iPad Intervention Boosts Cognition in Schizophrenia

In a previous post, I summarized some of the current thinking on the use of cognitive enhancement drugs in Alzheimer's disease, Parkinson's disease, ADHD and schizophrenia.

This summary was based on a review by Gabe Howard and colleagues. The review also included a summary of a clinical trial using an iPad cognitive training app for the treatment of cognition in schizophrenia.

Here are the key elements of the study and the results.

Study sample: 22 adults with a diagnosis of DSM-5 schizophrenia, schizoaffective disorder or schizophreniform disorder. Most subjects were receiving antipsychotic drug treatment during the course of the study.

Intervention design: Subjects were randomly assigned to two groups. One completed 8 hours of training on an iPad cognitive training app over 4 weeks while the remaining group continued as a treatment as usual control group

iPad app details: A study-designed app that used a paired associative learning task into a narrative game that provided feedback and used visual and music stimulation to keep subjects engage

Outcome measure: Baseline and 4 week neuropsychological testing using the CANTAB PAL task

Results: The CT intervention group showed superior pattern location, fewer errors and improved rating on the Global Assessment of Functioning scale compared to the treatment as usual group

This study has several implications. First, it appears game app design can be effectively used in schizophrenia. Additionally, this type of intervention appears to produce improvement in the types of memory impairment associated with the disorder. The study should stimulate further development and implementation of cognitive training tools in schizophrenia and other neuroscience medicine disorders.

Readers with more interest in this research can access the free full-text manuscript by clicking on the PMID link in the citation below.

Photo of winged warrior Nike is from the author's files.

Follow the author on Twitter at WRY999

Sahakian BJ, Bruhl AB, Cook J, Killikelly C, Savulich G, Piercy T, Hafizi S, Perez J, Fernandez-Egea E, Suckling J, & Jones PB (2015). The impact of neuroscience on society: cognitive enhancement in neuropsychiatric disorders and in healthy people. Philosophical transactions of the Royal Society of London. Series B, Biological sciences, 370 (1677) PMID: 26240429

Cognitive Enhancers in Neuroscience Medicine

Neuropsychiatric disorders cause impairment via multiple pathways. One pathway to impairment is cognitive impairment via attention problems, cognitive slowing and memory disruption.

Barbara Sahakian and colleagues recently published an interesting manuscript examining the issue of cognitive enhancement.

Their review begins by summarizing some of the research related to cognitive enhancement in four neuropsychiatric syndromes. I will summarize their main points by specific disorder.

Alzheimer's Disease (AD)

• Acetylcholinesterase inhibitors such as donepezil have been specifically developed to enhance and slow deterioration of cognitive function in AD
• NMDA receptor agonists such as memantine can also enhance cognitive function and these types of cognitive enhancement agents are typically used in later stages of the disease
• Early identification and early use of cognitive enhancement agents is estimated to decrease the cost of AD by $5000 per individual

Parkinson's Disease (PD)

• Cognitive impairment and dementia are commonly found in PD
• Dopamine agonists such as methylphenidate have been used in PD for treatment of fatigue and cognitive impairment but can worsen impulsivity/compulsive gambling problems
• Atomoxetine may hold promise in PD for psychomotor slowing, global cognition and executive functioning
• Anticholinesterase inhibitors and memantine have shown only marginal improvement in cognition in studies of PD subjects

Attention Deficit Hyperactivity Disorder (ADHD)

• Stimulant treatment of ADHD with drugs such as methylphenidate is effective in 60-70% of children and adults with ADHD
• However, new non-stimulant drug development is needed to address issues of stimulant abuse and non-response
• Methylphenidate improves spatial working memory performance in both individuals with ADHD and healthy volunteers
• Modafinil and atomoxetine may improve response inhibition in ADHD but appear to have limited effects on sustained attention and working memory

Schizophrenia

• Cognitive deficits are a hallmark of schizophrenia and the target of drug and non-drug intervention studies
• Modafanil has shown some early promise in schizophrenia with at least one study showing improvements in working memory, cognitive flexibility, emotion recognition, dorsolateral prefrontal cortex function
• Acetylcholinesterase inhibitors have shown limited effect on cognition in schizophrenia
• Non-drug interventions such as cognitive enhancement techniques (i.e. video games) may hold promise in schizophrenia

The authors go on to describe the results of a computer game study of cognition in schizophrenia using an iPad. I will describe the results of this study in my next post.

Readers with more interest in this manuscript can access the free full-text version by clicking on the PMID link in the citation below.

Follow the author on Twitter: @WRY999

Photo of Roman ruler Marcus Aurelius on horse from author's files.

Sahakian BJ, Bruhl AB, Cook J, Killikelly C, Savulich G, Piercy T, Hafizi S, Perez J, Fernandez-Egea E, Suckling J, & Jones PB (2015). The impact of neuroscience on society: cognitive enhancement in neuropsychiatric disorders and in healthy people. Philosophical transactions of the Royal Society of London. Series B, Biological sciences, 370 (1677) PMID: 26240429

Twitter Follow List From PsychCentral

Gabe Howard recently published a blog titled "21 Mental Health Doctors & Therapists You Should Be Following on Twitter" on the PsychCentral Blog.

I was honored have my Twitter feed @WRY999 listed on this post. 

The blog post provides a brief description for each recommendation. The format includes the Twitter feed author description.  Additionally, Gabe provides a response for each feed to the question "Why follow him?" (or her). For @WRY999 he posts:

William is one of the few MDs who made the list and his stream reflects his background. He shares excellent information from a more medical and technical perspective, but often provides a bit of context for laypeople.

I want to thank Gabe and PsychCentral for this recommendation.

The full list is worth checking out and can be found by clicking HERE

Photo of gulf fritillary or passion butterfly is an original photo from my files. 

Halloween Safety Tips for Parents

Halloween is fast approaching. Soon, the streets will be filled with ghosts, goblins, princesses and cowboys. To help make this year's festivities a trick-free treat, follow these simple safety tips:

For the Young Ones

• Spotted in the dark. Bright-colored costumes are more likely to be seen after dark. Add reflective tape to your child’s costume or to the trick-or-treat bag so you and cars can keep an eye out. 
• See and breathe easy. If the costume has wigs or beards, make sure they don’t cover your child’s eyes, noses, or mouths. Same goes for wearing a mask.
• Toxic makeup. Consider using nontoxic face paint or makeup. Test the face paint or makeup on your child's arm or hand before applying; ensuring the paint doesn't irritate the skin.
• Don’t trip. Try to avoid oversized and high-heeled shoes and costumes that have long fabric that can cause children to trip.
• Home safe. Check all treats to make sure they are sealed. Throw out any candy with holes in the packages, spoiled items and any homemade foods from strangers.

For Parents with Older Kids

• Be aware. If your child is trick-or-treating on their own, find out the route they'll be taking.
• Safer in groups. Make sure they go in a group and stress that they stay together.
• Welcome in. Advise them to only go to houses with porch lights on and walk on sidewalks on lit streets. 
• Don’t play with fire. Steer clear from candles and other flames. 
• Light it up. Equip your child with a flashlight with new batteries.

Finally, make sure trick-or-treaters will be safe when visiting your home as well. Remove anything that could cause kids to trip or fall on your walkway or lawn. Double check to see if the lights are on outside your house and light the walkway to your door, if possible.

Have a safe and fun Halloween! To help get started, download our Halloween Safety Tips for Parents.

click here to enlarge and download.

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5 reasons to limit your consumption of canned foods

Canned foods are advantageous in that it takes a shorter time to prepare especially if one has a busy schedule. It also has a longer shelf life compared to fresh foods.

Despite these advantages, using canned foods should not become a habit because it comes with its own disadvantages.

1 High amounts of sodium

The high amount of sodium in some canned foods can cause hypertension. Not all canned foods are high in sodium. However, canned foods that are low in sodium are not easy to come by in supermarkets. This sodium is put in canned foods in order to preserve them. High sodium in foods are detrimental to our health because they are prerequisites for hypertension and other diseases of the cardiovascular system.

2 some canned foods contain sulfites as a preservative

When buying canned foods, sulfites may not be seen as a single ingredient. It is often in combination with other elements to form compounds. An example is sodium sulfite and potassium bisulfite. There are some people who are allergic to sulfites. This allergy can manifest as difficulty in breathing after eating foods that contain sulfites.

3 some canned foods have a lot of sugar

Sugar is added to some canned foods to improve its taste, make it more palatable and enjoyable. Unfortunately, sugars are some of the artificial products that cause major damages to our health. It is better to buy canned foods that contain water without sugar or to buy canned foods that are stored in their own water.

4 some canned foods have lost their nutrients

Before some fruits and vegetables are canned, they are cooked. The cooking and canning process of foods results in the destruction of some nutrients found in the food. Vitamin C for example does not survive the cooking and canning process of foods. This therefore results in foods that have a lower nutritional content than those in their fresh and frozen state.

5 Bisphenol popularly known as BPA

The interior of the cans that carry canned food is usually coated with a thin film of plastic in order to keep the foods fresh and prevent the leaching of the metals of the can into the foods. This plastic coating contains BPA which is very harmful to our health. Taking small doses at irregular intervals may not be harmful. But if consuming canned foods becomes a regular and daily lifetime habit, the dangers are sure to manifest. BPA is made from crude oil and human beings are not supposed to consume crude oil or any of its products. When the amount of BPA consumed reaches a threshold level, it will be a risk factor for so many diseases like obesity, hypertension, heart disease, reproductive problems and cancer.

Sources:

http://www.livestrong.com/article/465106-the-disadvantages-of-canned-foods/

http://www.seattleorganicrestaurants.com/vegan-whole-foods/avoid-canned-food/

http://www.rebootwithjoe.com/5-chemicals-that-turn-our-food-toxic-and-how-to-avoid-them/

Tips To Stay Active This Fall

It seems as though everything is just a bit easier during the summer. People tend to be a little more laid back at work, there are less people on the road because many are on vacation and, with the added sunlight and warm temperatures, being active seems to be much less of a hassle.

Autumn, though, is here. Say goodbye to the warm temperatures and hello to shorter days and cooler weather. Perhaps it’s the fewer hours of sunlight, but this time of the year seems to be when many go into hibernation and ease up on their active summer lifestyles.

This doesn’t have to be the case as there are many fun things to do to stay fit during the cooler months.

“The change of seasons is a good time to focus on health and wellness goals," said Ngozi Onuoha, MD, FACP, of Penn Internal Medicine Mayfair. "Autumn is a great season to walk. Walking is a great form of exercise that does not require much preparation."

Here are some other tips to keep you moving and feeling healthy this fall.

• Make exercise fun: Autumn is synonymous with harvest season. What better way to stay active than to go pumpkin or apple picking with your family or friends? For the younger ones (or those simply young at heart, take part in physical activities such as corn mazes and haunted trails.
• Sign up for a holiday run: Fall is the season in which many fun runs and events occur. Participate in Halloween runs, turkey trots, reindeer romps, etc. Setting a specific goal, such as a race to train for, increases adherence to an exercise program. Signing up with friends or family will motivate you even more.
• Enjoy the colors: Grab a friend, and find a local park that has great trails to walk, run, or ride a bike on.
• Go to a farmer’s market: Many of the root vegetables are in season and are inexpensive. Grab some apples while you’re at it as they’re rich in antioxidants and flavanoids, both of which can reduce cholesterol.
• Take advantage of the cooler weather: Play catch, walk the dog, get a group of friends together to play ultimate Frisbee or touch football.
•  Make fall chores fun: Raking your lawn can be a real workout. Have fun with it (perhaps by jumping in the leaves??).

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Is it Fall Allergies or a Cold?

Fall Allergies or a Cold?

The cooler temperatures have arrived and you aren’t feeling too well. You can’t stop sneezing, sniffing and coughing?

So, what’s the deal? Is it allergies? Are you sick? Should you be scheduling an appointment with your doctor?

Before picking up the phone, it’s important to know the difference between the two. The common cold is typically the result of a viral respiratory tract infection, but an allergy is a hypersensitivity disorder when a person’s immune system reacts to normally harmless substances in the environment.

“You should make an appointment to see your doctor for any cold symptoms that last more than 1-2 weeks, or for any persistent allergy symptoms that do not respond to over-the-counter antihistamines,” said Lauren Strohm, DO, of Penn Medicine Valley Forge.

Contrary to what many think, spring is not the only allergy-prone season. As the temperatures begin to dip, many experience the effects of allergies similar to how they would in the spring.

Ragweed is the biggest culprit as it can travel hundreds of miles in the wind. While the yellow-flowering weed usually starts releasing pollen in August, it can last well into September and October. Nearly three-quarters of people who are allergic to spring plants are also allergic to ragweed.

Another fall trigger is mold. Many think of mold growing in their basement or bathroom, but mold spores also love outdoor wet spots such as piles of damp leaves.

Dust mites tend to get overlooked this time of the year, but can be allergy trigger for many. Although they are more common during the humid summer months, they can get mixed into the air when the individuals begin to use their heat.

Tips to Tell the Difference 

• Do you have a fever? If yes, you are dealing with something more than allergies. A fever is never a feature of an allergy.
• Itchiness and watery eyes? Although not always the case, this usually points to an allergy rather than a cold.
• A cold is usually self limiting (symptoms cease in a predictable manner), but an allergy needs interventions and treatment.
• Are others around you sick? A cold is contagious, while an allergy is not.
• How long have you not been feeling yourself? Colds can last a long time, usually between 1-3 weeks. Allergies, though, can stick around for a few days or months if an individual is continuously exposed to the allergen.
• When did the symptoms start? Symptoms of a cold take a few days to develop after the viral infection, but allergic symptoms begin immediately after the exposure.

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Create Healthy Habits Through Strength in Numbers

R. Aimee Ando, DO, a family medicine physician at Penn Family Medicine University City, discusses how a “partner in health” can help you achieve your goals.

Working in primary care, I have the privilege of learning a person’s most intimate hopes and challenges on a daily basis. Conversations with my patients often revolve around healthy lifestyle changes - eating sensible portions and more fruits and vegetables, exercising, quitting smoking - and the seemingly insurmountable barriers to achieving such goals.

I believe there is a better way to tackle these challenges. And that is by not doing it alone. Changing habits often works best when done with someone else, whether it be your spouse or significant other, a workout “buddy,” or with a group of like-minded individuals.

These four tips will help you and your partner get on the road to good health:

• No more excuses: We are social beings and at our core do not want to let others down. We often thrive on the support that a “partner in health” can provide. Having someone to whom one feels accountable keeps us motivated and committed.
• Choose wisely: Find someone who you like and who has an upbeat attitude. If you are single or if your spouse/significant other is not up for the challenge, broaden your scope. Look to friends or work colleagues with similar exercise schedules to go walk the neighborhood or hit the gym. Working out together can push you to keep moving and dig deeper than when solo. A little healthy competition can go a long way! And don’t give up hope on that spouse at home still sitting on the couch. The positive changes that you make in your own life often inspire those closest to you.
• Create fun incentives: Establishing rewards for your hard work can be a great motivator. If you are committed to quit smoking with your partner, make a separate fund with the money saved from cigarettes and use the funds for a getaway or something special for the house. The reward can even be psychological: sign up and train for a 5K run/walk a few months ahead and set a schedule that you both will stick to. Setting tangible markers of success helps you to keep your eye on the prize.
• Make it fit your reality: What works for some does not always work for others. As parents of two very young children, my husband and I rarely have time to do anything together, much less go off to the gym. Nonetheless, we block off time and space during the week when each of us gets to have her/his own time to be active while the other one watches the kids. And we don’t let the other one back out of it either. It can be so “easy” to make excuses, but when you make your own health a priority, those you love may make their health a priority too!

You never have to go it alone. We have learned time and again that when we partner with people who are more active, think positively, and eat well, we are more likely to do the same. So go ahead and be contagious!

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Nosebleeds: What Causes Them and How to Stop Them

Jeffrey Millstein, MD, a primary care physician at Penn Internal Medicine Woodbury Heights, discusses why we get nosebleeds and the correct way to stop them.

Ever have a nosebleed that makes it look like you just finished auditioning for the next big horror film?

Nosebleeds can be a scary sight since they often involve a fair amount of blood. The good news is that they are almost never indicative of a serious health condition.

“Nosebleeds are common in all age groups and rarely serious, although we always like to evaluate patients with frequent or severe ones," says Dr. Millstein. "Keeping the nostrils moistened with saline nasal spray is a helpful preventive measure during the dry months.”

So they aren’t serious, but why do we get them? And how do we make them stop?

Why do nosebleeds start?

There are several reasons why you might get a nosebleed, including trauma from an injury, interior deformities, or in rare cases, intranasal tumors. More common reasons include:

• Dry air that causes the lining of the nose to crack and bleed.
• Use of anticoagulant (blood-thinning) medications, or aspirin and nonsteroidal anti-inflammatory drugs (NSAIDS) that changes the ability of the blood to clot.
• Health conditions like liver disease, kidney disease or chronic alcohol consumption that lower the blood’s ability to clot.

Have You Been Stopping Nosebleeds the Wrong Way?

For many of us, we have a natural instinct to tilt our head back to stop a nosebleed. Makes sense right? We don’t want the blood running down our face onto our clothes.

The problem is, this method doesn’t really work… and can be dangerous.

When your head is tilted back, the blood runs down the back of your throat. If enough gets into your stomach, you could start feeling sick and even vomit. In rare cases, the blood could end up in your airways and lead to choking or illness.

So, What’s the Right Way to Stop a Nosebleed?

Sit straight up and tilt your head forward slightly. Take your thumb and forefinger and firmly pinch the soft part of your nose shut. If you have an ice pack, apply that to your nose and cheeks to constrict the blood vessels and stop the bleeding.

Continue pinching for a full 10 minutes and try not to release your fingers before the minutes are up. If your nose is still bleeding after 10 minutes, pinch for 10 more.

Once the bleeding has stopped, you can use saline or an antiseptic nasal cream. Also, try not to blow your nose for a few hours

Is There Ever a Time to Worry About a Nosebleed?

Nosebleeds are rarely a cause for concern, but it is recommended that you seek medical attention if:

• After 30 minutes, you are still unable to stop the bleeding.
• You have frequent nosebleeds.
• The blood is caused by what you believe could be a broken nose.
• You have a blood clotting disorder or are on blood thinners.

It’s also very important that you don’t drive yourself if you’re losing a lot of blood. Make sure you have someone that can take you to the doctor or hospital.

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5 Health benefits of palm wine

Palm wine is the sweet tasty sap gotten from wounded palm trees. Anyone who has grown in Cameroon, Nigeria, Ghana and other parts of central and West Africa has come across palm wine. Palm wine is good for our health, if only we drink pure palm wine. This is because preservatives and sweeteners are added to it in order to extend its shelf life, which makes it not good for our health.

palm wine. Image source:suggestkeyword.com

When palm wine is tapped, it is fresh and sweet but in 24 hours, it can become sharp and sour, and contain more alcohol than some of our alcoholic drinks. This is because the palm wine undergoes fermentation. Palm wine has benefits when consumed fresh or fermented, but the most benefits are gotten when it is consumed fresh.

In Cameroon and Nigeria, the process of tapping palm wine from palm trees is called palm wine tapping. A palm wine tapper climbs the palm tree with a rope that is locally designed for that purpose. He also climbs the palm tree with a cutlass, a knife and a gallon or calabash. When the tapper climbs the tree to the top, he will cut some palm branches to expose the tissue and use the knife to create a hole in the tree. A hollow bamboo or empty pipe is used to direct the sap into a gallon which is tied around the tree.

A palm wine tapper. Image source: pixcooler.com

Contents of palm wine

The following are found in palm wine

• Sugar 
• Protein 
• Carbohydrate, 
• Amino acid
• Vitamin C
• Yeast 
• Bacteria 
• Potassium 
• Zinc 
• Magnesium
• Iron
• Vitamin B1,B2 B3 and B6

Health benefits

1 Palm wine improves eyesight

Palm wine helps in maintaining good eye health. This is because it contains the antioxidant Vitamin C (ascorbic acid) which is also found in other fruits and vegetables. Vitamin B1 (thiamine) also helps in improving our vision. This is why some school of thought argue that our grandparents in the village have better eyesight than us because palm wine is their beverage.

2 Reduced risk of cardiovascular diseases

Research has showed that drinking moderate amounts of palm wine has been associated with a reduced risk of developing cardiovascular diseases such as heart failure. This study was conducted by Lingberg and Ezra in 2008. Palm wine contains potassium which has been proven by research to improve heart health and bring down hypertension.  However drinking it in excess has adverse effects like destroying the liver.

3 Palm wine can help fight against cancer

Palm wine contains vitamin B2, also known as riboflavin. Riboflavin is an antioxidant which helps in the fight against some cancer causing agents called free radicals.

4 Palm wine helps in maintaining a healthy hair, skin and nails

The Iron and vitamin B complex found in palm wine are needed for a healthy skin, hair and nail. Iron is very essential for the development, growth and functioning of some cells in our body. This property of palm wine makes it helpful in promoting wound healing by repairing our tissues and promoting the growth of healthy cells.

5 Palm wine promotes lactation

Palm wine is being used by many natural healers in Cameroon, Nigeria, Ghana and other parts of Africa to help a lactating mother when she has limited breast milk production. Research is needed to investigate the property of palm wine that makes it stimulate the production of breast milk.

Precautions

Do not drink fermented palm wine in excess. Fermented palm wine in excess is detrimental to our health. Fermented palm wine is locally referred to as “strong white mimbo” Fermented palm wine contains a high percentage of alcohol, which is probably higher than that found in some of the alcoholic beverages we drink. This fermented palm wine destroys our kidney, liver and other systems in our body. Drinking alcohol in excess is a risk factor for hypertension.

Sources:

Lingberg , M.L. and Ezra, A.A. (2008). “Alcohol, Wine and Cardiovascular Health”. Clinical Cardiology. 31(8), pp 350

http://jamesagbogun.hubpages.com/hub/Palmwine-Uses-and-Importance-of-the-Palm-Wine

http://healthcentre001.blogspot.com/2009/01/protect-your-sight-with-palm-wine_6802.html

Akinrotoye, Kehinde Peter. “Effects of fermented palm wine on some diarrhoeagenic bacteria. Available at http://www.eliteresearchjournals.org/erjbm/content/2014/august/Akinrotoye%20KP.pdf

Health education strategies/activities of Health Pleromana

We are out to teach people on how to live a healthy life through the power of information. It is not enough to tell someone he is suffering from a particular disease or not suffering from it. What is more important is teaching the individual on how to manage his health at home and prevent diseases from happening in the first place. Majority of diseases can be prevented if we live a healthy lifestyle.
 

The Christian Men Fellowship (CMF) and Christian Women Fellowship (CWF) of Bamunka Ndop were taught on how to determine if they are at risk of developing cardiovascular diseases like hypertension by using these three criteria:

• The body mass index (BMI), 
• Waist-to-height ratio and 
• Waist-to-hip ratio. 

They were also taught on the causes of overweight and obesity, the consequences of overweight and obesity and how to lose weight if they are overweight and obese.

Our parents were also taught on the causes of hypertension, consequences of having hypertension, foods to eat when one has hypertension, foods to avoid when one has hypertension and how to prevent hypertension from occurring in the first place. This was done with the aid of detailed handouts to be read at home.

We make people healthier through the power of information and education.

Our parents were very happy to know that common foods that are easily available can prevent hypertension. some of these foods include banana, sweet potato, watermelon and so on. 

7 health benefits of onions (When next you find yourself eating some roast fish, ask for more onions)

Onion is one of the oldest cultivated plants and has many health benefits to offer. Onion is highly valued for its therapeutic properties. When it comes to cooking, it is used because of the flavor it adds to food. The odour in onion is as a result of its organic sulfur compounds.

Onions could be white, red or yellow in colour. Onion should be eaten raw, to get the most of its curative properties.

Some nutrients found in onion include

• Fiber
• Phosphorus 
• Calcium
• Vitamin C
• Iron
• Vitamin B complex
• Biotin
• Manganese
• Copper
• Folate

The health benefits of onion are outlined below:

1 Prevention of heart attack

Recent studies have showed that onion is able to prevent the occurrence of heart attack. Onion contains quercetin which helps in preventing plaque from building up in our arteries which therefore reduces the risk of heart attack and stroke.

The presence of sulphur in onion acts as a blood thinner which prevents the platelets found in blood from clustering together. If blood platelets cluster together, the risk for heart attack and stroke increases if the clustered platelets obstructs a blood vessel.

2 Prevention of Cancer

The presence of quercetin in cancer helps in the prevention of cancer. Researchers have found out that quercetin is able to prevent breast, ovarian, endometrial, prostate, colon and long tumours from growing. Red onions have a high amount of quercetin when compared to white onion. Apples also contain quercetin.

3 Onion can relieve the symptoms of asthma

Onion has anti-inflammatory properties. A 2013 study published in the American Journal of Physiology showed that Quercetin which is found in onion, is able to relax the airway muscles and relieve the symptoms of asthma.

4 Helps in regulating blood sugar

Eating onions will help in regulating blood sugar levels. This is because onion contains chromium and sulphur which is able to lower the sugar levels in blood. Sulphur helps to trigger the production of insulin which helps in moderating high blood sugar levels. It is more beneficial if red onions are consumed for this purpose.

5 A remedy for cough, cold and bronchitis

Onion has expectorant properties. As a result of this, it is used as a home remedy for cough, cold and bronchitis. Onion has been used for centuries as a remedy for respiratory diseases. Equal amounts of onion juice and honey should be consumed as a home remedy for cough and colds.

6 Onion increases bone density in women who are undergoing menopause

Women who are undergoing menopause or Post-menopausal women who consume onions daily have a reduced risk of fractures that occur as a result of low bone density.

7 Bee sting

Applying chopped onion on the bite of a bee sting can give relieve from the pain associated with the sting.

Precautions:

• Since onion is able to lower blood sugar levels, anyone who has diabetes should use onion in moderation.  
• If too much onion is consumed, it will slow down the process of blood clotting and this might increase the risk of bleeding. Furthermore, it is not advisable to use onion extracts if you have a bleeding disorder. Anyone who is to undergo surgery should stop consuming large amounts of onions or consult their health care provider. This is because it can interfere with the process of blood clotting which may lead to prolonged bleeding.
• Medications that have been prescribed for diabetes can interact with onions. This is because your blood sugar might go to low and you will suffer from hypoglycemia which is life threatening. Examples of such medications include: glipizide (Glucotrol), tolbutamide (orinase), insulin, Glimepiride (Amaryl) etc.
• Medications that slow down the process of blood clotting interacts with onion. This is because it will further slow down the process of blood clotting which can promote bleeding when one is wounded or bruised. Examples of such medications include ibuprofen, naproxen, heparin, aspirin, diclofenac, warfarin etc

Sources:

http://www.livescience.com/45293-onion-nutrition.html

http://www.webmd.com/vitamins-supplements/ingredientmono-643-onion.aspx?activeingredientid=643&activeingredientname=onion

http://www.stylecraze.com/articles/amazing-health-benefits-of-onions/

Homeostasis in plants

Stomata have daily rhythms of opening and closing and also respond to changes in environmental conditions to

- allow diffusion of CO­_2­

- regulate water loss by transpiration

Stomata open due to:	Stomata close due to:
high light intensity low concentration of CO­2­	darkness high concentration of CO­2­  low humidity high temperature water stress

Opening and closing of stomata

1. ATP powers proton pumps to actively transport H⁺ out of cell
2. There is a low concentration of H⁺ and negative charge inside the cell --> K⁺ channels open --> K⁺ diffuse in
3. High concentration of K⁺ inside the cell decreases water potential
4. Water moves in via osmosis
5. Water entry increases the volume of the guard cell, causing it to expand --> open

Structure of stomata

Each stomatal pore is surrounded by 2 guard cells. Guard cells:

• open when turgid (gain water)
• close when flaccid (lose water)

Abscisic acid and stomatal closure

Abscisic acid (ABA) is a stress hormone that is secreted in response to difficult environmental conditions such as very high temperatures or much reduced water supplies. ABA triggers the closure of stomata to reduce transpiration and prevent water loss.

ABA binds to cell surface receptors 

• inhibits proton pumps: stop H⁺ pumped out
• stimulates movement of Ca²⁺ through the cell surface membrane and tonoplast

Ca²⁺ acts as a 2nd messenger to activate channel proteins to open that allow negatively charged ions to leave the guard cell. This in turn

• opens channel proteins that allow  K⁺ to leave the cell
• closes channel proteins that allow K⁺ to enter the cell
• --> net movement: K⁺ leaves cell

Loss of ions = higher water potential inside cell = water passes out by osmosis = guard cells become flaccid --> stomata close

14.2  Homeostasis in plants Stomatal aperture is regulated in response to the requirements for uptake of carbon  dioxide for photosynthesis and conserving water. a)   explain that  stomata have daily rhythms of opening and closing and also respond to changes in environmental conditions to allow diffusion of carbon  dioxide and regulate water loss by transpiration b)   describe the structure and function  of guard cells and explain the mechanism by which they  open  and close  stomata c)   describe the role of abscisic acid in the closure of stomata during times of water stress (the role of calcium  ions as a second messenger should  be emphasised)

Urine analysis, dipsticks and biosensors

The presence of glucose and ketones in urine indicates that a person may have diabetes. If the concentration for these rises above the renal threshold, then not all glucose has been absorbed from the filtrate in the proximal convoluted tubule --> so will be present in the urine.




A large quantity or long-term presence of protein in the urine indicates

• disease affecting glomeruli
• kidney infection
• high blood pressure (can lead to heart disease)

1. Dip sticks: test for glucose, pH, ketones, proteins

- urine analysis

- involves 2 immobilized enzymes: glucose oxidase and peroxidase

- shows the sugar level in urine from bladder NOT the current blood sugar level

2. Biosensor: allows people with diabetes to check their blood to see how well they are controlling their glucose concentration

- blood analysis: quantitative data

- a pad impregnated with glucose oxidase catalyses reaction to form gluconolactone

--> generates tiny electric current that is detected by electrode and is read by a meter

Exam question: question 9, specimen paper 2016

http://papers.gceguide.com/A%20Levels/Biology%20(9700)/9700_y16_sp_4.pdf

http://papers.gceguide.com/A%20Levels/Biology%20(9700)/9700_y16_sm_4.pdf

14.1  Homeostasis in mammals Homeostasis in mammals requires complex systems to maintain  internal conditions near  constant. The kidneys  remove wastes from the blood and are the effectors for controlling the water potential of the blood. a)   discuss the importance of homeostasis in mammals and explain the principles  of homeostasis in terms of internal and external stimuli, receptors, central  control,  co-ordination systems, effectors (muscles and glands) b)   define  the term  negative feedback and explain how it is involved in homeostatic mechanisms c)   outline  the roles of the nervous system and endocrine system in co-ordinating homeostatic mechanisms, including thermoregulation, osmoregulation and the control of blood glucose concentration d)   describe the deamination of amino  acids  and outline  the formation of urea  in the urea  cycle (biochemical detail of the urea  cycle is not required) e)   describe the gross structure of the kidney and the detailed structure of the nephron with its associated blood vessels using photomicrographs and electron micrographs f) describe how the processes of ultrafiltration and selective reabsorption are involved with the formation of urine in the nephron g)   describe the roles of the hypothalamus, posterior pituitary, ADH and collecting  ducts in osmoregulation h)   explain how the blood glucose concentration is regulated by negative feedback control mechanisms, with reference to insulin and glucagon i) outline  the role of cyclic AMP as a second messenger with reference to the stimulation of liver cells by adrenaline and glucagon j) describe the three main stages of cell signalling in the control of blood glucose by adrenaline as follows: •   hormone-receptor interaction at the cell surface •   formation of cyclic AMP which binds to kinase  proteins • an enzyme cascade involving activation  of enzymes by phosphorylation to amplify the signal k)   explain the principles  of operation of dip sticks  containing glucose oxidase and peroxidase enzymes, and biosensors that can be used for quantitative measurements of glucose in blood and urine l) explain how urine analysis  is used in diagnosis with reference to glucose, protein  and ketones