Online Health in the Developing World

sri-lankaFollowing on from Monday’s post about health information on twitter, it seemed a nice coincidence that I came across a research paper focusing on healthcare information available in the developing world.

The web is still relatively young and yet many people can barely remember a time when they could not simply click a mouse and gain access to health and medical information. Apparently, hundreds of millions of people regularly access the internet for the sole purpose of finding healthcare information, news about the latest medicines, and advice on every ailment and illness you can imagine and some you can’t.

According to Mahinda Kommalage and Anoj Thabrew, of the Faculty of Medicine at the University of Ruhuna in Sri Lanka, most research into such internet use has focused on health information in developed countries. There have been thousands of scientific papers published on this topic by Western researchers, but a mere handful of results on PubMed cite locations such as Sri Lanka, Nepal, and Bangladesh in keyword searches together with the word “internet”. Moreover, of the six results for “Sri Lanka and Internet”, just one study from 1999 is actually about a health website.

Kommalage and Thabrew suggest that given the enormous growth of Internet usage across the globe almost irrespective of geography, it is quite surprising that so little research into medical and health information sites in developing countries has been carried out. This is particularly worrying given the almost total lack of controls and regulations on medical information on the web.

The researchers have focused on health education websites in Sri Lanka in a survey of what is available. Their first discovery relates to the size of the website most (almost 90%) have fewer than 100 pages, which is barely enough to cover the basics. Moreover, while the quality of local non-commercial sites was higher than those owned by businesses fewer than one in ten provided health education content for the general public.

The notion that the internet might help the developing world improve its health status is not new. As long ago as 2000, the British Medical Journal published an article from WHO scientist Tessa Tan-Torres Edejer entitled “Disseminating health information in developing countries: the role of the internet”. A rare few related papers can be found with a little Googling, including one from Johns Hopkins’ Madhav Goyal and colleagues writing in JAMA who lament the fact that in poor nations invaluable healthcare information rarely reaches those who need it most.

I asked Gabriel Guimaraes a Physician at ASEFE in Brazil about the issue and he points out that the internet does reduce the differences. “This question has so many possible answers,” she says, “We could either talk about the evidence based medicine and everything related to it (MedLine, NCBI and Cochrane’s Metanalysis), which in Latin America would also relate to SCIELO database, or health record software which would relate for example to Health Informatics Societies (like SBIS), or about telemedicine. Anyway there is not much difference between developing and developed because we are talking about recent technology which has almost simultaneously started for every country.”

But, his conclusions do not bear up to the scrutiny of Kommalage and Thabrew, at least for Sri Lanka.

“The total number of websites has not increased compared to the increase in internet usage in Sri Lanka during the last few years,” the researchers say. If their findings apply to the wider developing world then the internet represents a massively underutilised health education resource in parts of the world where improved health education could be used to reduce significantly the incidence of many lethal diseases, such as malaria, HIV/AIDS, and parasitic infections.

For anyone interested in what is being done to redress the balance, check out antropologi.info blog and Health Information for all 2015. The raison d’être is the following fact:

Tens of thousands of people die every day, often for the simple reason that the parent, carer or health worker lacks the information and knowledge they need to save them.

Somewhat related to this post but more about scientific research than information is SciDev.net. Also of interest: Uneca, science with Africa.

Research Blogging IconMahinda Kommalage, Anoj Thabrew (2008). The use of websites for disseminating health information in developing countries: an experience from Sri Lanka Int. J. Electronic Healthcare, 4 (3/4), 327-338

Ionic Boron

Chemistry textbooks will tell you that you need at least two different elements to produce an ionic material. So, what to make of a paper in the journal Nature by Artem Oganov of the Swiss research center, ETH Zurich, and colleagus have simulated a superhard form of boron that contains ionic bonds.

The team was developing a computational method to help them predict the structure of various types of material and applied the technique to a newly synthesized form of pure boron that possesses some
unusual physical properties.

They were surprised to discover that this novel boron was more unusual than they could have imagined, revealing a degree of ionic bonding between boron atoms, that theoretically should not exist, but apparently do.

The new structure can be viewed as a NaCl-type structure, with anionic and cationic positions occupied by two different clusters of boron atoms (B12 and B2). The difference of the electronic properties of these clusters brings about charge transfer, making this material a partially ionic boron boride. the press release on this work says that boron is the chemical element most susceptible to changes in structure due to the presence of impurities. Maybe that’s the explanation…but of course it cannot be so, this is a computer simulation, there are no impurities.

The discovery could mark an important step towards a better understanding of boron. But, perhaps more intriguingly is that it beggars questions about what we mean by a chemical bond…

Health and Medicine on Twitter

health-on-twitterMy good friend Jo Brodie who works at DiabetesUK and twitters as @JoBrodie was crucial in helping publicise my recent scientists on twitter page. She recently gave the list a shout out on the PSCI-COM science communicators discussion group and added a few science tweeps of her own and a few in the health and medical communications area. So, here, with permission is Jo’s list:

Jo points out that if you’re “watching” an event unfold, there is usually a hash-tag associated with that event, whether it’s Obama’s Inauguration, the plane in the Hudson, the Mumbai bombings, or anything else of wide interest. For example, if the events at a conference are being live-blogged, then everyone talking about the event will usually use the agreed hash-tag e.g. #scienceconference, #scio09, #sciblog08. This makes the event easily searchable on twitter and is captured with all the other feeds mentioning that term. “Trending”, i.e increasingly popular terms are displayed on the twitter search page, or you can have them show up above the array of friends on the twitter page using a Greasemonkey script in Firefox.

You could also check out a ranked list of 100 health tweeps. Nice to see sciencebase ranking in the top 40.

*My add to Jo’s list.

I’m also occasionally adding to this list of medical types on twitter. Feel free to tweet it or leave a comment with your twitter ID:

Michael Bach
Cindy Oohlala
Eric Robertson
Terry Simpson
SwanL
Laikas
Bertalan Meskó
SearchMedica
vene2ia

For those unfamiliar with Twitter, a fairly useful slideshow:

Regelation experiment

Regelation is the process by which ice melting that is melting under applied pressure refreeze when the pressure is reduced. Gelation, to form a gel, regelation to form a gel again. Gel, here, being a synonym for freezing.

A simple experiment to demonstrate this phenomenon involves looping a fine wire around a block of ice, with a heavy weight attached to the wire and hanging freely below. The pressure exerted on the ice by the weight of the weight slowly melts locally where the wire is pressing on the ice. The wire can thus travel downwards through the ice and pass through the entire block. The ice above the wire, released from the pressure of the wire is able to refreeze.

Regelation Image from page 256 of "The Ontario high school physics" (1917)

The experiment works best if the ice is at ?10 degrees Celsius or colder and using a thin copper wire, i.e. a metal with high thermal conductivity. This is necessary to allow the latent heat of fusion (freezing) from the upper side of the wire to be transferred to the underside and so act as latent heat of melting. The exact details of how the processes work are not yet fully understood. It is worth noting that the phenomenon only occurs in water and other substances that expand, rather than contract, when they freeze.*

The regelation phenomenon was first described by 19th Century polymath scientist Michael Faraday.

*The fact that water expands when it freezes means that icebergs are less dense than liquid seawater and so can float. This is also related to how ponds and lakes freeze from the top down and so can stay liquid below an icy surface allowing life to survive within the cold liquid beneath.

Science News Updates

date-rape-analysisMy latest science news updates are now available on SpectroscopyNOW.com and ChemWeb.com, covering a wide range topics from date rape drug analysis to DNA that behaves parasitically and could underpin speciation and evolution:

Date rape analysis – Raman spectroscopy can be used to identify the date rape drug GHB and its precursor GBL in spiked drinks even if they’re in different types of drink or containers included coloured glass, plastic beakers, and polythene sample bags.

Parasitic genetic mobility – A stretch of DNA behaves like a parasite in the genome causes health problems but could explain certain aspects of evolution and speciation. The crystal structure of its protein reveals much about our ancient past and our possible futures

Nano MRI – Researchers at IBM working with a team at Stanford University have demonstrated MRI with a volume resolution 100 million times better than possible conventional systems. The technology could herald single-cell MRI and even allow protein interactions to be imaged clearly.

Getting inside bacteria with spectroscopy – Solid-state spectroscopy has been used for the first time to investigate large membrane proteins in bacteria, allowing researchers to investigate exactly how the sensory organs of these single-celled organisms function.

Ammonia caught on film – A sensor based on a composite plastic that conducts electricity (related to the materials used in OLED displays) can detect the poisonous gas ammonia very selectively and be ready to use again within seconds, unlike similar devices.

Taking the lead – Magnetic nanoparticles that can soak up lead from aqueous solutions, or even a blood sample, might be used to treat lead poisoning, but could have more immediate applications in diagnostics, biomedical research and environmental science.

The Alchemist discovers how to improve analytical chemistry by keeping things cool, how to improve anticancer therapy by lowering the dose and increasing frequency, and how to reduce lime scale in hot water appliances. Also this week a fall in air pollution has improved the life expectancy of Americans, melamine sentences have been passed in China, and pioneering global warming research earns geochemist Wallace Broecker one of the biggest cash prizes in science.

Salt Lowers Freezing Point of Water

bbc-snow-eventThis morning, my kids are listening eagerly to the local radio to hear if their school will be closed? Why? Because we’re in England, a few millimetres of snow has fallen, it’s a little chilly, and the nation is in chaos. Airports are shut, driving conditions are almost impossible, and schools are closing across the country. The radio meteorologists are telling us it’s the worst snow “event” since the early 1990s, although it was worse almost exactly twenty years ago as I seem to recall tramping to work in snow when I first moved to Cambridge.

Anyway, what has all this go to do with salt lowering the freezing point of water? Well, The Highways Agency, which looks after our main roads has had its fleet of gritter lorries spray pink grit across the roads. So, what is it they’re spreading? What is that grit? Well, it’s usually common salt, sodium chloride, but calcium chloride is also used.

Dissolving any compound in another will lower its freezing point slightly. So adding salt to water will lower its freezing point. Scattering salt on the roads therefore allows some salt to dissolve in the surface of snow and ice forming on the roads especially as the early cars put pressure on and briefly melt the very surface of any ice as they roll over it. The salt dissolved means that the temperature has to be that bit lower for water to remain frozen or to freeze further.

The same phenomenon, known to scientists as freezing point depression is the reason why the oceans, in all but the most extreme polar winter conditions, tend not to freeze. The salt content lowers the oceans’ freezing point so that conditions have to be a lot colder to make it freeze.

Freezing point depression

Freezing point depression, like boiling point elevation discussed previously on Sciencebase.com, is a colligative property. This means that the effect depends on the presence of dissolved particles and their number, but not their identity. Anything that dissolves in water will lower its freezing point. It does not have to be salt, indeed it does not have to be ionic like sodium chloride.

It is an effect of the dilution of the solvent in the presence of a solute. It is a phenomenon that happens for all solutes in all solutions, even in ideal solutions, and does not depend on any specific solute-solvent interactions. In other words, the explanation does not lie in some kind of interaction between the solute particles (the dissolved material, sodium chloride, usually used in the salt on roads case) and the solvent (the water ice on the roads) that prevents a solid from forming, it’s an entropy effect:

At the freezing (or melting if you’re heating a solid) point, the solid phase and the liquid phase have the same energy. The chemical potential of each is equivalent. Chemical potential depends on temperature, and at other temperatures the solid or liquid will be favoured over the other phase. At higher temperature, a liquid will exist, at lower a solid.

freezing-point-depression

Often, a solute will dissolve only in the liquid and not the solid solvent. If such a solute is added, the liquid is diluted, but its chemical potential does not change. To balance the energy books (you cannot create nor destroy energy), the equilibrium between liquid and solid shifts to a lower temperature, hence freezing point is depression.

Calcium chloride road gritting

So, why choose calcium chloride instead of sodium chloride for gritting roads? Well, both are readily extracted from brine, but CaCl2 has a subtle advantage over NaCl. Not only does calcium chloride shift that energy equilibrium when it dissolves in water so that the freezing point is depressed, it also releases heat when it dissolves in water. This has the distinct advantage of heating the surrounding ice, melting that and allowing more particles of solute to dissolve.

The dissolving process is highly exothermic and in the lab can produce temperatures of around 60 Celsius:

CaCl2 + 2 H2O –> CaCl2·2H2O

Aided by the heat evolved during its dissolution, calcium chloride is also used as an ice-melting compound. Unlike the more-common sodium chloride (rock salt or halite), it is relatively harmless to plants and soil; however, recent observations in Washington state suggest it may be particularly harsh on roadside evergreen trees. It is also more effective at lower temperatures than sodium chloride.

Regardless of the wonders of freezing point depression, at the time of writing, my kids were still huddled around the radio in the desperate hope that they are forced to stay away from school today and build snowmen in the garden and annoy each other with snowballs. And, whether they get to school or not you can rest assured that the “snow event” will continue to plunge Britain into chaos, at least that’s what the BBC will keep telling us.

Wrap up warm, now.