Health and Medical News and Resources

General interest items edited by Janice Flahiff

US Government Complementary & Alternative Medicine Agency Changes Name to Reflect Mission

nciih

 

 

The National Center for Complementary and Alternative Medicine (NCAAM) is now the National Center for Complementary and Integrative Health, or NCCIH.
According to the NIH Web page explaining the name change ,  “[t]he change was made to more accurately reflect the Center’s research commitment to studying promising health approaches that are already in use by the American public. Since the Center’s inception, complementary approaches have grown in use to the point that Americans no longer consider them an alternative to medical care. For example, more than half of Americans report using a dietary supplement, and Americans spend nearly four billion dollars annually on spinal manipulation therapy. The name change is in keeping with the Center’s existing Congressional mandate and is aligned with the strategic plan currently guiding the Center’s research priorities and public education activities.

The Center’s mission is unchanged.”The Center’s research priorities include the study of complementary approaches, such as spinal manipulation, meditation, and massage, to manage pain and other symptoms that are not well-addressed by conventional treatments, to encourage self-care methods that support healthier lifestyles, and to uncover potential usefulness and safety issues of natural products. The practices and products that will continue to be studied by the Center are prioritized by four guiding principles: scientific promise, amenability to be studied using the highest quality research methods, use by the American public, and the potential impact on public health.”

 Especially for Health Care Professionals

PubMed   often yields  more comprehensive searches in integrative and complementary medicine.  After a search is done, select Complementary Medicine in the left side bar (under Subjects).

Please do not hesitate to contact a reference librarian for consultation and assistance with your reference and research needs. Let us save you time and alleviate frustration!

December 19, 2014 Posted by | Uncategorized | Leave a comment

[Report] Trouble in Toyland 2014: Avoiding Dangerous Toys

Trouble in Toyland 2014: Avoiding Dangerous Toys

Report: Avoiding dangerous toys

Trouble in Toyland 2014

The 29th Annual Survey of Toy Safety
Released by: U.S. PIRG Education Fund

For almost 30 years, U.S. PIRG Education Fund has conducted an annual survey of toy safety, which has led to an estimated 150 recalls and other regulatory actions over the years, and has helped educate the public and policymakers on the need for continued action to protect the health and wellbeing of children.

Among the toys surveyed this year, we found numerous choking hazards and five toys with concentrations of toxics exceeding federal standards. In addition to reporting on potentially hazardous products found in stores in 2014, this installment of the report describes the potential hazards in toys and children’s products.

The continued presence of these hazards in toys highlights the need for constant vigilance on the part of government agencies and the public to ensure that children do not end up playing with unsafe toys.

Standards for toy safety are enforced by the Consumer Product Safety Commission (CPSC). Safety standards include limits on toxics in children’s products, size requirements for toys for small children, warning labels about choking hazards, measures to keep magnets and batteries inaccessible, and noise limits.

U.S. PIRG Education Fund staff examined hundreds of toys to confirm that they are safe. We discovered that unsafe toys remain widely available. The problems we found include:

    • Lead. Childhood exposure to even low levels of lead can undermine development, damaging academic achievement and attentiveness. We found unsafe levels of lead in one set of play sheriff and police badges. (More details and photos of all unsafe toys can be found in Appendix A.)
    • Chromium. Skin contact with chromium can cause severe allergic reactions including skin redness, swelling and ulcers. Chromium compounds are also known to cause cancer. This year, lab tests revealed that a tambourine marketed to children ages two and older contained chromium at nearly 10 times the legal limit.
    • Phthalates. Exposure to phthalates at crucial stages of development may harm development of the male reproductive system and is linked to early puberty. Lab tests confirmed that several items purchased by our shoppers contained high levels of banned phthalates. Those items include a rubber duck, plastic-covered hairclips, and a Dora the Explorer backpack.
    • Small parts are pieces that might block a child’s airway. Children, especially those under age three, can choke on small parts. Our shoppers purchased a set of foam blocks marketed to children two and up that contained multiple small parts that fit into a choke test cylinder. We also identified multiple toys containing near-small parts, which are pieces that almost fit into the choke tube and can be a choking hazard.
    • Small balls less than 1.75 inches in diameter represent a choke hazard for children three years old and younger. We found small balls that were not labeled with the appropriate choke hazard warning. We also remain concerned about other small, rounded toys, such as toy food, that present the same choke hazard as small balls but are not labeled as a hazard.
    • Balloons are easily inhaled in attempts to inflate them and can become stuck in children’s throats. Balloons are responsible for more choking deaths among children than any other toy or children’s product. As in past years, we continue to find balloons on store shelves marketed to children under eight.
    • Magnets. When two or more powerful magnets are swallowed, they can have fatal health consequences as their attractive forces draw them together inside the body, perforating intestinal walls. Our shoppers purchased small, high-powered magnets, despite their being recalled by the CPSC.
    • Batteries. When batteries are ingested, chemical reactions can burn through the esophagus and blood vessels, causing fatal internal bleeding. Our shoppers purchased a toy whale that contains batteries that are accessible to small children and are nearly small enough to constitute a choke hazard. The toy has been recalled in Australia because small children can easily remove the batteries.
    • Excessive noise. Excessive noise exposure can lead to hearing loss. This is especially problematic for young children: Hearing loss at an early age has ramifications for speech development. This year, our shoppers found toys that are loud, though not necessarily in violation of federal limits.

Despite recent progress in making toys safer, the findings of our 2014 investigation, as well as recent recalls and legal actions against importers, highlight the need for continued attention to shortcomings in existing standards and vigilance on the part of the shopping public. To keep children safe from potentially hazardous toys, there is still more to do.

Policymakers should continue building upon recent progress in the strengthening of toy safety standards. The CPSC should:

    • Continue to vigorously enforce the Consumer Product Safety Improvement Act’s mandatory standards for toys, including strict limits on lead and lead paint in any toys, jewelry or other articles for children under 12 years;
    • Vigorously enforce the Consumer Product Safety Improvement Act’s permanent ban on the use of three specific phthalates in all toys and children’s products;
    • Upgrade the interim ban on three additional phthalates into a permanent prohibition and expand it to include additional phthalates;
    • Enlarge the small parts test tube to be more protective of children under three;
    • Consider extending the standard for toys with spherical ends to apply to toys intended for children under six years old instead of under four years;
    • Change the small-ball rule to include small round or semi-round objects, and not just “balls” in the strictest definition, since these toys pose the same hazards as small balls (this is especially true of rounded toy food, since it is “intended” to be eaten);
    • Enforce the use of the United States’ statutory choke hazard warning label;
    • Continue to enforce CPSC rules requiring online warning labels; and
    • Fully enforce sound and battery standards.

Parents can also take steps to protect children from potential hazards. We recommend that parents:

    • Shop with U.S. PIRG Education Fund’s Toy Safety Tips, available at toysafetytips.org.
    • Examine toys carefully for hazards before purchase – and don’t trust that they are safe just because they are on a store shelf.
    • Report unsafe toys or toy-related injuries to the CPSC at www.saferproducts.gov.
    • Subscribe to government announcements of recalled products at www.recalls.gov.
    • Remember, toys on our list are presented as examples only. Other hazards may exist.

For toys you already own:

    • Remove small batteries if there is any question over their security or inaccessibility and keep them out of reach of children;
    • Remove batteries from or tape over the speakers of toys you already own that are too loud; and
    • Put small parts, or toys broken into small parts, out of reach. Regularly check that toys appropriate for your older children are not left within reach of children who still put things in their mouths.

December 12, 2014 Posted by | Consumer Safety | , , , , , , , , | Leave a comment

[CDC Press release] Only 3 in 10 Americans with HIV have virus in check | Full Text Reports…

Only 3 in 10 Americans with HIV have virus in check |

National Center for HIV/AIDS, Viral Hepatitis,
STD, and TB Prevention
404-639-8895, NCHHSTPMediaTeam@cdc.gov

HIV STAGES OF CARE
There is an urgent need to reach more people with testing and make sure those with the virus receive prompt, ongoing care and treatment.
Entire Infographic

Just 30 percent of Americans with HIV had the virus under control in 2011, and approximately two-thirds of those whose virus was out of control had been diagnosed but were no longer in care, according to a new Vital Signs report published today by the Centers for Disease Control and Prevention.  The new study underscores the importance of making sure people with HIV receive ongoing care, treatment, and other information and tools that help prevent transmission to others, as well as the need to reach more people with HIV testing.  Among those whose infection was not under control, more than three times the proportion (66 percent) were no longer in care as had never been diagnosed (20 percent).

The HIV epidemic continues to threaten the health and well-being of many Americans – with more than one million people living with the disease in the U.S. and 50,000 new infections each year.

When used consistently, antiretroviral medication can keep HIV controlled at very low levels in the body (known as viral suppression), allowing people with HIV to live longer, healthier lives and reducing the likelihood they will transmit HIV to others. Treatment has been shown to reduce sexual transmission of HIV by 96 percent, and U.S. clinical guidelines now recommend that everyone diagnosed with HIV receive treatment, regardless of their CD4 cell count or viral load.

“For people living with HIV, it’s not just about knowing you’re infected – it’s also about going to the doctor for medical care,” said CDC Director Tom Frieden, M.D., M.P.H.  “And for health care facilities, it’s not just about the patients in your care – it’s every person diagnosed, and every person whose diagnosis has not yet been made.  Key to controlling the nation’s HIV epidemic is helping people with HIV get connected to – and stay in – care and treatment, to suppress the virus, live longer and help protect others.”

The new study estimates that of the 1.2 million Americans living with HIV in 2011, 70 percent did not have their virus under control. Among the nearly 840,000 people who had not achieved viral suppression:

  • 66 percent had been diagnosed but were not engaged in regular HIV care,
  • 20 percent did not yet know they were infected,
  • 4 percent were engaged in care but not prescribed antiretroviral treatment, and
  • 10 percent were prescribed antiretroviral treatment but did not achieve viral suppression.

The percentage of Americans with HIV who achieved viral suppression remained roughly stable (26 percent in 2009 vs. 30 percent in 2011).

CDC focus on stopping HIV transmission through treatment

CDC has increased the focus on diagnosing people with HIV, supporting linkage to ongoing care and treatment, provision of risk reduction information, and increasing medication adherence.  By making the most of these strategies for those who are HIV-positive, as well as other high impact strategies to protect those who remain uninfected but are at highest risk for HIV, CDC believes substantial progress can be made in reducing new infections.

“There is untapped potential to drive down the epidemic through improved testing and treatment, but we’re missing too many opportunities,” said Jonathan Mermin, M.D., director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and Tuberculosis Prevention. “Treatment is crucial.  It is one of our most important strategies for stopping new HIV infections.”

Current initiatives to promote HIV testing and treatment include innovative partnerships to make HIV testing simple, accessible and routine; programs to help health departments identify and reach out to infected individuals who have fallen out of care; and public awareness campaigns to urge testing and encourage people with HIV to seek ongoing care.

These efforts are an essential component of the National HIV/AIDS Strategy, launched in 2010.  Key goals of the strategy include reducing HIV incidence, increasing access to care and optimizing health outcomes, and reducing HIV-related health disparities.

Younger adults with HIV least likely to have virus under control

Today’s study also found that viral suppression increased with age, with young people significantly less likely than older age groups to have their virus under control – only 13 percent of people aged 18-24 were virally suppressed, compared to 23 percent among those aged 25-34, 27 percent among those aged 35-44, 34 percent among those aged 45-54, 36 percent among those aged 55-64, and 37 percent among those aged 65 and older. The researchers attribute the disparity in large part to the fact that fewer than half (49 percent) of 18- to 24-year olds with HIV have been diagnosed, underscoring the need for more HIV testing in this population.

“It’s alarming that fewer than half of HIV-positive young adults know they are infected,” said Eugene McCray, M.D., director of CDC’s Division of HIV/AIDS Prevention.  “Closing that gap could have a huge impact on controlling HIV – knowing your status is the first critical step toward taking care of your own health and avoiding transmission to others.”

The study did not find statistically significant differences in viral suppression by race or ethnicity, sex, or risk group.
For additional resources on today’s analysis, visit
www.cdc.gov/nchhstp/newsroom.

December 12, 2014 Posted by | Uncategorized | , , , , , , , | Leave a comment

[Press release] Why Scientists Are Blaming Cilia for Human Disease – Scientific American

Why Scientists Are Blaming Cilia for Human Disease – Scientific American.

Hairlike structures on cells may play a role in a host of genetic disorders, including kidney degeneration, vision impairment and even some cancers

Hairlike cilia may be at the roots of of several genetic disorders.
Image Courtesy of StudyBlue.com

Scientists now believe that a number of genetic disorders, from polycystic kidney disease to some forms of retinal degeneration, can ultimately be traced back to cilia—bristly, hairlike structures that dot cell surfaces.

In a review article published in the December 1 BioScience, George B. Witman, a cellular biologist at the University of Massachusetts Medical School, highlighted the growing body of evidence that abnormal or absent cilia can cause a wide range of human disorders, dubbed “ciliopathies.”

“Kidney disease and blindness, multiple digits, shortened bones or extremities, obesity—all of these things, it turns out, are due to defects in cilia,” he says. Experts add that the discovery of a common thread between these disparate disorders may eventually help researchers develop gene-based therapies to combat those conditions.

At first blush, cilia seem relatively innocuous. As they beat back and forth outside the cell, coordinated brushes of so-called motile cilia regulate fluid flow nearby. But almost all human cells also have one primary, or nonmotile, cilium that functions more like a molecular antenna. The primary cilium is an internally dynamic structure, packed with proteins that detect and convey important messages to its cell about the local environment. “The signaling machinery is concentrated in the cilia,” Witman says. “All in this very tightly controlled, constrained space.”

December 12, 2014 Posted by | Medical and Health Research News | , , , , , , , , , , , | Leave a comment

[Press release] How long can Ebola live? No one really knows — ScienceDaily

How long can Ebola live? No one really knows

December 10, 2014

How Long Can Ebola Live?

Pitt researcher publishes article showing that the literature is lacking, receives NSF grant to conduct further study
Contact:

Cara Masset

412-624-4361

Cell: 412-316-7508

PITTSBURGH—The Ebola virus travels from person to person through direct contact with infected body fluids. But how long can the virus survive on glass surfaces or countertops? How long can it live in wastewater when liquid wastes from a patient end up in the sewage system? In an article published Dec. 9 in the journal Environmental Science & Technology Letters, Kyle Bibby of the University of Pittsburgh reviews the latest research to find answers to these questions.

HeKyle BibbyKyle Bibby and his co-investigators didn’t find many answers.

“The World Health Organization has been saying you can put (human waste) in pit latrines or ordinary sanitary sewers and that the virus then dies,” says Bibby, assistant professor of civil and environmental engineering in Pitt’s Swanson School of Engineering. “But the literature lacks evidence that it does. They may be right, but the evidence isn’t there.”

Bibby and colleagues from Pitt and Drexel University explain that knowing how long the deadly pathogen survives on surfaces, in water, or in liquid droplets is critical to developing effective disinfection practices to prevent the spread of the disease. Currently, the World Health Organization guidelines recommend to hospitals and health clinics that liquid wastes from patients be flushed down the toilet or disposed of in a latrine. However, Ebola research labs that use patients’ liquid waste are supposed to disinfect the waste before it enters the sewage system. Bibby’s team set out to determine what research can and can’t tell us about these practices.

The researchers scoured scientific papers for data on how long the virus can live in the environment. They found a dearth of published studies on the matter. That means no one knows for sure whether the virus can survive on a surface and cause infection or how long it remains active in water, wastewater, or sludge. The team concluded that Ebola’s persistence outside the body needs more careful investigation.

To that end, Bibby recently won a $110,000 National Science Foundation grant to explore the issue. His team will identify surrogate viruses that are physiologically similar to Ebola and study their survival rates in water and wastewater. The findings of this study will inform water treatment and waste-handling procedures in a timely manner while research on the Ebola virus is still being conducted.

December 12, 2014 Posted by | Health News Items | , , , , , | Leave a comment

[Press release] More holistic approach needed when studying the diets of our ancestors

More holistic approach needed when studying the diets of our ancestors.

[Journals]: More holistic approach needed when studying the diets of our ancestors

Contact: Emily Murphy / 773-702-7521 / emurphy@press.uchicago.edu

According to an article in the December 2014 issue of The Quarterly Review of Biology, current studies modeling the diets of early hominids are too narrow.

Researchers have long debated how and what our ancestors ate. Charles Darwin hypothesized that the hunting of game animals was a defining feature of early hominids, one that was linked with both upright walking and advanced tool use and that isolated these species from their closest relatives (such as ancestors of chimpanzees); modified versions of this hypothesis exist to this day. Other scholars insist that while our ancestors’ diets did include meat, it was predominantly scavenged and not hunted. Still others argue that particular plant foods such as roots and tubers were of greater importance than meat in the diets of these species.

 

Research technology has come a long way since Darwin’s time, making possible the kind of analysis early scholars could only have imagined. Recent work has presented reconstructions of early hominid diets on the basis of chemical makeups of fossil tooth enamel, evidence of microscopic wear on teeth, and advanced studies of craniodental anatomy, to name a few.

 

However, according to Ken Sayers (Georgia State University) and C. Owen Lovejoy (Kent State University) in an article published in the December 2014 issue of The Quarterly Review of Biology, although modern-day technology provides valuable insight, such tools alone cannot provide a complete picture of the diet of early hominids. Instead, they should be included—alongside other methodologies—in holistic studies grounded in the fundamentals of modern evolutionary ecology.

 

Sayers and Lovejoy suggest that researchers should examine a species’ particular habitat and “whole-body” anatomy, including digestion, locomotion, and possible cognitive abilities. In particular, foraging theory—a branch of evolutionary ecology that investigates animal feeding decisions through the lens of efficiency principles—is especially important to consider, as it demonstrates that diet is regulated by the potential value and costs of exploiting individual food items (whether plant, animal, or other) and by the relative abundance of the most profitable foods. In the case of the earliest-known hominids, evidence about their morphology and likely cognitive abilities—in addition to data obtained from modern technologies—provide little support for a reliance on any one particular food type. Rather, these species likely had a broadly omnivorous diet that became increasingly generalized over time.

 

According to Sayers and Lovejoy, the early hominid diet can best be elucidated by considering the entire habitat-specific resource base and by quantifying the potential profitability and abundance of likely available foods. Furthermore, they warn that hypotheses focusing too narrowly on any one food type or foraging strategy—such as hunting or scavenging or any one particular plant category—are too restrictive and should be viewed with caution. Modeling these species’ diets instead “requires a holistic, interdisciplinary approach that goes beyond merely what we can observe chemically or through a microscope, and draws from ecology, anatomy and physiology, cognitive science, and behavior.”

 

December 12, 2014 Posted by | Nutrition | , , , , , | Leave a comment

[Press release] People with opioid dependence in recovery show ‘re-regulation’ of reward systems — ScienceDaily

People with opioid dependence in recovery show ‘re-regulation’ of reward systems

Newswise — December 9, 2014 – Within a few months after drug withdrawal, patients in recovery from dependence on prescription pain medications may show signs that the body’s natural reward systems are normalizing, reports a study in the Journal of Addiction Medicine, the official journal of the American Society of Addiction Medicine. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

English: Source: The National Institute on Dru...

English: Source: The National Institute on Drug Abuse, part of the National Institutes of Health (NIH), which is part of the U.S. Department of Health and Human Services. Image taken from http://www.drugabuse.gov/pubs/teaching/Teaching2/Teaching4.html http://www.drugabuse.gov/pubs/teaching/Teaching2/largegifs/slide18.gif (Photo credit: Wikipedia)

The study by Scott C. Bunce, PhD, of Penn State University College of Medicine, Hershey, and colleagues provides evidence of “physiological re-regulation” of disrupted brain and hormonal responses to pleasurable stimuli—both drug- and nondrug-related.

Signs of Reward System Disruption After Drug Withdrawal…
The pilot study included two groups of seven patients in residential treatment for dependence on opioid pain medications. One group had recently gone through medically assisted opioid withdrawal—within the past one to two weeks. The other group was in extended care, and had been drug-free for two to three months. A group of normal controls were studied for comparison.

The researchers performed several tests to assess changes in the “brain reward system” during early recovery. After drug withdrawal, many people with opioid dependence have “persistent changes in the reward and memory circuits”—they may experience heightened “rewards” or “pleasure” in response to drugs and related stimuli, but greatly reduced responses to naturally pleasurable stimuli (such as good food, or friendship).

Dr Bunce explains, “This is thought to occur because opiates are potent stimulators of the brain’s reward system; over time, the brain adapts to the high level of stimulation provided by opiates, and naturally rewarding stimuli can’t measure up.” Such dysregulation of the natural reward system may contribute to the high risk of relapse during recovery.

The test results showed several significant differences in the reward system between groups. A test of startle reflexes showed that patients with recent drug withdrawal had reduced pleasure responses to “natural reward” stimuli—for example, pictures of appetizing foods or people having fun.

In brain activity studies, patients with recent drug withdrawal showed heightened responses to drug-related cues, such as pictures of pills. In the extended-care patients, these increased responses to drug cues—in a region of the brain called the prefrontal cortex, involved in attention and self-control —were significantly reduced.

…May Lead to New Objective Measures of Recovery
Patients who had recently withdrawn from opiates also had high levels of the stress hormone cortisol (adrenaline). In the patients who had been drug-free for a few months, cortisol levels were somewhat reduced, although not quite as low as in healthy controls. The recently withdrawn group also had pronounced sleep disturbances, while sleep in the extended care group was similar to controls.

All of these changes—brain and hormonal responses to drug cues and natural rewards, as well as sleep disturbances—were correlated with abstinence time. The more days since the patient used drugs, the lower the abnormal responses.

The study supports past research showing dysregulation of the reward system during early recovery from opioid dependence. It also provides evidence that these responses may become re-regulated during several weeks in residential treatment—a period of “clinically documented” abstinence from opioids.

That’s a potentially important step forward in addiction medicine research, Dr Bunce believes. “It shows that if the patient remains in treatment and off drugs for several months, the body’s natural reward systems may have the capacity to return toward normal, making it easier for them to remain drug-free outside the treatment setting.” With further study, tests of the natural reward system might provide useful, objective markers of recovery—clinical tests that help to evaluate how the patient’s recovery is proceeding.

Such tests might help in managing the difficult problem of prescription opioid dependence—an ongoing epidemic associated with a high risk of relapse after drug withdrawal. Dr Bunce and colleagues are conducting a follow-up study, funded by the National Institute on Drug Abuse, to determine whether measures of the brain’s reward system, sleep and the stress response system indicate the capacity for re-regulation and the patient’s risk of relapse during recovery.

Click here to read “Possible Evidence for Re-regulation of HPA Axis and Brain Reward Systems Over Time in Treatment in Prescription Opioid-Dependent Patients.”

December 12, 2014 Posted by | Medical and Health Research News | , , , , , , , , , | Leave a comment

[Press release] Combining insecticide spraying and bed nets no more protective against malaria than nets alone — ScienceDaily

Combining insecticide spraying and bed nets no more protective against malaria than nets alone — ScienceDaily.

Niger distribution malaria nets 20apr06 01

Niger distribution malaria nets 20apr06 01 (Photo credit: Wikipedia)

From the 5 December 2014 Lancet press release

The combined use of spraying insecticide inside homes and insecticide-treated bed nets is no better at protecting children against malaria than using bed nets alone, a study in The Gambia suggests. The findings, published in The Lancet, should encourage donors to invest their limited resources in additional bed nets, the more cost-effective solution to tackling malaria*.

 

Related article
Malaria death rate halved, but many still lack nets – health – 09 December 2014 – New Scientist

December 12, 2014 Posted by | Consumer Health | , , , , , , | Leave a comment

[Press release] Controlling obesity with potato extract

Controlling obesity with potato extract.

From the 9 December 2014 McGill University press release

Extract of Irish potatoes, rich in polyphenols, reduces weight gain to a surprising extent
Published: 9Dec2014

Take a look in your pantry: the miracle ingredient for fighting obesity may already be there. A simple potato extract may limit weight gain from a diet that is high in fat and refined carbohydrates, according to scientists at McGill University.

The results of their recent study were so surprising that the investigators repeated the experiment just to be sure.

Investigators fed mice an obesity-inducing diet for 10 weeks. The results soon appeared on the scale: mice that started out weighing on average 25 grams put on about 16 grams. But mice that consumed the same diet but with a potato extract gained much less weight: only 7 more grams. The benefits of the extract are due to its high concentration of polyphenols, a beneficial chemical component from the fruits and vegetables we eat.

“We were astonished by the results,” said Prof. Luis Agellon, one of the study’s authors. “We thought this can’t be right – in fact, we ran the experiment again using a different batch of extract prepared from potatoes grown in another season, just to be certain.”

The rate of obesity due to over-eating continues to rise in Canada, affecting 1 in every 4 adults. Obesity increases the risk of cardiovascular disease and cancer. According to this study, potato extracts could be a solution for preventing both obesity and type 2 diabetes.

Extract derived from 30 potatoes

“The daily dose of extract comes from 30 potatoes, but of course we don’t advise anyone to eat 30 potatoes a day,” says Stan Kubow, principal author of the study, “as that would be an enormous number of calories.” What the investigators envisage instead is making the extract available as a dietary supplement or simply as a cooking ingredient to be added in the kitchen.

Popularly known for its carbohydrate content, the potato is also a source of polyphenols. “In the famous French diet, considered to be very healthy, potatoes – not red wine – are the primary source of polyphenols,” says Kubow. “In North America, potatoes come third as a source of polyphenols – before the popular blueberries.”

A low-cost solution

“Potatoes have the advantage of being cheap to produce, and they’re already part of the basic diet in many countries,” Kubow explains. “We chose a cultivated variety that is consumed in Canada and especially rich in polyphenols.”

December 12, 2014 Posted by | Nutrition | , , , , , , | Leave a comment

Dying trying: The UN’s Development Agenda for the next 15 Years

Originally posted on Ruminations:

UN Secretary General Dr Ban Ki-moon today presented his synthesis report on the post-2015 Development Agenda. Entitled “The Road to Dignity by 2030: Ending Poverty, Transforming All Lives and Protecting the Planet”, this is Ban Ki-moon’s updating of the Millennium Development report (which Kofi Annan rather more modestly called “We the Peoples – The Role of the United Nations in the 21st Century).

I note in passing that the former penchant for having development “Decades” covering distinct topics has now swollen into a 15-year catch-all cycle. WHO’s Health for All, which all of us were supposed to be enjoying by the year 2000, was taken over by the UN and prolonged into 2015 in the Millennium Development Goals (MDGs). This is now being extended to 2030 in a new set of Sustainable Development Goals (SDGs) launched by the Secretary General’s report.

Well, health was not achieved by all by the…

View original 543 more words

December 11, 2014 Posted by | Uncategorized | Leave a comment

ClinicalKey tips from their latest newsletter

Try the Presentation Maker. When you find an image in your search results that you’d like to use in a presentation, hover over the image and click the “Add to Presentation Maker” button. Presentation Maker automatically imports the necessary citations into your presentation.

Save articles for later – without leaving the results page. If you find something interesting in your results but need to come back to it, save it for later. Make customized, searchable tags to keep your content organized.

 

Another tip …Meyler’s Side Effects Titles are in ClinicalKey

Search in CliicalKey for the specific substance
OR
Search for Meyler’s in ClinicalKey, these selections will appear in a drop down menu

  • Meyler’s Side Effects of Analgesics and Anti-inflammatory Drugs
  • Meyler’s Side Effects of Antimicrobial Drugs
  • Meyler’s Side Effects of Cardiovascular Drugs
  • Meyler’s Side Effects of Drugs Used in Anesthesia
  • Meyler’s Side Effects of Drugs in Cancer and Immunology
  • Meyler’s Side Effects of Endocrine and Metabolic Drugs
  • Meyler’s Side Effects of Herbal Medicines
  • Meyler’s Side Effects of Psychiatric Drugs

 

December 10, 2014 Posted by | Uncategorized | | Leave a comment

[News article] Friendly bacteria are protective against malaria

From the 4 December 2014 ScienceDaily article

Date: December 4, 2014
Source: Instituto Gulbenkian de Ciencia
Summary:
In a breakthrough study, a research team discovered that specific bacterial components in the human gut microbiota can trigger a natural defense mechanism that is highly protective against malaria transmission. It is estimated that 3.4 billion people are at risk of contracting malaria and WHO data from 2012 reveal that about 460,000 African children died from malaria before reaching their fifth birthday. The present study argues that if one can induce the production of antibodies against alpha-gal in those children one may be able to revert these grim numbers.
Over the past few years, the scientific community became aware that humans live under a continuous symbiotic relationship with a vast community of bacteria and other microbes that reside in the gut. These microbes, know as the gut microbiota, do not necessarily cause disease to humans and instead can influence a variety of physiologic functions that are essential to maintain health. Some of these microbes, including specific strains of Escherichia coli (E. coli) that are usual inhabitant of the human gut, express on their surface sugar molecules (known as carbohydrates or glycans). These glycans can be recognized by the human immune system, which results in the production of high levels of circulating natural antibodies in adult individuals. It has been speculated that natural antibodies directed against sugar molecules expressed by the microbiota may also recognize perhaps similar sugar molecules expressed by pathogens, that is, parasites that can cause diseases in humans.
It was well established before these studies, that onlya fraction of all adultindividuals thatare confronted to the bite of mosquitoes in endemic areas of malaria do become infected by the Plasmodium parasite and eventually go on to contract malaria. This argued that adults might have a natural defense mechanism against malaria transmission, which is in sharp contrast with children under 3-5 years old that are much more susceptible to contract malaria. When analyzingindividuals from an endemic area of malaria in Mali,in collaboration with a research team lead by Peter D. Crompton at National Institute of Allergy and Infectious Diseases (Maryland; USA) and at the University of Sciences, Techniques and Technologies of Bamako (Bamako, Mali), the research team lead by Miguel Soares established that thoseindividuals that have the lowest levels of circulating anti-alpha-gal antibodies are also those that are the most susceptible to contract malaria. In contrast those individuals that have the highest levels of circulating anti-alpha-gal antibodies are less susceptibleto be infected and to develop malaria. They conclude thatthe reason why young infants are so susceptible to contract malaria is probably due to the fact that they have not yet generatedsufficient levels of circulating natural antibodies directed against the alpha-gal sugar molecule….

Miguel Soares adds: “We observed that children under 3 years old do not have sufficient levels of circulating anti-alpha-gal antibodies, which might be one of the reasons for their exquisite susceptibility to malaria. One of the beauties of the protective mechanism we just discovered is that it can be induced via a standard vaccination protocol, leading to the production of high levels of anti-alpha-gal antibodies that bind and kill the Plasmodium parasite. If we can vaccinate these young children against alpha-gal, many lives might be saved.”

December 9, 2014 Posted by | Medical and Health Research News | , , , , | Leave a comment

[Press release] Drugs in the environment affect plant growth

From the 3 December 2014 University of Exeter press release

The drugs we release into the environment are likely to have a significant impact on plant growth, finds a new study nled by the University of Exeter Medical School and Plymouth University.

By assessing the impacts of a range of non-steroidal anti-inflammatory drugs, the research has shown that the growth of edible crops can be affected by these chemicals – even at the very low concentrations found in the environment.

Published in the Journal of Ecotoxicology and Environmental Safety, the research focused its analysis on lettuce and radish plants and tested the effects of several commonly prescribed drugs, including diclofenac and ibuprofen. These drugs are among the most common and widely used group of pharmaceuticals, with more than 30 million prescribed across the world every day.

The potential for these chemicals to influence plants is becoming increasingly relevant, particularly as waste management systems are unable to remove many compounds from our sewage. Drugs for human use make their way into soil through a number of routes, including the use of sewage sludge as fertiliser and waste water for irrigation.

Crop_research_main

Crop image via Shutterstock.

This study looked for a number of changes in edible plants, assessing factors such as water content, root and shoot length, overall size and how effectively the plants photosynthesised.

Each drug was shown to affect the plants in very specific ways, with marked differences between drugs that are closely related. For example, drugs from the fenamic acid class affected the growth of radish roots, whilst ibuprofen had a significant influence on the early root development of lettuce plants.

Dr Clare Redshaw, one of the scientists leading the project at the Medical School’s European Centre for Environment & Human Health, said: “The huge amounts of pharmaceuticals we use ultimately end up in the environment, yet we know very little about their effects on flora and fauna. As populations age and generic medicines become readily available, pharmaceutical use will rise dramatically and it’s essential we take steps towards limiting environmental contamination. We haven’t considered the impact on human health in this study, but we need to improve our understanding quickly so that appropriate testing and controls can be put in place.”

There have been growing concerns about the presence of pharmaceuticals in the environment, particularly as evidence emerges of the effects they can have on the development of animals and antibiotic resistance in bacteria. Yet their ability to affect plant growth is poorly understood.

December 9, 2014 Posted by | environmental health, Medical and Health Research News | , , , , | Leave a comment

[Press release] ‘Patients-in-waiting’: Even the perceived risk of disease prompts intention to act

From the 3 December 2014 Yale press release

Bubble_rev01_YaleNews(Photo via Shutterstock)

With so much focus on risk factors for disease, we are living in an era of surveillance medicine, in which the emphasis on risk blurs the lines between health and illness, argue researchers at Yale and Syracuse universities in a study published in the December issue of the Journal of Health and Social Behavior.

Co-authors Rene Almeling, assistant professor of sociology at Yale, and Shana Kushner Gadarian, assistant professor of political science at Syracuse University, conducted a nationwide survey of American adults to determine if healthy people react to hypothetical genetic risk information by wanting to take action.

The main finding of the study was that as the level of risk increases from 20% to 80%, people are more likely to want to take action of all kinds, including seeking information about the disease, managing risk by taking medications or undergoing surgery, consulting family members, organizing finances, and participating in community and political events.

The results of the survey showed the importance of risk information even to healthy people, suggesting that the experience of living between health and disease is not just limited to those who are already patients. “Social scientists have argued that we are now treating risk as if it were a disease, and these results provide strong evidence for that claim,” says Almeling.

Participants were asked if they have a family member or close friend with the disease to which they had been assigned to assess whether experience with the disease increased their interest in taking action. The researchers were startled to find that seeing a disease up close did not make much difference; across the board, people responded to the hypothetical risk information by wanting to take action.

The survey questions were hypothetical, but the issues that the study raises are real, note the researchers, adding that people use risk information to make significant medical decisions, such as whether to increase the frequency of cancer screenings or undergo prophylactic surgery.

“It is extremely important for social scientists and clinicians to understand how people respond to these risk numbers and how they are being used to make important life decisions,” says Almeling. She added, “Studies like this can aid health care providers in offering genetic information with sufficient context to insure that people make the best decisions for themselves.”

Given that people throughout the population — from the healthy to the sick and those with and without a family history of disease — had largely identical reactions suggests that normality has indeed become precarious and that we are all patients-in-waiting, say the researchers.

 

December 9, 2014 Posted by | Psychology, Public Health | , , , , , | Leave a comment

[Reblog] Germs. The pseudoscience of quality improvement

hmmm…position justifications? power plays?

C-Dif

From the 7 December 2014 post by Karen Siebel, MD at the HealthCare Blog

No one wants a hospital-acquired infection—a wound infection, a central line infection, or any other kind.  But today, the level of concern in American hospitals about infection rates has reached a new peak—better termed paranoia than legitimate concern.

The fear of infection is leading to the arbitrary institution of brand new rules. These aren’t based on scientific research involving controlled studies.  As far as I can tell, these new rules are made up by people who are under pressure to create the appearance that action is being taken.

Here’s an example.  An edict just came down in one big-city hospital that all scrub tops must be tucked into scrub pants. The “Association of periOperative Registered Nurses” (AORN) apparently thinks that this is more hygienic because stray skin cells may be less likely to escape, though there is no data proving that surgical infection rates will decrease as a result.  Surgeons, anesthesiologists, and OR nurses are confused, amused, and annoyed in varying degrees.  Some are paying attention to the new rule, and many others are ignoring it.  One OR supervisor stopped an experienced nurse and told to tuck in her scrub top while she was running to get supplies for an emergency aortic repair, raising (in my mind at least) a question of misplaced priorities.

The Joint Commission, of course, loves nothing more than to make up new rules, based sometimes on real data and other times on data about as substantial as fairy dust.

A year or two ago, another new rule surfaced, mandating that physicians’ personal items such as briefcases must be placed in containers or plastic trash bags if they are brought into the operating room.  Apparently someone thinks trash bags are cleaner.

Now one anesthesiology department chairman has taken this concept a step further, decreeing that no personal items at all are to be brought into the operating room–except for cell phones and iPods.  That’s right, iPods, not iPads.  This policy (of course) probably won’t be applied uniformly to high-ranking surgeons or to people like the pacemaker technicians who routinely bring entire suitcases of equipment into the OR with them.

What’s particularly irrational about this rule is that cell phones likely are more contaminated with bacteria than briefcases or purses, even if they’re wiped off frequently.

 

Instead of creating more and more rules governing the care of all patients, perhaps we need to focus on the subsets of patients and case types that we already know are at higher risk, and examine what additional steps we need to take on their behalf.

 

 

 

December 9, 2014 Posted by | health care | , , , , , , , | Leave a comment

[Press release] Wealth, power or lack thereof at heart of many mental disorders

From the 8 December 2014 EurkAlert!

UC Berkeley study finds self-worth key to diagnoses of psychopathologies

Donald Trump’s ego may be the size of his financial empire, but that doesn’t mean he’s the picture of mental health. The same can be said about the self-esteem of people who are living from paycheck to paycheck, or unemployed. New research from the University of California, Berkeley, underscores this mind-wallet connection.

UC Berkeley researchers have linked inflated or deflated feelings of self-worth to such afflictions as bipolar disorder, narcissistic personality disorder, anxiety and depression, providing yet more evidence that the widening gulf between rich and poor can be bad for your health.

The social self.

The social self. (Photo credit: Wikipedia)

 

 

“We found that it is important to consider the motivation to pursue power, beliefs about how much power one has attained, pro-social and aggressive strategies for attaining power, and emotions related to attaining power,” said Sheri Johnson, a UC Berkeley psychologist and senior author of the study published in the journal Psychology and Psychotherapy: Theory, Research and Practice.

In a study of more than 600 young men and women conducted at UC Berkeley, researchers concluded that one’s perceived social status – or lack thereof – is at the heart of a wide range of mental illnesses. The findings make a strong case for assessing such traits as “ruthless ambition,” “discomfort with leadership” and “hubristic pride” to understand psychopathologies.

“People prone to depression or anxiety reported feeling little sense of pride in their accomplishments and little sense of power,” Johnson said. “In contrast, people at risk for mania tended to report high levels of pride and an emphasis on the pursuit of power despite interpersonal costs.”

Specifically, Johnson and fellow researchers Eliot Tang-Smith of the University of Miami and Stephen Chen of Wellesley College looked at how study participants fit into the “dominance behavioral system,” a construct in which humans and other mammals assess their place in the social hierarchy and respond accordingly to promote cooperation and avoid conflict and aggression. The concept is rooted in the evolutionary principle that dominant mammals gain easier access to resources for the sake of reproductive success and the survival of the species.

Studies have long established that feelings of powerlessness and helplessness weaken the immune system, making one more vulnerable to physical and mental ailments. Conversely, an inflated sense of power is among the behaviors associated with bipolar disorder and narcissistic personality disorder, which can be both personally and socially corrosive.

December 9, 2014 Posted by | Psychology | , , , , , , , , , , | Leave a comment

[Press release] Religion or Spirituality Has Positive Impact on Romantic/Marital Relationships, Child Development, Research Shows

From the 8 December 2014 American Psychological Association press release

Praying for partners, spiritual intimacy, attending services with parents may improve quality of life

WASHINGTON — Adolescents who attend religious services with one or both of their parents are more likely to feel greater well-being while romantic partners who pray for their “significant others” experience greater relationship commitment, according to research published by the American Psychological Association.

These were among the findings of studies published in two special sections of APA’s Journal of Family Psychology® looking at how spiritual beliefs or behaviors have appeared to strengthen generally happy marriages and how a person’s religious and/or spiritual functioning may influence that of his or her family members.

“These studies exemplify an emerging subfield called relational spirituality, which focuses on the ways that diverse couples and families can rely on specific spiritual beliefs and behaviors, for better or worse, to motivate them to create, maintain and transform their intimate relationships,” according to Annette Mahoney, PhD, of Bowling Green State University, and Annamarie Cano, PhD, of Wayne State University, who edited special sections in the December and October issues of the journal. “Hopefully, publishing these articles will spur more research on ways that religion and spirituality can help or harm couples’ and families’ relationships and encourage more interchange between family psychology and the psychology of religion and spirituality.”

The December issue features five studies that offer novel insights into how religiosity or spiritualism affect children’s development and influence the importance of religion in their own lives.

The October section comprises four studies that focus on the ways that couples can draw on religious/spiritual beliefs and behaviors to transform their unions and help them cope with adversity. “Each of the studies in the October special section moves beyond general measures of people’s involvement in organized religion or spirituality and investigates specific spiritual beliefs or behaviors that appear to influence marital adjustment and human development,” according to APA President Nadine J. Kaslow, PhD, editor of the Journal of Family Psychology. “All the studies present rigorous research into the roles that religion and spirituality can play in enhancing family well-being.”

Articles in the December issue

Religious Socialization in African American Families: The Relative Influence of Parents, Grandparents, and Siblings (PDF, 110KB) by Ian A. Gutierrez, MA, University of Connecticut; Lucas J. Goodwin, MA, New York University; Katherine Kirkinis, MA, Teachers College, Columbia University; and Jacqueline S. Mattis, PhD, New York University.

Looking at three generations, the researchers found that mothers have the most consistently positive influence on the religious lives of their children “because they are socialized to transmit critical values, beliefs and practices across generations, and because they embrace norms of femininity that reinforce such roles.” Additionally, grandparents — especially grandmothers — play a significant role in the religious socialization of grandchildren in African-American families, according to this research.

Contact:Ian Gutierrez

Neighborhood Disorder, Spiritual Well-Being, and Parenting Stress in African American Women (PDF, 98KB) by Dorian A. Lamis, PhD, and Christina K. Wilson, PhD, Emory University School of Medicine; Nicholas Tarantino, MA, Georgia State University; Jennifer E. Lansford, PhD, Duke University; and Nadine J. Kaslow, PhD, Emory University School of Medicine

Read the entire press release here

On a related note...Nearly half of U.S. kids exposed to traumatic social or family experiences during childhood.

A quote “Broken down by state, Utah had the lowest number of children experiencing two or more traumatic experiences (16.3 percent) while Oklahoma had the highest (32.8 percent).” Wondering if religion/spirituality is a factor?

December 9, 2014 Posted by | Psychology | , , , , , , , | Leave a comment

[News article] Injectable 3-D vaccines could fight cancer, infectious diseases

From the 8 December 2014 ScienceDaily article

Date:December 8, 2014
 Source:Wyss Institute for Biologically Inspired Engineering at Harvard
Summary:
A non-surgical injection of programmable biomaterial that spontaneously assembles in vivo into a 3-D structure could fight and even help prevent cancer and also infectious disease such as HIV, scientists have demonstrated. Tiny biodegradable rod-like structures made from silica, known as mesoporous silica rods (MSRs), can be loaded with biological and chemical drug components and then delivered by needle just underneath the skin, they explain.

3DVaccine2H-875A

Their findings are reported in Nature Biotechnology.

“We can create 3D structures using minimally-invasive delivery to enrich and activate a host’s immune cells to target and attack harmful cells in vivo,” said the study’s senior author David Mooney, Ph.D., who is a Wyss Institute Core Faculty member and the Robert P. Pinkas Professor of Bioengineering at Harvard SEAS.

Tiny biodegradable rod-like structures made from silica, known as mesoporous silica rods (MSRs), can be loaded with biological and chemical drug components and then delivered by needle just underneath the skin. The rods spontaneously assemble at the vaccination site to form a three-dimensional scaffold, like pouring a box of matchsticks into a pile on a table. The porous spaces in the stack of MSRs are large enough to recruit and fill up with dendritic cells, which are “surveillance” cells that monitor the body and trigger an immune response when a harmful presence is detected.

December 9, 2014 Posted by | Medical and Health Research News | , , , , , | Leave a comment

[News item] Each dollar spent on kids’ nutrition can yield more than $100 later

 

 

Screen Shot 2014-12-09 at 5.26.07 AMFrom the 8 December 2014 ScienceDaily article

Date: December 8, 2014
Source: University of Waterloo
Summary: There are strong economic incentives for governments to invest in early childhood nutrition, reports a new paper that reveals that every dollar spent on nutrition during the first 1,000 days of a child’s life can provide a country up to $166 in future earnings.

There are strong economic incentives for governments to invest in early childhood nutrition, reports a new paper from the University of Waterloo and Cornell University. Published for the Copenhagen Consensus Centre, the paper reveals that every dollar spent on nutrition during the first 1,000 days of a child’s life can provide a country up to $166 in future earnings.

“The returns on investments in nutrition have high benefit-cost ratios, especially in countries with higher income levels and a growing economy,” said Professor Susan Horton, of the School of Public Health and Health Systems and the Department of Economics at Waterloo.

Children who are undernourished during the first 1,000 days of their lives typically show stunted growth patterns by the age of three and have poorer cognitive skills than their well-fed peers. As adults they are less educated, earn lower wages and have more health problems throughout their lives.

“Height-for-age is a much better measure of health than weight-for-age. It is also predictive of economic outcomes,”

Currently, the World Health Organization is aiming to reduce stunting among children under age five by 40 per cent as part of its 2025 nutrition goals, and it is widely expected that the rate of stunting will also be included in its Sustainable Development Goals, which will be announced in 2015.

More information can be found at: http://www.copenhagenconsensus.com/post-2015-consensus/nutrition

December 9, 2014 Posted by | Nutrition | , , , , | Leave a comment

[News article] Don’t worry, be happy: Just go to bed earlier — ScienceDaily

Don’t worry, be happy: Just go to bed earlier — ScienceDaily.

Excerpt

Date: December 4, 2014
Source: Springer Science+Business Media
Summary: Researchers link late evenings to repetitive negative thoughts. When you go to bed, and how long you sleep at a time, might actually make it difficult for you to stop worrying. So say researchers, who found that people who sleep for shorter periods of time and go to bed very late at night are often overwhelmed with more negative thoughts than those who keep more regular sleeping hours.

December 5, 2014 Posted by | Medical and Health Research News, Psychology | , , | Leave a comment

[Press release] Undiagnosed, undertreated Chagas disease emerging as U.S. public health threat — ScienceDaily

English: Rhodnius prolixus

English: Rhodnius prolixus (Photo credit: Wikipedia)

Undiagnosed, undertreated Chagas disease emerging as U.S. public health threat

From the 4 December 2014 press release

New research: Undiagnosed, undertreated Chagas disease emerging as US public health threat

ASTMH Annual Meeting presentations highlight massive treatment gap

NEW ORLEANS (November 4, 2014)–Across a broad swath of the southern United States, residents face a tangible but mostly unrecognized risk of contracting Chagas disease–a stealthy parasitic infection that can lead to severe heart disease and death–according to new research presented today at the American Society of Tropical Medicine and Hygiene (ASTMH) Annual Meeting.

Chagas disease (American trypanosomiasis) is typically spread to people through the feces of blood-sucking triatomine bugs sometimes called “kissing bugs” because they feed on people’s faces during the night. The disease, which can also be spread through blood supply, affects 7 to 8 million people worldwide and can be cured–if it is caught early. Often considered a problem only in Mexico, Central America and South America, Chagas disease is being seen in Texas and recognized at higher levels than previously believed, reported researchers from Baylor College of Medicine in Houston. Among those infected are a high percentage believed to have contracted the disease within the U.S. border, according to the scientists whose findings will also be published in the American Journal of Tropical Medicine and Hygiene.

“We were astonished to not only find such a high rate of individuals testing positive for Chagas in their blood, but also high rates of heart disease that appear to be Chagas-related,” said Baylor epidemiologist Melissa Nolan Garcia, one of the researchers who presented findings from a series of studies. “We’ve been working with physicians around the state to increase awareness and diagnosis of this important emerging infectious disease.”

And while this research was conducted in Texas, kissing bugs are found across half of the United States, according to the U.S. Centers for Disease Control. Bites from these insects may be infecting people who are never diagnosed, due to a lack of awareness of Chagas disease by healthcare personnel and the U.S. healthcare system.

Chagas Infection Rate Underreported; Often Overlooked as Risk Factor For Heart Disease

Garcia’s team conducted an analysis of routine testing of Texas blood donors for Chagas between 2008 and 2012. In that study published in Epidemiology and Infection (August 2014), the researchers found that one in every 6,500 blood donors tested positive for exposure to the parasite that causes Chagas disease. That figure is 50 times higher than the CDC’s estimated infection rate of one in 300,000 nationally, but according to Garcia, a rate that is consistent with other studies in the southern United States indicating a substantial national disease burden. Since 2007, all potential blood donors within the United States are screened for exposure to the Chagas disease parasite.

“We think of Chagas disease as a silent killer,” Garcia said. “People don’t normally feel sick, so they don’t seek medical care, but it ultimately ends up causing heart disease in about 30 percent of those who are infected.”

Symptoms can range from non-existent to severe with fever, fatigue, body aches, and serious cardiac and intestinal complications. Positive blood donors, who would likely develop chronic Chagas disease over time, could cost about US $3.8 million for health care and lost wages for those individuals, according to the researchers’ calculations. And according to a recent study published in the The Lancet Infectious Diseases, societal and healthcare costs for each infected person in the United States averages $91,531.

“We’re the first to actively follow up with positive blood donors to assess their cardiac outcomes and to determine where southeastern Texas donors may have been exposed to Chagas,” Garcia said. “We are concerned that individuals who test positive are not seeking medical care or being evaluated for treatment. And even if they do seek medical care, we heard from some patients that their primary care doctors assumed the positive test represented a ‘false positive’ due to low physician awareness of local transmission risk.”

Garcia shared the findings from separate pilot studies conducted by the Baylor team, which followed 17 Houston-area residents who were infected. They found that 41 percent of them had signs of heart disease caused by the infection, including swollen, weakened heart muscle and irregular heart rhythms caused by the parasite burrowing into heart tissue. Most of these individuals lived in rural areas or spent a significant amount of time outside. One of the individuals was an avid hunter and outdoorsman. At least six of them had insignificant travel outside the United States and they didn’t have mothers from foreign countries, indicating they had likely become infected locally in Texas.

As blood donor screening is currently the only active screening program in the United States, they provide an insight into the characteristics of who might be at risk for disease. “People who give blood are usually generally healthy adults. The people that we worry about in terms of burden of disease here are from rural settings and people who live in severe poverty. So the burden of disease may be even higher than what we see in this study,” said Kristy Murray, DVM, PhD, a co-author on the study and associate professor of tropical medicine at Baylor.

Local Kissing Bugs Spreading Disease

Kissing bugs emerge at night to feed. Once they have bitten and ingested blood, they defecate on their victim and the parasites then enter the body through breaks in the skin. While no firm data exists on how many bugs in the United States may carry the parasite, another pilot study conducted by the research team at Baylor, and presented as a poster during the ASTMH meeting, may shed some light on the issue. In that study, researchers collected a random sample of 40 kissing bugs found near homes in 11 central-southern Texas counties. They found 73 percent of the insects carried the parasite and half of the positive bugs had dined on human blood in addition to a dozen types of animals including dogs, rabbits, and raccoons.

“The high rate of infectious bugs, combined with the high rate of feeding on humans, should be a cause of concern and should prompt physicians to consider the possibility of Chagas disease in U.S. patients with heart rhythm abnormalities and no obvious underlying conditions,” said Murray.

New Analysis of CDC Data and National Blood Bank Data Uncovers Large Treatment Gap

Another ASTMH Annual Meeting presentation shows people who test positive for Chagas disease mostly go untreated. Jennifer Manne-Goehler, MD, a clinical fellow at Harvard Medical School and Beth Israel Deaconess Medical Center, collected data from the CDC and the American Association of Blood Banks and compared the almost 2,000 people who tested positive through the blood banking system to the mere 422 doses of medications administered by the CDC from 2007 to 2013.

“This highlights an enormous treatment gap,” said Manne-Goehler. “In some of the areas of the country we know there are a lot of positive blood donors, yet people still don’t get care. We don’t know what happens to them because there is no follow up.”

In the United States, most physicians are unfamiliar with the disease, and some who have heard of it mistakenly dismiss Chagas disease as a not-so-serious health concern, even in parts of the country where many people may be living with Chagas symptoms, she said at an ASTMH presentation on access to treatment. Further complicating the situation, in the United States the currently available medicines used to treat Chagas disease have not been approved by the U.S. Food and Drug Administration. Physicians seeking treatment for their patients are referred to the CDC, which makes two drugs–nifurtimox and benznidazole–available, both of which carry the risk of side effects including nausea, weight loss and possible nerve damage.

In addition to data collection, Manne-Goehler conducted interviews with physicians, state health directors, and other healthcare workers treating patients diagnosed with Chagas disease in states with higher numbers of cases: Texas, California, Florida, Virginia, New York and Massachusetts. The findings revealed a disjointed, ad hoc approach to both diagnosing and treating the disease. Most of the doctors interviewed had never treated a patient whose infection had been identified through the blood donor system.

Manne-Goehler and her colleagues Michael Reich, PhD, of the Harvard School of Public Health and Veronika Wirtz PhD, of the Boston University Center for Global Health and Development, are calling for the creation of an independent expert panel to define clinical screening guidelines to help improve identification of patients with Chagas disease in the United States. In addition, they argue for creation of a physician-referral network so that physicians who are unfamiliar with the disease can send patients to providers who regularly diagnose and treat cases of Chagas disease.

Several ASTMH presenters also argued for a more comprehensive system of surveillance beyond testing of blood donors.

“So little surveillance has been done that we don’t know the true disease burden here in the United States,” said Murray. “The next step is to study populations considered high risk. There is still a lot to be learned in terms of who is contracting the disease within the United States.”

###

About the American Society of Tropical Medicine and Hygiene

ASTMH, founded in 1903, is a worldwide organization of scientists, clinicians and program professionals whose mission is to promote global health through the prevention and control of infectious and other diseases that disproportionately afflict the global poor.

About the American Journal of Tropical Medicine and Hygiene

Continuously published since 1921, AJTMH is the peer-reviewed journal of the American Society of Tropical Medicine and Hygiene, and the world’s leading voice in the fields of tropical medicine and global health. AJTMH disseminates new knowledge in fundamental, translational, clinical and public health sciences focusing on improving global health.

December 5, 2014 Posted by | Medical and Health Research News | , , , , , , , | Leave a comment

[News article] 3-D printing to the rescue of gastronomy for frail seniors — ScienceDaily

 

 

Elderly334x2403-D printing to the rescue of gastronomy for frail seniors — ScienceDaily.

Excerpt

Date: December 4, 2014
Source: youris.com
Summary: Researchers are now developing personalised food for elderly people with chewing or swallowing problems, by working on printable versions of meat and vegetables.

December 5, 2014 Posted by | Nutrition | , , , , , | Leave a comment

[Press release] Distrust of police is top reason Latinos don’t call 911 for cardiac arrest

Distrust of police is top reason Latinos don’t call 911 for cardiac arrest.

From the 4 December 2014 EurkAlert

WASHINGTON – Fear of police, language barriers, lack of knowledge of cardiac arrest symptoms and financial concerns prevent Latinos – particularly those of lower socioeconomic status – from seeking emergency medical help and performing cardiopulmonary resuscitation (CPR), according to a study published online yesterday in Annals of Emergency Medicine (“Barriers to Calling 911 and Learning and Performing Cardiopulmonary Resuscitation (CPR) for Residents of Primarily Latino, High-Risk Neighborhoods in Denver, Colorado”).

English: CPR training

English: CPR training (Photo credit: Wikipedia)

“Residents of low-income, minority neighborhoods have two strikes against them: the incidence of out-of-hospital cardiac arrest is much higher than average and rates of bystander CPR are below average,” said lead study author Comilla Sasson, MD, PhD, FACEP of the American Heart Association and the University of Colorado School of Medicine in Aurora, Colo. “We need to do a better job of overcoming the significant barriers to timely medical care for Latinos suffering cardiac arrest. Culturally sensitive public education about cardiac arrest and CPR is a key first step.”

Researchers conducted focus groups and interviews with residents of primarily lower-income Latino neighborhoods in Denver to determine why they underutilize 9-1-1 emergency services and how to increase knowledge and performance of CPR on people suffering cardiac arrest. General distrust of law enforcement, of which 9-1-1 services are bundled, was cited as a top reason for not calling 9-1-1 by most participants.

Many subjects also believed – incorrectly – that they would not be able to ride an ambulance to the hospital without first paying for it, as that is the practice in Mexico where many participants came from. Subjects also expressed a lack of understanding about the symptoms of cardiac arrest and how CPR can save a life. Strong reticence about touching a stranger for fear that it might be misconstrued was a unique cultural barrier to performing CPR. Language barriers – either with 9-1-1 dispatchers or first responders – also inhibited subjects from getting involved with someone experiencing cardiac arrest.

In the interest of educating more people on how to perform CPR, participants widely supported policy changes that would make CPR either a high school graduation requirement or a pre-requisite for receiving a driver’s license.

“Future research will need to be conducted to better understand how targeted, culturally-sensitive public education campaigns may improve the provision of bystander CPR and cardiac arrest survival rates in high-risk neighborhoods,” said Dr. Sasson.

###

Annals of Emergency Medicine is the peer-reviewed scientific journal for the American College of Emergency Physicians, the national medical society representing emergency medicine. ACEP is committed to advancing emergency care through continuing education, research, and public education. Headquartered in Dallas, Texas, ACEP has 53 chapters representing each state, as well as Puerto Rico and the District of Columbia. A Government Services Chapter represents emergency physicians employed by military branches and other government agencies. For more information, visit http://www.acep.org.

December 5, 2014 Posted by | health care, Medical and Health Research News | , , , , , , | Leave a comment

[News item] Mapping human disease: ‘Not all pathogens are everywhere’ — ScienceDaily

Screen Shot 2014-12-05 at 6.48.18 AM

Mapping human disease: ‘Not all pathogens are everywhere’ — ScienceDaily.

From the news item

Date: December 3, 2014
Source: North Carolina State University
Summary: For the first time, researchers have mapped human disease-causing pathogens, dividing the world into a number of regions where similar diseases occur. The findings show that the world can be separated into seven regions for vectored human diseases — diseases that are spread by pests, like mosquito-borne malaria — and five regions for non-vectored diseases, like cholera.
The article is freely available here

December 5, 2014 Posted by | Medical and Health Research News | , | Leave a comment

[Report] Surveying Health Care Quality & Value

Surveying Health Care Quality & Value

From the 24 November 2014 Robert Woods Foundation report

Recent years have brought numerous efforts to educate and engage Americans in what “quality” health care is, how to find it and how they can get better value for their dollars. To better understand the latest trends, the Robert Wood Johnson Foundation funded the AP-NORC Center for Public Affairs Research at the University of Chicago to conduct three surveys through the summer and fall of 2014.

The surveys each individually examined how consumers and employers, as purchasers, perceive health care quality and how they use quality information and performance data on health plans and providers. Learn more about the research and access links to the full reports with accompanying materials.

 

 A medical assistant checks a patient's blood pressure and pulse.

Consumer Awareness of Provider Quality and Value

A number of initiatives in recent years have aimed at engaging consumers in making informed health care decisions, including empowering patients and their caregivers with data on provider quality, performance, cost and value. The first in the series of surveys looks at the inroads these efforts have made.

Thirty-seven percent of respondents don’t believe that higher health care costs correlate with better quality care—but 48 percent think they do. The poll also found that more than two-thirds say finding a doctor or hospital that offers the highest quality at the lowest possible cost is important to them. The survey also showed getting Americans to find quality information and use it in their health care decisions remains a challenge, with only 11 percent of Americans reporting they have done so.

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Cost- and Coverage-Based Decision-Making

As more provisions of the Affordable Care Act (ACA) are implemented over the next decade, the government projects that approximately 12 million additional people younger than 65 will enter the private insurance market. The second in the series of surveys looks at consumer opinions on health care costs and coverage, and how it impacts their decision-making.

It shows that nearly a fifth of insured Americans report skipping a trip to the doctor when they’re sick or injured to save money, and only 36 percent are confident they can pay for a major, unexpected medical expense. Those enrolled in health plans with high deductibles are greatly impacted by the out-of-pocket cost of health care—they are concerned with the uncertainty of major expenses, skip necessary medical treatment, and experience real financial burden when obtaining health care.

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Billboard Illustration for SHADAC ESI Report April 2013

Employers Use of Quality Information in Purchasing

As a group, employers represent the largest purchaser of care in the United States. Given this, it is critical that they demand good value for the money they spend, ensuring that the plans offered to employees be high quality. The third and final report in the series of surveys looks at the opinions of private sector employers, including small-, medium- and large-sized businesses.

It shows that American firms are hesitant to say they would pay more for higher quality care, and when it comes to measuring quality, 90 percent don’t know or don’t use independent quality information when deciding on what plans to offer employees. And while many employers are indeed providing wellness programs to benefit their employees’ health, relatively few are actively promoting those programs or offering incentives for participation.

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December 5, 2014 Posted by | health care | , , , , , , | Leave a comment

[Press Release] Efforts to improve patient safety result in 1.3 million fewer patient harms, 50,000 lives saved and $12 billion in health spending avoided

Efforts to improve patient safety result in 1.3 million fewer patient harms, 50,000 lives saved and $12 billion in health spending avoided

From the US Health and Human Services press release

Hospital-acquired conditions decline by 17 percent over a three-year period

A report released by the Department of Health and Human Services today shows an estimated 50,000 fewer patients died in hospitals and approximately $12 billion in health care costs were saved as a result of a reduction in hospital-acquired conditions from 2010 to 2013.  This progress toward a safer health care system occurred during a period of concerted attention by hospitals throughout the country to reduce adverse events. The efforts were due in part to provisions of the Affordable Care Act such as Medicare payment incentives to improve the quality of care and the HHS Partnership for Patients initiative.  Preliminary estimates show that in total, hospital patients experienced 1.3 million fewer hospital-acquired conditions from 2010 to 2013.  This translates to a 17 percent decline in hospital-acquired conditions over the three-year period.

“Today’s results are welcome news for patients and their families,” said HHS Secretary Sylvia M. Burwell. “These data represent significant progress in improving the quality of care that patients receive while spending our health care dollars more wisely.  HHS will work with partners across the country to continue to build on this progress.”

Today’s data represent demonstrable progress over a three-year period to improve patient safety in the hospital setting, with the most significant gains occurring in 2012 and 2013. According to preliminary estimates, in 2013 alone, almost 35,000 fewer patients died in hospitals, and approximately 800,000 fewer incidents of harm occurred, saving approximately $8 billion.

Hospital-acquired conditions include adverse drug events, catheter-associated urinary tract infections, central line associated bloodstream infections, pressure ulcers, and surgical site infections, among others.  HHS’ Agency for Healthcare Research and Quality (AHRQ) analyzed the incidence of a number of avoidable hospital-acquired conditions compared to 2010 rates and used as a baseline estimate of deaths and excess health care costs that were developed when the Partnership for Patients was launched. The results update the data showing improvement for 2012 that were released in May.

“Never before have we been able to bring so many hospitals, clinicians and experts together to share in a common goal – improving patient care,” said Rich Umbdenstock, president and CEO of the American Hospital Association. “We have built an ‘infrastructure of improvement’ that will aid hospitals and the health care field for years to come and has spurred the results you see today. We applaud HHS for having the vision to support these efforts and look forward to our continued partnership to keep patients safe and healthy.”

Additional Information

December 5, 2014 Posted by | health care | , , , , , | Leave a comment

[News article] Ciliopathies lie behind many human diseases — ScienceDaily

Ciliopathies lie behind many human diseases — ScienceDaily.

Excerpt

Date:December 1, 2014
Source: American Institute of Biological Sciences
Summary: Growing interest in cilia, which are finger-like organelles that extend from the bodies of individual cells, has revealed their role in a number of human ailments. As a result of cilia’s presence in a wide variety of cells, defects in them cause diverse human diseases that warrant further study.

Cilia perform a broad range of functions, including a starring role in cell signalling. Motile ones wiggle and so move fluids within the body, including cerebrospinal fluid in the brain. In humans, cilia are found on almost every cell in the body. Because of this, ciliopathies often make themselves known as syndromes with widely varying effects on a number of tissue types. For instance, the ciliopathy Jeune asphyxiating thoracic dystrophy involves the development of abnormally short ribs, accompanied by short limbs and, occasionally, the development of extra digits.

In primary ciliary dyskinesia, motile cilia are dysfunctional and fail to beat. This can lead to bronchitis resulting from the failure to clear mucus from the sufferer’s airways. Male patients with primary ciliary dyskinesia are infertile because of impaired motility of the sperm’s flagellum (flagella and cilia are structurally similar).

The article’s authors point to a number of other human diseases in which cilia may play a role; for example, some cancers and neurological diseases may be related to ciliopathies. Because of the limitations placed on research involving humans, the authors propose the use of model species ranging from the green alga Chlamydomonas to the house mouse to further study the role of cilia. They write, “We can anticipate that new and improved techniques will open new avenues for gaining further insight into these immensely important and ever more fascinating cell organelles.”

December 5, 2014 Posted by | Medical and Health Research News | , , , , , , , , | Leave a comment

[Reblog] Why We May Need Viruses More Than Vaccines | The GOLDEN RULE

 

Why We May Need Viruses More Than Vaccines | The GOLDEN RULE.Posted on by

 

An article by Sayer Ji,  Activist Post, provides some thought-provocation and a lateral approach to a science, vaccination, that is currently in the news for its controversial issues concerning adverse reactions.

A groundbreaking study published this month in Nature challenges a century-old assumption about the innate pathogenicity of these extremely small, self-replicating particles known as viruses. 

Titled, “An enteric virus can replace the beneficial function of commensal bacteria,” researchers found that an “enteric RNA virus can replace the beneficial function of commensal bacteria in the intestine.” Known as murine (mouse) noravirus (MNV), researchers found that infecting germ-free or antibiotic-treated mice infection with MNV “restored intestinal morphology and lymphocyte function without inducing overt inflammation and disease.”

The researchers found:

Importantly, MNV infection offset the deleterious effect of treatment with antibiotics in models of intestinal injury and pathogenic bacterial infection. These data indicate that eukaryotic viruses have the capacity to support intestinal homeostasis and shape mucosal immunity, similarly to commensal bacteria. Despite the commonly held belief that viruses are vectors of morbidity and mortality that must be vaccinated against in order to save us from inevitable harm and death, the new study dovetails with a growing body of research showing that our own genome is 80% viral in origin.

Find the full article here.

December 5, 2014 Posted by | Medical and Health Research News | , , , , , , , , | Leave a comment

Online Health Care Data Sources | Brookings Institution

Online Health Care Data Sources | Brookings Institution.

 

From the Web site

This is a preliminary scan of publicly available online health care datasets, transparency websites and tools, gathered from expert recommendations and intensive review. Though this list is not exhaustive, we have attempted to include the most relevant sources for the purposes of this study. Each health data source is assigned an icon representing (1) who the source is useful to i.e. consumers or researchers; (2) what information the source includes i.e. data pertaining to quality of care or cost of care; and (3) who the source provides information on i.e. providers or payers.

December 2, 2014 Posted by | health care | , , , , , | Leave a comment

[Reblog] Has the brain-zap backlash begun?

A fMRI scan showing regions of activation in o...

A fMRI scan showing regions of activation in orange, including the primary visual cortex (V1, BA17). (Photo credit: Wikipedia)

From the 28 November 2014 post at The New Scientist

Stimulating the brain with electricity improves working memory, mental mathsfocused attention, creativity and could help treat depression. You can even buy DIY kits online. That’s the good news. The bad news is that the most recent investigation has found it has almost no measurable effect on the brain.

It’s a conclusion that is likely to be controversial. Over the past decade, thousands of studies have reported a beneficial effect of transcranial direct current stimulation (tDCS) on the brain, as well as on behaviour and cognition – so much so that it has become something of a hot topic in neuroscience.

The idea behind tDCS is that passing a weak current through the brain changes the electrical potential of nerve cell membranes. This alters the strength of connections between neurons, making the circuit more, or less likely to fire. It’s a tricky thing to measure directly, so any physiological effect is inferred by blood flow changes on functional MRI scans, changes in brainwaves measured by EEG, or in the strength of muscle contraction when the motor cortex is stimulated, known as an MEP.

But when Jared Horvath and his colleagues at the University of Melbourne in Australia, pooled the results of more than 100 studies reporting any or all of these measures, they found that only one was convincingly changed after tDCS. The other two were inconsistent at best.

And what are the DIY stimulation enthusiasts to make of all this? “There are two options,” says Horvath. “The first is that tDCS is doing something, but we don’t know what, so take that on board. The second is a bit more innocuous: tDCS might not be doing anything to the brain, so have a good time, but temper your expectations.”

November 29, 2014 Posted by | Medical and Health Research News | , , | Leave a comment

[Interactive chart] Snake oil? Scientific evidence for popular nutritional supplements

Screen Shot 2014-11-29 at 5.57.56 AM

 From the Web site

This image is a “balloon race”. The higher a bubble, the greater the evidence for its effectiveness. But the supplements are only effective for the conditions listed inside the bubble.

You might also see multiple bubbles for certain supps. These is because some supps affect a range of conditions, but the evidence quality varies from condition to condition. For example, there’s strong evidence that Green Tea is good for cholesterol levels. But evidence for its anti-cancer effects is conflicting. In these cases, we give a supp another bubble.

This visualisation generates itself from this Google Doc. So when new research comes out, we can quickly update the data and regenerate the image. (How cool is that??)

Sources: PubMed, Cochrane.org

 

The interactive chart allows one to filter by health condition and supplement type (as enzyme, plant/herb). Data in this Google spreadsheet.

 

Related resources

MEDLINE plus: Complementary and Alternative Medicine Trusted health information links from the US National Institutes of Health (NIH). Includes basic information, news, organizations, specific conditions, multimedia, financial issues, and more

Bandolier: Evidenced Based Thinking about Healthcare - Alternative Medicine
The site brings together the best evidence available about complementary and alternative therapies for consumers and professionals. It contains stories, systematic reviews and meta-analyses of complementary and alternative therapies with abstracts.

Herbs at a Glance  Series of brief fact sheets that provides basic information about specific herbs or botanicals—common names, what the science says, potential side effects and cautions, and resources for more information. NCCAM (National Center for Complementary and Alternative Medicine)

Office of Cancer Complementary Alternative Medicine  The NIH, National Cancer Institute (NCI) Office of Cancer Complementary and Alternative Medicine (OCCAM) was established in October 1998 to coordinate and enhance the activities of the National Cancer Institute (NCI) in the arena of complementary and alternative medicine (CAM)
Quackwatch.com  Nonprofit  whose purpose is to combat health-related frauds, myths, fads, and fallacies. Information on quackery, questionable therapies and more

 

November 29, 2014 Posted by | Nutrition | , , , | Leave a comment

[News item] Only half of patients take their medications as prescribed: Are there interventions that will help them? — ScienceDaily

Only half of patients take their medications as prescribed: Are there interventions that will help them? — ScienceDaily.

From the news article

Date:November 20, 2014
Source:Wiley
Summary:The cost of patients not taking their medications as prescribed can be substantial in terms of their health. Although a large amount of research evidence has tried to address this problem, there are no well-established approaches to help them.

The cost of patients not taking their medications as prescribed can be substantial in terms of their health. Although a large amount of research evidence has tried to address this problem, there are no well-established approaches to help them, according to a new systematic review published in The Cochrane Library. The authors of the review examined data from 182 trials testing different approaches to increasing medication adherence and patient health. Even though the review included a significant number of the best studies to date, in most cases, trials had important problems in design, which made it hard to determine which approaches actually worked.

Only about half of all patients who are prescribed medication that they must administer themselves actually take their medication as prescribed. Many stop taking medication all together and others do not follow the instructions for taking it properly. This has been the case in many different diseases for at least the last half a century. In conditions where effective drug treatments are available, patients who take their medications as per their provider’s instructions can see a real difference to their health. However, when researchers in the field have tried to draw together evidence on this, they have found it unreliable and inconsistent.

November 28, 2014 Posted by | Medical and Health Research News | , , , , , | Leave a comment

[News item] Parents skipping needed care for children, pediatricians say | Association of Health Care Journalists

Parents skipping needed care for children, pediatricians say | Association of Health Care Journalists.

Joseph Burns

 

Photo: Alex Prolmos via Flickr

High-deductible health plans (HDHPs) discourage families from seeking primary care for their children, according to the American Association of Pediatricians. The problem is so severe that the federal government should consider limiting HDHPs to adults only, the AAP said in a policy statement published in Pediatrics.

“HDHPs discourage use of nonpreventive primary care and thus are at odds with most recommendations for improving the organization of health care, which focus on strengthening primary care,” the association said in its statement. Under the Affordable Care Act, preventive services are covered in full without charge.

This is the second time in as many months that a report has shown consumers skipping needed care because of the cost. Last month, we reported that out-of-pocket health care costs force one out of every eight privately insured Americans to skip necessary medical treatment, according to the survey from the AP-NORC Center, “Privately Insured in America: Opinions on Health Care Costs and Coverage.” The Robert Wood Johnson Foundation funded the survey. In a report earlier this month, “Too High a Price: Out-of-Pocket Health Care Costs in the United States,” the Commonwealth Fund expressed similar concerns.

In an article about the policy statement, Alyson Sulaski Wyckoff, associate editor of Pediatrics, quoted Budd Shenkin, M.D., the lead author of the AAP’s policy statement on HDHPs, saying parents are so concerned about the cost of care that they don’t bring in their children when they should. “They’re reluctant to come in, they seek more telephone care, they’re reluctant to complete referrals, and they’re reluctant to come back for appointments to follow up on an illness,” he said.

For children with chronic conditions, foregoing care can exacerbate illnesses, said Thomas F. Long, M.D., chair of the association’s Committee on Child Health Financing. “If it’s going to cost them out-of-pocket money, they may say, ‘Well, it’s just a cold, I don’t need to see the doctor.’ And ‘just a cold, turns into ‘just pneumonia,’” he added.

The problem of delaying necessary care is one Paul Levy addressed in his blog, Not Running a Hospital, about HDHPs. “Beyond the sad impact on individual families in any given year, I fear that the economic backlash of these policies will be a deferment of needed health care treatments and a resulting future bulge of cost increases. We’re playing Whac-A-Mole here,” he wrote.

For the Commonwealth Fund, researchers found that among privately insured consumers across all income groups, low- and moderate-income adults were most likely to skip the health care they need because of high out-of-pocket costs.

It’s no surprise that adults with the lowest incomes were most likely to skip needed care, the fund reported. Among consumers earning less than $22,890 annually, 46 percent cited at least one example of skipping needed health care because of copayments or coinsurance: 28 percent did not fill a prescription; 28 percent skipped a medical test or follow-up treatment; 30 percent had a medical problem but did not see a doctor; and 24 percent did not see a specialist when needed.

When deductibles are high relative to income, consumers tend to skip care as well, and low- and moderate-income adults had the most trouble, the report showed. Consumers whose deductibles represent 5 percent or more of their income cited at least one example of skipping needed health care because of their deductible: 29 percent skipped a medical test or follow-up treatment; 27 percent had a medical problem but did not go to the doctor; 23 percent skipped a preventive care test; and 22 percent did not see a specialist despite their physician’s advice.

For an article in Modern Healthcare, Bob Herman covered this topic well. He cited the case of a woman in Indiana who was searching for a health plan on HealthCare.gov. A single, 40-year-old nonsmoker, this woman could choose from 29 plans and 24 of them were considered HDHPs, he wrote.

Under IRS rules, (PDF) an HDHP in 2015 is defined as one that has an annual deductible of at least $1,300 for an individual and $2,600 for a family coverage and annual out-of-pocket costs that do not exceed $6,450 for individual or $12,900 for a family.

The Commonwealth Fund report showed that 13 percent of consumers with private health insurance had plans with a deductibles equivalent to 5 percent or more of their income; that figure includes 25 percent of adults with low incomes and about 20 percent of adults with moderate incomes ($11,490 to $45,960 a year for a single person).

November 28, 2014 Posted by | Consumer Health, health care | , , , , | Leave a comment

Do probiotics work? | Science Life

Do probiotics work? | Science Life.

From the 25 November 2014 University of Chicago press release

probiotic-yogurt

Walk past the dairy case or health food section of any grocery store and you’ll see a variety of yogurts, milk, shakes and even granola bars that say they contain probiotics. These “good” bacteria are added to foods to promote a healthy environment of microorganisms in the digestive tract, supposedly to aid in digestion and promote good gastrointestinal health. Are these claims based in real science, or are they just another food fad to squeeze money out of consumers?

We spoke to Stefano Guandalini, MD, Section Chief of Pediatric Gastroenterology, Hepatology, and Nutrition and Medical Director of the Celiac Disease Center at the University of Chicago, about probiotics and prebiotics, the precursor that provides fuel for the supposedly beneficial bacteria. He and his colleagues published a review paper recently looking at various studies and clinical trials that used pre- and probiotics to treat symptoms of inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) in children. The following is an edited version of that conversation.

Many people are familiar with the term probiotics, but what are prebiotics?

Prebiotics are basically the metabolic fuel for probiotics. It’s a term that encompasses a number of mostly carbohydrates that are present in vegetables and grains, for instance in wheat, artichokes, legumes, etc. They are only partially digested by the human intestinal tract, so they reach the colon where they are fermented by bacteria. We have trillions of bacteria happily living in our colon, and they ferment these substrates. They’re happy with them, and so they thrive. The idea of taking prebiotics is that you can encourage the growth of good bacteria in the gut by providing them the food they like.

Can you do that by changing your diet? Or is there a pill you can take?

You can do in both ways. If your diet is rich in things like onions, garlic, wheat, legumes and artichokes, then you ingest a lot of prebiotics already. But there are also chemically identifiable supplements that also serve the same purpose.

Are prebiotics effective for treating digestive diseases?

In theory these are a good way of promoting a healthy microflora in your gut, and one would expect beneficial effects, but in reality it has been quite disappointing. There’s not a lot of practical use for prebiotics as we speak, in terms of clinical effectiveness. The only niche in which we found them to be successful is as an additive to formula for premature babies, because human milk actually contains plenty of prebiotics. Other than that, there hasn’t been much practical use. In fact, in our review, we saw that prebiotics have been tried for treating irritable bowel syndrome, but actually with mostly negative results.

With inflammatory bowel disease, it’s likely different. Several preparations have been tried with mixed results, but again, nothing sticks out as important or with clinical relevance. So in spite of good conceptual reasons to expect good results, they have not been proven very effective.

How are probiotics different from prebiotics?

Probiotics are microorganisms that, if ingested in adequate amounts, confer a health benefit to the host beyond the nutritional value. In practical terms, it’s a class of mostly live bacteria that have been studied for a long time and found useful for treating or preventing a number of clinical conditions.

Our review paper focuses on the efficacy of probiotics for IBS and IBD, including both ulcerative colitis and Crohn’s disease. For IBS, we have some good evidence in adults that some probiotics actually seem to be effective in relieving some of the symptoms, mostly the bloating and abdominal pain that accompanies IBS, especially when there is either diarrhea or constipation that goes along with it.

And in the case of ulcerative colitis, there is a growing body of evidence supporting the efficacy of some specific strains as an adjuvant in the course of the therapy. Crohn’s disease is different, however. People have tried multiple ways of addressing the problem with different strains of probiotics, different clinical settings, different endpoints, but none of the researchers were able to show any efficacy with probiotics in Crohn’s disease patients.

You can go into any grocery store and find yogurt and other foods that have probiotics added to them. Do those products do any good?

Not all probiotics are equal, that’s an important thing to stress. People think they can walk into a store and pick any probiotic from the shelf and they’re just the same. That is not the case. Different probiotics have different strains and concentrations of bacteria that have different properties. Only a minority of them has been tested properly in clinical trials to find if they were indeed effective.

In reality, yogurt by definition has to have two strains of bacteria—Lactobacillus bulgaricus andStreptococcus thermophilus—to create the yogurt. However these strains do not pass the gastrointestinal tract intact. They are destroyed by the acidity of the stomach and the enzymes of the pancreas, so nothing reaches the colon and it’s not beneficial. However, like you said, some yogurts are now enriched with other live bacteria of different strains. Some of them indeed include strains that survive the passage through the intestinal tract and then can be beneficial, and some make that claim but they don’t, and it’s hard for the general public to discriminate. Activia, for instance, is one of the good preparations. These yogurts actually do have strains of live Bifidobacteria that have been studied and may be beneficial. Yakult, containing well-studied strains of Lactobacilli, is another one that does the same.

Is a food product the best way to treat symptoms of IBS or IBD, or do you need a special preparation in a pill?

The best way is to use specific strains that have been validated through clinical trials and published in peer-reviewed journals to show efficacy, and if possible reproduced by different groups using the same preparations. So the list of probiotics that have gone through this process is actually very short:

  • There is a product called Align, based on a specific Bifidobacterium, which is mostly for adults with IBS.
  • For infants and colicky babies there is some proof of effectiveness for a product called Biogaia, which has the bacterium Lactobacillus reuteri in it.
  • Then we have Culturelle with Lactobacillus GG, another one with a long record of scientific, well conducted studies, which has been found effective in treating diarrheal diseases.
  • Florastor, which contains a yeast [Saccharomyces boulardii] instead of bacteria, is also effective in treating and preventing antibiotic associated diarrhea. Children who get antibiotics often develop diarrhea, and in many cases that can be prevented by the use of Florastor.
  • Finally there is a preparation called VSL #3, which is a highly concentrated preparation of 8 different strains of probiotics. This has received a great deal of attention by the scientific world to treat a number of conditions. It seems to be effective for ulcerative colitis, both in adults and children, and it has been found effective in irritable bowel syndrome as well.

Outside of this incredibly short list, however, there is nothing else. There is no other probiotic that has been found to be effective in rigorous, controlled clinical trials. This is not to say they aren’t working, it’s just to say we don’t have any scientific proof yet.

Are probiotics safe?

One thing that all these probiotics have in common is that they are relatively safe. They are very tolerable and basically create no side effects. One caveat is for premature babies and people with profoundly depressed immune systems. Some of these preparations might be contaminated by yeasts, which can be dangerous in those cases. But with these two exceptions, probiotics have been used in large amounts for generations now. So they are safe, but if there is no clear cut indication, I wouldn’t necessarily recommend them. That’s a question I often get from patients, “Could we use probiotics?” And if it’s not to treat a specific condition and they just think it will improve health, I tell them it’s not necessary.

Where is the research on prebiotics and probiotics headed?

It’s interesting. There was a boom for years and then it died down quite a bit. From a laboratory standpoint, we don’t understand a lot about how the probiotics work. So I think the attention of scientists now is more focused on understanding the mechanisms of the interactions between these bacteria and the host, which are different between different individuals. Each one of us has a unique composition of intestinal flora. The same probiotics may have a different effect for you and me, because they interact with trillions of other bacteria, which are different for each person. So all of these nuances are going back to basic science before moving further to the clinical arena.

That seems to be a theme of microbiome research. Everyone agrees on its profound effect on our health, but getting to where you could change something meaningfully to treat a disease is a different thing.

Right, we are not there yet. It’s very complicated. As we have said many times, the genome of the microbes is thousands of times more complex and more numerous than the human genome. When we are talking about personalized medicine, we are really talking about the microbiome: how to understand all the subtle interactions with the human host, and how to possibly exploit this for health reasons. It’s an incredibly interesting area, and my colleagues here at the University of Chicago,David RubinEugene ChangCathryn NaglerBana Jabri and others are actively working on this. We aren’t there yet, but we will. I have great enthusiasm in this. I think this is the medicine of the future.

November 28, 2014 Posted by | Medical and Health Research News, Nutrition | , , , | Leave a comment

[TedTalk] How playing an instrument benefits your brain – Anita Collins

From the YouTube site

Published on Jul 22, 2014

View full lesson: http://ed.ted.com/lessons/how-playing…

When you listen to music, multiple areas of your brain become engaged and active. But when you actually play an instrument, that activity becomes more like a full-body brain workout. What’s going on? Anita Collins explains the fireworks that go off in musicians’ brains when they play, and examines some of the long-term positive effects of this mental workout. Lesson by Anita Collins, animation by Sharon Colman Graham.   http://youtu.be/R0JKCYZ8hng

November 28, 2014 Posted by | Psychiatry | , , , , | Leave a comment

[News article] Web-savvy older adults who regularly indulge in culture may better retain ‘health literacy’ — ScienceDaily

Web-savvy older adults who regularly indulge in culture may better retain ‘health literacy’ — ScienceDaily.

From the news article

Date:November 25, 2014
Source:BMJ-British Medical Journal
Summary:Older people who are active Internet users and who regularly indulge in a spot of culture may be better able to retain their health literacy, and therefore maintain good health, suggests research.

There was a link between age and declining health literacy, and being non-white, having relatively low wealth, few educational qualifications, and difficulties carrying out routine activities of daily living.

Poorer memory and executive function scores at the start of the study were also linked to greater health literacy decline over the subsequent six years.

Around 40% of the entire sample said they never used the internet or email, while one in three (32%) said they did so regularly. Similar proportions said they had consistently engaged in civic (35%) and/or leisure (31%) activities over the six year follow-up period.

Almost four out of 10 (39%) said they had regularly engaged in cultural activities, such as going to the cinema, theatre, galleries, concerts or the opera, during this time.

Across all time points, internet use and engagement in civic, leisure, or cultural activities were lower among those whose health literacy declined.

After taking account of influential factors, only the links between regular internet use and engaging in cultural activities remained statistically significant.

But each factor appeared to exert an additive effect, and a combination of all four seemed to afford the best protection against health literacy decline, a finding that was independent of any tailing off in cognitive function.

This is an observational study so no definitive conclusions can be drawn about cause and effect.

,,,

November 28, 2014 Posted by | Consumer Health, Medical and Health Research News | , , , , , , , | Leave a comment

[Reblog] Health Care for Dummies (and Innovators): In search of a practical definition of health | The Health Care Blog

Health Care for Dummies (and Innovators): In search of a practical definition of health | The Health Care Blog.

From the 25 November 2014 post

flying cadeuciiFor a while now, I’ve been working on an ebook about making digital health more useful and usable for older adults.

(Don’t hold your breath, I really have no idea when it will be done. I can only work on it for about an hour every weekday.)

In reflecting on the health innovation conferences and conversations in which I’ve participated these past few years, I found myself musing over the following two questions:

1. What is health?
2. What does it mean to help someone with their health?

Three Components

After all, whether you are a clinician, a health care expert, or a digital health entrepreneur, helping people with their health is the core mission. So one would think we’d be clear on what we’re talking about, when we use terms like health and health care.

But in fact, it’s not at all obvious. In practical parlance, we bandy around the terms health and health care as we refer to a wide array of things.

Actually defining health has, of course, been addressed by experts and committees. The World Health Organization’s definition is succinct, but hasn’t been updated since 1948:

“Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”

A more recent attempt to define health, described in this 2011 BMJ editorial, proposed health as “’the ability to adapt and self manage’ in the face of social, physical, and emotional challenges.”

This left me scratching my head a bit, since it sounded more like a definition of one’s resilience, or self-efficacy. Which intuitively seem much related to health (however we define it), but not quite the same thing.

I found myself itching for a definition of health that would help me frame what I perceive as the health – and life – challenges of my older patients.

Also, it seemed impossible to articulate how digital health tools might help us care for an aging population, if one didn’t start with a practical definition of health.

So after doing an hour of research in the literature (and finding endless scholarly rabbit holes), I ended up trying to sketch a model of health that felt true to my experiences.

In this post, I’d like to share what I came up with, and get your feedback. Then in a follow-up post, I’ll write about what this might mean for defining health care, and our efforts to improve or facilitate health care.

What is health?

Health is a dynamic state. For an individual, it involves three core components:

• How are you feeling? How do your body and mind feel? Are you experiencing any pain? Bothersome sensations? Mental distress? This component of health addresses the individual’s experience of suffering.

• How well are your body and mind outwardly working? Are your body and mind working as you expect them to, or need them to, or want them to? Can you get around physically as you usually do? Can you manage your thinking tasks? Can you see, hear, speak, and otherwise communicate effectively with others? This component addresses the individual’s ability to leverage body and mind in order to manage one’s usual activities and life tasks.

• How well are your body and mind internally working? This component relates to one’s inner physiology and function. When we peer inside, whether with modern technology, via the careful pulse auscultation used in some cultures, or any other method, is anything awry? Do we find signs of disease, disorder, or disruption? In Western medicine, we consider the workings of organs and cells, but other cultures have their own “inner workings” that they assess when evaluating health.

These three components are in constant interplay with each other. Right now I’ll refer to them your wellbeing, your macrofunction, and your microfunction. (But I’m not sure those are best terms.)

These three components of health are also in constant interplay with our social and physical environments, as well as with our nutrition and our “lifestyle choices.” For instance, rich social encounters and purposeful work improve wellbeing, as well as immune function and other aspects of our microfunction. Air pollution might make us cough, and can negatively impact our lung function, along with other less visible parts of our health.

Are these many external factors, and our behavior choices, synonymous with “your health”? I would call them influences on your health, or in certain cases “health care”, rather than your health itself. (And they aren’t diagrammed above, although I’d like to add them eventually.) These factors are incredibly important, but we confuse matters when we conflate things that influence health — such as access to clinicians, clean water, walkable cities — with the actual health of an individual.

Why does a person’s health matter?

Better health is an important end in of itself.

But to a large extent, health is a means to a more important end: that of living life.

In other words, being able to do the things we care about, need to do, and want to do. Being able to do things that give purpose, meaning, and pleasure to our lives. Being able to do the things that make us feel like our selves.

This is kind of obvious, but it’s actually fairly easy to lose sight of this when we get immersed in the weeds of health and health care. (Which is why the Unmentionables at Health 2.0 is so fantastic: it’s a much-needed reminder that health serves life.)

[Caveat: There is a lot of overlap between the life activities, but I haven’t yet figured out how to diagram this. Graphic design is not my forte.]

What is a health problem?

As a doctor, my job is to help people address their health problems. And I’d like for the digital health entrepreneurs to create tools that work better for this purpose.

So what is a health problem? How to define what people seem to need help with? How to define what digital health tools should help us – whether we are a patient, a clinician, or a family caregiver – address?

Here is a practical definition: a health problem is anything that is “wrong” with one or more of the three components of health above.

For instance:
• Wellbeing Problems: Examples include being in pain, being fatigued, having insomnia, feeling depressed, feeling anxious, feeling short of breath, and so forth. Many symptoms, pains, discomforts, and any other forms of suffering fall into this category.

• Macrofunction Problems: These might include having difficulty walking due to arthritis, problems exercising due to shortness of breath, or problems thinking due to dementia. You could also include vision problems, hearing problems, and speech difficulties due to stroke. These issues often cause noticeable functional impairments.

• Microfunction Problems: These would include problems such as having impaired glucose metabolism, high blood pressure, osteoporosis, kidney disease, as well as early stage cancer.

You’ll notice that problems with wellbeing and macrofunction are primarily person-defined. It’s the affected person – sometimes known as “the patient” – who experiences suffering, or difficulties in how the body and mind are working. Whereas microfunction problems are generally “expert-defined”: nobody knows they have osteoporosis until clinicians tell them.

Many diagnoses, diseases, or health stressors will cause problems in all three parts of health. For example, cancer symptoms and the related functional impairments (e.g. problems doing anything you can usually do) are the consequence of the cancer cells running amok within.

Congestive heart failure might cause uncomfortable dyspnea, as well decreased exercise tolerance, such that a person has difficulty managing usual ambulation and activities.

Your Life

Of course, there is a lot of room to argue about what constitutes “wrong” with a given health component. Cultural and social factors influence how people perceive their own suffering, or overt impairments. And we could quibble endlessly about what is ideal blood pressure, and how we might otherwise assess how right or wrong a person’s body and mind are internally working.

Still, in many cases, if most of agree that something seems “wrong” with a given component of health, this should provide us with a decent practical starting point for identifying health problems.

Do we need to distinguish between microfunction and macrofunction?

I believe we do. Problems with macrofunction are the things that people notice in themselves (or in others, when it comes to cognitive macrodysfunction). These are what patients are often most concerned about.

Macrofunction problems, along with forms of suffering, are also what directly impacts people’s ability to participate in life tasks, and their short-term quality of life.

So helping people correct, mitigate, or adapt to these types of functional impairments is incredibly powerful, if you want to address health problems in a way that makes people’s lives materially better. This is an approach that is common in geriatrics, palliative care, physical and occupational therapy, and behavioral therapy.

Microfunction, on the other hand, is what people need technical assistance to assess. (Historically that assistance have been clinicians, but we’re on the cusp of seeing advanced diagnostic tools in the hands of the public.)

Much of the work that we doctors do in modern medicine, especially in primary care, is address physiologic problems that are scarcely perceptible to the affected person: high blood pressure, high cholesterol, type 2 diabetes, kidney disease, asymptomatic atrial fibrillation.

We do this work because we are trying to prevent or delay more overt health problems, such as those associated with suffering and macrodysfunction. So it’s certainly worthwhile work. But it doesn’t always feel satisfying or worthwhile to patients, especially if they are pre-occupied by other problems which are causing suffering or overt functional impairments.

In fact, it seems to be fairly common that patients and clinicians are focused on different aspects of health. A typical example: a doctor might decide to unilaterally prioritize tinkering with the microfunction, such as by prescribing more statins, even though a patient’s most pressing concern is falls or pain.

November 28, 2014 Posted by | Consumer Health | , | Leave a comment

[Press release]NIH scientists determine how environment contributes to several human diseases

NIH scientists determine how environment contributes to several human diseases.
From the 25 November 2014 NIH Press Release

Using a new imaging technique, National Institutes of Health researchers have found that the biological machinery that builds DNA can insert molecules into the DNA strand that are damaged as a result of environmental exposures. These damaged molecules trigger cell death that produces some human diseases, according to the researchers. The work, appearing online Nov. 17 in the journal Nature, provides a possible explanation for how one type of DNA damage may lead to cancer, diabetes, hypertension, cardiovascular and lung disease, and Alzheimer’s disease.

Time-lapse crystallography was used by National Institute of Environmental Health Sciences (NIEHS) researchers to determine that DNA polymerase, the enzyme responsible for assembling the nucleotides or building blocks of DNA, incorporates nucleotides with a specific kind of damage into the DNA strand. Time-lapse crystallography is a technique that takes snapshots of biochemical reactions occurring in cells.

Samuel Wilson, M.D., senior NIEHS researcher on the team, explained that the damage is caused by oxidative stress, or the generation of free oxygen molecules, in response to environmental factors, such as ultraviolet exposure, diet, and chemical compounds in paints, plastics, and other consumer products. He said scientists suspected that the DNA polymerase was inserting nucleotides that were damaged by carrying an additional oxygen atom.

DNA polymerase

After the DNA polymerase (gray molecule in background) inserts a damaged nucleotide into DNA, the damaged nucleotide is unable to bond with its undamaged partner. As a result, the damaged nucleotide swings freely within the DNA, interfering with the repair function or causing double-strand breaks. These steps may ultimately lead to several human diseases. (Graphic courtesy of Bret Freudenthal)

 

“When one of these oxidized nucleotides is placed into the DNA strand, it can’t pair with the opposing nucleotide as usual, which leaves a gap in the DNA,” Wilson said. “Until this paper, no one had actually seen how the polymerase did it or understood the downstream implications.”

November 28, 2014 Posted by | environmental health, Medical and Health Research News | , , , , , , | Leave a comment

[Reblog] MyFitnessPal Works If You Use It | The Health Care Blog

MyFitnessPal Works If You Use It | The Health Care Blog. (November 24, 2014)

Screen Shot 2014-11-24 at 9.33.22 AMYou may have seen some news regarding a study MyFitnessPalrecently did with UCLA.

I wanted to take a minute to address this study, since we participated in it directly. We are excited that we got to work with some very smart people to answer a question we also wanted to know the answer to. We jumped at the opportunity to find out—is having your physician introduce you to the app and help you sign up enough to kickstart a health journey?

What we learned is that just introducing people to MyFitnessPal wasn’t enough. People have to be ready and willing to do the hard work.

The app itself does work—if you use it. Our own data and the data from the study show that the more you log on, the more you use the app, the more success you will see. Users that logged in the most lost the most weight. In fact, we already know that 88% of users who log for 7 days lose weight.

We make tools designed to make it as clear and simple as possible for you to see the path to achieving your fitness goals. We are not, however, making a magic bullet—because there is no magic bullet. Ultimately, you’re the one who has to do the work.

And my, how much work you guys have done.

You have:

  • lost over 180 million pounds
  • logged over 14.5 billion foods
  • burned 364 billion calories
  • supported each other with over 82 million status likes in the last year alone
  • and much more!

The first thing I say when people talk to me about MyFitnessPal is that user success is our true North. We are relentlessly focused on user success. We believe that if you are succeeding at reaching your goals then we will succeed as a company. We’re going to keep working to make our app even more accessible, simple to use, and motivating so we can help even more people succeed.

Of course, it’s our job to make the app as engaging and easy to use as possible. It’s not exactly where we want to be, yet. But we’ll keep working hard to get there. To that end, we’ve made lots of updates since this study was done. From a product perspective, in the last year and a half we’ve:

  • streamlined the logging experience
  • made logging streaks more visible
  • added more ways to get push notifications and reminders
  • added insights to help you get more out of logging
  • made a recipe tool that allows you to quickly log recipes from anywhere across the web

As long as you keep working on your goals, we’re going to work on better ways to help you get there.

Thanks for everything you do, making the MyFitnessPal community so amazing, and helping us toward our vision of making an even healthier world.

Mike Lee is the Founder and CEO of MyFitnessPal

November 28, 2014 Posted by | Consumer Health, Health News Items | , , , , , , | Leave a comment

[Brookings Report] Pharma Pays $825 Million to Doctors and Hospitals, ACA’s Sunshine Act Reveals | Full Text Reports…

Pharma Pays $825 Million to Doctors and Hospitals, ACA’s Sunshine Act Reveals 

From the report

Disclosure of the financial relationships between the medical industry and health care providers is a very important step toward transparency. Patients heavily rely on the recommendations of their doctors to make any kind of decision regarding their health and thus should have full awareness of payments between their doctors and the medical industry. Patients have a right to be informed about possible conflicts of interests.

A not so well-known provision of the Affordable Care Act is the Sunshine Act. The purpose of this act is to increase the transparency in the health care market by requiring doctors, hospitals, pharmaceutical companies, and medical device manufacturers to disclose their financial relationships. Mandated by the Sunshine Act, on September 30th, Centers for Medicare and Medicaid Services (CMS) publicly released the first set of data, under the Open Payments title. This data includes $3.5 billion paid to over half a million doctors and teaching hospitals in the last five months of 2013.

A subset of Open Payments data that is individually identifiable  includes two categories of payments. The first category are the payments that are made for other reasons such as travel reimbursement, royalties, speaking and consulting fees and the second are payments which are made as research grants. These datasets together include more than 2.3 million financial transactions which amount to a total of more than $825 million.

Total Payments by Manufacturers of Drugs, Medical Devices, and Biologicals

General Payments

Teaching hospitals and physicians together received $669,561,563 in general payments from 949 different medical manufacturers. Interestingly, close to 70 percent ($460,369,403) of this amount was paid to individual physicians and the rest was paid to teaching hospitals. More than half of the total general payments were made by only 20 companies led by Genentech, which paid $130,065,012 in general grants to various hospitals and doctors and in particular, City of Hope National Medical Center.

Research Payments

Two hundred and ninety-four manufacturers awarded 23,225 research grants to teaching hospitals and physicians. The total value of these grants was $155,815,828. About 70 percent ($107,969,961) of these grants were awarded to teaching hospitals and the rest were awarded to physicians. The top 20 manufacturers contributed more than 75 percent of the total value of these grants. By awarding $17,973,563 in research grants Bristol-Myers Squibb, leads the pack.

The following chart breaks down the payments of the top 20 most generous manufacturers of drugs, medical devices and biologicals to teaching hospitals and individual physicians.

Not surprisingly, the release of the payments data was not immune from criticism. The harshest ones were from the American Medical Association (AMA). In particular, the AMA cited “inadequate opportunity for physician review” and “inaccuracy of the data” as the main problems with the release of open payments data. Moreover, AMA was so concerned about the “misinterpretation” of the data that it released an official “Guide for Media Reporting” in which it “strongly encourage[s] members of the media to… help the public understand the important role that appropriate relationships between physicians and industry has in advancing the practice of medicine.”

November 28, 2014 Posted by | Medical and Health Research News | , , , , , , | Leave a comment

[Press release] eScienceCommons: Athletes’ testosterone surges not tied to winning, study finds

eScienceCommons: Athletes’ testosterone surges not tied to winning, study finds.
From the press release

Friday, November 21, 2014

Athletes’ testosterone surges not tied to winning, study finds

Kathleen Casto, number 1931 in the center, shown competing in cross country as an undergraduate in North Carolina. She is now a graduate student in psychology at Emory, studying the hormonal correlates of competition in women.

By Carol Clark

A higher surge of testosterone in competition, the so-called “winner effect,” is not actually related to winning, suggests a new study of intercollegiate cross country runners.

The International Journal of Exercise Science published the research, led byDavid Edwards, a professor of psychology at Emory University, and his graduate student Kathleen Casto.

“Many people in the scientific literature and in popular culture link testosterone increases to winning,” Casto says. “In this study, however, we found an increase in testosterone during a race regardless of the athletes’ finish time. In fact, one of the runners with the highest increases in testosterone finished with one of the slowest times.”

The study, which analyzed saliva samples of participants, also showed that testosterone levels rise in athletes during the warm-up period. “It’s surprising that not only does competition itself, irrespective of outcome, substantially increase testosterone, but also that testosterone begins to increase before the competition even begins, long before status of winner or loser are determined,” Casto says.

November 28, 2014 Posted by | Medical and Health Research News | , , , , , | Leave a comment

The sound of status: People know high-power voices when they hear them

From the Association for Psychological Science press release

Being in a position of power can fundamentally change the way you speak, altering basic acoustic properties of the voice, and other people are able to pick up on these vocal cues to know who is really in charge, according to new research published in Psychological Science, a journal of the Association for Psychological Science.

We tend to focus on our words when we want to come across as powerful to others, but these findings suggest that basic acoustic cues also play an important role:

This is a photo of a person holding a megaphone.“Our findings suggest that whether it’s parents attempting to assert authority over unruly children, haggling between a car salesman and customer, or negotiations between heads of states, the sound of the voices involved may profoundly determine the outcome of those interactions,” says psychological scientist and lead researcher Sei Jin Ko of San Diego State University.

The researchers had long been interested in non-language-related properties of speech, but it was former UK prime minister Margaret Thatcher that inspired them to investigate the relationship between acoustic cues and power.

….

November 28, 2014 Posted by | Psychology | , , , , , | Leave a comment

[Press release] Healthy gut microbiota can prevent metabolic syndrome, researchers say

Healthy gut microbiota can prevent metabolic syndrome, researchers say.

From the press release

intestinal_party

ATLANTA—Promoting healthy gut microbiota, the bacteria that live in the intestine, can help treat or prevent metabolic syndrome, a combination of risk factors that increases the risk of heart disease, diabetes and stroke, according to researchers at Georgia State University and Cornell University.

Their findings are published in the journal Gastroenterology.

The study, a follow-up to the research team’s previous paper in Science, uses an improved technical approach, making the results more significant.

The research team includes Dr. Andrew Gewirtz, a professor in the Institute for Biomedical Sciences at Georgia State; Dr. Benoit Chassaing, a post-doctoral student at Georgia State; and Dr. Ruth Ley of the departments of Microbiology and Molecular Biology at Cornell.

“These results suggest that developing a means to promote a more healthy microbiota can treat or prevent metabolic disease,” Gewirtz said. “They confirm the concept that altered microbiota can promote low-grade inflammation and metabolic syndrome and advance the underlying mechanism. We showed that the altered bacterial population is more aggressive in infiltrating the host and producing substances, namely flagellin and lipopolysaccharide, that further promote inflammation.”

Metabolic syndrome is a serious health condition that affects 34 percent of American adults, according to the American Heart Association. A person is diagnosed with metabolic syndrome when he or she has three of these risk factors: a large waistline, high triglyceride (type of fat found in the blood) level, low HDL cholesterol level, high blood pressure and high fasting blood sugar. A person with metabolic syndrome is twice as likely to develop heart disease and five times as likely to develop diabetes, according to the National Institutes of Health.

Because metabolic syndrome is becoming more common, scientists are exploring possible causes. In their previous study in Science, Gewirtz, Ley and other researchers showed altered gut microbiota play a role in promoting metabolic syndrome.

Gut microbiota perform key functions in health and when it becomes deregulated it can promote chronic inflammatory diseases such as Crohn’s disease and ulcerative colitis. In addition, altered gut microbiota promote inflammation that leads to metabolic syndrome.

“We’ve filled in a lot of the details about how it works,” Gewirtz said. “It’s the loss of TLR5 on the epithelium, the cells that line the surface of the intestine and their ability to quickly respond to bacteria. That ability goes away and results in a more aggressive bacterial population that gets closer in and produces substances that drive inflammation.”

Normally, the bacteria are in the mucous layer at a certain distance away from epithelial cells. The researchers showed altered gut microbiota is more aggressive in infiltrating the host and gets very close to the epithelium. This altered population produces flagellin and lipopolysaccharide, which further promote inflammation.

The research team improved the study by comparing mice that were siblings and littermates, making all conditions in the study the same. The mice only differed by whether they were missing a specific gene, TLR5. Previously, the researchers studied mice that were from two different strains and lived in separate environments. In this study, they found the absence of TLR5 on the intestinal surface leads to alterations in bacteria that drive inflammation, leading to metabolic syndrome.

This study was funded by the National Institutes of Health and the Crohn’s and Colitis Foundation of America.

November 28, 2014 Posted by | Medical and Health Research News, Nutrition | , , , , , , , , , , , , | Leave a comment

[Medical Journal Article] The Lancet: Universal health coverage for US military veterans within reach, but many still lack coverage

 

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The Lancet: Universal health coverage for US military veterans within reach, but many still lack coverage.

From the press release

Over a million US military veterans lacked healthcare coverage in 2012, according to new estimates published in The Lancet. While many people believe that all veterans are covered by the Veterans Affairs health care system, less than half (8.9 million) of the 22 million veterans in the US are covered by VA health benefits, and most veterans are covered by private health insurance. Uninsured veterans are more likely to be young, single, African American, and veterans of Iraq and Afghanistan.

However, the authors of this viewpoint estimate that universal health coverage for veterans is within reach, thanks to the Affordable Care Act and its Medicaid expansion and subsidies for private health care. According to the authors, 87% of currently uninsured veterans could be eligible for health coverage through the Medicaid expansion, via the subsidized private health insurance market, or by enrolling in VA health benefits. Uninsured veterans are more likely to be clustered in states that have rejected the ACA’s Medicaid expansion. Of the top five states with the highest number of uninsured veterans, four [1] are states that have rejected the expansion (the fifth, California, has accepted the expansion, but is also the most populous state in the union).

“Largely on account of the Affordable Care Act, the goal of universal health coverage for veterans is closer than ever,”* explains author Dave A Chokshi. “There remain political hurdles to achieving this goal, both in the false impression that the VA already provides universal coverage, and the decision by several states to reject the ACA’s Medicaid expansion. While eligibility for insurance is not tantamount to access to care, universal coverage is an important first step towards high-quality healthcare.”*

###

NOTES TO EDITORS:

*Quotes direct from author and cannot be found in text of Article

[1] There are an estimated 126000 uninsured veterans in Texas, 95000 in Florida, 54000 in North Carolina, and 53000 in Georgia

November 28, 2014 Posted by | Uncategorized | Leave a comment

[News article] A green transformation for pharmaceuticals — ScienceDaily

From the news article

Date:November 21, 2014
Source:The Agency for Science, Technology and Research (A*STAR)

Summary:


A more sustainable approach to a bond-forming reaction extensively used in the pharmaceutical and fine chemical industries has now been developed. The team used the solvent-free, catalytic reaction to produce high yields of a wide range of amides, including the antidepressant moclobemide and other drug-like molecules.

November 28, 2014 Posted by | Medical and Health Research News | , , , | Leave a comment

[Press release]Paper electronics could make health care more accessible

aPaper electronics could make health care more accessible.

From the 19 November 2014 EurekAlert

Flexible electronic sensors based on paper — an inexpensive material — have the potential to some day cut the price of a wide range of medical tools, from helpful robots to diagnostic tests. Scientists have now developed a fast, low-cost way of making these sensors by directly printing conductive ink on paper. They published their advance in the journal ACS Applied Materials & Interfaces.

Anming Hu and colleagues point out that because paper is available worldwide at low cost, it makes an excellent surface for lightweight, foldable electronics that could be made and used nearly anywhere. Scientists have already fabricated paper-based point-of-care diagnostic tests and portable DNA detectors. But these require complicated and expensive manufacturing techniques. Silver nanowire ink, which is highly conductive and stable, offers a more practical solution. Hu’s team wanted to develop a way to print it directly on paper to make a sensor that could respond to touch or specific molecules, such as glucose.

The researchers developed a system for printing a pattern of silver ink on paper within a few minutes and then hardening it with the light of a camera flash. The resulting device responded to touch even when curved, folded and unfolded 15 times, and rolled and unrolled 5,000 times. The team concluded their durable, lightweight sensor could serve as the basis for many useful applications.

November 25, 2014 Posted by | health care, Uncategorized | , , | Leave a comment

High-Cost Generic Drugs — Implications for Patients and Policymakers — NEJM

High-Cost Generic Drugs — Implications for Patients and Policymakers — NEJM.

Excerpt

It is well known that new brand-name drugs are often expensive, but U.S. health care is also witnessing a lesser-known but growing and seemingly paradoxical phenomenon: certain older drugs, many of which are generic and not protected by patents or market exclusivity, are now also extremely expensive. Take the case of albendazole, a broad-spectrum antiparasitic medication. Albendazole was first marketed by a corporate predecessor to GlaxoSmithKline (GSK) outside the United States in 1982 and was approved by the Food and Drug Administration (FDA) in 1996. Its patents have long since expired, but no manufacturer ever sought FDA approval for a generic version. One reason may be that the primary indications for the drug — intestinal parasites, neurocysticercosis, and hydatid disease — occur relatively rarely in the United States and usually only in disadvantaged populations such as immigrants and refugees. In late 2010, the listed average wholesale price (AWP) for albendazole was $5.92 per typical daily dose in the United States and less than $1 per typical daily dose overseas.

….

 

Meanwhile, there is little that individual consumers can do. Some drug companies, such as Amedra, offer assistance programs for indigent patients, but these programs often have complicated enrollment processes, and they do not offer an effective general safety net.5 Some patients instead seek to acquire these drugs in other countries, since many of them are widely and inexpensively available outside the United States, but such foreign sources may be of variable quality. Until regulatory and market solutions are implemented to reduce prices for these older drugs, patients requiring such drugs and the physicians treating them will continue to be faced with difficult choices.

November 25, 2014 Posted by | health care | , , | Leave a comment

[News item] Finding new ways to make drugs — ScienceDaily

Finding new ways to make drugs — ScienceDaily

Excerpt

Date:November 18, 2014
Source:Australian National University
Summary:Chemists have developed a revolutionary new way to manufacture natural chemicals by clipping smaller molecules together like Lego. They have used the new method to assemble a scarce anti-inflammatory drug

November 25, 2014 Posted by | Medical and Health Research News | , | Leave a comment

[Press release]Herbs and spices enhance heart health as well as flavor

Herbs and spices enhance heart health as well as flavor.

English: cinnamon bark Cinnamomum verum. Franç...

English: cinnamon bark Cinnamomum verum. Français : Canelle Cinnamomum verum. Ελληνικά: Κανέλα, μπαχαρικό (Photo credit: Wikipedia)

Excerpt

Spices and herbs are rich in antioxidants, which may help improve triglyceride concentrations and other blood lipids, according to Penn State nutritionists.

Triglyceride levels rise after eating a high-fat meal — which can lead to an increased risk of heart disease. If a high-antioxidant spice blend is incorporated into the meal, triglyceride levels may be reduced by as much as 30 percent when compared to eating an identical meal without the spice blend. The spiced meal included garlic powder, rosemary, oregano, cinnamon, cloves, paprika, turmeric, ginger and black pepper.

Sheila G. West, professor of biobehavioral health and nutritional sciences, and Ann C. Skulas-Ray, research associate in nutritional sciences, reviewed a variety of research papers that focused on the effects that spices and herbs have on cardiovascular disease risk. They published their findings in a supplement to the current issue of the journal Nutrition Today, based on papers presented at the McCormick Science Institute Summit held in May 2014.

“The metabolic effects of spices and herbs and their efficacy and safety relative to traditional drug therapy represent an exciting area for future research given the public health significance of cardiovascular disease,” the researchers wrote.

West and Skulas-Ray looked at three categories of studies — spice blends, cinnamon and garlic.

“We live in a world where people consume too many calories every day,” said West. “Adding high-antioxidant spices might be a way to reduce calories without sacrificing taste.”

West and Skulas-Ray reviewed several cinnamon studies that looked at the effect of the spice on both diabetics and non-diabetics. Cinnamon was shown to help diabetics by significantly reducing cholesterol and other blood lipids in the study participants. However, cinnamon did not appear to have any effect on non-diabetics.

The garlic studies reviewed were inconclusive, but this is likely because the trials had a wide range of garlic doses, from nine milligrams of garlic oil to 10 grams of raw garlic. The reviewers noted that across the studies there was an eight percent decrease in total cholesterol with garlic consumption, which was associated with a 38 percent decrease in risk of heart problems in 50-year-old adults.

November 25, 2014 Posted by | Nutrition, Uncategorized | , , , , , , | Leave a comment

Datasets used by policymakers, scientists for public health analyses inconsistent [press release]

 

From the 17 November 2014 press release at the University of Pittsburgh Schools of the Health Science 

Commercially available datasets containing a wealth of information about food and alcohol establishments differ significantly, raising concerns about their reliability as sources of information that could be used to set public policy or conduct scientific research, according to a University of Pittsburgh Graduate School of Public Health investigation.
The analysis, funded by the Aetna Foundation, will be presented Monday at the American Public Health Association’s (APHA) annual meeting in New Orleans. It examined systematic differences in two commercially available datasets when they were used to determine the relationship between neighborhood socioeconomic characteristics and the density of food and alcohol establishments.
“If we’re making decisions about setting public policy to improve public health – such as incentives for grocery stores that offer fresh produce in economically depressed areas – then we need to be making these decisions based on accurate data to back up the need for such incentives,” said lead investigator Dara Mendez, Ph.D., M.P.H., an epidemiologist at Pitt Public Health. “Our study found that relying on just one of these commercially available datasets likely wouldn’t provide robust information.”
There are numerous datasets available for a fee that give detailed information about food and alcohol establishments across the U.S. Typically, these datasets are purchased by companies that use them for marketing purposes.
Dr. Mendez and her team used two different commercially available datasets containing information about food and alcohol establishments in Allegheny County, which includes Pittsburgh. The information was divided into the 416 distinct census tracts in the county as a means to define neighborhoods. Each census tract consists of an average of 4,000 people.
Both of the datasets showed that the density of alcohol outlets increased as neighborhood poverty increased. However, the datasets differed when it came to grocery stores. One showed that as poverty increased, the number of grocery stores increased. The other showed no association.
“This is a perplexing disagreement that likely comes down to the datasets using different classification systems and also not accurately capturing all the information. For example, because we are familiar with Allegheny County, my team was able to determine that some of the key grocery stores in our area were not included,” said Dr. Mendez. “However, if we were doing a similar analysis for a city we were not familiar with, we likely wouldn’t catch the discrepancy and could come to an inaccurate conclusion.”
The Aetna Foundation funded the study as part of a larger grant to Pitt Public Health to study the potential influence of living in stressful neighborhoods on the health of African-American mothers and their babies.
Additional researchers on this study include Anthony Fabio, Ph.D., M.P.H., and Kevin H. Kim, Ph.D., both of Pitt; and Cecily Hardaway, Ph.D., of Duke University.
APHA Abstract No. 302593, “Examining systematic biases in secondary commercial data sources of food and alcohol environments: Differences across neighborhood racial and socioeconomic characteristics,” will be given as an oral presentation at 12:30 p.m. CST on Monday, Nov. 17, 2014.

 

November 25, 2014 Posted by | Uncategorized | | Leave a comment

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