One of the world’s leading health sciences universities, the University of California, San Francisco (UCSF), dates its founding to 1864, when South Carolina surgeon Hugh Toland founded a private medical school in San Francisco.
Toland had come west in 1849 to seek his fortune in the California Gold Rush, but after a few discouraging months as a miner, he set up a surgical practice in booming San Francisco. As his wealth and influence grew, he purchased land in North Beach and opened Toland Medical College.
The Affiliated Colleges, initially located at various sites in San Francisco, were united on a site overlooking Golden Gate Park — known today as Parnassus Heights.
The college prospered, and Toland sought to affiliate with the University of California, which had opened its campus in Berkeley in 1868. UC President Daniel Coit Gilman, who strongly supported science education, set a precedent for the young university by affiliating in 1873 with both Toland Medical College and the California College of Pharmacy. Eight years later, the UC Regents added a dental college.
The three Affiliated Colleges — also called UC departments — were located at various sites in San Francisco, and after several years there was strong interest in bringing them together. San Francisco Mayor Adolph Sutro donated 13 acres on a site overlooking Golden Gate Park — known today as Parnassus Heights — and the new Affiliated Colleges buildings opened in fall 1898.
Establishing an Academic Medical Center
When the great San Francisco earthquake destroyed much of San Francisco and the city’s medical facilities in April 1906, more than 40,000 people took shelter and sought treatment in a tent city in Golden Gate Park, where makeshift outdoor hospitals were set up. The Affiliated Colleges, located on the hill above the encampment in what was then the far western section of the city, suddenly were situated close to a significant population. Faculty sprung into action treating those injured from the earthquake and subsequent fire.
More than 40,000 people took shelter and sought treatment in a tent city in Golden Gate Park after the great 1906 earthquake in San Francisco.
Previous interest in establishing a UC teaching hospital on the Parnassus site took on momentum as a civic responsibility to provide care in an area where it was needed. This type of commitment to community service had been put in motion through an 1873 agreement struck by leaders of the Affiliated Colleges with the city to provide patient care at its public health hospital (later named San Francisco General Hospital).
One of the Affiliated Colleges buildings at Parnassus Heights was renovated as a facility for inpatients, outpatients and dental services, and opened in April 1907 with 75 beds.
With this new facility came the need to recruit nurses and the opportunity to train nursing students. In 1907, the UC Training School for Nurses was established, adding a fourth professional school to the Affiliated Colleges. To make room for expanded clinical services and instruction on Parnassus, the medical college basic science departments — pathology, anatomy and physiology — moved to the Berkeley campus.
In 1911, the last member of the American Indian Yahi tribe began living on the Parnassus campus. He was starving when he walked out of the wilderness in Oroville, Calif., capturing the attention of UC anthropologists who brought him to San Francisco. They named him Ishi, for “man” in the Yahi language. Over the next few years, UC physicians and anthropologists learned about Yahi culture from Ishi, and on weekends, hundreds flocked to the anthropology museum to watch him demonstrate arrow-making and other life skills. He continued to live on Parnassus until 1916, when he died of tuberculosis.
Over the next 50 years, leaders of the Affiliated Colleges and UC moved forward with an eye to establishing an institution with a national reputation. They improved the curriculum, upgraded admission requirements, expanded research and clinical programs, and built new facilities.
One key achievement came in 1914, when the Hooper Foundation for Medical Research selected Parnassus as the site for its work. Second in size only to New York’s Rockefeller Institute, Hooper was the first medical research foundation in the United States to be incorporated into a university.
Karl F. Meyer, PhD, pictured here in the 1920s, led the Hooper Foundation for more than three decades. Under his guidance the foundation became recognized throughout the world as a pioneer center for research on diseases of animals transmissible to man.
The George Williams Hooper Foundation added prestige to the Parnassus site amidst ongoing debate by UC leaders and faculty about the best location for the medical college: San Francisco or Berkeley. Fueling the discussion was a rumor that a major Rockefeller endowment would support a school of public hygiene on the Berkeley campus, but only if the medical college was located there. In a series of votes over the next three decades, the UC Regents supported consolidation of all clinical instruction and basic science departments in San Francisco, but the debate continued.
In 1949, the Regents designated the Parnassus campus as UC Medical Center in San Francisco. It still took several years for all the basic science departments to move back from the East Bay, due in part to the need to secure construction funds for new facilities to house them. When the Medical Sciences Building was completed in 1958, the basic science departments had a new home on the same campus as the clinical departments, uniting the medical college for the first time in 50 years.
Meanwhile, several new research institutes had been established and clinical services expanded.
New clinical facilities had opened about every 10 years, lining and defining Parnassus Avenue: the 225-bed UC Hospital (1917), Clinics Building (1934), Langley Porter Clinic (1942) and Herbert C. Moffitt Hospital (1955).
A highlight of the growth was an art project funded by the Works Progress Administration, setting the stage for a tradition of public art that has continued at UCSF. Artist Bernard Zakheim, a student of Diego Rivera, was commissioned in 1938 to paint a series of murals depicting the history of medicine in the lecture auditorium of UC Hospital, now UC Hall.
A 1941 nursing class in Toland Hall, with the murals of Bernard Zakheim, student of famed artist Diego Rivera, adorning the walls in the background.
By 1958, Parnassus was home to the Biomechanics Laboratory, Cancer Research Institute, Proctor Foundation for Research in Ophthalmology, Metabolic Research Unit and Cardiovascular Research Institute. The addition of Guy S. Millberry Union, also in 1958, provided dorms and support services for students.
Next: 1960s-1980s | 1980s-present | Dive deeper into the history of UCSF
Jul. 6—ASHLAND — Cultural influences permeate a new exhibit at the Highlands Museum and Discovery Center.
"Pamper: A History of Cosmetics and Self-Care" observes every aspect of personal care, from the use of soap to makeup," curator Heather Whitman said, noting the exhibit covers cosmetics, hair care products and perfumes from the 1920s through the 1990s.
Whitman said Egyptians were likely the first to use makeup — both men and women. Examples include kohl, which was used as eyeliner; eyeshadow in blue or green; and lipstick.
"The Egyptians were big proponents of bodily hygiene," Whitman said. "They used oils and ointments to clean, soften and protect their skin. Two thousand years later, makeup made its way to the ancient Greeks and Romans. Women used mixtures of plants, lead and mercury to dye their lips and cheeks."
During the middle ages, cosmetic use spread across Europe. Pale skin was valued and the look was in flour, chalk and even lead. Elizabeth I is noted for her very pale skin which she achieved with lead and vinegar. Makeup use petered out during the Victorian era, as Queen Victoria frowned on the use of cosmetics. Women who wore makeup during this time were considered to be prostitutes.
Makeup made a return in the 1920s, thanks to the rise of Hollywood and the Flapper movement.
Shampoo appeared in the 20th century, rising in popularity with bathing. Proctor and Gamble created the first synthetic shampoo in 1934. Curling the hair may have begun in 1872 with nonelectric curling irons, but rollers could date to the Egyptians. Hair dryers, invented in 1890, took beauty parlors by storm, showing up almost immediately. More portable inventions appeared in 1910.
The exhibit also takes on perfume, deodorant, nail care, shaving, toothpaste, sunscreen and lotion.
On the main floor, the exhibit will run through October.
Milk arcs across the canvas from the breasts of a naked woman stumbling through a pile of bed sheets as an infant is placed under her armpit to suckle. The woman in Venetian artist Jacopo Tintoretto’s painting is Juno who is the wife of Jupiter, an unfaithful husband and god of the sky. It was Jupiter who carried his half-mortal son, Hercules, toward Juno’s breast so the child could obtain full immortality from her divine milk. Startled from slumber, jets of her milk streak across the heavens, each terminating with a star. According to myth, these traces formed the Milky Way. Indeed, the root of the word “galaxy” comes from the Greek gála, which means milk.
Milk is not only humanity’s food but also a liquid dripping with symbolism, from spiritual salvation to maternal devotion. Human breast milk is liquid gold, a magical substance that has been celebrated over centuries and is long known as a medical remedy as well as an infant foodstuff.
For much of Greek and Roman antiquity, milk was thought to be menstrual blood transformed by the heat of childbirth, transported from the uterus via a special vein. As such, it was viewed with suspicion, as a possible contagion. The potential for milk to transmit physical or moral characteristics is evidenced in the strict advice on finding suitable wet nurses that can be found throughout history from disparate continents the world over.
Today, breastfeeding itself is also an emotional and sometimes divisive topic. Generally presented to new mothers as the best thing they can do for a baby’s development, parents often lack practical support, which would allow them to establish and sustain breastfeeding. This can leave parents facing numerous challenges, including balancing the demands of breastfeeding with paid employment or being asked to leave when nursing in a public place.
Throughout art history, we can find depictions of divine or mythological milk, like the aforementioned painting “Origin of the Milky Way” (1575). Or gushing breasts as a manifestation of nature, as in the 16th-century Fountain of Neptune in Bologna. Though idealized for centuries in Madonna and Child imagery, the corporeal, emotional, and practical realities of feeding a baby remain less often explored.
Other bodily fluids, typically blood or urine, have been used by artists since at least the 1960s, such as Richard Hambleton’s Bloodscapes series (c. 1992–1994), Antony Gormley’s use of his blood and semen in his Bodily Fluids series (1986–1992), and Portia Munson’s “Menstrual Print With Text” (1993). Paleolithic painters mixed pigment with their own spit.
Because of its associations with the maternal body, it is unsurprising that human milk — as both subject matter and medium — still represents something of a taboo in contemporary art, so much so that artists Oona and Lori Baldwin were removed from the Scope Gallery’s Art Basel exhibition due to claims that their performance was too controversial. “Milking the Artist” (2022) involved Oona producing breast milk while talking about the fetishization of female bodies, then auctioning glasses of milk to the audience for up to $200,000.
Was seeing someone express milk, albeit from a prosthetic breast, that provocative? Or was it the discomfort of monetizing milk, which in turn places a monetary value on caring labor? Or was the milk itself controversial? Can milk be considered a medium, as much as blood or spit?
Breast milk intervenes in the celluloid in Jennifer West’s handmade film, “My Milk Is Your Shit/Nirvana Alchemy Film 2” (2007), where the artist freezes 35mm film in breast milk. Eva Zasloff’s “Reflections of light on breastmilk particles” (2018) took images of the microscopic particles and projected them into an intimate space at MIT.
This telescoping in on breast milk offers shifting perspectives on what it signifies, as delicate orbs float across the field of vision like stars. A galaxy of proteins, minerals, fats, antibodies, and bioactive components — which makes milk a living substance — are revealed in this close examination. Responsive to a baby’s needs, every mother’s milk is different. Zasloff herself cares for families as a physician in the postpartum period, and her art is a reminder of the scale and specificity of maternal work.
Aimee Koran explores the unpredictability and generative aspects of the lactating body, especially in her ongoing series Milkscapes, elegant drifts of drying milk magnified in wall-hanging prints with opaline echoes of Hambleton’s otherworldly forms. In 2022, her prints of curdling spilled milk were made into eight flags, and hung outside Philadelphia’s Maternity Care Coalition’s Early Head Start Building, capturing transitory moments of maternity and appearing like the surfaces of another planet.
Approaching breast milk as a medium allows us to reconsider it as a subject matter too. Breastfeeding is often thought of as a process; rarely do we think about the product — milk — outside of child-rearing contexts. What are the origins of milk itself? Under what conditions is it produced? What value do we place on the labor of lactation and how taboo do we really think the final product is?
Ine Poppe caused a storm in the Netherlands when, after the birth of her child in 1983, she began to explore what it meant to be a milk-producing being. She started collecting her milk and used it to make cheese. “Dutch Mother’s Milk Cheese” (1984) formed part of a multimedia project that spanned audio, video, publications, and performances. Photographs show milk being expressed from the artist using glass pumps, sometimes with the help of men dressed in lab coats and surgical masks. Mainstream Dutch newspaper de Volkskrant claimed the work “makes us puke.”
This shock value of breastmilk hasn’t abated, as countless headlines attest. For example, a deli in Covent Garden, London, made the news in 2018 when it added breast milk ice cream to its menu. Parents who breastfeed an infant beyond babyhood are often met with disapproval and sometimes outright hostility.
The idea for a milk-tasting session, based on the idea of wine tasting, came to Canadian artist Jess Dobkin while she was pregnant. Offering audiences the chance to try different kinds of milk-centered concepts of hospitality and to probe group and cultural dynamics.
The first Lactation Station “happening” took place in Toronto in 2006 as part of a broader program of performance art around the theme of “taste.” Using donated, pasteurized breast milk, Dobkin set up bar areas in gallery spaces, and small groups were invited to try two samples each, served in a shot glass.
Lactation Station also involved in-depth interviews with milk donors, whose stories played over video in the gallery during the tastings. The responsibility and care Dobkin afforded her donors were meticulous, yet a high degree of trust was placed in the tasters, too, who were assumed to be respectful.
Dobkin was aware that the setup was an invitation to engage in a taboo activity, and this meant the happenings were designed to create a sense of order and normality, complete with menus and a maître d’. The gallery context was less about delineating the experience as “art,” and more about creating a sense of control with clean, white walls conveying hygiene, playing with the “indecency” (to some) of expressing milk in public.
In her hosting, Dobkin reciprocated the enormous generosity and trust donors and samplers placed in her. But the focus was ultimately on the milk itself, each demo differentiated by a unique name and backstory, based on interviews with the artist. As people drank from tiny plastic glasses of “Sweet Fall Harvest” and “Passion’s Legacy,” she advised them on the woman’s diet at the time of expression, the age of their child, and details of the women’s experiences with breastfeeding.
Lactation Station was staged three times, in 2006, 2012, and 2016. The artist sensed the cultural shifts that were taking place over this period, with women appearing more confident in breastfeeding, largely ascribed to the rise of social media and the potential for online connectivity, support, and conversation.
Dobkin placed emphasis on isolating the donors from their milk. They were alluded to through the naming of milk and their testimonies on the gallery walls, but their genuine labor was kept private. The final product served as a bodily commodity removed from its means of production.
It is a reminder that for all the accurate glamorous photoshoots of women wearing breast pumps, expressing milk remains an activity that is often hidden from view. Dobkin plays with this idea too, allowing the promotional posters for Lactation Station to be ribald as a counterpoint to the care and sanctity of the act itself. The striking promotional image shows the artist topless, manipulating her own breast to jet a substantial arc of breastmilk into a wine glass. The wine glasses point to instructions from Toronto public health authorities for the gallery to place highly visible signs around the space forbidding minors to demo the breastmilk. Milk was for adults only.
In “Baraka” (2013), Lynn Lu stood in front of an audience at Arte Nomade in Alma, Canada, and read an academic paper on breastfeeding and wet nursing in Islamic culture while connected to a breast pump. After the readings, the milk was poured into porcelain spoons, and the artist fed members of the audience. Milk is a gift, an act of hospitality, drawing attention to what we ask of our caretakers and how this labor is often overlooked or taken for granted.
Lu’s work is an invitation to intimately connect and join a community of “milk-kin.” In Ancient Egypt, for instance, biological children of wet nurses to the royal family were allowed to call themselves “milk-kin” of the king.
Allyship was a driving force behind the formation of the Los Angeles-based group Mother Artists Making Art (MAMA), who came together in the 1990s to support one another in investigating invisible or taboo aspects of the maternal experience.
The collective, comprising the artists Lisa Mann, Athena Kanaris, Karen Schwenkmeyer, Deborah Oliver, and Lisa Schoyer, worked on a number of projects that explored breastfeeding. The maternal response to their new postpartum bodies, transformed into a source of nourishment, was the subject of “Milkstained” (1998), a multisensory performance at the Electronic Café International in Santa Monica, which was also live-streamed on the internet as part of a festival celebrating video and new media art.
The performance began with a naked woman lying on a white pedestal, her back to the audience, white cloth draped over her buttocks and thighs. Soon, the visual flow of the body’s odalisque pose was disrupted by white liquid pouring down her back as damp patches blossomed on the white cloth. More women joined the stage, some hand-expressing milk from their very real breasts, others pouring milk into a fountain of cocktail glasses. Spoken word, the sounds of a baby feeding, and the unmistakable whir of an electric breast pump echoed around the small gallery space. In the end, the audience was invited to taste the freshly expressed milk. How different is this experience from Lactation Station, given that tasters heard the rhythmic whir of a breast pump, saw the nipple distend and stretch, and the milk spray into the bottle?
The perceived disarray and sensuality of the birthing body, the cultural taboos surrounding human milk, and the censored dimensions of lactation are rife with possibility. To deliver space to fully explore the political, poetic, and literal messiness of milk in all its forms, we need to expose the oversimplified dichotomy of breast versus bottle feeding and demonstrate that our individual actions as parents exist within societal structures that must be interrogated and improved.
The history of using essential oils and their aromas to Excellerate health and well-being dates back thousands of years. Like today, patients would inhale or topically apply these oils, which were typically extracted from plants – from leaves to flowers to roots to bark.
Pixabay
Extravagant claims are sometimes made about essential oils.But not until the 1930s was this form of therapy considered to have true potential in mainstream health care. That was when Rene Maurice Gattefossé, a French chemist who coined the word aromatherapie, wrote extensively about the properties of essential oils.
Today, depending on whom you talk to, aromatherapy comprises anything from pleasant odors associated with personal hygiene and cleaning products to a serious therapy practiced by aromatherapists.
As a nurse and educator for more than 30 years, I’ve taught nursing students everything from intensive care to end-of-life support. Since becoming an aromatherapist in 2016, I’ve tried to determine how this practice could fit into the health care community and how hospitals and clinics might use aromatherapy as adjunct support for different kinds of ailments.
Medical skepticism
Aromatherapy is not approved by the U.S. Food and Drug Administration for treatment of any medical condition. This is one reason why many clinicians are reluctant to use aromatherapy in their practice. They also say there’s not sufficient evidence to show that it works – nor do most have any training in aromatherapy.
Conversely, public acceptance of aromatherapy has never been higher. But this is not always a good thing. Although information about aromatherapy abounds on the internet, many of the claims are based on personal experience. This is not scientific evidence.
Yet millions of Americans subscribe to expensive multilevel marketing strategies that seem to suggest anything and everything is treatable with essential oils. But as with any substance, there are risks as well as benefits to using them – and sometimes, the information found online neglects to mention those risks.
Studies aren’t convincing
Though studies supporting the efficacy of aromatherapy are increasingly visible in peer-reviewed journal articles, they do not always stand up to scrutiny. In my own research, I have found that many studies on aromatherapy are flawed.
Here are just some of the problems: Exactly which essential oil was used is often not mentioned in these studies. How much essential oil was used, and for how long, is not always accurately described. The qualifications of the practitioner are frequently missing. Study participants may have a poor sense of smell, or a personal aversion to certain smells, which could skew results. The studies don’t always provide clear explanations on how they control for bias. Some have few participants, and many are done only on animals.
Also, some essential oils have many varieties; for example, some types of lavender may have calming properties, yet others are known for clearing of the sinuses. This is a critical distinction that may not be understood by the authors of these studies.
The good news: Efforts are underway to Excellerate the quality of research, and the future for this therapy appears promising.
Extravagant claims are sometimes made about essential oils.
Potential treatments
According to the National Cancer Institute, a growing body of studies shows aromatherapy can Excellerate the physical, mental and spiritual well-being of cancer patients and help reduce anxiety, nausea and vomiting.
The National Center for Complementary and Integrative Health notes that essential oils may be used for insomnia, pain, anxiety and for cancer treatment – though, again, rigorous research is lacking.
Researchers are exploring whether aromatherapy can help dementia and substance use disorder patients.
A 2021 meta-analysis of clinical trials revealed that the essential oil bergamot can reduce anxiety in humans. Based on this, it is reasonable to think that using bergamot via inhalation may reduce anxiety. It is also “generally recognized as safe”by the FDA.
The Aromatic Research Quality Appraisal Taskforce was founded in 2021 and has created a checklist to assess the quality of aromatherapy studies. This is foundational work to try to get aromatherapy research up to the highest standards.
Easy to use
Inhalation of the essential oil often incorporates aroma sticks – small cylinder-shaped tubes about the size of a lipstick container with a wick containing essential oils – or patches worn by the patient, or diffusers using either cool water vapor or ultrasonic dispersal.
For topical applications, essential oils do not dissolve in water, so use of a vegetable or other oil is necessary to dilute and decrease their concentration.
But before introducing essential oils into your life, you first have to find accurate information about them. There are professional organizations working to maintain a standard of practice for aromatherapy.
There is nothing wrong with searching for natural and clean products that might help you. This is why so many people are attracted to beautiful essential oils and their lovely aromas. Just remember that natural and beautiful does not mean they work – or that the oils are without risk.
This article is republished from The Conversation, an independent and nonprofit source of news, analysis and commentary from academic experts, under a Creative Commons license.
Days after Antonio "AJ" Armstrong Jr. was found guilty of killing his parents, he got a court-appointed attorney for his appeal because he can't afford to pay one.
HOUSTON — Antonio "AJ" Armstrong Jr. was back in the courtroom Friday morning where he told the judge he's broke and can't afford to hire an attorney for his appeal.
Judge Kelli Johnson appointed a public defender to represent the 23-year-old found guilty earlier this week of killing his parents, Antonio Armstrong Sr. and Dawn Armstrong, in 2016.
Armstrong was in handcuffs and wearing a yellow jumpsuit, instead of orange, since he was convicted of capital murder.
Unlike his three trials, only a handful of family members were there, including his wife, Kate, who broke down in tears outside the courtroom where she was comforted by her mother.
The Armstrong verdict
On Wednesday, jurors in Armstrong Jr.'s third trial convicted him after hearing from 31 witnesses over 11 days of testimony.
Because he was 16 at the time of the murders, he wasn't eligible for the death penalty and was automatically sentenced to life in prison with the possibility of parole after 40 years.
Armstrong Jr. showed no emotion in the courtroom when Judge Johnson read the verdict but his attorneys said he was very upset.
"He's devastated but he's one of the strongest young men I've ever known," defense attorney Rick DeToto said.
Jurors deliberated about 10.5 hours, about half the time as jurors in the earlier trials who couldn't agree on verdicts so mistrials were declared.
Dozens of family members, including Armstrong's wife, sister, grandparents, aunts, uncles, and cousins attended the trial to show support. His sister Kayra, who was 12 when their parents were killed, and his paternal grandmother Kay Winston testified for the defense.
"His family is amazing. Obviously, they're devastated right now. This is a difficult time for them, but they will rally and help A.J. and his young son and his wife get through this," DeToto said.
"We tried to deliver him hope, you know, it's a long road," defense attorney Chris Collings said. "Everybody's in shock and disbelief and it's going to take some time to process everything that's just occurred."
Harris County District Attorney Kim Ogg said her team, led by prosecutors John Jordan and Ryan Trask, spent countless hours to bring justice on behalf of the victims.
"In trying to speak for those who no longer had a voice to defend themselves or say what happened, our job was to find justice for them," Ogg said in a news conference. "Antonio Sr. and Dawn Armstrong died because they were trying to be good parents because they wanted their children to do right -- not to lie, to work to be law-abiding, contributing adults."
Throughout the trial, the victim's oldest son, Josh Armstrong, was painted as a more likely suspect by the defense because of his history of mental illness. But prosecutors said those issues didn't start until after the murders.
"There's somebody else we were in the courtroom defending and that was Josh Armstrong, and we passionately believe that it was inexcusable to drag his name through this courtroom in order to get this guilty defendant off," Jordan said.
Prosecutors said the jury was "confident in its decision" without needing the blood evidence that's now the focus of a federal lawsuit Armstrong Jr. filed against the City of Houston, accusing HPD of planting it.
Trask said the main factors in their decision were the shot Armstrong Jr. fired through the floor of his bedroom with the murder weapon, the fire he set outside his parents' bedroom, the 911 call and the inconsistencies in his statements.
Before the case went to the jury, prosecutors and defense attorneys spent four hours of sometimes heated closing arguments trying to convince jurors that Armstrong Jr. was or wasn’t the killer. Both sides recapped mountains of evidence, including the 911 call, the defendant's interview with homicide detectives, security alarm records, cell phone records and text messages.
The prosecution
Prosecutors pointed to three key events before Antonio Sr. and Dawn Armstrong were killed while they slept. About a week before the July 29, 2016 killings, Armstrong Jr. shot his father’s gun through the floor of his bedroom through a pillow and blanket.
"He shot the murder weapon in his room. Who does that?" prosecutor John Jordan asked loudly. "Purely coincidental? It’s ridiculous. Ridiculous."
Jordan said the then-16-year-old initially lied to detectives and said he did it because his friend had never heard a gun go off but later admitted he was alone at the time.
Forty-eight hours before the deaths, Jordan said Armstrong Jr. poured gasoline into a bottle of rubbing alcohol and set a fire outside his parents’ bedroom. He said Armstrong also searched how to make a car bomb on his iPad.
Jordan brought up Armstrong Jr.’s claim that he saw a 6-foot-tall, masked intruder after hearing gunshots in his parents’ room. The prosecutor pointed out that he didn’t mention an intruder on the 911 call or during the first few hours of his interview with detectives.
Also, during that interview, Jordan told jurors that Armstrong Jr. never asked about his mom or showed any emotion when told she was dead.
To counter the defense’s claims that the victim’s oldest son, Josh Armstrong, was a more likely killer, prosecutors called on his longtime girlfriend, Hannah Pilon, who testified that his mental health issues didn’t start until after his parents were killed.
While Josh was also having issues in school and smoking marijuana, jurors saw dozens of text messages with his mother that appeared to show a loving relationship. She sometimes confided in him about her frustrations with his younger brother.
Armstrong Jr. had been in trouble with his parents for getting kicked out of Kinkaid High School, failing in school and smoking marijuana.
Jordan showed cell phone records that showed Armstrong Jr.’s phone was being used just before the early-morning killings, beginning at 1:09 a.m. Jordan said the cell phone and motion sensors chronicled Armstrong Jr. moving around the house until 1:40 a.m. when he called 911.
Finally, he pointed to alarm records that he said proved the victims and their two youngest children were the only ones in the home. "The alarm records show nobody entered the house that night, period, end of discussion."
Throughout the trial, jurors heard from 31 witnesses, including the defendant’s sister Kayra Armstrong, who was 12 when her parents were killed, and his paternal grandmother Kay Winston.
One family member who hasn't attended any of the trials was again the focus of much of the testimony. The defense has tried to paint the Armstrongs' oldest son Josh Armstrong as an alternate suspect. He has a history of severe mental health issues although there were no medical records of such issues before his parents' deaths.
Both sides brought on forensics psychiatrists to go over thousands of pages of medical records documenting Josh Armstrong’s downward spiral in the months and years after his parents were killed, beginning on Dec. 19, 2016.
The defense argued that Josh Armstrong showed signs of paranoia and schizophrenia before their deaths. They point to testimony from the sister and grandmother who said Josh Armstrong “was different” when he moved back home from Blinn College weeks before the killings.
Both women testified that he neglected basic hygiene, would stare off into space and spend hours in the bathroom talking to himself. They said he was smoking a lot of marijuana and was kicked out of his parents’ house after throwing a party while they were out of town.
"Both doctors (for defense and prosecution) agreed and testified that marijuana can serve as a trigger for psychotic episodes," defense attorney Chris Collings told the jury.
He pointed out that Josh Armstrong thought he was both God and the devil during later stays at psychiatric hospitals and once told a doctor "I witnessed my parents’ murders."
Collings referred to Kay Winston’s testimony that Josh Armstrong once lit a towel on fire and put it in the oven when he was living with her after the killings. She and Kayra Armstrong both testified they were afraid of him as his issues became more severe.
The defense also cast doubt on the accuracy of alarm records and blood spatter evidence and the lack of DNA evidence.
Collings told jurors: "There is nothing, absolutely nothing that proves AJ was in the bedroom where his parents were shot to death."
"That is reasonable doubt all day long," defense attorney Rick DeToto said.
Case history
Armstrongs found dead in 2016
On July 29, 2016, investigators said Armstrong Jr. shot his parents at close range while they slept inside the Bellaire-area home.
Armstrong Jr. called 911 at 1:40 a.m. and told dispatchers he heard gunshots coming from his parent's room. He said his then-12-year-old sister was sleeping downstairs.
Hours after the shootings, Armstrong Jr. blamed a masked intruder, but investigators said they found no evidence of forced entry into the house.
Dawn Armstrong was shot twice in her head and Armstrong Sr. was shot once. They said both had pillows over their heads. Dawn Armstrong was pronounced dead at the scene while Armstrong Sr. was taken to a hospital where he later died. Both were 42.
HPD Sgt. J.P. Horelica said after discovering there was no forced entry and a bullet hole in the ceiling of the Armstrongs' bedroom, the focus shifted to Armstrong Jr. as a suspect.
Prosecutors said a .22-caliber pistol was found on the kitchen counter along with a note that read, "I have been watching you for a long time. Come get me.”
Armstrong Sr. was a motivational speaker. He and his wife owned 1st Class Training in Bellaire. Armstrong Sr. played football for Texas A&M and the Miami Dolphins and coached both of his sons when they were younger. Armstrong Sr. was also an associate pastor, according to police. Dawn Armstrong's Facebook page said they "serve in ministry together."
The final results of a landmark study published in The Lancet Infectious Diseases confirm that the benefits of combining the RTS,S/AS01E (RTS,S) malaria vaccine with antimalarial drugs in settings of highly seasonal malaria transmission continue over five years.
The vaccine-drug combination reduced clinical malaria episodes, including cases of severe malaria, and deaths from malaria in young children by nearly two-thirds compared with either RTS,S vaccination or seasonal malaria chemoprevention (SMC) alone.
The Phase 3 study, coordinated by the London School of Hygiene & Tropical Medicine (LSHTM) with partners Institut des Sciences et Techniques and Institut de Recherche en Sciences de la Santé, Burkina Faso; the Malaria Research and Training Center, University of Sciences, Techniques and Technologies of Bamako, Mali; and PATH, Seattle, Washington, U.S., followed more than 5,000 children over a total of five years. The study also confirmed that the efficacy of RTS,S in preventing malaria in highly seasonal settings was similar, or "non-inferior," to that of SMC.
The findings from five years of follow-up are consistent with those from the first three years, which were published in 2021. Those findings contributed to the World Health Organization's (WHO) decision that year to recommend the RTS,S vaccine for use in settings of moderate-to-high malaria transmission, including its use in areas with highly seasonal malaria or in areas of perennial malaria transmission with seasonal peaks. These new findings confirm the potential of seasonal vaccination to provide a high level of protection in young children over the first five years of life, a period when this protection is needed.
LSHTM's Professor Brian Greenwood, MD, a member of the research team, said, "In addition to the study's findings—which by themselves are remarkable—we can say that children who received the RTS,S-drug combination and also used bed nets likely had greater than 90% protection against malaria episodes during the study. This points to the importance of ensuring access to multiple malaria prevention tools for reducing the tremendous burden of malaria disease and death in these highly seasonal settings."
Professor Jean-Bosco Ouedraogo, Ph.D., of Institut des Sciences et Techniques, also a member of the research team, said, "It is tremendously exciting to know that our research could benefit the health of millions of children at high risk of malaria in countries like Burkina Faso and Mali. The challenge now is to determine how best to deliver the vaccine-drug combination and to follow these highly protected children as they grow older."
In light of what is already known about the potential for malaria "rebound" following the withdrawal of malaria prevention, children in the study who received SMC and/or the vaccine are being followed for a further two years. This additional follow-up will help to determine how long protection lasts and whether the high level of protection against malaria provided by the combination of SMC and seasonal RTS,S vaccination impaired the acquisition of naturally acquired immunity among the children in the study by reducing the number of infections they received in early life. Currently, SMC is not given to children above the age of 5 years in most countries where it is deployed.
The newly published results come from a two-year extension of the Phase 3 study begun in Burkina Faso and Mali in 2017. The extension began in April 2020, when 5,048 (94%) of the 5,433 children who completed the initial three-year follow-up were re-enrolled.
Over the full five years, protective efficacy of the RTS,S-SMC combination was very similar to that seen in the first three years, with protective efficacy of the combination versus SMC alone being 57.7% and versus RTS,S alone, 59%. The comparable figures for the first three years of the study were 62.8% and 59.6%, respectively. (The protective efficacy of each intervention alone could not be assessed because all children participating in the study received one or both interventions; there was not a group of children who received neither intervention.)
Compared with SMC alone, the RTS,S-SMC combination reduced by two-thirds hospital admissions for WHO-defined severe malaria (66.8%), malarial anemia (65.9%), blood transfusions (68.1%), and malaria deaths (66.8%).
Professor Alassane Dicko, MD, of the Malaria Research and Training Center and a member of the research team, said, "Our study showed that administering the RTS,S vaccine seasonally every year reduces the burden of malaria drastically in children under the age of 5, who are the most affected by this disease. Rapid implementation of this new additional tool is needed to reduce the huge burden of malaria on children in our countries."
SMC, which involves giving antimalarial drugs sulfadoxine-pyrimethamine and amodiaquine to young children four or five times during the rainy season when malaria transmission peaks, is highly effective in preventing malaria and was recommended by WHO in 2012 for use in areas with highly seasonal transmission.
Continued testing of a subset of children in the study found that the drugs currently used for SMC remain effective in the study areas. However, the study authors concluded that seasonal vaccination with RTS,S could be a potential solution, if resistance to the drugs increases and no alternatives are available.
The study took advantage of the fact that RTS,S efficacy is highest in the months immediately after vaccination, at about 70%. In this study, the primary course of three vaccine doses, administered one month apart in the run-up to the rainy season, was shown to have similar protective efficacy against clinical malaria as four courses of SMC. Efficacy of the combined intervention against clinical malaria was higher in the few months after the primary series of vaccination than after the booster doses, but efficacy was seen in each year of the study.
There were no safety issues following multiple annual booster doses of RTS,S, with some children receiving four seasonal booster doses after the initial three-dose primary series.
"These study results come at a critical time," said Mary Hamel, MD, Senior Technical Officer at the WHO Product Development Research Unit and Team Lead for Malaria Vaccines. "Nearly half of childhood deaths from malaria are in children living in areas of highly seasonal transmission. These data show the remarkable reduction in malaria that can be achieved by strategically delivering the vaccine with other effective interventions—and the potential for saving many young lives."
Mark Palmer, DPhil, Director of International Relations at the Medical Research Council, said, "It is exciting to see the potential for a significant reduction in malaria cases and deaths in children under 5 demonstrated by this landmark study. This crucial evidence expands the range of tools available to combat this disease in the future."
"This study's findings should be a source of hope for families in these highly malarious areas," said Ashley Birkett, Ph.D., Global Head of Malaria Vaccines and Biologics at PATH. "But they also present a challenge to regulators, policymakers, and donors: how to ensure that these lifesaving interventions are available and accessible to all who need them. No child should die from malaria or have their potential sapped by repeated malaria illnesses."
Thomas Breuer, MD, Chief Global Health Officer at GSK, said, "Once again, the RTS,S malaria vaccine is making scientific history. At GSK, we are excited by these new findings—the result of continued collaboration among scientists across the globe, including Africa, and with organizations such as PATH. We continue to see the potential for this vaccine to help protect children at risk of malaria while also paving the way for future vaccines against malaria. We remain fully committed to the rollout of this important vaccine in Africa."
"We know that seasonal administration of a vaccine poses a challenge to immunization services," said LSHTM's Professor Daniel Chandramohan, Ph.D., a member of the research team. "Not only are additional resources needed to determine how best to deliver vaccines in highly seasonal settings, but we also need to understand the barriers to implementing this approach and whether they can be overcome."
"Around 45 million children were reached with SMC in 2021," said Professor Greenwood. "Yet malaria is still killing tens of thousands of children each year in areas where SMC is used, and many more are hospitalized. This study points to what is possible when all the available tools are brought to bear, although new and improved tools and approaches are still needed if we are to end malaria altogether."
More information: Seasonal vaccination with RTS,S/AS01E vaccine with or without seasonal malaria chemoprevention in children up to the age of 5 years in Burkina Faso and Mali: a double-blind, randomised, controlled, phase 3 trial, The Lancet Infectious Diseases (2023). DOI: 10.1016/S1473-3099(23)00368-7
Provided by PATH
Citation: Dramatic reductions in malaria cases and deaths continue over five years with seasonal malaria vaccine-drug combination (2023, August 22) retrieved 24 August 2023 from https://medicalxpress.com/news/2023-08-reductions-malaria-cases-deaths-years.html
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During intense closing arguments, both sides recapped mountains of evidence, including the 911 call, alarm records, text messages and Armstrong Jr.'s brother Josh.
HOUSTON — More than seven years after Antonio Sr. and Dawn Armstrong were shot to death in their Bellaire-area home, their youngest son, Antonio "AJ" Armstrong Jr., is waiting to learn his fate in his third capital murder trial.
Jurors began deliberating around 1:45 p.m. Tuesday. At one point, they sent a note to the judge asking to review some evidence. Just after 7 p.m., the jurors were dismissed for the day. They're expected to return Wednesday morning at 9:30.
Before the case went to the jury, prosecutors and defense attorneys spent four hours of sometimes heated closing arguments trying to convince jurors that Armstrong Jr. was or wasn’t the killer. Both sides recapped mountains of evidence, including the 911 call, the defendant's interview with homicide detectives, security alarm records, cell phone records and text messages.
The prosecution
Prosecutors pointed to three key events before Antonio Sr. and Dawn Armstrong were killed while they slept. About a week before the July 29, 2016 killings, Armstrong Jr. shot his father’s gun through the floor of his bedroom through a pillow and blanket.
“He shot the murder weapon in his room. Who does that?” prosecutor John Jordan asked loudly. “Purely coincidental? It’s ridiculous. Ridiculous.”
Jordan said the then-16-year-old initially lied to detectives and said he did it because his friend had never heard a gun go off but later admitted he was alone at the time.
Forty-eight hours before the deaths, Jordan said Armstrong Jr. poured gasoline into a bottle of rubbing alcohol and set a fire outside his parents’ bedroom. He said Armstrong also searched how to make a car bomb on his iPad.
Jordan brought up Armstrong Jr.’s claim that he saw a 6-foot-tall, masked intruder after hearing gunshots in his parents’ room. The prosecutor pointed out that he didn’t mention an intruder on the 911 call or during the first few hours of his interview with detectives.
Also, during that interview, Jordan told jurors that Armstrong Jr. never asked about his mom or showed any emotion when told she was dead.
To counter the defense’s claims that the victims’ oldest son, Josh Armstrong, was a more likely killer, prosecutors called on his longtime girlfriend, Hannah Pilon, who testified that his mental health issues didn’t start until after his parents were killed.
While Josh was also having issues in school and smoking marijuana, jurors saw dozens of text messages with his mother that appeared to show a loving relationship. She sometimes confided in him about her frustrations with his younger brother.
Armstrong Jr. had been in trouble with his parents for getting kicked out of Kinkaid High School, failing in school and smoking marijuana.
Jordan showed cell phone records that showed Armstrong Jr.’s phone was being used just before the early-morning killings, beginning at 1:09 a.m. Jordan said the cell phone and motion sensors chronicled Armstrong Jr. moving around the house until 1:40 a.m. when he called 911.
Finally, he pointed to alarm records that he said proved the victims and their two youngest children were the only ones in the home. "The alarm records show nobody entered the house that night, period, end of discussion."
The defense
Throughout the trial, jurors heard from 31 witnesses, including the defendant’s sister Kayra Armstrong, who was 12 when her parents were killed, and his paternal grandmother Kay Winston.
One family member who hasn't attended any of the trials was again the focus of much of the testimony. The defense has tried to paint the Armstrongs' oldest son Josh Armstrong as an alternate suspect. He has a history of severe mental health issues although there were no medical records of such issues before his parents' deaths.
Both sides brought on forensics psychiatrists to go over thousands of pages of medical records documenting Josh Armstrong’s downward spiral in the months and years after his parents were killed, beginning on Dec. 19, 2016.
The defense argued that Josh Armstrong showed signs of paranoia and schizophrenia before their deaths. They point to testimony from the sister and grandmother who said Josh Armstrong “was different” when he moved back home from Blinn College weeks before the killings.
Both women testified that he neglected basic hygiene, would stare off into space and spend hours in the bathroom talking to himself. They said he was smoking a lot of marijuana and was kicked out of his parents’ house after throwing a party while they were out of town.
“Both doctors (for defense and prosecution) agreed and testified that marijuana can serve as a trigger for psychotic episodes,” Defense attorney Chris Collings told the jury.
He pointed out that Josh Armstrong thought he was both God and the devil during later stays at psychiatric hospitals and once told a doctor “I witnessed my parents’ murders.”
Collings referred to Kay Winston’s testimony that Josh Armstrong once lit a towel on fire and put it in the oven when he was living with her after the killings. She and Kayra Armstrong both testified they were afraid of him as his issues became more severe.
The defense also cast doubt on the accuracy of alarm records and blood spatter evidence and the lack of DNA evidence.
Collings told jurors “There is nothing, absolutely nothing that proves AJ was in the bedroom where his parents were shot to death."
“That is reasonable doubt all day long,” defense attorney Rick DeToto said.
Both earlier trials ended in mistrials because jurors couldn’t agree on a verdict. In one case, it was eight to four in favor of guilty. In the other case, it was eight to four in favor of not guilty.
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