English: Stages in the intracellular life-cycle of Listeria monocytogenes. (Center) Cartoon depicting entry, escape from a vacuole, actin nucleation, actin-based motility, and cell-to-cell spread. (Outside) Representative electron micrographs from which the cartoon was derived. LLO, PLCs, and ActA are all described in the text. The cartoon and micrographs were adapted from Tilney and Portnoy (1989). (Photo credit: Wikipedia)
From the 21 October 2013 ScienceDaily report
Researchers from Cornell University have identified some agricultural management practices in the field that can either boost or reduce the risk of contamination in produce from two major foodborne pathogens: salmonella, the biggest single killer among the foodborne microbes, and Listeria monocytogenes. Their findings are published ahead of print in the journal Applied and Environmental Microbiology.
“This is going to help make produce safer,” says Laura Strawn, a researcher on the study. “We could significantly reduce risk of contamination through changes that occur a few days before the harvest.”
Many of the risk factors were influenced by when they were applied to fields which suggests that adjustments to current practices may reduce the potential for contamination with minimal cost to growers, says Strawn.
Foodborne illness sickens an estimated 9.4 million, and kills around 1,300 annually in the US, according to the Centers for Disease Control and Prevention. Produce accounts for nearly half the illnesses, and 23 percent of the deaths.
“The research is the first to use field collected data to show the association between certain management practices and an increased or decreased likelihood of salmonella and L. monocytogenes,” says Strawn.
For salmonella, manure application within the year prior to the researchers’ sampling boosted the odds of a contaminated field, while the presence of a buffer zone between the fields and potential pathogen reservoirs such as livestock operations or waterways was protective.
Irrigation within three days before sample collection raised the risk of listeria contamination six-fold. Soil cultivation within the week before sampling also increased the chances of contamination.
“These findings will assist growers in evaluating their current on-farm food safety plans (e.g. “Good Agricultural Practices”), implementing preventive controls that reduce the risk of pre-harvest contamination, and making more informed decisions related to field practices prior to harvest,” says Strawn. “Small changes in how produce is grown and managed could result in a large reduction of food safety risks.”
From the 7 October 2013 press release at Trust for America’s Health – Preventing Epidemics. Protecting People.
Prescription Drug Abuse: More than Half of States Score 6 or Less out of 10 on New Policy Report Card, While Drug Overdose Deaths Doubled in 29 States in the Last Decade
Washington, D.C. October 7, 2013 – A new report, Prescription Drug Abuse: Strategies to Stop the Epidemic, finds that 28 states and Washington, D.C. scored six or less out of 10 possible indicators of promising strategies to help curb prescription drug abuse. Two states, New Mexico and Vermont, received the highest score receiving all 10 possible indicators, while South Dakota scored the lowest with two out of 10.
According to the report by the Trust for America’s Health (TFAH), prescription drug abuse has quickly become a top public health concern, as the number of drug overdose deaths – a majority of which are from prescription drugs – doubled in 29 states since 1999. The rates quadrupled in four of these states and tripled in 10 more of these states.
Prescription drug related deaths now outnumber those from heroin and cocaine combined, and drug overdose deaths exceed motor vehicle-related deaths in 29 states and Washington, D.C. Misuse and abuse of prescription painkillers alone costs the country an estimated $53.4 billion each year in lost productivity, medical costs and criminal justice costs. Currently only one in 10 Americans with a substance abuse disorder receives treatment.
“Prescription drugs can be a miracle for many, but misuse can have dire consequences. The rapid rise of abuse requires nothing short of a full-scale response – starting with prevention and education all the way through to expanding and modernizing treatment,” said Jeffrey Levi, PhD, executive director of TFAH. “There are many promising signs that we can turn this around – but it requires urgent action.”
In the Prescription Drug Abuse report, TFAH – in consultation with a number of public health, clinical, injury prevention, law enforcement and community organization experts – reviewed a range of national recommendations and examined a set of 10 indicators of strategies being used in states to help curb the epidemic. There are indications that some of these efforts and strategies may be having a positive impact — the number of Americans abusing prescription drugs decreased from 7 million in 2010 to 6.1 in 2011, according to the National Survey on Drug Use and Health.
Some key findings from the report include:
- Appalachia and Southwest Have the Highest Overdose Death Rates: West Virginia had the highest number of drug overdose deaths, at 28.9 per every 100,000 people – a 605 percent increase from 1999, when the rate was only 4.1 per every 100,000. North Dakota had the lowest rate at 3.4 per every 100,000 people. Rates are lowest in the Midwestern states.
- Rescue Drug Laws: Just over one-third of states (17 and Washington, D.C.) have a law in place to expand access to, and use of naloxone – a prescription drug that can be effective in counteracting an overdose – by lay administrators.
- Good Samaritan Laws: Just over one-third of states (17 and Washington, D.C.) have laws in place to provide a degree of immunity from criminal charges or mitigation of sentencing for individuals seeking to help themselves or others experiencing an overdose.
- Medical Provider Education Laws: Fewer than half of states (22) have laws that require or recommend education for doctors and other healthcare providers who prescribe prescription pain medication.
- Support for Substance Abuse Treatment: Nearly half of states (24 and Washington, D.C.) are participating in Medicaid Expansion – which helps expand coverage of substance abuse services and treatment.
- ID Requirement: 32 states have a law requiring or permitting a pharmacist to require an ID prior to dispensing a controlled substance.
- Prescription Drug Monitoring Programs: While nearly every state (49) has a Prescription Drug Monitoring Program (PDMP) to help identify “doctor shoppers,” problem prescribers and individuals in need of treatment, these programs vary dramatically in funding, use and capabilities. For instance, only 16 states require medical providers to use PMDPs.
“Fifty Americans die a day from prescription drug overdoses, and more than 6 million suffer from prescription drug abuse disorders. This is a very real epidemic – and warrants a strong public health response,” said Andrea Gielen, ScD, Director of the Johns Hopkins Center for Injury Research and Policy. “We must use the best lessons we know from other public health and injury prevention success stories to work in partnership with clinical care, law enforcement, the business community, community-based organizations, and other partners to work together to curb this crisis.”
Key recommendations from the report include:
- Educate the public to understand the risks of prescription drug use to avoid misuse in the first place;
- Ensure responsible prescribing practices, including increasing education of healthcare providers and prescribers to better understand how medications can be misused and to identify patients in need of treatment;
- Increase understanding about safe storage of medication and proper disposal of unused medications, such as through “take back” programs;
- Make sure patients do receive the pain and other medications they need, and that patients have access to safe and effective drugs;
- Improve, modernize and fully-fund Prescription Drug Monitoring Programs, so they are real-time, interstate and incorporated into Electronic Health Records, to quickly identify patients in need of treatment and connect them with appropriate care and identify doctor shoppers and problem prescribers;
- Make rescue medications more widely available by increasing access for at-risk individuals to naloxone and provide immunity for individuals and others seeking help; and
- Expand access to and availability of effective treatment options as a key component of any strategy to combat prescription drug abuse.
According to the National Center for Injury Prevention and Control (NCIPC), nationally, sales of prescription painkillers per capita have quadrupled since 1999 – and the number of fatal poisonings due to prescription painkillers has also quadrupled. Enough prescription painkillers were prescribed in 2010 to medicate every American adult continually for a month.
“The release of the prescription drug abuse report by the Trust for America’s Health represents a significant step forward in elevating public awareness of the state of prescription drug abuse in the US”, according to Ginny Ehrlich, CEO of Clinton Health Matters Initiative (CHMI). “We are proud that the Trust has completed this important research as part of its CHMI Commitment to Action and congratulate the Trust on continuing to advocate for innovation and action towards addressing this public epidemic.”
The report was supported by a grant from the Robert Wood Johnson Foundation.
Score Summary: A full list of all of the indicators and scores, listed below, is available along with the full report on TFAH’s web site at www.healthyamericans.org and RWJF’s web site athttp://www.rwjf.org/RxReport. For the state-by-state scoring, states received one point for achieving an indicator or zero points if they did not achieve the indicator. Zero is the lowest possible overall score, 10 is the highest. Data for the indicators were drawn from a number of sources, including the National Alliance for Model State Drug Laws, NCIPC, Centers for Disease Control and Prevention, the Alliance of States with Prescription Drug Monitoring Programs, the National Conference of State Legislators, the Network for Public Health Law, the Kaiser Family Foundation and a review of current state legislation and regulations by TFAH. In August 2013, state health departments were provided with opportunity to review and revise their information.
10 out of 10: New Mexico and Vermont
9 out of 10: Kentucky, Massachusetts, New York and Washington
8 out of 10: California, Colorado, Connecticut, Delaware, Illinois, Minnesota, North Carolina, Oklahoma, Oregon, Rhode Island and West Virginia
7 out of 10: Florida, Nevada, New Jersey, Tennessee and Virginia
6 out of 10: Arkansas, District of Columbia, Georgia, Hawaii, Iowa, Louisiana, Maryland, Michigan, North Dakota, Ohio, Texas and Utah
5 out of 10: Alaska, Idaho, Indiana, Maine, Mississippi, Montana, New Hampshire and South Carolina
4 out of 10: Alabama, Arizona, Kansas, Pennsylvania, Wisconsin and Wyoming
3 out of 10: Missouri and Nebraska
2 out of 10: South Dakota
STATE-BY-STATE DRUG OVERDOSE MORTALITY RANKINGS
Note: Rates include total drug overdose mortality rates, the majority of which are from prescription drugs. 1 = Highest rate of drug overdose fatalities, 51 = lowest rate of drug overdose fatalities. Rankings are based on data from CDC’s National Center for Health Statistics, WONDER Online Database, 2010. The numbers are based on the number of people per 100,000.
1. West Virginia**** (28.9); 2. New Mexico (23.8); 3. Kentucky**** (23.6); 4. Nevada (20.7); 5. Oklahoma*** (19.4); 6. Arizona (17.5); 7. Missouri*** (17); 8. (tie) Tennessee** and Utah (16.9); 10. Delaware** (16.6); 11. Florida** (16.4); 12. Ohio*** (16.1); 13. Rhode Island** (15.5); 14. Pennsylvania (15.3); 15. Wyoming*** (15); 16. South Carolina*** (14.6); 17. Indiana**** (14.4); 18. Michigan*** (13.9); 19. Louisiana*** (13.2); 20. Washington (13.1); 21. (tie) District of Columbia and Montana** and Oregon** (12.9); 24. Colorado (12.7); 25. Arkansas** (12.5); 26. (tie) Alabama*** and Idaho** and New Hampshire** (11.8); 29. Alaska (11.6); 30. (tie) Mississippi***and North Carolina** (11.4); 32. (tie) Maryland and Massachusetts (11); 34. (tie) Hawaii and Wisconsin** (10.9); 36. Georgia*** (10.7); 37. California (10.6); 38. Maine (10.4); 39. Connecticut (10.1); 40. Illinois (10); 41. New Jersey (9.8); 42. Vermont** (9.7); 43. (tie) Kansas** and Texas (9.6); 45. Iowa**** (8.6); 46. New York (7.8); 47. Minnesota** (7.3); 48. Virginia (6.8); 49. Nebraska** (6.7); 50. South Dakota (6.3); 51. North Dakota (3.4).
** Drug Overdose Mortality Rates doubled from 1999 to 2010
*** Drug Overdose Mortality Rates tripled from 1999 to 2010
**** Drug Overdose Mortality Rates quadrupled from 1999 to 2010
Trust for America’s Health is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make diseaseprevention a national priority. For more information, visit www.healthyamericans.org.
From the 20 October 2013 article at Science Daily
Revealing influenza’s truly insidious nature, Whitehead Institute scientists have discovered that the virus is able to infect its host by first killing off the cells of the immune system that are actually best equipped to neutralize the virus.
Confronted with a harmful virus, the immune system works to generate cells capable of producing antibodies perfectly suited to bind and disarm the hostile invader. These virus-specific B cells proliferate, secreting the antibodies that slow and eventually eradicate the virus. A population of these cells retains the information needed to neutralize the virus and takes up residence in the lung to ward off secondary infection from re-exposure to the virus via inhalation.
Read the entire article here
High-fructose corn syrup for sale (Photo credit: Steven Vance)
From the 20 October 2013 post at someone somewhere – from beyond the rainbow somewhere
According to The Illinois Environmental Protection Agency: Mercury poses a health risk to everybody but especially to young children and fetuses because they’re still developing. Prolonged low level exposure may cause learning disabilities by hurting the ability of children to think and read. Adults who have been exposed to high levels of mercury may experience trembling hands and numbness or tingling in their lips, tongues, fingers, and toes. Acute mercury poisoning especially through ingestion, can damage the brain, liver, kidneys, and even cause death.
Research published in Environmental Health and conducted in part by a scientist at the Institute for Agriculture and Trade Policy has revealed that high-fructose corn syrup (HFCS) is contaminated with the toxic heavy metal mercuryHigh-fructose corn syrup is used in almost everything, it seems. A second study conducted by David Wallinga, M.D., entitled “Not So Sweet: Missing Mercury andHigh Fructose Corn Syrup” reveals that nearly one-third of all grocery items sweetened with HFCS were contaminated with mercury
WHERE DOES ALL THE MERCURY COME FROM?
Most people don’t know how high-fructose corn syrup is really made. One of those processes is a bizarre chemical brew involving the creation of caustic soda by exposing raw materials to pools of electrified mercury in a large vat. Through this process, the caustic soda gets contaminated with mercury, and when corn kernels are exposed to this caustic soda to break them down, that contamination is passed through to the HFCS.
Another toxic chemical, glutaraldehyde, is also used in the production of HFCS. It’s so toxic that consuming even a small amount of it can burn a hole in your stomach.
Read the entire article here
From the 14 October Cover Story at Chemical and Engineering News
Many people assume that the chemicals in their detergents, floor cleaners, and other household products have undergone rigorous safety testing. But little is known about the potential risks associated with most of the estimated 80,000 chemicals in commerce today.
While industry tries to dispel links to illnesses that go beyond what science can prove, the public is skeptical because companies have a financial stake in showing their products are safe. This leads both sides to look to the federal government for help.
The agency charged with overseeing the safety of chemicals in the marketplace is the Environmental Protection Agency. EPA has the authority to require industry to provide extensive toxicity data for pesticides. But for most other chemicals, EPA must show that a substance is likely to be a risk to human health or the environment in order to require industry to provide safety data. Manufacturers don’t often give toxicity data to EPA voluntarily, nor does the agency have the resources to assess tens of thousands of chemicals using traditional in vivo rodent-based studies.
Instead, EPA has turned to computational modeling. One ambitious effort, called ToxCast, aims to screen thousands of chemicals for biological activity using about 600 high-throughput biochemical and cell-based assays. The data are then integrated with existing in vivo animal toxicity data and structure-activity information to predict toxicity.
But ToxCast has had problems. Most of the assays were developed for drug discovery, not to assess the hazards of chemicals in the environment. For example, thyroid-disrupting compounds in the environment can work through multiple pathways, but commercial tests focus on just one—a chemical binding to the thyroid receptor. If a chemical acts on a different pathway it will test negative, even though it does disrupt the thyroid.
Links jobs and hazardous tasks with occupational diseases and their symptoms.
Information on the health effects of common household products under your sink, in the garage, in the bathroom and on the laundry room shelf.
Maps of hazardous chemicals with links to related health resources.
Interactive game for 7-11 years olds with lessons about household chemical hazards.
An interactive guide about how the environment, chemicals and toxic substances affect human health.
Tox Town en español
From the 14 October post at Science Blogging – Science 2.0
A new paper suggests that lifestyle advice for people with diabetes should be no different from that for the general public – but diabetes may benefit more from that same advice.
In the study, the researchers investigated whether the associations between lifestyle factors and mortality risk differ between individuals with and without diabetes.
Within the European Prospective Investigation into Cancer and Nutrition (EPIC), a cohort was formed of 6,384 persons with diabetes and 258,911 EPIC participants without known diabetes. Computer modelling was used to explore the relationship (in both those with and without diabetes) of mortality with the following risk factors: body-mass index, waist/height ratio, 26 food groups, alcohol consumption, leisure-time physical activity, smoking.
The researchers found that overall mortality was 62% higher in people with diabetes compared with those without. Intake of fruit, vegetables, nuts, seeds, pasta, poultry and vegetable oil was related to a lower mortality risk, and intake of butter and margarine was related to an increased mortality risk.
While the strength of the association was different in those with diabetes versus those without, the associations were in the same direction in each case (see table 2 full paper). No differences between people with and without diabetes were detected for the other lifestyle factors including adiposity, alcohol consumption, physical activity, and smoking.
The authors say: “It appears that the intake of some food groups is more beneficial (fruits, legumes, nuts, seeds, pasta, poultry, vegetable oil) or more detrimental (soft drinks, butter, margarine, cake, cookies) with respect to mortality risk in people with diabetes. This may indicate that individuals with diabetes may benefit more from a healthy diet than people without diabetes. However, since the directions of association were generally the same, recommendations for a healthy diet should be similar for people with or without diabetes.”
From the 18 September 2013 post by Michelle Kraft at the Krafty Librarian
I just read a brief perspective article in the journal Evidence Based Medicine, “Medical apps for smartphones: lack evidence undermines quality and safety.” It is a quick little read and it brings up some very real and interesting points which I will try to summarize.
- There is no official vetting system for medical apps – Some apps are blatantly wrong and dangerous, some are out of date therefore also dangerous.
- Lack of information and clinical involvement in the creation of the apps – There is a paucity of information regarding the creator of the app. Some apps have no physician involvement.
- Companies (authors specifically mention Pharma) creating apps could create conflicts of interest and ethical issues – Pharma apps could produce drug guides or clinical decision tools that subtlety push their own products.
The FDA will regulate some apps but not all. The FDA will regulate apps that control a medical device or displays, stores, analyzes patient data (example: electrocardiogram). They will also regulate apps that use formulas or algorithms to give patient specific results such as diagnosis, treatment, recommendation or differential diagnosis. Finally they will regulate apps that transform a mobile device into a medical device (example: apps that use attachments or sensors to allow the smartphone to measure blood glucose).
That still leaves a ton of medical apps hanging out there in the app stores which are largely unregulated. The article states, “Until now, there has been no reported harm to a patient caused by a recalled app. However, without app safety standards, it is only a matter of time before medical errors will be made and unintended harm to patient will occur.” Basically it is the Wild West in the medical app arena.
There are two groups that are trying to evaluate medical apps. iMedicalApps.com and the Medical App Journal review various apps directed toward medical professionals. I take issue with the article authors who state these sites are a “good starting point for peer-reviewing apps, the current assessment criteria do not address the scientific evidence for their content, but rather matters of usability, design, and content control.” While I don’t use the Medical App Journal as often, I use iMedicalApps.com quite often and they do more than just assess the usability and design. I have read reviews where they question the medical correctness of apps, intended audience, and have even pushed for more information regarding authorship/responsibility. Several of their reviews questioned an app’s update schedule and updated content. They have also investigated, questioned, and reported instances of fraud and plagiarism with medical apps. I think iMedicalApps does a very good job in a very flooded market, but there are areas for improvement. As with any website that relies on a large number of reporters/reviewers, there is some variance in the quality based on the reviewer. I haven’t found any reviews that are bad, just some are better and more thorough than others. Perhaps a little more explanation or transparency regarding how they determine the accuracy or validity of medical app might be helpful, or a standardized checklist about the things they look at. I realize evaluating the latest UpToDate app is different compared to an app on EKGs. UpToDate already has an established proven product where as there is more to investigate and validate with an app that isn’t a version of an already established product.
The authors believe the medical community needs to be more involved with regulating medical apps. They suggest:
- Official certification marks guaranteeing quality
- Peer review system implemented by physicians’ associations or patient organizations
- Making high quality apps more findable by adding them to hospital or library collections
1. I like the idea of having an official certification indicating quality, but there are two things that must be addressed prior to that.
First you have to get the organizations to actually take responsibility for looking at apps that are in their area of expertise. The field is already cumbersome, I am not sure many organizations are able to handle that. Although I have found that several journals have now included app reviews. While they can’t come close to scratching the surface of medical apps, these journals often have MDs, RNs, MPTs writing reviews and evaluating the content. Specifically I have found some good reviews in the physical therapy and nursing journals.
Second, there is growing problem with fake certifications. If an app is created by a company or people who already don’t care about its accuracy or is a plagiarizing a product, they probably have no qualms about lifting the image of the certification and posting it on their website. They could create their own certifications to fake (but legit sounding) orgs and post those on their app’s site too. Official certification is a good idea and I like it but there needs to be more to it to make sure it truly represents quality.
2. I personally believe the writers at iMedicalApps.com are on their way to something of a peer review system. Right now they only have one person review an app. While that completely makes sense from a writing perspective, perhaps they can implement some sort of peer review process where more than just one person is reviewing the app, yet still retain the one voice post for ease of reading. Perhaps they could reach out to a few medical professionals who are leaders in their field to review specific apps. Thus giving the reviewed app a little bit more weight. This along with astandardized check list or illustrating how they review the medical accuracy of an app would make the information on their site even more important and provide an excellent way of separating the wheat from the chaff.
3. An online repository of approved apps would be great. Some hospital IT departments that have mobile device policies have this, but they seem to be only hospital type apps like Citrix or database subscription apps like LexiComp, PubMed, UpToDate, etc. While these apps are important, there is little worry about apps like LexiComp, UpToDate, or PubMed because they were well established medical information products before their app. Their app is just an extension of their verified product. I don’t see a lot of IT departments that have investigated having a pool of apps that aren’t hospital specific or from database subscriptions. Additionally, IT would either need to rely on an outside sources like iMedicalApps or content experts within the field in that hospital to build the app pool. IT would have no way of verifying the authenticity and validity of an app on pediatric emergency medicine.
Finally, getting hospitals to buy bulk licenses to apps is tricky at best. With exception of a few places like Epocrates, Unbound Medicine, Inkling, and Skyscape (many of those companies dealt with institutional subscriptions before app stores….remember PDAs?) there are very few places that sell or license apps to a group of people. The purchasing of apps was created as an individual service. Now academic medical centers may have a foot in the door with iTunes U, but I have heard that discussions with Apple and their app store and hospitals is an “interesting” process. The same principle applies to library repositories. Instead of IT aggregating the apps, the library would do that. There are a lot of library’s that already have great lists suggesting various medical apps. But the vast majority of medical libraries have app resources guides, suggesting apps that the individual must buy. Also just like with an IT repository of apps, the librarian must rely on sites like iMedicalApps.com or their own physician suggestions to ensure they are listing quality apps.
Like I said it is the Wild West when it comes to medical apps. That is because the whole app industry is a new frontier. There are quality and accuracy problems with other apps in the app stores. A pedometer app with errors is not going to kill somebody, but an inaccurate medical app can. Yes, the medical community needs to get involved in evaluating apps, but so does Apple and Google. Right now Apple’s iTunes store feedback and ranking system while good for games, is not adequate for medical apps and can easily be subject to fraud. Additionally, Apple is extremely tight lipped about its app store rules and regulations. Some apps have extreme difficulty getting approved, while others fly through approval process only to be mysteriously removed later. There is no transparency to the Apple App Store. For example, there is no information about the app Critical APPraisal which was determined to be a plagiarized version of Doctor’s Guide to Critical Appraisal. The app was available in the App Store July 2011. However, if you searched today for the app, you wouldn’t be able to find it in the App Store, it simply disappeared. Unless you happen to read the article in BMJ, iMedicalApps.com, or a few other British publications, you would have no clue as to why the app was removed. When it comes to dangerous apps, disappearing them from the App Store is not good enough. You must have transparency when it comes to medicine.
According to an updated BMJ article, the doctors accused of plagiarizing The Doctor’s Guide to Critical Appraisal to use in their app Critical APPraisal, have been cleared of plagiarism by the Medical Practitioners Tribunal Service.
“A regulatory panel rejected charges by the General Medical Council (GMC) that Afroze Khan, Shahnawaz Khan, and Zishan Sheikh acted dishonestly in knowingly copying structure, contents, and material from a book, The Doctor’s Guide to Critical Appraisal, when developing their Critical APPraisal app, representing it as their own work, and seeking to make a gain from the material.”
Shahnawaz Khan and Afroze Khan were also accused of dishonestly posting positive reviews of the app on the Apple iTunes Store without disclosing that they were co-developers and had a financial interest in the app. The GMC found that Shahnawaz Khan no evidence that he knew that the app, which was initiallly free, would later sold for a fee. His case was concluded without any findings. However, the GMC panel found that “Afroze Khan’s conduct in posting the review was misleading and dishonest.” Yet they considered this type of dishonesty to be “below the level that would constitute impairment of this fitness to practise.” The GMC panel said it was an isolated incident and did not believe it would be repeated in which they “considered his good character and testimonials attesting to his general probity and honesty and decided not to issue a formal warning.”
Free and low cost Health Apps in this section include:
And these may be helpful when selecting health apps
- 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
Environmental Protection Agency Seal (Photo credit: DonkeyHotey)
From the 9 September 2013 EPA press release
Release Date: 09/09/2013
Contact Information: Cathy Milbourn, Milbourn.email@example.com, 202-564-7849, 202-564-4355
WASHINGTON – The U.S. Environmental Protection Agency (EPA) has launched a web-based tool, called ChemView, to significantly improve access to chemical specific regulatory information developed by EPA and data submitted under the Toxic Substances Control Act (TSCA).
“This online tool will improve access to chemical health and safety information, increase public dialogue and awareness, and help viewers choose safer ingredients used in everyday products,” said James Jones, assistant administrator for the Office of Chemical Safety and Pollution Prevention. “The tool will make chemical information more readily available for chemical decision-makers and consumers.”
The ChemView web tool displays key health and safety data in an online format that allows comparison of chemicals by use and by health or environmental effects. The search tool combines available TSCA information and provides streamlined access to EPA assessments, hazard characterizations, and information on safer chemical ingredients. Additionally, the new web tool allows searches by chemical name or Chemical Abstracts Service (CAS) number, use, hazard effect, or regulatory action. It has the flexibility to create tailored views of the information on individual chemicals or compare multiple chemicals sorted by use, hazard effect or other criteria. The new portal will also link to information on manufacturing, processing, use, and release data reported under the Chemical Data Reporting Rule, and the Toxics Release Inventory.
In the months ahead, EPA will be continuously adding additional chemicals, functionality and links. When fully updated, the web tool will contain data for thousands of chemicals. EPA has incorporated stakeholder input into the design, and welcomes feedback on the current site.
By increasing health and safety information, as well as identifying safer chemical ingredients, manufacturers and retailers will have the information to better differentiate their products by using safer ingredients.
In 2010, EPA began a concerted effort to increase the availability of information on chemicals as part of a commitment to strengthen the existing chemicals program and improve access and usefulness of chemical data and information. This included improving access to the TSCA inventory, issuing new policies for the review of confidential business information claims for health and safety studies, and launching the Chemical Data Access Tool. Today’s launch of the ChemView provides the public with a single access point for information that has been generated on certain chemicals regulated under TSCA.
View and search ChemView: http://www.epa.gov/chemview
From the 10 October 2013 article at newswise
[From the article abstract - The Drug-Gene Interaction database (DGIdb) mines existing resources that generate hypotheses about how mutated genes might be targeted therapeutically or prioritized for drug development. It provides an interface for searching lists of genes against a compendium of drug-gene interactions and potentially 'druggable' genes. DGIdb can be accessed at http://dgidb.org/.]
Newswise — Researchers at Washington University School of Medicine in St. Louis have created a massive online database that matches thousands of genes linked to cancer and other diseases with drugs that target those genes. Some of the drugs are approved by the U.S. Food and Drug Administration, while others are in clinical trials or just entering the drug development pipeline.
The database was developed by identical twin brothers, Obi Griffith, PhD, and Malachi Griffith, PhD, whose interest in pairing drugs with genes is as much personal as it is scientific. Their mother died of breast cancer 17 years ago, just weeks before their high school graduation.
“We wanted to create a comprehensive database that is user-friendly, something along the lines of a Google search engine for disease genes,” explained Malachi Griffith, a research instructor in genetics. “As we move toward personalized medicine, there’s a lot of interest in knowing whether drugs can target mutated genes in particular patients or in certain diseases, like breast or lung cancer. But there hasn’t been an easy way to find that information.”
Details of the Drug Gene Interaction database are reported online Oct. 13 in Nature Methods. The database is weighted heavily toward cancer genes but also includes genes involved in Alzheimer’s disease, heart disease, diabetes and many other illnesses. The Griffiths created the database with a team of scientists at The Genome Institute at Washington University in St. Louis.
The database is easy to search and geared toward researchers and physician-scientists who want to know whether errors in disease genes – identified through genome sequencing or other methods – potentially could be targeted with existing drug therapies. Additional genes included in the database could be the focus of future drug development efforts because they belong to classes of genes that are thought to make promising drug targets.
“Developing the database was a labor of love for the Griffiths,” said senior author Richard K. Wilson, PhD, director of The Genome Institute. “There’s an amazing depth to this resource, which will be invaluable to researchers working to design better treatment options for patients.”
Wilson and his colleagues caution that the database is intended for research purposes and that it does not recommend treatments. The primary purpose of the database is to further clinical research aimed at treating diseases more effectively.
“This database gets us one step closer to that goal,” Malachi Griffith said. “It’s a really rich resource, and we’re excited to make it available to the scientific community.”
The database, which took several years to develop, is publicly available and free to use. It includes more than 14,000 drug-gene interactions involving 2,600 genes and 6,300 drugs that target those genes. Another 6,700 genes are in the database because they potentially could be targeted with future drugs.
Before now, researchers wanting to find out whether disease genes could be targeted with drugs had to search piecemeal through scientific literature, clinical trials databases or other sources of information, some of which were not publicly available or easily searchable. Further, many of the existing databases have different ways of identifying genes and drugs, a “language” barrier that can turn a definitive search into an exhaustive exercise.
The Griffith brothers are experts in bioinformatics, a field of science that integrates biology and computing and involves analyzing large amounts of data. The brothers got the idea for the drug-gene interaction database after they repeatedly were asked whether lists of genes identified through cancer genome sequencing could be targeted with existing drugs.
“It shouldn’t take a computer wizard to answer that question,” said Obi Griffith, research assistant professor of medicine. “But in reality, we often had to write special software to find out. Now, researchers can quickly and easily search for themselves.”
The new database brings together information from 15 publicly available databases in the United States, Canada, Europe and Asia. Users can enter the name of a single gene or lists of many genes to retrieve drugs targeting those genes. The search provides the names of drugs targeted to each gene and details whether the drug is an inhibitor, antibody, vaccine or another type. The search results also indicate the source of the information so users can dig deeper, if they choose.
The research is supported by a grant (U54 HG003079) from the National Human Genome Research Institute at the National Institutes of Health (NIH).
Griffith M, Griffith OL, Coffman AC, Weible JV, McMichael JF, Spies NC, Koval J, Das I, Callaway MB, Eldred JM, Miller CA, Subramanian J, Govindan R, Kumar RD, Bose R, Ding L, Walker JR, Larson DE, Dooling DJ, Smith SM, Ley TJ, Mardis ER and Wilson RK. DGIdb – Mining the druggable genome. Nature Methods. Oct. 13, 2013.
Washington University School of Medicine’s 2,100 employed and volunteer faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children’s hospitals. The School of Medicine is one of the leading medical research, teaching and patient care institutions in the nation, currently ranked sixth in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children’s hospitals, the School of Medicine is linked to BJC HealthCare.
Influenza (Photo credit: hesenrre)
From the 13 October 2013 post at The Health Care Blog By IYUE SUNG
As Washington remains deadlocked on the implementation of the Affordable Care Act, the US government’s shutdown has resulted in the furlough of nearly 70% of the Centers for Disease Control‘s (CDC’s) workforce. CDC Director Tom Frieden recently shared his thoughts in a tweet. We agree whole-heartedly. Although it’s all too easy to take the CDC staff for granted, they are the frontline sentinels (and the gold standard) for monitoring disease outbreaks. Their ramp-down could have serious public health consequences.
We are particularly concerned about the apparent temporary discontinuation of the CDC’s flu surveillance program, which normally provides weekly reports on flu activity. Although flu season typically begins in late fall, outbreaks have occurred earlier in previous years. In 2009, flu cases started accumulating in late summer/early fall. And given the potential for unique variants, such as the swine or avian flu, every season is unpredictable, making the need for regular CDC flu reports essential. We therefore hope to see the CDC restored to full capacity as soon as possible.
In the meantime, we would like to help by sharing data we have on communicable diseases, starting with the flu.
Because the athenahealth database is built on a single-instance, cloud-based architecture, we have the ability to report data in real time. As we have described in earlier posts, the physicians we serve are dispersed around the country with good statistical representation across practice types and sizes.
To get a read on influenza vaccination rates so far this season, we looked at more than two million patients who visited a primary care provider between August 1 and September 28, 2013 (Figure 1). We did not include data on vaccinations provided at retail clinics, schools or workplaces.
This year’s rates are trending in parallel to rates over the last four years, and slightly below those of the 2012-2013 season. However, immunizations accelerate when the CDC, and consequently the media, announce disease outbreaks and mount public awareness campaigns.
As for the government shutdown, nearly everyone hopes for a quick end. Should the standoff drag on, detection of the flu (or other diseases) may be delayed, in theory endangering the public. Fortunately, we currently see no evidence of an early influenza outbreak. But recent history shows that the flu can begin spreading at any time, and once it does begin, it spreads very quickly, as shown in Figure 2.
We believe that our data provides a reliable view of seasonal flu trends. Last year, wewrote about the 2012-2013 flu season and found that patterns in our patient population (consisting of a large proportion of patients receiving immunizations in primary care settings) closely mirrored CDC trends. With that in mind, we believe that sharing our 2013-2014 data would be valuable to the health care community.
Whether our nation’s politicians can come to an agreement tomorrow or next month, we will continue to deliver reports that monitor population health and look ahead to contributing any information we can. If you have any suggestions or comments – on the flu or other diseases where up-to-date data would be valuable – please leave a comment here or e-mail me directly at firstname.lastname@example.org.
Iyue Sung is the Director of Core Analytics at athenahealth. The post originally appeared on the athenahealth blog.
English: Close up shot of some high quality marijuana. (Photo credit: Wikipedia)
From the 8 October 2013 ScienceDaily article
High school seniors who frown upon the use of drugs are most likely to be female, nonsmokers or hold strong religious beliefs, according to a study¹ by Joseph Palamar of New York University. Palamar examines how teenagers’ attitudes toward marijuana influenced their thoughts on the further use of other illicit drugs. The work appears online in the journal Prevention Science², published by Springer.
The study was conducted as marijuana use continues to be on the upswing in the United States, along with more lenient legislation and diminishing public disapproval toward its use. Although previous research has shown that people who disapprove of a particular drug will in all likelihood not use it, little is known about how the use of one drug affects people’s attitudes toward using other drugs.
Palamar therefore examined how demographics and a lifetime use of various drugs — marijuana use in particular — can predict if a person will become partial to using “harder” and more dangerous drugs, such as powder cocaine, crack, LSD, heroin, amphetamine and ecstasy, also known as “Molly.” Data was obtained from 29,054 high school seniors who took part in the Monitoring the Future annual cross-sectional survey of approximately 130 public and private schools in 48 states between 2007 and 2011.
Palamar found that youths who smoked cigarettes or used more than one “hard” drug were consistently less critical of other drug use. The lifetime use of alcohol had no impact on people’s attitudes. Those who used only marijuana tended to be less judgmental of further using such so-called “socially acceptable” drugs as LSD, amphetamine and ecstasy. They did not approve of cocaine, crack or heroin, however, most likely because of their perceived dangers and addictive qualities.
Unsurprisingly, female high school seniors consistently disapproved of using cocaine, crack, LSD and ecstasy. Compared to their male counterparts, females are generally less likely to use most drugs. Palamar was also not surprised by the finding that religiosity robustly increased attitudes against drug use, as it is a major force in societal values.
Youths from more advantaged socio-economic backgrounds with highly educated parents as well as those living in urban areas were much less disapproving of the use of the so-called “less dangerous” drugs. Palamar believes that the higher prevalence of illicit drug use in urban areas may be helping to normalize drug use in cities.
The finding that Black students are less disapproving of powder cocaine, crack and ecstasy is somewhat paradoxical as members of this group generally use such drugs less than White students do. This could, in part, be explained by their strong religious beliefs and the higher rates of arrests and incarceration among Blacks that may serve as a deterrent. The normalization of ecstasy, specifically in rap and hip-hop music, may explain why Black youths are less disapproving of it.
“Public health and policy experts need to ensure that the use of other drugs does not increase in light of the growing prevalence of marijuana use and more lenient policies surrounding it,” Palamar explains. “Although it may be difficult to prevent an adolescent or a young adult from using alcohol, tobacco or marijuana, we need to prevent individuals from becoming users of multiple drugs.”
In memory of my mother-in-law who had severe osteoarthritis…
From the 8 October 2013 EurekAlert
(CHICAGO) – The results of a new study by bone and joint experts at Rush University Medical Center suggest that patients with knee osteoarthritis (OA) who wear flat, flexible footwear, which allows natural foot mobility and provide sufficient support for the foot, had significant reduction in knee loading—the force placed upon the joint during daily activities.
Findings from the study were published in an issue of Arthritis & Rheumatism, a journal of the American College of Rheumatology (ACR).
The research led by Dr. Najia Shakoor, a rheumatologist at Rush, shows that long term use of the such footwear, called “mobility shoes,” helped OA patients adapt their gait or how they walk, which improved knee loading, even when the mobility shoes were no longer worn.
In previous studies, Shakoor and colleagues from Rush found that walking barefoot as well as with ‘mobility shoes,’ which are designed to mimic barefoot mechanics, was linked to reduced knee loading compared to when walking with regular footwear worn by participants. However, the authors thought the long-term effects of the specialized footwear need further studying.
“There is much interest in biomechanical interventions, such as orthotic inserts, knee braces, and footwear that aim to improve pain and delay OA progression by decreasing impact on joints,” said Shakoor, the principal investigator of the study who is also an associate professor in the department of internal medicine at Rush. “In the present study, we expand understanding of our earlier research by evaluating the impact of the mobility footwear on gait after six months of use.”
More than 27 million Americans over the age of 25 have some form of OA, which causes painful swelling and stiffness in the hand, foot, knee or hip joints. According to existing research, doctor-diagnosed arthritis will swell to 67 million U.S. adults by 2030. Furthermore, the Centers for Disease Control and Prevention (CDC) estimate that 16% of adults 45 years of age and older are burdened with symptomatic knee OA.
The Rush team recruited 16 participants with knee OA, obtaining a baseline gait with participants walking in their own shoes, mobility shoes and barefoot. Participants wore the mobility shoes for six hours each day for six days per week and patient gait was evaluated at 6, 12 and 24 weeks in all conditions.
Findings suggest that by 24 weeks, participants wearing mobility footwear saw an 18 percent reduction in knee adduction moment (KAM), which is the load on the inner or medial aspect of the knee when walking compared to baseline knee loading in their own footwear. This is where most people develop knee OA.
No significant difference in KAM was found between walking with mobility shoes and barefoot. Compared to baseline, analyses indicate an 11 percent and 10 percent reduction in KAM for OA patients walking in their own shoes and barefoot, respectively, suggesting the mobility shoes may have “re-trained” participant’s gait.
“Patients with OA who use flat, flexible footwear may experience a significant reduction in knee loading with continued use,” said Shakoor. “Our investigation provides evidence that footwear choice may be an important consideration in managing knee OA.
The Rush research team involved in the study includes Roy H. Lidtke, Markus A. Wimmer, Rachel A. Mikolaitis, Kharma C. Foucher, Laura E. Thorp, Louis F. Fogg and Joel A. Block.
Please note: Based on the study results, a patented shoe design called X-Sole Relief Technology in Flex-OA has been developed by Dr. Comfort. The shoe has been available on the market since January 2013.
From the 12 October 2013 article at Time- Health and Family
New research for the University of Guelph shows that the majority of herbal products on the market contain ingredients that are not listed on their labels.
The study, published in the journal BMC Medicine, used DNA barcoding technology to assess the components of 44 herbal products from 12 companies. They found that 60% of the products contained plant species that were not listed on the label, and 20% used fillers like rice, soybeans, and wheat which were also not divulged on the bottles.
For instance, products sold as St. John’s wort supplement, which is sometimes used to treat depression, contained Senna alexandrina, which is a plant that spurs laxative symptoms. Other products contained Parthenium hysterophorus (feverfew), which is known to cause swelling and mouth numbness. One ginkgo product contained Juglans nigra (black walnut), which should not be consumed by people with nut allergies — but this warning was not noted on the label.
“It’s common practice in natural products to use fillers such as these, which are mixed with active ingredients. But a consumer has a right to see all of the plant species used in producing a natural product on the list of ingredients,” lead author Steven Newmaster, an integrative biology professor at the Guelph-based Biodiversity Institute of Ontario said in a statement.
Read more: http://healthland.time.com/2013/10/12/food-allergics-beware-herbal-products-may-contain-surprise-ingredients/#ixzz2hgeN2Srs
Methicillin-resistant Staphylococcus aureus Bacteria (Photo credit: NIAID)
From the 5 October 2013 post at Time- Health & Family
Bacterial infections can imperil the fragile patients at hospitals‘ intensive care units. And a new study reveals an unlikely spreader: the health care workers who treat them. The standard sterile hospital garb typically thought to prevent infections isn’t helping.
Physical barriers are the most effective way to block invisible intruders like the bacteria responsible for methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE) infections, which are among the most common hospital-acquired pathogens. Such strains, which are resistant to most antibiotic treatments, contribute to more than $4 billion in health care costs for treating the skin lesions, respiratory symptoms and sepsis that the bacteria cause.
It’s hardly been clear that requiring all health care workers to put on gowns and gloves before visiting each patient, then discarding and re-robing before visiting the next patient, would help to reduce the spread of such infections in ICUs. The Centers for Disease Control currently recommends that workers suit up with gowns and gloves before caring for patients with known MRSA or VRE infections, but researchers led by Dr. Anthony Harris at the University of Maryland School of Medicine wanted to see how effective universal gowning and gloving would be in lowering the number of new cases of disease in ICUs.
Read more: http://healthland.time.com/2013/10/05/gloves-and-gowns-dont-stop-spread-of-all-infections-in-hospitals/#ixzz2hgctzzKb
From the 4 October 2013 post at Straight, No Chaser by Dr. Sterling
Ever notice that people run straight to the medicine cabinet to do harm to themselves or others? I want you to know the harder the effort is to obtain items to hurt oneself, the less likely one is to follow through on the notion. On another related note, here’s a quick not-so-fun-but-interesting fact. One of the differences between America and say, certain European countries is the oversized influence of corporations in the States. Why am I talking about that on a medical blog? Read on. If you can’t tell where I’m going with this, you’ll get it pretty quickly.
Here’s my top five items I want you to take out your medicine cabinets and lock up.
1. Any jumbo sized container of any medication. Think about two of the most common over the counter (OTC) medications used for suicide attempts: acetaminophen (Tylenol) and salicylate (aspirin). One thing they have in common is you can buy what amounts to a tub-full of it at your local superstore in the United States. They should call these things ‘suicide quantities’, because often those in the midst of a suicide attempt will grab and swallow whatever is convenient. Many different medications will hurt you if you take enough; Tylenol and aspirin certainly fit that bill. Observing that (and additional considerations after the deaths due to the lacing of Tylenol with cyanide back in 1983), the Brits decided to not only pass a law limiting quantities, but certain medications that are high-frequency and high-risk for suicide use are now mandatorily dispensed in those annoying containers that you have to pop through the plastic container. Needless to say, observed suicide rates by medication rates plummeted as a result. Wonder why that hasn’t been implemented in the good ol’ USA?
2. Have teens in your house? Lock up the Robitussin and NyQuil.
Read the entire article here
From the 10 September post at Groping Towards Bethelem - Economics and Culture in Bite-Size Pieces
The University of Otago announced the results of some research in which I’ve been involved. The relevant blog post is here. What I really like about the post is the moderate tone:
In the first paper from the SPEND Project, we found that across 20-odd food groups, low-income people and Māori tended to change their consumption of foods more in response to price changes, using New Zealand data. This is entirely consistent with economic theory – and data about price impacts for other consumer goods such as tobacco.
This suggests – but does not prove for reasons we outline below – that taxes on ‘unhealthy’ foods like those high in saturated fat, salt, and sugar; and subsidies on ‘good’ foods like fruit and vegetables should not only improve diets across the board, but more so among socially disadvantaged groups with worse diets and health to start with.
But the proof is in the pudding, which in this case is the health and economic modelling to see what effect taxes and subsidies will actually have on disease rates. And due to data limitations our modelling is still only half-baked, no matter which research group’s findings you look at.
The post goes on from there and explains more about the different bits of research.
Of course, there are all the problems with implementing such tax/subsidy programmes, and the philosophical issues with ‘nudges’ and individual welfare. But importantly, we now have better estimates of prices elasticities in order to make better calculations about gains and losses.
From the 11 October 2013 post at Cardiac Exercise Research Group – The K.G. Jebsen Center for Exercise in Medicine’s blog about exercise and cardiac health
There remains little doubt that lack of exercise and a sedentary lifestyle represent key health problems in today’s modern society. A quick search on the World Health Organisation’s (WHO) website and you’ll find that physical inactivity ranks 4th in the global leading risk factors for mortality, with many countries around the world demonstrating a trend for women to be less active than men. While health organisations around the world are making a concerted effort to encourage the general public to incorporate exercise into their leisure and free time, this may not be the only period of our day that is dominated by sedentary behavior. Work forms one of the largest segments of sedentary time for employed individuals, and current trends have shifted parts of the working population into less active, ‘sitting’ jobs.
But what does this mean for our long-term health? One study, published last month in PLoS ONE, aimed to answer this question by assessing the impact of occupational sitting on the risk of cancer, cardiovascular disease, and all-cause mortality from a large number of British men and women. Stamatakis and colleagues gathered data from identical health surveys conducted in England and Scotland between 1994 and 2004. Subjects (5380 women, 5788 men) were classified based on whether the majority of time in their job was spent walking, standing or sitting. Subjects were further categorized on levels of physical activity during free time, alcohol intake, smoking, socioeconomic status, and whether they had cardiovascular disease or cancer at the time of the survey. The mortality rate (number of deaths) was then monitored over a 13 year follow-up period.
The major findings reported by this study were that standing/walking occupations carried a lower risk of mortality from either all-causes or cancer, in women but not men. When the researchers further compared groups based on free-time physical activity levels, they found that in both men and women, high levels of free-time physical activity coupled with a standing/walking occupation was associated with a lower risk of cancer and all-cause mortality versus low free-time activity coupled with sitting occupation. At first glance, it could be easy to take the results at face value, but there are limitations to the study design which the authors themselves highlight: Much of the data is self-reported, which may introduce bias, especially when it comes to levels of physical activity during free-time. In addition, there was no information available on how long individuals had been in their current jobs, nor was there any data for people switching jobs during the 13 year follow-up, which may have eventually placed them into a different category. The findings are also surprising given that a similar study published earlier in the year, found that even moderate free-time exercise was enough to reduce the risk of both cardiovascular and all-cause mortality, regardless of levels of physical activity in work.
The issue still seems unresolved, and it has also been discussed here on the blog earlier. Current exercise recommendations from the Norwegian Directorate of Health suggest daily physical activity levels should be at least 30 min, a total 3.5 hours per week, which has been shown in a number of studies to confer significant benefits to health and an overall decrease in mortality rates. However, a busy lifestyle, coupled with raising a family may make this target difficult to reach during our leisure time, making activity levels at work a significant factor in overall health. Everything is better than nothing, and maintaining a physically active lifestyle outside of work hours will contribute significantly to achieve the health benefits of exercise. However, if you’re still worried and have been sat at your desk for the last few hours, when you reach the end of this sentence, why not stand up and take a walk?
Allen Kelly, post doc at CERG.
Read the entire article here
English: Tailgating (Photo credit: Wikipedia)
From a fact sheet at the USDA Food Safety and Inspection Service
Keeping food safe at a tailgate gathering requires the same safe food handling practices as picnicking outdoors because a refrigerator and running water are probably not available. Include lots of clean utensils for preparing and serving the safely cooked food. In addition to a grill and fuel for cooking food, pack a food thermometer to be sure the meat and poultry reach a high enough temperature to destroy any harmful bacteria that may be present.
Q. Several of us are planning a tailgate party. How can we handle the foods safely?
A. Keeping food at a safe temperature between home, a store or restaurant, and the tailgate location helps prevent foodborne illness. Follow these tips from the U.S. Department of Agriculture (USDA) to ensure that your food stays safe.
- Carry cold perishable food like raw hamburger patties, sausages, and chicken in an insulated cooler packed with several inches of ice, frozen gel packs, or containers of ice.
- Place an appliance thermometer in the cooler so you can check to be sure the food stays at 40 °F or below.
- When packing the cooler for an outing, be sure raw meat and poultry are wrapped securely to prevent their juices from cross-contaminating ready-to-eat food.
- Perishable cooked food such as luncheon meat, cooked meat, chicken, and potato or pasta salads must be kept refrigerator cold, too.
- If bringing hot take-out food, eat it within 2 hours of purchase (1 hour if the temperature is above 90 °F).
- To keep food like soup, chili, and stew hot, use an insulated container. Fill the container with boiling water, let it stand for a few minutes, empty, and then put in the piping hot food. If you keep the insulated container closed, the food should stay hot (140 °F or above) for several hours.
- If you can’t keep hot food hot during the drive to your tailgate, plan ahead and chill the food in the refrigerator before packing it in a cooler. Reheat the food to 165 °F as measured with a food thermometer.
- In addition to a grill and fuel for cooking food, pack a food thermometer so you can check and make sure the meat and poultry reach a high enough temperature to destroy harmful bacteria that may be present.
- Include lots of clean utensils for preparing and serving the safely cooked food.
- Bring water for cleaning if none will be available at the site. Pack clean, wet, disposable cloths or moist towelettes and paper towels for cleaning hands and surfaces.
Read the entire fact sheet here
Listen to a podcast of the fact sheet here
Just one study. However, interesting….
From the 9 September 2013 article at Health Day
Monday, September 9, 2013
SATURDAY, Sept. 7 (HealthDay News) — Electronic cigarettes and nicotine patches are equally effective at helping smokers quit, according to findings from what’s thought to be the first clinical trial to compare the two methods.
However, e-cigarettes were more effective in reducing cigarette use among smokers who didn’t quit.
E-cigarettes are battery-powered devices that deliver nicotine, flavorings and other chemicals. They turn these substances into vapor that is inhaled by the user.
The new study included 657 smokers who used either e-cigarettes, fake e-cigarettes (they didn’t contain any nicotine) or nicotine patches for 13 weeks. At the end of the six-month study, about 6 percent of the participants had successfully quit.
Rates of those who successfully quit were 7.3 percent in the e-cigarette group, 5.8 percent in the nicotine patch group and 4.1 percent in the fake e-cigarette group.
These differences were not statistically significant, according to study leader Chris Bullen, director of the National Institute for Health Innovation at the University of Auckland in New Zealand, and colleagues….
From the 29th August 2013 article at Sound Progress by Julie Watts
Cold and flu season is just around the corner. So what do grocery and retail workers have to do with public health? In a nutshell, they handle your food and if they don’t have adequate sick days from their employers, you may be more likely to get sick.
That is why, paid sick leave for grocery and retail workers is so important.
In addition to the common colds and flus that are passed along when an ill cashier touches every item that goes into a customer’s grocery bag, serious illnesses are spread as a result of people working while sick.
A lack of paid sick leave can also harm child health and school performance.
No caregiver wants to be in the position of choosing between staying home to care for a sick child and going to work so they can pay the bills. However, without adequate paid sick leave, many families must decide between caring for a sick child at home and losing needed pay or risking their jobs.
- One in five workers in a recent survey we conducted of grocery and supercenter workers live with at least one child and do not have any other adults in their households.
- In Washington, the majority of preschoolers and school-age children live in homes where all parents are employed.
Adequate paid sick days mean fewer children going to school sick. When parents can stay at home with their kids, recovery times are shorter and germs stay home too—ensuring healthier schools, families and communities. For more information read our policy brief on Paid Sick Days on our website. Also see our article on the results of our examination of paid sick leave for grocery and retail workers.
So be sure to cover your cough with your elbow, AND ask your local supermarket if they offer paid sick days to their employees!
From the 27 August 2013 EurkAlert
All people have trillions of bacteria living in their intestines. If you place them on a scale, they weigh around 1.5 kg. Previously, a major part of these ‘blind passengers’ were unknown, as they are difficult or impossible to grow in laboratories. But over the past five years, an EU-funded research team, MetaHIT, coordinated by Professor S. Dusko Ehrlich at the INRA Research Centre of Jouy-en-Josas, France and with experts from Europe and China have used advanced DNA analysis and bioinformatics methods to map human intestinal bacteria.
-The genetic analysis of intestinal bacteria from 292 Danes shows that about a quarter of us have up to 40% less gut bacteria genes and correspondingly fewer bacteria than average. Not only has this quarter fewer intestinal bacteria, but they also have reduced bacterial diversity and they harbour more bacteria causing a low-grade inflammation of the body. This is a representative study sample, and the study results can therefore be generalised to people in the Western world, says Oluf Pedersen, Professor and Scientific Director at the Faculty of Health and Medical Sciences, University of Copenhagen.
Oluf Pedersen and Professor Torben Hansen have headed the Danish part of the MetaHIT project, and the findings are reported in the highly recognised scientific journal Nature.
The gut is like a rainforest
Oluf Pedersen compares the human gut and its bacteria with a tropical rainforest. He explains that we need as much diversity as possible, and – as is the case with the natural tropical rainforests – decreasing diversity is a cause for concern. It appears that the richer and more diverse the composition of our intestinal bacteria, the stronger our health. The bacteria produce vital vitamins, mature and strengthen our immune system and communicate with the many nerve cells and hormone-producing cells in the intestinal system. And, not least, the bacteria produce a wealth of bioactive substances which penetrate into the bloodstream and affect our biology in countless ways.
-Our study shows that people having few and less diverse intestinal bacteria are more obese than the rest. They have a preponderance of bacteria which exhibit the potential to cause mild inflammation in the digestive tract and in the entire body, which is reflected in blood samples that reveal a state of chronic inflammation, which we know from other studies to affect metabolism and increase the risk of type 2 diabetes and cardiovascular diseases, says Oluf Pedersen.
-And we also see that if you belong to the group with less intestinal bacteria and have already developed obesity, you will also gain more weight over a number of years. We don’t know what came first, the chicken or the egg, but one thing is certain: it is a vicious circle that poses a health threat, says the researcher.
Take care of your intestinal bacteria
The researchers thus still cannot explain why some people have fewer intestinal bacteria, but the researchers are focusing their attention at dietary components, genetic variation in the human host, exposure to antimicrobial agents during early childhood and the chemistry we encounter daily in the form of preservatives and disinfectants.
A French research team reports a study in the same issue of Nature showing that by maintaining a low-fat diet for just six weeks, a group of overweight individuals with fewer and less diverse intestinal bacteria may, to some extent, increase the growth of intestinal bacteria, both in terms of actual numbers and diversity.
-This indicates that you can repair some of the damage to your gut bacteria simply by changing your dietary habits. Our intestinal bacteria are actually to be considered an organ just like our heart and brain, and the presence of health-promoting bacteria must therefore be cared for in the best way possible. Over the next years, we will be gathering more knowledge of how best to do this,” says Oluf Pedersen, whose research team is studying, among other things, the impact of dietary gluten on gut bacteria composition and gut function.
Towards innovative early diagnostics and treatment options
Obesity and type 2 diabetes are not just a result of unfortunate combinations of intestinal bacteria or lack of health-promoting intestinal bacteria, Oluf Pedersen emphasises. There are likely many causal factors at play. But the MetaHit researchers’ contribution opens a new universe in which we begin to understand how gut bacteria in direct contact with the surrounding environment have a decisive impact on our health and risk of disease.
-At present we cannot do anything about our own DNA, individual variation in which also plays a crucial role in susceptibility for lifestyle diseases. But thanks to the new gut microbiota research, we now can start exploring interactions between host genetics and the gut bacteria- related environment which we may be able to change. That is why it is so exciting for us scientist within this research field– the possibilities are huge, says Oluf Pedersen.
-The long-term dream is to map and characterize any naturally occurring gut bacteria that produce appetite-inhibiting bioactive substances and in this way learn to exploit the body’s own medicine to prevent the obesity epidemic and type 2 diabetes, says Oluf Pedersen.
English: PET scan of a human brain with Alzheimer’s disease (Photo credit: Wikipedia)
From the 28 August 2013 article at Science Daily
A team of Columbia University Medical Center (CUMC) researchers, led by Nobel laureate Eric R. Kandel, MD, has found that deficiency of a protein called RbAp48 in the hippocampus is a significant contributor to age-related memory loss and that this form of memory loss is reversible. The study, conducted in postmortem human brain cells and in mice, also offers the strongest causal evidence that age-related memory loss and Alzheimer’s disease are distinct conditions.
“The fact that we were able to reverse age-related memory loss in mice is very encouraging,” said Dr. Kandel. “Of course, it’s possible that other changes in the DG contribute to this form of memory loss. But at the very least, it shows that this protein is a major factor, and it speaks to the fact that age-related memory loss is due to a functional change in neurons of some sort. Unlike with Alzheimer’s, there is no significant loss of neurons.”
Finally, the study data suggest that RbAp48 protein mediates its effects, at least in part, through the PKA-CREB1-CBP pathway, which the team had found in earlier studies to be important for age-related memory loss in the mouse. According to the researchers, RbAp48 and the PKA-CREB1-CBP pathway are valid targets for therapeutic intervention. Agents that enhance this pathway have already been shown to improve age-related hippocampal dysfunction in rodents.
“Whether these compounds will work in humans is not known,” said Dr. Small. “But the broader point is that to develop effective interventions, you first have to find the right target. Now we have a good target, and with the mouse we’ve developed, we have a way to screen therapies that might be effective, be they pharmaceuticals, nutraceuticals, or physical and cognitive exercises.”
“There’s been a lot of handwringing over the failures of drug trials based on findings from mouse models of Alzheimer’s,” Dr. Small said. “But this is different. Alzheimer’s does not occur naturally in the mouse. Here, we’ve caused age-related memory loss in the mouse, and we’ve shown it to be relevant to human aging.”
Read the entire article
I am all for decriminalizing illegal drug use. However, I am very concerned about substance abuse, especially among folks whose brains are still developing (and this goes on until age 25 or so).
From the abstract of the report at Full Text Reports
On an average day, 881,684 teenagers aged 12 to 17 smoked cigarettes, according to a report by the Substance Abuse and Mental Health Services Administration (SAMHSA). The report also says that on average day 646,707 adolescents smoked marijuana and 457,672 drank alcohol.
To provide some perspective, the number of adolescents using marijuana on an average day could almost fill the Indianapolis Speedway (seating capacity 250,000 seats) two and a half times.
“This data about adolescents sheds new light on how deeply substance use pervades the lives of many young people and their families,” said SAMHSA Administrator Pamela S. Hyde. “While other studies indicate that significant progress has been made in lowering the levels of some forms of substance use among adolescents in the past decade, this report shows that far too many young people are still at risk.”
The report, which highlights the substance abuse behavior and addiction treatment activities that occur among adolescents on an average day, draws on a variety of SAMHSA data sets.
The report also sheds light on how many adolescents aged 12 to 17 used illegal substances for the first time. On an average day:
- 7,639 drank alcohol for the first time;
- 4,594 used an illicit drug for the first time;
- 4,000 adolescents used marijuana for the first time;
- 3,701 smoked cigarettes for the first time; and
- 2,151 misused prescription pain relievers for the first time.
Using data from SAMHSA Treatment Episode Data Set (TEDS), the report also analyzes how many adolescents aged 12 to 17 were receiving treatment for a substance abuse problem during an average day. These numbers included:
- Over 71,000 in outpatient treatment,
- More than 9,302 in non-hospital residential treatment, and
- Over 1,258 in hospital inpatient treatment.
In terms of hospital emergency department visits involving adolescents aged 12 to 17, on an average day marijuana is involved in 165 visits, alcohol is involved in 187 visits and misuse of prescription or nonprescription pain relievers is implicated in 74 visits.
SAMHSA’s National Helpline is a confidential, free, 24-hour-a-day, 365-day-a-year, information service that people – including adolescents and their family members — can contact when facing substance abuse and mental health issues. This service provides referrals to local treatment facilities, support groups, and community-based organizations. Callers can also order free publications and other information in print on substance abuse and mental health issues. Call 1-800-662-HELP (4357) or visit the online treatment locators at http://findtreatment.samhsa.gov/.
The complete report contains many other facts about the scope and nature of adolescent substance abuse, treatment and treatment admissions patterns and is available at: http://www.samhsa.gov/data/2K13/CBHSQ128/sr128-typical-day-adolescents-2013.pdf. It was drawn from analyses of SAMHSA’s National Survey on Drug Use and Health, Treatment Episode Data Set, and National Survey of Substance Abuse Treatment Services, and Drug Abuse Warning Network.
Well, I still don’t feel inclined to try any…despite my FB profile.
Could psychedelics be healthy for you?
The researchers found that lifetime use of psilocybin or mescaline and past year use of LSD were associated with lower rates of serious psychological distress. Lifetime use of LSD was also significantly associated with a lower rate of outpatient mental health treatment and psychiatric medicine prescription.
The design of the study makes it impossible to determine exactly why the researchers found what they found.
“We cannot exclude the possibility that use of psychedelics might have a negative effect on mental health for some individuals or groups, perhaps counterbalanced at a population level by a positive effect on mental health in others,” they wrote.
Nevertheless, “recent clinical trials have also failed to find any evidence of any lasting harmful effects of psychedelics,” the researchers said, which supports the robustness of the PLOS ONE findings.
In fact, says Krebs, “many people report deeply meaningful experiences and lasting beneficial effects from using psychedelics.”
From the 19th August 2013 article at ScienceDaily
The use of LSD, magic mushrooms, or peyote does not increase a person’s risk of developing mental health problems, according to an analysis of information from more than 130,000 randomly chosen people, including 22,000 people who had used psychedelics at least once.
“After adjusting for other risk factors, lifetime use of LSD, psilocybin, mescaline or peyote, or past year use of LSD was not associated with a higher rate of mental health problems or receiving mental health treatment,” says Johansen.
Could psychedelics be healthy for you?
The researchers found that lifetime use of psilocybin or mescaline and past year use of LSD were associated with lower rates of serious psychological distress. Lifetime use of LSD was also significantly associated with a lower rate of outpatient mental health treatment and psychiatric medicine prescription.
The design of the study makes it impossible to determine exactly why the researchers found what they found.
“We cannot exclude the possibility that use of psychedelics might have a negative effect on mental health for some individuals or groups, perhaps counterbalanced at a population level by a positive effect on mental health in others,” they wrote.
Nevertheless, “recent clinical trials have also failed to find any evidence of any lasting harmful effects of psychedelics,” the researchers said, which supports the robustness of the PLOS ONE findings.
In fact, says Krebs, “many people report deeply meaningful experiences and lasting beneficial effects from using psychedelics.”
Read the entire article here
IF you’re only swimming laps when you’re in the water, then you’re missing out on a fun strength-training workout.
Water offers 12 times as much resistance as air, so it’s easy to do a total body workout quickly with the help of just a kickboard.
Sara Haley, a Santa Monica, California-based celebrity trainer who has developed workouts for “Cirque du Soleil” and created the DVD Sweat Unlimited(amazon.com), has put together this water workout, which provides cardio and toning. You may repeat the entire sequence two to three times.
Lunge and swoosh
Muscles targeted: Chest, glutes and legs
Warm up with this move. Stand in shallow water with your feet together, holding a kickboard at your chest. Since this is a warm-up, keep light resistance, with only about a third of the kickboard in the water.
Step out to the right in a plie squat (hips rotated out). As you squat, swoosh the kickboard (or just your arms if you don’t have a kickboard) in a big half circle to the right. Repeat to your left.
Continue alternating right and left – four on each side.
The ‘jog and kick’.
Jog and kick
Muscles targeted: Quads, hamstrings, back, triceps and core
With straight arms, hold the long sides of the kickboard above your head. Alternate lifting your knees to your chest eight times. Then, push the kickboard down into the water to chest level so one side is facing you.
To keep the kickboard under the water with straight arms, you’ll need to squeeze your shoulder blades together, engaging your triceps and back. As you hold the kickboard, alternate kicking your bottom, doing hamstring curls eight times.
Repeat the entire exercise eight times, trying to increase your speed. It should be difficult to breathe by the time you’re done.
Push and lift
Muscles targeted: Chest, core, legs and glutes
Begin with your feet together, holding your kickboard against your chest. Step one foot forward into a lunge position, pushing the kickboard forward so your arms are straight.
The deeper the kickboard is, the harder this exercise will be.
Hinge at the hips and lift your back leg up as if you are trying to kick your foot out of the water. Point your foot and pulse your back leg up so that your foot flutter kicks out of the water six times.
Lower your leg, step back together, bringing your kickboard back to your chest and repeat on the other side. Continue alternating right and left for a total of eight times.
Muscles targeted: Obliques
Hold the kickboard behind your head to help open your chest. Turning out from your hips, lift your right leg up. As your knee lifts, your upper body should also lift up and over toward your knee so your knee and elbow come closer together.
Repeat 10 times on the right side and then 10 times on the left. Finish by alternating right and left at a quick pace 10 times.
Muscles targeted: Outer thighs and glutes
Hold your kickboard on your left side for support. Your left forearm rests on the board and your right arm crosses in front of your body so your right hand can also rest gently on the board. The kickboard will help support your balance.
Let your left leg turn out (your knee may bend slightly – this will be your supporting leg). Lift your right heel up to the side to hip level. Lift and lower 10 times. On your last rep, keep your leg lifted and pulse it up 10 times. Repeat on the other side.
Muscles targeted: Back, biceps and triceps
Stand with your feet shoulder width apart and hold your kickboard like a plate. Slowly push the kickboard straight down into the water, and then curl it back up toward your chest.
Repeat the sequence eight times. Count to four as you lower and lift it again.
Abs tuck and twist
Muscles targeted: Abs and obliques
You don’t need your kickboard for this one. Start with your feet together and your elbows bent so your hands are up at your chest. Soften your knees and then jump, bringing your knees to your chest.
As your knees come up, push your hands into the water. Repeat eight times.
Then, repeat the entire exercise but angle your knees to your right, keeping your torso to the front so you can work your left oblique, repeating eight times. Do the same to the left.
Finally, tuck to the front, angle to the right, tuck to the front, angle to the left and repeat four times. – Chicago Tribune/McClatchy-Tribune Information Services
From the 2 August 2013 article at Scientific American
Artificial light sources can negatively affect circadian rhythms, scientists say
By Joel N. Shurkin and Inside Science News Service
This story was originally published byInside Science News Service.
Throughout most of human history, humans went to bed shortly after the sun went down and woke up in the morning as it rose. There were candles and later oil lamps, but the light was not very bright so people still went to bed early.
Scientists at the University of Colorado Boulder found that if you live by the sun’s schedule, you are more likely to go to bed at least an hour earlier, wake up an hour earlier, and be less groggy, because your internal clock and external reality are more in sync. The sun adjusts your clock to what may be its natural state, undoing the influence of light bulbs.
The work is published in the current issue of the journal Current Biology.
The disconnect between the outside environment and sleep is one reason why even native Alaskans have problems sleeping in the almost endless days of the Arctic summers, and get depressed during the long nights of winters.
The subjects in the Colorado study lived more normal lives.
Read the entire article here
Disparity of rich and poor in Rio de Janeiro (Photo credit: Wikipedia)
From the 5 August 2013 article at Quartz by Christopher Mims
“Tell me what kinds of toxins are in your body, and I’ll tell you how much you’re worth,” could be the new motto of doctors everywhere. In a finding that surprised even the researchers conducting the study, it turns out that both rich and poor Americans are walking toxic waste dumps for chemicals like mercury, arsenic, lead, cadmium and bisphenol A, which could be a cause of infertility. And while a buildup of environmental toxins in the body afflicts rich and poor alike, the type of toxin varies by wealth.
America’s rich are harboring chemicals associated with what are normally considered healthy lifestyles
People who can afford sushi and other sources of aquatic lean protein appear to be paying the price with a buildup of heavy metals in their bodies, found Jessica Tyrrell and colleagues from the University of Exeter. Using data from the US National Health and Nutrition Examination Survey, Tyrrell et al. found that compared to poorer people, the rich had higher levels of mercury, arsenic, caesium and thallium, all of which tend to accumulate in fish and shellfish.
The rich also had higher levels of benzophenone-3, aka oxybenzone, the active ingredient in most sunscreens, which is under investigation by the EU and, argue some experts, may actually encourage skin cancer.
America’s poor have toxins associated with exposure to plastics and cigarette smoke
Higher rates of cigarette smoking among those of lower means seem to be associated with higher levels of lead and cadmium. Poor people in America also had higher levels of Bisphenol-A, a substance used to line cans and other food containers, and which is banned in the EU, Malaysia, South Africa, China and, in the US, in baby bottles.
Previous research has established that rich Americans are more likely to eat their fruits and vegetables and less likely to eat “energy-dense” fast food and snacks, but this work establishes that in some ways, in moving up the economic ladder Americans are simply trading one set of environmental toxins for another.
Reblogged from 21st Century Library Blog:
While I’ve been busy with other things, I let this issue raised at ALA slip past unnoticed. Issues in library world don’t go unnoticed for very long, especially when they deal with government intrusion. Apparently, during ALA 2013 Conference a video was played in which there was a White House appeal to public librarians to help Americans understand the new Affordable Healthcare Act insurance system that goes into effect whenever – maybe.
Read more… 1,597 more words
I am hoping that the federal government can do a bit more to provide resources for librarians about ACA.
Back in my public library days, it wasn’t easy working with patrons when the topic was against my views!
However, I always tried to address people’s information needs without bias and as completely as possible with factual information.
“ObamaCare” questions are in the same arena. While librarians cannot advise or fill out forms, they can at least lead folks to factual information. However, this would work best if the federal government would do everything possible to lighten the load for libraries. This would include providing readable materials for consumers, as well as “pathways” for librarians.
Also, libraries can welcome trained volunteers and organizations to give in-depth information to folks. Many already do this around tax time with IRS trained volunteers.
Here in Toledo, folks from legal aid organizations “set up shop” in public libraries to assist folks. Representatives from the Ohio Benefit Bank do likewise. These volunteers screen people for government assistance programs as SNAP and the Medicare Savings Program.
It sure would be great if government employees and/or trained volunteers could do likewise for “ObamaCare”. Areas could include the health exchange marketplace, Medicaid expansion, free preventative care, and more.
And with articles as this, there is a real need for information professionals, including librarians!
Ohio insurance department claims Obamacare premium rates to rise 41 percent (Cleveland Plain Dealer, August 1, 2013)
Ohio insurance regulators Thursday released rates for health insurance to be sold on the new state marketplace
and said premiums for individuals will rise an average of 41 percent
compared with 2013 rates.
That average brought immediate condemnation from critics of the Affordable Care Act, with U.S. House Speaker John Boehner, a southwest Ohio Republican, calling it “irrefutable evidence” that the law known as Obamacare is driving up costs and hurting the economy……..
“…only 11 percent of respondents presented with a traditional insurance plan incorporating all four of these elements were able to compute the cost of a four-day hospital stay when given the information that should have enabled them to do so…
“”The ACA deals with the problem of consumer misunderstanding by requiring insurance companies to publish standardized and simplified information about insurance plans, including what consumers would pay for four basic services,” noted lead author Loewenstein. “However, presenting simplified information about something that is inherently complex introduces a risk of ‘smoothing over’ real complexities. A better approach, in my view, would be to require insurance companies to offer truly simplified insurance products that consumers are capable of understanding.”
A NIDA educational pamphlet. (Photo credit: Wikipedia)
From the 29 July 2013 EurekAlert
DURHAM, N.C. – Children who grow up in poverty are more likely than wealthier children to smoke cigarettes, but they are less likely to binge drink and are no more prone to use marijuana, according to researchers at Duke Medicine.
The researchers also found that economic strains in early life – including family worries about paying bills or needing to sell possessions for cash – independently erode a child’s self-control, regardless of strong parenting in adolescence. Lack of self-control often leads to substance use.
The findings, appearing July 30, 2013, in the Journal of Pediatric Psychology, debunk common assumptions about who abuses substances, and provide a basis for better approaches to prevent young people from falling into drug and alcohol addiction.
“Poverty during childhood not only appears to affect child development, but can have lasting effects on the types of health choices made during adolescence and early adulthood, especially as it relates to cigarette smoking,” said senior author Bernard Fuemmeler, Ph.D., MPH, MS, associate professor in Community and Family Medicine at Duke University School of Medicine. “Economic strains may shape an individual’s capacity for self-control by diminishing opportunities for self-regulation, or affecting important brain structures.”
Fuemmeler and colleagues at Duke set out to examine the direct effect of childhood economic strains on smoking, binge drinking, and marijuana use in young adults. They also sought to determine how financial difficulties impact self-control, and how positive parenting might mitigate the tendency to use drugs and alcohol.
The group analyzed data from 1,285 children and caregivers included in a representative sample of U.S. families studied from 1986-2009. Economic status was measured by annual family income, plus a survey with questions about economic problems such as difficulty paying bills or postponing medical care. Additional information was gathered to gauge childhood self-control and parental interactions.
Among the study participants who were transitioning to adulthood, young people who lived in poverty as children were far more likely to become regular cigarette smokers than children who grew up in wealthier households. The impoverished children also scored low on self-control measures.
“Poor self-control may be a product of limited learning resources and opportunities for developing appropriate behaviors,” Fuemmeler said.
Binge drinking, however, was much more common among the wealthier young people. And surprisingly, those who had good self-control as children were more likely to engage in heavy episodic drinking as young adults.
Neither wealth nor poverty appeared to influence marijuana use, although positive parenting did reduce the use of this drug. Parents who were nurturing and accepting, in fact, diminished the likelihood of young people using any of the substances.
The researchers also found no correlation between economic hardship and poor parenting – a contradiction to some other studies.
“We suspected we’d find a relationship between parenting and economic problems – the idea that economic strains may cause parents to have less capacity to deal with their children, but that relationship wasn’t there,” Fuemmeler said. “That means it’s not necessarily poverty that affects the parenting strategy, but poverty that affects the children’s self-control.”
Fuemmeler said the findings are important given the increase in U.S. children living in poverty. The U.S. Census Bureau reported 22 percent of children lived in poverty in 2010, compared to 18 percent in 2000.
“Continued work is needed to better understand how economic strains may influence the development of self-control, as well as to identify other potential mediators between economic strains and substance use outcomes,” Fuemmeler said.
In addition to Fuemmeler, study authors include Chien-Ti Lee, Joseph McClernon, Scott H. Kollins and Kevin Prybol.
The National Institutes of Health (RO1 DA030487), the National Cancer Institute (K07CA124905) and the National Institute on Drug Abuse (K24DA023464) funded the study.
English: Close up shot of some high quality marijuana. (Photo credit: Wikipedia)
While I believe the so called War on Drugs has largely been a failure, I am concerned about young folks indulging in substances that can have permanent health effects.
From the 24 July 2013 article at Science News Daily
Regular marijuana use in adolescence, but not adulthood, may permanently impair brain function and cognition, and may increase the risk of developing serious psychiatric disorders such as schizophrenia, according to a recent study from the University of Maryland School of Medicine. Researchers hope that the study, published in Neuropsychopharmacology — a publication of the journal Nature — will help to shed light on the potential long-term effects of marijuana use, particularly as lawmakers in Maryland and elsewhere contemplate legalizing the drug.
“Over the past 20 years, there has been a major controversy about the long-term effects of marijuana, with some evidence that use in adolescence could be damaging,” says the study’s senior author Asaf Keller, Ph.D., Professor of Anatomy and Neurobiology at the University of Maryland School of Medicine. “Previous research has shown that children who started using marijuana before the age of 16 are at greater risk of permanent cognitive deficits, and have a significantly higher incidence of psychiatric disorders such as schizophrenia. There likely is a genetic susceptibility, and then you add marijuana during adolescence and it becomes the trigger.”
“Adolescence is the critical period during which marijuana use can be damaging,” says the study’s lead author, Sylvina Mullins Raver, a Ph.D. candidate in the Program in Neuroscience in the Department of Anatomy and Neurobiology at the University of Maryland School of Medicine. “We wanted to identify the biological underpinnings and determine whether there is a real, permanent health risk to marijuana use.”
This is an example of Dental Erosion (Photo credit: Wikipedia)
From the 24 July 2013 article at Medical News Today
You may be saving calories by drinking diet soda, but when it comes to enamel erosion of your teeth, it’s no better than regular soda.
In the last 25 years, Kim McFarland, D.D.S., associate professor in the University of Nebraska Medical Center College of Dentistry in Lincoln, has seen an increase in the number of dental patients with erosion of the tooth enamel – the protective layer of the tooth. Once erosion occurs, it can’t be reversed and affects people their whole life.
“I’d see erosion once in a while 25 years ago but I see much more prevalence nowadays,” Dr. McFarland said. “A lot of young people drink massive quantities of soda. It’s no surprise we’re seeing more sensitivity.”
Triggers like hot and cold drinks – and even cold air – reach the tooth’s nerve and cause pain. Depending on the frequency and amount of soda consumed, the erosion process can be extreme.
Dr. McFarland said it’s best not to drink soda at all, but she offers tips for those who continue to drink it.
- Limit consumption of soda to meal time
- Don’t drink soda throughout the day
- Brush your teeth afterwards — toothpaste re-mineralizes or strengthens areas where acid weakened the teeth
- If tooth brushing is not possible, at least rinse out your mouth with water
- Chew sugar free gum or better yet, gum containing Xylitol.
Subject: Quinn, a boy with autism, and the line of toys he made before falling asleep See more about Quinn at: http://www.youtube.com/watch?v=G7kHSOgauhg Date: Circa 2003 Place: Walnut Creek, California Photographer: Andwhatsnext Original digital photograph (cropped and resized) Credit: Copyright (c) 2003 by Nancy J Price (aka Mom) (Photo credit: Wikipedia)
From the 23 July 2013 article at Science News Daily
The potential impact of exposure to low levels of mercury on the developing brain — specifically by women consuming fish during pregnancy — has long been the source of concern and some have argued that the chemical may be responsible for behavioral disorders such as autism. However, a new study that draws upon more than 30 years of research in the Republic of Seychelles reports that there is no association between pre-natal mercury exposure and autism-like behaviors.
Read the entire article here
From the summary at Full Text Reports
2013 World Drug Report: stability in use of traditional drugs, alarming rise in new psychoactive substances
Source: United Nations Office on Drugs and Crime
The 2013 World Drug Report released today in Vienna shows that, while the use of traditional drugs such as heroin and cocaine seems to be declining in some parts of the world, prescription drug abuse and new psychoactive substance [NPS]
An arrangement of psychoactive drugs (Photo credit: Wikipedia)
abuse is growing. In a special high-level event of the Commission on Narcotic Drugs, UNODC Executive Director Yury Fedotov urged concerted action to prevent the manufacture, trafficking and abuse of these substances.
Marketed as ‘legal highs’ and ‘designer drugs’, NPS are proliferating at an unprecedented rate and posing unforeseen public health challenges. The report shows that the number of NPS reported to UNODC rose from 166 at the end of 2009 to 251 by mid-2012, an increase of more than 50 per cent. For the first time, the number of NPS exceeded the total number of substances under international control (234). Since new harmful substances have been emerging with unfailing regularity on the drug scene, the international drug control system is now challenged by the speed and creativity of the NPS phenomenon.
This is an alarming drug problem – but the drugs are legal. Sold openly, including via the internet, NPS, which have not been tested for safety, can be far more dangerous than traditional drugs. Street names, such as “spice”, “meow-meow” and “bath salts” mislead young people into believing that they are indulging in low-risk fun. Given the almost infinite scope to alter the chemical structure of NPS, new formulations are outpacing efforts to impose international control. While law enforcement lags behind, criminals have been quick to tap into this lucrative market. The adverse effects and addictive potential of most of these uncontrolled substances are at best poorly understood.
The global picture for the use of traditional drugs such as heroin and cocaine shows some stability. In Europe, heroin use seems to be declining. Meanwhile, the cocaine market seems to be expanding in South America and in the emerging economies in Asia. Use of opiates (heroin and opium), on the other hand, remains stable (around 16 million people, or 0.4 per cent of the population aged 15-64), although a high prevalence of opiate use has been reported from South-West and Central Asia, Eastern and South-Eastern Europe and North America.
Chickens (Photo credit: Allie’s.Dad)
From the 11 July 2013 article at Science Daily
Raw, whole chickens purchased from farmers markets throughout Pennsylvania contained significantly higher levels of bacteria that can cause foodborne illness compared to those purchased from grocery stores in the region, according to a small-scale study by researchers in Penn State’s College of Agricultural Sciences.
Of 100 whole chickens purchased from farmers markets, 90 percent tested positive for Campylobacter and 28 percent harbored Salmonella.
By comparison, during the same period, 20 percent of raw, whole, organic chickens purchased from grocery stores were found to contain Campylobacterbacteria, and 28 percent tested positive for Salmonella. Just 8 percent of raw, whole, nonorganic, conventionally processed chickens from the grocery stores tested positive for Campylobacter and 52 percent of those contained Salmonella.
Overall, the chickens purchased at the farmers markets carried higher bacterial loads than the birds purchased at grocery stores.
“We are not doing the research to scare consumers or put people out of business; we’re here to improve public health,” she said. “We can train farmers and vendors to produce a safer product that won’t make people sick. This approach also has the potential to help consumers feel more confident about buying their locally grown and processed products.”
Bacteria that cause foodborne illness, such as Campylobacterand Salmonella, are destroyed by proper cooking of poultry products; however, they also can cause cross-contamination if they come in contact with other foods through contaminated cutting boards, sinks, countertops or utensils.
Logo of the United States National Center for Complementary and Alternative Medicine , part of the National Institutes of Health. (Photo credit: Wikipedia)
From the US National Center for Complementary and Alternative Medicine
People with cancer want to do everything they can to combat the disease, manage its symptoms, and cope with the side effects of treatment. Many turn to complementary health approaches, including natural products, such as herbs (botanicals) and other dietary supplements, and mind and body practices, such as acupuncture, massage, and yoga.
This fact sheet was produced through a collaboration between the National Center for Complementary and Alternative Medicine (NCCAM) and the National Cancer Institute (NCI). It provides an introductory overview of complementary health approaches that have been studied for cancer prevention, treatment of the disease, or symptom management, including what the science says about their effectiveness and any concerns that have been raised about their safety.
- Symptom management. A substantial amount of scientific evidence suggests that some complementary health approaches may help to manage some symptoms of cancer and side effects of treatment. For other complementary approaches, the evidence is more limited.
- Disease treatment. At present, there is no convincing evidence that any complementary health approach is effective in curing cancer or causing it to go into remission.
- Cancer prevention. A 2012 study indicated that taking a multivitamin/mineral supplement may slightly reduce the risk of cancer in older men. No other complementary health approach has been shown to be helpful in preventing cancer.
Keep in Mind
- Unproven products or practices should not be used to replace or delay conventional medical treatment for cancer.
- Some complementary approaches can interfere with standard cancer treatments or have special risks for people who have been diagnosed with cancer. Before using any complementary health approach, people who have been diagnosed with cancer should talk with their health care providers to make sure that all aspects of their care work together.
- Tell all your health care providers about any complementary health approaches you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.
Cancer is a term for diseases in which abnormal cells divide without control. Cancer cells can invade nearby tissues and spread to other parts of the body through the bloodstream and the lymph system. Although cancer is the second leading cause of death in the United States, improvements in screening, detection, treatment, and care have increased the number of cancer survivors, and experts expect the number of survivors to continue to increase in the coming years. Detailed information on cancer is available from NCI at www.cancer.gov.
About Complementary Health Approaches
Complementary health approaches are a group of diverse medical and health care systems, practices, and products whose origins come from outside of mainstream medicine. They include such products and practices as herbal supplements, other dietary supplements, meditation, spinal manipulation, and acupuncture.
The same careful scientific evaluation that is used to assess conventional therapies should be used to evaluate complementary approaches. Some complementary approaches are beginning to find a place in cancer treatment—not as cures, but as additions to treatment plans that may help patients cope with disease symptoms and side effects of treatment and improve their quality of life.
Use of Complementary Health Approaches for Cancer
Many people who have been diagnosed with cancer use complementary health approaches.
- According to the 2007 National Health Interview Survey (NHIS), which included a comprehensive survey on the use of complementary health approaches by Americans, 65 percent of respondents who had ever been diagnosed with cancer had used complementary approaches, as compared to 53 percent of other respondents. Those who had been diagnosed with cancer were more likely than others to have used complementary approaches for general wellness, immune enhancement, and pain management.
- Other surveys have also found that use of complementary health approaches is common among people who have been diagnosed with cancer, although estimates of use vary widely. Some data indicate that the likelihood of using complementary approaches varies with the type of cancer and with factors such as sex, age, and ethnicity. The results of surveys from 18 countries show that use of complementary approaches by people who had been diagnosed with cancer was more common in North America than in Australia/New Zealand or Europe and that use had increased since the 1970s and especially since 2000.
- Surveys have also shown that many people with cancer do not tell their health care providers about their use of complementary health approaches. In the NHIS, survey respondents who had been diagnosed with cancer told their health care providers about 15 percent of their herb use and 23 percent of their total use of complementary approaches. In other studies, between 32 and 69 percent of cancer patients and survivors who used dietary supplements or other complementary approaches reported that they discussed these approaches with their physicians. The differences in the reported percentages may reflect differences in the definitions of complementary approaches used in the studies, as well as differences in the communication practices of different groups of patients.
- Delaying conventional cancer treatment can decrease the chances of remission or cure. Do not use unproven products or practices to postpone or replace conventional medical treatment for cancer.
- Some complementary health approaches may interfere with cancer treatments or be unsafe for cancer patients. For example, the herb St. John’s wort, which is sometimes used for depression, can make some cancer drugs less effective.
- Other complementary approaches may be harmful if used inappropriately. For example, to make massage therapy safe for people with cancer, it may be necessary to avoid massaging places on the body that are directly affected by the disease or its treatment (for example, areas where the skin is sensitive following radiation therapy).
- People who have been diagnosed with cancer should consult the health care providers who are treating them for cancer before using any complementary health approach for any purpose—whether or not it is cancer-related.
What the Science Says
No complementary health product or practice has been proven to cure cancer. Some complementary approaches may help people manage cancer symptoms or treatment side effects and improve their quality of life.
Incorporating Complementary Health Approaches Into Cancer Care
In 2009, the Society for Integrative Oncology issued evidence-based clinical practice guidelines for health care providers to consider when incorporating complementary health approaches in the care of cancer patients. The guidelines point out that, when used in addition to conventional therapies, some of these approaches help to control symptoms and enhance patients’ well-being. The guidelines warn, however, that unproven methods should not be used in place of conventional treatment because delayed treatment of cancer reduces the likelihood of a remission or cure.
A comprehensive summary of research on complementary health approaches for cancer is beyond the scope of this fact sheet. The following sections provide an overview of the research status of some commonly used complementary approaches, highlighting results from a few reviews and studies focusing on preventing and treating the disease, as well as managing cancer symptoms and treatment side effects.
Talking With Your Health Care Providers About Complementary Approaches and Cancer
The National Institutes of Health (NIH) has resources that can help you talk with your health care providers about complementary approaches and cancer.
- NCI’s Office of Cancer Complementary and Alternative Medicine has a workbook to help cancer patients and their health care providers talk about and keep track of complementary approaches that patients are using. You can download it here: cam.cancer.gov/talking_about_cam.html?cid=ARcam_camnews.
- NCCAM’s Time to Talk campaign has tips to help both patients and health care providers discuss complementary health approaches.
Complementary Health Approaches for Cancer Symptoms and Treatment Side Effects
Some complementary health approaches, such as acupuncture, massage therapy, mindfulness-based stress reduction, and yoga, may help people manage cancer symptoms or the side effects of treatment. However, some approaches may interfere with conventional cancer treatment or have other risks.People who have been diagnosed with cancer should consult their health care providers before using any complementary health approach.
- There is substantial evidence that acupuncture can help to manage treatment-related nausea and vomiting in cancer patients. There is not enough evidence to judge whether acupuncture is effective in relieving cancer pain or other symptoms such as treatment-related hot flashes. Complications from acupuncture are rare, as long as the acupuncturist uses sterile needles and proper procedures. Chemotherapy and radiation therapy weaken the body’s immune system, so it is especially important for acupuncturists to follow strict clean-needle procedures when treating cancer patients.
- Recent studies suggest that the herb ginger may help to control nausea related to cancer chemotherapy when used in addition to conventional anti-nausea medication.
- Studies suggest that massage therapy may help to relieve symptoms experienced by people with cancer, such as pain, nausea, anxiety, and depression. However, investigators have been unable to reach definite conclusions about the effects of massage therapy because of the limited amount of rigorous research in this field. People with cancer should consult their health care providers before having massage therapy to find out if any special precautions are needed. The massage therapist should not use deep or intense pressure without the health care providers’ approval and may need to avoid certain sites, such as areas directly over a tumor or those where the skin is sensitive following radiation therapy.
- There is evidence that mindfulness-based stress reduction, a type of meditation training, can help cancer patients relieve anxiety, stress, fatigue, and general mood and sleep disturbances, thus improving their quality of life. Most participants in mindfulness studies have been patients with early-stage cancer, primarily breast cancer, so the evidence favoring mindfulness training is strongest for this group of patients.
- Preliminary evidence indicates that yoga may help to improve anxiety, depression, distress, and stress in people with cancer. It also may help to lessen fatigue in breast cancer patients and survivors. However, only a small number of yoga studies in cancer patients have been completed, and some of the research has not been of the highest quality. Because yoga involves physical activities, it is important for people with cancer to talk with their health care providers in advance to find out whether any aspects of yoga might be unsafe for them.
- Various studies suggest possible benefits of hypnosis, relaxation therapies, and biofeedback to help patients manage cancer symptoms and treatment side effects.
- A 2008 review of the research literature on herbal supplements and cancer concluded that although several herbs have shown promise for managing side effects and symptoms such as nausea and vomiting, pain, fatigue, and insomnia, the scientific evidence is limited, and many clinical trials have not been well designed. Use of herbs for managing symptoms also raises concerns about potential negative interactions with conventional cancer treatments.
Coping With Cancer
People who have cancer, or who have been treated for cancer, may have physical or emotional difficulties as a result of the disease or its treatment. Many conventional approaches can help people cope with these problems. For example, counseling may help people who are distressed about being diagnosed with cancer, medicines can control nausea related to chemotherapy, and exercise may help decrease treatment-related fatigue. Some people find that complementary approaches also help them cope with cancer and improve their quality of life. In addition, using complementary approaches can help people feel they are playing an active part in their own care. If you have cancer or if you have been treated for cancer, be sure to tell your health care providers about all approaches—both conventional and complementary—that you are using. Your health care providers need this information so they can make sure that all aspects of your care work well together. Additional information on coping with cancer is available from NCI at www.cancer.gov/cancertopics/coping.
Complementary Health Approaches for Cancer Treatment
This section discusses complementary health approaches to directly treat cancer (that is, to try to cure the disease or cause a remission).
No complementary approach has been shown to cure cancer or cause it to go into remission. Some products or practices that have been advocated for cancer treatment may interfere with conventional cancer treatments or have other risks. People who have been diagnosed with cancer should consult their health care providers before using any complementary health approach.
- Studies on whether herbal supplements or substances derived from them might be of value in cancer treatment are in their early stages, and scientific evidence is limited. Herbal supplements may have side effects, and some may interact in harmful ways with drugs, including drugs used in cancer treatment.
- The effects of taking vitamin and mineral supplements, including antioxidant supplements,during cancer treatment are uncertain. NCI advises cancer patients to talk to their health care providers before taking any supplements.
- A 2010 NCCAM-supported trial of a standardized shark cartilage extract, taken in addition to chemotherapy and radiation therapy, showed no benefit in patients with advanced lung cancer. An earlier, smaller study in patients with advanced breast or colorectal cancers also showed no benefit from the addition of shark cartilage to conventional treatment.
- A 2011 systematic review of research on laetrile found no evidence that it is effective as a cancer treatment. Laetrile can be toxic, especially if taken orally, because it contains cyanide.
Beware of Cancer Treatment Frauds
The U.S. Food and Drug Administration (FDA) and the Federal Trade Commission (FTC) have warned the public to be aware of fraudulent cancer treatments. Cancer treatment frauds are not new, but in recent years it has become easier for the people who market them to reach the public using the Internet.
Some fraudulent cancer treatments are harmful by themselves, and others can be indirectly harmful because people may delay seeking medical care while they try them, or because the fraudulent product interferes with the effectiveness of proven cancer treatments.
The people who sell fraudulent cancer treatments often market them with claims such as “scientific breakthrough,” “miraculous cure,” “secret ingredient,” “ancient remedy,” “treats all forms of cancer,” or “shrinks malignant tumors.” The advertisements may include personal stories from people who have taken the product, but such stories—whether or not they’re real—aren’t reliable evidence that a product is effective. Also, a money-back guarantee is not proof that a product works.
If you’re considering using any anticancer product that you’ve seen in an advertisement, talk to your health care provider first. Additional information on cancer-related health frauds is available from the FDA and from the FTC.
Complementary Health Approaches for Cancer Prevention
A large 2012 clinical trial has shown that taking a multivitamin/mineral supplement may slightly reduce the risk of cancer in older men. No other complementary health approach has been shown to be helpful in preventing cancer, and some have been linked with increased health risks.
Vitamin and Mineral Supplements. The results of a study of older men completed in 2012 indicate that taking a multivitamin/mineral supplement slightly reduces the risk of cancer. In this study, which was part of the Physicians’ Health Study II (a complex trial that tested several types of supplements), more than 14,000 male U.S. physicians were randomly assigned to take a multivitamin/mineral supplement or a placebo (an identical-appearing product that did not contain vitamins and minerals) for 11 years. Those who took the supplement had 8 percent fewer total cancers than those who took the placebo.
Other studies of vitamins and minerals—most of which evaluated supplements containing only one or a few nutrients—have not found protective effects against cancer. Some of these studies identified possible risks of supplementing with high doses of certain vitamins or related substances. Examples of research results include the following:
- In another part of the Physicians’ Health Study II (not the part described above), supplementing with relatively high doses of either vitamin E or vitamin C did not reduce the risks of prostate cancer or total cancer in men aged 50 or older. Men taking vitamin E had an increased risk of hemorrhagic stroke (a type of stroke caused by bleeding in the brain).
- A 2010 meta-analysis of 22 clinical trials found no evidence that antioxidant supplements (vitamins A, C, and E; beta-carotene; and selenium) help to prevent cancer.
- Two large-scale studies found evidence that supplements containing beta-carotene increased the risk of lung cancer among smokers.
- The Selenium and Vitamin E Cancer Prevention Trial (SELECT), funded by NCI, NCCAM, and other agencies at NIH, showed that selenium and vitamin E supplements, taken either alone or together, did not prevent prostate cancer. It also showed that vitamin E supplements, taken alone, significantlyincreased the risk of prostate cancer in healthy men. There was no increase in prostate cancer risk when vitamin E and selenium were taken together. The doses of selenium and vitamin E used in this study were substantially higher than those typically included in multivitamin/mineral supplements.
- Although substantial evidence suggests that calcium may help protect against colorectal cancer, the evidence of potential benefit from calcium in supplement form is limited and inconsistent. Therefore, NCI does not recommend the use of calcium supplements to reduce the risk of colorectal cancer.
Other Natural Products. A 2009 systematic review of 51 studies with more than 1.6 million participants found “insufficient and conflicting” evidence regarding an association between consuming green tea and cancer prevention. Several other natural products, including Ginkgo biloba, isoflavones, noni, pomegranate, and grape seed extract, have been investigated for possible cancer-preventive effects, but the evidence on these substances is too limited for any conclusions to be reached.
Do You Want To Learn More About Cancer Prevention?
People can reduce their risk of cancer in many ways. They include avoiding exposure to agents that cause cancer (such as cigarette smoke), having tests (such as colonoscopies) that find precancerous conditions early, and, for some people who are at high risk, taking medicines to reduce cancer risk (chemoprevention). Additional information on cancer prevention is available from NCI.
NIH Research on Complementary Health Approaches for Cancer
Both NCI and NCCAM fund many laboratory studies and clinical trials related to cancer. Some ongoing studies are investigating:
- The effects of genetic factors and intakes of calcium and magnesium on the risk of developing precancerous colorectal polyps
- Mechanisms of action of natural products that may be of value in cancer prevention or treatment, such as bamboo extract, grape seed extract, white tea, red ginseng, and S-adenosyl-L-methionine (SAMe)
- The use of acupuncture for difficulty in swallowing after treatment for head and neck cancer
- Mind and body practices to improve sleep in cancer patients.
Additional information is available from NCI and from NCCAM.
If You Have Been Diagnosed With Cancer and Are Considering a Complementary Health Approach
- Cancer patients need to make informed decisions about using complementary health approaches. NCCAM and NCI have written a brochure that can help: Thinking About Complementary and Alternative Medicine: A Guide for People With Cancer.
- Gather information about the complementary health product or practice that interests you, and then discuss it with your health care providers. If you have been diagnosed with cancer, it is especially important to talk with your health care providers before you start using any new complementary health approach. If you are already using a complementary approach, tell your health care providers about it, even if your reason for using it has nothing to do with cancer. Some approaches may interfere with standard cancer treatment or may be harmful when used along with standard treatment. Examples of questions to ask include:
- What is known about the benefits and risks of this product or practice? Do the benefits outweigh the risks?
- What are the potential side effects?
- Will this approach interfere with conventional treatment?
- Can you refer me to a practitioner?
- Do not use any health product or practice that has not been proven safe and effective to replace conventional cancer care or as a reason to postpone seeing your health care provider about any health problem.
- Tell all your health care providers about any complementary health approaches you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care. For tips about talking with your health care providers about complementary health approaches, seeNCCAM’s Time to Talk campaign.
- Boehm K, Borrelli F, Ernst E, et al. Green tea (Camellia sinensis) for the prevention of cancer.Cochrane Database of Systematic Reviews. 2009;(3):CD005004. Accessed at http://www.thecochranelibrary.com on February 14, 2013.
- Cramer H, Lange S, Klose P, et al. Can yoga improve fatigue in breast cancer patients? A systematic review. Acta Oncologica. 2012;51(4):559–560.
- Deng GE, Frenkel M, Cohen L, et al. Evidence-based clinical practice guidelines for integrative oncology: complementary therapies and botanicals. Journal of the Society for Integrative Oncology. 2009;7(3):85–120.
- Elkins G, Fisher W, Johnson A. Mind-body therapies in integrative oncology. Current Treatment Options in Oncology. 2010;11(3–4):128–140.
- Ernst E. Massage therapy for cancer palliation and supportive care: a systematic review of randomised clinical trials. Supportive Care in Cancer. 2009;17(4):333–337.
- Ernst E, Lee MS. Acupuncture for palliative and supportive cancer care: a systematic review of systematic reviews. Journal of Pain and Symptom Management. 2010;40(1):e3–5.
- Gaziano JM, Glynn RJ, Christen WG, et al. Vitamins E and C in the prevention of prostate and total cancer in men: the Physicians’ Health Study II randomized controlled trial. JAMA. 2009;301(1):52–62.
- Gaziano JM, Sesso HD, Christen WG, et al. Multivitamins in the prevention of cancer in men: the Physicians’ Health Study II randomized controlled trial. JAMA. 2012;308(18):E1–E10.
- Klein EA, Thompson IM Jr, Tangen CM, et al. Vitamin E and the risk of prostate cancer: the Selenium and Vitamin E Cancer Prevention Trial (SELECT). JAMA. 2011;306(14):1549–1556.
- Ledesma D, Kumano H. Mindfulness-based stress reduction and cancer: a meta-analysis. Psycho-Oncology. 2009;18(6):571–579.
- Lin K-Y, Hu Y-T, Chang K-J, et al. Effects of yoga on psychological health, quality of life, and physical health of patients with cancer: a meta-analysis. Evidence-Based Complementary and Alternative Medicine. 2011;2011:659876.
- Lippman SM, Klein EA, Goodman PJ, et al. Effect of selenium and vitamin E on risk of prostate cancer and other cancers: the Selenium and Vitamin E Cancer Prevention Trial (SELECT).JAMA. 2009;301(1):39–51.
- Lu C, Lee JJ, Komaki R, et al. Chemoradiotherapy with or without AE-941 in stage III non-small cell lung cancer: a randomized phase III trial. Journal of the National Cancer Institute. 2010;102(12):859–865.
- Manksy PJ, Wallerstedt DB. Complementary medicine in palliative care and cancer symptom management. Cancer Journal. 2006;12(5):425–431.
- Mao JJ, Palmer CS, Healy KE, et al. Complementary and alternative medicine use among cancer survivors: a population-based study. Journal of Cancer Survivorship. 2011;5(1):8–17.
- Milazzo S, Ernst E, Lejeune S, et al. Laetrile treatment for cancer. Cochrane Database of Systematic Reviews. 2011;(11):CD005476. Accessed at http://www.thecochranelibrary.com on February 14, 2013.
- Miller S, Stagl J, Wallerstedt DB, et al. Botanicals used in complementary and alternative medicine treatment of cancer: clinical science and future perspectives. Expert Opinion on Investigational Drugs. 2008;17(9):1353–1364.
- Myung S-K, Kim Y, Ju W, et al. Effects of antioxidant supplements on cancer prevention: meta-analysis of randomized controlled trials. Annals of Oncology. 2010;21(1):166–179.
- Paley CA, Johnson MI, Tashani OA, et al. Acupuncture for cancer pain in adults. Cochrane Database of Systematic Reviews. 2011;(1):CD007753. Accessed at http://www.thecochranelibrary.com on February 14, 2013.
- Pillai AK, Sharma KK, Gupta YK, et al. Anti-emetic effect of ginger powder versus placebo as an add-on therapy in children and young adults receiving high emetogenic chemotherapy. Pediatric Blood & Cancer. 2011;56(2):234–238.
- Ryan JL, Heckler CE, Roscoe JA, et al. Ginger (Zingiber officinale) reduces acute chemotherapy-induced nausea: a URCC CCOP study of 576 patients. Supportive Care in Cancer. 2012;20(7):1479–1489.
- Wilkinson S, Barnes K, Storey L. Massage for symptom relief in patients with cancer: systematic review. Journal of Advanced Nursing. 2008;63(5):430–439.
For More Information
The NCCAM Clearinghouse provides information on NCCAM and complementary health approaches, including publications and searches of Federal databases of scientific and medical literature. The Clearinghouse does not provide medical advice, treatment recommendations, or referrals to practitioners.
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National Cancer Institute
The National Cancer Institute is the Federal Government’s lead agency for cancer research. The National Cancer Institute’s Office of Cancer Complementary and Alternative Medicine coordinates and enhances the National Cancer Institute’s activities in CAM research.
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NCI’s Office of Cancer Complementary and Alternative Medicine
A service of the National Library of Medicine (NLM), PubMed® contains publication information and (in most cases) brief summaries of articles from scientific and medical journals.
NIH Clinical Research Trials and You
The National Institutes of Health (NIH) has created a Web site, NIH Clinical Research Trials and You, to help people learn about clinical trials, why they matter, and how to participate. The site includes questions and answers about clinical trials, guidance on how to find clinical trials through ClinicalTrials.gov and other resources, and stories about the personal experiences of clinical trial participants. Clinical trials are necessary to find better ways to prevent, diagnose, and treat diseases.
NCCAM thanks Cornelia Ulrich, Ph.D., German Cancer Research Center; Susan Folkman, Ph.D., University of California, San Francisco; Jun James Mao, M.D., University of Pennsylvania; Elizabeth Austin, M.S., Robin Baldwin, B.S.N., Barbara McMakin, M.S., and Jeffrey White, M.D., National Cancer Institute; and Carol Pontzer, Ph.D., and John (Jack) Killen, Jr., M.D., NCCAM, for their contributions to the 2013 update of this publication.
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NCCAM has provided this material for your information. It is not intended to substitute for the medical expertise and advice of your primary health care provider. We encourage you to discuss any decisions about treatment or care with your health care provider. The mention of any product, service, or therapy is not an endorsement by NCCAM.
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