Originally posted on Access Science:
Originally posted on HIV/AIDS in Global Context (PH770 - CUNY SPH):
One major statement that stuck out to me from Ida Susser’s discussion of her book AIDS, Sex and Culture was that “anthropology starts where public health ends.” In her lecture she discussed how easy it is to switch hats from public health to anthropologist. Susser was able to emphasize the fact that public health professionals must understand how data frames ideas. For example, an HIV mortality rate men to women of 10:1 is looked at differently from a public health eye then from an anthropologist eye. Public health would put more funding and research into men and would discount women since they are dying at a lesser rate than men. Anthropology would look deeper at similarities and differences, both within and among societies, and would pay attention to race, sexuality, class, gender, and nationality.
Public health addresses infectious disease epidemiology. However, anthropology can help inform public health about other components…
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Rice University analysis of state efforts show dramatic gains in reducing airborne particulate matter
HOUSTON – (March 27, 2014) – National efforts in the last decade to clear the air of dangerous particulate matter have been so successful that most urban areas have already attained the next benchmark, according to new research by Rice University.
Atmospheric researchers at Rice studied the state implementation plans (SIPs) from 23 regions mandated by the Environmental Protection Agency to reduce particulate matter (PM) smaller than 2.5 microns (PM 2.5) to less than 15 micrograms per cubic meter by 2009.
The Rice analysis appears this week in the Journal of the Air and Waste Management Association.
All but one of the regions studied reported they had met the goal by deadline. States with regions that met the deadline included Connecticut, Georgia, Illinois, Indiana, Kentucky, Maryland, Michigan, Missouri, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Tennessee and West Virginia, as well as the District of Columbia. The final region, Alabama, reported attainment in 2010.
PM 2.5 concentrations in the nonattainment regions that filed SIPs to attain the standard by 2009 declined by an average 2.6 micrograms per cubic meter – significantly greater improvement than in regions that had attained the standard from its inception. The study showed PM reductions in the SIP regions were broadly spread, rather than pinpointed at the most polluted monitors.
“One of the things we were most interested in looking at was to see if states were cherry-picking their measures to meet the standard by reducing pollution at their worst monitors, compared with how much they were doing to bring down levels all across the region so that people were breathing cleaner air,” said Daniel Cohan, an associate professor of civil and environmental engineering at Rice.
“It was encouraging to find that across the country, we have seen overall particulate-matter levels come down. We found very slight extra improvement at monitors that were targeted the most, but regions that had to develop plans achieved pretty solid controls that didn’t just pinpoint the worst monitors. And the large populations of these regions benefited.”
Cohan and Rice alumna Ran Chen also documented that air pollution continued to decline even after the 2009 standards were met. The majority of the SIP regions had already attained the mandated 2014 goal of 12 micrograms per cubic meter by 2012.
“We’ve been on a good trajectory,” Cohan said. “This demonstrates that the combination of state and federal controls has been substantially improving air quality in the U.S.”
- See more at: http://news.rice.edu/2014/03/27/us-clean-air-efforts-stay-on-target/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+Science360NewsServiceComplete+%28Science360+News+Service%3A+Complete%29&utm_content=Netvibes#sthash.eZJySuaf.dpuf
Originally posted on Health Services Authors:
The dilemma is pretty well addressed in this article:
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[News item] Religion, spirituality influence health in different but complementary ways — ScienceDaily
March 28, 2014
Oregon State University
Religion and spirituality have distinct but complementary influences on health, new research indicates. A new theoretical model defines the two distinct pathways. “Religion helps regulate behavior and health habits, while spirituality regulates your emotions, how you feel,” explains one of the authors.
Disclaimer: My husband’s cousin developed diabetes after serving in Afghanistan. Diabetes did not run in the family nor did he have a lifestyle that predisposed him to this disease (in our opinion, of course). The VA did pay for his treatment, no questions asked.
Am thankful that research is being done to show just how war related chemicals, and even preventive agents are very harmful and deadly.
March 27, 2014
University of California, San Diego Health Sciences
Veterans of the 1990-91 Persian Gulf War who suffer from “Gulf War illness” have impaired function of mitochondria – the energy powerhouses of cells, researchers have demonstrated for the first time. The findings could help lead to new treatments benefitting affected individuals — and to new ways of protecting servicepersons (and civilians) from similar problems in the future.
Golomb noted that impaired mitochondrial function accounts for numerous features of Gulf War illness, including symptoms that have been viewed as perplexing or paradoxical.
“The classic presentation for mitochondrial illness involves multiple symptoms spanning many domains, similar to what we see in Gulf War illness. These classically include fatigue, cognitive and other brain-related challenges, muscle problems and exercise intolerance, with neurological and gastrointestinal problems also common.”
There are other similarities between patients with mitochondrial dysfunction and those suffering from Gulf War illness: Additional symptoms appear in smaller subsets of patients; varying patterns of symptoms and severity among individuals; different latency periods across symptoms, or times when symptoms first appear; routine blood tests that appear normal.
“Some have sought to ascribe Gulf War illness to stress,” said Golomb, “but stress has proven not to be an independent predictor of the condition. On the other hand, Gulf veterans are known to have been widely exposed to acetylcholinesterase inhibitors, a chemical class found in organophosphate and carbamate pesticides, nerve gas and nerve gas pre-treatment pills given to troops.
“These inhibitors have known mitochondrial toxicity and generally show the strongest and most consistent relationship to predicting Gulf War illness. Mitochondrial problems account for which exposures relate to Gulf War illness, which symptoms predominate, how Gulf War illness symptoms manifest themselves, what objective tests have been altered, and why routine blood tests have not been useful.”
Originally posted on Full Text Reports...:
Source: Population Health Metrics
Cigarette smoking is a leading risk factor for morbidity and premature mortality in the United States, yet information about smoking prevalence and trends is not routinely available below the state level, impeding local-level action.
We used data on 4.7 million adults age 18 and older from the Behavioral Risk Factor Surveillance System (BRFSS) from 1996 to 2012. We derived cigarette smoking status from self-reported data in the BRFSS and applied validated small area estimation methods to generate estimates of current total cigarette smoking prevalence and current daily cigarette smoking prevalence for 3,127 counties and county equivalents annually from 1996 to 2012. We applied a novel method to correct for bias resulting from the exclusion of the wireless-only population in the BRFSS prior to 2011.
Total cigarette smoking prevalence varies dramatically between counties, even within states, ranging…
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Originally posted on Full Text Reports...:
Source: American Journal of Public Health
We sought to better understand acts of self-harm among inmates in correctional institutions.
We analyzed data from medical records on 244 699 incarcerations in the New York City jail system from January 1, 2010, through January 31, 2013.
In 1303 (0.05%) of these incarcerations, 2182 acts of self-harm were committed, (103 potentially fatal and 7 fatal). Although only 7.3% of admissions included any solitary confinement, 53.3% of acts of self-harm and 45.0% of acts of potentially fatal self-harm occurred within this group. After we controlled for gender, age, race/ethnicity, serious mental illness, and length of stay, we found self-harm to be associated significantly with being in solitary confinement at least once, serious mental illness, being aged 18 years or younger, and being Latino or White, regardless of gender.
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Originally posted on Full Text Reports...:
Source: Institute for the Study of Labor
We provide empirical evidence of crime’s impact on the mental wellbeing of both victims and non-victims. We differentiate between the direct impact to victims and the indirect impact to society due to the fear of crime. The results show a decrease in mental wellbeing after violent crime victimization and that the violent crime rate has a negative impact on mental wellbeing of non-victims. Property crime victimization and property crime rates show no such comparable impact. Finally, we estimate that society-wide compensation due to increasing the crime rate by one victim is about 80 times more than the direct impact on the victim.
Originally posted on GIS Use in Public Health and Health Care:
AIDSVu is an interactive online map illustrating the prevalence of HIV in the United States. The state- and county-level data on AIDSVu come from the U.S. Centers for Disease Control and Prevention’s (CDC) national HIV surveillance database, which is comprised of HIV surveillance reports from state and local health departments. ZIP code and census tract data come directly from state, county and city health departments, depending on which entity is responsible for HIV surveillance in a particular geographic area.
Uses can search through HIV prevalence data by race/ethnicity, sex and age, and see how HIV prevalence is related to various social determinants of health, such as educational attainment and poverty.
As one can see, HIV prevalence in the United States is concentrated in the South highlighting one of the many health disparities in the North-South divide in the United States.
Check out the map here.
Juhi Mawla, Intern, email@example.com
This resource is a bit off topic. It is an educational resource basically for junior high and high school teachers. However, I find it fascinating on how it shows the interrelationship among science and mathematical concepts. Here’s a few that are health/medical related
New JAMA article suggests review and certification process for mHealth apps
BOSTON–While the Food and Drug Administration (FDA) has released guidelines for the regulation of mobile health (mHealth) apps that act as medical devices or as accessories to medical devices, the vast majority of mHealth apps remain unregulated and unevaluated. In a Viewpoint article, “In Search of a Few Good Apps”, published in JAMA on March 24, 214, co-authors, David Bates, MD and Adam Landman, MD of Brigham and Women’s Hospital (BWH) and Adam Powell, PhD, president of Payer+Provider Syndicate, call for the creation of mHealth (mobile health) app review and certification organizations to evaluate apps that are not regulated by the government.
“This article gives health care providers, patients, policymakers and mHealth app developers a perspective on how the issue of determining which apps are most useful might be addressed,” said Bates, who is Chief Quality Officer at BWH and chaired the Food and Drug Administration Safety and Innovation Act (FDASIA) Workgroup that made recommendations to the government about regulation of HIT and mobile apps. “Establishing an unbiased review and certification process is a key step in helping mHealth apps achieve their potential.”
The concept for this Viewpoint article was conceived by Landman and Powell after discussing their mutual concern about the lack of oversight over the accuracy, quality, and security of mHealth apps at the BWH Hackathon, an event sponsored by BWH’s Innovation Hub (iHub).
“Dr. Powell and I examined numerous mHealth apps and it was difficult to assess app credibility,” said Landman, Chief Medical Information Officer for Health Information Innovation and Integration and an emergency medicine physician at BWH. “The currently available reviews of mHealth apps have largely focused on personal impressions, rather than evidence-based, unbiased assessments of clinical performance and data security. With more rigorous certification criteria and unbiased accrediting bodies, both clinicians and consumers could be more confident in their selection and use of mHealth apps.”
In the article, authors describe the potential for multiple organizations to be created that could review and objectively certify mHealth apps for quality, accuracy, security and safety, similar to the role that Health On the Net Foundation (HON), a non-profit, non-governmental organization, plays in evaluating the quality of online medical content.
“People are increasingly turning to their smartphones for assistance in improving their health, but are having difficulty determining which apps are the securest and most effective. We hope that our article will instigate action that will enable clinicians and patients to make more effective use of mHealth apps,” said Powell, lead author of the article. “We foresee a potential future in which physicians will be able to confidently prescribe apps to their patient, and will have the tools that they need to interpret the resulting data. The establishment of an unbiased app certification and review process will play a key role in getting us there.”
Wellocracy aims to help trackers choose and use health apps and devices
Free and low cost Health Apps sources include
- Health and Wellness Information Apps for locating information for personal health and wellness
- Health and Fitness Tracking Apps to help you enter and store your personal health and fitness information quickly
And these may be helpful when selecting health apps
- How to Choose A Better Health App (by LEXANDER V. PROKHOROV, MD, PHD at KevinMD.com on August 8, 2011) contains advice in the following areas
Set realistic expectations
Avoid apps that promise too much
Research the developers
Choose apps that use techniques you’ve heard of
See what other users say
Test apps before committing
iMedical apps has mobile medical app reviews and commentary by medical professionals. Most apps are about apps geared toward professionals and are not free.
The iMedical app forum now includes a medical librarian corner, with some patient/consumer apps
- iMedical apps has mobile medical app reviews and commentary by medical professionals. Most apps are about apps geared toward professionals and are not free.
PISCATAWAY, NJ – It’s no secret that drinking and driving can be a deadly mix. But the role of alcohol in U.S. traffic deaths may be substantially underreported on death certificates, according to a study in the March issue of the Journal of Studies on Alcohol and Drugs.
Between 1999 and 2009, more than 450,000 Americans were killed in a traffic crashes. But in cases where alcohol was involved, death certificates frequently failed to list alcohol as a cause of death.
Why does that matter? One big reason is that injuries are the leading cause of death for Americans younger than 45, according to the Centers for Disease Control and Prevention. And it’s important to have a clear idea of alcohol’s role in those deaths, explained Ralph Hingson, Sc.D., of the U.S. National Institute on Alcohol Abuse and Alcoholism.
“We need to have a handle on what’s contributing to the leading cause of death among young people,” Hingson said. What’s more, he noted, researchers need reliable data to study the effects of policies aimed at reducing alcohol-related deaths.
“You want to know how big the problem is, and if we can track it,” Hingson said. “Is it going up, or going down? And what policy measures are working?”
For the new study, I-Jen Castle, Ph.D., and a team led by Hingson focused on traffic deaths because, of all types of accidental fatalities, that’s where researchers have the best data. This is partly because many U.S. states—about half right now—require that fatally injured drivers be tested for blood alcohol levels, and nationwide about 70% of those drivers are tested.
Hingson’s team used a database maintained by the National Highway Traffic Safety Administration, called the Fatality Analysis Reporting System (FARS)—which contains the blood alcohol levels of Americans killed in traffic crashes. They compared that information with deaths certificate data from all U.S. states.
Overall, they found, death certificates greatly underreported the role of alcohol in traffic deaths between 1999 and 2009: Just over 3 percent listed alcohol as a contributing cause. But based on the FARS figures, 21 percent of those deaths were legally drunk.
The picture varied widely from state to state. In some states—such as Maryland, Nevada, New Hampshire, and New Jersey—alcohol was rarely listed on death certificates. Certain other states did much better, including Delaware, Iowa, Kansas, and Minnesota. It’s not fully clear why alcohol is so often left off of death certificates. One reason could be the time it takes to get blood-alcohol test results back. Coroners or medical examiners usually have to file a death certificate within three to five days, Hingson’s team notes, but toxicology results might take longer than that.
The reasons for the wide variation among states aren’t known either. But Hingson said that’s an important question. “Some states have been pretty successful,” he noted. “What are they doing right?”
It doesn’t seem to be only a matter of passing laws: States that mandate alcohol testing for deceased drivers did not always do better when it came to reporting alcohol as a contributor on death certificates.
Whatever the reasons, Hingson said, the role of alcohol in injury deaths may be seriously underestimated on death certificates. And the situation is likely worse with other types of accidental deaths, such as falls, drug poisoning/overdoses, and drowning, for which there is no mandatory blood alcohol testing or other reporting systems.
Hingson said he thinks testing should be done in those cases as well.
Tel Aviv University research shows fat mass in cells expands with disuse
Over 35 percent of American adults and 17 percent of American children are considered obese, according to the latest survey conducted by the Centers for Disease Control and Prevention. Associated with diabetes, heart disease, stroke, and even certain types of cancer, obesity places a major burden on the health care system and economy. It’s usually treated through a combination of diet, nutrition, exercise, and other techniques.
To understand how obesity develops, Prof. Amit Gefen, Dr. Natan Shaked and Ms. Naama Shoham of Tel Aviv University’s Department of Biomedical Engineering, together with Prof. Dafna Benayahu of TAU’s Department of Cell and Developmental Biology, used state-of-the-art technology to analyze the accumulation of fat in the body at the cellular level. According to their findings, nutrition is not the only factor driving obesity. The mechanics of “cellular expansion” plays a primary role in fat production, they discovered.
By exposing the mechanics of fat production at a cellular level, the researchers offer insight into the development of obesity. And with a better understanding of the process, the team is now creating a platform to develop new therapies and technologies to prevent or even reverse fat gain. The research was published this week in the Biophysical Journal.
Getting to the bottom of obesity
“Two years ago, Dafna and I were awarded a grant from the Israel Science Foundation to investigate how mechanical forces increase the fat content within fat cells. We wanted to find out why a sedentary lifestyle results in obesity, other than making time to eat more hamburgers,” said Prof. Gefen. “We found that fat cells exposed to sustained, chronic pressure — such as what happens to the buttocks when you’re sitting down — experienced accelerated growth of lipid droplets, which are molecules that carry fats.
“Contrary to muscle and bone tissue, which get mechanically weaker with disuse, fat depots in fat cells expanded when they experienced sustained loading by as much as 50%. This was a substantial discovery.”
The researchers discovered that, once it accumulated lipid droplets, the structure of a cell and its mechanics changed dramatically. Using a cutting-edge atomic force microscope and other microscopy technologies, they were able to observe the material composition of the transforming fat cell, which became stiffer as it expanded. This stiffness alters the environment of surrounding cells by physically deforming them, pushing them to change their own shape and composition.
“When they gain mass and change their composition, expanding cells deform neighboring cells, forcing them to differentiate and expand,” said Prof. Gefen. “This proves that you’re not just what you eat. You’re also what you feel — and what you’re feeling is the pressure of increased weight and the sustained loading in the tissues of the buttocks of the couch potato.”
The more you know …
“If we understand the etiology of getting fatter, of how cells in fat tissues synthesize nutritional components under a given mechanical loading environment, then we can think about different practical solutions to obesity,” Prof. Gefen says. “If you can learn to control the mechanical environment of cells, you can then determine how to modulate the fat cells to produce less fat.”
The team hopes that its observations can serve as a point of departure for further research into the changing cellular environment and different stimulations that lead to increased fat production.
HUNTSVILLE, TX (3/20/14) — Parents who use alcohol, marijuana, and drugs have higher frequencies of children who pick up their habits, according to a study from Sam Houston State University.
The study, “Intergenerational Continuity of Substance Use,” found that when compared to parents who did not use substances, parents who used alcohol, marijuana, and other illicit drugs were significantly more likely to have children who used those same drugs. Specifically, the odds of children’s alcohol use were five times higher if their parents used alcohol; the odds of children’s marijuana use were two times higher if their parents used marijuana; and the odds of children’s other drug use were two times higher if their parent used other drugs. Age and other demographic factors also were important predictors of substance use.
“The study is rare in that it assesses the extent to which parent’s substance use predicts use by their children within age-equivalent and developmentally-specific stages of the life course,” said Dr. Kelly Knight of the College Criminal Justice’s Department of Criminal Justice and Criminology. “If a parent uses drugs, will their children grow up and use drugs? When did the parent use and when did their children use? There appears to be an intergenerational relationship. The effect is not as strong as one might believe from popular discourse, but when you measure it by developmental stage, it can provide important information on its impact in adolescence and early adulthood, specifically.”
The study examined the patterns of substance use by families over a 27-year period. It documents substance use over time, giving a more complete understanding of when substance use occurs, when it declines, and the influence of parents in the process.
According to the National Survey on Drug Use and Health in 2011, about 22.6 million Americans age 12 years and older said they used illicit drugs in the last month. Other studies show that drug use is associated with reduced academic achievement, lower employment rates, poorer health, dependency on public assistance, neighborhood disorganization, and an increase in the likelihood of involvement in crime, criminal victimization and incarceration. The cost of drug use in this country from lost productivity, healthcare, and criminal justice is nearly $600 billion.
By plotting the life course of substance use within families, the study may be a valuable tool for the development of intervention programs. The study suggests that if substance use can be curtailed in adolescence, it may help to curb its prevalence in future generations.
The study also helps pinpoint the use of different illicit substances over the span of a lifetime, including its emergence in adolescence and when that use may decline. For example, marijuana and other drug use is most prevalent in adolescence and generally declines before or at age 24. Alcohol use continues to increase throughout adolescence and young adulthood, and then remains relatively steady over the lifetime.
These findings come from the National Youth Survey Family Study, which has collected data from three generations over a 27-year period. The analysis is based on 655 parents and 1,227 offspring from 1977 to 2004.
Addictive behavior such as drug and alcohol abuse could be associated with poor development of the so-called “love hormone” system in our bodies during early childhood, according to researchers at the University of Adelaide. The groundbreaking idea has resulted from a review of worldwide research into oxytocin, known as the “love hormone” or “bonding drug” because of its important role in enhancing social interactions, maternal behavior and partnership. This month’s special edition of the international journal Pharmacology, Biochemistry and Behavior deals with the current state of research linking oxytocin and addiction, and has been guest edited by Dr Femke Buisman-Pijlman from the University of Adelaide’s School of Medical Sciences. Dr Buisman-Pijlman, who has a background in both addiction studies and family studies, says some people’s lack of resilience to addictive behaviors may be linked to poor development of their oxytocin systems.
“We know that newborn babies already have levels of oxytocin in their bodies, and this helps to create the all-important bond between a mother and her child. But our oxytocin systems aren’t fully developed when we’re born – they don’t finish developing until the age of three, which means our systems are potentially subject to a range of influences both external and internal,” Dr Buisman-Pijlman says. She says the oxytocin system develops mainly based on experiences. “The main factors that affect our oxytocin systems are genetics, gender and environment. You can’t change the genes you’re born with, but environmental factors play a substantial role in the development of the oxytocin system until our systems are fully developed,” Dr Buisman-Pijlman says. IMAGE: This photo shows Dr. Femke Buisman-Pijlman from the University of Adelaide. She is the guest editor of the April 2014 edition of Pharmacology, Biochemistry and Behavior, which is focused on… Click here for more information. “Previous research has shown that there is a high degree of variability in people’s oxytocin levels. We’re interested in how and why people have such differences in oxytocin, and what we can do about it to have a beneficial impact on people’s health and wellbeing,” she says. She says studies show that some risk factors for drug addiction already exist at four years of age. “And because the hardware of the oxytocin system finishes developing in our bodies at around age three, this could be a critical window to study. Oxytocin can reduce the pleasure of drugs and feeling of stress, but only if the system develops well.” Her theory is that adversity in early life is key to the impaired development of the oxytocin system. “This adversity could take the form of a difficult birth, disturbed bonding or abuse, deprivation, or severe infection, to name just a few factors,” Dr Buisman-Pijlman says. “Understanding what occurs with the oxytocin system during the first few years of life could help us to unravel this aspect of addictive behavior and use that knowledge for treatment and prevention.”
New book Near-Death Experiences explores this controversial topic with historical reports and well-documented cases
In popular understanding, the expression “near-death experience” refers to the transition between the states of life and death. But how should such experiences be interpreted? Are they verifiable with scientific methods? If so, how can they be explained? Attempting to relate matters of scientific knowledge to subjective experience and the realm of belief is a difficult balancing act, and has led to a variety of approaches to the topic.
Near-Death Experiences by Birk Engmann scrutinizes the diverse views, and also myths, about near-death experiences and describes them from a scientific standpoint. Situated at the intersection of neuroscience, psychology, philosophy, and religious studies, his book will appeal to a broad audience of both scientists and general readers.
Engmann explains, “The multitude of views and models purporting explanation already indicates that near-death research is something of a tightrope walk between rationally explainable theories and the sphere of belief. There is an urgent need for a critical review, and indeed, one which examines the way the natural sciences can throw light on this matter. This is the main aim of my book.”
Near-Death Experiences provides explanations for the various experiences construed by some as proof of the supernatural. The author discusses this highly controversial topic, using interesting historical reports and recent well-documented cases.
Stress undermines empathic abilities in men but increases them in women
Stress, this enemy that haunts us every day, could be undermining not only our health but also our relationships with other people, especially if we are men. In fact, stressed women apparently become more “prosocial”. These are the main findings of a study carried out with the collaboration of Giorgia Silani, from the International School for Advanced Studies (SISSA) of Trieste. The study was coordinated by the Social Cognitive Neuroscience Unit of the University of Vienna and saw the participation of the University of Freiburg.
“There’s a subtle boundary between the ability to identify with others and take on their perspective – and therefore be empathic – and the inability to distinguish between self and other, thus acting egocentrically” explains Silani. “To be truly empathic and behave prosocially it’s important to maintain the ability to distinguish between self and other, and stress appears to play an important role in this”.
Stress is a psycho-biological mechanism that may have a positive function: it enables the individual to recruit additional resources when faced with a particularly demanding situation. The individual can cope with stress in one of two ways: by trying to reduce the internal load of “extra” resources being used, or, more simply, by seeking external support. “Our starting hypothesis was that stressed individuals tend to become more egocentric. Taking a self-centred perspective in fact reduces the emotional/cognitive load. We therefore expected that in the experimental conditions people would be less empathic” explains Claus Lamm, from the University of Vienna and one of the authors of the paper.
More in detail…
The surprise was that our starting hypothesis was indeed true, but only for males. In the experiments, conditions of moderate stress were created in the laboratory (for example, the subjects had to perform public speaking or mental arithmetic tasks, etc.). The participants then had to imitate certain movements (motor condition), or recognise their own or other people’s emotions (emotional condition), or make a judgement taking on another person’s perspective (cognitive condition). Half of the study sample were men, the other half were women.
“What we observed was that stress worsens the performance of men in all three types of tasks. The opposite is true for women” explains Silani.
Why this happens is not yet clear. “Explanations might be sought at several levels”, concludes Silani. “At a psychosocial level, women may have internalized the experience that they receive more external support when they are able to interact better with others.
This means that the more they need help – and are thus stressed – the more they apply social strategies. At a physiological level, the gender difference might be accounted for by the oxytocin system. Oxytocin is a hormone connected with social behaviours and a previous study found that in conditions of stress women had higher physiological levels of oxytocin than men”.
DALLAS, March 16, 2014 — Honey, that delectable condiment for breads and fruits, could be one sweet solution to the serious, ever-growing problem of bacterial resistance to antibiotics, researchers said here today.
Medical professionals sometimes use honey successfully as a topical dressing, but it could play a larger role in fighting infections, the researchers predicted. Their study was part of the 247th National Meeting of the American Chemical Society (ACS), the world’s largest scientific society.
The meeting, attended by thousands of scientists, features more than 10,000 reports on new advances in science and other topics. It is being held at the Dallas Convention Center and area hotels through Thursday.
“The unique property of honey lies in its ability to fight infection on multiple levels, making it more difficult for bacteria to develop resistance,” said study leader Susan M. Meschwitz, Ph.D. That is, it uses a combination of weapons, including hydrogen peroxide, acidity, osmotic effect, high sugar concentration and polyphenols — all of which actively kill bacterial cells, she explained. The osmotic effect, which is the result of the high sugar concentration in honey, draws water from the bacterial cells, dehydrating and killing them.
In addition, several studies have shown that honey inhibits the formation of biofilms, or communities of slimy disease-causing bacteria, she said. “Honey may also disrupt quorum sensing, which weakens bacterial virulence, rendering the bacteria more susceptible to conventional antibiotics,” Meschwitz said. Quorum sensing is the way bacteria communicate with one another, and may be involved in the formation of biofilms. In certain bacteria, this communication system also controls the release of toxins, which affects the bacteria’s pathogenicity, or their ability to cause disease.
Meschwitz, who is with Salve Regina University in Newport, R.I., said another advantage of honey is that unlike conventional antibiotics, it doesn’t target the essential growth processes of bacteria. The problem with this type of targeting, which is the basis of conventional antibiotics, is that it results in the bacteria building up resistance to the drugs.
Honey is effective because it is filled with healthful polyphenols, or antioxidants, she said. These include the phenolic acids, caffeic acid, p-coumaric acid and ellagic acid, as well as many flavonoids. “Several studies have demonstrated a correlation between the non-peroxide antimicrobial and antioxidant activities of honey and the presence of honey phenolics,” she added. A large number of laboratory and limited clinical studies have confirmed the broad-spectrum antibacterial, antifungal and antiviral properties of honey, according to Meschwitz.
She said that her team also is finding that honey has antioxidant properties and is an effective antibacterial. “We have run standard antioxidant tests on honey to measure the level of antioxidant activity,” she explained. “We have separated and identified the various antioxidant polyphenol compounds. In our antibacterial studies, we have been testing honey’s activity against E. coli, Staphylococcus aureus and Pseudomonas aeruginosa, among others.”
Around 1 in 5 of the population were infected in both recent outbreaks of seasonal flu and the 2009 H1N1 influenza pandemic, but just 23% of these infections caused symptoms, and only 17% of people were ill enough to consult their doctor.
These findings come from a major new community-based study comparing the burden and severity of seasonal and pandemic influenza in England over 5 years, published in The Lancet Respiratory Medicine journal.
“Reported cases of influenza represent the tip of a large clinical and subclinical iceberg that is mainly invisible to national surveillance systems that only record cases seeking medical attention”, explains lead author Dr Andrew Hayward from University College London, UK.
“Most people don’t go to the doctor when they have flu. Even when they do consult they are often not recognised as having influenza. Surveillance based on patients who consult greatly underestimates the number of community cases, which in turn can lead to overestimates of the proportion of cases who end up in hospital or die. Information on the community burden is therefore critical to inform future control and prevention programmes.”*
The Flu Watch study tracked five successive cohorts of households across England over six influenza seasons between 2006 and 2011. The researchers calculated nationally representative estimates of the incidence of influenza infection, the proportion of infections that were symptomatic, and the proportion of symptomatic infections that led to medical attention.
Participants provided blood samples before and after each season for influenza serology, and all participating households were contacted weekly to identify any cases of cough, cold, sore throat or ‘flu-like illness”. Any person reporting such symptoms was asked to submit a nasal swab on day 2 of illness to test for a variety of respiratory viruses using Real-Time, Polymerase Chain Reaction (RT-PCR) technology.
The results show that on average 18% of the unvaccinated community were infected with influenza each winter season—19% during prepandemic seasons and 18% during the 2009 pandemic. But most (77%) of these infections showed no symptoms, and only around 17% of people with PCR-confirmed influenza visited their doctor. Compared with some seasonal flu strains, the 2009 pandemic strain caused substantially milder symptoms.
The study indicates that primary-care surveillance greatly underestimates the extent of infection and illness in the community. The rate of influenza across all winter seasons was on average 22 times higher than rates of disease recorded by the Royal College of General Practitioners Sentinel Influenza-Like Illness Surveillance Scheme.
According to Dr Hayward, “Despite its mild nature, the 2009 pandemic caused enormous international concern, expense, and disruption. We need to prepare for how to respond to both mild and severe pandemics. To do this we need more refined assessments of severity, including community studies to guide control measures early in the course of a pandemic and inform a proportionate response.”
Writing in a linked Comment, Dr Peter William Horby from the Oxford University Clinical Research Unit in Vietnam says, “In view of the undoubtedly high rates of subclinical influenza infection, an important unanswered question is the extent to which mild and asymptomatic influenza infections contribute to transmission…A large number of well individuals mixing widely in the community might, even if only mildly infectious, make a substantial contribution to onward transmission.”
He concludes, “Surveillance of medically attended illnesses provides a partial and biased picture, and is vulnerable to changes in consulting, testing, or reporting practices. As such, it is clear that reliable estimates of the infection and clinical attack rates during the early stages of an influenza epidemic requires the collection of standardised data across the whole range of disease severity, from the community, primary care, and secondary care.”
Major ‘third-hand smoke’ compound causes DNA damage — and potentially cancer
DALLAS, March 16, 2014 — Leftover cigarette smoke that clings to walls and furniture is a smelly nuisance, but now research suggests that it could pose a far more serious threat, especially to young children who put toys and other smoke-affected items into their mouths. Scientists reported today that one compound from this “third-hand smoke,” which forms when second-hand smoke reacts with indoor air, damages DNA and sticks to it in a way that could potentially cause cancer.
Their talk was one of more than 10,000 presentations at the 247th National Meeting & Exposition of the American Chemical Society (ACS), the world’s largest scientific society, taking place here through Thursday.
Bo Hang, Ph.D., who presented the research, said that although the idea of third-hand smoke made its debut in research circles just a few years ago in 2009, evidence already strongly suggests it could threaten human health.
“The best argument for instituting a ban on smoking indoors is actually third-hand smoke,” said Hang, a scientist at Lawrence Berkeley National Laboratory (LBNL).
Researchers have found that many of the more than 4,000 compounds in second-hand smoke, which wafts through the air as a cigarette is smoked, can linger indoors long after a cigarette is stubbed out. Based on studies led by Hugo Destaillats, Ph.D., also at LBNL, these substances can go on to react with indoor pollutants such as ozone and nitrous acid, creating brand-new compounds, some of which may be carcinogenic.
One of those compounds goes by the acronym NNA. Hang’s research has shown that NNA, a tobacco-specific nitrosamine, locks onto DNA to form a bulky adduct (a piece of DNA bound to a cancer-causing chemical), as well as other adducts, in lab test tubes. Other large compounds that attach to DNA tend to cause genetic mutations. NNA also breaks the DNA about as often as a related compound called NNK, which is a well-studied byproduct of nicotine and a known potent carcinogen. This kind of DNA damage can lead to uncontrolled cell growth and the formation of cancerous tumors.
Just as it took years to establish the cancer-causing effects of first-hand smoke that is inhaled as a person breathes in directly from the cigarette, making the connection between third-hand smoke or NNA and cancer could take a long time, Hang said. But early research into its nature, exposure and health effects is compelling enough that a research consortium dedicated to investigating third-hand smoke was formed in California in 2010. That consortium helped fund Hang’s work on NNA-induced DNA damage, which he said could eventually be used as biomarkers to identify people who have been exposed to third-hand smoke.
The biggest potential health risk is for babies and toddlers, he noted. As they crawl and put their hands or toys in their mouths, they could touch, swallow or inhale compounds from third-hand smoke. Their small size and early developmental stage make them more vulnerable than adults to the effects of environmental hazards.
March 19, 2014
American Heart Association
Kids whose parents are demanding but not emotionally responsive are about one-third more likely to be obese than kids whose parents set healthy boundaries, are affectionate and discuss behavior. Researchers compared kids whose parents are generally affectionate, have reasonable discussions about behavior with their child and set healthy boundaries (authoritative) with those whose parents were strict about limits without much dialogue or affection (authoritarian).
[News story] Commonly used pain relievers have added benefit of fighting bacterial infection — ScienceDaily
Some commonly used drugs that combat aches and pains, fever, and inflammation are also thought to have the ability to kill bacteria. New research reveals that these drugs, better known as nonsteroidal anti-inflammatory drugs, act on bacteria in a way that is fundamentally different from current antibiotics. The discovery could open up new strategies for fighting drug-resistant infections and ‘superbugs.’
“We discovered that some anti-inflammatory drugs used in human and veterinary medicine have weak antibiotic activity and that they exert this secondary activity by preventing bacteria from copying their DNA, which they need to do in order to multiply,” explains senior author Dr. Aaron Oakley of the University of Wollongong, in Australia. The researchers analyzed three NSAIDs: bromofenac, carprofen, and vedaprofen. The more commonly known NSAIDs, which include aspirin, ibuprofen, and naproxen, were not tested.
Hypothyroid medication levothyroxine (Synthroid, AbbVie) was the nation’s most prescribed drug in 2013, whereas the antipsychotic aripiprazole (Abilify, Otsuka Pharmaceutical) had the highest sales, at nearly $6.5 billion, according to a new report from research firm IMS Health on the top 100 selling drugs in the United States.
Following levothyroxine as most prescribed were the cholesterol-lowering drug rosuvastatin (Crestor, AstraZeneca), the proton-pump inhibitor esomeprazole (Nexium, AstraZeneca), and the antidepressant duloxetine (Cymbalta, Eli Lilly).
Rounding out the top 10 most prescribed drugs in 2013 (in order) were the asthma drugs albuterol (Ventolin, HFA) and fluticasone propionate/salmeterol (Advair Diskus, GlaxoSmithKline), the antihypertensive valsartan (Diovan, Novartis), the attention deficit drug lisdexamfetamine dimesylate (Vyvanse, Shire), the antiepileptic pregabalin (Lyrica, Pfizer), and the chronic obstructive pulmonary disease drug tiotropium bromide (Spiriva, Boehringer Ingelheim).
Table 1. Top 100 Drugs by Sales
Rank Drug (brand name) Sales, 2013
1 Abilify $6,460,215,394
2 Nexium $6,135,667,614
3 Humira $5,549,996,855
4 Crestor $5,310,818,889
5 Cymbalta $5,219,860,418
6 Advair Diskus $5,121,312,668
7 Enbrel $4,681,201,645
8 Remicade $4,098,233,242
9 Copaxone $3,697,182,238
10 Neulasta $3,580,364,758
11 Rituxan $3,288,614,045
12 Lantus Solostar $3,005,681,663
13 Spiriva Handihaler $2,998,207,542
14 Atripla $2,856,818,557
15 Januvia $2,843,496,907
16 Avastin $2,688,414,938
17 Lantus $2,556,825,619
18 Oxycontin $2,534,909,675
19 Lyrica $2,415,254,835
20 Epogen $2,280,696,834
21 Celebrex $2,237,658,764
22 Truvada $2,235,712,145
23 Diovan $2,169,819,482
24 Herceptin $1,938,804,857
25 Gleevec $1,896,982,614
26 Lucentis $1,859,463,484
27 Namenda $1,856,822,750
28 Vyvanse $1,743,115,521
29 Zetia $1,710,526,476
30 Symbicort $1,563,242,161
31 Levemir $1,547,629,745
32 Suboxone $1,450,554,130
33 Novolog Flexpen $1,377,221,614
34 Novolog $1,349,403,122
35 Avonex $1,240,754,136
36 Seroquel Xr $1,226,532,019
37 Viagra $1,196,812,385
38 Alimta $1,192,134,813
39 Humalog $1,184,189,487
40 Nasonex $1,137,402,455
41 Victoza 3-Pak $1,104,811,637
42 Cialis $1,086,355,583
43 Gilenya $1,059,346,323
44 Flovent Hfa $1,050,009,900
45 Procrit $1,030,419,958
46 Isentress $1,014,678,055
47 Xarelto $996,441,091
48 Prezista $992,087,940
49 Janumet $987,663,598
50 Stelara $965,072,892
51 Neupogen $958,807,372
52 Orencia $957,680,500
53 Renvela $955,330,199
54 Reyataz $934,879,388
55 Vesicare $933,311,254
56 Dexilant $916,401,204
57 Tecfidera $879,673,483
58 Humalog Kwikpen $879,632,962
59 Synthroid $858,725,708
60 Vytorin $858,576,112
61 Lunesta $851,791,226
62 Pradaxa $836,573,805
63 Benicar $832,276,970
64 Evista $823,647,433
65 Xolair $821,783,471
66 Aranesp $809,245,700
67 Prevnar 13 $806,129,346
68 Sensipar $786,320,942
69 Xgeva $785,725,436
70 Invega Sustenna $779,834,172
71 Zytiga $775,269,249
72 Avonex Pen $768,655,140
73 Synagis $767,786,422
74 Betaseron $767,648,290
75 Xeloda $754,133,787
76 Ventolin Hfa $745,629,470
77 Zyvox $726,184,205
78 Afinitor $721,629,719
79 Gardasil $710,208,856
80 Zostavax $705,140,729
81 Incivek $701,317,408
82 Sandostatin Lar $697,961,265
83 Aciphex $683,359,951
84 Benicar Hct $681,353,719
85 Bystolic $681,318,227
86 Treanda $679,052,250
87 Focalin Xr $660,161,202
88 Erbitux $648,984,405
89 Tamiflu $641,134,799
90 Tarceva $640,597,157
91 Pristiq $632,619,542
92 Complera $630,039,312
93 Cubicin $628,034,439
94 Velcade $621,800,823
95 Strattera $616,604,042
96 Viread $599,074,197
97 Stribild $598,844,153
98 Welchol $573,939,710
99 Combivent Respimat $573,179,772
100 Xifaxan $569,762,570
Source: IMS National Prescription Audit, IMS Healt
[Report] Less Than Half of Part D Sponsors Voluntarily Reported Data on Potential Fraud and Abuse (OEI-03-13-00030) 03-03-2014
More than half of Part D plan sponsors did not report data on potential fraud and abuse between 2010 and 2012. Of those sponsors that did report data, more than one-third did not identify any incidents for at least one of their reporting years. In total, sponsors reported identifying 64,135 incidents of potential fraud and abuse between 2010 and 2012. Sponsors’ identification of such incidents varied significantly, from 0 to almost 14,000 incidents a year.
CMS requires sponsors to conduct inquiries and implement corrective actions in response to incidents of potential fraud and abuse; however, 28 percent of Part D plan sponsors reported performing none of these actions between 2010 and 2012. Although CMS reported that it conducted basic summary analyses of the data on potential fraud and abuse, it did not perform quality assurance checks on the data or use them to monitor or oversee the Part D program.
WHAT WE RECOMMEND
We recommend that CMS (1) amend regulations to require sponsors to report to CMS their identification of and response to potential fraud and abuse; (2) provide sponsors with specific guidelines on how to define and count incidents, related inquiries, and corrective actions; (3) review data to determine why certain sponsors reported especially high or low numbers of incidents, related inquiries, and corrective actions; and (4) share sponsors’ data on potential fraud and abuse with all sponsors and law enforcement. CMS did not concur with the first recommendation, partially concurred with the second and fourth recommendations, and concurred with the third recommendation.
[Press release] Summary Health Statistics for U.S. Adults: National Health Interview Survey, 2012 | Full Text Reports…
This report presents detailed tables from the 2012 National Health Interview Survey (NHIS) for the civilian noninstitutionalized adult population, classified by sex, age, race and Hispanic origin, education, current employment status, family income, poverty status, health insurance coverage, marital status, and place and region of residence. Estimates (frequencies and percentages) are presented for selected chronic conditions and mental health characteristics, functional limitations, health status, health behaviors, health care access and utilization, and human immunodeficiency virus testing. Percentages and percent distributions are presented in both age-adjusted and unadjusted versions.
[Press release] Shared psychological characteristics that are linked to aggression between patients with Internet addiction and those with alcohol dependence | Full Text Reports…
Internet addiction (IA) is considered as one of behavioral addictions. Although common neurobiological mechanisms have been suggested to underlie behavioral addiction and substance dependence, few studies have directly compared IA with substance dependence, such as alcohol dependence (AD).
We compared patients with IA, AD, and healthy controls (HC) in terms of the Five Factor Model of personality and with regard to impulsiveness, anger expression, and mood to explore psychological factors that are linked to aggression. All patients were treatment-seeking and had moderate-to-severe symptoms.
The IA and AD groups showed a lower level of agreeableness and higher levels of neuroticism, impulsivity, and anger expression compared with the HC group, which are characteristics related to aggression. The addiction groups showed lower levels of extraversion, openness to experience, and conscientiousness and were more depressive and anxious than the HCs, and the severity of IA and AD symptoms was positively correlated with these types of psychopathology.
IA and AD are similar in terms of personality, temperament, and emotion, and they share common characteristics that may lead to aggression. Our findings suggest that strategies to reduce aggression in patients with IA are necessary and that IA and AD are closely related and should be dealt with as having a close nosological relationship.
…many supposed psychological differences between the sexes are as illusory as the physical ones. In 2005, Janet Hyde, a researcher at the University of Wisconsin-Madison, analyzed data from studies of apparent sex differences in traits such as aggression, social ability, math, and moral reasoning. Nearly four fifths of the traits showed only a minor or negligible difference between men and women.
In the rare cases where actual psychological differences exist, they cannot be attributed to innate neurology alone. Everything in the brain is a combination of nature and nurture. Culture comes into play, which affects behavior, which then affects the brain. From birth (and even in the womb), a baby is labeled as a girl or boy and treated a certain way as a result. For example, a 2005 study of 386 birth announcements in Canadian newspapers showed that parents tend to say they’re “proud” when it’s a boy and “happy” when it’s a girl. Anne Fausto-Sterling, a biologist at Brown University, has shown that mothers talk to infant girls more than infant boys. This could partly explain why girls tend to have better language skills later on. “Some differences end up fairly entrenched in adult human beings,” Fausto-Sterling says. “But that doesn’t mean that you were born that way or that you were born destined to be that way.”
Writing in Science, the chair of the Presidential Commission for the Study of Bioethical Issues notes it is increasingly common for physicians and medical researchers to discover a disease that was not the original target of a medical test or screening.
Amy Guttman Ph.D. notes these surprise clinical test results are called incidental and secondary findings. Guttman explains the surprise discovery of an unexpected illness from screening and similar tests is called an ‘incidental’ finding. Guttman adds when clinicians deliberately seek to discover a second or third disease in addition to the primary target, these results are called ‘secondary’ findings.
Guttman, who is the president of the University of Pennsylvania, writes (and we quote): ‘Improved technologies are making incidental and secondary findings increasingly common. They are becoming a growing certainty in clinical practice as well as in the distinct contexts of research and direct-to-consumer testing’ (end of quote). For example, Guttman notes an array of unexpected clinical findings may be generated by new CT scans intended to detect lung cancer in heavy smokers. The increased screening will occur because of recent recommendations from the U.S. Preventive Services Task Force, which we discussed in last week’s podcast.
Guttman writes before CT scans or other medical tests, clinicians should alert patients about the possibility of surprise findings regardless whether screening deliberately seeks (or accidentally finds) new, unexpected illnesses.
Guttman notes while some persons will ask a physician to tell them about whatever clinical tests discover, some patients do not want to learn about incidental or secondary findings.
As a result, the Presidential Bioethics Commission recommends physicians and medical practitioners need to know a patient’s health priorities and tolerance to manage surprising results prior to clinical testing. Guttman writes (and we quote) ‘A patient who does not wish to learn about information related to the primary purpose of the test should not undergo the test. If a patient wishes to opt out of receiving incidental or secondary findings that are clinically significant and actionable, then clinicians should exercise their discretion whether to proceed with testing’ (end of quote).
Guttman notes health care providers should explain both the risks and rewards of finding unexpected illnesses that can occur from a new generation of sophisticated clinical tests, such as human genome screenings. While false positive findings are among the risks, Guttman explains the rewards include the detection of diseases and illness that could be clinically actionable.
In terms of biomedical ethics, Guttman concludes (and we quote):’ In keeping with shared decision-making, clinicians live up to their highest calling when they discuss how they will handle incidental findings with their patients’ (end of quote). While the Presidential Bioethics Commission provides more specific recommendations in their report, their overall intent is to improve patient-provider disclosure and communication as well as help patients anticipate the possibility of unexpected findings from routine testing.
The Commission’s report is available at bioethics.gov.
Meanwhile, a link to a website that explains some of the ethical issues associated with patient and provider health decision making (from Beth Israel Medical Center) is available in the ‘specific conditions’ section of MedlinePlus.gov’s medical ethics health topic page.
Similarly, a link to a website that explains some of the ethical issues associated with patient and provider treatment decisions (also from Beth Israel Medical Center) can be found in the ‘specific conditions’ section of MedlinePlus.gov’s medical ethics health topic page.
MedlinePlus.gov’s medical ethics health topic page also provides links to the latest pertinent journal research articles, which are available in the ‘journal articles’ section. You can sign up to receive updates about medical ethics as they become available on MedlinePlus.gov.
To find MedlinePlus.gov’s medical ethics health topic page type ‘medical ethics’ in the search box on MedlinePlus.gov’s home page. Then, click on ‘medical ethics (National Library of Medicine).’ MedlinePlus.gov additionally contains a health topic page on talking with your doctor, which provides tips to enhance provider and patient communication.
The Dalai Lama, the Nobel Peace Prize winner and exiled spiritual leader of Buddhism in Tibet, discussed his admiration for scientists and made some interesting remarks about emotional health during a recent speech at the National Institutes of Health.
The Dalai Lama was effusive in his praise for scientists. He said (and we quote): ‘I deeply admire my scientific friends’ (end of quote). The Dalai Lama pinpointed the open minded of scientists and what he described as a healthy skepticism about evidence and hyperbole. He also emphasized the capacity of scientists from around the world to work together and ignore differences in geography, race, ethnicity, gender, religion, and social class.
The Dalai Lama noted these traits set scientists apart and provided an international, professional role model.
However, the Dalai Lama also said he found some scientists were unhappy despite their gifts and intelligence. He briefly discussed the lack of inner peace among scientists with a sense of humor rather than admonishment. The Dalai Lama’s infectious laugh and self-deprecating humor delighted many NIH staff members who packed an auditorium to hear him.
The Dalia Lama’s discussion about emotional inner peace led to broader remarks about the impact of maternal affection in the life long health of children. The Dalai Lama explained he was pleased that scientific evidence seemed consistent with his personal, long-standing observation of the vital role of maternal love and sincerity in the development of a child’s brain and emotional health.
Similarly, the Dalai Lama noted that he had long observed a perceived link between maternal affection, attention, and sincerity for their children and the development of life long compassion for others. He encouraged behavioral and other scientists to further assess the extent of this relationship.
The Dalai Lama also was moved by a series of drawings from young patients at NIH’s Children’s Inn and underscored his appreciation for the artists. Similarly, he praised a project he saw at NIH’s Clinical Center that seeks to restore the ability to walk for young persons with Cerebral Palsy.
In response to a question from NIH Director Francis Collins M.D., the Dalai Lama confessed he sometimes gets frustrated and irritated – and even occasionally loses his temper. For example, he explained he became angry once during an interview when a New York Times columnist asked him four times to describe his probable legacy. Although the Dalai Lama noted he believed he answered the question the first time, the story revealed even renowned spiritual leaders sometimes can get cross. It also deftly reminded the audience there always is room for improvement in how we manage our lives and work.
“Phthalates belong to a group of industrial compounds known as endocrine disruptors because they interfere with the endocrine system, which governs the production and distribution of hormones in the body. The chemicals have been implicated in a range of health problems, including birth defects, cancers and diabetes.
But it is their effect on the human reproductive system that hasmost worried researchers. A growing body of work over the last two decades suggests that phthalates can rewire the male reproductive system, interfering with the operation of androgenic hormones, such as testosterone, that play key roles in male development. That mechanism, some experts believe, explains findings that link phthalate exposure to changes in everything from testicular development to sperm quality.”
“There are different kinds of phthalates complicating the picture; some seem to have a much larger effect than others. And these are far from the only factors, chemical and otherwise, that influence human fertility. Dr. Buck Louis’s group is looking at a broad range of industrial compounds, including heavy metals like lead and cadmium, that tend to accumulate in the body.
Phthalates, by contrast, tend to be metabolized within a few hours. Their impact would not be so profound if it were not that people are constantly exposed from multiple sources.
These include not only cosmetics and plastics, but also packaging, textiles, detergents and other household products. Phthalates are found in the tubing used in hospitals to deliver medications; in water flowing through PVC pipes; enteric coatings on pills, including some aspirin; materials used to create time-release capsules; and countless other products. In 2008, the government banned them in children’s toys, and the European Union is also moving forward on restrictions.
“The W.H.O. called them ‘pseudopersistent’ in one report,” Dr. Woodruff said, because continued exposure keeps phthalates in the body. But here’s the silver lining: the transient nature of these compounds also means that consumers can take fairly simple measures to reduce their phthalate levels.
One is to read the labels on cosmetics and other personal care products and to choose those without phthalates. Another is to be cautious with plastic food containers, and to avoid using them to heat food and drink, as the phthalates in them may get transferred to what you consume.
“These compounds leach from plastics,” Dr. Buck Louis said. “You can switch to glass for drinking. You can cook your frozen dinners on paper plates.”
Studies have shown that these kinds of actions do make a difference; experiments have found measurably lower levels within several days in people who make these changes.
“Lifestyle has an important place here,” said Dr. Buck Louis.”
Surely, as one of the wealthiest countries in the world, we can find a way to provide basic health care for all.
And this includes prisoners, they too are human beings.
If used widely, a new generation of antiviral drugs has the potential to wipe out the deadly hepatitis C virus in the United States. But the high price of the drugs might prevent their use in prisons, which house as many as one-third of those who are infected.
The drugs cost anywhere from about $65,000 to $170,000 for a single course of treatment—between three and nine times more than earlier treatments. Ronald Shansky, former medical director of the Illinois prison system and founder of the Society of Correctional Physicians, described that price as “extortionarily high, criminal.”
States and municipalities typically pay for prisoner health care out of their corrections budgets. When effective HIV treatments emerged in the late 1990s, those budgets grew to accommodate the cost of the drugs, said Edward Harrison, president of National Commission on Correctional Health Care, which sets standards for prisoner health care.
But the new hepatitis C medications present a much bigger challenge. “The prevalence of HCV [hepatitis C) is 10 times greater than HIV and the cost of treatment is probably 10 times greater than a year’s worth of treating HIV,” said Anne Spaulding of Emory University, one of the leading researchers on hepatitis C in prisons.
The new hepatitis C drugs and others in the pipeline could be the “straw that breaks the back of corrections” and force large-scale changes in penal systems. Already, as a result of a U.S. Supreme Court decision, California has had to reduce its prison population by tens of thousands because of inadequate health care. Spaulding said she can foresee the high costs of medicine could force cuts in prison populations across the United States.
Another possibility, she said, would be to create a different mechanism for paying for prison health care, perhaps by extending Medicaid to jail and prison populations.
One thing is clear: The goal of eradicating hepatitis C won’t be achieved unless the campaign involves prisons.
“Because of these new drugs, the conversation about eliminating hepatitis C is finally happening,” said Ninburg of the Hepatitis Education Project. “But if it’s going to be eliminated, we are going to have to address hep C in the correctional setting.”
Originally posted on O.N.E.—One Nation’s Echo:
As social inequalities in health in the U.S. and international evidence continue to increase, disparities in income and wealth widened the gap making social class as a key determinant of population health. The gap is widening between upper-middle-class Americans and middle class Americans. Health and longevity are determined by the access of advances in medicine and disease prevention. These benefits are disproportionately delivered to individuals who have more education, connections, money, and good jobs. They are the ones in the best position to learn new information early, modify their behavior, take advantage of the latest treatments and have the cost covered by insurance. Since 1911, mortality statistics in Britain have consistently shown an inverse relation between measures of socio-economic status and mortality. While social class has been a less popular topic in the United States, this has been a trend in Europe since George III. Socio-economic…
View original 402 more words
A vascular surgeon explains why he ditched statins for more meat and less sugar, lowering his cholesterol in the process
Originally posted on National Post | Life:
It was quite a shock. The general practitioner instantly prescribed statins, the cholesterol-lowering drugs that are supposed to prevent heart disease and strokes. For eight years, I faithfully popped my 20mg atorvastatin pills, without side effects. Then, one day last May, I stopped. It wasn’t a snap decision; after looking more closely at the research, I’d concluded statins were not going to save me from a heart attack and that my cholesterol levels were all but irrelevant.
[np_storybar title="Red-faced drinkers have spiked risk of high blood pressure, study says" link="http://life.nationalpost.com/2013/11/20/red-faced-drinkers-have-spiked-risk-of-high-blood-pressure-study-says/"]
That uncle or aunt who turns beet red after a few beers or a couple of glasses of wine?…
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Originally posted on Natural Products News and Updates:
For additional information, please see JAMA.
Image courtesy of [patrisyu]/FreeDigitalPhotos.net
Originally posted on Full Text Reports...:
Source: World Health Organization
In new estimates released today, WHO reports that in 2012 around 7 million people died – one in eight of total global deaths – as a result of air pollution exposure. This finding more than doubles previous estimates and confirms that air pollution is now the world’s largest single environmental health risk. Reducing air pollution could save millions of lives.
Originally posted on One Punch Too Many:
- People who are younger, from lower socioeconomic areas, and of lower education status are more likely to use and abuse alcohol and be involved with violent behaviours; meaning these groups are particularly vulnerable to experiencing alcohol-related violence.
- Victims of alcohol-related violence are often young men, but men and women from all ages can be affected directly or indirectly, including children.
- The victims of alcohol-related violence can be killed by a single punch, often in unprovoked or unexpected attacks. Those that live often have expensive hospitalisations, severe morbidities and long recoveries.
For health, social justice revolves around four key ideas; access, equity, rights and participation. The statements above establish that there is inequality…
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Originally posted on Science for the Future:
Polluted air killed seven million human beings in 2012.
So concludes a new report from the World Health Organization, which also found that one-third of the deaths occurred in Asia.
Air pollution is now Earth’s most dangerous environmental threat to health, the WHO study says, and it accounts for one out of every eight deaths.
Emissions of pollution to the atmosphere raises the risk that individuals will suffer heart attacks, strokes, and cancer. About 40 percent of heart disease victims and about 40 percent of stroke victims die as a result of outdoor air pollution. Indoor air pollution, such as from smoke and soot, accounts for 34 percent of stroke deaths and 26 percent of ischemic heart disease fatalities.
Overall, WHO estimates that 4.3 million people died as a result of exposure to indoor air pollution, while 3.7 million individuals perished due to outdoor air pollution.
“Cleaning up the air…
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Two thoughts on disparities highlighted in the article
What about folks who do not have the background and access to resources to self diagnose? In all countries, “developed” (as USA, most of Europe) and “developing” (asmuch of Africa, parts of Asia…)
Is it ethical for some health information to be physician/research access only?
By 1997, those irregular heartbeats became common, leading to “hundreds and hundreds” of serious episodes, capable of causing death. She eventually received an ICD, an implanted cardioverter-defibrillator, which would shock her heart back into the proper rhythm.
Goodsell began studying her condition, drawing back on her own education. While she has no medical degree, Goodsell had been a pre-med student at UC San Diego, where she met Charles, who was studying chemistry. She dropped out after falling in love with nature during a trip to Peru.
Looking for that unifying theory, Goodsell delved into genomics, searching for mutations that could encompass her symptoms. She found it with a gene called LMNA, that codes for making proteins called lamins that stabilize cells. Defects in these proteins can cause a form of Charcot-Marie-Tooth disease, damaging nerves in the extremities and causing muscle wasting, including in the hands.
Symptom after symptom checked with the mutation. But to be sure, she needed a genetic test, and her Mayo doctors resisted.
Taking the research into self-therapy, Goodsell researched risk factors associated with the disease, examining what goes on at a molecular level. She changed her diet: Out went sugars, out went gluten and any food with additives. And out went a beloved snack.
“I used to eat bowls of jalapeño peppers. I discontinued.”
But she added certain fats she had previously avoided, such as omega-3 fatty acids and nuts, which are rich in fats.
“Cell membranes are fat, and we need fat — good fat,” she said. “I was advised to start eating fat.”
Goodsell said her symptoms improved. Control over her hands improved enough to allow her to eat with chopsticks and to resume kitesurfing.
Goodsell’s doctor wrote up her case history, listing her as co-author “because he said I had done the lion’s share of the work.” The study is to be presented at an upcoming meeting of the Heart Rhythm Society.
- Are you an ePatient? (enbloommedia.com)
- The Rise of the e-Patient: Slideshow (ScienceRoll)“It’s always good to see the trends about the growing number and importance of e-patients. Lee Rainie, director of the Pew Internet Project, presented this wonderful overview of the Project’s health findings at Providence St. Joseph Medical Center in Burbank, CA, on January 12.”
- Why patients are turning less to media and friends for health information (jflahiff.wordpress.com)
- Can differential diagnosis be crowdsourced to Facebook Friends?(medgadget)
- ePatient Connections: A Patient Checks In. (sixuntilme.com)
- From E-patient Hackers to Health Games on Mobiles (scienceroll.com)
- The end of social – O’Reilly Radar (queuniversidade2.wordpress.com)
- Meet e-patient Dave – a voice of patient engagement (and related resources) (jflahiff.wordpress.com)
- 2020 Vision: The ePatient Evolution Over the Next 10 Years (prweb.com)
- ePatients Come Together to Brainstorm and Share (brassandivory.org)
- 6 P’s Of Social Health (socialmediaclub.org)
- The Rise of the ePatient – presentation by Pew Internet Project (casesblog.blogspot.com)
A hospital in Staffordshire is set to become the first in Europe where doctors consult with their patients via Skype
A hospital is set to become the first in Europe to tackle waiting times by getting overworked doctors to consult with their patients via Skype.
Managers at the University Hospital of North Staffordshire claim using the online video calling service could reduce outpatient appointments by up to 35 per cent.
They argue that using Skype will help free up consultants’ time and car parking spaces – while also helping patients who are unable to take time off work.
If approved, they would become the first UK hospital to use Skype to consult with patients.
The proposals, by Staffordshire’s biggest hospital, also include doctors treating patients via email consultations……..
“The key issue for doctors will be to recognise when this mode of consultation is not sufficient to properly assess the patient and address the problem, and to arrange a face-to-face consultation instead.”
California took steps to reduce the toxins found in children’s sleeping products and home and building supplies on Thursday, when regulators announced they would begin asking manufacturers to eliminate chemicals known to cause cancer and other illnesses.
In making the announcement, regulators with the California Department of Toxic Substances Control rolled out a program six years in the making — the first of its kind in the nation — that aims to minimize consumers’ exposure to toxic chemicals.
“I can’t even tell you what a big deal this is,” said Kathleen Curtis, the national coordinator for the Alliance for Toxic-Free Fire Safety, a nationwide coalition. “It’s huge, and it’s a super smart strategic move by the state of California.
On Thursday, state leaders announced the first round of top priority chemicals that they want reduced or eliminated from products many Californians use: children’s bedding items, spray foam used to insulate and weatherize buildings, and paint strippers, removers and surface cleaners. All of these products, state officials say, contain toxins that can cause cancer, hormone imbalances and environmental degradation.
Meredith Williams, deputy director of the Department of Toxic Substances Control, said the state’s message to manufacturers is this: If you want to sell products in California, you must make products that are safe — or risk being banned from the country’s largest economy.
The announcement signals a larger victory for environmental advocates who have been working for years to rid furniture of toxins that were added as flame retardants. Studies have shown that some of these flame retardants do very little to reduce fires and have been linked to startling health risks. One of the most widely used flame retardants is TDCPP, which, under the Safer Consumer Products regulations, the state will pressure manufacturers to remove from toddlers’ nap mats, cots, cribs, playpens and bassinets.
TDCPP is one of three chemicals the state announced it is targeting: the others are diisocyanates, a chemical found in spray polyurethane foam that is used to weatherize buildings, and has been linked to lung damage, asthma, cancer and respiratory ailments; and methylene chloride, a carcinogen found in paint or varnish removers, paint strippers and surface cleaners. Thursday’s announcement marked the start of what is expected to be a yearlong process that will include a public comment period, discussions with manufacturers and studies to identify safe substitutions. In October, the state will release a second, and much lengthier, list of priority chemicals and products, Williams said. Manufacturers who don’t meet the new standards could be compelled to label their ingredients or have their products banned from California as early as 2016,
Originally posted on Hofstra H.E.A.L.:
A Harvard Medical School study revealed that one in three Medicare patients with narcotic prescriptions received the prescriptions for the same drug from multiple doctors. The doctors of these patients did not know the patients were receiving the prescriptions from other doctors already. It is likely that this trend contributes to the rise in prescription narcotics, as well as to the deaths from patients overdosing unintentionally on these drugs. Another study, published in the British Medical Journal, revealed that 35% of 1.2 million Medicare patients who received prescriptions for opioids received prescriptions for the same drug from several doctors.
Read more here.
Originally posted on Jeff Bloem:
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Originally posted on The Inverse Square Blog:
Fairfax is a place of the haves, and McDowell of the have-nots. Just outside of Washington, fat government contracts and a growing technology sector buoy the median household income in Fairfax County up to $107,000, one of the highest in the nation. McDowell, with the decline of coal, has little in the way of industry. Unemployment is high. Drug abuse is rampant. Median household income is about one-fifth that of Fairfax.
One of the starkest consequences of that divide is seen in the life expectancies of the people there. Residents of Fairfax County are among the longest-lived in the country: Men have an average life expectancy of 82 years and women, 85, about the same as in Sweden. In McDowell, the averages are 64 and 73, about the same as in Iraq.
There have long been stark economic differences between Fairfax County…
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Originally posted on Library News:
The Lancet wants to see public health transformed and is asking health professionals to commit to their manifesto.
Our vision is for a planet that nourishes and sustains the diversity of life with which we co-exist and on which we depend. Our goal is to create a movement for planetary health.
Read and register your agreement with the manifesto.