Death of the Pharma Sales Rep?

We’re not feeling a whole load of Christmas cheer among the pharmaceutical industry this festive season.

First came the news that GSK is phasing out all payments to doctors and will no longer be bonusing their reps based on sales.  Now, a new study suggests the end of the road may be nigh for pharma sales reps.

According to a survey of nearly 3,000 physicians undertaken by CapGemini and QuantiaMD, when it comes to receiving clinical and medical info, reps rank last as a resource behind print, digital media and phone links.

• 67% of physicians say digital media is their preferred source of information from drug-makers
• 40%  believe digital media has the most relevant and personalized content
• 52% believe sales reps will eventually become information coordinators
• Only a paltry 20% say reps are their favorite source of information

In parallel, more health care providers are shifting toward larger, organized health systems, which make it more difficult for reps to reach physicians for visits. Sixty four  percent of those surveyed say they restrict rep visits and 31 % of physicians in organized health systems do not allow reps any access, due to corporate policies.

Newer and younger physicians are more likely to rebuff reps – as many as 80%  impose restrictions. 90% of new physicians are joining organized health systems right out of medical school.

“Physicians today are in a time crunch, juggling more commitments than ever before and no longer have the time to dedicate to in-person meetings with pharmaceutical representatives. So the reliance on more digital channels comes as no surprise,” said Dan Malloy, Senior Vice President at Quantia. “This study supports what we’re already seeing from our 200,000 members–that a physician-centric, digital communication model is the most effective way for reaching and engaging doctors.”

On a more positive note, reps slightly edge out other resources when it comes to finding product info and patient education.

Hala Qanadilo, a principal in life sciences at CapGemini says, “While the more traditional face-to-face, in-office visits might decrease, the role of these representatives is projected to be as important as ever. Moving forward, they will need them to be the directors of multiple information sources, customizing their outreach so it is more personalized and physician-centric.”

How are you tackling the changing healthcare environment in these increasingly restrictive times?  We’d love to hear from anyone out there in Pharmaland.

Don’t end up Black & Blue this Black Friday

Congratulations!  You survived another Thanksgiving.  Hopefully the only thing that ended up being stuffed this year was your turkey.

However, the holiday hazards aren’t over yet.  Experts warn that the stress that accompanies Black Friday shopping can add costs, far greater than those we ring up at the mall.

While retail stores are raking in the money, shoppers are probably having a more negative experience. Although we all love a Black Friday deal, “it is more like Red Friday for the consumer, as the shopper goes into debt to pay for purchases,” says Nancy Barton, professor in the School of Physical Education and Tourism Management at Indiana University-Purdue University.

Besides overspending, four people have died and dozens of injuries have occurred in the Black Friday shopping frenzy in the past four years.

Who can forget the images of the trampled Walmart worker in Long Island; the collapsed man bypassed by shoppers at a West Virginia Target and a shooting at a Toys R Us over an item brawl.

Clearly, both consumers and stores are clearly unprepared for the post-Thanksgiving stress and excitement.

“Some have argued that we are wired for desire as a result of our dopamine reward pathways.” Barton adds, “When we are overstimulated by a novel experience or unlimited choices on Black Friday, a craving (for more) and insatiable desire is triggered.”

The key to combating these desires relies on the executive, thinking part of the brain. However, this control can be hindered if you are stressed out, tired and hungry, arguably the three main traits of an all-night Black Friday shopper.

How can you avoid these stressors?  How about? :

Opting out of Black Friday shopping. Think of another way to give a gift. How about buying an “experience” for your loved one(s)?  After all, there is plenty of evidence that it’s experiences, rather than things that make us happy. What about a family gym membership? Not only will you stay healthy, but the family that works out together, is more likely to stay together

Paying It Forward. Instead of spending, how about giving? Think about those who are less fortunate than you and do something for them. Visit an elderly neighbor living alone; volunteer at a local hospital / animal shelter, soup kitchen. Your smile and touch may be the greatest gift of all.

Trying some self-reflection. The perfect antidote for ungrateful feelings is to practice gratefulness.  List three things that you are grateful for. Embody the feelings of gratefulness. Positive emotions and satisfaction with what you already have will start to unfold as you reflect on your list.

Whatever you end up doing today – please stay safe.

Side Effects of Sex

It’s Monday morning, it’s cold and the holidays are still too far away to be a reality for most of us.  Not a lot to be cheerful about?  Right!

Never fear, SRxA’s Word on Health is here to help start your week off right with some health news that may just bring a smile to your face.

While many people associate a healthy lifestyle with grueling workouts, strict dieting and general deprivation and misery  – this is a misconception.

According to Dr Joseph Mercola, an osteopathic physician, web entrepreneur and New York Times best selling author, healthy habits can be among the most rewarding.  Take sex. It counts as moderately intense exercise plus it boosts numerous aspects of both physical and mental health. As long as you’re engaging in safe-sex practices, increasing your sexual activity is a surefire strategy to better health!

Mercola suggests regular sex can reduce stress, bolster self-esteem and foster feelings of intimacy and bonding between partners.  Better still, a healthy sex life can result in a longer, healthier and, most would agree, more enjoyable life.

In case that’s not enough – here’s 10 more healthy side effects of sex:

1. Improved Immunity

People who have sex frequently have significantly higher levels of immunoglobulin A (IgA). IgA is part of the immune system that forms your body’s first line of defense. Its job is to fight off invading organisms at their entry points, reducing or even eliminating the need for activation of your body’s immune system. This may explain why people who have sex frequently also take fewer sick days.

2. Heart Health

According to one study, men who made love regularly (at least twice a week) are 45% less likely to develop heart disease than those who did so once a month or less.

Sexual activity not only provides many of the same benefits to your heart as exercise but also keeps levels of estrogen and testosterone in balance, which is important for heart health.

3. Lower Blood Pressure

Sexual activity, and specifically intercourse, is linked to better stress response and lower blood pressure.

4. It’s a Form of Exercise

Sex helps to boost your heart rate, burn calories and strengthen muscles, just like exercise. In fact, research recently revealed that sex burns about 4 calories a minute for men and 3 for women, making it (at times) a ‘significant’ form of exercise. It can even help you to maintain your flexibility and balance.

5. Pain Relief

Sexual activity releases pain-reducing hormones and has been found to help reduce or block back and leg pain, as well as pain from menstrual cramps, arthritis and headaches. One study even found that sexual activity can lead to partial or complete relief of headache in some migraine and cluster-headache patients.

6. Help to Reduce Risk of Prostate Cancer

Research has shown that men who ejaculate at least 21 times a month (during sex or masturbation) have a lower risk of prostate cancer.

7. Improve Sleep

After sex, the relaxation-inducing hormone prolactin is released, which may help you to nod off more quickly. The “love hormone” oxytocin, released during orgasm, also promotes sleep.

8. Stress Relief

Sex triggers your body to release it’s natural feel-good chemicals, helping to ease stress and boost pleasure, calm and self-esteem. Research also shows that those who have sexual intercourse responded better when subjected to stressful situations like speaking in public.

9. Boost Your Libido

The more often you have sex, the more likely you are to want to keep doing it. There’s a mental connection there but also a physical one, particularly for women. More frequent sex helps to increase vaginal lubrication, blood flow and elasticity, which in turn make sexual activity more enjoyable.

10. Improved Bladder Control in Women

Intercourse helps to strengthen pelvic floor muscles, which contract during orgasm. This can help women improve their bladder control and avoid incontinence.

Happy Monday!

Working Out to Ward Off Depression

Physical activity is being increasingly recognized as an effective tool to treat depression. But now researchers have taken the connection one step further.  In a review published in the October issue of the American Journal of Preventive Medicine, George Mammen has demonstrated that moderate exercise can actually prevent episodes of depression.

This is the first longitudinal review to focus exclusively on the role that exercise plays in maintaining good mental health and preventing the onset of depression later in life.

Mammen analyzed over 26 years’ worth of research findings to discover that even low levels of physical activity (walking and gardening for 20-30 minutes a day) can ward off depression in people of all age groups.

Mammen’s findings come at a time when mental health experts want to expand their approach beyond treating depression with costly prescription medication. “We need a prevention strategy now more than ever,” he says. “Our health system is taxed. We need to shift focus and look for ways to fend off depression from the start.”

Mammen acknowledges that other factors influence a person’s likelihood of experiencing depression, including their genetic makeup. But he says that the scope of research he assessed demonstrates that regardless of individual predispositions, there’s a clear take-away for everyone. “It’s definitely worth taking note that if you’re currently active, you should sustain it. If you’re not physically active, you should initiate the habit. This review shows promising evidence that the impact of being active goes far beyond the physical.”

Let’s hope so.  Now that I’m back in the gym six days a week maybe all the push-ups and perspiration will keep the Prozac at bay!

 

Scientists Mite have found a cause for Pimples

Having a bad skin day?  With apologies in advance – it’s probably just about to get a whole lot worse!

Especially for the estimated 5-20% of people, predominantly women, between the ages of 30 and 60 who sometimes develop rosacea –  a condition characterized by red inflamed skin, with swelling, roughness and fine, visible blood vessels, usually in the central zone of the face. , In severe cases it can resemble acne, irritate the eyes and lead to the bulbous red nose seen in caricatures of the elderly.

The disease affects all races but is sometimes referred to as the “curse of the Celts” as it frequently affects people with very fair skin. Rosacea is commonly and perhaps erroneously, blamed on another alleged Celtic curse – excessive drinking. But while alcohol can trigger a flare-up, so can many other kinds of stress. In fact, according to the US National Rosacea Society, tee-totallers are just as susceptible as drinkers.

Now, Kevin Kavanagh of the National University of Ireland, thinks he has discovered the cause – and it isn’t for the faint-hearted.

According to Dr Kavanagh, rosacea is due to the presence of tiny mites – eight-legged arachnids related to spiders – living in the pores of facial skin. They are particularly fond of the hair follicles of eyebrows and eyelashes, and the oily pores most common on the nose, forehead and cheeks.

Called Demodex folliculorum and Demodex brevisare, the mites eat sebum, or facial oil, and colonize your face at puberty. Healthy adults have around one or two mites per square centimeter of facial skin. People with rosacea, however, can have 10 times as many.

The mites crawl about your face in the dark to mate, then crawl back into pores to lay their eggs and die. Because Demodex do not have an anus they cannot get rid of their feces. “Their abdomen just gets bigger and bigger, and when they die and decompose they release their feces all at once in the pore,” says Kavanagh. When the mites are numerous, he believes that the material is enough to trigger an immune reaction, inflammation and tissue damage.

Grossed out???  Try not to be, because research suggests that the stress that causes flare-ups of rosacea changes the chemicals in sebum, making it better food for mites.

Kavanagh is now trying to get funding to develop antibodies to the bacterial proteins, to track their location and link them more firmly to the disease. Ultimately, treatments aimed at the trigger proteins may prevent rosacea.

As a fair, European that fits the rosacea age-range I, for one, am hoping he succeeds. In the meantime, I’m debating whether to ditch my make-up magnifying mirrors or switch to one with a much, much higher resolution!

PS If you made it to the end of this post without scratching  your face or checking yourself out in a mirror – congratulations!

10 Brain Damaging Habits

According to the World Health Organization here’s 10 habits that can severely damage your brain:

1.  No Breakfast – Skipping breakfast in order to lose weight or save time is totally wrong and directly affects our brain. Those who don’t take breakfast or take unhealthy breakfast having lower blood sugar level and sometime it may cause overweight.

2. Overreacting – causes hardening of the brain arteries, leading to a decrease in mental power.

3. High Sugar consumption – Too much sugar will interrupt the absorption of proteins and nutrients causing malnutrition and may interfere with brain development by reducing the production of Brain Derived Neutrotrophic Factor, without which the brain cannot learn.

4. Smoking – causes brain shrinkage, damages memory, judgment, learning and thinking powers and may even lead to dementia and Alzheimer’s disease.

5. Air Pollution – The brain is the largest oxygen consumer in our body. Inhaling polluted air decreases the supply of oxygen to the brain, bringing about a decrease in brain efficiency.

6. Sleep Deprivation – Sleep allows our brain to rest. Long term deprivation from sleep will accelerate the death of brain cells.

7. Head covered while sleeping – Sleeping with the head covered decreases available air space and forces you to start breathing carbon dioxide instead of oxygen. This leads to a rise in intracranial pressure and results in brain hypoxia which may lead to brain damaging effects.

8. Working your brain during illness – Working hard or studying with sickness may lead to a decrease in effectiveness of the brain. When we are sick the brain is at its weakest and becomes more easily stressed. This stress can also affect memory.

9. Drinking too little water – Water is the main source of energy and is essential for brain function and activity of neurotransmitters. Dehydration can lead to anger, stress, exhaustion, depression and lack of mental clarity.

10. Rarely Talking – Intellectual conversations help to train and promote efficiency of the brain. Conversely, lack of stimulating thoughts may cause brain shrinkage. Reading SRxA’s Word on Health and discussing the content with friends is an excellent way to avoid this!  So grab a glass of water and subscribe today. Consider it free brain fuel!

Immune to Stress?

Following on from last Friday’s post on the beneficial effects of stress hormones, we bring you news of study that helps us to better understand the stress process at a cellular level and how stress can lead to mood disorders.

The new research from Ohio State University, published in The Journal of Neuroscience, shows that certain cells from the immune system are recruited to the brain during stress, causing symptoms of anxiety.

Researchers discovered the dynamic mind-body interaction – a two-way communication from the central nervous system to the rest of the body – and back to the central nervous system that ultimately influences behavior during prolonged stress.

Under prolonged stress, the brain sends signals out to the bone marrow, calling up monocytes. The cells travel to specific regions of the brain and generate inflammation that causes anxiety-like behavior.

In experiments conducted in mice, researchers showed that repeated stress exposure caused the highest concentration of monocytes migrating to the brain. The cells surrounded blood vessels and penetrated brain tissue in several areas linked to fear and anxiety, including the prefrontal cortex, amygdala and hippocampus, and their presence led to anxiety-like behavior in the mice.

“In the absence of tissue damage, we have cells migrating to the brain in response to the region of the brain that is activated by the stressor,” said John Sheridan, senior author of the study. “In this case, the cells are recruited to the brain by signals generated by the animal’s interpretation of social defeat as stressful.”

The mice in this study were subjected to stress that might resemble a person’s response to persistent life stressors. In this model male mice were given time to establish a hierarchy, and then an aggressive male was added to the group for two hours. This elicits a “fight or flight” response in the resident mice as they are repeatedly defeated. The experience of social defeat leads to submissive behaviors and the development of anxiety-like behavior.

Mice subjected to zero, one, three or six cycles of this social defeat were then tested for anxiety symptoms. The more cycles of social defeat, the higher the anxiety symptoms. For example, the mice took longer to enter an open space and opted for darkness rather than light when given the choice. Anxiety symptoms corresponded to higher levels of monocytes that had traveled to the animals’ brains from the blood. Additional experiments showed that these cells did not originate in the brain, but traveled there from the bone marrow.

Exactly what happens at this point in the brain remains unknown, but the research offers clues. The monocytes that travel to the brain don’t respond to natural anti-inflammatory steroids in the body and have characteristics signifying they are in a more inflammatory state.

These results indicate that inflammatory gene expression occurs in the brain in response to the stressor.

These findings do not apply to all forms of anxiety, the scientists noted, but they are a game-changer in research on stress-related mood disorders.

“Our data alter the idea of the neurobiology of mood disorders,” said Eric Wohleb, a pre-doctoral fellow in Ohio State’s Neuroscience Graduate Studies Program. “We’re saying something outside the central nervous system – something from the immune system – is having a profound effect on behavior.”

Adrenaline Junkie

Although we repeatedly hear about the negative health effects of stress, today we’re here to tell you that stress isn’t necessarily all bad. Like food, sex, and shoes, it’s quality, not quantity, that determines whether stress helps or hurts!

Beneficial stress comes in the form of an acute, stimulating surge, like when your raft starts to overturn in some seriously churning rapids. The resulting single adrenaline (epinephrine) burst that comes and goes very quickly is a good thing because it gives you energy and gets you ready to mobilize for immediate action.

Physiologically, the adrenaline created by an abrupt blast of stress sends a flood of oxygen-rich red blood cells through your body, boosts your immune system, and signals your brain to start releasing painkilling endorphins.

Bad stress, on the other hand, is intense and drags on and on. This constant grind causes your adrenal glands to leak a slow, steady stream of another stress hormone: cortisol. And unlike adrenaline, which tends to hit your system in a flash and then dissipate, cortisol often wears out its welcome by hanging around in your bloodstream, driving up blood pressure, suppressing your immune system, and making you more susceptible to a slew of stress-related ailments, including colds, irritable bowel syndrome, migraines, and even heart disease and stroke.

So how do good stressors battle the bad ones? It all comes back to the positive power of adrenaline. In addition to all of its performance-enhancing effects, it triggers the release of dopamine and endorphins, two neurotransmitters that make you feel good – really, really good.

It also makes me feel good – really, really good, given the activities I have planned this weekend. But more of that later…

For now, let’s return to our favorite stress hormone – epinephrine. If you’ve ever tried skydiving, bungee jumping or heli-skiing, you’ll probably remember literally flipping out during your first attempt. But once you landed safely you probably experienced a euphoric, fist-pumping high thanks to dopamine flooding your brain’s pleasure center, giving you. During the next jump, you may still have felt all the same physiological stress responses such as a pounding heart and sweaty palms but instead of being terrifying, it’s exhilarating, because your mind’s already anticipating the thrill of that dopamine reward.

And the more times you do it, the less anxiety you’re likely to feel and the more fun you’ll have. That’s because your brain’s tagging the experience as a positive one.

And the benefits persist.  Before long, your body can start to develop an almost Pavlovian response to stressful situations. If your nerves are tingling, your stomach is clenching, and you can barely breathe, then it’s tricked into thinking something really awesome is about to happen!

That’s what researchers at Texas A&M University found when they put a small sample of men and women through a series of purposely stressful outdoor adventure tasks. Some subjects – the fittest ones who were already comfortable with physical challenges fared better than others. The researchers discovered that those participants had a reduced stress response (including lower blood levels of cortisol) when facing demanding activities like whitewater canoeing or rock climbing. Essentially, they were more confident and less stressed out, even though the tasks were potentially hazardous. This may be because their past experience blazing through strenuous situations made them less likely to perceive new challenges as stressful or difficult. And according to the researchers, it’s possible to transfer that oh-so-cool-and-collected response to life’s other nerve-racking events.

Better still, you don’t have to scuba dive with great whites or BASE jump off the Empire State Building to reap the stress-busting perks of adrenaline. Whether you hit the bunny slope or the double-black-diamond mogul fields, as long as you’re taking a giant step outside your comfort zone, you’ll give your body that adrenaline kick and when you do it regularly and keep testing your edge, you’ll change your relationship with stress for the better.

So next time that little voice inside your head starts clamoring, no freaking way, just go for it and be prepared to reap the rewards.

Which brings me back to my weekend. Keen to test the above theory for myself and readers of SRxA’s Word on Health, I will be spending tomorrow riding some of the longest, highest, fastest most insane rollercoasters in the country…and the following day I will be running with the bulls. If being pursued by twenty-four 1,000-pound bulls doesn’t set my adrenaline firing on all cylinders, then I guess nothing will.

I”ll let you know (hopefully) on Monday!

Stress and Distress at Work

Here’s a classic Catch-22 conundrum for co-workers to consider. Psychological distress, such as feelings of  worthlessness, hopelessness, nervousness, and/or restlessness)  can be predictors  of early stage anxiety and depression. It can also lead to decreased job productivity and absenteeism. But, it may actually be the job that’s creating the mental distress in the first place. Norwegian researchers have identified that perceived role conflicts and emotional demands are the most important and most consistent risk factors for psychological distress. While other psychosocial working conditions have been linked to distress, this study is the first to highlight the importance of these two issues. Håkon A. Johannessen, PhD, and colleagues from the Norwegian National Institute of Occupational Health, looked at how the work environment affected employees’ levels of psychological distress. Sixteen percent of workers said they were at least slightly bothered by psychological distress over the past month. The study focused on two main risk factors: role conflict, such as being given work tasks without enough resources to complete them and receiving contradictory requests from different people; and emotional demands, defined as “dealing with strong feelings such as sorrow, anger, desperation and frustration” at work. Problematic levels of distress were 53% more likely for workers reporting role conflict and 38% more likely for those facing high emotional demands. Other risk factors were low job control, bullying/harassment, and job insecurity. The researchers conclude that employers should focus on the identified risk factors to improve the psychosocial work environment and thus promote good mental health and productivity among employees. Is your job getting you down? Have you any tips for beating work-related stress?  We’d love to hear from you.

Does Belly Fat cause tumors to go Belly Up?

People store fat in two ways – one you can see and one you can’t. The fat you can see is just under the skin in the thighs, hips, buttocks, and abdomen. That’s called subcutaneous fat. The fat you can’t see is deeper inside, around the vital organs – heart, lungs, digestive tract, liver as well as in the chest, abdomen, and pelvis. That’s called visceral fat.

Many people are self-conscious about the fat they can see. But actually, it’s the hidden visceral fat that may be a bigger problem, even for thin people.  Having too much of it is linked to a greater chance of developing high blood pressure, type 2 diabetes, heart disease, dementia, and certain cancers.

According to a new study published in the journal Cancer Prevention Research, visceral fat is directly linked to an increased risk for colon cancer.

“There has been some skepticism as to whether obesity per se is a bona fide cancer risk factor, rather than the habits that fuel it, including a poor diet and a sedentary lifestyle,” said Derek M. Huffman, Ph.D., postdoctoral fellow at the Institute for Aging Research at the Albert Einstein College of Medicine in Bronx, N.Y. “Although those other lifestyle choices play a role, this study unequivocally demonstrates that visceral adiposity is causally linked to intestinal cancer.

Prior research has shown that obesity markedly increases the likelihood of being diagnosed with, and dying from, many cancers. In this animal study, Huffman and his colleagues wanted to see if removing visceral fat in mice genetically prone to developing colon cancer might prevent or lessen the development of these tumors.

To do this they randomly assigned the mice to one of three groups. Mice in the first group underwent a sham surgery and were allowed to eat an unrestricted “buffet style” diet, which resulted in them becoming obese. Those in the second group were also provided an unrestricted diet and became obese, but they had their visceral fat surgically removed at the outset of the study. Mice in the third group underwent a sham surgery, but were then put on a calorie restricted diet causing them to lose visceral fat.

“Our sham-operated obese mice had the most visceral fat, developed the greatest number of intestinal tumors, and had the worst overall survival,” Huffman said. “However, mice that had less visceral fat, either by surgical removal or a calorie-restricted diet, had a reduction in the number of intestinal tumors. This was particularly remarkable in the case of our group where visceral fat was surgically removed, because these mice were still obese, they just had very little abdominal fat.”

The researchers then subdivided the groups by gender. In female mice, the removal of visceral fat was significantly related to a reduction in intestinal tumors, but calorie restriction was not. In male mice, calorie restriction had a significant effect on intestinal tumors, but removal of visceral fat did not.

These finding suggest what most women have known for years i.e., that there are important gender differences when it comes to weight. But it also provided an explanation for how belly fat, diet and cancer risk are linked.  In addition, the study emphasizes the need to promote strategies that reduce abdominal fat in obese individuals.

So how can you get rid of this dangerous deep belly fat?  According to experts, there are four: exercise, diet, sleep, and stress management.

Exercise: Vigorous exercise trims fat, including visceral fat. It can also slow down the build-up of visceral fat that tends to happen over the years. But forget spot-reducing. There aren’t any moves you can do that specifically target visceral fat. Half an hour of vigorous aerobic exercise, done four times a week is ideal.  Jog, if you’re already fit, or walk briskly at an incline on a treadmill if you’re not yet ready for jogging. Vigorous workouts on stationary bikes and elliptical or rowing machines are also effective.

Diet: There is no magic diet for belly fat. But when you lose weight on any diet, belly fat usually goes first.  A fiber-rich diet may help. Research shows that people who eat 10 grams of soluble fiber per day, without any other diet changes, build up less visceral fat over time than others. That’s as easy as eating two small apples or a cup of green peas.

Sleep: Getting the right amount of shut eye helps. In one study, people who got six to seven hours of sleep per night gained less visceral fat over 5 years compared to those who slept five or fewer hours per night or eight or more hours per night.

Stress: It’s unavoidable, but what you do with your stress matters. When you’re stressed you  tend not to make the best food choices when they’re stressed. Getting social support from friends and family, meditating, and exercising can all help to tame stress.

Short on time? If you could only afford the time to do one of these things, exercise probably has the most immediate benefits, because it tackles both obesity and stress.