2020 Year of the nurse and the midwife

The World Health Organization (WHO) Executive Board designated “2020 Year of the Nurse and the Midwife” in honor of the 200th birth anniversary (May 12) of Florence Nightingale (1820–1910).¹ The WHO is focused on mobilizing nurses and midwives to achieve universal healthcare coverage since they serve as the bridge to patients, communities, and institutions globally.

Florence Nightingale's legacy is extremely relevant as our modern world is in the midst of the Covid-19 global pandemic. Covid-19 has spread to over 190 countries and territories, prompting governments to essentially cause a global standstill. Healthcare workers are at the frontline, working night and day to treat those infected while scientists are working around the clock to produce a vaccine.

Modern nursing finds a proud heritage in its founder, Florence Nightingale—a mystic, visionary, reformer, healer, environmentalist, feminist, practitioner, scientist, and politician.2., 3., 4. Her contribution to nursing theory, research, statistics, public health, and health care reform are foundational and inspirational; her spiritual example prompts us in our own healing journey.

Nightingale has captivated the hearts and minds of people globally by sharing significant stories about humanity and human caring for the health of the world—keenly relevant for today. In our time, the same environmental and social issues that were of concern to Nightingale—are now understood as key factors in achieving global development and global health. Since 2015, these issues have been identified as the United Nations 17 Sustainable Development Goals (SDGs).⁵ Indeed, “health” is a central common thread that runs through all 17 SDGs.

As we move through the Covid-19 pandemic, global nurses and midwives are expanding their consciousness to raise their powerful voices as planetary citizens, becoming more aware of strategies for personal and planetary health (local to global), and resulting in an ideal of healthy people living on a healthy planet worldwide.⁶ Planetary citizenship requires nurses and midwives and all concerned citizens to strive for universal human dignity, and to embrace a holistic awareness of honoring all of life for the sustainability of self, others, and our environment.

Explore readers, as concerned global citizens, are invited to sign the Nightingale Declaration for a Healthy Word at https://www.nighvision.net/declaration.html

Written and submitted by Barbara Dossey, PhD, RN, AHN-BC, FAAN, HWNC-BC

Does Parkinson's disease have a smell?

Currently there is no definitive diagnostic test for Parkinson's disease (PD). Thanks to a Scottish nurse named Joy Milne, however, that might change. Milne, who credits her “super smelling” ability to synesthesia, was able to smell a “sort of woody, musky odor” associated with Parkinson's emanating from her husband more than a decade before his diagnosis.

Researchers have been using Milne's unusual abilities to try to identify what it is she is smelling. A study published in ACS Central Science on March 20, 2019 has helped scientists isolate four compounds associated with the singular Parkinson's scent: Three—eicosane, hippuric acid and octadecanal—appeared at higher than average levels among Parkinson's patients, while a fourth, perillic aldehyde, was present at reduced levels.

Milne claims she can smell the scents of other diseases, like Alzheimer's and cancer, as well, and she is eager to work on diagnostic testing for potentially spotting even more. Researchers say the earlier these illnesses are discovered the better, and perhaps they can discover how to prevent these maladies before having to deal with a cure when they get to the latter stages.

To read the study, see: https://doi.org/10.1021/acscentsci.8b00879

Clinical trial supports acupuncture as option for reducing migraine

A study published online in the BMJ on March 25, 2020 supports acupuncture as an option for reducing migraines. Acupuncture has been investigated as a method of reducing the frequency of migraines with mixed results. The new study, led by Wei Wang, a neurologist at Tongji Hospital and the Huazhong University of Science and Technology, decided to compare real acupuncture against either sham acupuncture or usual migraine care.

Over eight weeks, 150 participants received 20 treatment sessions. Over the following 12 weeks, those in the manual acupuncture group had 1.4 fewer migraine days in weeks 13–16 of the study, and about two fewer migraine days at weeks 17–20 compared to people in the sham acupuncture group. Those in the sham acupuncture group still had fewer migraine days compared to those in the non-acupuncture, usual care, (1.6 vs. 0.4) in weeks 17–20.

Researchers noted that the study was short and longer studies are needed. Since some patients respond poorly to drugs and other patients don't want to use them, these results suggest that acupuncture can be recommended as a preventive treatment.

To read the study, see https://doi.org/10.1136/bmj.m697

70-year-old woman's DNA mutation may be key to a new Alzheimer's treatment

A study published in Nature Medicine on November 4, 2019 has identified a Columbian woman in her 70s who carries the same mutation that usually guarantees dementia. Her brain was filled with plaques formed by a sticky protein called amyloid. Many scientists view that accumulation as one of the earliest signs of the disease, yet she stayed sharp decades longer than previously seen.

Researchers were stumped until they discovered that the woman also carried another, extremely rare genetic mutation that seemed to protect her from the effects of the first one, slowing the disease down by decades.

Although the discovery is based on a single person, it may point to a biological weak spot in the degenerative disease. So far, nearly every clinical trial designed to slow or stop the disease has failed. Perhaps this unusually resilient woman can show a way to alter those bleak outcomes.

To read the brief communication, see: https://doi.org/10.1038/s41591-019-0611-3

How stress turns hair white

Science has long known there is a connection between stress and greying hair, but so far there has been little scientific validation for the link. A study from the Universities of Sao Paulo and Harvard published in Nature on January 22, 2020 finds that the sympathetic nervous system is responsible.

The study shows that pain in mice triggered the release of adrenaline and cortisol, making their hearts beat faster and their blood pressure to rise, thus affecting the nervous system and causing acute stress. This process then sped up depletion of stem cells that produced melanin in hair follicles, causing permanent, irreversible, damage. Additionally, they could identify the protein involved in causing damage to stem cells from stress.

Authors of the study caution that the findings are not a cure or treatment for grey hair but is only the beginning of a long journey to finding an intervention. The findings also suggest an idea of how stress might affect every other part of the body.

To read the study, see: https://doi.org/10.1038/s41586-020-1935-3

Text #FlipYourScrip to donate unused prescription drugs

A first-of-its-kind national program for donating unused prescription drugs is now accepting unexpired bottles of pills or capsules so they can be forwarded to needy patients. The program is administered by a nonprofit organization based in Memphis, Tennessee called Remedichain.org.

A smartphone text is all it takes to initiate the donation transaction. From there, the organization attempts to match the donation to a financially needy patient. After a multi-step inspection to ensure safety, a matched donation is delivered free via FedEx to the recipient. If there is no match, the donor will receive a text with the location of the nearest “take-back box” to enable safe disposal.

The goal is to reclaim unused drugs instead of trashing them in landfills and toilets. The new initiative is accepting a wide variety of medications, but has an interest in oncology products, such as costly oral chemotherapies, which can be passed onto patients who may not be able to afford them.

To see how it works, go to: https://www.remedichain.org/

Group medical meetings help low-income patients with chronic pain, depression

A study published online by PLOS ONE on December 18, 2019 found that patients with chronic pain and depression who participated in medical group visits in which they learned mindfulness techniques were able to reduce their use of pain medication and make fewer emergency room visits.

Integrative medical groups, in which up to 15 patients meet with a primary care clinician, can be especially valuable for low-income patients who may have limited access to complementary therapies. Each patient is seen individually before meeting as an entire group. Educational activities designed to help reduce pain through mindfulness and yoga, as well as lifestyle practices like movement and healthy eating, are taught as they can help alleviate chronic conditions.

Overall, the integrative medical group visit was not more effective at reducing depressive symptoms compared to usual care, however, participants were less likely to use pain medication at the end of the study and had a greater decrease in emergency department visits after the group visits ended.

For more information, please see: https://doi.org/10.1371/journal.pone.0225540

Biography

Matters of Note is written and compiled bySusie Demarinis, MSEditorial Director for EXPLORE: The Journal of Science and Healing.