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New Treatment Approved for Rare Disease PKU

FRIDAY, May 25, 2018 (HealthDay News) -- Palynziq (pegvaliase-pqpz) has been approved by the U.S. Food and Drug Administration to treat phenylketonuria, commonly called PKU.
People with the rare yet serious inherited disorder can't break down an amino acid called phenylalanine, which is found in many sweeteners and protein-containing foods.
The disorder affects about 1 in 10,000 to 15,000 people in the United States. Left untreated, it can lead to serious learning, developmental and psychiatric disabilities, the FDA said in a news release.
Palynziq's safety and effectiveness were evaluated in clinical studies involving people with high concentrations of blood phenylalanine. The most common side effects of the enzyme substitution therapy were injection-site reactions, allergic-like hypersensitivity reactions, joint pain, headache, itchy skin, nausea, dizziness and abdominal pain.
The drug's label warns of a less-common risk of life-threatening anaphylaxis, which the agency said most often occurred when the dosage was increased during the first year of treatment.
Palynziq is produced by BioMarin Pharmaceutical, based in Novato, Calif.
More information
The FDA has more about this approval (https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm608835.htm ).
Article written by Scott Roberts

Coal Miners Face Growing Wave of Black Lung Disease

FRIDAY, May 25, 2018 (HealthDay News) -- The deadliest form of black lung disease is on the rise among American coal miners, a new study finds.
Increases in cases of progressive massive fibrosis (PMF) are occurring despite measures to control coal dust that were put into place decades ago.
The finding stems from an analysis of U.S. Department of Labor data on former coal miners who applied for benefits from the Federal Black Lung Program between its start in 1970 and 2016. The program's launch coincided with use of modern dust control measures.
Over 46 years, more than 4,600 coal miners were diagnosed with black lung. Half of the cases occurred since 2000, the data showed.
Lead researcher Kirstin Almberg said increases in the disease have been reported by both the U.S. National Institute of Occupational Safety and Health Administration and black lung clinics. Almberg is an assistant professor in the School of Public Health at the University of Illinois at Chicago.
Though she said the results weren't a total surprise, the researchers did find some unexpected things.
"We were, however, surprised by the magnitude of the problem and are astounded by the fact that this disease appears to be resurging despite modern dust control regulations," Almberg said. "This is history going in the wrong direction."
The researchers found that most people with PMF last mined in West Virginia (29 percent), Kentucky (20 percent), Pennsylvania (20 percent) and Virginia (15 percent).
West Virginia, Kentucky and Virginia had the largest increases in PMF diagnoses over the past 40 years. And Tennessee reported a 10 percent increase in claims over that time -- something researchers said had not been recognized in previous studies.
The findings were presented Tuesday at a meeting of the American Thoracic Society, in San Diego.
Several theories might explain the resurgent epidemic. Affected miners appear to have worked in smaller mines that might have invested less in dust reduction systems. In addition, today's mines produce higher levels of crystalline silica, which is more damaging to the lungs than coal dust, Almberg said.
Also, miners may be working longer hours on more days each week. That leaves less time for their lungs to clear the inhaled dust.
In black lung disease, also known as coal workers' pneumoconiosis, lungs go from pink to black. The disease may go unnoticed in its early stages. As it progresses, nodules may form in the lungs, along with emphysema and fibrosis, or lung scarring, according to the researchers.
These conditions lead to obstruction of the airway, shortness of breath and often premature death.
Miners who work 10 years or more are at greater risk for black lung disease. "In general, the higher concentration of dust, the more days worked per week, and the more years worked, the greater the risk," Almberg said in a meeting news release.
New federal regulations should help reduce dust exposure in coal mines, but researchers say mine operators and workers should be educated about the harmful effects of coal dust.
Research presented at meetings is viewed as preliminary until published in a peer-reviewed journal.
More information
To learn more about black lung disease, visit the American Lung Association (http://www.lung.org/lung-health-and-diseases/lung-disease-lookup/pneumoconiosis/ ).
SOURCE: American Thoracic Society, news release, May 22, 2018
Article written by Scott Roberts

Obesity May Offer Some Protection When Severe Infection Strikes

FRIDAY, May 25, 2018 (HealthDay News) -- Obesity brings with it many health ills, but there could be one silver lining, new research shows.
If you're in the hospital suffering from an infectious disease, you're half as likely to die if you're overweight or obese, Danish researchers report.
For the study, Sigrid Gribsholt, from Aarhus University Hospital's department of clinical epidemiology, and colleagues collected data on more than 35,000 patients hospitalized for infections from 2011 to 2015.
Among these patients, the investigators looked at whether weight affected the risk of dying in the three months after discharge.
Gribsholt's team found that for underweight patients, the risk of dying was two times higher than for patients of normal weight. That seemed tied, however, to recent weight loss due to some underlying disease. Deaths did not increase for underweight patients who had not recently lost weight.
The surprise finding was that overweight patients were 40 percent less likely to die and obese patients were 50 percent less likely to die, compared with normal-weight patients.
Among obese patients, whether they had recent changes in weight, other medical conditions or if they smoked had little effect on the risk of dying, the findings showed.
"Overweight and obesity were associated with substantially reduced 90-day mortality following incident hospital admission for infection," the researchers wrote.
The results of the study were presented May 24 at the European Congress on Obesity in Vienna, Austria.
Similar findings arose in three other studies also presented at the meeting:
In a study jointly conducted by researchers in the United States and Taiwan, a look at the medical records from nearly 1.7 million Americans hospitalized with pneumonia found that the odds of dying fell by 20 to 30 percent if the patient was overweight or obese. A study conducted by the same team, using the same database, found that hospitalized overweight or obese patients were also about 22 to 23 percent less likely to die from the blood infection sepsis, compared to normal-weight patients. A study led by Dutch researchers at the Erasmus MC, University Medical Center Rotterdam found that, in a group of 26 seriously ill patients, the nine who were obese were less likely to undergo rapid muscle wasting compared to their normal-weight peers.
But obesity expert Dr. Mitchell Roslin said the so-called "obesity paradox" -- where a normally unhealthy weight appears to have some health benefit -- "has to be kept in perspective."
Even though excess weight might somehow offer protection in dire circumstances, obesity is linked to a number of deadly diseases, including diabetes, heart disease and even some cancers.
"What is happening today is that the obesity epidemic is causing far more [ill health] than it is protecting," said Roslin, who is chief of obesity surgery at Lenox Hill Hospital in New York City.
"Just because you are overweight does not mean you are unhealthy," he said, but "if your obesity is severe, it is unlikely you are healthy."
The new findings were all presented at a medical meeting, and as such should be considered preliminary until published in a peer-reviewed journal.
More information
For more about obesity, visit the U.S. Centers for Disease Control and Prevention (https://www.cdc.gov/obesity/ ).
SOURCES: Mitchell Roslin, M.D., chief, obesity surgery, Lenox Hill Hospital, New York City; May 24, 2018, presentations, European Congress on Obesity, Vienna, Austria
Article written by Scott Roberts

Are Yawns Really Contagious?

FRIDAY, May 25, 2018 (HealthDay News) -- We've all "caught" yawning from other people, but why that happens is unclear, according to a psychologist who has researched the behavior.
"In short, we don't know why yawns are contagious," said Meredith Williamson, a clinical assistant professor at Texas A&M College of Medicine. "Researchers used to think that yawning was only signaling a need for sleep, but now they believe that it can communicate a shift in alertness or boredom."
One theory is that contagious yawning is related to empathy, and that people with higher levels of empathy yawn more often when someone else yawns, compared to people with lower levels of empathy or those with a mental disorder.
"Researchers have seen that yawning may not be as contagious to people with autism or schizophrenia," Williamson said in a university news release. "More research is being done to determine the cause of this."
She also noted that children under the age of 4 and older adults are less likely to yawn in response to somebody else yawning.
Yawning may be an unspoken form of communication, but it's not unique to people, Williamson added. Some species of primates and canines yawn in response to each others' yawns, and dogs will even yawn after a person yawns.
Yawning is "multifactorial. It could be partly an innate form of communication or it could be related to empathy, or a bit of both combined with other factors," she suggested.
More information
The Library of Congress has more on yawning (https://www.loc.gov/rr/scitech/mysteries/yawn.html ).
SOURCE: Texas A&M College of Medicine, news release, April 2018
Article written by Scott Roberts

Be Smart When It Comes to Spring Allergies and Asthma

FRIDAY, May 25, 2018 (HealthDay News) -- Lots of things grow in the spring, including your risk of severe allergic reactions and asthma attacks. So people need to take preventive measures and know when to seek medical care, an emergency physician says.
"Spring tends to bring more people to the emergency department," Dr. Paul Kivela, president of the American College of Emergency Physicians, said in a college news release.
"Conditions like asthma and allergies are manageable for most people but they can easily become life-threatening. Minimize your risk by limiting your exposure to known triggers, carrying your medicines with you if needed, and developing an action plan for asthma and allergic reactions with your care provider."
Each year, asthma sends more than 1.8 million people to U.S. emergency rooms, according to the federal Centers for Disease Control and Prevention. Kivela said people with asthma should go to the ER when: symptoms do not improve quickly after the use of rescue inhalers; they're straining to breathe or can't complete a sentence without pausing for breath; their lips or fingernails turn blue.
Picnics, barbecues, pool parties and other outdoor get-togethers can put some people at risk for a life-threatening allergic reaction (anaphylaxis), which is most often caused by a food allergy. It's estimated that a food allergy sends somebody to a U.S. emergency room every three minutes.
Insect bites and stings are another common cause of anaphylaxis.
Symptoms such as tingling, numbness or a metallic taste in the mouth may occur within minutes, but it might take up to several hours for life-threatening reactions to develop, according to Kivela.
Seek immediate emergency care if you or someone else develops any combination of the following symptoms:
Difficulty swallowing or breathing Swelling of the tongue, throat, nasal passages or face Welts, hives, itchiness, redness on the skin, lips, eyelids or other areas of the body Bluish skin, especially the lips or nail beds (or grayish in darker complexions) Nausea, stomach cramping, vomiting/diarrhea Heart palpitations; weak and rapid pulse; confusion, slurred speech; dizziness, a drop in blood pressure, fainting or unconsciousness.
If someone develops anaphylaxis, call 911 immediately. And while you wait for first responders to arrive: lay the person flat and elevate the feet; administer self-injectable epinephrine (such as EpiPen) if available; check for a medical tag, bracelet or necklace that may identify anaphylactic triggers, Kivela said.
More information
The American Academy of Family Physicians has more on anaphylaxis (https://familydoctor.org/condition/anaphylaxis/?adfree=true ).
SOURCE: American College of Emergency Physicians, news release
Article written by Scott Roberts

Health Tip: Care for a Pressure Sore

(HealthDay News) -- A pressure sore is an area of the body that breaks down because something keeps rubbing or pressing against the skin.
A pressure sore can develop if you use a wheelchair or stay in bed for long periods, have a disease that affects blood flow, have fragile skin or are malnourished.
The U.S. Library of Medicine suggests how to care for a pressure sore:
Relieve pressure on the area by using a pillow, foam cushion, booties or a mattress pad. In a wheelchair, change your position every 15 minutes, and in a bed, you should move about every 2 hours. Care for the sore as directed by your health care provider. Avoid additional pressure on the sore. Call your doctor if you have an open sore or develop a blister.
Article written by Scott Roberts

Leave Tablets, Smartphones Out of the Bedroom for Better Sleep

FRIDAY, May 25, 2018 (HealthDay News) -- Are tablets, smartphones and laptops robbing Americans of shut-eye? Absolutely, said researchers who found that the unending entertainments and the light the devices emit are a powerful, slumber-killing combo.
The finding comes from a small analysis of nine otherwise healthy adults in their 20s. Their sleep was tracked after five straight nights of unrestricted tablet use, and then compared to their sleep patterns after reading printed materials alone.
It wasn't just that light from electronic devices suppressed their secretion of melatonin, the sleep-regulating hormone, study author Jeanne Duffy said. Researchers expected that based on other studies.
"What was new was that participants [who used electronic devices] would choose to go to bed significantly later, even though they knew they had to wake up at 6 a.m.," Duffy said.
But exactly how a tablet's glow interferes with sleep remains unclear. Duffy, a neuroscientist at Brigham and Women's Hospital, and an associate professor of medicine at Harvard Medical School in Boston, suggested there could be several possible explanations.
For one, she noted, the human body's 24-hour circadian clock is "very sensitive" to the blue light that electronic devices give off. Or it might be the brightness: People tend to hold screens close to their face, filling their visual field with light.
"It could be that the participants were living in our lab for the entire study and not getting bright outdoor light so, relatively, the screen light was quite bright," Duffy added. "We want to do future studies to tease apart those effects."
The experiment took place in a sleep lab where light and sound pollution were kept to a minimum. For five nights, participants chose whether to use their electronic devices for reading, emailing, browsing the internet, playing games or watching videos. They also chose when to finally go to sleep, knowing that they had to be up at a specific time the next morning.
During a separate five-day period, the study participants were allowed to read only printed books, magazines or newspapers, though the content choice was theirs.
In both situations, the setting was dimly (and similarly) lit, until participants chose to go to bed, at which time the lights were turned off.
The researchers found that tablet users were less sleepy at bedtime and less alert during the first hour after awakening, compared with print readers.
Tablet users' bodies waited longer at night to produce melatonin, and they fell asleep, on average, 30 minutes later than print readers, the findings showed.
So what are fans of device-based bedtime reading to do?
Apart from switching to printed material, there's no simple answer, Duffy said.
"Turning down the screen brightness ought to help, but we don't know how much," she said. "Using a program to change the screen output or using a filter may help, (but) again we don't know how much. And spending a lot of time outdoors during the day should help, but it has to be the day you're using the screen in bed, not the day after."
Duffy said these strategies need to be tested in a lab setting so scientists can understand whether -- and how -- they work.
Dr. Nathaniel Watson is a professor of neurology with the University of Washington Medicine Sleep Center in Seattle, and past-president of the American Academy of Sleep Medicine.
His prescription?
"There is no substitute for sleep. Put down the electronics and wind down in the evening before heading off to bed for the best night's sleep possible," Watson advised.
The report was published online May 22 in Psychological Reports.
More information
Find out how to get a good night's sleep from the U.S. National Institutes of Health (https://medlineplus.gov/healthysleep.html ).
SOURCES: Jeanne Duffy, M.B.A., Ph.D., neuroscientist, Brigham and Women's Hospital, and associate professor of medicine, Harvard Medical School, Boston; Nathaniel Watson, M.D., M.Sc., professor of neurology, University of Washington Medicine Sleep Center, Seattle, and immediate past president, American Academy of Sleep Medicine; May 22, 2018, Psychological Reports, online
Article written by Scott Roberts

Little Follow-Up for Many Concussion Patients

FRIDAY, May 25, 2018 (HealthDay News) -- Although millions of Americans suffer concussions each year, many aren't given information about traumatic brain injury or follow-up care, a new study finds.
"The lack of follow-up after a concussion is concerning because these patients can suffer adverse and debilitating effects for a very long time," said study lead author Seth Seabury.
"Even patients who reported experiencing significant post-concussive symptoms often failed to see a provider. This reflects a lack of awareness, among patients and providers, that their symptoms may be connected to their brain injury," Seabury added.
He's director of a population health initiative at the University of Southern California Schaeffer Center for Health Policy and Economics.
The findings, published online May 25 in JAMA Network Open, are based on a sample of 831 patients who went to a top-level trauma center with a concussion, or mild traumatic brain injury (TBI).
Of those, 47 percent said they were given educational materials about TBI when they were discharged. Forty-four percent said they saw a doctor or other health care professional in the three months after their injury.
Of 28 percent of patients whose CT scans showed they had a brain injury, about 40 percent did not see a health provider three months after discharge, the researchers reported.
In addition, about one-third of the patients had three or more moderate-to-severe concussion symptoms within three months, but only about half of those patients had a follow-up visit, the researchers found.
Although concussions are often labeled mild, that term can be misleading, the researchers pointed out. People can have significant symptoms after a concussion, including migraines, thinking issues, vision loss, memory loss, emotional distress or personality disorders.
Too many patients are being treated as if a concussion is a minor injury, study co-author Dr. Geoffrey Manley said in a journal news release.
"This is a public health crisis that is being overlooked. If physicians did not follow-up on patients in the emergency department with diabetes and heart disease, there would be accusations of malpractice," he said.
Manley is principal investigator of the ongoing Transforming Research and Clinical Knowledge in Traumatic Brain Injury study, or TRACK-TBI.
An estimated 3.2 million to 5.3 million Americans live with long-term health effects from a traumatic brain injury, according to the U.S. Centers for Disease Control and Prevention.
Moreover, TBIs accounted for 2.8 million emergency department visits in the United States in 2013, and more than $76 billion in direct and indirect costs.
"Everyone who falls off their bike, slips off their skateboard or falls down the steps needs to be aware of the potential risks of concussion," Manley said.
Seabury concluded that "the study shows that we need to give patients and doctors the tools to better identify who should be going in for follow-up care."
More information
To learn more about traumatic brain injury and concussion, visit the U.S. Centers for Disease Control and Prevention (https://www.cdc.gov/traumaticbraininjury/symptoms.html ).
SOURCE: JAMA Network Open, news release, May 25, 2018
Article written by Scott Roberts

To Repel Ticks This Summer, Try Insecticide-Treated Clothes

FRIDAY, May 25, 2018 (HealthDay News) -- Outdoor enthusiasts: Here's a bit of good tick-fighting news just in time for Memorial Day weekend and the unofficial start of summer.
A new U.S. government study confirms that insecticide-treated clothes marketed for preventing tick-borne ills do, in fact, thwart the pests.
In lab tests of clothes bought from one manufacturer, researchers found that the garments either quickly caused ticks to fall off, or rendered them unable to bite.
The study involved three types of ticks that, in the United States, are major carriers of disease -- including Lyme disease, Rocky Mountain spotted fever, and what's known as southern tick-associated rash illness, or STARI.
The clothes were pretreated with permethrin, a synthetic form of an insect-thwarting compound from the chrysanthemum flower. It's used in insecticide sprays and shampoos and creams that treat lice and scabies.
Several companies already market permethrin-treated shirts, pants, socks and other clothing, as a way to ward off disease-transmitting pests. The new study adds to evidence that the garments are indeed toxic to ticks, according to senior researcher Lars Eisen, of the U.S. Centers for Disease Control and Prevention.
"All tested tick species and life stages experienced the 'hot-foot' effect after coming into contact with permethrin-treated clothing," Eisen said.
That, he explained, made the ticks drop off of "vertically oriented" clothes -- which would simulate a pair of pants when a person is standing.
In addition, Eisen said, when the ticks were in contact with the clothes for up to five minutes, they lost their ability to move normally -- and to bite.
There are still questions, he noted, including what types of clothing offer the best protection in the real world.
The CDC already recommends permethrin as one tactic for avoiding tick bites. It says that people can "treat clothing and gear, such as boots, pants, socks and tents, with products containing 0.5 percent permethrin."
The agency further says that "pretreated clothing is available and may be protective longer."
Thomas Mather is director of the University of Rhode Island's Center for Vector-Borne Disease and its TickEncounter Resource Center.
He said the new findings, published May 24 in the Journal of Medical Entomology, offer more support for the tick-fighting garments.
"This can be a pretty effective way to stop ticks," said Mather, who was not involved in the study.
In his own research, Mather found there are benefits even with permethrin-treated summer clothes that leave some skin uncovered -- shorts, T-shirts, socks and sneakers.
His team had a group of brave volunteers watch a movie while allowing lab-raised, disease-free ticks to crawl on their bodies. Some wore regular clothes, some wore clothes with permethrin -- either pretreated or with the insecticide added using home kits. Those wearing either kind of treated clothing ended up with far fewer live ticks on their bodies by the end of the movie.
While people can use permethrin on their regular clothes, the pretreated garments hold up to many more washings, according to Mather -- up to 70.
Some people may be wary of chemically treated clothes. But, Mather said, the amount of permethrin in clothing is very low: A solution containing only 0.5 percent of the pesticide is "dried into" the fabric.
According to the U.S. Environmental Protection Agency, research indicates that permethrin is "poorly absorbed" through the skin, and there's no evidence that treated clothing could be harmful to children or pregnant women.
U.S. military members have been using permethrin-treated uniforms since the 1990s, the EPA noted. According to Mather, the garments may also be a good bet for people whose jobs keep them outdoors -- or for gardeners or anyone else who spends time in places where tick exposure is a concern.
Eisen pointed to some other CDC-recommended ways to cut the risk of tick-borne ills: Avoid wooded and brushy areas with high grass and "leaf litter"; walk in the center of outdoor trails; use EPA-registered repellents containing ingredients such as DEET, picaridin or oil of lemon eucalyptus; thoroughly check your body and clothes for ticks after being outdoors; and shower within two hours of coming back indoors.
More information
The CDC has more advice on how to avoid tick bites (https://www.cdc.gov/ticks/avoid/on_people.html ).
SOURCES: Lars Eisen, Ph.D., research entomologist, U.S. Centers for Disease Control and Prevention; Thomas Mather, Ph.D., director, Center for Vector-Borne Disease, and TickEncounter Resource Center, University of Rhode Island, Kingston; May 24, 2018, Journal of Medical Entomology, online
Article written by Scott Roberts

What Makes for a Healthy Community?

THURSDAY, May 24, 2018 (HealthDay News) -- Where you live can have a major effect on your health, new research suggests.
Living in a diverse community where people are better educated, make more money and have good health care nearby is linked to greater well-being and a better quality of life, the study authors said.
"Our communities have a big impact on our health and well-being," said study lead author Dr. Brita Roy. She's an assistant professor of medicine and director of population health at Yale University School of Medicine in New Haven, Conn.
"This study suggests that if we are going to start working toward building communities to promote health and well-being, we need to work across sectors. Health care alone can't do it. Transportation alone can't do it. There has to be a collaborative effort to improve health and well-being for everyone," Roy said.
Feelings of well-being and satisfaction with your quality of life have been associated with a longer life and better health outcomes, the researchers noted.
But Roy pointed out that the design of the new study means researchers can't prove a cause-and-effect relationship between certain community characteristics -- such as medical, social and environmental factors -- and a sense of well-being.
"That means we don't know at this point if we improve these factors if well-being will go up," she said.
The study included more than 300,000 adults from a nationwide sample. The researchers identified 77 characteristics that they felt might contribute to peoples' well-being.
But many of those characteristics are related to one another, Roy said. For example, a low-income area might also have a higher minority population and more people with lower education. So, the researchers worked to remove duplication and narrowed the list to a dozen characteristics.
"These 12 factors accounted for more than 90 percent of the variation we see in well-being," Roy said.
Factors found in communities with higher well-being included:
More black residents. Lower rates of child poverty. Fewer people with less than a high school diploma. Fewer people with a high school diploma/GED. More people with a college degree. A higher average household income. Fewer divorced people. More eligible women obtaining mammography. Lower rates of preventable hospitalizations. Fewer federally qualified health centers. More people commuting by bicycle. Fewer people commuting by public transit.
The racial make-up of a community was an important factor in its well-being.
"I was pleasantly surprised to see that a greater percentage of black residents was associated with higher well-being," Roy said. "After you account for income and education, places that are more racially mixed have higher well-being. Prior studies have shown that more diversity generally leads to more tolerance in the community and less overall stress and worry."
Another key factor was how many people commuted to work on a bicycle.
"This had a big impact on physical and mental well-being," Roy noted.
The third big factor in well-being was access to health care, especially preventive care.
"When people perceive that they have access to good medical care, it gives them peace of mind," Roy said.
Two factors Roy expected to see on the list that didn't make it were crime rates and income inequality.
Mary Rzeszut, a licensed clinical social worker in the department of behavioral health at NYU Winthrop Hospital in Mineola, N.Y., said the study underscores what hospital workers see every day.
"People who don't have access to health care have poorer outcomes and a decrease in well-being. The same is true for people with lower socioeconomic status," she said.
"The researchers really honed in on what we might do to bring forth well-being, and it will likely require thinking outside the box, like when Citibank sponsored the Citi Bike program in New York City to give people access to a bike and the ability to exercise. It helps improve quality of life and opens up other options to us," Rzeszut explained.
The study by Roy and colleagues was published online May 23 in the journal PLoS One.
More information
Read more about community well-being from the University of Minnesota ( https://www.takingcharge.csh.umn.edu/enhance-your-wellbeing/community/what-community-wellbeing ).
SOURCES: Brita Roy, M.D., M.P.H., assistant professor of medicine, and director of population health, Yale University Medicine, New Haven, Conn.; Mary Rzeszut, L.C.S.W., department of behavioral health, NYU Winthrop Hospital, Mineola, N.Y.; May 23, 2018, PLoS One, online
Article written by Scott Roberts