Saturday, June 25
Day dreaming whilst winding flowers and ribbon onto a willow head garland for Winnie this morning at Ring A Ring O' Roses,
2011-06-30
Glastonbury Festivals - News - Green blog 2011 Ring a ring o'roses
Drug treatments for Alzheimer's disease - Alzheimer's Society
Drug treatments for Alzheimer's disease
No drug treatments can provide a cure for Alzheimer's disease. However, drug treatments have been developed that can improve symptoms, or temporarily slow down their progression, in some people. This factsheet explains how the main drug treatments for Alzheimer's disease work, clarifies their availability, and sets out the most recent guidance from the National Institute for Health and Clinical Excellence (NICE) on their usage. (For more information about Alzheimer's disease, see Factsheet 401, What is Alzheimer's disease?)
What are the main drugs used?
There are two main types of drugs used to treat Alzheimer's disease. Aricept, Exelon and Reminyl all work in a similar way, and are known as acetylcholinesterase inhibitors. Ebixa works in a different way from the other three.
- Aricept (donepezil hydrochloride), produced by Eisai and co-marketed with Pfizer, was the first drug to be licensed in the UK specifically for Alzheimer's disease.
- Exelon (rivastigmine), produced by Novartis pharmaceuticals, was the second drug licensed in the UK specifically for Alzheimer's disease.
- Reminyl (galantamine) was co-developed by Shire pharmaceuticals and the Janssen Research Foundation. Originally derived from the bulbs of snowdrops and narcissi, it was the third drug licensed in the UK specifically for Alzheimer's disease.
- Ebixa (memantine) is produced by Merz and marketed in Europe by Lundbeck. It is the newest of the Alzheimer's drugs.
How do they work?
Aricept, Exelon and Reminyl
Research has shown that the brains of people with Alzheimer's disease show a loss of nerve cells that use a chemical called acetylcholine as a chemical messenger (Tariot et al, 2004). The loss of these nerve cells is related to the severity of impairment that people experience.
Aricept, Exelon and Reminyl prevent an enzyme known as acetylcholinesterase from breaking down acetylcholine in the brain. Increased concentrations of acetylcholine lead to increased communication between the nerve cells that use acetylcholine as a chemical messenger, which may in turn temporarily improve or stabilise the symptoms of Alzheimer's disease.
All three cholinesterase inhibitors work in a similar way, but one might suit an individual better than another, particularly in terms of side-effects experienced.
Ebixa
The action of Ebixa is quite different from, and more complex than, that of Aricept, Exelon and Reminyl. Ebixa blocks a messenger chemical known as glutamate. Glutamate is released in excessive amounts when brain cells are damaged by Alzheimer's disease, and this causes the brain cells to be damaged further. Ebixa can protect brain cells by blocking this release of excess glutamate.
Can Ebixa be taken at the same time as Aricept, Exelon or Reminyl?
Research in the United States has suggested that combining Aricept and Ebixa is more effective than using Aricept alone. Although this research is not conclusive, there is little evidence to support a contrary view. Ebixa works in a completely different way from the acetylcholinesterase inhibitors, and if a person stopped taking Aricept in order to try Ebixa, their symptoms could become worse, which could then make it difficult to assess their suitability for Ebixa. However, whether doctors will prescribe both drugs together − especially on the NHS − is currently unclear.
Are these drugs effective for anyone with Alzheimer's disease?
The latest (2011) guidance from NICE (see 'NICE guidance', below) recommends that Aricept, Exelon and Reminyl are available as part of NHS care for people with mild-to-moderate Alzheimer's disease. There are also now several studies − including work supported by Alzheimer's Society − suggesting that cholinesterase inhibitors may also help people with more severe Alzheimer's disease. However, these treatments are not yet licensed for this purpose.
Between 40 and 60 per cent of people with Alzheimer's disease benefit from cholinesterase inhibitor treatment, but it is not effective for everyone, and may improve symptoms only temporarily. According to an Alzheimer's Society survey of 4,000 people, those using these treatments often experience improvements in motivation, anxiety and confidence, in addition to memory and thinking.
Ebixa can temporarily slow down the progression of symptoms, including everyday function, in people in the middle and later stages of the disease. Ebixa is licensed for the treatment of moderate-to-severe Alzheimer's disease. Recent evidence suggests that Ebixa may also help behavioural symptoms such as aggression and agitation (see Factsheet 408, Drugs used to relieve depression and behavioural symptoms and Factsheet 509, Dealing with aggressive behaviour).
The 2011 NICE guidance (see below) recommends use of Ebixa as part of NHS care for severe Alzheimer's disease, and for patients with moderate disease who cannot take the cholinesterase inhibitor drugs.
Are there any side-effects?
Generally, cholinesterase inhibitors and Ebixa are very well tolerated, with good side-effect profiles. Not everyone experiences the same side-effects, or has them for the same length of time, if they have them at all. The most frequent side-effects of Aricept, Exelon and Reminyl include nausea and vomiting, diarrhoea, stomach cramps and headaches, dizziness, fatigue, insomnia and loss of appetite, while side-effects of Ebixa include dizziness, headaches, tiredness, increased blood pressure and, on rare occasions, hallucinations and confusion.
Ebixa is not recommended for people with severe kidney problems because there has been no safety test for this group of people as yet. Caution is recommended for people with epilepsy and heart problems.
Side-effects can be less likely for people who start treatment by taking the lower prescribed dose for at least a month. Sometimes 'splitting' the dose, taking half in the morning and half later in the day, can help, but the correct full daily dose must be maintained overall.
It is important to discuss any side-effects with the doctor.
None of these drugs is addictive.
How and where can these drugs be obtained?
Aricept, Exelon and Reminyl
In the first instance, these drugs can only be prescribed by a consultant. A GP will need to refer the person to a hospital for a specialist assessment. A consultant will carry out a series of tests to assess whether the person is suitable for treatment, and will write the first prescription, if appropriate. Subsequent prescriptions may be written by the GP or the consultant.
Some people may wish to obtain these drugs privately. Private prescriptions can be obtained through a consultant, a GP or a private hospital. Private prescriptions are subject to consultation fees, prescription charges and dispensing fees, which vary.
The current cost of these drugs to the NHS ranges from £800 to £1,000 per patient each year. Whether these drugs are obtained on the NHS or privately, the patient must be willing to take the treatment, and should discuss any possible benefits, risks or side-effects with the doctor.
Ebixa
Ebixa is the newest of the Alzheimer's drugs in the UK, launched in October 2002. It has not routinely been available as an NHS treatment until publication of the 2011 NICE guidance.
Are these drugs effective for other types of dementia?
The acetylcholinesterase inhibitors were developed specifically to treat Alzheimer's disease. We do not yet know whether they can be helpful for people with other forms of dementia, although there is evidence that they may be effective in dementia with Lewy bodies and dementia related to Parkinson's disease. One of the cholinesterase inhibitors, Exelon, is licensed for the treatment of dementia associated with Parkinson's disease, but use as an NHS treatment has not yet been considered by NICE. (See Factsheets 403, What is dementia with Lewy bodies?, and 442, Rarer causes of dementia.)
There are several trials examining cholinesterase inhibitors for the treatment of vascular dementia, but the benefits are very modest, except in the individuals with a combination of both Alzheimer's disease and vascular dementia. Cholinesterase inhibitors are not licensed for the treatment of vascular dementia. (See Factsheet 402, What is vascular dementia?) Research is continuing.
Taking the drugs
NICE guidelines (2011) recommend that the consultant seeks the carer's views of the person's condition before treatment and during follow-up appointments. He or she should also seek the patient's views. The person must take the drugs as prescribed, and the consultant will need to be sure that this is the case.
Dosages vary. Usually a patient will start on a low dose, which will be increased later to maximise effectiveness. It is important to be on the highest tolerable dose to get the maximum effect:
- Aricept is administered once a day, and can be taken with or without food. It is available in 5mg or 10mg tablets.
- Exelon is taken twice a day, normally in the morning and evening. People start with 3mg a day, which will usually increase to a dosage of between 6mg and 12mg. An Exelon patch is also available, and delivers a similar daily dosage to 12mg per day of the capsules with fewer side-effects.
- The recommended starting dose for Reminyl XL capsules is 8mg each day. The 4mg tablets (twice-daily starting dosage) were discontinued at the end of July 2006, and supplies are limited. This was due to reduced demand following the introduction of the once-daily formulation, Reminyl XL. The other, higher-strength, Reminyl tablets for maintenance treatment (twice-daily 8mg and 12mg), and Reminyl XL once-daily capsules, continue to be available. Reminyl will also remain available as a 4mg/ml (twice-daily) oral solution. Reminyl XL is available in 8mg, 16mg and 24mg capsules.
- Ebixa comes in two forms, as 10mg tablets and as 10mg oral drops. The tablets can be broken in half, into 5mg doses, and taken with or without food. The recommended starting dose is 5mg a day, increasing after four weeks to up to 20mg a day.
If the person misses a dose, they should take it as soon as they remember, if it is on the same day. If it is the next day, the person should not take two tablets but should simply continue with their normal dose.
Tips: questions to ask the doctor
- What are the potential benefits of taking these drugs?
- How long will it be before I see a result?
- How often do these drugs need to be taken?
- If I get side-effects, should I stop taking the drug immediately?
- What will happen if I stop the drug suddenly?
- What other treatments (prescription and over-the-counter) might interact with these drugs?
- Can I drink alcohol while taking the drug?
- How might these drugs affect other medical conditions?
- What changes in health should I report immediately?
- How often will I need to visit the clinic or surgery?
- Can someone with Alzheimer's disease living in a residential or nursing home take these drugs?
- Are there any costs associated with taking these drugs?
- Why have I been prescribed one drug rather than another?
- If one drug proves ineffective can I try another drug?
Stopping treatment
If the person with dementia decides to stop taking a drug, they should speak to the doctor first, if possible, or as soon as they can after stopping treatment.
If someone stops taking their prescribed drug, their condition will deteriorate over a period of about four to six weeks, until their symptoms are no better than in someone who has never taken the drug.
NICE guidance
Update: In March 2011, after a period of consultation which started in October 2010, NICE issued new guidance recommending that people with Alzheimer's disease should now have increased access to the drugs available. Clinicians can therefore choose to start prescribing the drugs immediately. For more information, see alzheimers.org.uk/accesstodrugs.
The National Institute for Health and Clinical Excellence (NICE) reviews drugs and decides whether they represent good enough value for money to be available as part of NHS treatment. The latest NICE guidance on anti-Alzheimer's drugs recommends that people in the mild-to-moderate stages of Alzheimer's disease should be given treatment with donepezil (Aricept), galantamine (Reminyl) or rivastigmine (Exelon), including individuals with Alzheimer's disease and learning disabilities.
This differs from the previous (2007) NICE guidance, which indicated these drugs could be prescribed only to people in the moderate stages of Alzheimer's disease.
The 2011 NICE guidance further recommends that Ebixa should be prescribed as part of NHS care for patients with severe Alzheimer's disease, or for those with moderate disease who cannot take the cholinesterase inhibitor drugs. This differs from the previous NICE guidance, which stated that memantine (Ebixa) should not be prescribed as part of NHS care, but emphasised further studies with Ebixa as an important research priority.
The clinical care guideline on the care and treatment of people with dementia, which NICE publishes alongside its guidance, stresses that the severity of someone's dementia should not be determined by cognition scores alone, but by a more holistic view of the patient's condition.
NICE has not yet formally appraised the use of Aricept, Exelon or Reminyl for the treatment of dementia with Lewy bodies or dementia associated with Parkinson's disease. The decision as to whether these treatments are appropriate for particular individuals lies with the specialist doctor.
A more detailed summary of the March 2011 NICE guidance is provided below:
Donepezil (Aricept), galantamine (Reminyl) and rivastigmine (Exelon) are recommended as options for mild-to-moderate Alzheimer's disease, and if:
- treatment is started by a doctor who specialises in the care of people with dementia
- patients who are started on one of the drugs are checked regularly, usually by a specialist team
- the check-up includes an assessment of the patient's cognition, behaviour and ability to cope with daily life
- the views of carers on the patient's condition are discussed at the start of drug treatment and at check-ups
- the drug is no longer supplied if the patient enters the severe stage of Alzheimer's, or if the drug isn't working
- the least expensive of the three drugs is prescribed first. However, if it is not suitable for the patient another drug could be chosen.
Memantine (Ebixa) is recommended as an option for people with severe Alzheimer's disease and for patients with moderate Alzheimer's disease who cannot tolerate the cholinesterase inhibitor drugs.
From July 2006 Reminyl 4mg tablets (twice-daily starting dosage) are discontinued and supplies are limited. The other higher-strength Reminyl tablets for maintenance treatment (twice-daily 8mg and 12mg) and Reminyl XL once-daily capsules continue to be available. Reminyl will also remain available as a 4mg/ml (twice-daily) oral solution. Reminyl XL is available in 8mg, 16mg and 24mg capsules. The recommended starting dose for Reminyl XL capsules is 8mg/day.
Printed copies of CG42 Dementia: supporting people with dementia and their carers can be ordered from NICE by calling 0845 003 7780, or downloaded from http://www.nice.org.uk/
Alzheimer's Society continues to campaign for drugs to be made freely available to anyone who may benefit from them.
For details of Alzheimer's Society services in your area, visit alzheimers.org.uk/localinfo
For information about a wide range of dementia-related topics, visit alzheimers.org.uk/factsheetsReference
Tariot, PN et al for the Memantine Study Group (2004) Memantine Treatment in Patients With Moderate to Severe Alzheimer Disease Already Receiving Donepezil; A Randomized Controlled Trial, Journal of the American Medical Association 291:317-324.
Factsheet 407
Last updated: March 2011
Last reviewed: September 2008Reviewed by: Clive Ballard, Director of Research, Alzheimer's Society
Fresh water supplies are going to run out, so what can do to make the taps keep running? - Nature, Environment - The Independent
Fresh water supplies are going to run out, so what can do to make the taps keep running?
How we manage the rest of this precious resource will dictate the planet's future.
REUTERS/AFP/GETTY
Drainage problem: Chinese fishermen push their boat through a dried up canal
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This may seem like a surprising statement, but the world's supply of fresh water is finite. As global population rises, the demand for food – and the water that produces it – grows inexorably. Globally, farming accounts for 70 per cent of our withdrawals from this fixed "bank account", this in the face of ever-greater domestic and industrial usage.
Water tables are falling in many parts of the world. Himalayan glaciers will shrink massively in the next century, reducing natural water storage in the mountains. The shortfalls will have to come from groundwater and surface storage. Many great rivers have drastically diminished flows.
Bangladesh is suffering from the diversion of Ganges River water and increased salinisation. Underground aquifers in many places are shrinking so rapidly that NASA satellites are detecting changes in the Earth's gravity. The Water Resources Group has estimated that India may face a 50 per cent lag in water availability relative to demand by 2030 and that global availability may lag demand by as much as 40 per cent; the statistics have been questioned. Sixty years ago, the world's population was about 1.25 billion people; few people, even in arid lands, worried about water supplies. Then came the Green Revolution, with its new, high-yielding crops, which depend on fertilisers and a great deal more irrigated farming. Global populations skyrocketed to nearly seven billion by 2009, with a projected nine billion by 2050. By the same year, the five hundred million people living in areas chronically short of water in the year 2000 will have grown by 45 per cent to four billion. A billion of us currently go hungry because there is not enough water to grow food. Much of the world's water is still unpriced, but it is now the most valuable commodity in the world. To compound the problem, 60 per cent of the world's people live in crowded river basins shared by several countries, often with daggers drawn.
The problems are acute, especially in arid areas with growing populations, where boreholes and aquifers are thought to be the answer. Seemingly a miraculous solution, but not if the drawdown exceeds the replenishment rate, as is the case with the ground water beneath a now-sinking Mexico City's 20 million inhabitants and with Bangkok, Buenos Aires and Jakarta, where pollution and rising salt levels combine with overdrafting.
In China, deep groundwater levels have dropped as much as 295ft (90m) in places. We have perforated the Earth's surface with boreholes to deplete a resource that we all, ultimately, hold in common. Now we stand at the threshold of what I call a third stage in our relationship with water; one where, apparently, cataclysm looms on every side. Vivid Doomsday scenarios espoused by numerous writers have Phoenix imploding as its water supplies fail, the Nile drying up, tens of thousands of people crossing national boundaries to find water.
Futurist after futurist warns that water wars are a certainty in coming centuries. Alas, at least some of these cataclysms could descend upon us if we persist in denying the seriousness of the water crisis and deluding ourselves into thinking that uncontrolled growth and more dams are the solution. They are not.
Yes, there will be shortfalls, people will go thirsty and die, but in the end, as has happened so many times in the past, human ingenuity, quite apart from technology, will find solutions. And in the process, we will develop new, much more respectful relationships with water, even if they do not necessarily have the profound spiritual intertwinings of earlier times.
In the short term, there are four potential ways of improving the situation, but none of them will solve the problem of chronic overdrawing. One lies in spending large sums on systematic improvements to storage and delivery, to the infrastructure behind water supplies. Underground reservoirs have potential. So do simple things like replacing leaking pipes, lining earth-bottomed canals and irrigating plants at their roots with just the right amount of water, among many others. A second solution also makes sense: make farming less thirsty, by using drought-resistant, higher-yielding, even genetically-modified crops. This is much easier said than done, for significant technological breakthroughs lie a long way in the future. Also, we should not forget that planting more crops means more use of water, since each plant transpires vapour into the atmosphere through photosynthesis. One possible solution may lie in developing plants that can grow using saline water but, again, this development is in the future. Then there's another seemingly attractive option: desalinisation. Surprisingly, this has been around a long time. Aristotle remarked that "salt water, when it turns to steam, becomes sweet and the steam does not form salt water when it condenses". Julius Caesar's legions drank fresh water condensed from sea water during his siege of Alexandria in 48-47 BCE. As self-appointed visionaries keep reminding us, desalinisation seems like the answer to all our problems but, in spite of improvements in efficiency, there remain significant environmental and technical problems. Desalinisation, which involves creating and recondensing steam, consumes prodigious amounts of energy, even in its most efficient iterations, so it is currently confined to nations where oil is cheap and abundant.
Nearly half the existing desalinisation plants are in the Arabian Peninsula and along the Persian Gulf, especially in Saudi Arabia and the Gulf states. In most other places, the cost of desalinisation is three or four times that of conventional water sources.
The cost of oil is rising, so the alternatives are either coal or nuclear power, both of which have their own environmental consequences and political baggage. Desalinisation plants operate along sea coasts; many of the most water-hungry areas are far inland, thereby adding huge transport costs to the already high price of a gallon of desalinised water. What, also, are we to do with the brine resulting from desalinisation, which has to be disposed of? Once again, breakthroughs lie in the long-term future. At present, desalinisation is no panacea, for it contributes only about 0.4 per cent of global water supplies.
Finally, there's conservation, which involves both profound changes in our mindsets and completely new attitudes toward water as a marketable commodity. Water is scarce, but it is also a complicated thing to market. It is difficult to move, hard to measure accurately in large quantities and complex to price and charge for. Most people resent paying for water, for they think it should be free or very cheap. Even in dry parts of the world where every drop is precious, the price of water seldom reflects its true scarcity. However, we are entering an era of potentially ferocious trading in water rights and a time when water could cost more than oil, as managing demand becomes an international priority. It's no coincidence that privately owned companies are quietly and aggressively purchasing water rights in many countries. Increasingly, municipal and other authorities are pricing water according to usage. Judging from experience in Australia, Los Angeles and other water markets, the strategy leads to reduced water use, especially when combined with measures to save water, such as reduced-flow toilets and strict timetables for watering. Like oil, water is a commodity that will be the subject of market forces, with price mechanisms that will bring supply and demand into balance. Once water is priced properly, the economics of international trade may encourage water-rich countries to produce water-intensive goods and arid ones to make those that are water-light. Mindsets are notoriously difficult to change, especially in societies accustomed to abundance and seemingly unlimited water supplies.
Using the forces of the marketplace and stricter allocations will not be strategies of first choice, especially in urban settings with high levels of poverty. Nor will conservation in the form of another commonly proposed measure, yet more dam construction, prove effective. History from the near and remote past tells us that dams are no panacea, for they silt up and silt has to be removed or the dam becomes shallower and ever less useful. And, even more important, where is the water to fill them going to come from? No dam ever creates water; it merely captures what is a finite supply. How can new dams provide more water in the era of prolonged global drought that lies ahead? Besides, there's adequate dam capacity in the American West to store any water that will come from the smaller snowpacks of future decades. Short of creating more water, more efficient allocation, extensive water recycling for landscaping and other purposes, drastic reductions in agribusiness water subsidies and miserly use of current supplies are some viable strategies for the future. And this kind of conservation, on scales small and large, is the responsibility of us all. Our survival depends upon it. We have much to learn about water conservation from the experience of our ancestors. Humans have managed water successfully for thousands of years in ways that are often far from the historical radar screen. We learn from their experiences that it is the simple and ingenious that often works best – local water schemes, decisions about sharing and management made by kin, family and small communities. These experiences also teach us that self-sustainability is attainable.
Such ingenuity comes in many forms. It may be a simple idea in the field or, in this day and age, more likely the inspiration for a social and political initiative that changes the way people think. We are moving into an entirely new water future, where equity of use, sustainability to protect future generations and affordability for everyone are major components.
A new paradigm for water management, based on well-defined priorities in which all stakeholders have a voice, will have to govern our future water use. Our salvation lies in long-term thinking, indecisive political leadership and in a reordering of financial priorities for, after all, investing heavily in water management will alleviate much disease and poverty automatically. Above all, the future will need a shift in our relationship with water to one that equates, at least approximately, with that of those who went before us – characterised by a studied caring and reverence.
Elixir: A Human History of Water by Brian Fagan is published by Bloomsbury (£20). To order a copy for the special price of £17 (free P&P) call Independent Books Direct on 08430 600 030. www.independentbooksdirect.co.uk
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Mystery Ingredient In Coffee Boosts Protection Against Alzheimer’s Disease » The Behavioral Medicine Report
A yet unidentified component of coffee interacts with the beverage’s caffeine, which could be a surprising reason why daily coffee intake protects against Alzheimer’s disease. A new Alzheimer’s disease mouse study by researchers at the University of South Florida found that this interaction boosts blood levels of a critical growth factor that seems to fight off the Alzheimer’s disease process.
The findings appear in the early online version of an article to be published June 28 in the Journal of Alzheimer’s Disease. Using mice bred to develop symptoms mimicking Alzheimer’s disease, the USF team presents the first evidence that caffeinated coffee offers protection against the memory-robbing disease that is not possible with other caffeine-containing drinks or decaffeinated coffee.
Previous observational studies in humans reported that daily coffee/caffeine intake during mid-life and in older age decreases the risk of Alzheimer’s disease. The USF researchers’ earlier studies in Alzheimer’s mice indicated that caffeine was likely the ingredient in coffee that provides this protection because it decreases brain production of the abnormal protein beta-amyloid, which is thought to cause the disease.
The new study does not diminish the importance of caffeine to protect against Alzheimer’s disease. Rather it shows that caffeinated coffee induces an increase in blood levels of a growth factor called GCSF (granulocyte colony stimulating factor). GCSF is a substance greatly decreased in patients with Alzheimer’s disease and demonstrated to improve memory in Alzheimer’s mice. A just-completed clinical trial at the USF Health Byrd Alzheimer’s Institute is investigating GCSF treatment to prevent full-blown Alzheimer’s disease in patients with mild cognitive impairment, a condition preceding the disease. The results of that trial are currently being evaluated and should be known soon.
“Caffeinated coffee provides a natural increase in blood GCSF levels,” said USF neuroscientist Dr. Chuanhai Cao, lead author of the study. “The exact way that this occurs is not understood. There is a synergistic interaction between caffeine and some mystery component of coffee that provides this beneficial increase in blood GCSF levels.”
The researchers would like to identify this yet unknown component so that coffee and other beverages could be enriched with it to provide long-term protection against Alzheimer’s disease.
In their study, the researchers compared the effects of caffeinated and decaffeinated coffee to those of caffeine alone. In both Alzheimer’s mice and normal mice, treatment with caffeinated coffee greatly increased blood levels of GCSF; neither caffeine alone or decaffeinated coffee provided this effect. The researchers caution that, since they used only “drip” coffee in their studies, they do not know whether “instant” caffeinated coffee would provide the same GCSF response.
The boost in GCSF levels is important because the researchers also reported that long-term treatment with coffee (but not decaffeinated coffee) enhances memory in Alzheimer’s mice. Higher blood GCSF levels due to coffee intake were associated with better memory. The researchers identified three ways that GCSF seems to improve memory performance in the Alzheimer’s mice. First, GCSF recruits stem cells from bone marrow to enter the brain and remove the harmful beta-amyloid protein that initiates the disease. GCSF also creates new connections between brain cells and increases the birth of new neurons in the brain.
“All three mechanisms could complement caffeine’s ability to suppress beta amyloid production in the brain” Dr. Cao said, “Together these actions appear to give coffee an amazing potential to protect against Alzheimer’s – but only if you drink moderate amounts of caffeinated coffee.”
Although the present study was performed in Alzheimer’s mice, the researchers indicated that they have gathered clinical evidence of caffeine/coffee’s ability to protect humans against Alzheimer’s and will soon publish those findings.
Coffee is safe for most Americans to consume in the moderate amounts (4 to 5 cups a day) that appear necessary to protect against Alzheimer’s disease. The USF researchers previously reported this level of coffee/caffeine intake was needed to counteract the brain pathology and memory impairment in Alzheimer’s mice. The average American drinks 1½ to 2 cups of coffee a day, considerably less than the amount the researchers believe protects against Alzheimer’s disease.
“No synthetic drugs have yet been developed to treat the underlying Alzheimer’s disease process” said Dr. Gary Arendash, the study’s other lead author. “We see no reason why an inherently natural product such as coffee cannot be more beneficial and safer than medications, especially to protect against a disease that takes decades to become apparent after it starts in the brain.”
The researchers believe that moderate daily coffee intake starting at least by middle age (30s – 50s) is optimal for providing protection against Alzheimer’s disease, although starting even in older age appears protective from their studies. “We are not saying that daily moderate coffee consumption will completely protect people from getting Alzheimer’s disease,” Dr. Cao said. “However, we do believe that moderate coffee consumption can appreciably reduce your risk of this dreaded disease or delay its onset.”
The researchers conclude that coffee is the best source of caffeine to counteract the cognitive decline of Alzheimer’s disease because its yet unidentified component synergizes with caffeine to increase blood GCSF levels. Other sources of caffeine, such as carbonated drinks, energy drinks, and tea, would not provide the same level of protection against Alzheimer’s disease as coffee, they said. Coffee also contains many ingredients other than caffeine that potentially offer cognitive benefits against Alzheimer’s disease.
“The average American gets most of their daily antioxidants intake through coffee,” Dr. Cao said. “Coffee is high in anti-inflammatory compounds that also may provide protective benefits against Alzheimer’s disease.”
An increasing body of scientific literature indicates that moderate consumption of coffee decreases the risk of several diseases of aging, including Parkinson’s disease, Type II diabetes, and stroke. Just within the last few months, new studies have reported that drinking coffee in moderation may also significantly reduce the risk of breast and prostate cancers.
“Now is the time to aggressively pursue the protective benefits of coffee against Alzheimer’s disease,” Dr. Arendash said. “Hopefully, the coffee industry will soon become an active partner with Alzheimer’s researchers to find the protective ingredient in coffee and concentrate it in dietary sources.”
New Alzheimer’s diagnostic guidelines, now encompassing the full continuum of the disease from no overt symptoms to mild impairment to clear cognitive decline, could double the number of Americans with some form of the disease to more than 10 million. With the baby-boomer generation entering older age, these numbers will climb even more unless an effective preventive measure is identified.
“Because Alzheimer’s starts in the brain several decades before it is diagnosed, any protective therapy would obviously need to be taken for decades,” Dr. Cao said. “We believe moderate daily consumption of caffeinated coffee is the best current option for long-term protection against Alzheimer’s memory loss. Coffee is inexpensive, readily available, easily gets into the brain, appears to directly attack the disease process, and has few side-effects for most of us.”
According to the researchers, no other Alzheimer’s therapy being developed comes close to meeting all these criteria.
“Aside from coffee, two other lifestyle choices – physical and cognitive activity – appear to reduce the risk of dementia. Combining regular physical and mental exercise with moderate coffee consumption would seem to be an excellent multi-faceted approach to reducing risk or delaying Alzheimer’s,” Dr. Arendash said. “With pharmaceutical companies spending millions of dollars trying to develop drugs against Alzheimer’s disease, there may very well be an effective preventive right under our noses every morning – caffeinated coffee.”
Material adapted from IOS Press BV.
Reference
Chuanhai Cao, Li Wang, Xiaoyang Lin, Malgorzata Mamcarz, Chi Zhang, Ge Bai, Jasson Nong, Sam Sussman and Gary Arendash. Caffeine Synergizes with Another Coffee Component to Increase Plasma GCSF: Linkage to Cognitive Benefits in Alzheimer’s Mice. Journal of Alzheimer’s Disease, 25(2), June 28, 2011.
via bmedreport.com
Chris Malloy builds the 'hoverbike': the world's first flying motorbike | Metro.co.uk
Man builds the 'hoverbike': the world's first flying motorbike
It may not be equipped with a laser cannon but Stars Wars fans could soon get behind the controls of a real ‘hoverbike’.
Inventor Chris Malloy sits on his tethered ‘hoverbike’, which he built in his garage and hopes to sell for £30,000 to farmers in remote areas of Australia (Picture: Caters)
Chris Malloy claims his flying machine, which is ridden like a bike but has horizontal propellers instead of wheels, will reach altitudes of up to 3,000m (10,000ft) and speeds of more than 270kph (170mph).
But the 32-year-old’s creation has so far remained tethered just a few metres off the ground.
‘I am still ground testing at the moment, only because I’m not 100 per cent sure what will happen so the straps are there to cover the unknown,’ he said.
‘I haven’t had the pleasure of flying round the countryside yet. It is quite stable and doesn’t want to tip over but, if something unplanned happened during testing, I wouldn’t want to break the prototype.’
The hoverbike bears a striking resemblance to The Speeder Bike seen in the Star Wars films (Pic: LucasFilm
The Australian inventor has spent his life savings and two and a half years constructing the space-age bike in his Sydney garage using a custom built frame and a BMW engine.
The futuristic design, which is complete with parachutes in case of an emergency, bears a passing resemblance to the Speeder Bikes seen roaring across alien planets in the Star Wars films or The Jetsons’s 2062 hovercar.
Mr Malloy hopes outback farmers will be willing to pay £30,000 for his creation to help them control cattle on sprawling ranches.
Previous experience of flying a helicopter or plane would help before piloting his bike, which could fly for about 45 minutes on one tank of fuel.
‘This is a new way to fly and one would need to learn to ride the hoverbike in much the same manner as a helicopter or riding a motorcycle,’ he added.
Watch the hoverbike be subjected to a smoke test in the video below:
via metro.co.uk
2,300 sex offenders have groomed more than 2,000 children for sex | Metro.co.uk
2,300 sex offenders have groomed more than 2,000 children for sex
More than 2,300 sex offenders have physically approached and groomed 2,000-plus children for abuse in the past three years, a report has found.
The NSPCC has called for action to provide a clearer picture on the scale of the problem of child grooming
And in the cases where ethnicity was known, 26 per cent of offenders were Asian.
But the Child Exploitation and Online Protection Centre, which carried out the study, warned the data was not comprehensive enough to draw firm conclusions and the focus should not be on ethnicity.
The study focused on ‘localised grooming’ that takes place in person, for example on the street, rather than on the internet.
It was undertaken after the conviction of the ringleaders of a grooming gang in Derbyshire which preyed on girls aged 12 to 18.
The report found there were 2,379 offenders recorded since the start of 2008, mostly men aged 18 to 24, and ethnicity had been identified in around half of the cases. Of the remaining groups, 38 per cent were white, 32 per cent were recorded as unknown, three per cent were black and 0.2 per cent Chinese. About 90 per cent of the 2,083 victims were white.
Agencies involved in child protection have failed to put in place ‘basic processes’ to stop sexual abuse, the report warned.
Victims are disorientated and manipulated as part of the grooming process. They have trouble dealing with the police and reluctant to give evidence in court.
‘This is a horrific kind of crime. It involves systematic, premeditated rape of children and needs to be understood in those stark terms,’ said CEOP head Peter Davies. ‘It needs to be brought out of the dark’.
Children’s charities, including the NSPCC, have called for action to provide a clearer picture of the scale of the problem.
via metro.co.uk
Dementia will be the new tax unless a charging revolution is achieved – Alzheimer’s Society - Alzheimer's Society
Dementia will be the new tax unless a charging revolution is achieved – Alzheimer’s Society
Published 30 June 2011
People do not plan for care and risk facing a 'dementia tax' unless the system of funding for care changes dramatically, Alzheimer’s Society warns today (Thursday, 30 June).
Publishing the results of Dementia Tax 2011, a major investigation into charging for care for people with dementia and carers, the charity is revealing that just three per cent of people with dementia have long term care insurance. More than half of those without it did not know it existed.Alzheimer's Society has developed a five point test which it will use to determine whether any new proposals eliminate a dementia tax that leaves thousands in the UK paying huge bills for their care. The test will check for quality, early access to care, simplicity, fairness and impact on carers.
The findings of Dementia Tax 2011 come the week before the Dilnot Commission on Funding of Care and Support is due to advise the government on future funding options for the system in England. The Commission is expected to recommend that the state and the individual must both make a contribution to costs, with a cap on care fees and incentives to stimulate a care insurance market.
The Alzheimer's Society survey questioned over 3,700 people with dementia and carers. It found:
- A quarter of people with the condition said they would have bought insurance if it was more affordable
- 52 per cent of carers said they or their loved one had to contribute to, or pay all of, the cost of their care
- Nearly half of all people surveyed (44 per cent of carers and 49 per cent of people with dementia) said on reflection, they did not wish they had taken out insurance
- The main reasons people did not take up insurance were: not knowing it exists; not anticipating care needs; not knowing they would have to contribute to care costs.
The Dilnot Commission was set up last July to review the funding system for social care in England and make recommendations to the government about how to achieve an affordable and sustainable system for adults in a range of settings.
Jeremy Hughes, Chief Executive at Alzheimer's Society, said:
'People are often very surprised by the huge amounts they have to pay for care; yet alternative solutions like insurance are currently out of their reach. State support is inadequate. We need a new system that can change this stark reality for millions of people and develop a long term system that works. The opportunity offered by the Dilnot Commission must not be lost.
'We must be able to provide good quality care that provides quality of life for people with dementia. It is vital we have a long term answer to the current broken system. We must stop forcing people to pay a dementia tax for poor quality care.'
Alzheimer's Society is a member of the Care and Support Alliance, a group of charities and organisations campaigning for radical reform of the care and support system, and supports its consensus statement on the funding of the system.Kevin Jennings, aged 77, from Halifax in West Yorkshire, paid for his wife Jo's care. Jo died with Alzheimer's disease last August. Kevin said:
You can download the Dementia Tax 2011, or for more information, and spokespeople or case study interviews please contact Alzheimer's Society's press office on 020 7423 3595.'It was so stressful having to cope with the financial pressures caused by the sky high costs of Jo's care that I ended up having a heart attack. Jo then had to go into a nursing home which cost us £250 a week - double the cost of support when I was caring for her in our home. It was a real struggle - we didn't have a bottomless pit of funds. It doesn't seem fair that families have to pay so much towards essential care.'
Sacks by Subject | Oliver Sacks, M.D., Physician, Author, Neurologist
Sacks by Subject
This list is not comprehensive, and most of Dr. Sacks’ writings fall into many different categories, so be sure to consult the index of each of his books for additional information. (Help us improve this list; send your suggestions to mail@oliversacks.com.)
Agnosia
HAT: title chapter
A LEG TO STAND ON
MARS: “To See and Not See”
MIND’S EYE: “Sight Reading” and other chapters
Alexia / Reading
MIND’S EYE: “A Man of Letters” and “Sight Reading”
Alzheimer’s / Dementia
MIND’S EYE: “Sight Reading”
MUSICOPHILIA: “Irrepressible: Music and the Temporal Lobes,” “Music and Identity: Dementia and Music Therapy”
–Sacks, Oliver and Melanie Shulman. 2005. Steroid Dementia: An Overlooked Diagnosis? Neurology 64:707-709 February.
Amnesia / Memory
HAT: “The Lost Mariner,” “A Matter of Identity,” “Murder”
MARS: “The Last Hippie,” “The Landscape of His Dreams”
MUSICOPHILIA: “In the Moment”
–Sacks, Oliver. 1996. Gowers’s memory. Neurology 46, pp. 1467-69, May.
–Sacks, Oliver. 2004. On Memory, Threepenny Review, volume 100, Winter.
Aphasia / Language
HAT: “The President’s Speech”
MIND’S EYE: “Recalled to Life”
MUSICOPHILIA: “Speech and Song: Aphasia and Music Therapy”
Auden, W.H.
–Sacks, Oliver: Dear Mr. A….. In Stephen Spender, ed., W.H. Auden: A Tribute.
Autism / Savant Syndrome
HAT: “A Walking Grove,” “The Twins,” “The Autist Artist”
MARS: “Prodigies,” “An Anthropologist on Mars”
MUSICOPHILIA: “Two Thousand Operas: Musical Savants”
–Sacks, Oliver. 2001. Henry Cavendish: An Early Case of Asperger’s syndrome? Neurology vol. 57, October 9.
–Sacks, Oliver. Introduction to the paperback edition of Glenn Gould by Peter Ostwald.
–Sacks, Oliver. Foreword to Thinking in Pictures, by Temple Grandin
Films: “The Mind Traveller: Rage for Order” (BBC)
Blindness (see also Vision)
HAT: “Hands”
ISLAND OF THE COLORBLIND: cycads (Guam, Rota)
MARS: “To See and Not See”
MIND’S EYE: title chapter
MUSICOPHILIA: “An Auditory World: Music and Blindness”
Botany
OAXACA JOURNAL: all chapters (ferns, tobacco, morning glory, chilies, chocolate, rubber, corn)
–Cox, Paul Alan and Sacks, Oliver. 2002. Cycad neurotoxins, consumption of flying foxes, and ALS-PDC disease in Guam. Neurology 2202 (58): 956-59.
–Sacks, Oliver. 2008. Darwin and the Meaning of Flowers, New York Review of Books, November 20, pp. 64-67.
–Sacks, Oliver. 2007. Botanists on Park, “Talk of the Town,” New Yorker, August 13, p. 25.
Chemistry / Physical Science
UNCLE TUNGSTEN: all chapters
–Sacks, Oliver. 1999. Hard Times for Curious Minds, New York Times, op-ed page, May 13.
–Sacks, Oliver. 1999. Everything In Its Place. New York Times Magazine, April 18, pp. 126-130.
–Sacks, Oliver. Scotoma: Forgetting and Neglect in Science. In Robert Silvers, ed., Hidden Histories of Science, pp. 141-87.
–Sacks, Oliver. 1993. Remembering South Kensington. Discover, November, pp. 78-80.
–Sacks, Oliver. 1993. Humphry Davy: a poet-chemist. New York Review of Books, November 4, pp. 50-56.
Color Vision
THE ISLAND OF THE COLORBLIND: Pingelap chapter
MARS: “The Colorblind Painter”
–Sacks, O., Wasserman, R.L., Zeki, S., and Siegel, R.M. 1998. Sudden color-blindness of cerebral origin. Society for Neuroscience Abstracts
Films: “The Mind Traveller: Island of the Colorblind” (BBC)
Creutzfeld-Jacob disease (BSE, mad cow disease)
–Sacks, Oliver. 1997. Eat, Drink, and Be Wary, review of Deadly Feasts by Richard Rhodes. New Yorker, April 14, pp. 82-85
Francis Crick
Add New York Review of Books
Charles Darwin
Sacks, Oliver. 2008. Darwin and the Meaning of Flowers. New York Review of Books, November 20.
Deafness / Language
SEEING VOICES
–Sacks, Oliver: foreword to A Man Without Words, by Susan Schaller.
Films: “The Mind Traveller: The Ragin’ Cajun” (BBC)
Depression
MUSICOPHILIA: “Lamentations: Music and Depression”
Dreams
MIND’S EYE: title chapter
MUSICOPHILIA: “Awake and Asleep: Musical Dreams”
–Sacks, Oliver. Neurological Dreams. In Deirdre Barrett, ed., Trauma and Dreams, pp. 212-16.
Dystonia
MUSICOPHILIA: “Athletes of the Small Muscles”
Encephalitis: see Parkinsonism
Epilepsy
HAT: “Reminiscence,” “A Passage to India”
MARS: “The Landscape of His Dreams”
MUSICOPHILIA: “A Strangely Familiar Feeling” and “Fear of Music”
–Devinsky, Julie; Devinsky, Orrin; and Sacks, Oliver. 2010. Klüver Bucy Syndrome, Hypersexuality, and the Law, Neurocase, in press.
–Sacks, Oliver. 2009. Michael Powell’s Neurological Cinema, Lancet, vol. 373, March 21, p. 1. [reprinted in Film Comment, vol. 45, no. 3, May/June 2009]
Face-blindness / Prosopagnosia
MIND’S EYE: “Face-Blind”
Freud, Sigmund
Sacks, Oliver. The Other Road: Freud as Neurologist. in Michael S. Roth, ed. Freud: Conflict and Culture, pp. 221-34.
Frontal Lobe Syndrome
MARS: “The Last Hippie”
MUSICOPHILIA: many chapters, see book index
–Sacks, Oliver. Foreword to The Executive Brain, by Elkhonon Goldberg.
Hallucinations
HAT: “Reminiscence”
MIGRAINE: “Migraine Aura and Classical Migraine,” “Migraine Aura and Hallucinatory Constants”
MUSICOPHILIA: “Musical Hallucinations”
Luria, A. R. (see also footnotes in most books)
–Sacks, Oliver: Luria and “Romantic Science.” In E. Goldberg, ed., Festschrift for Alexandr Romanovich Luria.
–Sacks, Oliver: Foreword to The Man with a Shattered World, by A. R. Luria.
–Sacks, O. W. 1977. Obituary for A.R. Luria, The Times (London).
–Sacks, O. W. 1973. The mind of A.R. Luria. The Listener, June 28.
Madness / Manic Depressive Illness / Schizophrenia
MUSICOPHILIA: “Seduction and Indifference”
–Sacks, Oliver. 2009. The Lost Virtues of the Asylum, New York Review of Books, September 24, pp. 50-52.
–Sacks, Oliver. 2008. A Summer of Madness, New York Review of Books, September 25, pp.57-61.
Migraine
HAT: “The Visions of Hildegard”
MIGRAINE
–Sacks, Oliver. 2008. Patterns, New York Times blog on migraines, posted February 14, http://migraine.blogs.nytimes.com
Music
AWAKENINGS
HAT: “Reminiscence,” “A Walking Grove,” “Witty Ticcy Ray”
A LEG TO STAND ON
MARS: “The Last Hippie”
MIND’S EYE: “Sight Reading”
MUSICOPHILIA
–Sacks, Oliver. Introduction to the paperback edition of Glenn Gould by Peter Ostwald (New York: W. W. Norton, 1998).
–Sacks, Oliver. 2006. The Power of Music, Brain, vol. 129, no. 10, October, pp. 2528-32.
Film: “Musical Minds” (NOVA)
Neural Darwinism
–Sacks, Oliver. 1993. Making up the mind. Review of work by Gerald Edelman, New York Review of Books, April 8, pp. 42-49.
–Sacks, Oliver. 1990. Neurology and the Soul. New York Review of Books, November 22.
Parkinsonism / Post-encephalitis
AWAKENINGS
HAT: “Incontinent Nostalgia,” “On the Level”
ISLAND OF THE COLORBLIND: “Guam”
MUSICOPHILIA: “Kinetic Melody: Parkinson’s and Music Therapy”
–Sacks, Oliver: Foreword to Shadow Over my Brain: A Battle against Parkinson’s Disease, by Cecil Todes.
–Sacks, Oliver: Review of Ivan: Living with Parkinson’s Disease, by Ivan Vaughan. British Medical Journal 294: 503, February 121, 1987.
–Sacks, Oliver. 1983. The origins of Awakenings. British Medical Journal 287: 1968-1969, December 24.
–Sacks, Oliver: Awakenings revisited. M. Sarner, ed., Advanced Medicine 18.
–Sacks, Oliver. 1993. Guam disease and post-encephalitic parkinsonism. Letter to the editor, Science 262, November 5, p. 826.
–Cox, Paul Alan and Sacks, Oliver. 2002. Cycad neurotoxins, consumption of flying foxes, and ALS-PDC disease in Guam, Neurology 2202 (58): 956-59.
–Murch, S. J., Cox, P. A., Banack, S. A., Steele, J. C., and Sacks, O. W. 2004. Occurrence of B-methylamino-L-alanine (BMAA) in ALS/PDC patients from Guam. Acta Neurol Scand 110: 267-269.
Films: “The Mind Traveller: Poison In Paradise” (BBC); “Awakenings” (Yorkshire Television)
Phantoms / Alienation / Proprioception
HAT: “The Disembodied Lady,” “The Man Who Fell Out of Bed,” “Phantoms”
A LEG TO STAND ON
MUSICOPHILIA: “The Case of the One-Armed Pianist”
–Sacks, Oliver. Foreword to Phantoms in the Brain, by V.S. Ramachandran and Sandra Blakeslee.
–Sacks, Oliver: Foreword to Pride and a Daily Marathon, by Jonathan Cole.
–Sacks, Oliver. Phantom faces. British Medical Journal, vol. 304, February 8, 1992, p. 364.
Photography
MIND’S EYE (stereo photography): “Stereo Sue”
UNCLE TUNGSTEN: “Images”
–Sacks, Oliver: Color photography in the forties, Letter to the editor, Scientific American, March 1990.
Savant Syndrome — see Autism
Seizure Disorders — see Epilepsy
Smell
HAT: “The Dog Beneath the Skin.”
MIGRAINE: “Migraine Aura and Classical Migraine,” “Migraine Aura and Hallucinatory Constants”
Stereo Vision
MIND’S EYE: “Stereo Sue” and “Persistence of Vision”
–Sacks, Oliver. Foreword to Fixing My Gaze by Susan R. Barry
Swimming
–Sacks, Oliver. 1997. Doug Stern’s Curacao swim camp. Triathlete, September, p. 10.
–Sacks, Oliver. 1997. Water Babies. New Yorker, May 26, pp. 44-45.
Synesthesia
MUSICOPHILIA: “The Key of Clear Green”
(neuro) Syphilis
HAT: “Cupid’s Disease”
Tourette’s Syndrome
HAT: “Witty Ticcy Ray,” “The Possessed”
MARS: “A Surgeon’s Life”
MUSICOPHILIA: “Come Together: Music and Tourette’s Syndrome”
–Sacks, Oliver. Tourette’s syndrome: a human condition. In Roger Kurlan, ed., Handbook of Tourette’s Syndrome and Related Tic and Behavioral Disorders, pp. 509-514.
–Sacks, Oliver. 1992. Tourette’s and creativity. British Medical Journal 305:1515-1516, December 19.
–Sacks, Oliver. Foreword to Don’t Think about Monkeys, ed. by Adam Seligman and John Hilkevich.
–Sacks, Oliver. 1998. The Divine Curse: Tourette’s syndrome among a mennonite family. Life, September.
–Sacks, Oliver: 1987. Tics. New York Review of Books, January 29.
–Sacks, Oliver: Acquired Tourettism in adult life. In A.J. Friedhoff and T.N. Chase, eds., Gilles de la Tourette Syndrome, Advances in Neurology 35 (NY: Raven Press, 1982).
Film: “The Mind Traveller: Shane” (BBC)
Travel
ISLAND OF THE COLORBLIND (Guam, Micronesia, Pingelap, Pohnpei, Pacific Islands)
OAXACA JOURNAL (Oaxaca, Mexico)
–Sacks, Oliver. 1989. Canada: Pause (1960). Antaeus 62, Spring, 192-200.
–Sacks, Oliver: 1988. Travel happy (1961). Antaeus 61, Autumn, 391-406.
–Sacks, Oliver. 2010. Colorado Springs Revisited. Columbia journal.
Twins
Sacks, Oliver. 1986. Review of The Silent Twins by Marjorie Wallace. New York Times Book Review, October 19.
Vision / Blindness
HAT: “Hands,” “Eyes Right!”
MARS: “The Colorblind Painter,” “To See and Not See.”
MIND’S EYE: “Persistence of Vision,” “Stereo Sue,” “The Mind’s Eye”
MUSICOPHILIA: An Auditory World: Music and Blindness
Williams Syndrome
MUSICOPHILIA: “A Hypermusical Species”
Audio/Visual: “The Mind Traveller: Don’t Be Shy, Mr. Sacks” (BBC film)
via oliversacks.com
Malaysia drugs mum to return to Harlech | News
Malaysia drugs mum to return to Harlech
30 June 2011
A HARLECH woman who was jailed in Malaysia this week for drug offences will be returning home to Harlech on her release in September.
Family and friends of 46-year-old Shivaun Orton have this week spoken of their relief that she will be coming home.
Speaking to the Cambrian News, Shivaun’s sister Stephanie Hiscox said her family and friends were happy with the result.
“She’ll be coming back to Harlech soon with her sons,” Stephanie said.
“I expect the whole thing has been such a shock for her. Before she hadn’t dared to make plans, so it’s probably only just sank in that she’s going to have a future.”
Ms Orton and her husband Abdul Harris Fadilah were arrested last December after police seized drugs, including heroin and ecstasy, from their home in Chetarin, in the northern state of Terengganu.
It had initially been feared that the mum-of- two would be hanged.
But on Monday, Ms Orton was jailed for 14 months for four drug offences.
The sentence will run concurrently from the date she was arrested, meaning she will be home by September.
Thralldom Synonyms, Thralldom Antonyms | Thesaurus.com
Main Entry: slavery Part of Speech: noun Definition: state of working under duress or without freedom Synonyms: bondage, bullwork, captivity, chains constraint, drudge, drudgery, enslavement, enthrallment, feudalism, grind, helotry, indenture, labor, menial labor, moil, peonage, restraint, serfdom, serfhood, servitude, subjection, subjugation, thrall, thralldom , toil, vassalage, work Antonyms: mastery
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Servitude - Wikipedia, the free encyclopedia
From Wikipedia, the free encyclopedia
Jump to: navigation, searchServitude may refer to:
- Service
- Conscription
- Employment
- Slavery
- Indentured servitude
- Involuntary servitude
- Penal servitude
- Servitude (BDSM)
- Equitable servitude, a term of real estate law
- Servitude in civil law
This disambiguation page lists articles associated with the same title.
If an internal link led you here, you may wish to change the link to point directly to the intended article.Retrieved from "http://en.wikipedia.org/wiki/Servitude"Hidden categories: All article disambiguation pages | All disambiguation pages
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