other “adverse weather conditions,” farmers are allowed to bend these rules if the animal’s wellness is in jeopardy, but they must maintain meticulous records. Unfortunately, these regulations are, for the most part, a paper tiger.

Missing Oversight

Marilyn Noble of the American Grassfed Association argues that beef producers have little incentive to stick with those rules. “It’s a big issue, and there is a lot of misunderstanding. The Agricultural Marketing Service developed the grass-fed standard, but the Food Safety and Inspection Service actually enforces it,” says Noble. “The two organizations, even though they’re both part of the USDA, don’t communicate especially well. You see a lot of beef labeled as ‘grass-fed,’ but whether or not it actually meets that standard is questionable.”

Noble’s skepticism is rooted in the fact that, for the most part, the USDA allows producers to determine whether or not their beef meets the grass-fed beef marketing claim standard. Noble says farms “self-certify” their own beef, and the Food Safety and Inspection Service generally goes along with their claim. The ubiquitous “naturally raised” label on meat has no enforceable meaning either, and further muddles a consumer’s ability to find beef that has been exclusively raised on pasture.

The American Grassfed Association, established in 2003, has far more stringent standards for its own label than the USDA, and hires third-party auditors to inspect the farms of its 100-plus certified producers across the country each year.

Farmers’ markets are also often full of vendors offering grass-fed beef from their own pastures. And the rising popularity of meat CSAs and whole animal buying clubs is an indication of how dramatically this trend has grown in recent years. With these options, consumers can talk directly to farmers to find out how their beef was raised. Many of these producers have begun using the term “pasture raised,” another unregulated labeling term that is popular among ranchers.

Even Whole Foods has adopted some of this farm-to-market language in its meat sourcing standards. For example, “pasture-centered” farms score a 4 out of 5 on the grocer’s Animal Welfare Rating scale (owned by Global Animal Partnership). In reality, Niman says, these animals may not be doing much of the foraging that gives grass-fed beef its nutritional benefits.

“[Whole Foods] has been encouraging this segment of beef in the marketplace where animals are roaming on a small area with vegetative cover,” says Niman. “But they’re being provided feed, and not actually getting most of their nutrition from foraging. It’s almost like a feedlot.”

At BN Ranch, which Nicolette operates with her husband, Bill Niman, “the godfather of sustainable meat” and founder of Niman Ranch, cattle is given more time to slowly develop fat over a period of more than two years. For the Nimans, good “eating quality” in the beef is paramount. But, Nicolette says, that’s not always the case on farms where people are “doing it for philosophical reasons. They believe that grazing is ecologically superior, and that it is the right way to raise cattle. The things that are motivating them are not eating quality.”

As a result, grass-fed beef’s lean flavor is often seen as inferior. Some chefs, particularly in fine-dining steakhouses, still resist serving grass-fed beef in favor of corn-fed, USDA prime beef, because of its fat content.

Worth the Wait

Michael Sohocki, chef of Restaurant Gwendolyn in San Antonio, Texas, chooses grass-fed beef over the cheaper, richer, corn-fed cuts because he firmly believes that the process is worth the extra time and money. And his discerning diners come to his restaurant because they know the meat has been properly sourced. “When you eat stockyard beef, all of that beef is the same,” says Sohocki. “It’s done that way to guarantee its consistency. That’s what McDonald’s specializes in.”

Sohocki calls grass-fed beef “the only trustworthy product left in this world.” He sources it from nearby Shudde Ranch, where Jeanne and Gerry Shudde make a point of raising a specialized cross-breed of species suited to naturally develop fat on pasture.

“Our [cows] are on grass when they’re with their mother. And when separated, they stay on the grass,” says Gerry Shudde.

The Shuddes decided to go grass-fed by chance after acquiring a herd of Longhorn cattle that they planned to cross-breed with their own. The offspring did not fare well, but the Shuddes ultimately decided to keep the longhorn cows. When they butchered a six-year-old cow, which had been raised on grass for much longer than usual, Jeanne says, “It was really tender. We thought ‘gosh, this tastes better than what we get in the grocery store.’”

From there, the Shuddes developed their own, new breed of grass-fed cattle. They were already raising cows without antibiotics or hormones, and their farm eventually evolved into a completely grass-fed operation by 2002. Still, they had to find the right cow to produce the quality of beef that they desired. “Most of the animals that you find today have been genetically selected to do well in a feedlot environment,” says Jeanne. “If you take them and put them on grass and think they will [taste good], I’d say maybe, maybe not. But if you take an animal that is genetically survival-oriented, it will become well-marbled on grass.”

Their own cows are now a cross between that original herd of Longhorn cattle and a heritage Devon bull. “Our belief is that if they eat what they evolved to eat, and live in the way that they have evolved to, the nutrition for the animal’s survival will be there,” says Jeanne. “If the nutrition is there, humans will get that nutrition when we eat the meat.”

This article originally appeared on Civil Eats

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TIME Healthcare

10 Products You Think Are Healthy (But Aren’t)

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Some products meant to improve your health and well-being can actually have the opposite effect if used incorrectly

You buy these products with the best intentions: antibacterial soap to kill germs, toothpaste to prevent cavities, a humidifier to relieve sinus congestion. But everyday items like these can trigger your allergies, leave you with a skin infection, or cause other problems if used incorrectly. The good news: the fixes are resoundingly simple, super quick, and keep you safe.

Your loofah

It might make your shower nice and sudsy, but you wouldn’t believe what’s hiding in the nooks and crannies of your loofah. “These act as a perfect environment for growth of bacteria, fungi, and mold,” says Jessica Weiser, MD, of the New York Dermatology Group. Any small open wounds (even microscopic ones from shaving or dry skin) are at risk for infections, from impetigo to folliculitis, she says.

Stay safe: Loofah lovers, don’t worry—you can still use one. Choose one made with natural fibers—they have enzymes to control bacteria, mold, and mildew growth—and replace it every month. Rinse thoroughly and wring out all the water after each use, and store the loofah in a cool, dry environment.

The humidifier

Hooking up a humidifier can bring you much-needed relief from cold-weather ailments like stuffy nose and dry skin. The downside: if not cleaned properly or often enough, humidifiers can grow mold and pathogens, spewing plumes of the stuff into the air, says Miguel Wolbert, MD, medical director of West Texas Allergy in Midland, Texas. Plus, having too much moisture in the air can turn your home into a breeding ground for dust mites, a problem if you suffer from indoor allergies.

Stay safe: After running the humidifier at night, don’t just turn it off and let it sit. Freestanding water left in the bowl is what will accumulate mold. Empty and dry it out completely. The Environmental Protection Agency also recommends cleaning portable humidifiers every third day by using a brush or scrubber on the tank to remove deposits and film.

Cotton swabs

Even though it’s gunky, wax exists to protect your delicate inner ear structures from dust and debris. So it’s healthy, but if it builds up, it can cause an ache or annoying feeling of fullness. That’s why you might routinely dig out whatever’s in there with Q-tips, something doctors don’t recommend: “If you accidentally place the Q-tip anywhere past the ear canal, you can push wax further in and even perforate the ear drum,” says Sujana Chandrasekhar, MD, director of New York Otology in Manhattan.

Stay safe: Forget the cotton swab. “There’s no reason to clean out any of the gunk from your ears except the part that can be removed by sweeping the pad of your index finger in the opening of the canal,” Dr. Chandrasekhar says. “Any wax deeper than that is actually doing a nice job of protecting your ears already.” If you do have an earache, see your doctor for any remedies.

Antibacterial soap

For so long we’d scrub up, aiming to kill germs at every turn. But as it turns out, antibacterial soaps are ineffective at best, says Elaine Larson, PhD, a professor of epidemiology at Columbia University. A decade ago she authored a double-blind randomized clinical trial (the gold standard of study methods) comparing households that used antibacterial products to those without them. The result? There was no difference in the rates people got sick. “It was clear that in a healthy home, antibacterial soap doesn’t really help that much,” she says. At worse, antibacterial ingredients like triclosan may spur antibacterial resistance, says the FDA.

Stay safe: Wash up with plain soap and water, period. And scrub well—it’s the friction between your two hands that physically removes germs and sends the buggers down the drain, says Larson.

Your chair

The risks of sitting keep piling up: an increased risk of heart disease, obesity, and mortality (and the list goes on). Unfortunately, research also shows that even if you’re a regular exerciser, it’s not enough to offset sitting all day during your commute, at work, and then at night in front of the TV.

Stay safe: Unless you get a stand-up desk, you probably can’t change the fact you sit at your desk job. But you can move just a bit more. Get up and walk to refill your glass of water or chat with a colleague. Light walking for two minutes out of every hour reduced mortality risk by 23% compared to spending the full time on your duff, according to a 2015 study published in the Clinical Journal of the American Society of Nephrology.

The blender

You know to wash your blender every time you make one of your yummy spinach smoothies, but you’re probably skipping one of the most important parts: the blender gasket (the rubber ring that helps hold the blade in place). In a 2013 report by NSF International, an independent organization that tests the health and safety of consumer products, the blender gasket was found to be the third germiest item in the kitchen, harboring Salmonella, E. coli, yeast, and mold. When researchers asked people what they thought were the top sources of grime in their kitchen, the blender didn’t even make their list.

Stay safe: After sucking down the smoothie, the NSF recommends disassembling the blender and pulling the blade and gasket out for a thorough washing. Yes, every time.

Nail tools

At-home manis and pedis keep your hands and feet summer-ready, but the tools you use could be harboring a dirty secret. It’s normal for bacteria to live on your skin, so when you use a cuticle clipper or pumice stone, you’re transferring those bacteria to the tools. Skip cleaning them properly and the bacteria can grow and potentially lead to skin infections, notes Dr. Weiser.

Stay safe: Wash pumice stones with soap and water every time you use it and get a new one every three to four weeks. As for nail and cuticle clippers, clean those with soap and water after using, too. More importantly, don’t share. “Normal flora differ from person to person, so bacteria harmless to you could cause infection in your friend, sibling, or partner,” she says.

Rubber spatula

Sure, you clean it every time you use it, but you should consider adding an important step: pulling the spatula head off the handle before you wash. Forgetting to do so is one of the reasons the NSF declared the rubber spatula the number-two dirtiest kitchen item. It was found to contain E. coli, yeast, and mold—not things you want to mix into your batter.

Stay safe: If your spatula is detachable, wash both pieces separately. If it’s a one-piece, you still need to take precautions because yeast can hide and grow in the joint. Make sure to give extra TLC to that section when washing.

Stuffed animals

What could go wrong with the impossibly cute and cuddly toys you use to comfort your little kids? “These are a magnet for dust mites,” says Dr. Wolbert. And dust mites are the biggest culprit in indoor dust allergens, setting off sneezing, runny nose, and red, itchy eyes. Dust mites living in your kids’ stuffed animals can prompt allergy attacks in anybody else in your household.

Stay safe: Keep one or two on your kid’s bed and keep the rest on a shelf. Trade them out every couple of weeks, he suggests. (It cuts down on exposure if you’re not surrounded by 10 at a time.) Or, wrap them in a plastic bag and stash in the freezer overnight—the cold kills mites.

Whitening toothpaste

Here’s the rub: you rely on toothpaste for fresh breath and fighting cavities, and many are designed to make your pearly whites white again. But just because whitening toothpastes are available over the counter doesn’t mean they’re completely harmless. Long-term use of some of these toothpastes—especially grittier ones designed to scrub off stains—can wear away your enamel and increase sensitivity, says Clifton M. Carey, PhD, professor in the school of dental medicine at the University of Colorado Anschutz Medical Campus.

Stay safe: Look for whitening toothpastes with the American Dental Association’s ADA Seal of Acceptance, which is an indication that they gently polish teeth to remove surface stains. If your teeth feel more sensitive after beginning a new whitening product, see your dentist.

This article originally appeared on Health.com

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TIME public health

Turkey Bacon and Six Other Foods to Avoid This Week

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Spoiled turkey bacon and bread with glass bits are being recalled

In our food supply, safety sometimes slips through the cracks. Unfortunately, the U.S. saw quite a few recalls this week, and since not every recall reported to authorities makes headlines, we’ve rounded them up for you. If you purchased a product that’s been recalled, you can often return it from where you bought it for a refund.

Turkey bacon
Brand: Oscar Mayer
Contaminated with: Spoils earlier than indicated.
Kraft Heinz Foods Company is recalling about 2,068,467 pounds of turkey bacon products because the products may spoil before their “best when used by” date. The issue was discovered when consumers complained about spoilage problems. The company has received reports of illness. Read the full report here.

Breads
Brands: Sara Lee, Great Value, Kroger, Bimbo, Nature’s Harvest and L’Oven Fresh
Contaminated with: Possible glass fragments
Bimbo Bakeries has recalled some of its breads sold under a variety of brands due to the possible presence of glass from a broken light bulb in one of the company’s bakeries. The company was made aware of the problem after three consumers reported small pieces of glass on the outside of the bread. Read the full report here.

Duck head and neck
Brand: California Qi Li’s Braised Chicken
Contaminated with: Undeclared soy sauce
California Qi Li’s Braised Chicken is recalling about 6,644 pounds of duck head and duck neck products due to undeclared soy sauce. There have been no reports of illness from the product. Read the full report here.

MORE: Why You Shouldn’t Eat Delicious Charred Foods

Macadamia nuts
Brand: Jansal Valley
Contaminated with: Salmonella
Food distributor Sid Wainer and Son of New Bedford, MA is recalling Jansal Valley brand Raw Macadamia Nuts after the bacteria Salmonella was found in a one-pound package of the nuts. So far no illnesses have been reported. Read the full report here.

Gluten Free Chocolate Chip Granola Bars
Brand: Sam Mills
Contaminated with: Undeclared dairy
Sam Mills is recalling 11,083 cases of 4.4 ounce boxes of Gluten Free Chocolate Chip Granola Bars due to possible contamination with dairy. The product currently claims to be dairy-free even though there is a risk of cross contamination with dairy. This could be problematic for people with dairy sensitivities. Read the full report here.

Dark Chocolate covered Honey Grahams with Sea Salt
Brand: Trader Joe’s
Contaminated with: Undeclared milk
Candy retailer Jo’s Candies is recalling Trader Joe’s Dark Chocolate covered Honey Grahams with Sea Salt because the product may contain milk which is not listed on the label. That’s problematic for people who have milk-related allergies. So far there have been two reactions to the product reported. Read the full report here.

Green beans
Brand: Cascadian Farm
Contaminated with: Listeria monocytogenes
General Mills is recalling packages of its Cascadian Farm Cut Green Beans. One package tested positive for the bacteria Listeria monocytogenes. No illnesses have been reported. Read the full report here.

TIME SoulCycle

Proposed Lawsuit Against Soulcycle Says the Studio ‘Robs’ Customers

SoulCycle
The Washington Post—The Washington Post/Getty Images A SoulCycle class.

Using ‘Series Certificates’ is not a fair and transparent practice, suit alleges

The SoulCycle IPO just got a little more interesting.

Less than a month after the high-end cycling studio filed for an initial public offering, SoulCycle has been hit with a proposed class-action lawsuit, reports Business Insider.

The lawsuit, which was filed by (former) California-based customer Rachel Cody, brings seven charges against the studio, although the crux of the lawsuit is the violation of the Credit Card Accountability and Disclosure Act. The law states that businesses must “establish fair and transparent practices relating to the extension of credit under an open end consumer credit plan.”

The lawsuit alleges that SoulCycle’s practice of not allowing customers to directly pay for classes, instead requiring them to purchase “Series Certificates,” is not a fair and transparent practice, as these Series Certificates “have unreasonably short expiration periods—much briefer than the expiration periods allowed under federal and state laws.”

The lawsuit accuses SoulCycle of a “relentless effort to maximize its profits” and states that the expiration policies “rob customers of their money, creating windfall profits for SoulCycle.”

Creating windfall profit is definitely the goal, especially since the studio hopes to raise $100 million in its upcoming IPO.

TIME Depression

Teenage Goths At Higher Risk of Depression, Study Says

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Researchers could not fully explain the link

Young people who identify as goths may be more likely to suffer from depression or to self-harm, according to new research published Thursday in The Lancet Psychiatry.

The goth subculture began in England during the early 1980s, an offshoot of the post-punk era, and its members are most easily identified by their dark clothing and makeup.

The study showed that 15-year-olds who identified very strongly with being a goth were three times more likely to be clinically depressed and five times more likely to self-harm by the age of 18.

“Our study does not show that being a goth causes depression or self-harm, but rather that some young goths are more vulnerable to developing these conditions,” said lead author Dr Lucy Bowes from the University of Oxford.

The research was based on surveys of 3,694 British teens, who were asked to identify with a variety of subcultures, including sporty, popular, skaters, loners and bimbos. Three years later, they were reassessed for symptoms of depression and self-harm. Researchers found that skaters and loners were also at higher risk, while ‘sporty’ teenagers were the least likely to suffer from the same problems.

The study’s authors said teenage goths should be closely monitored so that they could be offered support easily if needed.

 

TIME Drugs

FDA Approves New Cholesterol-Lowering Drug

Repatha

It’s the second in a new class of drugs that works in a different way from statins to bring cholesterol levels down

The U. S. Food and Drug Administration approved a new drug for treating high cholesterol levels on Thursday. Evolocumab, called Repatha, is made by Amgen and is the second of a new class of lipid-lowering agents that are hitting the market.

Known as PCSK9 inhibitors, these drugs work by suppressing genes that slow down production of cholesterol receptors on the liver. With these medications, more receptors that are free to emerge and act like sponges can soak up LDL cholesterol and lower their levels in the blood.

MORE: This New FDA-Approved Cholesterol Drug Is a Game Changer

Evolocumab was approved first by the European Medicines Agency in July. In the same month, the U.S. FDA approved another drug in the same class, alirocumab (Praluent), made by Sanofi and Regeneron. In studies, both drugs helped to lower cholesterol levels in the blood by 60% more than the amount achieved by statins. The drugs carry labels that say medications should be used first in people with a strong family history of high cholesterol conditions, or in people who have tried and not responded to statin medications.

PCSK9 inhibitors were discovered among a group of people who happened to have genetic mutations that gave them extremely low cholesterol levels. Researchers studied this rare population, and found they did not have any negative health effects from their mutation other than the beneficial effect on their lipids. So drug makers began investigating ways to replicate the condition with a medication.

MORE: Memory Loss Not Caused By Cholesterol Drugs After All

Having another drug that can lower cholesterol levels will be a boon to treating heart disease, which remains the leading killer of Americans each year. Keeping cholesterol levels down, in addition to eating a healthy diet and exercising to maintain weight are crucial to lowering the risk of heart events.

TIME Research

Only a Third of Psych Studies Are Reliable. Now What?

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We must stop treating single studies as unassailable authorities of the truth

The ability to repeat a study and find the same results twice is a prerequisite for building scientific knowledge. Replication allows us to ensure empirical findings are reliable and refines our understanding of when a finding occurs. It may surprise you to learn, then, that scientists do not often conduct – much less publish – attempted replications of existing studies.

Journals prefer to publish novel, cutting-edge research. And professional advancement is determined by making new discoveries, not painstakingly confirming claims that are already on the books. As one of our colleagues recently put it, “Running replications is fine for other people, but I have better ways to spend my precious time.”

Once a paper appears in a peer-reviewed journal, it acquires a kind of magical, unassailable authority. News outlets, and sometimes even scientists themselves, will cite these findings without a trace of skepticism. Such unquestioning confidence in new studies is likely undeserved, or at least premature.

A small but vocal contingent of researchers – addressing fields ranging from physics to medicine to economics – has maintained that many, perhaps most, published studies are wrong. But how bad is this problem, exactly? And what features make a study more or less likely to turn out to be true?

We are two of the 270 researchers who together have just published in the journal Science the first-ever large-scale effort trying to answer these questions by attempting to reproduce 100 previously published psychological science findings.

Attempting to re-find psychology findings

Publishing together as the Open Science Framework and coordinated by social psychologist Brian Nosek from the Center for Open Science, research teams from around the world each ran a replication of a study published in three top psychology journals – Psychological Science; Journal of Personality and Social Psychology; and Journal of Experimental Psychology: Learning, Memory, and Cognition. To ensure the replication was as exact as possible, research teams obtained study materials from the original authors, and worked closely with these authors whenever they could.

Almost all of the original published studies (97%) had statistically significant results. This is as you’d expect – while many experiments fail to uncover meaningful results, scientists tend only to publish the ones that do.

What we found is that when these 100 studies were run by other researchers, however, only 36% reached statistical significance. This number is alarmingly low. Put another way, only around one-third of the rerun studies came out with the same results that were found the first time around. That rate is especially low when you consider that, once published, findings tend to be held as gospel.

The bad news doesn’t end there. Even when the new study found evidence for the existence of the original finding, the magnitude of the effect was much smaller — half the size of the original, on average.

One caveat: just because something fails to replicate doesn’t mean it isn’t true. Some of these failures could be due to luck, or poor execution, or an incomplete understanding of the circumstances needed to show the effect (scientists call these “moderators” or “boundary conditions”). For example, having someone practice a task repeatedly might improve their memory, but only if they didn’t know the task well to begin with. In a way, what these replications (and failed replications) serve to do is highlight the inherent uncertainty of any single study – original or new.

More robust findings more replicable

Given how low these numbers are, is there anything we can do to predict the studies that will replicate and those that won’t? The results from this Reproducibility Project offer some clues.

There are two major ways that researchers quantify the nature of their results. The first is a p-value, which estimates the probability that the result was arrived at purely by chance and is a false positive. (Technically, the p-value is the chance that the result, or a stronger result, would have occurred even when there was no real effect.) Generally, if a statistical test shows that the p-value is lower than 5%, the study’s results are considered “significant” – most likely due to actual effects.

Another way to quantify a result is with an effect size – not how reliable the difference is, but how big it is. Let’s say you find that people spend more money in a sad mood. Well, how much more money do they spend? This is the effect size.

We found that the smaller the original study’s p-value and the larger its effect size, the more likely it was to replicate. Strong initial statistical evidence was a good marker of whether a finding was reproducible.

Studies that were rated as more challenging to conduct were less likely to replicate, as were findings that were considered surprising. For instance, if a study shows that reading lowers IQs, or if it uses a very obscure and unfamiliar methodology, we would do well to be skeptical of such data. Scientists are often rewarded for delivering results that dazzle and defy expectation, but extraordinary claims require extraordinary evidence.

Although our replication effort is novel in its scope and level of transparency – the methods and data for all replicated studies are available online – they are consistent with previous work from other fields. Cancer biologists, for instance, have reported replication rates as low as 11%25%.

We have a problem. What’s the solution?

Some conclusions seem warranted here.

We must stop treating single studies as unassailable authorities of the truth. Until a discovery has been thoroughly vetted and repeatedly observed, we should treat it with the measure of skepticism that scientific thinking requires. After all, the truly scientific mindset is critical, not credulous. There is a place for breakthrough findings and cutting-edge theories, but there is also merit in the slow, systematic checking and refining of those findings and theories.

Of course, adopting a skeptical attitude will take us only so far. We also need to provide incentives for reproducible science by rewarding those who conduct replications and who conduct replicable work. For instance, at least one top journal has begun to give special “badges” to articles that make their data and materials available, and the Berkeley Initiative for Transparency in the Social Sciences has established a prize for practicing more transparent social science.

Better research practices are also likely to ensure higher replication rates. There is already evidence that taking certain concrete steps – such as making hypotheses clear prior to data analysis, openly sharing materials and data, and following transparent reporting standards – decreases false positive rates in published studies. Some funding organizations are already demanding hypothesis registration and data sharing.

Although perfect replicability in published papers is an unrealistic goal, current replication rates are unacceptably low. The first step, as they say, is admitting you have a problem. What scientists and the public now choose to do with this information remains to be seen, but our collective response will guide the course of future scientific progress.

This article originally appeared on The ConversationThe Conversation

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