My final project I

For my final project, I chose to talk about addiction in general but more on the drug's side. In order to learn about it, I tried and found some questions I'd like to get answers to. Moreover, reading an article, I found some informations about a way to cure addiction, and I, then, decided to contact one of the organizers of this experiment. After contatcing Bridgett Martell, she accepted to be my interviewee. So I asked her my questions.

Here's the report of the interview:

INTERVIEW

1-How did you come to study on cocaine addiction?

I was a Medical Director at a Methadone clinic in the Bronx for two years after completing my residency training in order to pay back a scholarship I had to receive to pay for medical school. This is how I became interested and eventually board certified in Addition Medicine. The concept of a therapeutic vaccine to treat cocaine addiction also married well with my graduate work in Immunology ( happened before I went to medical school)

2-Whose idea was it?

The genesis of the idea was with a company called Immunologic in 1996. Tom Kosten had a collaborative relationship with one of the principal scientist Barbara Fox who tested the concept in rats first.

3-What was the main purpose of this study?

This study is called a Phase IIb in drug development which is also sometimes called a “proof of concept” study. This mean you are trying to prove in a relatively small, select patient population that something has the effect that you are predicting (hypothesis testing). The purpose of this study in particular was to test the hypothesis that cocaine specific antibodies can attach to cocaine as is enters the blood stream and prevent a certain amount from entering the brain. If successful, then the person using cocaine will not have enough cocaine to enter the brain and cause the expected feeling one gets from using cocaine and they would be less likely to use again if they were really trying to stop (as opposed ot someone who is not motivated to stop)

4-What was your role and Dr Kosten’s in this study?

Dr. Kosten was the Principal Investigator (the guy who wrote the grant to fund the study and who has the experience to conduct clinical trials) and I was the sub-investigator in charge of managing the daily activities of the trial.

5-How could you explain the procedure of the research and the experimental parts?

Read the paper under Material and Methods

6-Did people volunteered for being tested?

All people who enter into clinical trials do so voluntarily and must sign an informed consent given their written permission for us to treat them within the context of the trail

7-Were they paid?

They got free medicine and medical care and a nominal fee for coming to clinic

8-Were they all addicted to cocaine?

Yes, as reported in DSM IV under Substance Dependence (you can Google the term)

9-How may of them were they?

115 entered the trial (were randomized) but only 14 got the vaccinations

10-Who was in charge of the study, who was supervising?

I was in charge and Tom was supervising. For any trial conducted in the US there is also a requirement for an Institutional Review Board to monitor the trial for ethical considerations and safety of subjects. Often a second and a separate Data Monitoring Review Board will also independently review the study at fixed intervals to make sure the study is being conducted properly

11-Who paid for it?

The National Institutes of Drug Abuse paid for the conduct (operations) of the study, the company Xenova (now Celtic) provided the drug, and I was paid by a grant I received called a VA Career Development Award

12-Do you think that you could use this same method for trying to beat other addictions from other drugs?

Yes, including nicotine

13-This question is less formal and comes directly from me;

Do you really think that this study is really relevant? Not that I disagree with all this, I am just wondering if you had ever thought that maybe people, after receiving the vaccine, would increase the quantity of drug they take to overpass the effect of the vaccine or simply switch to another drug, maybe more powerful, more violent and more dangerous?

There does exist the possibility that people will use more cocaine to overcome the effects of the vaccine and for certain drugs the effects can be potentially dangerous. That is why this treatment needs to be given in conjunction with a structured drug recovery program where people engage in other therapies known to help drug addiction (such as cognitive behavioural therapy).

For those addicted to drugs, people tend to have a preference. So, in other words, people that use alcohol tend not to use opioids, etc. Those that believe in the Biology of Addiction (and it is usually those that treat addicted people) believe that there is a chemical imbalance in the brain and that by using certain drugs people are trying to create that balance. It is similar ot the concept of self-medicating.

This helped me a lot.

Cell phone dangerous but necessary.

Today, I'd like to talk about the cell phone's controversial. In effect, studies are made at this time and this subject is a great question concerning the relationships in the society and also the raise of children, becoming teenagers. Cnn declared in one of its article that more evidences of the relation between a long-term cell phone use and cancers, even if at this point, there isn't any proof of cause and effect nor definitive explanation.
The cell phone reject a lot of harmful electromagnetic radiation causing tumors and its strongly recommended to keep a cell phone as far as possible from the body.

But as we say that we also realize that the cell phone is necessary and undispensable in the communication part of life. Most of the work is now done or at least planned or started by cell phone (you can do a lot of things with all those iPhone's applications). And even more, childrem becoming teenagers feel the desire of getting one. The world is getting tougher, and the schools, work places or leisures are getting farther. You can easily understand a parent giving a cell phone to his 13 years old child when he has to travel daily in train, subway and others vehicles getting him away from home. Some others are more like you have to use it only in emergency. If you dont need it, turn it off so the radiation wont be emitted. But if someone is trying to reach you, how can you do it with a turned off cell phone?
But life isn't impossible without cell phone although inconceivable. It is a hard life though. You can easily get out of your home and live your day without a cell phone, but you will have now, in this world of progress, the feeling of being naked, unable to do anything, and if your work requires a constant contact with other people, now you have a problem. You would probably feel less safe too.

The technology is going forward and the progress wont stop. The need is increasing and the offer is way more temptative. With new applications and options, you can discover new ways of using your cell phone, pushing the world into different societies of consommations

Digital tools: this is new for me.

Earlier in the week, I participated to a presentation in which we presented the use of a social bookmarking. I didn't really know about it, to be frank, I had never heard of it. And then I learned that it is, in fact, like a favorites page, like you can have on your computer, but online, using websites, like Digg.com. You are just bookmarking your favorite websites on a public site, where everybody can access it. Moreover, you are usually able to create a profile page, so you can add friends, or people sharing (or not) your opinion so you can debate with them, or just talking. One of the major good point with this is that you can access to your "onliner reader" from anywhere, you dont have to be from your computer and it's way easier to share it with students or teachers..

You can see our presentation and ressource document.

But other groups presented different digital tools such as Wikis or RSS Feeds. I learned that a Wiki is not only Wikipedia. A Wiki is a web page in which the people invited to share in it are able to edit and write on the page. This is a good way to interact without losing time in sending e-mails. A person just has to click edit on the page and modify its content. Their ressource pages are accessible.

So far, my activity, student, doesn't really request the use of a social bookmarking but a wiki page is really useful.

Do you see any interest in a social bookmarking?

An old breathing technique could help many people suffering from asthma.

A 58 years old man, David Wiebe live at Woodstock, NY and has a 48-years history of violent asthma, causing him a lot of problems and was treated for 20 years with steroids.

After consulting a doctor for vision problem, he tried to get rid of those so he wouldn't cause more damages to his body. But his trial was badly supported with several terrifying attacks and more and more travels to the emergency. He couldn't stand it and after a couple of years of a constantly reducing quality of life, he was going to go back on steroids so he could breath better.

But last year, he heard about a 50 years old breathing method, the Buteyko method. The Russian doctor Konstantin Buteyko named and developped it in 1952.
After watching a video on Youtube where its procedure and effects were demonstrated, he mimicked it and actually felt lighter and was breathing easier."I could actually feel my airways relax and open," he said. The participants of the video, themselves suffering from a very strong asthma explained that even being difficult to practice, the method reduced their needs of steroids and medication by about 75%.
When David Weibe explain his situation before the use of this technique, it's hard to believe the shape he is now in. He was using his rescue inhaler more than 2o times a day and was " [he] was a mess" he said. He then came to the Buteyko Center USA and then practiced breathing exercises without, or almost, using his inhaler.
After three months, he was taking no more drugs and was using his inhaler once a day.
But the reason of this technique is that Buteyko noticed that during an asthma attack, people panic and breath faster. Hyperventilation is caused by a too fast and too deep breath, and it lowers the level of Carbon Dioxyde in the blood instead of oxygen.
There are two Buteyko practitioners in Woodstock; Sasha and Thomas Yakovlev- Fredricksen which were trained in Moscow by a Buteyko disciple, Andrey Novozhilov.
The main purpose of their two courses of five sessions each is to gradually enable the client to lengthen the time between two actions of breathing.
This study is a new hope for people suffering from violent asthma.

Swine flu: Pregnant women in a safe state, but an alert one for Gaza City

It appears that pregnant women, which are supposed to be the most exposed and vulnerable to the swine flu and its possible complications, would be completely safe if they take a shot, while Gaza city call to a swine flu alert because of the unstopable movement of bacteria and its 1.5 million population squeezed in 360 square kilometers.

In effect, a clinical trial explained on cnn that almost very healthy pregnant women would be carefree about the swine flu. The trial was led by Dr Anthony Fauci, director of the National Institute of Allergy and Infectious Disease and it consisted in injecting a single 15-microgram dose of an H1N1 vaccine and over 100 women, 90% showed a strong immunity response, without apparents side effects.

But what really caught my attention was this swine flu alert in Gaza City, still from CNN. The H1N1 viral movement seems to have no borders line and keep spreading. It already caught Europe without, however, hitting as strongly as here and its road let's think that all the world would suffer from it, and Gaza City hopes for a miracle after declaring the alert state because of its great population, being in a lot of contact to each others. Knowing the actual situation, if Gaza City was to suffer a deadly wave of flu infections, the consequences could be terrible. But will we ever be able to stop the movement of this infection?

Cocaine vaccine.

Yale School of Medicine housing a Study concerning a vaccine against cocaine addiction is my local story for my journalism class. Several websites and newspapers like CNN and the New York Times reported the study. Even though both explained the main concept of the study, apparently led by Dr Thomas Kosten, the CNN article really explained in details the study and answered some of my questions but didn’t fill the reader’s ignorance about Dr Kosten’s identity and job, while the Times’ didn’t say much about the study and was completely devoting his article to Dr Kosten and the many reactions to his study. They simply mentioned something about the use of the antibiotics but no more. And I wanted to learn more about it and I started wondering things, details, deeper information, questions, so that I started preparing an interview. I collected information that I put on my wiki page on bhsjournalism.pbworks.com and made of this page my resource information. Dr Kosten is a professor of psychology and neuroscience at Baylor College of Medicine in Houston, Texas. I read more attentively the articles from the newspapers and learned that Dr Bridget Martell, from Yale School of Medicine, was part of this study, and I wanted to know more about her role, and why they actually studied on that. So I contacted her by mail and I asked her, after introducing myself and making clear that my approach was within the framework of the journalism class of my High School, if we could meat or have a brief conversation so I could ask her some questions. She accepted and proposed a brief discussion over the phone, even though I would have preferred to see her. Our first appointment was a disaster. She had a medical emergency and she couldn’t warn me so I waited for four hours after calling three times, waiting for an answer. We finally agreed that it would be too difficult for her to actually take some real time to speak with me, because of the intensity of her job. I sent her a mail including my questions and she will answer those within the week. I’m happy to finally interview her but I’m disappointed because a mail questioning isn’t a real interview. The best thing that could have happened was if I actually had met her but it was impossible.

I am still waiting for her answers so I will be able to share those and my impressions with you. But I would like you to tell me what your impressions and questions are.

By the way, as I did to Dr Martell, I'd like to ask you: Do you think that this study is really relevant?

American and foreign newspapers: do they see the same thing?

This entry is not really related to my topic but it will permit me to go further into my opinion that different newspapers from different doesn't think the same way or that, thought they report the same information, the articles incite readers to react differently. For instance, I want to come back at the Nobel Peace Prize recently awarded to the President of the United States of America, Barack Obama. Everybody in the world has been kind of shocked by this choice of the comitee to choose this young president. But I can affirm that people doesn't think the same way. The New York Times' article let us believe that the americans are really happy, surely they are, and that they think, rightfully, that he deserved that prize. But however, the French newspaper le Parisien published some comments, which are surely representative of their majority, saying that Barack Obama has been awarded for his promesses and not for his actions. It is their right to express themselves and to remind truely that Obama is doing war on two fronts ( Iraq and Afghanistan ) and is willing to send thousands more troops. I'm only in the capacity to show the french opinion being french myself but I am pretty sure that the spanish's point of view is different too. It would be interesting to see the point of view of the iraqis or afghans. I wouldn't be surprised that being in war they would express their disapprouval but I also think that some people would see a step ahead and a futur of peace with the United States of America, and the world (as promised by Barack Obama).

The Brain Miracle.

Michelle Mack, a 37 years-old woman was found born with only a half of a brain and live her life today normally but doctors and family are still shocked by the extent of the damage. A study of Mack's brain showed that 95% of the cortex is missing and still, she can speaks and walk....This phenomenon is explained by Doctor Jordan Grafman by simply thinking that the right side of the brain has taken over some faculties usually supported by the left side of the brain. It has rewired itself. Michelle has improved by now intellectual functions but still have abstract concepts and is easily los in an unfamiliar environment. Doctor says that she will always have problems but the diagnostic of Grafman and his treatment give Michelle's father, Wally, hope.
Michelle is conscient that she will need assistance for the rest of her life and wanted to talk about her case so that people would understand more persons like her, "normal but with special needs".

As long as you are getting older and growing up, that you're interesting yourself more and more in life, information is more accessible and indispensable, you have to be on the wave to understand the changements in the society and their consequences. Then a regular basis of reading become important and you're surprised to discover that you're enjoying knowing what's happening. You can then express yourself ( like I am doing right know ) and comment ideas that you've heard.



For example, I am more interested in the science / health topic and I read about it, differents article or the sames from different sources..



These sources generally are New York Times or CNN or some french paper like Le Monde, yes french. It's interesting to see how other countries evaluate the importance of some situation...







I read this article from The New York Times and it talked about a study (again) in hospitals which was supposed to prove that some hospitals aren't more " postoperatory deathly" than others. This idea about some hospitals being more dangerous than others are only about reputation on their postoperative complication. During this study from 2005 to 2007 and implicating more than 80,000 persons in about 150 hospitals, the death rates showed some difference in function of the hospitals but that the complication postoperative weren't more elevated in the high-death hospitals but in the low-death ones (24.6% against 26.9%).

This lead to think that the way that a team, in a hospital, reacts or responds to the complication is definitely more important than the the frequency of those.





Speaking of hospitals, children like this 3 years old boy received the first nasal spray swine-flu vaccine on last Tuesday, while the shots are supposed to begin in the following week...

The 50 states of the US already sent orders for the shots, but the officials also start to critic the vaccine by diffusing on radio and websites comments about their concerns. They qualify the vaccine as "untested" and say that the good one would come too late, but Dr Thomas R.Frieden hardly debunked them. "..flu is not a 'mild' illness-it can make you pretty sick, knock you out for a day or two or three. And in rare case, it kills." Conceding that the flu returned faster than a vaccine could be ready, he rejected the suggestions that it is too late.

Flu vaccine's disease?

I found today a blog named Americablog, thanks to blogrunner, where the blogger discussed about the New York Times' article about the pseudo-reaction on the flu vaccine. I agree with his idea about the fact that this impression of augmentation of seizure, heart attacks.... is purely psychological. There are a lot of seizure and heart attacks every day and the injections give an explanation, a cause for these tragical events. I liked his comparison, that he explained with a very common case. A man is walking down the street and you sneeze. Right after that 2 cars crash in front of you. "Just because you sneezed and then two cars crashed doesn't mean you SNEEZE caused the car crash.". This is a very simple exemple but that clarify everything.

A study give hope in the fight against AIDS

According to the New York Times and CNN, a study started in 2006 in Thailand and using 16,402 volunteers, showed that a vaccine had a significant result. Apparently, half of the volunteers received a combination of 6 vaccines over 6 months and the other half received placebos. They were all followed during 3 years and the trials showed that the vaccined ones were 31 percents less likely to get infected by the HIV than the placebos receivers. The Vaccine is now known as RV 144. This is a big step in the research against this virus that kills millions of people each year. Colonel Jerome Kim told CNN that "before this study, it was thought vaccine for HIV is not possible" as a reaction on these hopeful results. Moreover, Dr. Anthony S. Fauci, the director of the National Institute of Allergy and Infectious Diseases and one of the trial's bakers added to The New York Times that "there's [not] any doubt that this is a very important result". "For more than 20 years now, vaccine trials have essentially been failures".

An AIDS Vaccine Conference will take place in Paris, France next month, where researchers will expose the details of their initial findings.

We also know that this study was funded by the National Institute of Allergy and Infectious Diseases and the U.S Army Medical Research and Material Command.

Health day by day

Let's change of support and talk about something else than the swine flu. The federal health officials apparently prohibited the sale of cigarettes with flavors in, because of the attraction that these perfumes do on teenagers and young adults. A commissioner of food and drugs, Dr Margaret A. Hamburg, said that " These flavored cigarettes are a gateway for many children and young adults to become regular smokers". Studies also show that every day, about 1,100 children and teenager become daily smokers. These are part of the 3,600 that start to smoke each day. We also learn that one of the more famous flavored cigarettes introduction make was Camel Exotic Bends by J.R Reynolds with different flavors such as Warm Winter Toffee or Twista Lime.

Why Health?

I choose the health topic because right now, the flu ( H1N1 ) is still threatening a great part of the population. I wanted to know about the actual medical progress on this subject. I first search on cnn.com where I found that the vaccin's trials were good on children between 10 and 17 but needed a review for younger people.

Then I searched on the New York Times . There was an article about new drugs coming soon, but maybe not soon enough to attack vthe flu in time. The H1N1 flu is, according to the article, already resistant to 2 other older drugs, and in rare tests, it was resistant to one younger drug, Tamiflu. In the same time, researchers say that they need to find new drugs because if the resistance on Tamiflu still go on, there would be only one drug effective, Relenza, a cure that you will be inhaling rather than inhaling, which is kind of unconvenient.

Is a blog helpful?

A blog is really a kind of help to learn journalism, you can find yourself in the same position than a reporter, you write an article for people who are going to read it online. Like a journalist, you have to think about how make your article interesting so many people will read it. Moreover, it establish a connection between writting ( what the blogger publish on his blog ), and reading an thinking ( what the reader will say in his comment, he will try to be pertinent ). You can also introduce some news to people without rewriting the original article. Your text may be long or short, it is succesful if the reader will see the source to learn the actual facts, for example, my first entries subject is on nytimes.com .

What do I know now?

The most important thing I've learned so far is that you can't right an article , news or not, by putting words together without thinking about the whole story you are going to tell...
You have to imagine how to make it interesting for the type of readers that are reading you, you have to anticipate their interests, and that will affect a lot your kind of writing (vocabulary, phrase' construction)!! It is a big work of reflexion..
The news have to be understood, we have to read between the lines; when an article is written, it's precious to know how to analyze it.. ( timeliness...)
I hope that these aspects of journalism will be discovered more and more. We have to be prepared to know and learn about the world we live in, actuality, curremt events...

Some future alterations for the firefighters?

Original article by Ian Urbina for the New York Times from nytimes.com


This article shows us how firefighters from a Washington unit become the target of every medical emergency phone calls, even as much as fire emergency; those calls are about asthma, heart attack or even diabetic sores...

Timeliness isn't a very present element in this article, the ''when'' just tell us that non-fire emergency calls increased in a year but....
Proximity isn't the point too. Washington isn't that close to us.

However, Prominence, Consequence and Human Interest are there:
the event deals with firefighters, people who are charged to protect and react against in case of fire. We can easily imagine that this situation could lead us to a possible modification of the exact conditions of this profession. Then we can see the Human Interest:
people who wish they could go to the hospital but can't, often because of money, can see here an open in the system and could benefit of it.
But this is just an idea..

Even if it is good for people, firefighter aren't that glad, Mr Muyleart said to the New York Times that ''[he] joined the force to battle blazes, not to be an emergency room doctor''.

It is, in fact, really interesting, because people do care about how and by who they are going to be treated in case of accident.