Showing posts with label Birth. Show all posts
Showing posts with label Birth. Show all posts

January 10, 2018

Age and Aging Societies

It is common knowledge that Western societies are facing demographic change. But why is it a problem everyone is concerned about?

Germany's Demographics 
Demography is the social science dealing with statistical measures of populations, including humans. It analyzes several features of populations (including age, health, reproduction as well as migration, education and religion) in order to extrapolate future development. In Germany, the Federal Statistical Office which monitors demographics, estimated the number of inhabitants in 2014 to be more than 80 million people (the 16th most populous country in the world). The estimated average life expectancy is 81 years and the fertility rate is 1.4 children per woman [1] (in contrast to Somalia where life expectancy is less than 50 years and the fertility rate is 6.4 [2]).

Paying it Backward? 
These numbers summarize what the demographic change looks like: higher life expectancy with fewer births. People live longer due to better hygiene and medical care. In addition, the more young people are educated and socio-economically situated, the fewer children they have. This is called the demographic-economic paradox [3]. Especially in Germany, the demographic change is critical as the social and health insurance systems are based on an idea called the intergenerational contract (Generationenvertrag). This system, implemented after the Second World War, required jobholders to pay taxes into a pay-as-you-go system to provide financial security for a limited number of elderly retirees [4].
Back then, considering the shape of Germany's population pyramid, the system made sense. People born in these years (1945 -1965) are today commonly referred to as baby boomers [5], which justifies this concept. However, birth rates dropped steadily by 1967, plateauing since 1990 to their current levels. But, low birth rates do not keep people from aging, they only lead to fewer people taking care of an increasing number of older people. Thus, aging of the population is a socio-economic problem, which has to be addressed by significant changes in the financing of social pension programs.

Bevoelkerungsentwicklung DeutschlandAdapted from Wikipedia bit.ly/1PMBcCr


Healthcare and Aging Populations 
Retirees are getting older: With improved medical care, the life expectancy at birth rose from an average 50 years in 1900 to an average 78 years in 2008, with women living several years longer than men [6]. Unfortunately, most people do not remain healthy in old age, but develop several age-related comorbidities.
This adds to the socio-economic costs of an aging society, as healthcare burdens increase, with rising costs and a lack of staff. To make things worse, the diseases of the elderly will be accompanied not only by an increase in the number of cases, but also an increase in complexity. Although personalized therapy is a promising solution for many diseases, it requires more extensive diagnostics – this eventually leads to imbalances in the ratio of workload to qualified personnel in the medical sector [7].
In addition, the changes in household structure also play a major role in the outbreak and spreading of infections. In the olden days, families were large and infections spread easily, whereas now families are much smaller. Today, however, those opposed to vaccination ("anti-vaxxers") make society susceptible to explosive outbreaks of numerous diseases [8]. 

Bevölkerungspyramide
data source: Statistisches Bundesamt

Familial Trends 
Demographic change does not solely affect societies: it also affects the family by changing its composition. In the 19th century, only a minor proportion of young adults got to know their grandparents. Today, about 80% of people have at least one living grandparent. This causes an increasing demand to nurse the elderly generation, which threatens individuals’ financial, psychological and physical abilities [6]. Thanks to improvements in gender equality and the education of women, the mean age at first childbirth has increased from 21 years in the 1970s to 25 years today. Together, these factors cause a “crunch” situation for people in their 50s and 60s where raising their children and caring for their own parents compete [6]. 
Demographic change also affects how family members interact and take care of each other: As families become smaller, parents distribute their money and time more equally among their offspring and grandchildren [6].
Demographic change may appear to be a problem of Western countries, but it is definitely a global one. Ten years ago, the WHO reported a global mean age of 27.6 years, with 10% of the population being older than 60 years. By 2050, the United Nations expects the mean age to be 38 years with 22% of people being older than 60. Further, the proportion of children is predicted to decrease from 30% to less than 20% [9]. The socio-economic impact of these changes cannot be ignored.

[1] bit.ly/1ScMbK1 
[2] http://bit.ly/1PSObsc 
[3] bit.ly/1PMdwy2 
[4] http://bit.ly/1KUTobt 
[5] http://bit.ly/1JVUjxq 
[6] Seltzer and Bianchi, Annu Rev Sociol, 2013 
[7] Warth et al., Virchows Arch, 2015
[8] Geard et al., Epidemics, 2015 
[9] http://bit.ly/1Is6Qaq 

by Bettina Schmerl, PhD student AG Shoichet
This article originally appeared 2016 in CNS Volume 9, Issue 1, The Aging Brain

July 12, 2017

Little Einsteins-In-The-Making: Brain Development in Newborns

The fertility rate in Germany has risen to a 33-year high after years of decline in the rate of births. How will life be for this new generation? How will they percieve the world ? Time to have a look at a newborn's brain!

The emergence of new life, the creation of a little human being, is one of the most fascinating events in this world. Of all organs, the development of the brain is one of the first to start and one of the last to end (although it never really ends). The first structure, the neural tube, forms within the first weeks after conception. The first movements of the fetus can be detected by ultrasound after only 7 weeks and are probably because the first neurons and synapses have already developed in the spinal cord. Although a very basic functional brain is present at birth, many aspects of brain development are nowhere near complete yet.

The Birth of Consciousness
Future parents often wonder how much of the outside world their fetus experiences consciously. For example, is it beneficial to play piano music or speak to the little one in the uterus? Although fetuses can open their eyes after some months, they are mainly asleep and can hardly be woken up. Consciousness is defined as awareness of the body, the self and the outside, and is linked to the condition of being awake. Consequently, the process of birth initiates the development of consciousness by waking the fetus. When a newborn is touched by another person, it reacts differently compared to when it touches itself, indicating it has awareness of its own body.
Sleeping newborn infant with an EEG net.
Fifer, William P., et al. "Newborn infants learn during sleep."  
Proceedings of the National Academy of Sciences 107.22 (2010)

Furthermore, the awareness of smell allows the newborn to pursue the mother's milk. In addition, the ability to discriminate between the mother's voice and that of a stranger develops early on. The effort to reach the mother's breast right after birth also indicates purposeful behavior. Together with other signs such as the sense of pain, language, and short-term memory, newborns fulfil the criteria of basic consciousness and are perfectly equipped to explore the new world [1].

Explosion of Synapses and Glial Cells
Interestingly, the brain of an infant at birth already contains almost the same number of neurons as an adult brain. Now they only have to form their various connections to form mature neuronal circuits. Therefore, an extremely high number of synapses is built during the first months in a process called synaptogenesis, which requires the selection and elimination of synapses. This process, known as pruning, is highly delicate and, therefore, it is not surprising that early life stress can result in the development of behavioral dysfunctions and mental disorders in adulthood [2].



A NEWBORN'S BRAIN 
DEPENDS ON OUTSIDE STIMULI
 

In the past, it was believed that the selection is mainly dependent on the activity of neuronal connections, while the help of glial cells is only required for removing synapses by phagocytosis. However, more recent evidence supports the important role of glial cells in all stages of pruning. A stepwise removal of low-activity synaptic contacts is achieved by a fine-tuned interplay between neurons, astrocytes, microglia and oligodendrocytes that communicate with each other by secreting molecules [3]. For example, during postnatal development, neurons express the chemokine Cc3cl1 (fractalkine) whose receptor is expressed by microglia. As reported first by Paoliceli et al., the lack of this chemokine leads to fewer microglia and delayed synaptic pruning [4].

Sleep, Baby, Sleep…
When one considers the numerous events taking place in the newborn brain  and I've only mentioned a few here  it is not surprising that sleep is absolutely essential for flawless neuronal development. All this learning and processing of environmental stimuli, with their accompanying reorganization of nascent neuronal circuits sounds extremely exhausting for such a fragile organism. Intuitively, one would thus think that the phase of sleep linked to physical rest would be most important for newborns. But quite the contrary. It's actually active sleep, also referred to as rapid eye movement (REM) sleep, which seems crucial for postnatal brain development. Newborns spend about 50% of their sleep in REM (compared to 20% in adults). Indeed, it has been shown that twitching during REM sleep leads to increased activity of Purkinje cells in the cerebellum of rat neonates, indicating that active sleep is important for sensorimotor development [5].

Impact on Our Future Minds
Since the development of a newborn's brain is highly dependent on environmental stimuli, these bewitching creatures should be protected from any harmful influences  beginning already at pregnancy. Everything we experience in our first years after birth will somehow shape our mind for the rest of our lives. This thought is amazing and terrifying at the same time because at that stage these poor little creatures are dependent on how responsible the outside world is …

[1] Langercrantz and Changeaux, Semin Perinatol, 2010
[2] Bock et al., Front Neurosc, 2014
[3] Terni et al., Brain Res Bull, 2016
[4] Paoliceli et al., Science, 2011
[5] Sokoloff et al., Dev Neurobiol, 2014

by Eileen Schormann, PhD Student, AG Krüger

This article was voted "best contribution of the December 2016 issue"

April 16, 2017

How Different Cultures View Early Life and Death


The students of MedNeuro are multinational and so diverse are their ways of celebrating easter and other festivities. Betty Jurek had a look of how beginning and end of life are celebrated around the globe.

The Beginning…
When a baby is born, parents are usually overwhelmed with emotions, and only want the best for their child. But the interpretation of what “the best” is also depends on the parents’ nationality and can be somewhat, let’s say, "unique".

Baptism by keskieve via pixabay


Sifudu Smoke
This ritual is practiced in Nigeria and means “passing baby through smoke”. Between the third and fourteenth day after birth, leaves from a Sifudu tree are burnt, causing a pungent smoke that is irritating to the mouth and eyes. The baby is held head downwards into this smoke several times, in the belief that this prevents the child from being frightened, timid or shy [1].

Precious Saliva
An interesting way to give blessings to a baby is practiced by the Wolof people in Mauritania. They believe that saliva can retain words so the women spit into the baby’s face while men spit into the baby’s ear. To ensure that the blessing works, they rub the saliva all over its head [1].

Recycled Wedding Cake
In comparison to applying saliva onto Mauritanian babies, Irish babies seem to have better luck. Couples freeze the top tier of their wedding cake and re-use it for the christening of their first baby. Some crumbs are sprinkled over the baby’s head and if the couples have leftovers from their wedding champagne, this will also be used to wet the baby’s head for good luck [1]. Cheers!

Placenta Power
In contrast to many animal species, eating up the placenta following delivery is a somewhat unusual practice for humans. Proponents of human placentophagy claim that eating their own placenta results in better mood, increased energy and lactation although there is no study that gives evidence for a causal effect. Dried placenta is also commonly used in Chinese traditional medicine to treat infertility, impotence and other conditions [2].

Lithuanian Baby Race
Every year on International Children’s Day (June 1st), Lithuanian toddlers compete in a race where they have to crawl a 5-meter carpet to their mothers as fast as they can. All participants seem to have great fun, and the winner this year crawled the distance within 11 seconds [3].

Toddler Tossing
This ritual may be the scariest one for outsiders. At an annual festival in India, babies and toddlers are tossed from a 15-meter high tower, right onto a landing sheet. Despite appearing to be a traumatic experience for the babies, it is supposed to give luck, health and prosperity to the child [4].

…And The End
Depending on our spiritual or religious backgrounds, we see death as either the end of life or as some sort of transition. Every people has its own way of dealing with death and grief. Some of them seem very creative, others more disturbing.

 fantasy coffin by Regula Tschumi via Wikimedia Commons


Fantasy Coffins
This interesting tradition from southern Ghana is based on the belief that life continues after death the same way as it was before. Therefore, people make individual, colorful coffins that often reflect the dead person’s profession or passion, which is thought to allow them to start the afterlife as conveniently as possible [5]. From a boat to a piano to a pack of cigarettes, everything is possible.

Death Beads
Space in graveyards in South Korea is running out, so a law was passed in 2000 mandating that people who get buried need to be removed 60 years later. This crisis led to an invention which has gained popularity during the last decade: Death beads. These turquoise beads are generated by melting the cremated ashes at ultrahigh temperatures [6]. In this way, the beloved one can be kept at home “forever”.

Consuming Grief
As an act of compassion, some tribes in South America, Africa and India used to eat their deceased family members. As a part of the grieving process, the Wari’ people in Brazil ate the complete corpse whereas other tribes, like the Amahuaca Indians, made some sort of gruel out of the ground bones and corn [7].

Death is Not the End
In contrast to Western culture, members of the Toraja ethnic group in Indonesia are buried weeks, months or even years after they pass away. For the Toraja, death is a gradual process toward the afterlife. Therefore, the deceased is wrapped in several layers of cloth and kept in a special room in the family’s home. They are still part of family life, are symbolically fed and taken out every once in a while. At the actual funeral, the social status of the deceased is reflected in the numbers of sacrificed chickens and water buffaloes [8].

Sky Burial
This special form of funeral is practiced in different regions of Asia (e.g., Tibet, Mongolia), where people practice Vajrayna Buddhism. A monk or a rogyapas (body-breaker) prepares the dead body (by taking out the organs) and places it on a mountaintop to return the body to nature. Most of the time, this means that the dead body will be devoured by vultures to the bone. The bones are then ground with a special sort of flour and given to crows and hawks that wait until the vultures have departed [9]. This way, the deceased merges with the wind.

[1] http://glblctzn.me/2ewEsaT                               
[2] http://bit.ly/2ewE5Ng           
[3] http://bit.ly/2ewEtLS                             
[4] http://dailym.ai/2eo6Wbq                   
[5] http://bit.ly/2ewFl39                              
[6] http://lat.ms/2eo69Ho
[7] http://bit.ly/2ewEfo0                             
[8] http://bit.ly/2enT6Wx           
[9] http://bit.ly/2eo70I6

by Betty Jurek, PhD Student AG Prüß
This article originally appeared 2016 in CNS Volume 9, Issue 4, From Cradle to Grave in the Brain