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Potato Feast Fest

October 15, 2018

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Target Healthy Eating

Pretty to present and ohhhhhh so tasty. Easy to make, as well. Maybe you'll serve these on Thanksgiving or any festive occasion. Or, how about next week. Jules gives my recipe 5 stars. He loves to grab one from the fridge and eat as a snack. ©Joyce Hays, Target Health Inc.
Fun to make and attractive to look at. ©Joyce Hays, Target Health Inc.
Last week we had these festive potatoes with the most tender center cut fillet mignon and a mushroom marsala sauce, accompanied with Paul Hobbs cabernet and a toast to BFF. Life doesn't get much better! ©Joyce Hays, Target Health Inc.
You see everything before you taste it. Therefore, it make sense to use color and design to whet the appetite. ©Joyce Hays, Target Health Inc.

Ingredients

3 or 4 red potatoes, the largest you can find

3 garlic cloves, squeezed (through garlic press)

3 chopped scallions, some for cooking, some for garnish

1 cup gruyere, grate it yourself

1 cup cheddar, grate it yourself

1 jalapeno, seeded, then well chopped

1 teaspoon curry

Extra olive oil for cooking

1 red onion, sliced on a mandolin, for garnish

Just these few fresh ingredients, are needed for my new potato recipe. The results are delicious and so colorful. ©Joyce Hays, Target Health Inc.

Directions

1. Preheat oven to 375 degrees

2. Scrub the potatoes, rub skins with olive oil and bake them, the way you usually would. Cover with foil or not.

3. Bake for one hour or after poking a potato with a fork, the fork goes in and comes out easily.

Glistening with olive oil and going into the oven. Put a tiny bit of olive oil in bottom of pan. ©Joyce Hays, Target Health Inc.

4. While potatoes are baking, do all the squeezing, chopping, seeding, grating, slicing. And put everything into a large mixing bowl.

Slicing the red onion on the mandolin, then set aside. This is for garnish, so don't add these onion slices to the mixing bowl. ©Joyce Hays, Target Health Inc.
Put onion slices on plate and set aside. ©Joyce Hays, Target Health Inc.
Jalapeno seeded and now getting chopped. ©Joyce Hays, Target Health Inc.
Two cheeses getting grated. ©Joyce Hays, Target Health Inc.
After, cutting, squeezing, grating, add everything to a large mixing bowl, including some of the scallions, the ground curry and garlic; then combine very well, so that ingredients are well combined. You want that garlic to be well distributed. ©Joyce Hays, Target Health Inc.
Stir everything in the bowl, very well. ©Joyce Hays, Target Health Inc.

5. After potatoes are done, cut each in half and scoop out all the flesh and put into a mixing bowl. In the potato shell, leave about an 1/8 of an inch of flesh, next to the skin, to keep the shell supportive.

6. After filling each empty potato shell with the stuffing, add 1 red onion ring on top of the stuffing and return the stuffed potatoes to the oven.  Oven should be set at 375 degrees.  Bake for another 20 minutes.

7. Remove potatoes, place on a serving platter (use an oven mitt, if they're too hot to handle) and garnish with the chopped scallions.

8. Serve and enjoy!

Potatoes baked, out of oven, and cut in half. ©Joyce Hays, Target Health Inc.
White flesh of the potatoes has been scooped out and put into the mixing bowl. ©Joyce Hays, Target Health Inc.
When you scoop out the baked potato flesh, add all of it to the mixing bowl and mix well to combine all the ingredients. This is your delicious stuffing for the potatoes. ©Joyce Hays, Target Health Inc.
Using the same baking pan, with tiny drop of oil on bottom, fill each potato half with the stuffing in the mixing bowl. ©Joyce Hays, Target Health Inc.
Top each potato with one slice of red onion, before going into the oven. ©Joyce Hays, Target Health Inc.
Going back into the oven. ©Joyce Hays, Target Health Inc.
Out of the oven. Final touch, scallion garnish. ©Joyce Hays, Target Health Inc.
We started our meal with chopped chicken liver on tiny French baguettes. A choice of chilled Pouilly-Fuisse or Paul Hobbs cabernet. Then came the garden fresh salad. ©Joyce Hays, Target Health Inc.
Our relatives from Germany asked for seconds. The potato feast recipe was in their honor, served with chicken thighs, roasted with carrots, mangos and many spices (last week's recipe). ©Joyce Hays, Target Health Inc.
Here is our jello cake dessert. We topped it with cool whip. ©Joyce Hays, Target Health Inc.
Paul Hobbs (Napa) cabernet is our recent “go-to“ red. It is liquid velvet caressing your nose, throat and a glorious finish. ©Joyce Hays, Target Health Inc.

From Our Table to Yours

Have a great week everyone!

Bon Appetit!

New DNA-Based Test Determines Blood Compatibility

October 15, 2018

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Regulatory

Human blood can be classified into different groups based on the antigens on the surfaces of red blood cells. In addition to the ABO blood group antigens, the presence or absence of other specific blood group antigens can be important when matching blood for transfusions since some people develop antibodies to non-ABO antigens. People who receive repeated blood transfusions, such as individuals with sickle cell disease, are more likely to develop these antibodies. If red blood cells with poorly matched non-ABO antigens are transfused, red blood cell destruction and a transfusion reaction can occur in a transfusion recipient. Traditionally, red blood cell antigens have been identified using serological methods that involve the use of antisera, a blood serum that contains antibodies for testing. Serologic testing presents limitations and certain antisera may be scarce or unavailable.

The FDA has approved ID CORE XT, a molecular-based assay used in blood transfusion medicine to help determine blood compatibility. The assay can be used to determine blood donor and patient non-ABO red blood cell (RBC) types. ID CORE XT is the second molecular assay approved for use in transfusion medicine, and the first to report genotypes as final results. To obtain approval, a study was conducted to compare the typing results of the ID CORE XT Test with licensed serological reagents, the first FDA-approved molecular assay, and DNA sequencing tests. The results demonstrated comparable performance between the methods.

The approval of the ID CORE XT Test was granted to Progenika Biopharma S.A., a Grifols company.

Novel Vaccine for Lassa Fever and Rabies

October 15, 2018

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Immunology

Africa is also at high risk for human rabies. The WHO estimates that 95% of the estimated 59,000 human rabiesdeaths per year occur in Africa and Asia. Nearly all human rabies deaths are caused by bites or scratches from infected dogs. Effective rabies vaccines and post-exposure shots are available, but many deaths still occur in resource-limited countries, according to the Centers for Disease Control and Prevention.

There are currently no approved Lassa fever vaccines. Although Lassa fever is often a mild illness, some people experience serious symptoms, such as hemorrhage (severe bleeding) and shock. The overall Lassa virus infection case-fatality rate is about 1%, according to the World Health Organization (WHO), but that rate rises to 15% for patients hospitalized with severe cases of Lassa fever. People contract Lassa virus through contact with infected Mastomys rats and through exposure to an infected person's bodily fluids. Lassa fever is endemic to West Africa where these rats are common. In 2018, Nigeria experienced its largest-ever Lassa fever outbreak, with 514 confirmed cases and 134 deaths from Jan. 1 through Sept. 30, according to the Nigeria Centre for Disease Control.

According to an article published in Nature Communications (11 October 2018), a novel vaccine designed to protect people from both Lassa fever and rabies showed promise in preclinical testing. The inactivated recombinant vaccine candidate uses a weakened rabies virus vector, or carrier. The authors inserted genetic material from Lassa virus into the rabies virus vector so the vaccine expresses surface proteins from both the Lassa virus and the rabies virus. These surface proteins prompt an immune response against both Lassa and rabies viruses. The recombinant vaccine was then inactivated to "kill" the live rabies virus used to make the carrier.

The newly published findings show that LASSARAB, when administered with GLA-SE adjuvant (an immune response-stimulating protein), elicits antibodies against Lassa virus and rabies virus in mouse and guinea pig models. The vaccine also protected guinea pigs from Lassa fever after being exposed to the virus 58 days after vaccination. Prior research indicated that an antibody-mediated immune response is not correlated with protection from Lassa fever, the authors note. However, the new findings show that high levels of non-neutralizing immunoglobulin G (IgG) antibodies that bind to the Lassa virus surface protein correlate with protection against Lassa virus. Levels of this type of antibody could potentially be a Lassa fever correlate of protection used to determine vaccine efficacy, according to the authors. They note the next step is to evaluate the experimental vaccine in nonhuman primates before advancing to human clinical trials.

Global Public Attitudes About Clinical Research and Patient Experiences With Clinical Trials

October 15, 2018

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Public Policy

Editor's Note: Take Heed: Clinical trial participation was perceived as inconvenient and burdensome; in the latest survey, 1,075 respondents (49%) expressed that their clinical trial participation disrupted their daily routine.

According to an article published in JAMA Open Networks (December 2018), a study was performed to identify the views of clinical trial participants and nonparticipants and characterize trends in these views over time. This survey study included a questionnaire that was administered online from May 8 to July 24, 2017, by the Center for Information and Study on Clinical Research Participation (CISCRP), and findings were compared with previous studies conducted in 2013 and 2015. The 2017 sample included responses from 12,427 individuals from 68 countries and represents a 10% participation rate. Similar to international assessments conducted by the CISCRP and other organizations, this study drew responses from a convenience sample; any adult older than 18 years who received an email or had online access was eligible to participate. The main outcome measures were changes observed in the perceptions and clinical trial experiences of the public and study volunteers compared with past CISCRP studies.

A total of 12,427 individuals 55 +/- 15] years, of whom 7,355 (59%) were female; 10,085 (81%) were caucasian, and 2,194 (17.7%) of whom had participated in previous clinical research studies, responded to the survey in 2017. Results indicated a belief in the importance of clinical research, but limited understanding of the research process persists. In 2017, a total of 10,506 individuals (84.5%) perceived clinical research to be very important to the discovery and development of new medicines; however, 4,079 of 6,919 respondents (59%) were unable to name a place where studies were conducted. A total of 11,182 respondents (90%) believed that clinical research is generally safe; however, 5,578 (44.9%) reported that clinical trials are rarely considered as an option when discussing treatments or medications with their physician. Clinical trial participation was perceived as inconvenient and burdensome; in the latest survey, 1,075 respondents (49%) expressed that their clinical trial participation disrupted their daily routine.

According to the authors, the results of this study may provide a foundation from which to build meaningful and effective engagement with the public and patients and revealed roadblocks, including knowledge gaps among the public, limited physician involvement in discussing clinical trials as treatment options, and the inconveniences that patients encounter after they volunteer to participate. These findings may inform patient engagement strategies and tactics and ultimately help accelerate the drug-development process.

Carl Gustav Jung MD (1875 - 1961)

October 15, 2018

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History of Medicine

Carl Gustav Jung MD
This work is in the public domain in its country of origin and other countries and areas where the copyright term is the author's life plus 70 years or less. This file has been identified as being free of known restrictions under copyright law, including all related and neighboring rights.

Carl Gustav Jung (1875-1961) was a Swiss psychiatrist and psychoanalyst who founded his own style of psychoanalysis, after being mentored by Sigmund Freud. Jung's work was influential in the fields of psychiatry, anthropology, archaeology, literature, philosophy, and religious studies. Jung worked as a research scientist at the famous Burgholzli hospital, under Eugen Bleuler. During this time, he came to the attention of the Viennese founder of psychoanalysis, Sigmund Freud. The two men conducted a lengthy correspondence and collaborated on a joint vision of human psychology. Freud saw in the younger Jung the potential heir he had been seeking to carry on his “new science“ of psychoanalysis.

Among the central concepts of analytical psychology is individuation - the lifelong psychological process of differentiation of the self out of each individual's conscious and unconscious elements. Jung considered it to be the main task of human development. He created well known psychological concepts, including synchronicity, archetypal phenomena, the collective unconscious, the psychological complex, and extraversion and introversion. Jung was also an artist, craftsman and builder as well as a prolific writer. Many of his works were not published until after his death and some are still awaiting publication.

Carl Gustav Jung was born in Kesswil, in the Swiss canton of Thurgau, on 26 July 1875 as the second and first surviving son of Paul Achilles Jung (1842-1896) and Emilie Preiswerk (1848-1923). Their first child, born in 1873, was a boy named Paul who survived only a few days. The father, was the youngest son of a noted Basel physician of German descent, also called Karl Gustav Jung (de) (1794-1864). When Jung was six months old, his father was appointed to a more prosperous parish in Laufen, but the tension between his parents was growing. Emilie Jung was an eccentric and depressed woman; she spent considerable time in her bedroom where she said that spirits visited her at night. Although she was normal during the day, Jung recalled that at night his mother became strange and mysterious. He reported that one night he saw a faintly luminous and indefinite figure coming from her room with a head detached from the neck and floating in the air in front of the body. Jung's mother left Laufen for several months of hospitalization near Basel for an unknown physical ailment. Emilie Jung's continuing bouts of absence and depression deeply troubled Karl and caused him to associate women with “innate unreliability“, whereas “father“ meant for him reliability but also powerlessness. In his memoir, Jung would remark that this parental influence was the “handicap I started off with. Later, these early impressions were revised: “I have trusted men friends and been disappointed by them, and I have mistrusted women and was not disappointed.“ After three years of living in Laufen, Paul Jung requested a transfer; he was called to Kleinhuningen, next to Basel in 1879. The relocation brought Emilie Jung closer into contact with her family and lifted her melancholy. When he was nine years old, Jung's sister Johanna Gertrud (1884-1935) was born. Known in the family as “Trudi“, she later became a secretary to her brother.

Jung was a solitary and introverted child. From childhood, he believed that, like his mother, he had two personalities - a modern Swiss citizen and a personality more suited to the 18th century. “Personality Number 1“, as he termed it, was a typical schoolboy living in the era of the time. “Personality Number 2“ was a dignified, authoritative and influential man from the past. A number of childhood memories made lifelong impressions on him. As a boy, he carved a tiny mannequin into the end of the wooden ruler from his pencil case and placed it inside the case. He added a stone, which he had painted into upper and lower halves, and hid the case in the attic. Periodically, he would return to the mannequin, often bringing tiny sheets of paper with messages inscribed on them in his own secret language. He later reflected that this ceremonial act brought him a feeling of inner peace and security. Years later, he discovered similarities between his personal experience and the practices associated with totems in indigenous cultures, such as the collection of soul-stones near Arlesheim or the tjurungas of Australia. He concluded that his intuitive ceremonial act was an unconscious ritual, which he had practiced in a way that was strikingly similar to those in distant locations which he, as a young boy, knew nothing about. His observations about symbols, archetypes, and the collective unconscious were inspired, in part, by these early experiences combined with his later research.

At the age of 12, shortly before the end of his first year at the Humanistisches Gymnasium in Basel, Jung was pushed to the ground by another boy so hard that he momentarily lost consciousness. A thought then came to him - “now you won't have to go to school anymore.“ From then on, whenever he walked to school or began homework, he fainted. He remained at home for the next six months until he overheard his father speaking hurriedly to a visitor about the boy's future ability to support himself. They suspected he had epilepsy. Confronted with the reality of his family's poverty, he realized the need for academic excellence. He went into his father's study and began poring over Latin grammar. He fainted three more times but eventually overcame the urge and did not faint again. This event, Jung later recalled, “was when I learned what a neurosis is.“ Jung did not plan to study psychiatry since it was not considered prestigious at the time. But, studying a psychiatric textbook, he became excited when he discovered that psychoses are personality diseases. His interest was immediately captured - it combined the biological and the spiritual, exactly what he was searching for. In 1895 Jung began to study medicine at the University of Basel. Barely a year later in 1896, his father Paul died and left the family near destitute. They were helped out by relatives who also contributed to Jung's studies. During his student days, he entertained his contemporaries with the family legend, that his paternal grandfather was the illegitimate son of Goethe and his German great-grandmother, Sophie Ziegler. In later life, he pulled back from this tale, saying only that Sophie was a friend of Goethe's niece.

In 1900 Jung began working at the Burgholzli psychiatric hospital in Zurich with Eugen Bleuler. Bleuler was already in communication with the Austrian neurologist Sigmund Freud. Jung's dissertation, published in 1903, was titled On the Psychology and Pathology of So-Called Occult Phenomena. In 1906 he published Diagnostic Association Studies, and later sent a copy of this book to Freud. As it turned out, Freud had already bought a copy. Eventually a close friendship and a strong professional association developed between the elder Freud and Jung, which left a sizeable correspondence, evidence that they cooperated in their work. During World War I Jung was drafted as an army doctor and soon made commandant of an internment camp for British officers and soldiers (The Swiss were neutral, and obliged to intern personnel from either side of the conflict who crossed their frontier to evade capture). Jung worked to improve the conditions of soldiers stranded in neutral territory and encouraged them to attend university courses. In 1903, Jung married Emma Rauschenbach, seven years his junior and the elder daughter of a wealthy industrialist in eastern Switzerland, Johannes Rauschenbach-Schenck, and his wife. Rauschenbach was the owner, among other concerns, of IWC Schaffhausen - the International Watch Company, manufacturers of luxury time-pieces. Upon his death in 1905, his two daughters and their husbands became owners of the business. Jung's brother-in-law - Ernst Homberger - became the principal proprietor, but the Jungs remained shareholders in a thriving business that ensured the family's financial security for decades. Emma Jung, whose education had been limited, evinced considerable ability and interest in her husband's research and threw herself into studies and acted as his assistant at Burgholzli. She eventually became a noted psychoanalyst in her own right. Emma died in 1955.

Jung was thirty when he sent his Studies in Word Association to Sigmund Freud in Vienna in 1906. The two men met for the first time the following year and Jung recalled the discussion between himself and Freud as stimulating and provocative. He recalled that they talked almost unceasingly for thirteen hours. Six months later, the then 50-year-old Freud sent a collection of his latest published essays to Jung in Zurich. This marked the beginning of an intense correspondence. Jung and Freud influenced each other during the intellectually formative years of Jung's life. Jung had become interested in psychiatry as a student by reading Psychopathia Sexualis by Richard von Krafft-Ebing. In 1900, Jung completed his degree, and started work as an intern (voluntary doctor) under the psychiatrist, Eugen Bleuler at Burgholzli Hospital. It was Bleuler who introduced him to the writings of Freud by asking him to write a review of The Interpretation of Dreams (1899). In 1905 Jung was appointed as a permanent senior doctor at the hospital and also became a lecturer Privatdozent in the medical faculty of Zurich University. In that period psychology as a science was still in its early stages, but Jung became a qualified proponent of Freud's new “psycho-analysis.“ At the time, Freud needed collaborators and pupils to validate and spread his ideas. Burgholzli was a renowned psychiatric clinic in Zurich and Jung's research had already gained him international recognition. Preceded by a lively correspondence, Jung met Freud for the first time, in Vienna on 3 March 1907. In 1908, Jung became an editor of the newly founded Yearbook for Psychoanalytical and Psychopathological Research. In 1909, Jung traveled with Freud and the Hungarian psychoanalyst Sandor Ferenczi to the United States; they took part in a conference at Clark University in Worcester, Massachusetts. The conference at Clark University was planned by the psychologist G. Stanley Hall and included twenty-seven distinguished psychiatrists, neurologists and psychologists. It represented a watershed in the acceptance of psychoanalysis in North America. This forged welcome links between Jung and influential Americans. Jung returned to the United States the next year for a brief visit. In 1910, Jung became Chairman for Life of the International Psychoanalytical Association with Freud's support. Freud would come to call Jung “his adopted eldest son, his crown prince and successor.“ In 1910, Jung worked on his Wandlungen und Symbole der Libido (Psychology of the Unconscious: a study of the transformations and symbolisms of the libido, a contribution to the history of the evolution of thought). At that time, Jung again traveled to the United States and gave the Fordham University lectures, a six-week series, which were published as The Theory of Psychoanalysis (1912). While they contain some remarks on Jung's dissenting view on the libido, they represent largely a “psychoanalytical Jung“ and not the theory of analytical psychology, for which he became famous in the following decades. Jung's observations overlap to an extent with Freud's model of the unconscious, what Jung called the “personal unconscious.“ The collective unconscious is not so much a 'geographical location', but a deduction from the alleged ubiquity of archetypes over space and time. Freud had actually mentioned a collective level of psychic functioning but saw it primarily as an appendix to the rest of the psyche.

In November 1912, Jung and Freud met in Munich for a meeting among prominent colleagues to discuss psychoanalytical journals. At a talk about a new psychoanalytic essay on Amenhotep IV, Jung expressed his views on how it related to actual conflicts in the psychoanalytic movement. While Jung spoke, Freud suddenly fainted and Jung carried him to a couch. Jung spoke at meetings of the Psycho-Medical Society in London in 1913 and 1914. His travels were soon interrupted by the war, but his ideas continued to receive attention in England. In 1913, at the age of thirty-eight, Jung experienced a horrible “confrontation with the unconscious“. He saw visions and heard voices. He worried at times that he was “menaced by a psychosis“ or was “doing a schizophrenia“. He decided that it was valuable experience and, in private, he induced hallucinations or, in his words, “active imaginations“. He recorded everything he felt in small journals. Jung began to transcribe his notes into a large red leather-bound book, on which he worked intermittently for sixteen years. Jung left no posthumous instructions about the final disposition of what he called the Liber Novus or the Red Book. Sonu Shamdasani, a historian of psychology from London, tried for three years to persuade Jung's resistant heirs to have it published. Up to mid-September 2008, fewer than two dozen people had seen it. Ulrich Hoerni, Jung's grandson who manages the Jung archives, decided to publish it to raise the additional funds needed when the Philemon Foundation was founded.

Jung made a more extensive trip westward in the winter of 1924, financed and organized by Fowler McCormick and George Porter. Of particular value to Jung was a visit with Chief Mountain Lake of the Taos Pueblo near Taos, New Mexico. Jung made another trip to America in 1936, giving lectures in New York and New England for his growing group of American followers. He returned in 1937 to deliver the Terry Lectures at Yale University, later published as Psychology and Religion. The C. G. Jung Institute, was established in K?snacht, Switzerland. Jung continued to publish books until the end of his life, in June 1961. He died at Kusnacht, after a short illness. He had been beset by circulatory diseases. Three major concepts, still of great interest today in the United States and around the world, of analytical psychology as developed by Jung include:

Archetypal images - universal symbols that can mediate opposites in the psyche, often found in religious art, mythology and fairy tales across cultures

Shadow - the repressed, therefore unknown, aspects of the personality including those often considered to be negative

Collective unconscious - aspects of unconsciousness experienced by all people in different cultures

The persona, Jung argues, is a mask for the “collective psyche“, a mask that pretends individuality, so that both self and others believe in that identity, even if it is really no more than a well-played role through which the collective psyche is expressed. Jung regarded the “persona-mask“ as a complicated system which mediates between individual consciousness and the social community: it is “a compromise between the individual and society as to what a man should appear to be“. But he also makes it quite explicit that it is, in substance, a character mask in the classical sense known to theatre, with its double function: both intended to make a certain impression on others, and to hide (part of) the true nature of the individual. The therapist then aims to assist the individuation process through which the client (re)gains their “own self“ - by liberating the self, both from the deceptive cover of the persona, and from the power of unconscious impulses. Jung's work on himself and his patients convinced him that life has a spiritual purpose beyond material goals. Our main task, he believed, is to discover and fulfill our deep, innate potential. Based on his study of Christianity, Hinduism, Buddhism, Gnosticism, Taoism, and other traditions, Jung believed that this journey of transformation, which he called individuation, is at the mystical heart of all religions. It is a journey to meet the self and at the same time to meet the Divine.

In Jungian psychology, the “shadow“, “Id“, or “shadow aspect/archetype“ may refer to (1) an unconscious aspect of the personality which the conscious ego does not identify in itself, or (2) the entirety of the unconscious, i.e., everything of which a person is not fully conscious. In short, the shadow is the “dark side“. Because one tends to reject or remain ignorant of the least desirable aspects of one's personality, the shadow is largely negative. There are, however, positive aspects that may also remain hidden in one's shadow (especially in people with low self-esteem, anxieties, and false beliefs). Contrary to a Freudian definition of shadow, the Jungian shadow can include everything outside the light of consciousness and may be positive or negative. “Everyone carries a shadow,“ Jung wrote, “and the less it is embodied in the individual's conscious life, the blacker and denser it is.“ It may be (in part) one's link to more primitive animal instincts, which are superseded during early childhood by the conscious mind. Carl Jung stated the shadow to be the unknown dark side of the personality. According to Jung, the shadow, in being instinctive and irrational, is prone to psychological projection, in which a perceived personal inferiority is recognized as a perceived moral deficiency in someone else. Jung writes that if these projections remain hidden, “The projection-making factor (the Shadow archetype) then has a free hand and can realize its object - if it has one - or bring about some other situation characteristic of its power.“ These projections insulate and harm individuals by acting as a constantly thickening veil of illusion between the ego and the real world. From one perspective, “the shadow is roughly equivalent to the whole of the Freudian unconscious“; and Jung himself asserted that “the result of the Freudian method of elucidation is a minute elaboration of man's shadow-side unexampled in any previous age“. The shadow may appear in dreams and visions in various forms and typically “appears as a person of the same sex as that of the dreamer“. The shadow's appearance and role depend greatly on the living experience of the individual because much of the shadow develops in the individual's mind rather than simply being inherited in the collective unconscious. Nevertheless, some Jungians maintain that The shadow contains, besides the personal shadow, the shadow of society fed by the neglected and repressed collective values. Interactions with the shadow in dreams may shed light on one's state of mind. A conversation with an aspect of the shadow may indicate that one is concerned with conflicting desires or intentions. Identification with a despised figure may mean that one has an unacknowledged difference from the character, a difference which could point to a rejection of the illuminating qualities of ego-consciousness. These examples refer to just two of many possible roles that the shadow may adopt and are not general guides to interpretation. Also, it can be difficult to identify characters in dreams  “all the contents are blurred and merge into one another 'contamination' of unconscious contents“ so that a character who seems at first to be a shadow might represent some other complex instead. Jung made the suggestion of there being more than one layer making up the shadow. The top layers contain the meaningful flow and manifestations of direct personal experiences. These are made unconscious in the individual by such things as the change of attention from one thing to another, simple forgetfulness, or a repression. Underneath these idiosyncratic layers, however, are the archetypes which form the psychic contents of all human experiences. Jung described this deeper layer as “a psychic activity which goes on independently of the conscious mind and is not dependent even on the upper layers of the unconscious - untouched, and perhaps untouchable - by personal experience“ (Joseph Campbell, 1971). According to Jung: “The shadow personifies everything that the subject refuses to acknowledge about himself“ and represents “a tight passage, a narrow door, whose painful constriction no one is spared who goes down to the deep well.“ If and when 'an individual makes an attempt to see his shadow, he becomes aware of (and often ashamed of) those qualities and impulses he denies in himself but can plainly see in others - such things as egotism, mental laziness, and sloppiness; unreal fantasies, schemes, and plots; carelessness and cowardice; inordinate love of money and possessions, a painful and lengthy work of self-education.“ The dissolution of the persona and the launch of the individuation process also brings with it 'the danger of falling victim to the shadow, the black shadow which everybody carries with him, the inferior and therefore hidden aspect of the personality' - of a merger with the shadow. According to Jung, the shadow sometimes overwhelms a person's actions; for example, when the conscious mind is shocked, confused, or paralyzed by indecision. 'A man who is possessed by his shadow is always standing in his own light and falling into his own traps, living below his own level': hence, in terms of the story of Dr. Jekyll and Mr. Hyde, 'it must be Jekyll, the conscious personality, who integrates the shadow ... and not vice versa. Otherwise the conscious becomes the slave of the autonomous shadow'.

Individuation inevitably raises that very possibility. As the process continues, and “the libido leaves the bright upper world sinks back into its own depths. below, in the shadows of the unconscious,“ so too what comes to the forefront is “what was hidden under the mask of conventional adaptation: the shadow“, with the result that “ego and shadow are no longer divided but are brought together in an - admittedly precarious - unity.“ The impact of such “confrontation with the shadow produces at first a dead balance, a stand-still that hampers moral decisions and makes convictions ineffective, chaos, melancholia.“ Consequently, (as Jung knew from personal experience) “in this time of descent?one, three, seven years, more or less - genuine courage and strength are required,“ with no certainty of emergence. Nevertheless, Jung remained of the opinion that while “no one should deny the danger of the descent, every descent is followed by an ascent and assimilation of - rather than possession by - the shadow becomes at last a real possibility. The struggle is to retain awareness of the shadow, but not identification with it. “Non-identification demands considerable moral effort prevents a descent into that darkness“; but though “the conscious mind is liable to be submerged at any moment in the unconscious... understanding acts like a life-saver. It integrates the unconscious“ - reincorporates the shadow into the personality, producing a stronger, wider consciousness than before. “Assimilation of the shadow gives a man body, so to speak,“ and provides thereby a launching-pad for further individuation. “The integration of the shadow, or the realization of the personal unconscious, marks the first stage of the analytic process, without it a recognition of anima and animus is impossible.“ Conversely, “to the degree to which the shadow is recognized and integrated, the problem of the anima, i.e., of relationship, is constellated,“ and becomes the center of the individuation quest. Nevertheless, Jungians warn that “acknowledgement of the shadow must be a continuous process throughout one's life;“ and even after the focus of individuation has moved on to the animus/anima, “the later stages of shadow integration“ will continue to take place - the grim “process of washing one's dirty linen in private,“ accepting one's shadow.

https://academyofideas.com/2015/12/carl-jung-and-the-shadow-the-hidden-power-of-our-dark-side/

Further reading

On Acceptance of Healing

More Jungian reading on the dark side of humans

Alan Watts comments on the work of Carl Jung (when Watts repeats several sentences 3 times, it's not a mistake. Watts does this to emphasize the importance of a particular idea.

Research Psychologists Define the 'Dark Core of Personality' in 2018

October 15, 2018

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Quiz

Dysfunction of the orbitofrontal cortex, among other areas, is implicated in the mechanism of psychopathy.Graphic credit: PaulWicks (talk) - The original image was uploaded on en.wikipedia as en:Image:OFC.JPG (log), Public Domain, https://commons.wikimedia.org/w/index.php?curid=4823984

Editor's note: The first half of this quiz is about the dark side of all humans. The second half is about very recent research which focuses on the neurotic behavior that can occur in humans, when the dark core becomes conscious without being understood consciously. Such an individual acts-out, rage in a manner destructive to self and society. Society labels this behavior psychopathic and categorizes certain dark traits, as related to one another. The psychoanalytic approach is to become, slowly aware of the dark feelings in each unconscious human mind, understand them, make them conscious and therefore, be in a position to control and channel the energy, derived from hellish rage, into constructive behavior. When one has done this, the individual personality becomes more integrated and better able to solve complex problems, as well as a more tolerant member of society.

In his riveting one act play, Incident at Vichy, it is the great American playwright, Arthur Miller's contention that the horrors perpetrated by the Nazis happened because some streak of sadism or self-interest lurks in all of us. This is Arthur Miller at his most searching and provocative, peeling the leaves of motivation as though they were coming off an artichoke, always more remaining to shroud the core, as in the core of human darkness. Miller, no doubt influenced by Sigmund Freud MD and Carl Jung MD, believed that until all humans finally acknowledge the (usually unconscious) killer within, which means each individual's murderous rage, (representing awesome untamed energy), we will continue to project our own (unconscious) demons, onto others. This automatic behavior creates scapegoats and enemies. The ability to recognize our own unconscious hellishness, gradually enables a more cohesive, wise and tolerant personality.

In some respects, Sigmund Freud's picture of human 1) ___ is more devastating to human self-esteem than Charles Darwin's theory of a common ancestor of apes and humans. Humans are animals with inborn biological “drives“ for reproduction and aggression. Every person is subject to unconscious mental processes that are capable of influencing behavior. Freud changed the view of human nature from that of a rational being to a complex animal of primitive urges, desires and emotional preferences barely kept under control by peer pressure and the repression of society. The unconscious is such an important part of one's existence that to follow the philosophical injunction and really “know thyself“ is probably not possible, without guidance. Freud, Jung and many other psychoanalysts, today, are quick to point out, that with the right chemistry, between analyst and analysand, the goal of a more integrated personality, can be reached. Psychoanalysis is considered a form of therapy; however, it should be available to everyone, since, more than anything else, it is a profound learning experience (about oneself), that each individual should have the opportunity to go through.

Editor's note: One way to know whether or not you've found a well-trained psychoanalyst, is whether or not he/she has gone through a personal analysis of at least 2 or 3 years

Research Psychologists Define the 'Dark Core of Personality' in 2018

Editor's note: Keep in mind that the research in this study is only focusing on neurotic humans who have not been able to acknowledge, understand and control the unconscious inner core of murderous rage. As Freud, Jung and many others have pointed out, we all have unconscious diabolical dark feelings. This 2018 study of the human dark side, looks at the traits involved in acting-out the inner feelings, instead of knowing and feeling them consciously and channeling this energy into a more constructive behavior.

Egoism, Machiavellianism, narcissism, psychopathy, sadism, spitefulness, and others are among the 2) ___ that stand for the malevolent dark sides of human personality. As results from a recently published research project show, these traits share a common 'dark core'. So, if you have one of these tendencies, you are also likely to have one or more of the others. Both world history and everyday life are full of examples of people acting ruthlessly, maliciously, or selfishly. In psychology as well as in everyday language, we have diverse names for the various dark tendencies humans may have, most prominently psychopathy (lack of empathy), narcissism (excessive self-absorption), and Machiavellianism (the belief that the 3) ___ justify the means), the so-called 'dark triad', along with many others such as egoism, sadism, or spitefulness. Although at first glance there appear to be noteworthy differences between these traits -- and it may seem more 'acceptable' to be an egoist than a psychopath -- new research shows that all dark aspects of human personality are very closely linked and are based on the same tendency. That is, most dark traits can be understood as flavored manifestations of a single common underlying disposition: The 4) ___ core of personality. In practice, this implies that if you have a tendency to show one of these dark personality traits, you are also more likely to have a strong tendency to display one or more of the others. As the new research reveals, the common denominator of all dark traits, the D-factor, can be defined as the general tendency to maximize one's individual utility -- disregarding, accepting, or malevolently provoking disutility for others -- , accompanied by beliefs that serve as justifications. In other words, all dark traits can be traced back to the general tendency of placing one's own goals and interests over those of 5) ___ even to the extent of taking pleasure in hurting other's -- along with a host of beliefs that serve as justifications and thus prevent feelings of guilt, shame, or the like. The research shows that dark traits in general can be understood as instances of this common core -- although they may differ in which aspects are predominant (e.g., the justifications-aspect is very strong in narcissism whereas the aspect of malevolently provoking disutility is the main feature of sadism) .

Ingo Zettler, Professor of Psychology at the University of Copenhagen, and two German colleagues, Morten Moshagen from Ulm University and Benjamin E. Hilbig from the University of Koblenz-Landau, have demonstrated how this common denominator is present in nine of the most commonly studied dark 6) ___ traits:

Egoism: an excessive preoccupation with one's own advantage at the expense of others and the community

Machiavellianism: a manipulative, callous attitude and a belief that the ends justify the 7) ___

Moral disengagement: cognitive processing style that allows behaving unethically without feeling distress

Narcissism: excessive self-absorption, a sense of superiority, and an extreme need for attention from others

Psychological entitlement: a recurring belief that one is better than others and deserves better treatment

Psychopathy: lack of empathy and self-control, combined with impulsive 8) ___

Sadism: a desire to inflict mental or physical harm on others for one's own pleasure or to benefit oneself

Self-interest: a desire to further and highlight one's own social and financial status

Spitefulness: destructiveness and willingness to cause harm to others, even if one harms oneself in the process

In a series of studies with more than 2,500 people, the authors asked to what extent people agreed or disagreed with statements such as “It is hard to get ahead without cutting corners here and there.,“ “It is sometimes worth a little suffering on my part to see others receive the punishment they deserve.,“ or “I know that I am 9) ___ because everyone keeps telling me so.“ In addition, they studied other self-reported tendencies and behaviors such as aggression or impulsivity and objective measures of selfish and unethical behavior. The  mapping of the common D-factor, which has just been published in the Psychological Review, can be compared to how Charles Spearman showed about 100 years ago that people who score highly in one type of intelligence test typically also score highly in other types of intelligence tests, because there is something like a general factor of intelligence. 'For example, in a given person, the D-factor can mostly manifest itself as narcissism, psychopathy or one of the other dark traits, or a combination of these. But with our mapping of the common denominator of the various dark personality traits, one can simply ascertain that the person has a high D-factor. This is because the D-factor indicates how likely a person is to engage in behavior associated with one or more of these dark traits', he says. In practice, this means that an individual who exhibits a particular malevolent behavior (such as likes to humiliate others) will have a higher likelihood to engage in other malevolent activities, too (such as cheating, lying, or stealing). The 10) ___ dark traits are by no means the same, and each can result in specific kinds of behavior. However, at their core, the dark traits typically have far more in common that actually sets them apart. And knowledge about this 'dark core' can play a crucial role for researchers or therapists who work with people with specific dark personality traits, as it is this D-factor that affects different types of reckless and malicious human behavior and actions, often reported in the media. Sources: University of Copenhagen; The dark core of personality.. Psychological Review, 2018; DOI: 10.1037/rev0000111; ScienceDaily.com; nih.gov; Wikipedia

ANSWERS: 1) nature; 2) traits; 3) ends; 4) dark; 5) others; 6) personality; 7) means; 8) behavior; 9) special; 10) nine

Technology Driven Clinical Trials

October 15, 2018

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What's New

With drug and device manufacturers and the regulators supplying much of the push, virtual and paperless clinical trials are gaining momentum. This past week, Dr. Jules Mitchel, President of Target Health, presented a webinar on  Regulatory Concerns When Running Virtual/Paperless Clinical Trials which included the future landscape and regulatory concerns of paperless clinical trials and clinical trials incorporating mobile tools. Over 100 people registered for the webinar so there is clear interest in the topic.

On 2 October 2018, at the North American eClinical Forum Autumn Meeting held in Philadelphia, Dr. Jules Mitchel presented on the new FDA Guidance on the use of the Electronic Health Record Data in Clinical Research.

For more information about Target Health, contact Warren Pearlson (212-681-2100 ext. 165). For additional information about software tools for paperless clinical trials, please also feel free to contact Dr. Jules T. Mitchel. The Target Health software tools are designed to partner with both CROs and Sponsors.

Joyce Hays, Founder and Editor in Chief of On Target

Jules Mitchel, Editor

Roast Chicken Thighs with Mango, Dates and Chopped Pistachios

October 8, 2018

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Target Healthy Eating


We had relatives over for dinner this weekend and served this special chicken recipe over another of my recipes: saffron rice with golden raisins and toasted pine nuts.  D e e lish!  ©Joyce Hays, Target Health Inc.
One of the secrets of this yummy chicken is marinating it overnight and in this case, marinating it over two nights. Joyce Hays, Target Health Inc.
Some people added sauteed broccoli with garlic to the chicken and rice.  ©Joyce Hays, Target Health Inc.

Ingredients

Zest of 1 fresh lemon

4 Tablespoons freshly squeezed lemon juice

1 teaspoon kosher salt

Zest of 1 fresh orange

4 Tablespoons freshly squeezed orange juice

Zest of 1 fresh lime

4 Tablespoons freshly squeezed lime juice

5 Tablespoons extra virgin olive oil

2 Tablespoons whole grain mustard

4 Tablespoons honey

1/2 cup cream sherry

1/2 cup chicken stock or broth

1 bay leaf

1 pinch chili flakes

1 pinch black pepper

2 teaspoons curry powder

8 chicken thighs (skin on, bone in)

3 cups sliced carrots (1/4-inch thick)

1 onion, halved and thinly sliced

25 fresh garlic cloves, sliced

2 cups sliced dates

3 mangos cut in cubes

1 Tablespoon fresh thyme leaves

2/3 cup fresh cilantro, well chopped

2/3 cup fresh parsley, well chopped

2 scallions, chopped (for roast)

2 scallions, thinly sliced (for garnish)

1/2 cup pistachio nuts, toasted, then chopped, for garnish

Fresh delicious ingredients make all the difference. ©Joyce Hays, Target Health Inc.

Directions

1. Get all of your squeezing, slicing, chopping, grinding, etc. done first.

Slicing veggies.  ©Joyce Hays, Target Health Inc.
Peeled the mangoes, then cut into bite size pieces.  ©Joyce Hays, Target Health Inc.

2. Zest of one lemon

3. Zest of one orange

4. Zest of one lime

5. Quarter the lemon, lime and the orange lengthwise, removing any seeds. Thinly slice crosswise into small wedges Reserve slices.

6. In a saucepan, whisk together lemon juice, lime juice, orange juice, oil, mustard, honey, salt, bay leaf, chili flakes and black pepper. Bring to a boil and simmer for 5 minutes. Let cool.

Mustard honey mixture.  ©Joyce Hays, Target Health Inc.

7. In a very large bowl, add the honey mixture.  Next, add carrots, onion, garlic slices, chopped scallions, dates, thyme, curry, flax seeds, cream sherry, chicken stock or broth, orange and lemon slices, cilantro. Stir this mixture several times.

8. Add chicken thighs to the bowl with sauce, stir sauce over the chicken several times.  Cover and let marinate overnight in the refrigerator.

Marinating overnight.  ©Joyce Hays, Target Health Inc.

9. Heat oven to 425 degrees.

10. Line a large roasting dish with parchment to make cleaning easier, later.

11. Transfer all ingredients, including all of the marinade, to a large roasting dish that can go from oven to table. Chicken should be skin side up. Roast until chicken is browned and cooked through, about 30 to 40 for thighs.

12. While chicken is roasting, make saffron jasmine rice, with curry, golden raisins, and toasted pine nuts

13. When the chicken is done, give the sauce in the pan a stir; if the sauce looks too dry add 2 to 3 Tablespoons chicken stock or broth or white wine.  Add the parsley and scallions and stir into the sauce.  If you want the sauce thicker, mix some chickpea flour into several Tablespoons of plain Greek yogurt, and add to the sauce, mixing the flour very well into the rest of the sauce.

14. Continue roasting the carrots until they are tender, about 7 to 12 minutes longer.

Into the oven.  ©Joyce Hays, Target Health Inc.
My plate and ohhhh so flavorful and good. ©Joyce Hays, Target Health Inc.

15. Serve the chicken and saffron rice with sauce spooned over.

16. Sprinkle the chicken with the toasted, chopped pistachio nuts.

We started with wine and finger food in the little quiet area near our Koi. The red wine is Paul Hobbs cabernet. We offered two whites: Pouilly-Fuisse and Pino Grigio, well chilled, of course. ©Joyce Hays, Target Health Inc
Here is the always reliable Santa Margherita Pinot Grigio. Here's to your health, everyone! ©Joyce Hays, Target Health Inc.

Have a great week everyone!

Bon Appetit!

Self-Fitting Hearing Aid Approved by FDA

October 8, 2018

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Regulatory

Editor's Comment: So interesting that a commercial Premium Headphones and Speakers company like BOSE is now in the medical arena. Bravo!!

Approximately 37.5 million adults aged 18 and over report having some trouble hearing without a hearing aid, ranging from "a little trouble" to "deaf." Hearing loss can be caused by aging, exposure to loud noises, certain medical conditions and other factors. Hearing loss may be permanent or temporary. Individuals with permanent hearing loss can use hearing aids to help them hear the speech and sounds around them better, enabling them to communicate more effectively with others.

The FDA has cleared a new device, the Bose Hearing Aid, intended to amplify sounds for individuals 18 years or older with perceived mild to moderate hearing impairment (hearing loss). This is the first hearing aid authorized for marketing by the FDA that enables users to fit, program and control the hearing aid on their own, without assistance from a health care provider.

The Bose Hearing Aid is a user-fitted wireless air conduction hearing aid. Air conduction hearing aids work by capturing sound vibrations through one or more microphones. The signal is processed, amplified, and played back through an earphone placed in the ear canal. Patients can adjust the hearing aid through a mobile application on their phone. This technology enables users to fit the hearing aid settings themselves, in real-time and in real-world environments without the assistance of a health care professional. While users may fit, program and control the Bose Hearing Aid on their own, the device must comply with applicable federal and state laws regarding the sale of hearing aids, including state laws that might require hearing aids to be purchased from or dispensed by a licensed hearing aid dispenser. The FDA is in the process of drafting proposed regulations for a new category of over-the-counter hearing aids as required by the FDA Reauthorization Act of 2017.

In authorizing marketing of the Bose device, the FDA reviewed data from clinical studies of 125 patients, which demonstrated that outcomes with self-fitting of the Bose Hearing Aid are comparable on average to those with professional fitting of the same device with respect to the amount of amplification selected, speech in noise testing and overall benefit. In addition, when participants self-fit the Bose Hearing Aid, they generally preferred those hearing aid settings over the professionally-selected settings. The Bose Hearing Aid has been labeled to inform the consumer when to consult a hearing health care professional.

The Bose Hearing Aid was reviewed under the FDA's De Novo premarket review pathway, a regulatory pathway for some low- to moderate-risk devices that are novel and for which there is no prior legally marketed device.

The FDA granted marketing authorization of the Bose Hearing Aid device to Bose Corporation.

Every Cell Has a Story to Tell in Brain Injury

October 8, 2018

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Neurology

According to an article published in Nature Communications (25 September 2018), while traumatic head injury can have widespread effects in the brain, it is now possible to look in real time at how head injury affects thousands of individual cells and genes simultaneously. This approach, studied in the mouse, could lead to precise treatments for traumatic brain injury (TBI).

For the study, the authors used a novel method known as Drop-seq to closely look at individual brain cells in the hippocampus, a region involved in learning and memory, after TBI or in uninjured control animals. Drop-seq allows thousands of cells and genes to be analyzed simultaneously. Its creation was in part funded by the NIH's Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative.

In one set of experiments the team looked at TBI's effects on gene expression activity in individual cells. Results showed that certain genes were upregulated or downregulated across many different cell types, suggesting these genes may play important roles in TBI. Some of these genes are also known to be involved in diseases, such as Alzheimer's disease, which may help explain how TBI can be a risk factor for other disorders. For example, it was observed that altered activity in genes that are involved in regulating the amyloid protein, which builds up in Alzheimer's.

In particular, the genomic analysis revealed that the activity of the Ttr gene, which is involved in both thyroid hormone transport and scavenging of amyloid protein in the brain, was increased in many cells following TBI, suggesting the thyroid hormone pathway may be a potential target for therapy. When the authors treated animals with the thyroid hormone thyroxine (T4) 1 and 6 hours after brain injury and saw that they performed much better on learning and memory tasks compared to animals that received a placebo. The authors also identified 15 clusters of cells based on gene activity, including two clusters, named Unknown1 and Unknown2, the cells of which had not been described previously in the hippocampus. Further analysis of these clusters revealed that the cells in the Unknown1 group were involved in cell growth and migration and the cells in Unknown2 were involved in cell differentiation during development. The findings in this study also reveal that although two cells may have similar structure and shape, their functions, as suggested by the analysis of gene activity, may differ.

Future studies will examine how TBI affects cells in areas other than the hippocampus. In addition, more research is needed to learn about long-term effects of TBI. Analyzing individual cells and genes may identify potential therapies for TBI.

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