What $85 million could get the NFL: thinking about the NFL concussion settlement

All opinions are my own and do not necessarily reflect those of Novo Nordisk.

Yesterday the NFL and the NFL Players Association reached a settlement concerning compensation for concussions and other football-related injuries.  The impending lawsuit was brought by former NFL players who claimed, among other things, that the NFL downplayed the risk of concussions despite having knowledge of their effects and also did not do all it could to help former players.

The total amount earmarked for the settlement is reported to be $765 million dollars, with the vast majority ($675 million) in a fund to support former players and families in dealing with the aftermath of concussions.  Commentators have noted that this appears to be a great victory for the NFL.  First, the amount of money is less than many expected even with a settlement.  Second, the NFL did not have to go through discovery, which would have laid open exactly what the NFL did know about concussions and possible side effects, as well as potentially other damaging information that, once released in court, could never be private again.

It seems likely that those who were bringing forward the suit settled because they were motivated to help the most needy members of their group.  Many former NFL players are suffering dementia and lingering aftereffects from their playing days.  Some families of deceased players will also benefit.  The former player pool can’t really afford to wait for the long protracted time a trial and subsequent appeals would take since in the interim many would fall into poverty and even poorer health; some could also die. Continue reading

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Gaming to help beat cancer

All opinions my own and do not necessarily reflect those of Novo Nordisk.

Plants versus Zombies 2: It’s About Time just came out.  My son spent a significant fraction of his weekend playing it on my iPad.  Okay, fine, I did too.  It’s a lot of fun, it challenges (but not too much) and it teaches you facts like, uh, like that Egyptian society in the past had a real fascination with pyramids.

So it’s not the most educational of games.

Which is why I was stoked to see the writeup of Re-Mission 2 in FierceBiotechIT.  This game takes elements of cancer treatment and places them in the context of a game that both educates patients undergoing cancer treatment as well as provides them a way to feel more in control of their situation.  Version 2 also builds on the impact of the first Re-Mission game, which showed success in improving adherence of patients to their treatment regimens.  Adherence is an important element of medical treatment and trying to make sure people take their medicines is an ongoing problem as we try to improve the efficiency of our healthcare systems.

In addition to behavioral metrics being changed by Re-Mission, functional Magnetic Resonance Imaging (fMRI) also showed that playing the game activated brain areas associated with motivation–again, tying gameplay to elements of adherence.  Some brain region activations also correlated with subject described positive and improved attitudes towards chemotherapy after gameplay. Continue reading

Internet access is a public (and private) health issue

All opinions are my own and do not necessarily reflect those of Novo Nordisk.

If the Founding Fathers had lived today, they would surely have included internet access as one of our inalienable rights.  No, scratch that, because if they had lived today they would have used Google Docs to crowdsource the Declaration and the result would probably have been much more generic and middle of the road than it actually is.  Also, the Declaration would also have been limited it to about 500 words so readers wouldn’t get bored and surf somewhere else, and it would have had embedded GIFs. Preferably animated.

Still, the ability to access the internet and everything that comes with that is, if not a right, an incredible advantage.  So I was stunned when I read in the Seattle Times the other day that a significant fraction of people in the US–about twenty percent–have little to no internet connection, although those numbers have recently begun to creep up, presumably due to smartphone uptake.   But of course, being a good Seattlelite with a liberal bent, my next reaction was to say, well, let’s not rush to judgement or conclusions.  Maybe those people just don’t want the internet.  Not that there’s anything wrong with that…

Except the article goes on to say that while seniors generally did not feel they were missing anything, the majority of other respondents did feel they were missing something important and were being left behind because of their limited access.  So it’s not a life decision; it’s a question of cost, access and education. Continue reading

Batman, Blockbusters, and Biopharma

All opinions are my own and do not necessarily reflect those of Novo Nordisk.

This blogging thing is interesting.  I’m discovering one of the challenges with blogging on a regular basis is the back and forth tidal pull between length/quality and speed/relevance.  There are measured, thought-out, lengthy pieces I’m working on about things and concepts I am interested in exploring.  But at the same time I find myself responding to current events that spark a thought and connection, an Aha! moment, with quick reaction pieces.  Finding that balance is tough, especially since I like both kinds of writing and think they add to the general blog environment that I’m trying to create.  And time is limited.  In a given week I shoot for maybe 3+ posts, in an effort not to get too burnt out or disenchanted in the way described by Chuq van Rospach.  Sometimes, though, a combination of thoughts, articles and other bits of information come together and I find myself staying up to pound out those 500 or 1000 words to capture an idea in the moment.  All for the benefit of the 3 or so people who will skim this post, plus the random butt-click registered by some poodle sitting on an iPad.

But whatever.

So, Batman. Continue reading

Enter citizen science

All opinions my own and do not necessarily reflect those of Novo Nordisk.

h/t to @engagedethics for the heads up.

What do you think of when you think of citizen science?  Maybe dads buying Geek Dad and helping their kids build Lego robots that can manipulate a lego binary clock.  Maybe people tracking their health, thoughts, bodies, or other things in a really granular way in an effort to get at their quantified self.  Maybe hobbyists building and flying drones to sample atmospheric particle levels or track neighborhood traffic patterns.  Maybe patients groups banding together and funding research into cures, like the Cystic Fibrosis Foundation did with Kalydeco.  Maybe birdwatchers helping researchers track the migration patterns and populations of North American birds.  Maybe it’s something else, something you know about or have heard about or are planning to do right now.  Choose any or all of the above and you’re completely right.

Because citizen science, like a lot of movements these days, isn’t something legislated or codified or directed from on high. It’s something organic and crowd-based and bottom up, and it’s going on everywhere.

This is the world that’s being enabled by technology.  Whether it’s 3D printing, DIY Bio, computer modeling, personal monitoring or other kinds of tools, the barriers to experimentation are falling rapidly, and interest in figuring stuff out is on the rise.

The Citizens Science Association has been working on ways to support this new way of doing science.  They’ve been convening groups to look at topics like Governance, Conferences, ways to publish, and ways to communicate via other means.  There will be a webinar on September 17th to report on progress and it sounds like a worthwhile thing to listen to.  I haven’t been involved in the Association, but I’m planning to listen in.  Because technology keeps lowering the barriers to entry, and I’m really excited to see what comes out.

Maternal versus paternal effects on autism

All opinions my own and do not necessarily reflect those of Novo Nordisk

A report just out in JAMA Pediatrics (behind a paywall, but you can see the abstract at the link) reports the intriguing finding (by the way, just for the record, in blogging I’m finding it hard to find synonyms for “interesting.”  Please bear with me) that the recurrence risk for siblings of children with autism is seen even with half-siblings, albeit at a lower rate.  And more intriguing, the risk for sequential half-siblings is higher when the siblings share a mother than when they share a father.

This strikes a chord to me because it is consistent with other recent research I’ve described before, in which the presence of maternal autoantibodies to certain sets of neural proteins was predictive for development of autism.  As the abstract for the current work says, “the significant recurrence risk in maternal half-siblings may support the role of factors associated with pregnancy and the maternal intrauterine environment in ASDs.”  Whether maternal autoantibodies are associated with recurrence risk in this cohort is unknown.  The earlier study was at UC Davis; this one is from Denmark.  I’m generally of the mind that autism is an extremely complex collection of related syndromes, with many different contributing factors (but not vaccines!), so I think it’s best to just do the experiment and test for autoantibodies in the mothers of recurrent siblings.

And the nice thing about a country like Denmark is that this is probably feasible.  Unlike some other nations with extremely fragmented and incomplete health care systems (*cough*United States*cough*), Denmark has very good, integrated medical records.  Denmark also has very high standards for ethics and consent.  So finding a reasonable cohort of mothers and recontacting them may allow a test of whether an association to autoantibodies can be found here as well.  All towards figuring things out, all good.

I wrote to the authors of the study to ask about their work and how it might relate to the autoantibody studies and received the following email response from Dr. Diana E. Schendel of the CDC, via Therese Grønborg:

“Since our paper supports a role for maternal intrauterine effects in ASD, in addition to familial factors, our results are consistent with findings such as the (sic) UC Davis of maternal-derived factors that put the fetus at risk for ASD in pregnancy. One of the pregnancy related factors investigated in ASD etiology concerns abnormal immune system function – perhaps in the mother or perhaps in the fetus – that could impact brain development.

It is important to note that ASD has many potential causes and our study supports the notion of many etiologic pathways – both through family history and prenatal fetal  environments.”

This is a great statement as it jibes with my own views on diseases like autism–that we’re still very early in our understanding of what creates the presentation of a complex phenotype like autistic behavior, and that we need to keep looking and certainly not expecting simple explanations.  Finding explanations is not going to lead directly to new drugs, but greater understanding and a more personalized and nuanced view of each child’s challenges will help maximize their chances of finding success in life.

Do Biopharma workers hate their jobs? Answer, I don’t think so, but…

All opinions are my own and do not necessarily reflect those of Novo Nordisk

A colleague of mine when I worked for Merck used to drop by my office to discuss project management, and one of his favorite terms was “engagement.”  I was reminded of this when the people at Gallup published their most recent results about their polling of the American workplace.  You can find their report here, and a writeup here.  One of the interesting/sad findings was that only 30% of their survey respondents (and there were 25 million respondents) report being engaged in their work.  This astounds me.

One of the many perks of science is that far more than 30% of the people I work with on a daily basis are very engaged in what they do.  By engaged, let me refer to the Gallup report:  “Gallup defines “engaged” employees as those who are involved in, enthusiastic about, and committed to their work and contribute to their organization in a positive manner.”  Sounds like a good working definition.  There are a number of reasons to go into science, but rarely do I find people saying they’re doing it for the money.   Probably because that just doesn’t compute when you say it out loud. Continue reading