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February 2012
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1
2 © The Student Body 2012
Editorial Board
Sarah Parauda - Editor-in-ChiefMytien Nguyen- Design Editor
Susan Duan - Treasurer
AdvisorBruce Lewenstein
Produced by Mytien Nguyen, Jessica Ye, and Erica Johnson
TABLE OF CONTENTS
3
Medical Records and Genetic Test Results: Any of Employers’ Business?
Under Pressure
All in Your Head?
What are you putting in your mouth?
The Rise of Fitness App
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6
8
10
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Cover and Table of Contents graphics reproduced from [1- 2]
The Student Body is an undergraduate student organization affiliated with Gan-nett University Health Services. Publication of The Student Body is funded by SAFC.
The contents of The Student Body are the works of the authors and do not necessarily re-flect the views or beliefs of the organization, its affiliates, advisers, or Cornell University.
TABLE OF CONTENTS
4 © The Student Body 2012
Imagine a world in which employers evaluate you solely on the basis of externally imperceptible traits over which you have no
control. A world in which you’re barred from the career you’ve always dreamed of because of natural variation in your DNA. A world in which you have no say in your own destiny.
This could be our world, according to the 1997 science fiction film Gattaca, the title designed to contain the letters G, T, C, and A of the genetic code. But what was once sci-fi could become real-ity - especially when you consider the increasing availability of inexpensive genetic testing, the exciting prospect of an efficient nation-wide, digital medical records system, and businesses’ on-going hunt for ways to cut costs in a tenuous economy.
For $99, you can order a kit from the 23andMe genetic testing service (www.23andme.com), submit your saliva, and receive a detailed analysis of your genome for “over 100 traits and dis-eases.” This is accomplished by probing for SNPs (Single Nucleo-tide Polymorphisms), or variations in a single letter of a region of DNA, which indicate the presence or absence of a trait. The website assures its customers that “multiple levels of encryption and security protocols” protect their results, and cites GINA, the Genetic Information Nondiscrimination Act, as another measure safeguarding their privacy. This legislation, enacted in 2008, is designed to prevent health insurers from denying individuals coverage based on genetic predispositions to disease, and bars employers from considering genetic information when hiring, firing, or promoting employees.
The rationale for allowing employers access to the genetic test results or overall medical records of their current or potential employees is primarily economically motivated. By rejecting predisposed job applicants and eliminating employees prone to disease, employers would only have to purchase minimal health insurance for their workers, or may not have to offer health in-surance at all.
But would companies really go through all the effort of obtaining medical records or genetic analysis for each employee or poten-tial hire? If cutting costs and maximizing profits is a top priority, paying $99 to “protect” the company from an economic liability who could cost thousands of dollars in sick leave and drive up insurance premiums would probably be considered a worth-while investment. And even though discrimination on the basis
Reproduced from [3]
by Ariel Wampler
Medical Records and Genetic Test Results:
Any of Employers’ Business?
5
of genetic information is currently outlawed under GINA, there aren’t sufficient resources to prevent such discrimination in practice, and illegal corpo-rate routines could fly under the radar.
Because of the economic incentives involved, em-ployer access to private health information would inevitably be abused. Discrimination based on genetics is extremely unfair—simply having a ge-netic predisposition does not guarantee that a per-son will develop a disease. Studies after studies have shown that genetics can only account for half of the variation in intelligence and in likelihood of becoming overweight or obese—essentially, the effects of “nurture” (en-vironment and lifestyle) are just as significant as those “nature” endows, or encoded in our DNA. Refusing to hire some-one because he or she possesses a potentially disease-causing gene is analogous to refusing a woman because it is assumed that she will, at some point, take maternity leave and be a net cost to the company for several months.
Additionally, employers may not be able to under-stand genetic test results. They may throw out applicants or fire employees who they perceive as liabilities because they are at risk for Condition X, even if Condition X has little or no effect on an in-dividual’s ability to perform his or her job. And even if a person with genetic predispositions was hired, they may be treated with disdain when tak-ing sick leave, or feel pressured to stay and work even when they should be seeking treatment, and would be subject to a hostile work environment.
Moreover, if awareness of such discrimination became widespread, people may begin avoid-ing seeing their doctors, mentioning their health concerns, or getting genetic testing to be aware of their risks, out of fear that they wouldn’t be hired or be eligible to receive health insurance if their records were available to employers. But this would be extremely detrimental for public health, especially for individuals with chronic diseases—early detection and preventative measures facili-tated through genetic testing can save millions or even billions of dollars annually by curbing health problems before they require costly treatment.
A company should be more than merely a place you where you get paid to do as your boss says—it should be a special, supportive community where employees are valued for the unique contribu-tions and valuable personal qualities they bring to their jobs. But the practice of using health records in workplace to determine who is hired, fired, or promoted is dehumanizing—it sends the message that an employee is only worth as much work as the company can reap from them. Many people al-ready feel unappreciated and undervalued enough at their jobs, and the discrimination likely to occur
if employers could access medical information would only make this worse. Any sense of job security in the face of unforeseen circum-stances would be gone—and peo-ple should not have to live in con-stant fear that if their health takes a hit, their job prospects would suffer as well.
It is easy for a company to exclude someone based on their medical records or the results of a genetic test, but making that choice devalues the inher-ent merit of the determination it takes to over-come adversity, and assumes erroneously that people are powerless to resist genetic “fate.” At their core, medical re-cords are information, and whoever possesses information holds tre-mendous power. Like any kind of power, medi-cal information can be used to help or to harm. Therefore, we must be attentive to promote re-sponsible handling of medical records while also preventing their un-ethical use.
-Ariel Wampler, College of Human Ecology 2015
“paying $99 to “protect” the company from an
economic liability...would probably be considered a worthwhile investment.”
Reproduced from [4]
6 © The Student Body 2012
You’re sitting in Uris Hall, heart racing, taking an impossibly long prelim. There’s a paper due
tomorrow and presentation stuck impossibly be-tween. Stress doesn’t even begin to describe how you’re feeling as you wonder how 40% of your se-mester grade can possibly be determined in a day! The feeling of being under pressure is all too famil-iar to college students – and Cornell students are certainly no exception. Yet the pressure of classes, internships, friends, family, clubs and sports isn’t the only concern. Dramatic changes in lifestyles over the past several decades are trans-lating into higher blood pressure for young adults at an alarming rate. Previous estimates suggested that less than 5% of young adults exhibited elevated blood pressure. Yet, according to a long-term study initiated by the National Institutes of Health, the actual figure is expected to be nearly 1 out of every 5! Even more startling is that only approximately half of the af-fected young population is even aware of the prob-lem. High blood pressure is still more prevalent in the older population. Yet relatively recently it has be-come standard to include blood pressure mea-surements as part of the annual physical routine
for patients as young as 3 years old, revealing that high blood pressure can affect a person of any age. Indeed, a long-range study involving nearly 20,000 Harvard students demonstrates that those who have high blood pressure upon entering college are considerably more likely to face serious and potentially fatal complications from cardiovascu-lar disease. High blood pressure, formally known as hypertension, is often regarded as a silent condi-
tion because there are typically no noticeable symp-toms. Though some individuals experience dizzi-ness or dull head-aches, the generic nature of such
symptoms makes diagnosis problematic. This is particularly true for young people – and as a result, teenagers and college-aged individuals are much less likely to have their irregular blood pressure well-controlled with either medication or lifestyle adjustments. Additionally, the more pressing con-sequences develop gradually with persistent high blood pressure and are often not noticed until the condition has become critical. The delayed nature of the appearance of symp-toms often results in adolescents and young adults feeling lit-
“...teenagers and college-aged individu-als are much less likely to have their ir-regular blood pressure well-controlled with either medication or lifestyle ad-
justments.”
Under Pressure
7
tle concern over their blood pressure readings. Yet the long-term effects of consistently elevated blood pressure are quite serious. Most significant is the hardening of arteries resulting in advanced heart disease and potentially strokes. “Normal” blood pressure is characterized by consistent readings at or below 120/80 mmHg, though these values vary naturally with age and even during the course of the day. Most people with readings slightly above the specified norm are classified as pre-hypertensive, which indicates a much greater risk of developing hypertension in the future. However, even in this pre-hy-pertensive phase, any occurrence of higher blood pressure – even for just short period of time – can be damag-ing to the blood vessels of the heart, kidneys, brain and eyes. Though there is believed to be a ge-netic or familial component to the risk of developing hypertension, certain strategies can markedly reduce your risk. Stress, excess salt intake, alcohol consumption greater than 2 drinks per day, caffeine, smoking and a lack of sufficient physical activity are all documented contributors to high blood pressure as well as a host of other health issues. How many of us are guilty of going a little crazy with nighttime salty snacks? Or consid-ering the long walk to the quad to qualify as daily exercise? Or stopping by a café to pick up a coffee
on the way to morning classes? Even irregular or insufficient sleep is to blame. A 2008 study at Case Western Reserve University suggests that, for the younger population, getting fewer than 6.5 hours of sleep per night more than doubles the risk of high blood pressure. Naps in the library (or during class, for that matter) don’t count! Unfortunately, the college-aged population is par-ticularly susceptible to all of these risk factors.
The high-stress nature of pursuing higher education, as well as other personally stressful situations, can cause sharp spikes in blood pres-sure. When experiencing stress, the body produces hormones that nar-row the blood vessels and increase heart rate, thus temporarily raising one’s blood pressure. Though these elevated blood pressure readings are typically temporary, researchers
have hypothesized that the cumulative effect is likely to be long-term hypertension later in life. The good news? Recent studies by Brown Uni-versity researchers show that merely obtaining a college education increases a person’s chance of maintaining a healthy blood pressure throughout adulthood. That’s a start! Just don’t let the high-pressure environment of college translate into high blood pressure.
By: Alison JarmasReproduced from [5]
Reproduced from [6]
8 © The Student Body 2012
Impairment. Deficiency. Disability. It wouldn’t be right to assume that you’ve
never associated any of these adjectives with the mental “disorder” known as autism. But, how ac-curate are these descriptions in the first place? People with autism have a neurological disorder, a developmental disability. However, the “issue” of autism may not be as crystal clear as one is led to believe. True, we may define autism using biological differences, but the problem may go deeper and spread wider than just that. For-get the cellular level. Autism may not even be a disorder, at all. And it may be affecting the social level all the more potently. The National Institute of Neurological Disorders and Stroke (NIMDS) defines autism as a range of neurological disorders dealing with commu-nication, socializing, and repetitive, stereotypi-cal behavior. Symptoms of autism may include a preference for objects over people, decreased social interactions, and even self-abusive behav-ior. Currently, three forms of autism are recog-nized: autistic disorder, Asperger syndrome and Pervasive Developmental Disorder-Not Otherwise Specified ( PDD-NOS), with autistic disorder be-
ing the most severe. Usually, children with some, but not enough, symptoms of autisticm disorder are diagnosed with PDD-NOS while children with symptoms, but well-developed language skills, are instead diagnosed with Asperger Syndrome. Regardless, the three categories still fall under the same, general umbrella of autism, which psychia-trists and doctors have been using for years. Despite the fact that we have done much research on the subject of autism, the causes have not yet been identified. As with most “disorders”,
researchers believe that both genetics and the environment play a role, but neither a specific gene nor environmental fac-tor has been identified. In addition, no cure has been
discovered. Currently, several classes of “treat-ment” exist, including: educational interventions, medication and various therapies, with earlier in-terventions being the most effective. Regardless, individuals with autism are rarely “cured.” Indi-viduals with autism just learn to live with their autism and with a society that fluctuates from accepting to rejecting them, rather than actually receiving any biological intervention.
“...autism should be treated less as a disorder and more
as a ‘difference’.”
All in Your Head?
By Elizabeth DenningReproduced from [7]
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Currently, the APA is debating a sensitive topic concerning autism, namely the specific defi-nition of their “created-disease.” Every ten years, or so, the APA publishes an updated, revised edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual provides, in simplified terms, the criteria for mental disorders listed. The last edition was published in 1994 and the next is due in just over a year: May 2013. This edition will include several revisions. Much atten-tion has been brought to the proposed changes concerning the autism article, which will most prominently feature the combination of the three types of autism aforementioned into one over-arching, main classification of autism. Naturally, the planned altera-tion of the defini-tion has aroused much controversy in both autistic and non-autistic members of soci-ety. Some, like Simon Baron-Cohen, a professor of psychology at the University of Cambridge, claim that autism should be treated less as a disorder and more as a “difference.” After all, just because someone takes an interest in something other than human interaction doesn’t mean he or she is necessarily disabled. Why should those with au-tism who take interest in objects over people be any different? In addition, while surrounded with a supportive environment, many autistic people are able to succeed both personally as well as pro-
fessionally. The APA, however, disagrees with Baron-Cohen, calling autism “the most severe devel-opmental disability,” a definition that is widely accepted by the public. As long as people continue to view autism as such a negative disorder, this “social disease” will only continue to escalate. On the other hand, many worry—perhaps rightfully so—that this narrowing of the defini-tion will reduce healthcare benefits for many autistic people. Because the APA singlehand-edly decides the definitions of numerous mental disorders, many fear that their lone decision will lead to a lessening of social benefits for those
with autism and a rever-sion to the stereotype that autistic people are “freaks.” Whether positive or negative, this revision of the definition of autism will have a widespread
impact and the public should take note. In addi-tion, the stigma of autism should be brought to the forefront of the current debate instigated by the APA’s new edition of the DMS. The floor will open for debate this coming spring. With that said, perhaps, autism is not all in the head, after all. In addition, maybe the “cure” needed for autism isn’t biological at all. The cure may very well exist in the air, all around us. And maybe it’s up to us to try and find it.
“this revision of the definition of autism will have a widespread im-pact and should be noted properly
by the public”
All in Your Head?Re
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10 © The Student Body 2012
The alarm clock buzzes. It’s 8:30 in the morning and you are thinking why the heck did I sign up
for a 9:05 class? Oh that’s right . . . you got blocked out of all of your 10:10 or later classes on sign up day . . . . Well, you force yourself to get out of bed. You grab the cereal box on the desk and you pour some out into a bowl. You start to eat. There’s something dark on one of the pieces of cereal, but you pass it off as being burnt and eat it anyway. As you walk to your first class, a dragon appears out of nowhere and begins to chase you. An as-tronaut floats by you and a professor comes up to you and tells you that you are exempted from all of your prelims this semester. Guess what? You’re hallucinating . . . What could have caused your hallucina-tions? One answer may be that you have contract-ed a foodborne illness. A foodborne illness can be caused by several factors such as microorganisms, toxins and allergic reactions. One organism that may have caused your hallucinations is a Claviceps fungus. These fungi produce hard, black clumps and are found on products made from grains such as wheat, rye, barley, rice and oats. These fungi thrive in wet, cool conditions. That burnt piece of cereal was probably not burnt. Instead, it was
probably contaminated by hard, black fungal products. You probably have contracted what is called ergot, an extremely rare foodborne illness. Symptoms include gangrene in the extremities, feelings of being burned and hallucinations. This foodborne illness has been known to be fatal. In-terestingly, it may have also been the cause of the hallucinations noted in the Salem Witch trials in 1692. Later that day, after recovering from your ergotism, you sit down at the dinner table and there is a plate of chicken ready to eat, right in front of you. Do you stop to think what you are about to eat? Probably not. You assume that it’s just chicken, maybe with some herbs or in a fancy sauce. You begin to eat. An hour later, you start to feel queasy and you rush to the bathroom. And then it hits you. Maybe you should have thought about what you were putting in your mouth an hour before. Now, what might have been on the chicken dinner that caused you so much discomfort? The first bacterium that comes to mind is Campylo-bacter jejuni. In the United States, C. jejuni is the foremost cause of bacterial diarrhea illnesses. Studies have shown that as few as 500 C. jejuni
By Biagio DiSalvo
What Are You Putting
In Your Mouth?
Reproduced from [9]
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cells or perhaps even fewer are needed to infect a human. Symptoms can manifest themselves 1 to 11 days after consuming contaminated food, although they usually appear within 2 to 5 days. The initial symptoms are mus-cle pain, headache and fever. Nausea is common, but vomit-ing rarely occurs. The number one symptom is watery diar-rhea, while deaths are rare. But how could this bacterium have gotten onto the chicken in the first place? C. jejuni naturally lives in the intestinal tract of chickens. While the chicken is being eviscerated (gutted), some of these bacteria can spill onto the meat of the chicken. C. jejuni may have been the culprit that caused your digestive woes, however, there are many more microorganisms that produce nasty effects on the human body. Consider Clostridium botulinum which is more commonly found on meat (pigs, goats, cattle, sheep) and fish rather than poul-try. You can also find it in foods that are canned or in other air tight conditions since C. botulinum is an obligate an-aerobe (it only grows when there is no oxy-gen). C. botuli-num produces a very dangerous poison, a neu-rotoxin called botulinum tox-in which causes muscle paraly-sis. As few as 100 spores of the C. botulinum or the ingestion of preexisting botulinum toxin on food is enough to contract the disease common-ly called botulism. The first symptoms can appear between 12 and 36 hours after eating contaminat-ed food, however, there have been reported cases of patients who experienced symptoms within 4 hours and as late as 8 days. Common symptoms are double or blurry vision, dry mouth, muscle weakness, and difficulty swallowing, talking and breathing. Botulism is a very serious disease that
can lead to death or serious repercussions if not treated quickly. Paralysis of the respiratory sys-tem usually causes death. See a doctor right away if you suspect that you may have contracted botu-
lism. There are several ways in which the contamination of food can be avoided. Here are some tips to minimize your chances of contracting a food-borne illness. Tip One: Make sure all utensils are properly cleaned after use or use new
utensils after the food is properly cooked! Cross contamination is a very common cause of food-borne diseases. People often use the same utensils to prepare food as they use after the food is cooked. Contaminants can pass from the used utensils to the cooked food. Tip Two: Wash your hands be-fore cooking! Different types of bacteria are pres-ent on human hands, and if hands are improperly washed or not washed at all, these bacteria can be transferred over to the food. Tip Three: Refriger-ate your food! Refrigerators slow down the growth of bacteria that may be living on the food. By re-
frigerating the food, it will last longer and be healthier to eat. Tip Four: Cook your food prop-erly. If food isn’t cooked all the way through, the chances of dangerous m i c r o o r g a n -isms surviving is much higher. Therefore, look up the suggest-ed internal tem-perature of the
food you wish to cook before you start cooking. Remember, foodborne illnesses can be dan-gerous and should not be taken lightly. Contact your doctor if you believe that you have contract-ed one and take the medications your doctor may prescribe to you. This being said, enjoy food to its fullest and have a plan in advance to avoid taking any 9:05 classes.
“...foodborne illness can be caused by several fac-tors such as microorgan-isms, toxins and allergic
reactions.”
Reproduced from [9]
Reproduced from [10]
12 © The Student Body 2012
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I’d like to introduce you to my new friend. She’s very kind and encouraging, regu-
larly spouting out phrases such as “Get mov-ing, Sarah,” “Let’s go, Sarah,” and my personal favorites, “I like you, Sarah” and “Hug me, Sar-ah.” She’s rather petite at one inch tall, and she spends most of her life clipped clothespin-style to my waistband, meticulously counting the number of steps I take. What is this strange creature, you ask? She is none other than my Fitbit wireless ac-tivity tracker, one of the many gadgets to recently emerge for the purpose of getting “Generation App” back into shape. While the Fitbit is on the pricey side for what essentially boils down to a clip-on pedom-eter and calorie-counter, selling at $99.99 ac-cording to Fitbit.com, there are plenty of other gadgets and smartphone apps now available at much lower prices. For example, the “Lose It!” app is free on iTunes and is an effective way of keeping a “calorie diary.” The app calculates your daily caloric intake based on your current weight, age, gender, and weight loss goals, and offers a catalogue of nutritional information for a wide array of foods so that you can log your meals and stay on target. Lose It! doesn’t automatically keep track of your daily exercise like the Fit-bit, but if you know roughly how long you worked out for and at what intensity, the app can make a good estimate of how many extra calories you burned that day. Not all of these new fitness apps are for counting calories. There are ones specifically designed for new runners (e.g. Couch-to-5K) and yoga-lovers, among others. But the common theme appears to be overall health and wellness.What do these fitness apps mean for our genera-
tion? In my opinion (but perhaps my sycophantic Fitbit has brainwashed me), they represent a po-tential solution to our nation’s obesity problem—the numbers are now at 33.8% of U.S. adults and 17% of children and adolescents struggling with obesity, according to the Centers for Disease Con-trol. Why not take advantage of the burgeoning technology industry to combat a serious prob-lem? These apps are almost perfectly tailored to human nature: typically they reward you for reaching goals (it’s amazing how motivating a dig-ital badge can be when it says you’ve climbed the height of an average helicopter), provide you with a support network/source of competition in the fellow app users who flaunt their achievements on various social media, and leave little room for “cheating” in their accuracy. It may be tedious at times, and your friends may start to get annoyed when you spend ten minutes before every meal
hunched over your phone, entering everything you’re planning on eat-ing into your daily food log, but it may be well worth the effort. At the very least, these apps help you form good habits that will
stick with you in some form, even if you quickly get fed up with obeying the perky software pro-gram of your choice. Maybe I’ll eat my words when we start serving our fitness app overlords in a few years. But for now, I’ll keep in step with my Fitbit.
The Rise of the Fitness App
By Sarah Parauda
Reproduced from [11]
Reproduced from [12]
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Have Something to Say? Be Heard.
Write for The Student Body.
contact: Sarah Parauda (scp69)
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Photo References1 . h t t p : / / w w w. f l i c k r. c o m / p h o t o s / g e o r g e b u s h l i -brary/6276870163/ 2.http://www.flickr.com/photos/mikebaird/3195053131/3.http://news.byu.edu/archive08-nov-dnasequencer.aspx4.http://www.bearishnews.com/post/36245.http://1.bp.blogspot.com/-_fnNWuvfEnI/TaxVABMCtwI/AAAAAAAAAIk/LI6boyPS8-k/s1600/heartbeat.jpg6.http://www.flickr.com/photos/mortonfox/359030918/sizes/o/in/photostream/7.http://www.flickr.com/photos/wactout81/4786691139/sizes/l/in/photostream/8.http://www.flickr.com/photos/wactout81/4786691139/sizes/l/in/photostream/
9.http://www.flickr.com/photos/lynac/476729014/sizes/l/in/photostream/10.http://www.flickr.com/photos/ugacommunica-tions/6299070668/sizes/l/in/photostream/11.http://www.flickr.com/photos/alper/5669465400/sizes/z/in/photostream/12.http://www.flickr.com/photos/playerx/4012662559/sizes/m/in/photostream/13.http://www.flickr.com/photos/lululemonathleti-ca/43125216114. http://www.flickr.com/photos/elwillo/4355765412
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16 © The Student Body 2012
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