Health and Medical News and Resources

General interest items edited by Janice Flahiff

[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

[Press release] Complementary and alternative medicine for veterans and military personnel — update from Medical Care

Complementary and alternative medicine for veterans and military personnel — update from Medical Care.

From the 17 November 2014 press release

Special issue reports progress, but more work needed to incorporate CAM into military health settings

November 17, 2014 – A growing body of research evidence shows that complementary and alternative medicine (CAM) has health benefits for US military veterans and active duty personnel, according to a special December supplement to Medical Care. [All articles are free].The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

The special issue presents new studies and commentaries on the benefits and increasing use of CAM techniques in the Veterans Health Administration (VHA) and other military health settings. “The papers in this supplement represent promising steps to improve the health of veterans and active military personnel,” according to an introductory article by Guest Editors Stephanie L. Taylor, PhD, of Greater Los Angeles VA Healthcare System and A. Rani Elwy, PhD, of Edith Nourse Rogers Memorial Veterans Hospital, Bedford, Mass. “They mirror the countless stories we hear from veterans and their providers about the positive effect that CAM is having on their lives.”

Studies Show Value of CAM for Improving Health of Military Personnel

The supplement presents 14 original studies reporting on specific CAM therapies and on the current use, perceptions, and acceptance of CAM in veterans and current military personnel. The special issue of Medical Care is sponsored by the VHA’s Office of Patient Centered Care and Cultural Transformation.

Complementary and alternative medicine therapies are increasingly available, used, and appreciated by military patients, according to Drs Taylor and Elwy. They cite statistics showing that CAM programs are now offered at nearly 90 percent of VA medical facilities. Use CAM modalities by veterans and active military personnel is as at least as high as in the general population.

 

Previous systematic reviews have reported benefits of CAM treatments for many of the important problems seen in military populations, including chronic pain, anxiety, posttraumatic stress disorder (PTSD), and depression. Those prior results suggest that CAM therapies are “moderately effective” for these conditions–although these conclusions must be weighed against the weaknesses of the evidence base.

Highlights of the research included in the special issue include:

  • Studies reporting benefits of specific types of meditation practices. One study finds that a mindfulness-based intervention reduced depression and improved psychological well-being in veterans with PTSD. A study of mindfulness-based stress reduction for veterans shows reductions in anxiety and depression, as well as suicidal thoughts.
  • A report showing beneficial effects of acupuncture for veterans with PTSD. In addition to reduced severity of PTSD symptoms, the study shows improvements in depression, pain, and physical and mental health functioning. Another study finds that most veterans use vitamins and nutritional supplements, often substituting them for prescription drugs.
  • Studies showing high rates of use and favorable perceptions found of CAM modalities among veterans of the Gulf War and Operation Enduring Freedom/Operation Iraqi Freedom. Veterans with PTSD are more likely to be accepting of CAM therapies.
  • Reports describing the rates and preferred types of CAM mind-body and other modalities among military members and veterans, as well as on health care providers’ attitudes toward CAM. While VA providers vary in their knowledge of CAM, many perceive benefits for their patients.

A commentary by Laura P. Krejci, MSW, and colleagues of the VA’s Office of Patient Centered Care & Cultural Transformation discusses the role of CAM in meeting the “number one strategic priority” of providing “personalized, proactive, patient-driven health care to veterans.” Dr Wayne B. Jonas and colleagues of the Samueli Institute, Alexandria, Va., draw attention to several bodies of research on CAM in the US military. They conclude that current policy and priorities leave “the majority of active duty service members, veterans, and their families to fend for themselves, to pay for or go without the beneficial effects of CAM and integrative medicine practices.”

While the studies in the special issue show progress, Drs Taylor and Elwy stress the need for additional rigorous research to better understand CAM’s potential for managing important conditions seen in military populations. They conclude, “It is time for more funding to be awarded to CAM …to improve the capacity of the field to carry out rigorous CAM research, which in turn will benefit veterans and military personnel, as well as the general population.”

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Click here to read “Building the Evidence Base for Complementary and Integrative Medicine Use among Veterans and Military Personnel.”

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

[New item] Secondhand marijuana smoke may damage blood vessels as much as tobacco smoke — ScienceDaily

From Secondhand marijuana smoke may damage blood vessels as much as tobacco smoke — ScienceDaily.

English: one high-quality "bud " nug...

English: one high-quality “bud ” nugget of marijuana (Photo credit: Wikipedia)

Date:November 16, 2014

Source:American Heart Association

 Summary:Secondhand marijuana smoke may have similar cardiovascular effects as tobacco smoke. Lab rats exposed to secondhand marijuana smoke had a 70 percent drop in blood vessel function.

“If you’re hanging out in a room where people are smoking a lot of marijuana, you may be harming your blood vessels,” he said. “There’s no reason to think marijuana smoke is better than tobacco smoke. Avoid them both.”

Secondhand tobacco smoke causes about 34,000 premature deaths from heart disease each year in the United States among nonsmokers according to the U.S. Surgeon General’s 2014 report on the consequences of smoking.

More research is needed to determine if secondhand marijuana smoke has other similar effects to secondhand cigarette smoke in humans.

 

 

November 25, 2014 Posted by | Consumer Health | , , | Leave a comment

Poor-quality weight loss advice often appears first in an online search — ScienceDaily

From the 14 November 2014 item at ScienceDaily

Source:Health Behavior News Service, part of the Center for Advancing Health
Summary:More than 40 percent of U.S. Internet users use online search engines to seek guidance on weight loss and physical activity. A new study finds that high-quality weight loss information often appears after the first page of search engine results.

Given that obesity affects one-third of Americans, it is not surprising that more than 40 percent of U.S. Internet users use online search engines to seek guidance on weight loss and physical activity. A new study in the American Journal of Public Health finds that online searchers often initially encounter poor-quality weight loss information.

The study reveals that the first page of results, using a search engine like Google, is likely to display less reliable sites instead of more comprehensive, high-quality sites, and includes sponsored content that makes unrealistic weight loss promises.

..

“Federal agencies, academic institutions and medical organizations need to work a lot harder at search engine optimization to get their links on top of searches,” Modave added. “Consumers need to be more critical when reading online. Ideally, they could read original studies from which many stories are written but, of course, that’s not realistic for most people.”

 

Related Resources

 

November 25, 2014 Posted by | Consumer Health | , , , , | Leave a comment

[Psychology Resource] APA Center for Organizational Excellence

APA Center for Organizational Excellence

·http://www.apaexcellence.org

From the Scout Report

The science of psychology is often associated with either carefully controlled lab experiments or the soft-spoken tones of a therapist’s office. But psychologists actually study a huge range of behavioral phenomena. This site from the American Psychological Association (APA) focuses on work and work environments, asking questions such as: What makes work meaningful? How can companies help people love their jobs? And what’s in it for the companies if they invest in making the workplace healthier? There is a lot to discover here, including the Articles & Research section, which links readers to coverage of workplace research by such media outlets as USA Today and Market Watch. The Good Company section is another great find and features Podcasts as well as a Newsletter and Blog that provide focused, research-based content for both employers and workers. Company executives may also want to look into the Psychologically Healthy Workplace Award, which has been “shining the spotlight on exemplary organizations” since 1999. [CNH]

November 25, 2014 Posted by | Psychology, Uncategorized, Workplace Health | , , , | Leave a comment

[Reblog] Tech Innovations in Healthcare | HealthWorks Collective

Tech Innovations in Healthcare | HealthWorks Collective.

From the 6 November 2014 post

As technology continually expands with each passing year so do the industries it affects. This year the world has been witness to everything from wearable technology like Fitbit Google Glass to 3D printing, both of which are prime examples of tech and healthcare melding.

The healthcare industry has been no stranger to advancements in technology. These medical marvels are changing the way people are impacted and thereby changing the face of the healthcare industry.

1. Mobile Apps

2. Telehealth

google glass3. Google Glass

4. 3D Printing

5. Optogenetics

 

6. Digestible Sensors

 

 

November 25, 2014 Posted by | Health News Items | , , | Leave a comment

[Reblog] Rewarding Patient Recovery | HealthWorks Collective

Rewarding Patient Recovery | HealthWorks Collective.

From the 6 November 2014 item at HealthWorks Collective

What if we paid for patient recovery rather than just patient services?

What if we paid to treat patients rather than just conditions?

What if we paid to personalize care rather just population health quality measures?

While these questions may sound academic, there is a groundswell of innovative healthcare providers working on the answers.  To realign the healthcare system to overall patient recovery and well-being, it will take physicians and other healthcare providers transforming the entire system. The good news is that this is quietly happening from within, with physicians, healthcare systems and health plans working together.

They include the over 500 Accountable Care Organizations6,500 providers considering bundled payment pilots and providers signing risk sharing agreements with health plans.  Physicians, healthcare systems and insurance plans are sharing data, sharing financial risk and focusing on improving overall patient outcomes and cost.

With little debate or fanfare outside the healthcare industry, Medicare quietly saved $372 million with their versions of the ACO. While some critics predict that ACOs will follow Health Maintenance Organizations (HMOs) demise in the 1990s, ACOs are different.  Patients are assigned to ACOs and remain free to go to any provider.  ACOs can’t limit care or require patients to see providers in their network.  The ACO’s were still able deliver great results even with these two major challenges which they call “churn” (ACO assigned patient turnover) and “leakage” (patients going outside the provider network).

Bundled Payments are just getting started with up to 6,500 providers deciding soon whether to go live Jan 1, 2015 with Medicare’s Bundled Payment for Care Improvement (BPCI) pilot. Provider/Health Plan risk sharing arrangements are expanding rapidly, indicating they are delivering.  This surge began when the Affordable Care Act (ACA) started requiring health plans to write rebate checks if they paid out less than 85% of their premiums in medical claims. This encouraged Health Plans to partner and reward providers for improvements in patient outcomes and cost. Health Plans leaders believe that the “blurring of the lines” between providers and health plans is just getting started.

Patient Recovery vs. Patient Services

 

 

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

[Reblog] “Health care consumers in the dark” – no kidding

“Health care consumers in the dark” – no kidding.

From the 24 November 2014
That headline appeared in the Minneapolis Star Tribune print edition yesterday. The focus of the article was how difficult it is to obtain medical cost data despite a state law and other efforts to increase transparency.item at HealthNewsReview.org

The same newspaper had a brief column the previous day about open enrollment season for workplace medical benefits, but that column’s final line seemed to conflict with the point of the longer story mentioned above.  The shorter column quoted the executive director of the MN Community Measurement group saying that the group’s rankings – “rating doctors on whether they provide optimal care to patients with diabetes, depression and other conditions….can help consumers make informed choices.”  The exec said consumers can now ask, “Is there much difference in quality, given the difference you might be asked to pay in price?”

Well, the “Health care consumers in the dark” story drove home the point that consumers can’t get the price answers.

Meantime, it was great to see a JAMA Internal Medicine article about a great piece of journalism on this same topic.  The article, by Lisa Aliferis of KQED radio in San Francisco, was entitled, “Variation in Prices for Common Medical Tests and Procedures.” It gives details about the PriceCheck project of KQED, KPPC, and the excellent ClearHealthCosts.com effort run by Jeanne Pinder.  Aliferis concludes the article:

“The window is cracked open on health cost transparency. We have been here before—with car sales, with airline tickets. Now, technology in combination with transparency can do the same for health care.

And yes, we have been asked whether people should “shop” for medical treatment in the same way they shop for a new car. If there were a correlation between cost and quality, this might be a reasonable question. Instead, in American health care, money is spent on unnecessary or unproven treatments much too often, and there’s widespread variation in price. People are waking up to these facts.

The money conversation makes the practice of medicine very complicated: the “gotcha” bill and the medication that is not covered challenge the physician-patient relationship. It is time to take off the blindfold and embrace transparency in pricing for medical care and services.”

 

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

3D printed personalized medicine, prescribed by the doctor and yourself | Meet the biomarker pioneers

3D printed personalized medicine, prescribed by the doctor and yourself | Meet the biomarker pioneers.

Excerpt from the 11 November 2014 post at MyCartis blog

“When I go to a doctor now, he will examine me, diagnose me, write a prescription which I will take to the pharmacist, who will then give me my medicines that are mass-produced. In the future, I will still consult a doctor, and together, we will decide about the treatment. Based on my genome sequence, the doctor can choose the right dose, design a blueprint, send that to the pharmacist who will 3D print my medicines.”

Will this be the future of healthcare? It will be, according to the medical futurist, Dr. Bertalan Meskó. In his book The Guide to the Future of Medicine: Technology and the Human Touch he discusses 22 trends that are going to shape the future of healthcare.

Personalized medicine is one of them. “We are at the verge of a truly meaningful use of personalized medicine”, Meskó said. “All around the world you see promising examples in the fields of lung cancer, breast cancer and many other research areas.”

- See more at: http://www.mycartis.net/blog/?p=59#sthash.opDwHiJW.dpuf

November 24, 2014 Posted by | Medical and Health Research News | , , , | Leave a comment

HHS and NIH take steps to enhance transparency of clinical trial results

From the HHS Press Release,  Wednesday, November. 19, 2014

 The U.S. Department of Health and Human Services today issued a Notice of Proposed Rulemaking (NPRM), which proposes regulations to implement reporting requirements for clinical trials that are subject to Title VIII of the Food and Drug Administration Amendments Act of 2007 (FDAAA). The proposed rule clarifies requirements to clinical researchers for registering clinical trials and submitting summary trial results information to ClinicalTrials.gov, a publicly accessible database operated by the National Library of Medicine, part of the National Institutes of Health. A major proposed change from current requirements is the expansion of the scope of clinical trials required to submit summary results to include trials of unapproved, unlicensed, and uncleared products.

clinicatrials

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ClinicalTrials.gov currently contains registration information for more than 178,000 clinical trials and summary results for more than 15,000. These numbers include trials that are not subject to FDAAA. Among the primary benefits of registering and reporting results of clinical trials, including both positive and negative findings, is that it helps researchers prevent unnecessary duplication of trials, particularly when trial results indicate that a product under study may be unsafe or ineffective, and it establishes trust with clinical trial participants that the information from their participation is being put to maximum use to further knowledge about their condition.

Developed by NIH in close coordination with the FDA, the proposed rule details procedures for meeting the requirements established by FDAAA to improve public access to clinical trial information. FDAAA and the proposed rule apply to certain interventional studies of drugs, biological products, and devices that are regulated by the FDA, but, generally, not to phase 1 trials of drugs and biological products and small feasibility studies of devices. The proposed rule specifies how data collected and analyzed in a clinical trial would be required to be submitted to ClinicalTrials.gov. It would not affect requirements for the design or conduct of clinical trials or for the data that must be collected during clinical trials.

“This proposed rule would close an important gap, making additional information about clinical studies of investigational drugs, medical devices and biological products available to the public,” said FDA Commissioner Margaret A. Hamburg, M.D. “It would help eliminate unnecessary duplicative trials, advance biomedical innovation, and provide the public with a much richer understanding about the clinical trials for these products.”

Notable changes from current requirements and practice that are outlined in the proposed rule include:

A streamlined approach for determining which trials are subject to the proposed regulations and who is responsible for submitting required information.

Expansion of the set of trials subject to summary results reporting to include trials of unapproved products.

Additional data elements that must be provided at the time of registration (not later than 21 days after enrolling the first participant) and results submission (generally not later than 12 months after completion).

Clarified procedures for delaying results submission when studying an unapproved, unlicensed, or uncleared product or a new use of a previously approved, licensed, or cleared product and for requesting extensions to the results submission deadline for good cause.

More rapid updating of several data elements to help ensure that users of ClinicalTrials.gov have access to accurate, up-to-date information about important aspects of a clinical trial.

Procedures for timely corrections to any errors discovered by the responsible party or by the Agency as it processes submissions prior to posting.

 

 

Read a summary of the proposed changes: http://www.nih.gov/news/health/nov2014/od-19_summary.htm.

Read the entire text of the proposed regulations here. Options are available for comment submission electronically or in written form.

 

November 21, 2014 Posted by | Medical and Health Research News | , | Leave a comment

[News article] Vaccination leads to decline in pneumococcal disease and antibiotic resistance | Daily Science News

Vaccination leads to decline in pneumococcal disease and antibiotic resistance | Daily Science News.

Wits University and the National Institute for Communicable Diseases (NICD) released a new study, led by Wits academics, showing rates of invasive pneumococcal disease (IPD) – including cases caused by antibiotic resistant bacteria – have fallen substantially in South Africa following the introduction of a pneumococcal conjugate vaccine (PCV) in 2009.

The release of the results of the study coincides with World Pneumonia Day, commemorated annually on 12 November.

The study, titled: Effects of Vaccination on Invasive Pneumococcal Disease in South Africa, published in the latest edition of the New England Journal of Medicine (NEJM), compares IPD incidence after the introduction of PCV (post-introduction: 2011 and 2012) to incidence prior to its introduction (2005-2008), focusing on high-risk groups.

Although the majority of childhood pneumococcal deaths occur in Africa, evidence of the potential impact of pneumococcal vaccines in routine use has largely been drawn from high-income countries. However, two recent publications from South Africa have demonstrated PCVs to be effective in preventing pneumococcal disease among South African children, in conditions of routine vaccine use.

“The results show that the vaccine works as rolled out in our immunization program and this supports the hard work of our national and provincial Departments of Health. However, much still remains to be done in South Africa, other countries in Africa and elsewhere to prevent children from developing and dying from pneumonia,”said Dr Anne von Gottberg, lead author of the paper, Clinical Microbiologist, Head of the Centre for Respiratory Diseases and Meningitis at the NICD and Associate Professor in the School of Pathology at Wits.

This study demonstrates significant declines in pneumococcal disease cases caused by bacteria resistant to one or more antibiotics, a phenomenon of growing concern among health professionals. In fact, the rate of infections resistant to two different antibiotics declined nearly twice as much as infections that could be treated with antibiotics. This proportionately greater effect of vaccination on antibiotic-resistant strains points to a very valuable added benefit of immunization.

“These are very compelling results,” said Dr Seth Berkley, CEO of Gavi, the Vaccine Alliance, a Geneva-based global health organization that part-funded the research. “Not only does it add significant weight to the growing body of evidence that PCV prevents disease, but it suggests that vaccines may have a role to play in the fight against antibiotic resistance.”

“Vaccination is one of the most effective and underappreciated tools available to reduce antibiotic resistance. The majority of resistant strains of pneumococcus are of types which are included in the vaccine, for this reason, vaccine introduction in South Africa, has led to a substantial decline in antibiotic resistant invasive pneumococcal disease,” said Dr Cheryl Cohen, co-author of the paper, Clinical Epidemiologist at the NICD and senior lecturer in the School of Public Health at Wits.

In 2009, South Africa became the first African country – and the first nation in the world with a high HIV prevalence – to introduce PCV7 into its routine immunization program. The current study shows a significant decline in IPD in children and in unvaccinated adults, which demonstrates the indirect protection conferred by herd immunity. Among children under two years of age, overall incidence of IPD declined nearly 70% after PCV introduction, and rates of IPD caused by bacteria specifically targeted by the vaccine plummeted nearly 90%.

A recent study published by the researchers in the Pediatric Infectious Disease Journal found that the risk of IPD in South African children increased with HIV exposure, as well as with underlying medical conditions, malnutrition, tuberculosis, upper-respiratory tract infections and exposure to other children.

“We have shown that HIV-infected and HIV-exposed children experience a disproportionate burden of pneumococcal disease. The vaccine has also been shown to be highly effective in HIV-exposed children and disease reductions have been observed in both HIV-infected and uninfected children,” said Dr Claire von Mollendorf, a medical epidemiologist from the NICD. “This study reinforces what the scientific community has known – that the pneumococcal vaccine saves lives.”

Although incidence of HIV among infants is decreasing in South Africa due to improved prevention of the mother-to-child HIV transmission and the use of anti-retrovirals, a large number of HIV-exposed yet uninfected children remain, for whom vaccination against pneumococcal disease may be of particular importance to ensuring reduced risk of life-threatening infections in childhood.

November 14, 2014 Posted by | Medical and Health Research News | , , , | Leave a comment

‘[news article] Smart’ drugs won’t make smart people smarter, research concludes — ScienceDaily

‘Smart’ drugs won’t make smart people smarter, research concludes — ScienceDaily.

Excerpt

Date: November 12, 2014
Source: University of Nottingham
Summary: It is claimed one in five students have taken the ‘smart’ drug Modafinil to boost their ability to study and improve their chances of exam success. But new research into the effects of Modafinil has shown that healthy students could find their performance impaired by the drug.

November 14, 2014 Posted by | Psychiatry | , , | Leave a comment

[Press release] ‘Nudges’ try to help college students live healthier

‘Nudges’ try to help college students live healthier 

 

College-weight-111214-300x199

Students run up the bleachers at Ben Hill Griffin Stadium on the University of Florida campus. A new national study aimed at preventing college students from gaining weight used Internet lessons and “nudges” to try to get them to live healthier lifestyles. Karla Shelnutt, a UF/IFAS assistant professor in family, youth and community sciences and a study investigator, considers the web messages successful if they helped students progress from thinking about eating more fruits and vegetables to actually doing so.Credit: UF/IFAS file photo.

From the 14 November 2014 University of Florida press release:

From the 12 November 2014 University of Florida press release

GAINESVILLE, Fla. – Internet lessons and “tailored” text alerts can help some young people adopt healthier lifestyles, according to a national study aimed at preventing weight gain.

Although experimental group students didn’t gain or lose more weight than their control group counterparts, researchers remain hopeful the Internet-message approach can work because it helped college students progress from what researchers call the “contemplative stage” to the “action stage.”

An example of the contemplative stage would be someone who’s thinking about trying to eat fatty foods less frequently, but hasn’t taken action to do so, while someone at the action stage would choose to eat a salad, instead.

In the study, students aged 18-24 received individually targeted messages. Some students were in the “pre-contemplative” stage; others fell into the “action” stage, while others were in various stages between those two.

The study, published online last week in the Journal of Nutrition Education and Behavior, found more students who received the Web messages ate more fruits and vegetables and were more physically active than those in the control group.

Researchers weren’t as concerned about students losing weight as they were with giving them strategies to lead healthier lives to prevent weight gain, said Karla Shelnutt, a University of Florida assistant professor in family, youth and community sciences.

 

 

November 14, 2014 Posted by | Medical and Health Research News | , , , , , , | Leave a comment

[News article] Understanding natural compounds when antibiotics no longer work — ScienceDaily

Understanding natural compounds when antibiotics no longer work — ScienceDaily.

Excerpts

Date:November 12, 2014
Source:ETH Zürich
Summary:Medicine is drifting towards a major problem. An increasing number of bacteria is no longer sensitive to known antibiotics. Doctors urgently need to find new ways of fighting these multi-resistant pathogens. To address the problem, pharmaceutical research is turning back to the source of most of our drugs: nature.

Although hundreds of thousands of known active agents are found in nature, exactly how most of them work is unclear. A team of researchers from ETH Zurich has now developed a computer-based method to predict the mechanism of action of these natural substances. The scientists hope this method will help them to generate new ideas for drug development. “Natural active agents are usually very large molecules that often can be synthesized only through very laborious processes,” says Gisbert Schneider, a professor of computer-aided drug design at the Institute of Pharmaceutical Sciences at ETH Zurich. An understanding of the exact mechanism of action of a natural substance enables the design of smaller, less complex molecules that are easier to synthesize. Once a substance is chemically synthesized, it can be optimized for medical applications.

In order to understand the mechanism of action, researchers are studying which parts of a pathogen interact with the natural substance to inhibit its growth for example. In the past, this involved highly complex laboratory tests through which scientists usually identified only the strongest effect of a substance. However, this interaction alone is often unable to explain the entire effect of a natural substance. “Minor interactions with other target structures can contribute to the overall effect as well,” explains Schneider.

“By using the computer to break down the molecules, which can be quite large, into separate building blocks, we discover which parts might be essential for the mechanism of action,” says Schneider. Thus, it might be possible to design less complex molecules that chemists could synthesize instead of the laborious process of isolating them from the natural source.

Analysis of 210,000 natural substances

Using the computer-based method, the researchers led by Gisbert Schneider were able to predict a variety of potential target structures for 210,000 known natural substances.

November 14, 2014 Posted by | Medical and Health Research News | , , , , | Leave a comment

[News article] Marijuana’s long-term effects on the brain demonstrated — ScienceDaily

Marijuana’s long-term effects on the brain demonstrated — ScienceDaily.

Excerpts

Date:November 10, 2014
Source:Center for BrainHealth
Summary:
The effects of chronic marijuana use on the brain may depend on age of first use and duration of use, according to new research. Researchers for the first time comprehensively describe existing abnormalities in brain function and structure of long-term marijuana users with multiple magnetic resonance imaging (MRI) techniques.

November 14, 2014 Posted by | Consumer Health, Psychiatry | , , , , | Leave a comment

[News article] Recognizing emotions, and what happens when this is interrupted — ScienceDaily

Recognizing emotions, and what happens when this is interrupted — ScienceDaily.

Excerpt

Date:November 10, 2014
Source:Sissa Medialab
Summary:
Recognizing the emotions other people feel is crucial for establishing proper interpersonal relations. To do so, we look at (amongst other things) facial expressions and body posture. Unfortunately, in some neurological disorders this ability is heavily impaired. This happens, for example, in multiple sclerosis where scientific evidence shows that people affected by the disease often have trouble recognizing expressions that communicate emotions. A new study now demonstrates that the same difficulty may also be encountered with emotions conveyed by posture.

November 14, 2014 Posted by | Psychology | , , , , , , , | Leave a comment

[Reblog] THIEVES Essential Oil – Crimes against public health | Science-Based Pharmacy

THIEVES Essential Oil – Crimes against public health | Science-Based Pharmacy.

Excerpt:

As discussed in one of my previous posts, the promotion of quackery is so ubiquitous in my town it’s become white noise for me. I mostly tune it out unless I’m personally asked my opinion. Often this promotion comes in the weekly newspaper, in the advertising-disguised-as-advice page “Ask the Expert.” Occasionally there are columns by financial advisors and home improvement experts, but by far the majority of “expert advice” comes from chiropractors, naturopaths, Chinese Medicine practitioners, and holistic nutritionists. One regular advertiser is a local who calls herself a “Divine Healer”. She has some initials after her name, none of which I can trace back to any actual licenced health profession, degree or diploma. Her services include reflexology, mediumship, craniosacral therapy, aromatherapy and card-reading. She also offers a special massage called “vibrational raindrop technique” which apparently involves the use of essential oils and tuning forks or singing bowls.

 

This actually sounds like it might be kind of relaxing and entertaining. Something I would personally never pay the money for, but harmless, right? Earlier this year, however, a local public health nurse who I consider a kindred spirit based on our views of alternative medicine contacted me about the weekly claim. In the wake of a severe local flu outbreak and depletion of vaccine supply, the healer recommended an essential oil called “Thieves” claiming that “research shows that it has a 99.96 percent kill rate against airborne bacteria – interrupting the life cycle and interfering with the ability of viruses to replicate.” Further information available on her website goes on to describe how you can boost your immune system by placing a few drops on your feet every morning (this old wives’ tale makes me shake my head, every time I read it – which is too often).

Also provided are several recipes for making your own capsules with various essential oils which you should then take three times a day if you actually become sick. In bold, she warns that you must never take essential oils internally unless they are Young Living brand, which of course, is the brand that she represents. I found that information to be very interesting, considering the Health Canada guidelines for approval for aromatherapy essential oils clearly states that they are for topical or inhalation only. Also interesting is the fact that Young Living doesn’t appear to have an NPN for Thieves.

Young Living has also been under fire recently from the FDA for boldly claiming that Thieves can kill Ebola. While the letter from the FDA may prompt some correction at their top level, I doubt the message has trickled down to their thousands of distributors who will still likely be selling it any way they can, and that really is the modus operandi of all multi-level marketing schemes. Dr. Harriet Hall discussed a similar MLM company, and states:

November 9, 2014 Posted by | Uncategorized | , , | Leave a comment

[Press release] Future air quality could put plants, people at risk

Future air quality could put plants, people at risk — ScienceDaily.

Kyoto is intended to cut global emissions of g...

Kyoto is intended to cut global emissions of greenhouse gases. (Photo credit: Wikipedia)

From the 6 November 2014 press release

Source:University of Sheffield
Summary:Future ozone levels could be high enough to cause serious damage to plants and crops, even if emissions of greenhouse gases are reduced, says new research. And without sufficient reductions in emissions, ozone levels could also pose a risk to human health.

y combining projections of climate change, emissions reductions and changes in land use across the USA, an international research team estimate that by 2050, cumulative exposure to ozone during the summer will be high enough to damage vegetation.

Although the research findings — published in Atmospheric Chemistry and Physics Discussions — focus on the impact in the USA, they raise wider concerns for global air quality, according to lead researcher Dr Maria Val Martin, from the University of Sheffield’s Faculty of Engineering

“Modelling future air quality is very complex, because so many factors need to be taken into account at both a global and local scale,” says Dr Val Martin. “The picture isn’t uniform across the USA, with some areas seeing much higher surface ozone levels than others. However, our findings show that the emissions reductions we’re expecting to achieve won’t guarantee air quality on their own, as they will be offset by changes in climate and land use and by an increase in wildfires. This is an issue that will affect all parts of the world, not just the USA.”

The research looked at air quality under two scenarios set out by the Intergovernmental Panel on Climate Change: one which envisages greenhouse gas emissions peaking in 2040 and then falling, the other in which emissions continue to rise until 2100. The team combined data on climate change, land use and emissions to create a picture of air quality across the USA in 2050.

The model showed that, if greenhouse gas emissions peak in 2040, then by 2050 surface ozone will remain below levels set to safeguard human health, despite increases in ozone caused by higher temperatures and changes in agriculture and forestation. If emissions continue to rise until 2100, then some areas of the USA will see surface ozone above the safe levels set for human health.

November 9, 2014 Posted by | environmental health | , , , , , , , | Leave a comment

[Press release] How important is long-distance travel in the spread of epidemics?

How important is long-distance travel in the spread of epidemics?.

Three scenarios depicting the simulated spread of a simple epidemic from a single point outbreak. Long-range jumps — mimicking air travel, for example — lead to sub-outbreaks. If long-distance jumps are rare, the main outbreak will quickly merge with the satellite outbreaks, leading to a rippling, wave-like growth (left). As the likelihood of long-distance jumps increases, the epidemic spread exhibits a super-linear power-law growth (center) or a stretched exponential or “metastatic” growth. (Simulations by Oskar Hallatschek, UC Berkeley, and Daniel Fisher, Stanford. Video editing by Christian Collins.)

From the 4 November 2014 UC Berkely press release

Robert Sanders, Media Relations

BERKELEY —

The current Ebola outbreak shows how quickly diseases can spread with global jet travel.

Yet knowing how to predict the spread of these epidemics is still uncertain, because the complicated models used are not fully understood, says a UC Berkeley biophysicist.

Using a very simple model of disease spread, Oskar Hallatschek, assistant professor of physics, proved that one common assumption is actually wrong. Most models have taken for granted that if disease vectors, such as humans, have any chance of “jumping” outside the initial outbreak area – by plane or train, for example – the outbreak quickly metastasizes into an epidemic.

Hallatschek and co-author Daniel Fisher of Stanford University found instead that if the chance of long-distance dispersal is low enough, the disease spreads quite slowly, like a wave rippling out from the initial outbreak. This type of spread was common centuries ago when humans rarely traveled. The Black Death spread through 14th-century Europe as a wave, for example.

But if the chance of jumping is above a threshold level – which is often the situation today with frequent air travel –the diseases can generate enough satellite outbreaks to spread like wildfire. And the greater the chance that people can hop around the globe, the faster the spread.

“With our simple model, we clearly show that one of the key factors that controls the spread of infection is how common long-range jumps are in the dispersal of a disease,” said Hallatschek, who is the William H. McAdams Chair in physics and a member of the UC Berkeley arm of the California Institute for Quantitative Biosciences (QB3). “And what matters most are the rare cases of extremely long jumps, the individuals who take plane trips to distant places and potentially spread the disease.”

November 9, 2014 Posted by | Public Health | , , , | Leave a comment

[Press release] Study shows integrative medicine relieves pain and anxiety for cancer inpatients

 

Study shows integrative medicine relieves pain and anxiety for cancer inpatients.

From the 6 November 2014 EurekAlert!

 

Study shows integrative medicine relieves pain and anxiety for cancer inpatients

Pain is a common symptom of cancer and side effect of cancer treatment, and treating cancer-related pain is often a challenge for health care providers.

The Penny George Institute for Health and Healing researchers found that integrative medicine therapies can substantially decrease pain and anxiety for hospitalized cancer patients. Their findings are published in the current issue of the Journal of the National Cancer Institute Monographs.

“Following Integrative medicine interventions, such as medical massage, acupuncture, guided imagery or relaxation response intervention, cancer patients experienced a reduction in pain by an average of 47 percent and anxiety by 56 percent,” said Jill Johnson, Ph.D., M.P.H., lead author and Senior Scientific Advisor at the Penny George Institute.

“The size of these reductions is clinically important, because theoretically, these therapies can be as effective as medications, which is the next step of our research,” said Jeffery Dusek, Ph.D., senior author and Research Director for the Penny George Institute.

The Penny George Institute receives funding from the National Center of Alternative and Complementary Medicine of the National Institutes of Health to study the impact of integrative therapies on pain over many hours as well as over the course of a patient’s entire hospital stay.

“The overall goal of this research is to determine how integrative services can be used with or instead of narcotic medications to control pain,” Johnson said.

Researchers looked at electronic medical records from admissions at Abbott Northwestern Hospital between July 1, 2009 and December 31, 2012. From more than ten thousand admissions, researchers identified 1,833 in which cancer patients received integrative medicine services.

Patients were asked to report their pain and anxiety before and just after the integrative medicine intervention, which averaged 30 minutes in duration.

Patients being treated for lung, bronchus, and trachea cancers showed the largest percentage decrease in pain (51 percent). Patients with prostate cancer reported the largest percentage decrease in anxiety (64 percent).

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

[Press release] Is violent injury a chronic disease? Study suggests so & may aid efforts to stop the cycle

From the 8 November 2014 U of M press release

Two-year study of urban teens & young adults shows high risk of additional violent injuries among assault victims, especially those with PTSD or drug use

ANN ARBOR, Mich. — Teens and young adults who get seriously injured in an assault are nearly twice as likely as their peers to end up back in the emergency room for a violent injury within the next two years, a new University of Michigan Injury Center study finds.

The researchers call this repeating pattern of violent injury a reoccurring disease, but their landmark study also suggests potentially powerful opportunities to intervene in ways that could stop the cycle.

The first six months after a young person seeks care for a violence-related injury is an especially important time, the study shows.

Patients with post-traumatic stress disorder or drug abuse problems have the highest likelihood of suffering injuries in another violent incident, the researchers find.

The findings come from a unique effort that involved multiple interviews and medical record chart reviews conducted over two years with nearly 600 residents of the Flint, Mich. area between the ages of 14 and 24 — starting when each one sought emergency care at a single hospital. Nearly 350 of them were being treated for assault injuries at that first encounter.

The findings are published online in JAMA Pediatrics by a group from the University of Michigan Medical School and School of Public Health, the VA Ann Arbor Healthcare System, and other colleagues.

Rebecca Cunningham, M.D., director of the U-M Injury Center and first author of the new paper, notes that it’s the first prospective study of its kind, and 85 percent of the young people enrolled were still in the study at 24 months. Five of the participants died before the study period ended, three from violence, one from a drug overdose, and one in a motor vehicle crash.

“In all, nearly 37 percent of those who qualified for this study because they were being treated for assault-related injuries wound up back in the ER for another violent injury within two years, most of them within six months,” says Cunningham, who is a Professor in the Department of Emergency Medicine at the U-M Medical School and the Department of Health Behavior and Health Education in the U-M School of Public Health.

“This ER recidivism rate is 10 percentage points higher than the rate for what we traditionally call chronic diseases,” she continues. “Yet we have no system of standard medical care for young people who come to us for injuries suffered in a violent incident. We hope these data will help inform the development of new options for these patients.”

The authors note that non-fatal assault-related injuries lead to more than 700,000 emergency visits each year by youth between the ages of 10 and 24. Fatal youth violence injuries cost society more than $4 billion a year in medical costs and $32 billion in lost wages and productivity.

Despite this costly toll, most research on how often the cycle of violent injury repeats itself, and in which young people, has relied on looking back at medical records. This has resulted in widely varying estimates of how big the problem is.

But through the Flint Youth Injury Study, based at U-M, the research team was able to study the issue prospectively, or starting with an index visit and tracking the participants over time.

The study was performed at Hurley Medical Center in Flint, where Cunningham holds an appointment and where U-M emergency physicians work with Hurley staff to provide care.

The study’s design allowed them to compare two groups — those whose index visit was for assault injuries and those seen for other emergency care. Each time a new assault victim was enrolled, the research team sought to enroll the next non-assault patient of the same gender and age range who was treated at the same ER.

Nearly 59 percent of the participants were male, and just over 58 percent were African American, reflecting the broader population of Flint. Nearly three-quarters of those in the study received some form of public assistance.

Among those whose first visit was for assault, nearly 37 percent wound up back in the ER for violent injuries in the next two years, compared with 22 percent of those whose first visit wasn’t for an assault injury. And a larger proportion of the “assault group” actually came back more than once for violent injuries, compared with the other group.

“Future violence interventions for youth sustaining assault-related injury may be most effective in the first six months after injury, which is the period with the highest risk for recidivism,” says Maureen Walton, MPH, Ph.D. senior author and associate professor in the U-M Department of Psychiatry. “These interventions may be most helpful if they address substance use and PTSD to decrease future morbidity and mortality.”

November 9, 2014 Posted by | Public Health | , , , , , , , | Leave a comment

[Press release] Swallowing sponge on a string could replace endoscopy as pre-cancer test

 

From the 4 November 2014 Cancer Research UK press release

Swallowing a sponge on a string could replace traditional endoscopy as an equally effective but less invasive way of diagnosing a condition that can be a forerunner of oesophageal cancer.

“[The Cytosponge test] should be considered as an alternative to endoscopy for diagnosing the condition and could possibly be used as a screening test in primary care.” – Professor Rebecca Fitzgerald, lead author.

The results of a Cancer Research UK trial involving more than 1,000 people are being presented at the National Cancer Research Institute’s annual conference (link is external) in Liverpool.

The trial invited more than 600 patients with Barrett’s Oesophagus – a condition that can sometimes lead to oesophageal cancer – to swallow the Cytosponge and to undergo an endoscopy. Almost 500 more people with symptoms like reflux and persistent heartburn did the same tests.

The Cytosponge proved to be a very accurate way of diagnosing Barrett’s Oesophagus. More than 94 per cent of people swallowed the sponge and reported no serious side effects. Patients who were not sedated for endoscopy were more likely to rate the Cytosponge as a preferable experience.

Lead author Professor Rebecca Fitzgerald, based at the MRC Cancer Unit at the University of Cambridge, said: “The Cytosponge test is safe, acceptable and has very good accuracy for diagnosing Barrett’s Oesophagus. It should be considered as an alternative to endoscopy for diagnosing the condition and could possibly be used as a screening test in primary care.”

Barrett’s Oesophagus is caused by acid coming back up the food pipe from the stomach – known as acid reflux – which can cause symptoms like indigestion and heartburn. Over time people with these symptoms may develop changes in the cells that line the oesophagus. These cells can become cancerous and so patients with Barrett’s Oesophagus are tested every couple of years.

Barrett’s Oesophagus is usually diagnosed by having a biopsy during an endoscopy. This can be uncomfortable and carries some risks – and it’s not always practical for everyone who has symptoms like reflux and heartburn.

Oesophageal cancer is the thirteenth most common cancer in the UK. Around 5,600 men develop the disease each year compared with 2,750 women. And each year around 5,200 men and 2,460 women die from the disease.

Dr Julie Sharp, Cancer Research UK’s head of health information, said: “These results are very encouraging and it will be good news if such a simple and cheap test can replace endoscopy for Barrett’s oesophagus.

“Death rates are unacceptably high in oesophageal cancer so early diagnosis is vital. Tackling oesophageal cancer is a priority for Cancer Research UK and research such as this will help doctors to diagnose people who are at risk quickly and easily.”

 

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

[Press release] Flu infection has long-ranging effects

From the Rockefeller University Press  4 November 2014 press release

English: Main symptoms of influenza. (See Wiki...

English: Main symptoms of influenza. (See Wikipedia:#Influenza#Symptoms_and_diagnosis). Model: Mikael Häggström. To discuss image, please see Template talk:Häggström diagrams References Centers for Disease Control and Prevention > Influenza Symptoms Page last updated November 16, 2007. Retrieved April 28, 2009 (Diarrhea is not mentioned, since it is mainly a symptom in children) (Photo credit: Wikipedia)

Flu infection has long-ranging effects beyond the lung that can wreak havoc in the gut and cause a dreaded symptom, diarrhea, according to a study published in the Journal of Experimental Medicine.

Gastrointestinal symptoms are often seen with flu infection, but because the virus only grows in lung cells, it’s unclear how intestinal symptoms develop. Researchers in China now show that flu infection in mice prompts responding immune cells in the lung to alter their homing receptors, causing them to migrate to the gut. Once there, they produce the antiviral mediator IFN-γ, which alters the natural composition of gut bacteria. In turn, the bacterial changes lead to inflammation that promotes tissue injury and diarrhea. Blocking inflammatory molecules in the intestine or treating mice with antibiotics to deplete bacteria attenuated flu-induced intestinal injury without affecting immune responses in the lung.

Why some flu infected patients develop gastrointestinal symptoms while others do not remains unknown. However, these findings suggest ways to directly relieve intestinal symptoms like diarrhea during flu infection without interfering with the body’s ability to fight the virus in the lung.

Reference: Wang, J., et al. 2014. J. Exp. Med. doi:10.1084/jem.20140625

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

[Reblog] From a physician: A plea to big medical corporations

Next time my physician urges a screening, I’ll wonder if it is because of his concern for my health (most likely- knowing my physician) or his corporation’s interest in profit…
As this article outlines is that physicians in corporations are often

English: A doctor examines a female patient.

English: A doctor examines a female patient. (Photo credit: Wikipedia)

in Catch-22 positions.

From a November 2014 post at KevinMD

thought more highly of business folks until I started working for them.  I thought CEOs and boards of directors of companies had a vision, whether to maximize shareholder profit, or to produce a stellar product or provide a singular service, etc.  Once the vision was elucidated, everyone worked together like a team to make it happen.

Then I became employed by a large corporation as a family physician to provide medical care.  And it’s been one eye opening experience after another ever since.  To me, it’s quite simple.  The vision of a medical practice should be to provide good medical care while being cost conscious, and maintaining strong patient satisfaction.  That’s how all the money gets generated, right?  The patient pays his/her premium, part of which gets funneled to our large corporation, who is then tasked to provide care for that patient.  How is care provided to that patient?  By having a doctor see, talk to, examine and treat that said patient.

OK.  So we all know that it’s not quite that simple.  Enter primary care 2014, the world of risk adjustment factor (RAF) scores (which entail the corporation getting paid more for sicker patients), electronic health records (EHR), and quality metric incentive payments (the corporation gets more money from insurance companies by meeting certain goals in screening, like colonoscopies, mammograms, etc.).  Now health care has become more complicated.  But it’s still all based on that interaction we physicians have with our patients.  We can’t meet quality metric goals if we don’t see the patients, we can’t determine if they are sicker and therefore require more funds to care for if we don’t see them, and we can’t use EHR if we don’t see the patient.  There’s just a bunch of road blocks and distractions added in….

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

[Magazine article] Sorry, Your Gut Bacteria Are Not the Answer to All Your Health Problems | Mother Jones

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Sorry, Your Gut Bacteria Are Not the Answer to All Your Health Problems | Mother Jones.

Excerpts

In 2001, Joshua Lederberg, a Nobel Prize-winning biologist, coined the term “microbiome,” naming the trillions of microorganisms that reside in and on our bodies. Today, if you type that word into Google, you’ll turn up thousands of hits linking gut bacteria to a laundry list of health problems, from food allergies to Ebola. Between 2007 and 2012, the number of journal articles published on the microbiome increased by nearly 250 percent. Our bodily inhabitants are quickly being cast as culprits or saviors for a diverse array of ailments.

Still, despite the optimism, some researchers caution that much of what we hear about microbiome science isn’t always, well, science. Dr. Lita Proctor heads the National Institutes of Health (NIH) Human Microbiome Project (HMP), an outgrowth of the Human Genome Project. “We are discovering a whole new ecosystem,” she says. But “I do have some fear—we all do in the field—that the hype and the potential overpromise, and the idea that somehow this is going to be different—there is a terrific fear that it will all backfire.”

he goal of the first phase of the HMP was to identify the microbial makeup of a “healthy” microbiome. And, in a study published earlier this year, researchers made an important discovery—that there is no such thing. Even among people who were examined and found to be perfectly healthy, each person’s microbiome was unique.

“We were going about it all wrong,” Proctor explains. “It is not the makeup—these communities come together and they actually become bigger than the sum of their parts…It almost doesn’t matter who is present, it just matters what they are doing.”

Jonathan Eisen, a professor and biologist who studies the ecology of microbes at the University of California-Davis, shares Proctor’s concerns. In a series on his blog called “The Overselling the Microbiome Awards,” Eisen highlights what he considers to be skewed science. He has taken on transplants purported to treat multiple sclerosis, celiac disease, and Crohn’s disease. He casts doubt on a study claiming there’s a connection between a mother’s oral hygiene during pregnancy to the health of her newborn. He critiques the notion that you can use bacteria to battle breast cancer, prevent stroke, and cure Alzheimer’s.

Eisen says that one of the most common errors in studies is confusion between correlation and causation. [My emphasis!]  “The microbiome has 400 million different variables that you can measure about it,” Eisen explains. “The different sites, the different species, the relative abundance of those species, the variation—if you have that many variables, I can guarantee statistically that some of them will be perfectly correlated with Crohn’s disease and have nothing to do with it.”

November 4, 2014 Posted by | Consumer Health, Medical and Health Research News | , , , , | Leave a comment

[Report] A one-year assessment of the ACA | Association of Health Care Journalists

A one-year assessment of the ACA | Association of Health Care Journalists.

From the 31 October 2014 report

The New York Times recently pulled their reportorial and graphics know-how together to do a one-year assessment of the ACA.  It concludes: “After a year fully in place, the Affordable Care Act has largely succeeded in delivering on President Obama’s main promises, an analysis by a team of reporters and data researchers shows. But it has also fallen short in some ways and given rise to a powerful conservative backlash.”

Image by HealthCare.gov.

The package consists of seven sections that run the gamut, with some key numbers and charts.  Overall it’s a positive but not uncritical look. The cost section is particularly nuanced, noting the challenges of narrow networks and high deductibles.

Most of these topics we’ve considered on this blog over the last few years. But the series provides a nice, compact overview and handy reference going into the second year.

Here are the seven sections covered, and the nutshell conclusion the Times provided for each.

November 4, 2014 Posted by | health care | , , | Leave a comment

[News article] Clean smell doesn’t always mean clean air — ScienceDaily

Clean smell doesn’t always mean clean air — ScienceDaily.

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Excerpts from the 29 October 2014 article

Source: Drexel University
Summary: Scientists are taking a closer look at aerosol formation involving an organic compound — called limonene — that provides the pleasant smell of cleaning products and air fresheners. This research will help to determine what byproducts these sweet-smelling compounds are adding to the air while we are using them to remove germs and odors.
… while researchers are still striving to fully understand the health and environmental impact of increased levels of secondary organic aerosols in the atmosphere, studies have linked exposure to outdoor aerosols generally to morbidity and mortality outcomes.”
Related Resource
    This is a screenshot, go to Household Products Database for the actual Website
Screen Shot 2014-11-04 at 7.01.22 AM

November 4, 2014 Posted by | Consumer Health, Consumer Safety, Medical and Health Research News | , , | Leave a comment

[Press release] Can social media help stop the spread of HIV?

Pinmap of Tweets Related to HIV

Caption: This is a map showing the origins of tweets related to HIV.

Credit: Sean Young

Usage Restrictions: Credit required.
[Sean Young, Center for Digital Behavior at the University of California,
http://www.uclahealth.org/main.cfm?id=2341, scroll down for short bio]

 

From the 30 October 2014 UCLA press release

In addition to providing other potential benefits to public health, all of those tweets and Facebook posts could help curb the spread of HIV.

Although public health researchers have focused early applications of social media on reliably monitoring the spread of diseases such as the flu, Sean Young of the Center for Digital Behavior at the University of California, Los Angeles, writes in an October 29th article in the Cell Press journal Trends in Microbiology of a future in which social media might predict and even change biomedical outcomes.

“We know that mining social media will have huge potential benefits for many areas of medicine in the future, but we’re still in the early stages of testing how powerful these technologies will be,” Young said.

With the right tools in place, he says, social media offers a rich source of psychological and health-related data generated in an environment in which people are often willing to share freely.

His recent work on Behavioral Insights on Big Data (BIBD) for HIV offers the tantalizing possibility that insights gleaned from social media could be used to help governments, public health departments, hospitals, and caretakers monitor people’s health behaviors “to know where, when, and how we might be able to prevent HIV transmission.”

Young details a social-media-based intervention in which African American and Latino men who have sex with men shared a tremendous amount of personal information through social media, including when or whether they had ‘come out,’ as well as experiences of homelessness and stigmatization. What’s more, they found that people who discussed HIV prevention topics on social media were more than twice as likely to later request an HIV test.

In the context of HIV prevention, tweets have also been shown to identify people who are currently or soon to engage in sexual- or drug-related risk behaviors. Those tweets can be mapped to particular locations and related to actual HIV trends.

What’s needed now is the updated infrastructure and sophisticated toolkits to handle all of those data, Young said, noting that there are about 500 million communications sent every day on Twitter alone. He and a team of University of California computer scientists are working to meet that challenge now.

Although privacy concerns about such uses of social media shouldn’t be ignored, Young says there is evidence that people have already begun to accept such uses of social media, even by corporations looking to boost profits.

“Since people are already getting used to the fact that corporations are doing this, we should at least support public health researchers in using these same methods to try and improve our health and well being,” he said. “We’re already seeing increased support from patients and public health departments.”

November 4, 2014 Posted by | Medical and Health Research News, Public Health | , , , , , , , , | Leave a comment

[Press release] From age 8 to 80, expert reveals the price we pay for not sleeping

From the 28 October 2014 Ohio State University press release

 

““For children, sleep deprivation can lead to behavior problems, trouble focusing and learning in school and it can affect their immune systems,” said Dr. Aneesa Das, a sleep medicine specialist at Ohio State’s Wexner Medical Center. “Chronic tiredness makes it harder to cope and process what’s going on around you.”

When children enter the teen years, sleep becomes a bigger issue. Das says a teen’s circadian rhythm, or internal body clock, tells them to stay awake later and sleep later than children and adults do. She says only 15 percent of teenagers get the recommended sleep they need.

“Sleep is time the body uses to restore itself. Muscles and other tissues repair themselves, hormones that control growth, development and appetite are released. Energy is restored and memories are solidified, so we need to try to get regular sleep on a regular basis,” Das said.

For adults, sleep loss is even more serious. It accumulates over the years and has been shown to contribute to several chronic diseases including heart disease, diabetes, high blood pressure, depression and obesity.”

….

To improve the chances of getting a good night’s sleep, Das offers a few tips: don’t perform vigorous exercise within four hours of bedtime; have a wind down routine that includes dim light; avoid using tablets, phones and laptops before bed because they emit blue light that interferes with sleep; try a warm bath two hours before bedtime and beware of sleep aid medications because they can have side effects.

 

November 4, 2014 Posted by | Consumer Health, Medical and Health Research News | , | Leave a comment

[News article] High milk intake linked with higher fractures and mortality, research suggests — ScienceDaily

High milk intake linked with higher fractures and mortality, research suggests — ScienceDaily.
A glass of milk Français : Un verre de lait

Excerpts from the 28 October 2014 article

Source:
BMJ-British Medical Journal
Summary:
A high milk intake in women and men is not accompanied by a lower risk of fracture and instead may be associated with a higher rate of death, suggests observational research. Women who drank more than three glasses of milk a day had a higher risk of death than women who drank less than one glass of milk a day.
“there may be a link between the lactose and galactose content of milk and risk, although causality needs be tested.

“Our results may question the validity of recommendations to consume high amounts of milk to prevent fragility fractures,” they write. “The results should, however, be interpreted cautiously given the observational design of our study. The findings merit independent replication before they can be used for dietary recommendations.”

Michaëlsson and colleagues raise a fascinating possibility about the potential harms of milk, says Professor Mary Schooling at City University of New York in an accompanying editorial. However, she stresses that diet is difficult to assess precisely and she reinforces the message that these findings should be interpreted cautiously.

“As milk consumption may rise globally with economic development and increasing consumption of animal source foods, the role of milk and mortality needs to be established definitively now,” she concludes.”

A glass of milk Français : Un verre de lait (Photo credit: Wikipedia)

 

November 4, 2014 Posted by | Medical and Health Research News, Nutrition, Uncategorized | , , , , | Leave a comment

[Repost] Medical Cost Offsets from Prescription Drug Utilization Among Medicare Beneficiaries

Medical Cost Offsets from Prescription Drug Utilization Among Medicare Beneficiaries

Screen Shot 2014-11-03 at 6.29.04 AM

Excerpt from the commentary by M. Christopher Roebuck, PhD, MBA

SUMMARY
This brief commentary extends earlier work on the value of adherence to derive medical cost offset estimates from prescription drug utilization. Among seniors with chronic vascular disease, 1% increases in condition-specific medication use were associated with significant (P<0.001) reductions in gross nonpharmacy medical costs in the amounts of 0.63% fordyslipidemia, 0.77% for congestive heart failure, 0.83% for diabetes, and1.17% for hypertension.
J Manag Care Pharm.
2014;20(10):994-95
Excerpts:
With about half of patients not taking their medications as directed, avoidable adverse health events and use of medical services are estimated to add up to $290 billion in U.S.health care expenditures annually. Improvements in clinical and economic outcomes from medication adherence have been demonstrated across a variety of conditions and patientcohorts. As an example, in 2011 my colleagues and I (Roebuck et al.) determined that adherence to medication for chronic vascular disease was associated with fewer inpatient hospital days and emergency department visits and lower overal health care costs. Specifically, annual net savings in healtcare expenditures for an adherent (compared to nonadherent) elderly beneficiary were estimated to be $7,893 for congestive
heart failure, $5,824 for hypertension, $5,170 for diabetes, and $1,847 for dyslipidemia—or approximately 9% to 28% of total
health care costs. This research employed a rigorous observational study design that addressed a key concern and limitation
ofprior analyses—the potentialendogeneity (confounding) of adherence. More plainly, results reported in earlier publications mayhave been biased if patients who took medications as directed also engaged in other unmeasured healthy behaviors

(i.e., the “healthy adherer effect”)
..
Figure 1 presents the new findings and includes the CBO estimate for reference. Specifically, 1% increases in condition-specific prescription drug utilization were significantly (P<0.001) associated with reductions in seniors’ gross nonpharmacy medical costs in the amounts of 0.63% for dyslipidemia, 0.77% for congestive heart failure, 0.83% for diabetes, and 1.17% for hypertension. These results demonstrate that medical cost offsets from prescription drug utilization likely vary bychronic condition and that impacts for therapeutic classes used to treat these 4 conditions—which represent 40% of Medicare Part D utilization—may be between 3 and 6 times greater than the CBO’s assumption. In dollar terms, these relative impacts are not trivial. For example, 53% of Medicare (fee-for-service) beneficiaries have the comorbidity combination of hyperten sion plus high cholesterol—with average annual medical costs of $13,825. The current findings suggest that a 5% increase in the use of antihypertensive medication by patients with those conditions may prompt reductions in medical (Parts A and B) costs of more than $800 annually per beneficiary.
….
The present analysis examined retirees with employer-sponsored insurance in addition to Medicare. To the extent that these individuals differed from the broader Medicare population, the generalizability of study findings may be limited.

November 3, 2014 Posted by | health care | , , , , , , , | Leave a comment

[News item] Vitamin supplements may lower exercise endurance (but the jury seem to be out)

Vitamin supplements may lower exercise endurance |BBC Health

Excerpts:

Taking some types of vitamin supplement may make it harder to train for big endurance events like marathons, researchers in Norway suggest.

They said vitamins C and E should be used with caution as they may “blunt” the way muscles respond to exercise.

However, actual athletic performance was not affected in the 11-week trial leading other experts to questions the research.

The findings were published in The Journal of Physiology.

The team at the Norwegian School of Sport Sciences in Oslo argued vitamin supplements were readily taken and available, but were unsure if they affected athletic ability.

Endurance runs

There was no difference in their performance during a Beep test – running faster and faster between two points 20m apart.

However, blood samples and tissue biopsies suggested there were differences developing inside the muscle.

Each muscle cell contains lots of tiny mitochondria which give the muscle cell its energy.

Those taking the supplements seemed to be producing fewer extra mitochondria to cope with the increasing demands placed on the muscle.

Hmmm

However, Mike Gleeson, a professor of exercise biochemistry at Loughborough University, is not convinced.

He said the biggest factor in performance was how fast the heart and lungs could get oxygen to the muscle, not mitochondria.

 

November 3, 2014 Posted by | Medical and Health Research News, Nutrition | , , , | Leave a comment

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