We could do a lot to improve public health and reduce runaway medical expenses if we focussed more on preventing disease and less on medical fixes, says Gary Bennett. 

Bennett is a professor of psychology and neuroscience at Duke University. 

Transcript:

From Duke University, this is “Glad You Asked,” where we consider the question, “What should we be talking about this election season?”

"I’m Gary Bennett. I’m a professor of psychology and neuroscience at Duke. I think we should be talking about the idea that good policy is better than medicine. The problem that we have in the U.S. right now is that we have healthcare costs that are just spiraling completely out of control. And this is really unsustainable. 

And if you look at what we’re dying of, there are things like cardiovascular disease, cancer, diabetes. These are all mostly preventable conditions. And then the burden of those conditions falls disproportionately on the poor. And if you can’t get behind the moral imperative to fix that problem, then I think you have to get behind the economic one, which is, we just can’t afford it. 

The good news here is that if you look at these leading killers, you can seriously mitigate your risk by doing some extremely common sense, very simple things. Things like never smoking, losing weight, eating a healthy diet and being physically active. For those four conditions, we have good treatments. But they all require high levels of motivation. And we know that a lot of the American population just is not motivated to improve their obesity and their diet and their physical activity and their smoking rates. 

And that’s where good policy comes in. Because good policy can help to structure environments in a way that the default choice is always a healthy choice. So we really need to be thinking about the kinds of policies that can make our world a place where it’s easier to be healthier. In the area of physical activity, what would really help is for us to create neighborhoods that had greater street connectivity, to increase the number of sidewalks, to increase our bike lanes, to really make our physical environments conducive to physical activity. And that requires good public policy. It requires investments in our physical infrastructure.

In the area of obesity, we have good examples here in North Carolina of policies that are designed to make it easier for corner store operators to offer healthy fruits and vegetables. These are really important policies that can add meaningfully to the health of Americans."

You’ve been listening to “Glad You Asked.” To subscribe, visit bitly.com/gladyouaskeditunes. Again, that’s bitly.com/gladyouaskeditunes. 




Sidewalks Versus Surgery {Glad You Asked, Episode 23}

Our society gives the mentally ill short shrift, so much so that "we'll look back on it in 100 years' time as absolutely appalling," says Jane Costello. 

Severe mental illness burdens families, taxes the criminal justice and shortens lives. And we'll continue to pay those heavy prices until we take the issue seriously, Costello says. 

Costello is a professor in the psychiatry department at the Duke University School of Medicine and the Duke department of psychology and neuroscience an associate director of the Duke Center for Child and Family Policy.

Turning Our Backs on Mental Illness {Glad You Asked, Episode 30}

The United States has long been a magnet for scientists from all over the world. With both science and immigration under attack, Raphael Valdivia wonders if that legacy is at risk. 

"Glad You Asked" is a series of short commentaries by Duke experts on issues that deserve public attention. In Season 2, Duke experts share a question they would like to pose to our nation's new president -- and describe why that question matters.   

Valdivia is a professor of molecular genetics and microbiology in the Duke University School of Medicine and vice dean for basic science at Duke University.

Photo of the Noor lab at Duke University by Duke Photograpy.

Transcript:

From Duke University, this is “Glad You Asked.” A new administration in the White House means new issues on the table. So we wondered, if you could ask our new President one question, what would it be?

“My name is Raphael Valdivia. I’m a professor of molecular genetics and microbiology at the School of Medicine. I’m also the vice dean of basic sciences at Duke University. 

“President Trump, I am a scientist and an immigrant. And my question for you is, ‘Am I welcome here?’ 

“I was born and raised in Lima, Peru. I left there to attend college here. Once I got here, that’s when I discovered a passion for the sciences, for discovery, for knowledge. And it was very much a sense here in the United States that that was valued. To be curious, to be creative, to be an intellectual was never a dirty word. 

“And it is really in the last decade or so where that has become a problem. So the support for sciences, I’ve seen it erode at the beginning in the context of climate science. And certainly funding of the NIH, of NSF, of the EPA, of the USDA, of all these different government agencies
-- the erosion of that foundation just percolates to the entire system. 

“So there’s me as a scientist, but there’s also me as an immigrant. Many of the scientists in the United States actually were born abroad, and they came here really looking for opportunities and to tap onto this excitement about discovery and knowledge. The U.S. is the magnet, you know, we come here because we know the possibilities. We bought into the dream. 

“And I had never really felt until the last couple of years, especially after the election, that I would be judged by how I would look as opposed to what I can bring to the table. Now that I suddenly feel that I may not be welcome, for the first time in 30 years that I’ve been here, I have second guessed whether I made the right decision or not when I decided to come here to work, live and have a career in science.”

This is Glad You Asked. To subscribe, visit bitly.com/gladyouaskeditunes. That’s bitly.com/gladyouaskeditunes.

Is America Still a Beacon for Immigrant Scientists? {Glad You Asked, Season 2, Episode 3}

Ken Poss, PhD, James B. Duke Distinguished Professor of Cell Biology and Director of the Regeneration Next Initiative, explains how salamanders can regenerate limbs and discusses what implications that has for the future of human limb regeneration.

Transcript

Lindsay Key: 
Welcome to Headscratchers, a mini-cast from the Duke University School of Medicine. We ask Duke experts to help us understand the questions in science that have us scratching our heads. Today we're speaking with Dr. Ken Poss, an expert in human regeneration. We asked him: Dr. Poss, I've heard about how a salamanders’ limbs can regrow after being amputated. How do they do that? And why can't human limbs do the same thing?

Dr. Poss:
When a mammalian species loses an arm? Well, first, there's a lot of bleeding. There's clotting, there's inflammation. And ultimately what happens is, it forms a scar to limit the damage and that limb will form a stump that can be adequate for the rest of that animal's life. Now, salamanders, it's different. After an amputation, there's bleeding. There's clots. There's inflammation -- those first things happen.  

But then something special happens, something that's really important for regeneration. And that is the formation of a structure called the blastema. And a blastema is a unique structure in biology, even kind of hard to describe. Many have considered this similar to a tumor. It's a mass of cells that continues to grow, and it forms kind of a ball of proliferative, or dividing, cells. But in many other ways, it's nothing like a tumor, because that blastema has all of the information needed to recreate that limb. A new limb essentially sprouts from the blastema; really fascinating. 

We are on our way to understanding how to stimulate something similar in, say, an injured human limb. I think something people may not realize is that we humans are actually really good at regenerating certain things. So while we can't regenerate something like an amputated limb, we can regenerate our blood, our liver; our intestinal lining is continually regenerating. I think humans have the general machinery where it's possible, with the right manipulations -- we will be able to make human limbs regenerate at some point in the next decade, two decades, 50 years. It's going to be very exciting. We really might be able to change things.

Lindsay Key: 
Thanks for listening. This podcast was produced by the Duke University School of Medicine music by Blue Dot Sessions. Visit us online at headscratcherspodcast.duke.edu, or subscribe on iTunes or SoundCloud. If you like us, leave us a review.
Medical Disclaimer & Terms of use at https://bit.ly/2LrjWdh

Headscratchers: Salamanders Can Grow Back Amputated Limbs—Why Can’t We?

Duke University School of Medicine is one of the nation’s top medical schools.

Headscratchers: Salamanders Can Grow Back Amputated Limbs—Why Can’t We?

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