Is maternal health better in societies with more older women?

Is maternal health better in societies with more older women?

Do post-reproductive aged females promote maternal health? Preliminary evidence from historical populations” by Alison Gemmill  and Ralph Catalano is now published in final form in Evolution, Medicine & Public Health. Open access. 

 

Background and Objectives: Much literature argues that natural selection conserved menopause and longevity in women because those who stopped childbearing helped bolster daughters’ fertility and reduce infant mortality among grandchildren. Whether the presence of grandmothers ever improved fitness sufficiently to affect longevity via natural selection remains controversial and difficult to test. The argument underlying the grandmother and associated alloparenting literature, however, leads us to the novel and testable prediction that the presence of older women in historical societies could have affected population health by reducing lethality associated with childbearing.Methodology: Using historical life table data from four societies (Denmark, England and Wales, France and Sweden), we test the hypothesis that death rates among women initiating childbearing declined when the societies in which they were embedded included unexpectedly high frequencies of older women. We use time series analysis to measure the extent to which the observed likelihood of death among women aged 20–24 differs from statistically expected values when the number of older women grows or declines.

Results: In three of the four countries examined, we find an inverse relationship between the frequency of post-reproductive females in the population and odds of mortality among females at the peak of childbearing initiation.

Conclusions and Implications: Results suggest that the presence of older women in a population may enhance population health by reducing mortality among women who face high risk of maternal death, although additional research is needed to determine if this relationship is causal.

BMJ recommends against full course of antibiotics–End of a medical mistake?

BMJ recommends against full course of antibiotics–End of a medical mistake?

This week’s British Medical Journal has an article “The antibiotic course has had its day,” by Llewelyn et al., that recommends against taking antibiotics for a full standard course. It goes further to challenge the WHO advice to take antibiotics “exactly as prescribed,” and suggests that cessation of symptoms is a better indicator of when to stop. This is welcome, and about time. However the bad advice doctors have given their patients for decades results from ignorance about evolutionary biology. The BMJ article does not use the word “evolution” or the phrase “natural selection.” It does not cite the work of evolutionary biologists who have analyzed this problem for years. Instead, it relies on brute empiricism. When will medicine incorporate sophisticated evolutionary biology so it can avoid making such mistakes?

The article is behind a paywall, but here are choice bits.   “in materials supporting Antibiotic Awareness Week 2016 WHO advised patients to “always complete the full prescription, even if you feel better, because stopping treatment early promotes the growth of drug-resistant bacteria.”  However the article goes on to say, “the idea that stopping antibiotic treatment early encourages antibiotic resistance is not supported by evidence, while taking antibiotics for longer than necessary increases the risk of resistance.” “Outside hospital, where repeated testing may not be feasible, patients might be best advised to stop treatment when they feel better, in direct contradiction of WHO advice. Of note, a recent clinical trial found that using fever resolution to guide stopping antibiotics in community acquired pneumonia halved the average duration of antibiotic treatment without affecting clinical success.”

“The fallacious belief that antibiotic courses should always be completed to minimise resistance is likely to be an important barrier to reducing unnecessary antibiotic use in clinical practice and to developing evidence to guide optimal antibiotic use. The idea is deeply embedded, and both doctors and patients currently regard failure to complete a course of antibiotics as irresponsible behaviour.”

Llewelyn, M. J., Fitzpatrick, J. M., Darwin, E., SarahTonkin-Crine, Gorton, C., Paul, J., … Walker, A. S. (2017). The antibiotic course has had its day. BMJ, 358, j3418. https://doi.org/10.1136/bmj.j3418
Royal College of Psychiatrists Interest Group Meeting 12 Jan, 2018

Royal College of Psychiatrists Interest Group Meeting 12 Jan, 2018

Second Symposium of the Evolutionary Psychiatry Special Interest Group (EPSIG) 12 January 2018
Royal College of Psychiatrists 21 Prescot Street London E1   Book online now 

EPSIG Newsletter available here

Time

Session

9.00-9.30

Registration and coffee

9.30-9.35

Welcome
Dr Riadh Abed EPSIG Chair

9.35-12.20

Morning Session
Chair: Professor George Ikkos

9.35-10.05

Evolutionary Models of Mental Disorders (I) ADHD
Dr Annie Swanepoel

10.15-10.30

Q&A

10.30-11.20

Keynote: What Clinicians Can Learn from Evolutionary Psychiatry
Professor Alfonso Troisi

11.20-11.35

Q&A

11.35-12.05

Evolutionary Models of Mental Disorders (II) Eating Disorders
Dr Riadh Abed

12.05-12.20

Q&A

12.20-13.20

Lunch

13.20-17.00

Afternoon Session: Chair: Dr David Geaney

13.20-14.10

Keynote: An Evolutionary Account of Brain Laterality
Dr Iain McGilchrist

14.10-14.25

Q&A

14.25-15.15

Keynote: Life History Theory: A Framework for the Understanding of Personality Disorder
Professor Martin Brüne

15.15-15.30

Q&A

15.30-16.00

Coffee Break

16.00-16.30

Evolutionary Models of Mental Disorder (III): The Addictions
Dr Paul St John-Smith

16.30-17.00

Q&A

17.00-17.30

General Discussion and Close

 

This meeting qualifies for 6 CPD points subject to peer group approval (CPD Certificates will be issued at the end of the meeting)

A conference dinner will be held at 7pm on 12 January. This is optional and is booked separately.

Special Lancet series about Evolution and Public Health

Special Lancet series about Evolution and Public Health

This week’s issue of The Lancet has three articles in a landmark series about evolution and public health: an overview, an article about human microbe interactions, and the third about reproductive health. All are behind a paywall, but the accompanying  editorial is open access. Its final paragraph reflects the journal’s concern about  publishing articles about evolutionary biology: “The Series may be challenging to public health practitioners vested in action. For those working to advance broader social and political change to enhance public health and reduce disparities, the use of evolutionary theory may feel too reductionistic. We welcome readers’ engagement with and response to this fascinating and thought-provoking Series.”  It will be interesting to see if they get the criticism that they anticipate.

These are the first major review articles on evolution and medicine or public health to appear in any major medical journal. Work on them began at an October 2014 Workshop sponsored by the ASU Center for Evolution and Medicine.  Jonathan Wells took the lead in editing the series.

Lancet, T. (2017). What can evolutionary theory do for public health? The Lancet, 390(10093), 430. https://doi.org/10.1016/S0140-6736(17)31998-0

Wells, J. C. K., Nesse, R. M., Sear, R., Johnstone, R. A., & Stearns, S. C. (2017a). Evolutionary public health: introducing the concept. The Lancet, 390(10093), 500–509. https://doi.org/10.1016/S0140-6736(17)30572-X

Jasienska, G., Bribiescas, R. G., Furberg, A.-S., Helle, S., & Mora, A. N. la. (2017). Human reproduction and health: an evolutionary perspective. The Lancet, 390(10093), 510–520. https://doi.org/10.1016/S0140-6736(17)30573-1
Rook, G., Bäckhed, F., Levin, B. R., McFall-Ngai, M. J., & McLean, A. R. (2017). Evolution, human-microbe interactions, and life history plasticity. The Lancet, 390(10093), 521–530. https://doi.org/10.1016/S0140-6736(17)30566-4

 

In Memory of Jeremy Taylor, Associate Editor

In Memory of Jeremy Taylor, Associate Editor

Jerry Taylor passed away July 17, 2017, at age 70 from pancreatic cancer.  He was an enormous force for good in the field of evolutionary medicine, and a wonderfully creative, critical, and energetic Associate Editor for the Evolution & Medicine Review. He is survived by his son Linus, and his wife, the actress Barbara Flynn. 

I first met him at evolution and medicine meeting in the UK in 2010, but was only when the University of Chicago sent me proofs of his book, Body by Darwin, that I recognized that the field had a new champion. His background was as a producer for BBC television, where he created many films for the Horizon series, and many more for other science channels, but his writing and scientific acumen were unparalleled.No one else has tackled multiple big topics including cancer, Alzheimer’s disease and autoimmune disease by mastering the relevant science, getting personal interviews with the scientists, and even finding patients who talked eloquently about how an evolutionary perspective changed their view of their disease, and sometimes even its treatment. This required not only industry and intelligence, but extraordinary social and organizational skills that are equaled by few.  If you have not read his book yet, get a copy now and prepare to enjoy yourself 

After the book came out, to wide appreciation, Jeremy and I talked about his possible contributions to the EMR. I thought he might write an occasional article, but soon he was writing eloquent essays twice a week, bringing new insights to the entire community. Readership rose sharply. He wielded his critical faculties firmly but gently.  He was a consummate editor.  I asked him if  he would like to become the Editor. In typical modest fashion, he said no, he thought it was better if he just continued as the Associate Editor. However, he kept coming up with great ideas for how The Evolution & Medicine Review could become more interesting and more useful to its readers. In my last Skype with him just a few weeks ago. he was full of new ideas and eager to write more for the Review despite knowing his prognosis was grim. He loved the Evolution & Medicine Review, and it joined with his intelligence to infuse his many posts. 

Some people you just plain like and admire and enjoy spending time with. Jeremy was one of those. His curiosity and wide range of knowledge and good humor made him someone everyone wanted to be with, and someone who will be missed very much by all who know him, and even by many who know him only through his prose.

For those in London, here will be a celebration and cremation  on Monday 7th August at 2pm prompt at St Marylebone Crematorium.  Donations  made in his name to the UCL Hospitals Charity. fund. will go straight to the lab of Professor Charles Swanton (The Crick Institute and UCLH) whose team is focusing on the cancer that killed Jerry.

NYTimes feature on Trumble’s paper on ApoE4 and Alzheimer’s disease

NYTimes feature on Trumble’s paper on ApoE4 and Alzheimer’s disease

“An Ancient Cure for Alzheimer’s?” is the title of Pagan Kennedy’s article in this week’s New York Times Sunday Review about the paper by Ben Trumble, et al., showing that the allele that increases risk of Alzheimer’s disease in most people causes decreased risk in foragers from the Tsimane population in Bolivia who are carriers of intestinal parasites. Her article is available here. 

The original scientific report, cited below, is available here.

Trumble, B. C., Stieglitz, J., Blackwell, A. D., Allayee, H., Beheim, B., Finch, C. E., … & Kaplan, H. (2017). Apolipoprotein E4 is associated with improved cognitive function in Amazonian forager-horticulturalists with a high parasite burden. The FASEB Journal31(4), 1508-1515.