Mandrake by Sarah Das Gupta

A screaming root
beneath the moon’s watery spears
black hound needed

by Sarah Das Gupta
Botanical name:Mandragora officinarum
Popular names:Satan’s Apple, Devil’s Turnip, Manroot, Circe’s Plant
Family:Solanaceae
Origin:Mediterranean, Middle East, North Africa.
Flower:Purple–yellow-green, bell-shaped corolla, five petals, flowers grow from rosette of  leaves.
Habitat:Stony waste ground, edge of woodland, coastal areas

The long taproot, shaped like a human form, was said to scream when pulled from the ground. Anyone hearing this would go mad. In Medieval times, it was believed the only way to harvest the plant was on a moonlit night and using a black dog with a cord attached to the plant to uproot it!

It was also believed that the mandrake first grew from the dripping ‘juices’ of a hanged man. This, by the medieval Doctrine of Signatures which taught that the shape and appearance of a plant linked it to parts of the human body, made the mandrake highly valued for specific ailments. However, the poisonous nature of the plant made its medicinal use difficult, as Harry Potter fans may know

The mandrake contains tropane alkaloids which give it narcotic, emetic, sedative and hallucinogenic properties. As early as the fourteenth century BC the plant is mentioned in cuneiform texts and subsequently in Arabic, Greek and Roman writing. It was said the root could be seen as a baby in form, albeit a rather ugly one. This gave rise to the belief that the plant helped childless women to conceive.

Mandrake roots were valuable and not surprisingly there were fraudsters at country fairs with oddly-shaped ‘mandrakes’ carved from turnip roots. It was even believed that these roots knew the sites of buried treasure. They would whisper the secret to their owner, if they trusted him. These beautiful lines from Shakespeare suggest Mandrake was still in use in the 16th century:

‘Give me to drink mandragora.
That I might sleep out the great gap of time
My Antony is away.’

William Shakespeare,
Anthony and Cleopatra, Act 1, Scene 1.

Further reading:

‘Pagan Portals – By Wolfsbane & Mandrake Root: The Shadow World of Plants and Their Poisons’, 2017, Draco, M., John Hunt Publishing Limited, ISBN: 1780995725.

‘Poisonous Plants in Great Britain’, 2008, Gillam, F., Wooden Books, ISBN: 1904263879.

‘Witch’s Garden: Plants in folklore, magic and traditional medicine’, 2020, Lawrence, S., Welbeck   London, ISBN: 978178739436.

Author bio:

Sarah Das Gupta is a young 81 year old. Loves writing haiku and most forms of poetry. Is learning to walk after an accident. Main outside interests include equine sports. Lives near Cambridge, UK. Read other sciku by Sarah here.

Monkshood by Sarah Das Gupta

imposing imperial purple
deadly to man, beast and bird
Shiva’s throat turned blue

by Sarah Das Gupta
Botanical name:Aconitum napellus (over 250 species)
Popular names:Aconite, Blue helmet, Blue rocket, Leopard’s bane, Monkshood, Wolfsbane
Family:Ranunculaceae
Origin:Mountain slopes of Europe eastward to the Himalayas.
Flower:Purple-blue (white, yellow), tall floral spires, mid-late summer.
Habitat:Northern Hemisphere, mountain meadows, partial shade, east or west facing.

Monkshood, so called because its hooded flowers resemble a monk’s cowl, is a hairless perennial of the buttercup family. Several species are cultivated, often at the back of herbaceous borders. Every part of the plant is poisonous and eating even a leaf can be fatal. It is best to wear gloves when handling and keep out of the reach of children or pets. Apparently, it tastes so repulsive that accidental poisoning seems unlikely.

Several unpleasant symptoms result from rubbing the plant into the skin, including numbness. Ingesting it results in stomach pain, dizziness, and heart problems. It is still used in medicines today but in very small quantities.

From ancient times, people have been aware of the dangers of this plant. The ancient Greeks associated it with Hades and it was believed to have sprung up from the saliva of the three-headed dog, Cerberus. The goddess, Athena, is said to have sprinkled the sap on the maiden Arachne, turning her into a spider! In Hinduism the plant is sacred to Lord Shiva who saved the Earth by drinking poison, which he stored in his throat, turning it blue. In European tradition, aconite is linked to Hecate which is why it was found at crossroads and gateways which were associated with her cult. Anglo-Saxon hunters covered the tips of their arrows with aconite when hunting wolves, hence the name wolfsbane.

Further reading:

‘Pagan Portals – By Wolfsbane & Mandrake Root: The Shadow World of Plants and Their Poisons’, 2017, Draco, M., John Hunt Publishing Limited, ISBN: 1780995725.

‘Poisonous Plants in Great Britain’, 2008, Gillam, F., Wooden Books, ISBN: 1904263879.

‘Witch’s Garden: Plants in folklore, magic and traditional medicine’, 2020, Lawrence, S., Welbeck   London, ISBN: 978178739436.

Author bio:

Sarah Das Gupta is a young 81 year old. Loves writing haiku and most forms of poetry. Is learning to walk after an accident. Main outside interests include equine sports. Lives near Cambridge, UK. Read other sciku by Sarah here.

Microplastics by Tom Lagasse

The microplastics
Swim in the ocean like fish
Straight to the heart

By Tom Lagasse

According to projections, there will be more microplastics in the ocean than fish by 2050.  And we are what we eat. As research is increasingly showing, microplastics are already being found in our bodies.

Further reading:

‘More plastic than fish’, Plastic Soup Foundation, available: https://www.plasticsoupfoundation.org/en/plastic-problem/plastic-soup/more-plastic-than-fish/

‘With microplastics, scientists are in a race against time’, 2024, Osaka, S., The Washington Post, available: https://www.washingtonpost.com/climate-environment/2024/03/11/microplastics-health-impacts-unknown/

Author bio:

Tom’s poetry has appeared in The Silver Birch Poetry Series, Freshwater Literary Journal, The Eunoia Review, and in numerous anthologies. He will be one of the Writers in Residence at the Edwin Way Teale House at Trail Wood this summer. He lives in Bristol, Connecticut, USA. You can follow him on X/Twitter at @tomlagasse.

See more sciku by Tom: Geological Maps.

The iceberg of dementia risk by Timothy Daly

acts buy our brains time
but dementia risk runs deep . . .
let’s change society

by Timothy Daly

Following years of failed drug trials to find a cure for dementia, many researchers have turned to the strategy of promoting healthy lifestyles to improve brain health. A recent article of mine argues that from the point of view of fair and far-reaching prevention, lifestyle approaches are only the tip of an iceberg of dementia risk, below which we find social inequalities and unhealthy environments. We should encourage lifestyle changes alongside changes in society itself to improve access to health and reduce inequalities.

Further reading:

‘The iceberg of dementia risk: empirical and conceptual arguments in favor of structural interventions for brain health’, 2024, Daly, T., Cerebral Circulation – Cognition and Behavior, 6, https://doi.org/10.1016/j.cccb.2023.100193


‘Individuals with dementia and populations with dementia’, 2024, Elizabeth Shaaban, C., Cerebral Circulation – Cognition and Behavior, 6, https://doi.org/10.1016/j.cccb.2024.100221


‘A whole-population approach is required for dementia risk reduction’, 2022, Walsh, S., et al., The Lancet Healthy Longevity, 3(1), E6-E8, https://doi.org/10.1016/S2666-7568(21)00301-9

Author bio:

Dr. Timothy Daly researches dementia and writes poetry. You can follow him on X/Twitter @PhilAlz

Flickerings by John Hawkhead

migraine flickerings
sighting an electron stream
leave free radicals

by John Hawkhead

A free radical is an atom, ion or molecule with at least one unpaired valence electron and which are usually highly chemically reactive with short lifetimes.

They are formed either from other radicals or by breaking a covalent bond in a spin-paired molecule, leaving each of the fragments with one of the electrons in the original bond.

The author of this haiku suffers from migraines where vision is impaired in such a way that there appears to be a stream of electrical waves and particles across the eye.

Further reading:

‘Radical (Chemistry)’, Wikipedia article: https://en.wikipedia.org/wiki/Radical_(chemistry)

‘Migraine’, Wikipedia article: https://en.wikipedia.org/wiki/Migraine

Author bio:

John Hawkhead (@HawkheadJohn) has been writing haiku and illustrating for over 25 years. His work has been published all over the world and he has won a number of haiku competitions. John’s books of haiku and senryu, ‘Small Shadows’ and ‘Bone Moon’, are now available from Alba Publishing (http://www.albapublishing.com/). Read more of John’s sciku here!

Gene Editing by John Hawkhead

a cure for cancer…
cutting the gordian knot
in a gene sequence

by John Hawkhead

Gene editing provides us with the ability to make highly specific changes in the DNA of a living organism. It has the potential to revolutionize cancer treatment via manipulation of the genome to target specific genetic mutations that drive the growth and spread of tumours.

The cutting of the Gordian knot is a legend associated with Alexander the Great about a complex knot that tied an oxcart. It was claimed that whoever was able to untie it would be destined to rule all of Asia. When Alexander was challenged to untie the knot he cut through it with his sword rather than attempt to untie it. This is now used as a metaphor for solving a seemingly intractable problem through bold means or thinking differently.

Further reading:

‘What is genome editing?’, 2019, National Human Genome Research Institute, available: https://www.genome.gov/about-genomics/policy-issues/what-is-Genome-Editing

‘How CRISPR Is Changing Cancer Research and Treatment’, 2020, National Cancer Institute, available: https://www.cancer.gov/news-events/cancer-currents-blog/2020/crispr-cancer-research-treatment

‘The Potential Revolution of Cancer Treatment with CRISPR Technology’, 2023, Stefanoudakis, D., et al., Cancers (Basel), https://doi.org/10.3390/cancers15061813

Author bio:

John Hawkhead (@HawkheadJohn) has been writing haiku and illustrating for over 25 years. His work has been published all over the world and he has won a number of haiku competitions. John’s books of haiku and senryu, ‘Small Shadows’ and ‘Bone Moon’, are now available from Alba Publishing (http://www.albapublishing.com/). Read more of John’s sciku here!

Bird’s Foot Trefoil by Sarah Das Gupta

Trefoil, bright yellow
a field of eggs and bacon
or granny’s toenails

by Sarah Das Gupta

Bird’s foot trefoil is native to most of Europe. It was taken to North America to enrich the grass for cattle and to prevent erosion at the sides of roads. It has a number of  popular names derived from its yellow flowers, tinged with red or the claw shape of the seed pods. It provides feed for caterpillars, bees and butterflies.

‘Trefoil’ is derived from Old French and refers to the pattern of three leaves. For this reason, it was included in Midsummer wreathes, fixed to front doors, as a symbol of the Trinity. Strangely enough, in the Victorian language of flowers, the plant symbolised jealousy and revenge!

Medicinally it was used to treat mild depression and insomnia. Its anti-inflammatory properties were used to alleviate skin conditions. The seed is sold commercially to enrich grazing and forage for cattle. Recently gardeners have planted it to add to the revival of wild flower meadows.

Botanical name:Lotus corniculatus
Popular names:Bird’s-foot trefoil, eggs and bacon, granny’s toenails, baby’s slippers
Family:Fabaceae
Origin:Native to Europe, parts of Asia (taken to N.America)
Flowering:March to June
Habitat:Meadows, rocky-crevices, roadside (Favours sandy soil)

Further reading:

‘Collins Complete Guide to Wild Flowers’, Paul Sterry, 2006, HarperCollins Publishers.

‘Meadowland: The Private Life of an English Field’, John Lewis-Stempel, 2014, Transworld Publishers Ltd.

Articles from ‘The Woodland Trust‘ and ‘Nature’.

Author bio:

Sarah Das Gupta is a young 81 year old. Loves writing haiku and most forms of poetry. Is learning to walk after an accident. Main outside interests include equine sports. Lives near Cambridge, UK. Read other sciku by Sarah here.

Dog’s Mercury by Sarah Das Gupta

Green dog’s mercury
your tiny secret flowers
toxic to canines

By Sarah Das Gupta

Originally a coloniser of ancient woodland, dog’s mercury is a useful ancient woodland indicator, determining areas of ancient woodland, even if there is no tree cover. Some ground-nesting birds like woodcock seem drawn to the plant. Speckled bush cricket nymphs feed on it, as do species of beetle, weevil and mollusc. It is a contributor to biodiversity in ancient woodland.

All parts of this plant are poisonous and can induce jaundice, diarrhoea, vomiting, even death. The epithet ‘dog’ in this context means ’lesser’ or ‘inferior’ to other plants of the family, as applied to other species such as ‘dog’ violet or ‘dog’ rose. The reference to ‘mercury’ probably refers to the god Mercury and the medicinal properties of the species.

From ancient times it has been used externally and its juice is emetic, ophthalmic and purgative. It was used particularly to treat warts and sores. If the leaves are thoroughly heated and dried, it is no longer toxic.

Botanical name:Mercurialis  perennis
Popular names: Dog’s mercury, false mercury, boggard posy, dog’s cole
Family: Euphorbiaceae
Origin:Native to most of Europe – almost excluding Ireland, Orkney and Shetland
Flowering: February to April
Habitat:Ancient woodland, broad-leaf woodland, hedgerows

Further reading:

‘Collins Complete Guide to Wild Flowers’, Paul Sterry, 2006, HarperCollins Publishers.

‘Meadowland: The Private Life of an English Field’, John Lewis-Stempel, 2014, Transworld Publishers Ltd.

Articles from ‘The Woodland Trust‘ and ‘Nature’.

Author bio:

Sarah Das Gupta is a young 81 year old. Loves writing haiku and most forms of poetry. Is learning to walk after an accident. Main outside interests include equine sports. Lives near Cambridge, UK. Read other sciku by Sarah here.

1827-2023 by Joy Stahl

Analyzing locks
Beethoven’s sequenced genome
Unfinished symphony

by Joy Stahl

The composer Ludwig van Beethoven left behind locks of his hair and written wishes that his body be examined for science. I find it fascinating that DNA could still be obtained from that hair after so much time has passed. Researchers are trying to determine the causes of his deafness, other ailments, and cause of death. Only a portion of those questions have been answered, leading to the last line of my haiku.

Further reading:

‘Genomic analyses of hair from Ludwig van Beethoven’, T.J.A. Begg et al., 2023, https://doi.org/10.1016/j.cub.2023.02.041

Author bio:

Joy Stahl teaches middle school in southwestern Kansas. Her poetry has appeared in Voices of Kansas. Check out Joy’s sciku ‘Hibernation’!

Redundant Vets by Sarah Das Gupta

A cat has nine lives
each belongs to an old witch
what need for a vet

by Sarah Das Gupta

“And therof hath come the prouerb as trew as common, that a Cat hath nine liues, that is to say, a witch may take on her a Cats body nine times.” William Baldwin, Beware the Cat.

Cats may have been worshipped in ancient Egypt but by the time of Shakespeare superstitions about cats were largely negative despite their usefulness at hunting rats and mice. In fact, in medieval France cats were burnt alive as a form of entertainment, with some believing that the ashes of burnt cats gave good luck.

In the medieval and early modern period, people believed witches had nine chances of turning into their feline familiars. If a witch turned into a cat for a ninth time then they would be unable to turn back. The first written mention of this comes from William Baldwin’s ‘Beware the Cat’. Written in 1553 and published in 1570, ‘Beware the Cat’ is thought by many to be the first novel ever published in English. The gap between its writing and publication is down to the book’s anti-Catholic sentiments at a time when the devoutly Catholic Mary I was on the English throne.

“Good king of cats, nothing but one of your nine lives.” From Romeo and Juliet, William Shakespeare.

The idea that witches could turn into cats is tied to the Cat-sìth of celtic mythology – a large black cat with a white spot on its chest that resides in the Scottish Highlands. The Cat-sìth was thought to be either a fairy or a witch, and is linked to the British folk tale ‘The King of the Cats’, references to which appear in both Baldwin’s ‘Beware the Cat’ and William Shakespeare’s ‘Romeo and Juliet’. Tales of the Cat-sìth may actually have been sightings of the Kellas cat, an interspecific fertile hybrid between the Scottish wildcat and the domestic cat.

“A cat has nine lives. For three he plays, for three he strays and for the last three he stays.” Old English proverb

The origins of the nine lives myth are hard to know accurately, but many cultures believe that cats have multiple lives: in some European countries cats have seven lives whilst in Arabic traditions the number is six. Regardless of the specific number, many believe that the myth of having multiple lives is down to the quick reactions and righting reflexes that enable cats to survive perilous situations.

Whilst impressive, a cat’s ability to survive falls from great heights is not infallible, and neither is our ability to study this achievement. A study by Whitney and Mehlhaff (1987) suggested that the chance of injury from falling increased with falling height… up to a point. A falling cat reaches a terminal velocity of ~60 mph after falling about five storeys. The researchers found that up to this point the numbers of injuries increased but after seven storeys the number of injuries deceased. The explanation given by Whitney and Mehlhaff was that over a short distance a cat tenses and arches its back to turn in mid-air, but over a longer fall the cat adopts a more relaxed body state leading to fewer injuries.

Whilst there’s truth to their findings in terms of how cats behave whilst falling and the different injury types prevalent from different heights as a result, the hypothesis that heights greater that seven storeys lead to fewer injuries isn’t supported by the methodology.  The study was based on cats that had been brought into a veterinary surgery for care but cats that had fallen and not survived were, for obvious reasons, not brought into the surgery and not included in the study’s fall survival and injury statistics. Indeed, a later study by Vnuk et al. (2004) found that falls from the seventh storey or higher were associated with more severe injuries.

Cats may not always need vets but they can certainly help preserve each of their many lives!

Further reading:

‘Beware the Cat’, William Baldwin, https://www.presscom.co.uk/halliwell/baldwin/baldwin_1584.html

‘Beware the Cat’, Wikipedia page, https://en.wikipedia.org/wiki/Beware_the_Cat

‘Cat-sìth’, Wikipedia page, https://en.wikipedia.org/wiki/Cat-s%C3%ACth

‘A cat that can never be tamed’, Scientific American, https://blogs.scientificamerican.com/running-ponies/a-cat-that-can-never-be-tamed/

‘High-rise syndrome in cats’, W. Whitney and C.J. Mehlhaff, 1987, https://europepmc.org/article/med/3692980

‘Feline high-rise syndrome: 119 cases (1998–2001)’, D. Vnuk, B. Pirkić, D. Matičić, B. Radišić, M. Stejskal, T. Babić, M. Kreszinger, and N. Lemo, 2004, https://doi.org/10.1016/j.jfms.2003.07.001

Author bio:

Sarah Das Gupta is a young 81 year old. Loves writing haiku and most forms of poetry. Is learning to walk after an accident. Main outside interests include equine sports. Lives near Cambridge, UK. Read other sciku by Sarah here.

Hibernation by Joy Stahl

Survival in space
Cold sleep on long missions
Arctic Ground Squirrel

by Joy Stahl

I’m a huge fan of science fiction novels and shows that use hibernation chambers to allow humans to reach distant planets in their lifetime.

I read an article about scientists who are studying arctic squirrels and how they hibernate, to create hibernation solutions for astronauts. Arctic squirrels are super-hibernators . They hibernate over winter for 7 to 9 months, reducing their core body temperature from 37 °C (99 °F) to as low as −2.9 °C (26.8 °F), and yet they manage to retain muscle and bone mass during this extended hibernation. Understanding this remarkable adaptation may help researchers looking at prolonged space travel and may also lead to improved critical and emergency health care and treatments.

Further reading:

‘Arctic squirrels may hold key to helping astronauts survive on long missions’, AccuWeather.com: https://www.accuweather.com/en/space-news/arctic-squirrels-may-help-astronauts-survive-long-missions/1481578

Author bio:

Joy Stahl is a middle school teacher in southwestern Kansas. Her poetry has appeared in Voices of Kansas. Check out Joy’s other sciku ‘1827-2023’!

Vested Interests by Jerome Berglund

corporations decide
who’s sane, and the pharmacies
what medicine we need

By Jerome Berglund

Where vested interests and profit motives exist, there is a direct incentive to treat indefinitely rather than cure.

When those deciding how best to combat symptoms have a direct stake in the sales of pharmaceuticals for example – or those negotiating peace the sale of weapons for warfare similarly – it is a serious concern and given that, the worst sort of perversion of medicine and harming of patients will invariably occur indefinitely.  Just so with a system predicated upon, rewarding of greed, consumption, predation, which will quite reasonably in self-preservation deem heretical and absurd any alternative to the various overt madnesses its adjudicators represent, condone, and perpetuate.    

Further reading: 

Many Authors of Psychiatry Bible have Industry Ties, New Scientist: https://www.newscientist.com/article/dn21580-many-authors-of-psychiatry-bible-have-industry-ties/

Author bio:

Jerome Berglund, recently nominated for the 2022 Touchstone awards, graduated from USC’s film program, worked in the entertainment industry before returning to the midwest where he has been employed as everything from dishwasher to paralegal, night watchman to assembler of heart valves.  Jerome has exhibited many haiku, senryu and haiga online and in print, most recently in the Asahi Shimbun, Bear Creek Haiku, Bamboo Hut, Cold Moon Journal, Daily Haiga, Failed Haiku, Haiku Dialogue, Scarlet Dragonfly, Under the Basho, and the Zen Space. You can follow him on Twitter @BerglundJerome and find more of his poetry here:  https://flowersunmedia.wixsite.com/jbphotography/post/haiku-senryu-and-haiga-publications

Check out more sciku from Jerome here: ‘Environmental Charlie Browns’, ‘Illusion’, ‘Civil Disobedience’ and ‘Exploitation in Micro and Macro’.

Dance Therapy by Dr Michael J. Leach

beating heart & drums—
she dances through the grey in
a persimmon dress

by Dr Michael J. Leach

This sciku suggests the therapeutic benefits of dancing through the bright orange colour persimmon—a symbol of happiness and good health. The therapeutic benefits of dancing, such as significantly reduced anxiety following dance movement therapy, were recently reported in a meta-analysis of individual studies by Koch et al. (2019).

In early 2022, therapeutic benefits of dancing were also artistically expressed in the music video for Florence + the Machine’s single ‘Free’ (directed by Autumn de Wilde):

This music video provided the visual inspiration for my sciku while the research paper by Koch et al. (2019) provided the underlying science.

Original Research:

Koch SC, Riege RFF, Tisborn K, Biondo J, Martin L, Beelmann A. Effects of dance movement therapy and dance on health-related psychological outcomes. A meta-analysis update. Frontiers in Psychology. 2019; 10: 1806. doi: https://doi.org/10.3389/fpsyg.2019.01806

Author Bio:

Michael J. Leach (@m_jleach) is an Australian poet and academic at Monash Rural Health. His poetry collections include Chronicity (MPU, 2020) and Natural Philosophies (Recent Work Press, forthcoming).

Check out more sciku by Michael, including ‘The Burden of Bushfire Smoke‘, ‘The Core Correlate of COVID-19 Vaccine Acceptance‘,Drug-Induced Hip Fractures‘, ‘The Psychopharmacological Revolution‘, ‘Quality of Life at Seven Years Post-Stroke‘, ‘The Early Impacts of COVID-19 on Australian General Practice, A Sciku for Rayner Explainer, and ‘Australian Science Poetry‘ with science communicator Rachel Rayner. Michael also has another Covid-19-related sciku published in Pulse which is well worth checking out: ‘flu shot announcement‘.

Optimism

Elixir of life
lies within our own outlook.
Old age will be great!

Meher Baba was on to something with when he came up with his adage “Don’t Worry, Be Happy”. The Indian spiritual master’s famous saying received global recognition in Bobby McFerrin’s chart-topping a cappella hit in 1988 (and later at the turn of the century thanks to ‘Big Mouth Billy Bass’).

Yet new research suggests that Meher Baba was on to something when he coined is famous phrase. Koga et al. (2022) tracked the longevity of more than 150,000 women over the course of 26 years and examined factors influencing morbidity and mortality including ethnicity, lifestyle and psychological outlook.

The researchers found that higher optimism was associated with longer lifespans, overall and across racial and ethnic groups. Whilst optimism is partly heritable, research shows that “optimism is modifiable with accessible methods that target optimism such as writing exercises and cognitive-behavioural strategies”.

All too often we focus on factors that negatively impact longevity. We should take a leaf out of Meher Baba’s book, be happy and remember the importance of thinking that the glass is half-full.

Intriguingly, whilst this research in the USA suggests the link between optimism and longevity, a study released earlier in 2022 by Okuzono et al. suggests that contrary to the latest research from Western populations, optimism is unrelated to longevity among Japanese older adults.

Original research:

Koga et al. (2022) https://doi.org/10.1111/jgs.17897

Okuzono et al. (2022) https://doi.org/10.1007/s10902-022-00511-8

The Burden of Bushfire Smoke in Contemporary Australia by Dr Michael J. Leach

summer wildfires taint
our air…hospital visits
and deaths exceed norms

by Dr Michael J. Leach

In contemporary Australia, the frequency and intensity of bushfire events have increased alongside the rate of global warming. This disastrous consequence of climate change is illustrated by the 2019-20 Australian bushfire season: the so-called ‘Black Summer’. Over the course of that bushfire season, hundreds of wildfires burned across 24 million hectares of land inhabited by diverse flora, fauna, and humans, primarily in the southeast of Australia. Bushfire events peaked during December 2019 and January 2020.

Bushfire smoke has multiple real-world impacts, including adverse effects on public health. In order to gain a preliminary understanding of the public health burden of bushfire smoke generated by the 2019-20 Australian bushfire season, Arriagada et al. (2020) undertook a quantitative analysis of publicly available air quality, demographic, and health data over the period 1/10/2019-10/2/2020. Population-level exposure to particulate matter below a known critical level of 2.5 micrometres in diameter (i.e. PM2.5) was estimated for the four most bushfire-affected jurisdictions of Australia: New South Wales (NSW), the Australian Capital Territory (ACT), Queensland, and Victoria. PM2.5 concentrations were compared with past average values recorded by air quality stations. The authors also determined, for each jurisdiction, the incidence of several relevant health outcomes: hospital admission for respiratory or cardiovascular issues, asthma-related visits to emergency departments (EDs), and excess deaths. The PM2.5 data and incidence rates were used to calculate a measure of exposure-response risk.

The authors’ analysis revealed that, across the four Australian jurisdictions under investigation, bushfire smoke led to an estimated 2,027 hospital admissions for respiratory issues, 1,305 asthma-related visits to EDs, 1,124 hospital admissions for cardiovascular issues, and 417 excess deaths. For each of these health outcomes, the public health burden was greatest for NSW followed by Victoria, Queensland, and then the ACT. It is important to note, however, that there are levels of uncertainty attached to these estimates: they may be underestimates or overestimates of the true values. The authors highlighted the importance of more detailed epidemiological analyses of the public health burden associated with bushfire smoke in Australia. While such studies would build the evidence base in this area, the preliminary statistics reported here are still substantial in magnitude and suggestive of the need for bushfire prevention and preparedness strategies in contemporary Australia.

The original research article described here is available open access online:

Arriagada NB, Palmer AJ, Bowman DMJS, Morgan GG, Jalaludin BB, Johnston FH. (2020). Unprecedented smoke-related health burden associated with the 2019-20 bushfires in eastern Australia. Medical Journal of Australia. 213(6): 282-283. https://www.mja.com.au/journal/2020/213/6/unprecedented-smoke-related-health-burden-associated-2019-20-bushfires-eastern   

Michael J. Leach (@m_jleach) is an Australian epidemiologist, biostatistician, and poet who works at Monash University. His poetry collections include Chronicity (MPU, 2020) and Natural Philosophies (Recent Work Press, forthcoming).

Check out more sciku by Michael, including ‘The Core Correlate of COVID-19 Vaccine Acceptance‘,Drug-Induced Hip Fractures‘, ‘The Psychopharmacological Revolution‘, ‘Quality of Life at Seven Years Post-Stroke‘, ‘The Early Impacts of COVID-19 on Australian General Practice, and ‘Australian Science Poetry‘ with science communicator Rachel Rayner. Michael also has another Covid-19-related sciku published in Pulse which is well worth checking out: ‘flu shot announcement‘.

Public Health by Dr Alex Stockdale

In mid-2021 The Sciku Project teamed up with the Literature and Science Hub at the University of Liverpool to run the ‘Research in Verse Poetry Competition’, open to staff and postgraduate research students across the university to submit poems about their research subject. The competition saw poems addressing all sorts of topics, ranging from gravity to slavery to life in the lab.

Dr Alex Stockdale’s poem ‘Public Health’ was praised by the judges as a notable entry:

Public Health

In a long corridor wailing
Bite
The virus knuckles and grasps
Enters cells
At birth was I living with him
His genome nestling in mine

Now fluid fills the belly
Tumour fills my liver
Hope left this station
Staring out the window
At a blue calm sky on a roaring hot day in Malawi

Too late they said
Too hard
Nothing more to say
I don’t have much time left to live but I want you to know
It could have been prevented

Background

This poem is about my research into liver disease in Blantyre, Malawi. We found that over 70% of liver cancer is caused by hepatitis B. Infection can be prevented by vaccination starting at birth and by antiviral treatment for pregnant women. Currently, vaccination starts at 6 weeks of age and my research is exploring whether this is sufficient to prevent transmission. This poem draws attention to the many people who present with late stage liver cancer in Malawi, for whom median prognosis is only 6 weeks at diagnosis, and for whom hepatitis B infection remains a preventable disease. 

Dr Alexander Stockdale is a clinical researcher at the University of Liverpool with a focus on viral hepatitis and HIV in sub-Saharan Africa.

Mammoth document by Dr Janette Greenhalgh

In mid-2021 The Sciku Project teamed up with the Literature and Science Hub at the University of Liverpool to run the ‘Research in Verse Poetry Competition’, open to staff and postgraduate research students across the university to submit poems about their research subject. The competition saw poems addressing all sorts of topics, ranging from gravity to slavery to life in the lab.

Dr Janette Greenhalgh’s fascinating poem using a repeating haiku structure was a notable entry:

Mammoth document

Mammoth document
Brim-full of words, so URGENT!
Fight, flight, cup of tea?

URGENT document
Mammoth in the room, storming
Kettle shrieks volumes

Words, words, words and more
Unwrap, repurpose, rebind
With fight, flight and tea

Mammoth document
Brim-full of our words. Job done!
Outside, sweet birdsong

Background

Our research is mainly commissioned by the NIHR Health Technology Assessment programme on behalf of the National Institute for Health and Care Excellence (NICE). Our core work is to provide a critique of evidence submissions to NICE from pharmaceutical companies for the clinical and cost effectiveness of new drugs. We have multi-disciplinary teams working on each report (clinical effectiveness reviewer, statistician, economic modeller, clinical expert). The timelines are very short – we have 8 weeks from receipt of the evidence to submitting our critique to NICE.

Dr Janette Greenhalgh is a Senior Research Fellow with the Liverpool Reviews and Implementation Group, Department of Health Data Science, Institute of Psychology and Health. You can connect with her on Twitter here: @drjanetteg

Vaccines and Protection by B.R. Shenoy

Vaccines protect us
Trigger an immune response
Prevent infection

by B.R. Shenoy

Mechanism of Action of Vaccines

“A vaccine works by training the immune system to recognize and combat pathogens, either viruses or bacteria. To do this, certain molecules from the pathogen must be introduced into the body to trigger an immune response.

“These molecules are called antigens, and they are present on all viruses and bacteria. By injecting these antigens into the body, the immune system can safely learn to recognize them as hostile invaders, produce antibodies, and remember them for the future. If the bacteria or virus reappears, the immune system will recognize the antigens immediately and attack aggressively well before the pathogen can spread and cause sickness”

PublicHealth, ‘How Vaccines Work’

B.R. Shenoy is a biochemistry and chemical toxicology, M.S. She is a contributing writer for The Good Men Project. Her work has also appeared in Scary Mommy, Positively Positive, and Idle Inks. She is a content creator on Medium. You can catch up with her on Twitter @Shenoy100.

This sciku was originally published on Medium: https://medium.com/illumination/vaccines-and-protection-a-sciku-ca1491e36b13

The Early Impacts of COVID-19 on Australian General Practice by Dr Michael J. Leach

General practice
as COVID strikes—workloads rise
as revenues fall

by Dr Michael J. Leach

The coronavirus disease-19 (COVID-19) pandemic has affected populations and industries in multifarious ways. For more than a year now, global viral spread and associated lockdowns have driven major health and economic crises. While industries such as travel and entertainment have experienced dramatic reductions in both workload and revenue, the situation in the health care industry is more complex.

In a health services research study, Kippen et al. (2020) explored the early impacts of COVID-19 on Australian general practice through a national online survey. This survey was distributed to 4,891 Australian general practice supervisors on 14 April 2020—less than one month after the World Health Organization upgraded the COVID-19 epidemic to a pandemic on 11 March 2020. The cut-off date for survey completion was 13 May 2020. Overall, 572 of the 4,891 general practice supervisors responded, giving a relatively good physician response rate of 12%.

Of the 572 respondents, 61% reported an increased overall workload during the pandemic while 77% reported reduced practice revenue. Increased workloads related to the implementation of new hygiene practices and clinical regimens, heightened community anxiety, and higher volumes of phone calls. Reduced practice revenues, meanwhile, stemmed from additional administrative work, additional clinical work that could not be reimbursed through the government in the usual way, and the need to purchase new resources such as disinfectant and personal protective equipment. Such changes have adversely affected the viability of Australian general practice—a cornerstone of the health care sector, especially during a pandemic.

The original research article described here is available open access online:
Kippen R, O’Sullivan B, Hickson H, Leach M, Wallace G. (2020). A national survey of COVID-19 challenges, responses and effects in Australian general practice. Australian Journal of General Practice. 49(11): 745-751. https://www1.racgp.org.au/ajgp/2020/november/national-survey-of-covid-19-challenges

Michael J. Leach (@m_jleach) is an Australian epidemiologist, biostatistician, and poet based at the Monash University School of Rural Health. His debut poetry collection is Chronicity (Melbourne Poets Union, 2020).

Check out more sciku by Michael, including ‘The Core Correlate of COVID-19 Vaccine Acceptance‘,Drug-Induced Hip Fractures‘, ‘The Psychopharmacological Revolution‘, ‘Quality of Life at Seven Years Post-Stroke‘, ‘The Burden of Bushfire Smoke‘, and ‘Australian Science Poetry‘ with science communicator Rachel Rayner. Michael also has another Covid-19-related sciku published in Pulse which is well worth checking out: ‘flu shot announcement‘.

The Core Correlate of COVID-19 Vaccine Acceptance by Dr Michael J. Leach

vaccine acceptance
correlates with a belief
in the greater good

by Dr Michael J. Leach

During 2020 and 2021, acceptance of coronavirus disease-19 (COVID-19) vaccines has been among the most topical areas of health science research. As COVID-19 vaccine availability continues to rise worldwide in a global effort to combat the ongoing coronavirus pandemic, more and more people are faced with the question of whether or not to get vaccinated. Even when an approved COVID-19 vaccine is readily available to a particular subgroup of the global population, a high level of vaccine uptake cannot be guaranteed. For one reason or another, individuals within the population may be hesitant to roll up their sleeves to receive the COVID-19 vaccine.

In a UK population-based study, Freeman et al. (2021) investigated factors related to vaccine hesitancy through an online survey completed by 5,114 adults over September-October 2020. The research team measured vaccine hesitancy within the study population using a specially developed tool—the Oxford COVID-19 vaccine hesitancy scale. While 71.7% of surveyed adults expressed willingness to accept the COVID-19 vaccine, 16.6% were very unsure about vaccination and 11.7% showed strong vaccine hesitancy.

Among the various beliefs, views, attitudes, and past experiences considered by the researchers in their analysis, the factor most strongly correlated with vaccine hesitancy was whether or not individuals believed in the collective importance of COVID-19 vaccination. An individual’s belief in the collective importance of COVID-19 vaccination is defined as the recognition that getting vaccinated protects the community and saves lives. This belief is consistent with the critically important field of public health and with the idea of doing something—in this case, getting vaccinated—for ‘the greater good’.

Based on the results of their study, Freeman et al. suggest that public health messages highlighting the societal benefits of vaccination could be broadcast in an effort to increase belief in the collective importance of COVID-19 vaccination and, thus, improve vaccine acceptance and uptake.

The original research article described here is available open access online:
Freeman D et al. (2021). COVID-19 vaccine hesitancy in the UK: the Oxford coronavirus explanations, attitudes, and narratives survey (Oceans) II. Psychological Medicine 1–15. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7804077/pdf/S0033291720005188a.pdf

Michael J. Leach (@m_jleach) is an Australian epidemiologist, biostatistician, and poet based at the Monash University School of Rural Health. His debut poetry collection is Chronicity (Melbourne Poets Union, 2020).

Check out more sciku by Michael, including ‘Drug-Induced Hip Fractures‘, ‘The Psychopharmacological Revolution‘, ‘Quality of Life at Seven Years Post-Stroke‘, ‘The Early Impacts of COVID-19 on Australian General Practice‘, ‘The Burden of Bushfire Smoke‘, and ‘Australian Science Poetry‘ with science communicator Rachel Rayner. Michael also has another Covid-19-related sciku published in Pulse which is well worth checking out: ‘flu shot announcement‘.

Indirect Inequality

Covid cares not for
the racial disparity
of heart disease

It was well-known before the pandemic that different racial/ethnic populations in the United States had different burdens of cardiovascular disease, with Black populations the worst affected.

The Covid-19 pandemic, however, has found ways of making bad things even worse, with deaths from heart disease and cerebrovascular disease rising across the whole of the USA. Yet new research by Wadhra et al. (2021) suggests that these increases aren’t evenly distributed across all racial/ethnic populations. Black, Asian and Hispanic populations have experienced a much larger relative increase in deaths (~19%) than the non-Hispanic White population (~2%).

A number of factors could be combining to result in this disproportionate impact of the pandemic on different racial/ethnic groups, including “reduced access to healthcare services, increased health system strain, and hospital avoidance due to fear of contracting the virus in high-burden areas. In addition, inequities in the social determinants of health that are associated with cardiovascular risk, such as poverty and stress, have likely worsened for these groups.”

Whilst depressingly unsurprising, these results make it clear that the United States urgently needs public health and policy strategies to “monitor and mitigate the short- and long-term adverse effects of the pandemic on the cardiovascular health of diverse populations.”

Original research: https://doi.org/10.1161/CIRCULATIONAHA.121.054378

Privateer, the phage by Dr. Jolene Ramsey

What’s in the EM?
A crayon? A tailocin?
No, that’s Privateer!

By Jolene Ramsey

Proteus mirabilis is an opportunistic human pathogen, causing a large proportion of urinary tract infections. These infections are particularly severe in the elderly, and their treatment is recalcitrant to many antibiotics. There is great interest in using the natural predators of Proteus, their viruses (bacteriophages), to mitigate this issue. However, not many Proteus bacteriophage have been identified or characterized yet.

In our recent study (Corban & Ramsey, 2021), we describe a new phage called Privateer that infects and kills Proteus mirabilis. We first saw this phage in the electron microscope (EM) and noticed its unusual elongated head shape. Privateer has some interesting genes that seem to be common only among the closest related phages. Studies like these are the foundation for future applications combating multi-drug resistant bacterial problems.

Original research: https://doi.org/10.7717/peerj.10645  

Jolene Ramsey studies bacterial viruses (phage) as a Center for Phage Technology postdoctoral researcher. She focuses on their explosive escape from the host cell after a successful infection. You can catch up with her on Twitter: @jrrmicro

Enjoyed Jolene’s sciku? Check out her other sciku ‘Click click go!’, ‘TF gets in on the bud’, ‘The Phriendly Phage’ and ‘Saba, the morning breeze’.

Wildfire’s Secrets

Hidden harm of smoke.
Microbial long-haul flights.
Lurking, infecting.

Wildfires cause huge amounts of long-term harm, including human, other animal and plant deaths, habitat loss, property and infrastructure destruction, the loss of carbon reservoirs and increased chances of flooding and landslides. Small airborne particles in smoke can be inhaled and cause fatal problems within the respiratory system, whilst the high levels of carbon monoxide produced can result in long-term brain damage, heart problems and even suffocation.

Yet researchers are revealing a new potential health threat as a result of wildfires – some microbes and fungi known to cause human infections are able to survive in the smoke plumes. Wildfires disturb soils causing these microbes to become airborne. Within the smoke the microbes ‘travel’ on particulate matter which is likely to protect them from ultraviolet radiation.

Kobziar & Thompson (2020) argue that the ability of microbes to survive in smoke plumes means that wildfires could play a role in geographical patterns of infection and that more research is needed to understand this threat. Particulate matter from wildfire smoke has been found to travel inter-continental distances. Those living close to wildfires, and even more so those firefighters working on the front lines are likely to be most at risk to such microbes – the US Centre for Disease Control has already stated that firefighting is an at-risk profession for coccidioidomycosis, a fungal infection also known as Valley fever.

The researchers argue that too little is currently known about microbe survival and spread in wildfire smoke. Essential questions remain, the answers to which will only be more important as the likelihood of wildfires increases as a result of climate change.

Original research: Kobziar & Thompson, 2020, Science, ‘Wildfire smoke, a potential infectious agent’ https://science.sciencemag.org/cgi/doi/10.1126/science.abe8116

Technomancy by Debbie Lee

Fitbit in your skull,
neuroscience leap
Musk technomancy

by Debbie Lee

Neuralink is a brain implant with 1,024 5-micron-wide (very, very thin!) electrodes and includes sensors for motion, temperature and pressure. Ultimately, according to Elon Musk, the medical goal is for such implants to be able to control prosthetic limbs, alleviate memory loss, help with addiction and fix mental illnesses and vision and hearing impairments.

Musk has described it as “a Fitbit in your skull” and some of his more enthusiastic claims are that this technology could one-day record and replay memories and (due to the device’s wireless capabilities) enable telepathy – sending and receiving words, concepts and images.

All this sounds incredible and Neuralink is certainly a step up from what has currently been available to neuroscientists – the current Utah Array has 64 electrodes and installation can cause significant tissue damage on installation and removal.

Whilst Neuralink represents a huge step forward for neuroscientists, however, there are still plenty of unknowns to do with how neurons function and how this type of technology can remain in the brain for long periods of time without causing tissue damage or being damaged by the environment within the cranium and the human immune response. For all of Musk’s technomancy hype, Neuralink currently asks more questions than it provides answers to and there are still plenty of difficult barriers to overcome before any of the promised advantages are possible.

Further reading: https://www.wired.com/story/neuralink-is-impressive-tech-wrapped-in-musk-hype/

Debbie Lee (@lee_debbie):
Writing from places light and dark,
awkward data nerd,
elegant word nerd,
dreaming in colour,
clumsily balancing love, hope,
kindness with pragmatic realism.

Lost Matters

Birthweight advantage
of Black immigrants: lost in
a generation.

Birthweight can be a predictor of a range of health and socioeconomic outcomes, and in the United States Black women are known to have the highest prevalence of low birthweight babies of all racial groups. Evidence also suggests that immigrant women who give birth in the US have babies with higher weights than women born in the US.

Yet new research suggests that this birthweight advantage of immigrants extends beyond a single generation… for some races.

Andrasfay & Goldman (2020) looked at 1971-2015 Florida birth records to assess intergenerational changes in birthweight. They found that Black immigrants typically have larger babies than US-born Black women but that, in contrast to Hispanic immigrants, this ‘healthy immigrant’ effect is lost within a generation.

Whilst the study did not specifically investigate reasons for this difference, the authors suggest that a “lifetime exposure to discrimination and socioeconomic inequality is associated with adverse health outcomes for Black women.

Original research: Andrasfay & Goldman (2020) Intergenerational change in birthweight: effects of foreign-born status and race/ethnicity, Epidemiology, https://doi.org/10.1097/EDE.0000000000001217

Aid pride

Got hearing aid shame?
No sense in letting age-pride
steal away your brain.

For many people the idea of needing a hearing aid is embarrassing, a sign of ageing that they don’t want to be reminded of or seen to need. Yet this shame may actually be harmful – a new study by Sarant et al. (2020) suggests that the use of a hearing aid may stave off cognitive decline.

The researchers assessed 99 adults aged between 60 and 84 before and after hearing aid use. After 18 months they found cognitive executive function (the higher level mental abilities used organise information, plan, and initiate and complete tasks) improved across the whole sample, especially in women.

Whilst sample sizes were small, the researchers also found that speech perception in quiet environments improved, as did participants’ self-reported quality of life and listening disability. This is an exciting development and, whilst further and larger studies are needed, it suggests that hearing aids may help to delay cognitive decline.

Further reading: http://dx.doi.org/10.3390/jcm9010254

The Psychopharmacological Revolution

’50s to ’60s
use of new psychotropics
soars in both genders

by Dr Michael J. Leach.

Psychotropic drugs act on the central nervous system to elicit a range of therapeutic effects, such as improved sleep and anxiety relief.

Barbiturate psychotropics are older medicines with narrow therapeutic indices, meaning that there is little difference between beneficial and harmful doses. Actress Judy Garland is one of many people who has tragically died from a barbiturate overdose.

Non-barbiturate psychotropics such as benzodiazepines, meanwhile, are newer and safer alternatives to barbiturates for the treatment of psychological disorders. An example of a psychotropic that is widely used in modern society is the benzodiazepine diazepam, which was first marketed under the brand name Valium.

Historically, the Psychopharmacological Revolution of the 1950s and 1960s saw the introduction of a wide range of non-barbiturate psychotropics onto a growing global pharmaceutical market. There has been little research into the gender-specific, community-level use of psychotropic drugs over the Psychopharmacological Revolution of the 1950s and 1960s.

In order to shed light on the origins of Australia’s relatively high modern-day consumption of psychotropics, my colleague and I conducted a study to explore gender-specific volumes of psychotropic dispensing at a Melbourne pharmacy during the 1950s and 1960s. This original research has been published in the peer-reviewed journal Pharmaceutical Historian.

In this study, I sourced data on the name of medicine dispensed, dispensing date during 1954 or 1961, and patient gender from a set of old prescription books that were kept at a community pharmacy in the inner Melbourne suburb of Toorak. I cross-referenced the dataset with historical pharmacy reference books to classify each medicine into one of the following mutually exclusive categories: barbiturate psychotropics, non-barbiturate psychotropics, and non-psychotropic medicines. After collecting data and classifying each medicine, I calculated the number of prescriptions dispensed in each year and adjusted for the size of the population residing in the surrounding local government area.

The study results indicated that twice and 1.7 times as many medicines were dispensed to females than to males during 1954 and 1961, respectively. Such gender differences were evident across all three categories of dispensed medicines: barbiturate psychotropics, non-barbiturate psychotropics, and non-psychotropic medicines. There was also a pronounced shift in psychotropic dispensing from the older, more dangerous barbiturates (77% in 1954; 38% in 1961) to newer, safer non-barbiturate psychotropics (23% in 1954; 62% in 1961). The extent of this shift over time to newer, safer psychotropics was similar in both genders.

Original research: Gender differences in psychotropic medicine dispensing at a pharmacy in Melbourne, Australia, 1954 and 1961 by Michael J. Leach and Rebecca Kippen.

Michael Leach (@m_jleach) is an Australian health researcher, biostatistician, and poet with a PhD in Pharmacoepidemiology and a passion for health humanities. Examples of his science poems are online here: https://imagesofhealth.wordpress.com/.

If you enjoyed this sciku, check out Michael’s other sciku ‘Quality of Life at Seven Years Post-Stroke‘ and ‘Drug-Induced Hip Fractures, ‘The Core Correlate of Covid-19 Vaccine Acceptance’, The Early Impacts of COVID-19 on Australian General Practice‘, ‘The Burden of Bushfire Smoke‘, and ‘Australian Science Poetry‘ with science communicator Rachel Rayner.

Supine Risks

Supine position,
dreaming towards tragedy.
The risk of stillbirth.

New research has found that the risks of stillbirth are higher when the mother falls asleep lying on her back. Cronin et al (2019) analysed sleeping position and resulting birth success. Whilst no difference was found between going-to-sleep on the left or right side, the researchers found evidence that the supine going-to-sleep position is a contributing factor for late stillbirth. In fact, they suggest that if every pregnant woman of 28 weeks gestation and beyond settled to sleep on her side the number of late stillbirths could be reduced by 5.8%.

Original research: http://dx.doi.org/10.1016/j.eclinm.2019.03.014

Drug-Induced Hip Fractures

psychoactive drugs
flood and fog brains soon before
falls and hip fractures

by Dr Michael J. Leach

There is an inherent poetry to pharmacy whereby medicines can help people through intended beneficial effects and harm people through unintended adverse events, including side effects and drug-drug interactions. It is crucial for prescribers to carefully weigh up the risks and benefits of treatment whenever a new medicine is considered for any given patient. As the modern world has an aging population, there have been rises in frailty, multiple morbidities (i.e. multimorbidity), and multiple medicine use. Multiple medicine use can be defined in terms of polypharmacy, which denotes the concurrent use of five or more drugs, and hyper-polypharmacy, which denotes the concurrent use of ten or more drugs. The increasing prevalence of polypharmacy and hyper-polypharmacy means that, in modern society, there is high potential for harmful side effects and drug-drug interactions.

Psychoactive medicines are examples of drugs that have unfavourable side effects and that can interact with one another to cause harm. Psychoactive medicines act on the central nervous system in different ways to elicit therapeutic and adverse effects. The main types of psychoactive medicines are antidepressants, antipsychotics, benzodiazepines, benzodiazepine-related drugs, opioid analgesics, anticholinesterases, antiepileptics, and anti-Parkinson medicines. A common side effect across all these psychoactive medicines is sedation. While treatment with benzodiazepines, benzodiazepine-related drugs, and antipsychotics may be aimed at helping people to relax or sleep at night, the sedative effect can still be harmful when there is unwanted daytime sedation or oversedation. The sedative effects of psychoactive medicines likely explain why these drugs increase the risk of falls and fractures, especially in older, frailer individuals. Furthermore, when any one psychoactive medicine is taken with another psychoactive medicine, there is an increased sedative burden on the patient. This increased sedative burden can place people at an even greater risk of falls and fractures.

Pharmacoepidemiology is the population-level study of medicine use. In original research conducted as part of my PhD in Pharmacoepidemiology, I used a number of study designs and statistical methods to quantify the risk of hip fracture following psychoactive medicine use in older people. I focused on particular types of psychoactive medicines (e.g. antipsychotic drugs and selective serotonin reuptake inhibitor [SSRI] antidepressants) used individually and in combination with one another. The risk of hip fracture was increased for a range of psychoactive medicines, most notably when they were used concurrently. This research is relevant to real world medical practice because the risk factors identified are potentially modifiable. If prescribers better understand the risks associated with psychoactive medicine use, then they can make more informed prescribing decisions and de-prescribe psychoactive medicines where appropriate. Older patients, their carers, and their family members, as well as nursing home staff, would also benefit from better understanding the significant risk posed by the use of psychoactive medicines.

The pharmacoepidemiological studies that make up my PhD thesis have been published in peer-reviewed journals and are available online:

Leach MJ, Pratt NL, Roughead EE. The risk of hip fracture due to mirtazapine exposure when switching antidepressants or using other antidepressants as add-on therapy. Drugs – Real World Outcomes. 2017; 4(4): 247-255. http://dx.doi.org/10.1007/s40801-017-0120-y

Leach MJ, Pratt NL, Roughead EE. The risk of hip fracture in older people using selective serotonin reuptake inhibitors and other psychoactive medicines concurrently: a matched case-control study in Australia. Drugs – Real World Outcomes. 2017; 4(2): 87-96. http://dx.doi.org/10.1007/s40801-017-0107-8

Leach MJ, Pratt NL, Roughead EE. Psychoactive medicine use and the risk of hip fracture in older people: a case-crossover study. Pharmacoepidemiology and Drug Safety. 2015; 24(6): 576-582. https://doi.org/10.1002/pds.3785

Leach MJ, Pratt NL, Roughead EE, Hayward K, Jenkins N. Medicine use among the elderly before and after hip fracture. Australian Journal of Pharmacy. 2014; 95(1125): 72-74. [A secondary publication arranged by the original publisher]. Available here.

Leach MJ, Pratt NL, Roughead EE. Medicine use among older Australians before and after hip fracture. Journal of Pharmacy Practice and Research. 2013; 43(4):265-268. https://doi.org/10.1002/j.2055-2335.2013.tb00271.x

Michael Leach (@m_jleach) is an Australian health researcher, biostatistician, and poet with a PhD in Pharmacoepidemiology and a passion for health humanities. Examples of his science poems are online here: https://imagesofhealth.wordpress.com/.

If you enjoyed this sciku, check out Michael’s other sciku ‘Quality of Life at Seven Years Post-Stroke‘ and ‘The Psychopharmacological Revolution, ‘The Core Correlate of Covid-19 Vaccine Acceptance’, The Early Impacts of COVID-19 on Australian General Practice‘, ‘The Burden of Bushfire Smoke‘, and ‘Australian Science Poetry‘ with science communicator Rachel Rayner.

A body projects by Prof Tania Douglas

A body projects

to a model of others

and finds its own shape

by Tania Douglas

Reyneke et al (2018) review the state of the art in 3D reconstruction of bone from 2D images, based on deformable models. Such reconstructions are useful in a variety of clinical applications such as surgery planning and postoperative evaluation, and implant and prosthesis design.

Original research: https://doi.org/10.1109/RBME.2018.2876450

Prof Tania Douglas is the South African Research Chair in Biomedical Engineering & Innovation at the University of Cape Town, South Africa. You can follow her on Twitter under the handle @tania_douglas