Healthstyles Today: “Observation Status”–Policy Gone Wrong? | HealthCetera – CHMP’s Blog.
Across the country, people on Medicare who become ill are being admitted to hospitals on what is called “observation status” or “admit to observation” to provide regular assessments to ensure that the patient’s condition doesn’t deteriorate and require a higher level of care. Medicare pays less for observation status since it’s assumed that the patient needs less care. It makes sense, but in reality it’s creating huge problems for some of the patients, their families and the hospitals. The issue has become a national concern and New York State has responded with legislation aimed to provide some protection for Medicare patients who are admitted to the state’s hospitals.
Today on Healthstyles on WBAI 9.5 FM (www.wbai.org), producer and host Diana Mason, RN, PhD, talks about this issue with Toby Edelman, Senior Policy Attorney in the Washington, DC, office of the Center for Medicare Advocacy. You can listen to the interview here: [link available at the blog]
Question your medical tests? Oh yeah, it’ll make you happy!.
From the 24 July 2014 KevinMD.com post
Who knew questioning medical tests could be so much fun? Watch Pharrell Williams’ “Happy” with lyrics that advocate more sensible medical testing. James McCormick, co-host of the Best Science Medicine Podcast, wrote this pitch perfect parody. The ABIM Foundation’s Choosing Wisely campaign educates both physicians and the public to question medical tests and treatments.
The ABIM provides links to Things Physicians and Providers Should Question.
Doctors Call Out 90 More Unnecessary Medical Tests, Procedures
Posting this because I can relate. Was diagnosed with a lumbar sprain two weeks ago. It was only acute for two days. Am better now and going to physical therapy once a week for awhile.
Dr. Evans has videos on other health subjects at http://www.evanshealthlab.com
Topics include smoking, insomnia, type 2 diabetes,
Everything you need to know about back pain in 11 minutes.
From the YouTube site
Published on Jan 24, 2014
Check out our new website, http://www.evanshealthlab.com/
Follow Dr. Mike for new videos! http://twitter.com/docmikeevans
Dr. Mike Evans is founder of the Health Design Lab at the Li Ka Shing Knowledge Institute, an Associate Professor of Family Medicine and Public Health at the University of Toronto, and a staff physician at St. Michael’s Hospital.
Evans Health Lab fuses clinicians and creatives, filmmakers and patients, social entrepreneurs and best evidence to create “edutaining” healthcare information.
Exercise is also mentioned as a possible replacement for unnecessary medical testing/health screenings.
(Remember, discuss personal health decisions with your health care provider!)
From the YouTube link below
Who knew questioning medical tests could be so much fun? Watch Pharrell Williams’ “Happy” with lyrics that advocate more
sensible medical testing. James McCormick, co-host of the Best Science Medicine Podcast, wrote this pitch perfect parody. The
ABIM Foundation’s Choosing Wisely campaign educates both physicians and the public to question medical tests and
From the 14 May 2014 post at Venture Beat News
Millions of people around the world immediately go to the Web for information after feeling a mysterious ache, pain, rash, or bump. This often results in either a panic attack or a false sense of calm. Doctors have warned against this practice since the days of Netscape, and now a new report puts some science behind their fears.
Researchers at Campbell University in North Carolina compared Wikipedia entries on 10 of the costliest health problems with peer-reviewed medical research on the same illnesses. Those illnesses included heart disease, lung cancer, depression, and hypertension, among others.
The researchers found that nine out of the 10 Wikipedia entries studied contained inaccurate and sometimes dangerously misleading information. “Wikipedia articles … contain many errors when checked against standard peer-reviewed sources,” the report states. “Caution should be used when using Wikipedia to answer questions regarding patient care.”
At Wikipedia anybody can contribute to entries on health problems — no medical training (or even common sense) is required.
“While Wikipedia is a convenient tool for conducting research, from a public health standpoint patients should not use it as a primary resource because those articles do not go through the same peer-review process as medical journals,” said the report’s lead author, Dr. Robert Hasty in a statement.
And there’s a lot of health information on Wikipedia. The site contains more than 31 million entries, and at least 20,000 of them are health-related, the report says.
The study findings were published in this month’s Journal of the American Osteopathic Association. You can see the full text of the study here.
Via: Daily Mail
Wikipedia is a project operated by a non-profit organization, the Wikimedia Foundation, and created and maintained by a strong community of 80,000 international active volunteer editors. Founded in 2001 by Jimmy Wales, Wikipedia has be… read more »
Powered by VBProfiles
How to evaluate health information (flahiff.google.com)
Evaluating health information (MedlinePlus)
How to evaluate health information (NIH)
Great ideas on a variety of exercises. Not for seniors only!
From the 7 May 2014 item at the Brookings Institute
Disadvantaged children who often experience deep poverty, violence, and neglect simultaneously are particularly vulnerable to the pernicious effects of chronic stress. New research reveals that chronic stress alters childrens’ rapidly developing biological systems in ways that undermine their ability to succeed in school and in life. But there is good evidence that specialized programs can help caretakers learn to be more supportive and responsive. High-quality childcare can offer a safe, warm, and predictable environment amid otherwise chaotic lives, and home visiting programs can help both parents and foster parents learn to provide an environment of greatly reduced stress for their children.
On May 7, Princeton University and the Brookings Institution released the Spring 2014 volume and accompanying policy brief of the Future of Children. The release event featured researchers and policy experts who explained how chronic stress “gets under the skin” to disrupt normal development and how programs can provide the support so urgently needed by children who face chronic stress.
From the 6 May 2014 EurkAlert
WASHINGTON, May 6, 2014 — Pregnant women go through a lot to bring a baby into this world: 2 a.m. food cravings, hypersensitivity to certain smells and morning sickness, not to mention labor and delivery. In honor of Mother’s Day, the American Chemical Society’s (ACS’) newest Reactions video highlights the chemistry behind a pregnant woman’s altered sense of taste and smell, how mom’s diet influences baby’s favorite foods and other pregnancy phenomena. The video is available at http://youtu.be/Gnqjh-L4e9g
And because moms always deserve more, we’ve created a bonus video on what scientists believe causes dreaded morning sickness in pregnant women. The bonus video can be seen here: http://youtu.be/09bCTERVrms
Subscribe to the series at Reactions YouTube, and follow us on Twitter @ACSreactions to be the first to see our latest videos.
Originally posted on Johns Hopkins University Press Blog:
Today is the fifth and final in a series of brief podcast excerpts from The 36-Hour Day: A Family Guide to Caring for People Who Have Alzheimer Disease, Related Dementias, and Memory Loss. This bestselling title by Nancy L. Mace, M.A., and Peter V. Rabins, M.D., M.P.H., is in its fifth edition and is now available in an audio edition.
Podcast #5: Excerpt from Chapter 10: Getting Help
In this excerpt from Chapter 10, Dr. Rabins focuses on the need for caregivers to have outside help and have time away from the responsibilities of caregiving. He describes how to find good information on available services, how to seek and accept help from friends and neighbors, and how to address problems you may encounter.
You can find this podcast and the rest of the series of podcasts here.
These podcasts are excerpted from a Johns Hopkins University Press audio…
View original 107 more words
This resource is a bit off topic. It is an educational resource basically for junior high and high school teachers. However, I find it fascinating on how it shows the interrelationship among science and mathematical concepts. Here’s a few that are health/medical related
Here’s a sample
In search of a few good apps.
New JAMA article suggests review and certification process for mHealth apps
BOSTON–While the Food and Drug Administration (FDA) has released guidelines for the regulation of mobile health (mHealth) apps that act as medical devices or as accessories to medical devices, the vast majority of mHealth apps remain unregulated and unevaluated. In a Viewpoint article, “In Search of a Few Good Apps”, published in JAMA on March 24, 214, co-authors, David Bates, MD and Adam Landman, MD of Brigham and Women’s Hospital (BWH) and Adam Powell, PhD, president of Payer+Provider Syndicate, call for the creation of mHealth (mobile health) app review and certification organizations to evaluate apps that are not regulated by the government.
“This article gives health care providers, patients, policymakers and mHealth app developers a perspective on how the issue of determining which apps are most useful might be addressed,” said Bates, who is Chief Quality Officer at BWH and chaired the Food and Drug Administration Safety and Innovation Act (FDASIA) Workgroup that made recommendations to the government about regulation of HIT and mobile apps. “Establishing an unbiased review and certification process is a key step in helping mHealth apps achieve their potential.”
The concept for this Viewpoint article was conceived by Landman and Powell after discussing their mutual concern about the lack of oversight over the accuracy, quality, and security of mHealth apps at the BWH Hackathon, an event sponsored by BWH’s Innovation Hub (iHub).
“Dr. Powell and I examined numerous mHealth apps and it was difficult to assess app credibility,” said Landman, Chief Medical Information Officer for Health Information Innovation and Integration and an emergency medicine physician at BWH. “The currently available reviews of mHealth apps have largely focused on personal impressions, rather than evidence-based, unbiased assessments of clinical performance and data security. With more rigorous certification criteria and unbiased accrediting bodies, both clinicians and consumers could be more confident in their selection and use of mHealth apps.”
In the article, authors describe the potential for multiple organizations to be created that could review and objectively certify mHealth apps for quality, accuracy, security and safety, similar to the role that Health On the Net Foundation (HON), a non-profit, non-governmental organization, plays in evaluating the quality of online medical content.
“People are increasingly turning to their smartphones for assistance in improving their health, but are having difficulty determining which apps are the securest and most effective. We hope that our article will instigate action that will enable clinicians and patients to make more effective use of mHealth apps,” said Powell, lead author of the article. “We foresee a potential future in which physicians will be able to confidently prescribe apps to their patient, and will have the tools that they need to interpret the resulting data. The establishment of an unbiased app certification and review process will play a key role in getting us there.”
Wellocracy aims to help trackers choose and use health apps and devices
Free and low cost Health Apps sources include
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
- iMedical apps has mobile medical app reviews and commentary by medical professionals. Most apps are about apps geared toward professionals and are not free.
Relaxation Techniques for Health: An Introduction | NCCAM
Excerpts from the Web page at The National Center for Complementary and Alternative Medicine
On this page:
Relaxation techniques include a number of practices such as progressive relaxation, guided imagery,biofeedback, self-hypnosis, and deep breathing exercises. The goal is similar in all: to consciously produce the body’s natural relaxation response, characterized by slower breathing, lower blood pressure, and a feeling of calm and well-being.
Relaxation techniques (also called relaxation response techniques) may be used by some to release tension and to counteract the ill effects of stress. Relaxation techniques are also used to induce sleep, reduce pain, and calm emotions. This fact sheet provides basic information about relaxation techniques, summarizes scientific research on effectiveness and safety, and suggests sources for additional information.
- Relaxation techniques may be an effective part of an overall treatment plan for anxiety, depression, and some types of pain. Some research also suggests that these techniques may help with other conditions, such as ringing in the ears and overactive bladder. However, their ability to improve conditions such as high blood pressure and asthma is unclear.
- Relaxation techniques are generally safe.
- Do not use relaxation techniques to replace scientifically proven treatments or to postpone seeing a health care provider about a medical 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.
About Relaxation Techniques
Relaxation is more than a state of mind; it physically changes the way your body functions. When your body is relaxed breathing slows, blood pressure and oxygen consumption decrease, and some people report an increased sense of well-being. This is called the “relaxation response.” Being able to produce the relaxation response using relaxation techniques may counteract the effects of long-term stress, which may contribute to or worsen a range of health problems including depression, digestive disorders, headaches, high blood pressure, and insomnia.
Go here for the entire article
From the 6 February 2014 ScienceDaily article
Despite the fact that heart disease is the leading cause of death for both men and women in the U.S., about three-quarters (74 percent) of Americans do not fear dying from it, according to a recent survey.
Despite the fact that heart disease is the leading cause of death for both men and women in the U.S., about three-quarters (74 percent) of Americans do not fear dying from it, according to a recent survey from Cleveland Clinic.
Conducted as part of its “Love Your Heart” consumer education campaign in celebration of Heart Month, the survey found that Americans are largely misinformed about heart disease prevention and symptoms, and almost a third (32 percent) of them are not taking any proactive steps to prevent it. Even among those Americans with a family history of the disease (39 percent), who are at a significantly higher risk, 26 percent do not take any preventative steps to protect their heart health, according to the survey.
Perhaps even more concerning is that the majority (70 percent) of Americans are unaware of all the symptoms of heart disease, even though two out of three (64 percent) have or know someone who has the disease. Only 30 percent of Americans correctly identified unusual fatigue, sleep disturbances and jaw pain as all being signs of heart disease — just a few of the symptoms that can manifest.
“Heart disease is the No. 1 killer of men and women in this country, so it’s disappointing to see that so many Americans are unaware of the severity of not taking action to prevent heart disease, or how exactly to do so,” said Steven Nissen, M.D., Chairman of Cardiovascular Medicine at Cleveland Clinic. “This is a disease that can largely be prevented and managed, but you have to be educated about how to do so and then incorporate prevention into your lifestyle.”
Many Americans believe the myth that fish oil can prevent heart disease.
Vitamins are viewed — mistakenly — as a key to heart disease prevention.
There is a lack of awareness about secret sodium sources.
Americans believe there is a heart disease gene.
There is no single way to prevent heart disease, given that every person is different,” Dr. Nissen added.
“Yet there are five things everyone should learn when it comes to their heart health because they can make an enormous difference and greatly improve your risk:
know your cholesterol,blood pressure, and body mass index numbers,
do not use tobacco,
and know your family history.
Taking these steps can help lead to a healthier heart and a longer, more vibrant life.”
From the 2 February 2014 post at Public Health Talks
English: one high-quality “bud ” nugget of marijuana (Photo credit: Wikipedia)
On January 1st, 2014, Colorado enacted a law that legalized the recreational use of marijuana for adults. For long, discussions have gathered around the health risks involved with the legalization of marijuana.
Marijuana’s long term use can lead to addiction along with respiratory illnesses and cognitive impairment. The risks of addiction are most prominent amongst adolescents. The legalization of marijuana and its increased accessibility can lead to increased use and abuse of the drug. However, with decriminalizing the drug many see benefits arise.
#PubHT wants to discuss the public health implications of legalization of marijuana with you! Please join us on Monday, February 3 at 9 PM ET for a one hour discussion on this topic.
For more information on marijuana use visit:http://www.drugabuse.gov/publications/drugfacts/marijuana
Excepts from the publication
- How Does Marijuana Affect the Brain?
Marijuana overactivates the endocannabinoid system, causing the “high” and other effects that users experience. These effects include altered perceptions and mood, impaired coordination, difficulty with thinking and problem solving, and disrupted learning and memory.Marijuana also affects brain development, and when it is used heavily by young people, its effects on thinking and memory may last a long time or even be permanent.
- What Are the Other Health Effects of Marijuana?
Marijuana use may have a wide range of effects, particularly on cardiopulmonary and mental health.
Marijuana smoke is an irritant to the lungs, and frequent marijuana smokers can have many of the same respiratory problems experienced by tobacco smokers, such as daily cough and phlegm production, more frequent acute chest illness, and a heightened risk of lung infections.
Many have called for the legalization of marijuana to treat conditions including pain and nausea caused by HIV/AIDS, cancer, and other conditions, but clinical evidence has not shown that the therapeutic benefits of the marijuana plant outweigh its health risks.
However, THC-based drugs to treat pain and nausea are already FDA approved and prescribed, and scientists continue to investigate the medicinal properties of other chemicals found in the cannabis plant—such as cannabidiol, a non-psychoactive cannabinoid compound that is being studied for its effects at treating pain, pediatric epilepsy, and other disorders. For more information, see DrugFacts – Is Marijuana Medicine?
- Additionally, because it seriously impairs judgment and motor coordination, marijuana contributes to risk of injury or death while driving a car. A recent analysis of data from several studies found that marijuana use more than doubles a driver’s risk of being in an accident.
- Research shows marijuana may cause problems in daily life or make a person’s existing problems worse. Heavy marijuana users generally report lower life satisfaction, poorer mental and physical health, more relationship problems, and less academic and career success compared to non-marijuana-using peers. For example, marijuana use is associated with a higher likelihood of dropping out of school. Several studies also associate workers’ marijuana smoking with increased absences, tardiness, accidents, workers’ compensation claims, and job turnover.
[Letter to editor] Legalizing marijuana and preventing youth pot use
From the Office of the Surgeon General Website
January 11, 2014 marked the 50th anniversary of the first Surgeon General’s Report on Smoking and Health. The 1964 landmark report, released by Surgeon General Dr. Luther Terry, was the first federal government report linking smoking and ill health, including lung cancer and heart disease. This scientifically rigorous report laid the foundation for tobacco control efforts in the United States. In the last 50 years, 31 Surgeon General’s Reports have been released, increasing our understanding of the devastating health and financial burdens caused by tobacco use. We now know that smoking causes a host of cancers and other illnesses and is still the leading preventable cause of death in the United States, killing 443,000 people each year. In 2014, we highlight half a century of progress in tobacco control and prevention, present new data on the health consequences of tobacco use, and introduce initiatives that can potentially end the tobacco use epidemic in the United States in the 32rd Surgeon General’s Report on smoking and health, The Health Consequences of Smoking—50 Years of Progress.
Below is an image of a widget at the Surgeon General site
Click here to go to the widget, then click on the links as About Tobacco.
Additional Resources and Articles
Ever been scared or made uncomfortable about threats to your health? And solutions that seemed too good to be true?
Here’s a book for just about everyone that can help one understand the statistics behind health information. And how to spot misinformation easily.
What This Book is About – Know Your Chances – NCBI Bookshelf.
From the intro
Every day we are faced with news stories, ads, and public service announcements that describe health threats and suggest ways we can protect ourselves. It’s impossible to watch television, open a magazine, read a newspaper, or go online without being bombarded by messages about the dangers we face.
Many of the messages are intended to be scary, warning us that we are surrounded by danger and hinting that everything we do or neglect to do brings us one step closer to cancer, heart disease, and death. Other messages are intended to be full of hope, reassuring us that technological miracles and breakthrough drugs can save us all. And many messages do both: they use fear to make us feel vulnerable and then provide some hope by telling us what we can do (or buy) to lower our risk. In addition, as you may suspect, a great many of these messages are wildly exaggerated: many of the risks we hear about are really not so big, and the benefits of many of the miraculous breakthroughs are often pretty small.
As a result, we are often left misinformed and confused. But it doesn’t have to be that way.
The goal of this book is to help you better understand health information by teaching you about the numbers behind the messages—the medical statistics on which the claims are based. The book will also familiarize you with risk charts, which are designed to help you put your health concerns in perspective. By learning to understand the numbers and knowing what questions to ask, you’ll be able to see through the hype and find the credible information—if any—that remains.
Don’t worry: this is not a math book (only a few simple calculations are required). Instead, this is a book that will teach you what numbers to look for in health messages and how to tell when the medical statistics don’t support the message. This book will help you develop the basic skills you need to become a better consumer of health messages, and these skills will foster better communication between you and your doctor.
From the book (pages 130-132)
From the book
CREDIBLE SOURCES OF HEALTH STATISTICS
Sources Created Primarily for Consumers BMJ (British Medical Journal) Best Treatments
Medical publishing division of the British Medical Association (no commercial ads allowed). Rates the science supporting the use of operations, tests, and treatments for a variety of conditions. In the United States and Canada, available only with a Consumer Reportssubscription.
Center for Medical Consumers
Independent, nonprofit organization. Offers a skeptical take on health claims and recent health news. Free.
Consumer Reports Best Buy Drugs* www.consumerreports.org/health/bestbuy-drugs.htm
Independent, nonprofit organization. Compares the benefits, side effects, and costs of different prescription drugs for the same problem, based on information from the Drug Effectiveness Review Project (see listing on page 131). Free.
Foundation for Informed Medical Decision Making*
Independent, nonprofit organization. Offers decision aids that describe the treatment options and outcomes for various conditions in order to promote patient involvement in decision making. DVDs must be purchased at http://www.healthdialog.com/hd/Core/CollaborativeCare/videolibrary.htm.
* Two of us (Drs. Schwartz and Woloshin) are on the advisory board for Consumer Reports Best Buy Drugs (unpaid positions). We have been paid consultants reviewing materials for the Foundation for Informed Medical Decision Making.
Informed Health Online
Institute for Quality and Efficiency in Health Care, an independent, nonprofit organization established by German health care reform legislation. Describes the science supporting the use of operations, tests, and treatments for a variety of conditions. Free.
Ottawa Health Research Institute Patient Decision Aids
Academic affiliate of the University of Ottawa. Provides a comprehensive inventory of decision aids (plus a rating of their quality), and tells patients how to get them. Some are free.
Sources Created Primarily for Physicians and Policy Makers Agency for Healthcare Research and Quality (AHRQ)
U.S. federal agency under the Department of Health and Human Services. Summarizes all the available data about treatments for specific conditions (look for EPC Evidence Reports). Free.
International, independent, nonprofit organization of researchers. Summarizes all the available data about treatments for specific conditions (look for Cochrane Reviews). Abstracts free, full reports by subscription.
Drug Effectiveness Review Project (DERP)
Collaboration of public and private organizations developed by Oregon Health and Science University. Provides comparative data on the benefit, side effects, and costs of different prescription drugs for the same problem (source for Consumer Reports Best Buy Drugs). Free.
National Institute for Health and Clinical Excellence (NICE)
Independent, nonprofit British organization that advises the British National Health Service. Summarizes all the available data about treatments for specific conditions (look for NICE Guidance). Free.
Physician Data Query (PDQ)—National Cancer Institute
U.S. federal government (part of the National Cancer Institute). Summa- rizes all the available data about cancer prognosis and treatments (look for Cancer Information Summaries). Free.
U.S. Food and Drug Administration (FDA), Center for Drug Evaluation and Research
U.S. federal agency under the Department of Health and Human Services, which reviews and approves new and generic drugs. To look up individual drugs, go to http://www.accessdata.fda.gov/scripts/cder/drugsatfda/index.cfm. After you choose a drug from the index, the Drug Details page appears. If you click Approval History, you may be able to access a Review and then a Medical Review. TheMedical Review contains all the relevant randomized trials submitted to the FDA for approval. From the Drug Details page, you can also access Label Information, when it is available (the package insert that comes with prescription drugs and summarizes excerpts of the review documents). Warning: This site can be challenging. The review documents can be hundreds of pages, and there may be multiple entries for the same drug (because it is used for multiple purposes). Free.
US Preventive Services Task Force
Independent panel of experts sponsored by AHRQ. Summarizes the available data about preventive services. After you choose a topic, you’ll see the relevant recommendations; at the bottom of the list, you can click Best- Evidence Systematic Review under Supporting Documents. Free.
- From My Bookshelf to Yours. 2013 (bookaddictgurl.wordpress.com)
- NCBI Educational Resources (bettyblazetech.wordpress.com)
- eBooks added Dec. 2013 (wulibraries.typepad.com)
From the Resource page
The Association of Health Care Journalists offers a wide range of resources – many of which are available exclusively to members.
AHCJ publications include our newsletter, HealthBeat, as well as several guides to covering specific aspects of health and health care.
Members share ideas and ask questions of fellow members on the AHCJ electronic mailing list. Tip sheets are prepared for our conferences and workshops, often offering sources and information about covering specific stories.
Contest entries are from the Awards for Excellence in Health Care Journalism, recognizing the best health reporting in print, broadcast and online media. We have links to past winners and information culled from questionnaires submitted with the entries about how each story was researched and written.
We include links to some recent reports and studies of interest to our membership, as well as links to Web sites relevant to health care.
Members and other journalists write articles specifically for AHCJ about how they have reported a story, issues that our members are likely to cover and other important topics.
Of particular note in the health/medical area….
GUIDES TO FINDING AND EVALUATING HEALTH INFORMATION ON THE WEB
Needless to say, I’ve added a link to this at my Health Resources for all Web site
From the 26 November 2013 posting at Susannah Fox – Internet geologist**. Health care gadfly. Community colleague.
The Pew Research Center released a report today on people living with chronic conditions: The Diagnosis Difference.
Policy makers, patient advocates, entrepreneurs, investors, clinicians — all health care stakeholders — can use the data to map the current landscape. There are still barren patches, where people remain offline and cut off from the resources and tools. But there are lush valleys, too, where engagement and change is happening.
I see e-patients as the guides to those valleys since unless you are living with chronic conditions — or love someone who is — you don’t see that side of the internet. So here’s my request: provide your evidence. Show what you have learned.
First, a quick summary of the report:
1. 45% of U.S. adults have a chronic condition (For some, that’s a revelation and there is still a considerable distance to go before that reality is widely known. For you, that’s not the news. That’s just proof that we have a sample that matches the CDC’s estimate and you can therefore trust the data.)
2. 72% of adults with chronic conditions have internet access, compared with 89% of U.S. adults who report no conditions. There are digital divide implications to this because having a chronic disease is an independent factor in predicting if someone has access — apart from things like age, income, and educational attainment.
3. Clinicians are central resources. People living with chronic conditions are more likely than other adults to consult a clinician when they need help or after they Google for a diagnosis.
4. Self-tracking is a massive activity, particularly for people living with 2 or more chronic conditions, and this group is more likely to use formal means, not just tracking in their heads as many “well” trackers do. For example, 41% of health trackers who report having one or more chronic conditions use pencil and paper and 14% of this group uses a medical device such as a glucometer.
5. Living with a chronic condition has an independent, significant effect on behaviors that are often described as signs of consumer health engagement, like reading up on drug safety, medical treatments, or delivery-of-care reviews. Internet users living with chronic conditions are more likely than others to read or watch someone else’s commentary or personal experience about health or medical issues online.
I want to stop a moment and give some examples of what that might look like.
And now we come to the category that personally means the most to me since I’ve spent time in rare disease communities: the 16% of U.S. adults who are living with “other conditions,” like rheumatoid arthritis, epilepsy, or fibromyalgia (to name a very few of thousands). They are hardly ever in the mainstream spotlight. They may have awareness days or weeks or months that their communities honor, but you won’t see the National Football League wearing their colors.
The internet is their spotlight. A blog, a hashtag, a YouTube channel, or a Facebook group can be their lifeline. Yes, they consult clinicians like everyone else, but those who are online know that the path to health — for them — is often found in the advice shared by someone like them or the person they are caring for. The feeding tip that will help their baby get the nutrients she needs to grow. The heating-pad tip that will ease their painsomnia.
As I wrote at the top, unless you are living with chronic conditions — or love someone who is — you don’t see that side of the internet. So let’s open up the landscape.
Please post in the comments what you have learned online from a fellow spoonie, from a fellow caregiver, from a fellow traveler along the path to health. What would you tell someone just diagnosed with your condition to do, especially in tapping into the resources available online? When someone asks you, maybe over Thanksgiving, about why you spend time online, what will you say?
Post it here [at Samantha Fox's blog] . Links to blogs, videos, tweets — all are welcome.
** From Susannah Fox’s About Page (Internet Geologist definition)
I was at a cocktail party, struggling to describe in just a few sentences what I do for a living, when my friend Paul Tarini broke in and said, “You’re an internet geologist. You study the rocks, you don’t judge them.” Exactly. I study patterns in the online landscape and provide data so people can make better decisions about the social impact of the internet.
My other favorite description of the kind of research I do is “nowist” (meaning: instead of being a futurist, understand what people are doing now and be alert to changes).
“Health care gadfly” describes my role outside the fray, as an observer, hopefully contributing to the public conversation in a useful way.
Ted Eytan coined the phrase “community colleague” for people who collaborate by default. That’s me. My work is enriched by the health geek tribe. I can’t imagine doing the work I do without the help of my community.
NSA BAHRAIN_130708-N-AZ907-005 (Photo credit: U.S. Naval Forces Central Command/U.S. Fifth Fleet)
From the 16 November 2013 American Heart Association press release via EurkAlert
RESS Abstract 19453/157 (Omni Dallas Hotel, Dallas Ballroom D-H)
Just one minute of CPR video training for bystanders in a shopping mall could save lives in emergencies, according to research presented at the American Heart Association’s Scientific Sessions 2013.
Researchers used a one-minute CPR video to improve responsiveness and teach compression only CPR to people with no CPR experience.
Participants were divided into two groups: 48 adults looked at the video, while 47 sat idle for one minute. In a private area with a mannequin simulating a sudden collapse, both groups were asked to do “what they thought best.” Researchers measured responsiveness as time to call 9-1-1 and start chest compression and CPR quality reflected by chest compression depth, rate and hands-off interval time.
Adults who saw the CPR video called 9-1-1 more frequently, initiated chest compression sooner, had an increased chest compression rate and a decreased hands-off interval, researchers said.
“Given the short length of training, these findings suggest that ultra-brief video training may have potential as a universal intervention for public venues to help bystander reaction and improve CPR skills,” said Ashish Panchal, M.D., Ph.D. lead researcher of the study.
From a previous post (which includes videos)
A link to information about the new CPR guidelines (Compression - Airway- Breathing) may be found here.
A presskit with media materials, statements from experts, and real life stories may be found here.
Excerpt from the American Heart Association Oct 18, 2010 news release
- The 2010 AHA Guidelines for CPR and ECC update the 2005 guidelines.
- When administering CPR, immediate chest compressions should be done first.
- Untrained lay people are urged to administer Hands-Only CPR (chest compressions only).
DALLAS, Oct. 18, 2010 — The American Heart Association is re-arranging the ABCs of cardiopulmonary resuscitation (CPR) in its 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation andEmergency Cardiovascular Care, published in Circulation: Journal of the American Heart Association.
Recommending that chest compressions be the first step for lay and professional rescuers to revive victims ofsudden cardiac arrest, the association said the A-B-Cs (Airway-Breathing-Compressions) of CPR should now be changed to C-A-B (Compressions-Airway-Breathing).[Editor Flahiff's emphasis]
“For more than 40 years, CPR training has emphasized the ABCs of CPR, which instructed people to open a victim’s airway by tilting their head back, pinching the nose and breathing into the victim’s mouth, and only then giving chest compressions,” said Michael Sayre, M.D., co-author of the guidelines and chairman of the American Heart Association’s Emergency Cardiovascular Care (ECC) Committee. “This approach was causing significant delays in starting chest compressions, which are essential for keeping oxygen-rich blood circulating through the body. Changing the sequence from A-B-C to C-A-B for adults and children allows all rescuers to begin chest compressions right away.”
In previous guidelines, the association recommended looking, listening and feeling for normal breathing before starting CPR. Now, compressions should be started immediately on anyone who is unresponsive and not breathing normally.
All victims in cardiac arrest need chest compressions. In the first few minutes of a cardiac arrest, victims will have oxygen remaining in their lungs and bloodstream, so starting CPR with chest compressions can pump that blood to the victim’s brain and heart sooner. Research shows that rescuers who started CPR with opening the airway took 30 critical seconds longer to begin chest compressions than rescuers who began CPR with chest compressions.
The change in the CPR sequence applies to adults, children and infants, but excludes newborns.
Other recommendations, based mainly on research published since the last AHA resuscitation guidelines in 2005:
- During CPR, rescuers should give chest compressions a little faster, at a rate of at least 100 times a minute.
- Rescuers should push deeper on the chest, compressing at least two inches in adults and children and 1.5 inches in infants.
- Between each compression, rescuers should avoid leaning on the chest to allow it to return to its starting position.
- Rescuers should avoid stopping chest compressions and avoid excessive ventilation.
- All 9-1-1 centers should assertively provide instructions over the telephone to get chest compressions started when cardiac arrest is suspected.
From the US Substance Abuse and Mental Health Administration press release
Behavioral Health United States 2012
SAMHSA’s newly-released publication, Behavioral Health, United States, 2012, the latest in a series of publications issued by SAMHSA biannually since 1980, provides in-depth information regarding the current status of the mental health and substance abuse field. It includes behavioral health statistics at the national and State levels from 40 different data sources. The report includes three analytic chapters:
- Behavioral Health Disorders across the Life Span
- Mental Health and Substance Use Disorders: Impairment in Functioning
- Mental Health and Substance Use Disorders: Treatment Landscape
The volume also includes 172 tables, which are organized into four sections:
- Behavioral Health of the Population: the mental health status of the U.S. population and prevalence of mental illness;
- Behavioral Health Service Utilization: providers and settings for behavioral health services; types of behavioral health services provided; and rates of utilization;
- Behavioral Health Treatment Capacity: number of facilities providing mental health and substance abuse services; numbers of qualified specialty mental health and substance abuse providers; and
- Payer and Payment Mechanisms: expenditures and sources of funding for behavioral health services.
No other HHS publication provides this type of comprehensive information regarding behavioral health services delivery in the U.S. This publication is the only available comprehensive source of national-level statistical information on trends in both private and public sector behavioral health services, costs, and clients. Drawing on 40 different data sources, this publication also includes State-level data, and information on behavioral health treatment for special populations such as children, military personnel, nursing home residents, and incarcerated individuals.
This page is geared towards health care providers, but it may be of interest to others.
From the US FDA (Food and Drug Administration) Web page
FDA’s Bad Ad program is an outreach program designed to educate healthcare providers about the role they can play in helping the agency make sure that prescription drug advertising and promotion is truthful and not misleading.
The Bad Ad Program is administered by the agency’s Office of Prescription Drug Promotion (OPDP) in the Center for Drug Evaluation and Research. The program’s goal is to help raise awareness among healthcare providers about misleading prescription drug promotion and provide them with an easy way to report this activity to the agency: e-mail BadAd@fda.gov or call 855-RX-BADAD.
Continuing Medical Education Video itself is free for anyone to view (http://www.sigmatech.com/BadAd/courses/index.htm)It covers what is legal/illegal for pharmaceutical companies and their representatives when advertising their products at different venues
Prescription drug advertising must:
- Be accurate
- Balance the risk and benefit information
- Be consistent with the prescribing information approved by FDA
- Only include information that is supported by strong evidence
What types of promotion does OPDP regulate?
- TV and radio advertisements
- All written or printed prescription drug promotional materials
- Speaker program presentations
- Sales representative presentations
OPDP does not regulate promotion of:
- Over-the-Counter Drugs
- Dietary Supplements
- Medical Devices
- Omitting or downplaying of risk
- Overstating the effectiveness
- Promoting Uses Not Addressed in Approved Labeling
- Misleading drug comparisons
Examples of Violations
Example of Omission of Risk
You attend a speaker program which features a slide show that presents efficacy information about Drug X, but no risk information.
This presentation would be misleading because it fails to include a fair balance of benefit and risk information for Drug X.
Example of Uses Not Addressed in Approved Labeling
You are in a commercial exhibit hall and a company representative tells you that a drug is effective for a use that is not in the FDA-approved product labeling.
This presentation would be illegal because it promotes an unapproved use.
Example of Overstating the Effectiveness
“Doctor Smith, Drug X delivers rapid results in as little as 3 days.”
This presentation is misleading because the majority of patients studied in the clinical trials for Drug X showed results at 12 weeks, with only very few showing results in 3 days.
Frequently Asked Questions
1. Can I report anonymously?
Yes, anonymous complaints often alert FDA to potential problems. However, complaints accompanied by names and contact information are helpful in cases for which FDA needs to follow-up for more information.
2. Will OPDP be able to stop the misleading promotion?
In many cases, yes, especially if the appropriate evidence is provided. Evidence can include the actual promotional materials or documentation of oral statements made by company representatives.
3. What will happen to my complaint once I have contacted OPDP?
The information you provide will be sent to the Regulatory Review Officer in OPDP responsible for this class of drugs. The reviewer will evaluate it and determine if it may serve as the basis for a potential enforcement action or as valuable information for our ongoing surveillance activities.
4. How do I learn more?
To learn more about OPDP in-service training for large medical group/hospitals call 301-796-1200.
From the 25 October 2012 blog post by Patrick J. Skerrett, Executive Editor, Harvard Health
There’s something satisfying about getting immediate feedback about exercise, sleep, and other activities. That’s why more and more people are joining the “quantified-self” movement. It involves formal tracking of health and habits, usually using apps and devices that feed data to them—from heart rate, activity, and sleep monitors to Bluetooth connected scales. I haven’t yet become a full-fledged member, partly because having so many apps and connected devices on the market makes it hard to decide which ones are worth trying.
I’m hoping that Wellocracy will help. This website, launched by the Harvard-affiliatedCenter for Connected Health, aims to give people like me impartial information about fitness trackers, mobile health apps, and other self-help technologies.
Wellocracy lists dozens of sleep trackers, wearable activity trackers, mobile running apps, and mobile pedometer apps, each with a mini-review and a “what we wish it had” listing. The site lets you compare apps and devices in each of the four categories. The compare feature isn’t yet as helpful as those from Consumer Health Reports, but that may be coming.
The site also provides a guide for beginners like me, and offers tips for adding activity “bursts” throughout the day.
“There are millions of people struggling to eat well, exercise, manage a chronic disease or decrease other health risks. Wellocracy will help them select and use digital health tools, understand their individual motivations, and make incremental lifestyle changes that can easily be incorporated into busy schedules,” said Wellocracy founder, Dr. Joseph C. Kvedar, an associate professor at Harvard Medical School.
One theme the site promotes is “stickiness.” That means finding motivational strategies, apps, and devices that help you stay on track to achieve your goals. You can calculate your “stickiness factor” on the website.
Maybe the information on Wellocracy is enough to nudge me from contemplation to action.
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
I am especially grateful for #4.
From the ABIM fact sheet
From the 21 October 2013 article at ScienceDaily
Previous research has shown that the most popular way Americans get their health news is by watching local television broadcasts. Now, researchers at the University of Missouri School of Journalism have found that while local television news is the most common source of health news for Americans, most health news stories on local news broadcasts are only 30 seconds or less in length. Glen Cameron, the Maxine Wilson Gregory Chair in Journalism Research and professor of strategic communication at the MU School of Journalism, says this trend may lead to misunderstanding of important but complicated health news stories.
“This pattern of local health news reporting may be problematic because of the complex and rather technical nature of many health news stories,” Cameron said. “For example, there is much medical jargon such as “pseudoephedrine,” “dementia,” or “cardiovascular arrest,” involved with reporting health news; stories that are too short can leave viewers confused and inappropriately alarmed or complacent. In this sense, health news may need to be allocated more time to be truly beneficial to viewers.”
Read the entire article here
From the 30 September 2013 transcript by Robert Logan, Director of the US National Library of Medicine
Greetings from the National Library of Medicine and MedlinePlus.gov
Regards to all our listeners!
I’m Rob Logan, Ph.D. senior staff National Library of Medicine for Donald Lindberg, M.D, the Director of the U.S. National Library of Medicine.
Here is what’s new this week in MedlinePlus.
The extent of caregivers’ assistance to patients — and suggested strategies for physicians to assist caregivers — are detailed in an interesting commentary recently published in the Journal of the American Medical Association.
The commentary’s author (who is a professor at Harvard Medical School) explains about 42 million Americans are caregivers and they assist patients for an average of 20 hours a week. Muriel Gillick M.D. reports the majority of caregivers are middle-aged women caring for aging parents.
Dr. Gillick notes caregivers often assist patients with daily living activities, such as shopping, cooking, bathing, and dressing. However, Dr. Gillick writes (and we quote) “Nearly half of all caregivers report responsibility for complex medical tasks that often are the province of a professional nurse or trained technician’ (end of quote).
Dr. Gillick finds caregivers report they are responsible for clinical activities including: diet adherence, wound care, treating pressure ulcers, providing medications and intravenous fluids, as well as operating medical equipment.
Dr. Gillick notes the recipients of caregiving are likely to be seniors in the last stages of their life. In the year before death, Dr. Gillick explains only 17 percent of Americans are without a disability while about 22 percent have a persistent severe disability. She reports the largest groups of caregiver-dependent adults include seniors who are frail or have advanced dementia. Dr. Gillick notes about 28 percent of Americans are frail and 14 percent have advanced dementia in their last year of life.
Dr. Gillick adds patients who are frail or have dementia often cannot participate in the management of their care, which necessitates a caregiver’s involvement. Dr. Gillick writes (and we quote): ‘If (end of life) medical care is to be patient centered, reflecting the values (patients) no longer have the cognitive capacity to articulate, clinicians must rely on surrogates to guide them. Yet, few programs caring for patients with dementia (or frailty) regularly incorporate caregivers in every phase of care’ (end of quote).
To improve assistance to caregivers, Dr. Gillick suggests physicians need to better explain a patient’s underlying health condition as well as work with caregivers to prioritize a patient’s health care goals.
Dr. Gillick adds caregivers should be encouraged to provide input about a patient’s surroundings as well as more fully participate in health care planning in a partnership with attending physicians.
Dr. Gillick notes caregivers are especially helpful in creating a continuity of patient care within different settings. She writes (and we quote): ‘In the complex US health care system, in which patients are cared for in the home, the physician’s office, the hospital, and the skilled nursing facility, the most carefully thought-out plan of care will prove useless unless its details can be transmitted across sites’ (end of quote).
Dr. Gillick concludes physicians as well as health care organizations need to provide more educational support to help caregivers.
Meanwhile, MedlinePlus.gov’s caregivers health topic page provides comprehensive information about caregiving’s medical and emotional challenges. For example, a helpful website from the American Academy of Family Physicians (available in the ‘start here’ section) helps caregivers maintain their health and wellness.
A similar website that addresses overcoming caregiver burnout (from the American Heart Association) can be found in the ‘coping’ section of MedlinePlus.gov’s caregivers health topic page.
In addition, there are special sections loaded with tips to provide caregiving to seniors as well as women and children within MedlinePlus.gov’s caregivers health topic page.
MedlinePlus.gov’s caregivers health topic page also provides links to the latest pertinent journal research articles, which are available in the ‘journal articles’ section. Links to clinical trials that may be occurring in your area are available in the ‘clinical trials’ section. You can sign up to receive updates about caregiving as they become available on MedlinePlus.gov.
To find MedlinePlus.gov’s caregivers health topic page, type ‘caregiver’ in the search box on MedlinePlus.gov’s home page. Then, click on ‘caregivers (National Library of Medicine).’ MedlinePlus.gov additionally features health topic pages on Alzheimer’s caregivers, child care, and home care services.
It is helpful to see JAMA address some caregiving issues. Let’s hope other medical journals will help educate caregivers and encourage more physician-caregiver communication.
Before I go, this reminder… MedlinePlus.gov is authoritative. It’s free. We do not accept advertising …and is written to help you.
To find MedlinePlus.gov, just type in ‘MedlinePlus.gov’ in any web browser, such as Firefox, Safari, Netscape, Chrome or Explorer. To find Mobile MedlinePlus.gov, just type ‘Mobile MedlinePlus’ in the same web browsers.
We encourage you to use MedlinePlus and please recommend it to your friends. MedlinePlus is available in English and Spanish. Some medical information is available in 43 other languages.
Your comments about this or any of our podcasts are always welcome. We welcome suggestions about future topics too!
Please email Dr. Lindberg anytime at: NLMDirector@nlm.nih.gov
That’s NLMDirector (one word) @nlm.nih.gov
A written transcript of recent podcasts is available by typing ‘Director’s comments’ in the search box on MedlinePlus.gov’s home page.
The National Library of Medicine is one of 27 institutes and centers within the National Institutes of Health. The National Institutes of Health is part of the U.S. Department of Health and Human Services.
A disclaimer — the information presented in this program should not replace the medical advice of your physician. You should not use this information to diagnose or treat any disease without first consulting with your physician or other health care provider.
It was nice to be with you. I look forward to meeting you here next week.
Read entire transcript here
From the Web site
Listen to the voice of NPIC! Our new PestiBytes PODcasts feature NPIC specialists discussing common pesticide questions from people like you. PestiBytes are short (1-2 minute) interviews with NPIC pesticide specialists on each of the topics. Watch for more to come!
Available PestiByte PODcasts:
||My yard is being sprayed; can my kids go out and play? Episode 22 – A specialist discusses ways to minimize exposure to children after lawn treatments. Download and Listen, View Transcript – 2:17 min., 1.4MB
||Don’t let pesticides make your bed bug problem worse! Episode 21 – A specialist discusses some do’s and dont’s about getting rid of bed bugs. Download and Listen, View Transcript – 2:26 min., 1.4MB
||Slug Baits with Iron Phosphate Episode 20 – A veterinarian gives pet owners some important information about slug & snail products containing iron phosphate. Download and Listen, View Transcript -2:11 min., 0.96MB
||Fasten the Lid. Protect Your Kids! Episode 19 – A specialist discusses how to store pesticides during and after use to keep kids from being exposed. Download and Listen, View Transcript – 2:26 min., 1.67MB
||The Crop Was Just Sprayed. Can I Work There Today? Episode 18 – A specialist provides information on reentering fields after pesticides have been applied. Download and Listen, View Transcript – 2:27 min., 1.69MB
||My Home is Being Sprayed. Should I Go or Stay? Episode 17 – A specialist discusses steps you can take to minimize your risk when your home is going to be treated with pesticides. Download and Listen,View Transcript – 2:05 min., 1.43MB
||Precautions for Using Spot-on Flea and Tick Products Episode 16 – A veterinarian gives pet owners some important pointers about using flea and tick spot-on treatments. Download and Listen, View Transcript -2:38 min., 4.95MB
||Can Bug Bombs Really Explode? Episode 15 – A specialist warns about the fire hazards of insecticide foggers and lists safety steps to take before setting off bug bombs. Download and Listen, View Transcript – 2:02 min., 3.73MB
||Don’t Distress Over Uninvited Guests (Roaches)! Episode 14 – A pesticide specialist discusses common problems with cockroaches in the home and simple ways to prevent infestations. Download and Listen,View Transcript – 2:06 min., 3.85MB
||Cover the Holes When Baiting for Moles (or Gophers)! Episode 13 – A specialist answers questions about the risks of gopher bait for dogs, and how to keep them from snacking on the bait. Download and Listen,View Transcript – 2:03 min., 3.85MB
||Pesticides and Food Containers Just Don’t Mix Episode 12 – A specialist points out the dangers of storing pesticides in any container other than the original container. Download and Listen, View Transcript – 2:06 min., 3.94MB
||Would I Hurt the Fish by Weeding and Feeding the Lawn? Episode 11 – A specialist explains ways to keep weed killers from harming fish.Download and Listen, View Transcript – 1:50 min., 3.36MB
||Get Rid of the Mouse! With Kids In the House? Episode 10 – A specialist lists precautions to consider when thinking of using rat or mouse baits around pets and children. Download and Listen, View Transcript – 1:53 min., 3.45MB
||When to Plant After Using Weed Killer? Episode 9 – A specialist provides information about using weed killers to prepare a vegetable garden. Download and Listen, View Transcript – 1:44 min., 3.96MB
||With a Baby on the Way… Is It Okay to Spray? Episode 8 – A specialist discusses infant sensitivity to pesticides and lists some ideas for minimizing exposure. Download and Listen, View Transcript – 1:55 min., 4.41MB
||Could Snail Bait Hurt My Dog? Episode 7 – A specialist cautions dog owners about the risks of snail baits and provides ways to to protect their pets. Download and Listen, View Transcript – 1:56 min., 4.42MB
||Dirty Work Clothes: How Should I Wash Out Pesticides? Episode 6 – A specialist explains how to handle and launder clothes that are contaminated with pesticides. Download and Listen, View Transcript- 1:33 min., 3.57MB
||What Should I Do During Mosquito Spraying? Episode 5 – A specialist answers questions about why city health departments might spray for mosquitoes and ways people can avoid contact with the mosquito spray. Download and Listen, View Transcript – 1:39 min., 1.50MB
||Should Kids Use Bug Spray? Episode 4 – A specialist lists precautions a parent might take if they choose to use insect repellents on children.Download and Listen, View Transcript – 2:07 min., 1.94MB
||A Mothball Mishap? Episode 3 – A specialist debunks mothball myths and describes how improper use of mothballs can lead to unpleasant or even unhealthy results. Download and Listen, View Transcript – 1:32 min., 1.41MB
||How Can I Wash Pesticides From Fruit and Veggies? Episode 2 – A specialist discusses how to best wash pesticide residues from produce, including potential risks of using household products to clean fruit and vegetables. Download and Listen, View Transcript – 1:41 min., 1.54MB
||About NPIC Episode 1 – Our director discusses how NPIC can assist people when making decisions about pesticides. Ways to contact NPIC are provided. Download and Listen, View Transcript – 2:07 min., 1.95MB
PestiBytes are brought to you by the National Pesticide Information Center, a cooperative agreement between Oregon State University and the Environmental Protection Agency and produced by OSU’s Environmental Health Sciences Center, funded by the National Institute of Environmental Health Sciences.
If you have questions about this, or any pesticide-related topic, please call NPIC at 1-800-858-7378 (7:30am-3:30pm PST), or email at email@example.com.
Similar podcasts by the US NIH agency explore how environmental exposures affect our health. Each episode highlights ways researchers work in partnership with community groups to understand and address environmental health issues.
Dietary supplements, such as the vitamin B supplement show above, are typically sold in pill form. (Photo credit: Wikipedia)
This morning I read a post about the health benefits of green tea. It included a resource new to me – ConsumerLab.com. Their stated mission is to “identify the best quality health and nutritional products through independent testing”. To be honest, I was a bit wary. Testimonials always raise a red flag with me, I am not sure who the folks are and who initiated the testimonial. The section “Where to buy products” also concerned me, I was wondering if this was paid advertising…not that this alone would discredit the company. (Click here for tips on how to evaluate a Web site).
The Alliance for Natural Health has a decent review on Consumer Lab, outlining how Consumer Lab conducts business.
Consumer Lab asks companies to pay for the tests. If the company does not wish to pay, Consumer Lab often conducts the test (through outsourcing to unidentified companies) anyway without billing the company. And then publishes the results. Interesting… The
Dr. Sanford Levy, board certified in Integrative Holistic Medicine, has written a short informative article on the quality of Dietary Supplements.
His professional judgements include the following
- FDA (Food and Drug Adminstration) – Their final rules on dietary supplements tend to be reactive rather than proactive.
- Consumerlab- He is rather neutral on how they operate, as opposed to The Alliance (above). He does note there is a $33 subscription fee to access the information at the site
- Companies which certify manufacturers of supplements.
(Beware though that even if a company is certified …this information is not necessarily included on the product label.)
- uspcertificed.com -addresses bioavailability as well as chemical composition
- Natural Products Association – addresses only chemical composition, not bioavailability
- Emerson Ecologics- serves health care professionals as a distributor for multiple manufacturers. Emerson initiated a quality program in 2010, ranking manufacturers based on a number of criteria. Manufacturers who choose not to distribute through Emerson Ecologics will not be listed in any of the categories.
More detailed information on supplements by him at http://www.acsu.buffalo.edu/~shlevy/dietsuppqualitysafetyefficacy.htm
His outline on supplement regulation is at
He covers other topics at http://www.acsu.buffalo.edu/~shlevy/
Someone I know takes a multitude of supplements. As this article points out, it is a good idea to get objective medical advice on which supplements may be helpful. This person started taking Vitamin D on the advice of a friend to stop back pain. It did work. And to to be honest, I was very skeptical. After a year, he told his doctor, and the doctor said that it probably did help. However, I do think that overall if folks ate right that supplements would be unnecessary.
Also, as the article points out, supplements cannot reverse medical conditions or replace other therapies.
Looking for more information on supplements? Check out the resources below, after the article summary.
A Look at Vitamins, Minerals, Botanicals and More
From the NIH August 2013 Newsletter
When you reach for that bottle of vitamin C or fish oil pills, you might wonder how well they’ll work and if they’re safe. The first thing to ask yourself is whether you need them in the first place.
More than half of all Americans take one or more dietary supplements daily or on occasion. Supplements are available without a prescription and usually come in pill, powder or liquid form. Common supplements include vitamins, minerals and herbal products, also known as botanicals.
People take these supplements to make sure they get enough essential nutrients and to maintain or improve their health. But not everyone needs to take supplements.
“It’s possible to get all of the nutrients you need by eating a variety of healthy foods, so you don’t have to take one,” says Carol Haggans, a registered dietitian and consultant to NIH. “But supplements can be useful for filling in gaps in your diet.”
Some supplements may have side effects, especially if taken before surgery or with other medicines. Supplements can also cause problems if you have certain health conditions. And the effects of many supplements haven’t been tested in children, pregnant women and other groups. So talk with your health care provider if you’re thinking about taking dietary supplements.
Read the entire article here
- Dietary Supplement Fact Sheets (US National Institutes of Health)
with links to decision making aids and consumer protection information
- Dietary Supplement Label Database (US National Institutes of Health)
ingredients of thousands of dietary supplements with information from the label on dosage, health claims and cautions
- Drugs, Supplements, and Herbal Information (US National Library of Medicine)
browse dietary supplements and herbal remedies to learn about their effectiveness, usual dosage, and drug interactions.
- Longwood Herbal Task Force
This site has in-depth monographs about herbal products and supplements written by health professionals and students. It provides clinical information summaries, patient fact sheets, and information about toxicity and interactions as well as relevant links. The task force is a cooperative effort of the staff and students from Children’s Hospital, the Massachusetts College of Pharmacy and Health Sciences, and the Dana Farber Cancer Institute.
From the 3 August 2013 blog item at Soumyadeep B -Caffeinated Works & Random Musings
The Lancet Global Health published a paper yesterday titled , ” Governments are legally obliged to ensure adequate access to health information ” that calls to increase the availability and use of healthcare information in low- and middle-income countries globally and recognition of access to health information as a legal right of citizen The paper has been written by Dr. Soumyadeep Bhaumik, HIFA Country Representatives for India together with his colleagues Pranab Chatterjee, and Tamoghna Biswas along with Dr Neil Pakenham Walsh , coordinator of HIFA2015 and CHILD2015 networks and codirector of Global Healthcare Information Network.
The full article may be read here
A 2012 analysis12 by the New York Law School and HIFA2015 concluded that “health information is an essential component of many identified and established human rights. States party to treaties such as the International Covenant on Civil and Political Rights must provide and guarantee access to health information.”
People are growing their health-consumer muscles in 2013 | Health Populi.
From the 31 July 2013 article at HealthPopuli
Most Americans are concerned about their ability to for medical bills, even when they have health insurance. As a result, most are comfortable asking their doctor about how much their medical treatment will cost. People are becoming savvier health care shoppers largely because they have to: 37% of people in the U.S. have an annual health insurance deductible over $2,000, according to the Spring/Summer 2013 Altarum Institute Survey of Consumer Health Care Opinion, published on 11th July 2013.
Many of the media stories coming out of the Altarum survey since its publication have been about people and their trust in doctors – or lack thereof.
But the other side of this coin is growing patient/consumer health empowerment.
It appears that people feel competent to take on a greater role in shared decision making, self-diagnosis or assessment of symptoms, and information collecting on conditions – even before seeing the doctor. Take a look at the table, which illustrates that most do “health homework” before going to see their doctor.
Altarum polled a survey sample of 2,357 U.S. consumers in May, 2013.
Health Populi’s Hot Points: The internet has truly become a go-to source for people and their health, every day. I grew up with a thick tome of a health guide on my parents’ living room bookshelf – I remember a dog-eared Mayo Clinic Guide to Health, as well as a Merck Manual my mom picked up from a library sale in the early 1970s and her nutrition bible, Adelle Davis’ Let’s Get Well.
Today’s 5-inch-thick guide to health isn’t a book at all; it’s WebMD, NIH.gov, FDA.gov, Yahoo! health groups, WEGO Health, PatientsLikeMe, CureTogether, DiabetesMine, TuDiabetes, Migraine.com – and to be sure, Paging Dr. Google. And, it’s also friends and neighbors, whose opinions 75% of Americans trust to choose a doctor – more than online rates on a doc’s bedside manner, office waiting times, or objective information on clinical quality, according to Altarum’s poll.
What Altarum finds is that people are preparing in advance of their doctor’s appointments – preparing questions, which means spending time thinking through symptoms, family histories, observations of daily living, and other factors that may feed into an acute situation or a question about how to stay well, fit, and out of the health system.
Includes areas as nutrition, healthcare, health communication, and health/medical resources
Originally posted on SurroundHealth Blog:
With tons of health blogs out there today, it can be overwhelming trying to find solid ones to follow that are a good fit for your topic of interest. At SurroundHealth, we look for bloggers that align with our goals of sharing resources and best practices in areas such as: health education/communication, professional development and health careers, health and education technology, and current health events.
While this isn’t a FULL list of the blogs we follow, we thought it would be nice to share with our members and readers some of our favorite (in no specific order) health blogs out there!
Our ‘favorites’ blog roll:
Health ECareers Network- HeCN is a really informative blog providing access to everything healthcare careers- news, information, events, career resources and employment opportunities – all specific to individual career paths. Definitely a good one to check out if you are looking to learn…
View original 290 more words
I usually don’t reblog articles that endorse commercial products or alternative/complementary medicine (without biomedical evidence).
Still, this post had a lot of good information on testing and one’s rights.
A few years back at a library where I worked, some of the folks at circulation were having breathing difficulties. They believed it was the HVAC system, but did not report it. Now I wish I could have worked with them to report it….
The folks at the circ desk were union, I was not. So they were more protected than I…..
- MedlinePlus: Molds, including
- Molds (US Occupational Safety and Health Administration – OSHA)
- Legal Aspects of Mold Contamination (Clean Water Partners – Environmental Law Experts)
For Renters,Landlords, Home Sellers, Home Buyers, Employers, Employees
Originally posted on Mom's Mold Resources:
We are getting a lot of inquiries about where to go for testing and treatment after exposure to toxic levels of Mycotoxins from damp and moldy environments.
Unfortunately few doctors are experienced in testing or treating patients that are suffering from Biotoxin Illness and other health issues that arise after living or working for long periods of time inside of a home/office/school with poor indoor air.
My best advise is to try to find an Environmental Medicine Specialist either in the US or abroad. Surprisingly Spain has a high incidence of people affected by chemicals that require treatment for MSC (Multiple Chemical Sensitivity) so there seems to be more Environmental Medicine doctors available there.
In the US I have been able to make contact with several doctors and centers who have treated people I have met along my journey.
Dr Gray in Arizona has been mentioned countless times by people…
View original 613 more words
Not just for teachers!
From the About Page
Welcome to BioEd Online, the online educational resource for educators, students, and parents. BioEd Online utilizes state-of-the-art technology to give you instant access to reliable, cutting-edge information and educational tools for biology and related subjects. Our goal is to provide useful, accurate, and current information and materials that build upon and enhance the skills and knowledge of science educators. Developed under the guidance of our expert Editorial Board, BioEd Online offers the following high-quality resources.
- Streaming Video Presentations – View timely presentations given by thought leaders on education in biology and related subjects, classroom management, science standards, and other issues in education. Presentation topics include content reviews for prospective biology teachers, content updates for experienced teachers, research lab technique demonstrations, inquiry science, and assessment. In addition, BioEd Online offers helpful presentations for teachers in training as they prepare for the classroom experience.
- Slide Library – Customize exciting and relevant lesson plans and activities from hundreds of searchable slides developed by our Editorial Board and contributors. The slide library is updated regularly. Each slide is complete with talking points and references and can be downloaded into your own PowerPoint program for personal educational use.
- Editors’ News Picks – Stay current with science news selected by our Editorial Board. Check back each week for new science stories and related discussion questions to complement your ongoing science activities, and to stimulate an exchange of ideas in your classroom. All Editors’ Picks are maintained in our archive for easy access whenever you need them.
BioEd Online is regularly updated with pertinent new slides in the slide library, presentations on breakthrough research, reviews, and virtual workshops on educational approaches and materials. Stay current with the latest research from top educators in the country by bookmarking BioEd Online for later use!
Other resources of note
- A variety of free, interactive courses designed for science educators and other life-long learners seeking to increase their knowledge of key scientific subjects. Course offerings range from cutting edge genetics to topical environmental health content and the fascinating science of water. Materials are sorted by topic, making it easy locate the content most appropriate for you.
- BioEd Online’s library contains student storybooks, magazines, supplemental materials and other items integrated with teacher’s guides and lessons found on this website. Some items may be used as stand-alone reading and language arts activities.
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.
TTY (for deaf and hard-of-hearing callers):
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.
Toll-free in the U.S.:
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.
This publication is not copyrighted and is in the public domain. Duplication is encouraged.
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.
* Note: PDF files require a viewer such as the free Adobe Reader.
Great links to resources as
–High Value Care resources intended to help patients understand the benefits, harms and costs of tests and treatments for common clinical issues.
–Case Management Society of America’s has a consumer page that describes Case Management as a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual’s health needs
–Academy of Nutrition and Dietetics is a resource for food, nutrition, and health information. Consumers can find tip sheets, videos, brochures, and health & nutrition guides for women, men, and children.
Originally posted on Camille Davidson:
Consumer health literacy is the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.
According to the National Adult Assessment of Literacy (2003), 14% of American cannot comprehend basic health information. The study indicates that health illiteracy is especially prevalent among:
- Adults who did not complete high school, with 49% having below basic health literacy
- Hispanic adults, who have lower health literacy than any other ethnic/racial group, with 41% having below basic health literacy
Low consumer health literacy costs between $106 to $236 billion a year in the form of longer hospital stays; emergency room visits, increased doctor visits, and increased medication, according to a recent report from the University of Connecticut. Consumers with low literacy levels often fail to engage in early detection and preventive health care. They also have significant difficulties navigating the health…
View original 493 more words
Don’t use websites for child health, parents told.
PARENTS have been warned against the dangers of trying to diagnose their children’s health problems using the internet.
An online poll of 1,800 mothers in April conducted by the parenting website Eumom.com found that 43pc of respondents consult the internet first when their child presents with symptoms rather than going directly to a doctor or pharmacist.Close to half of Irish mothers are using the web to diagnose conditions, a new survey reveals.
But such a practice can cause unnecessary anxiety or result in a misdiagnosis, according to Dr Conor Fitzgerald.
“Firstly, if your children have a serious condition, it might go undetected and untreated without a professional, medical examination by a doctor. Secondly, internet searches often lead parents to believe their child might have a more serious condition than is actually the case, creating unnecessary worry.”
But Dr Fitzgerald, who has a GP practice in Lucan, west Dublin, said parents should always consult a GP if they are concerned about their child’s health.
However, he added the internet could be a useful tool once a diagnosis has been made by a doctor, whereby the patient can read up on their condition.
Free Library Puts Resources About Minority Health Within Arm’s Reach
From the 9 April 2013 article at the National Partnership for Action to End Health Disparities
The Office of Minority Health Knowledge Center supports National Minority Health Month by highlighting many information resources available to the public. The Knowledge Center focuses its collection on consumer health and many other health equity issues, and builds on this year’s theme ofAdvance Health Equity Now: Uniting Our Communities to Bring Health Care Coverage to All.
Created in 1987, the Knowledge Center indexed and tracked the concept of health disparities in the available literature long before it appeared in the forefront of public health concerns. Today, the library offers both a historical and present day picture of the health status of minority populations and holds a collection of 10,000 reports, books, journals and media, and over 35,000 articles, which makes it the largest repository of minority health information in the nation.
Equal access to health care has long been a factor in health equity, and the Knowledge Center library catalog reflects those concerns. By searching our catalog, you will find many reports, books and fact sheets which explain disparities in access to health insurance and health care.
And the Knowledge Center is more than a library. We also contribute to the outreach and educational activities of the Office of Minority Health and reach out to other libraries to support their consumer health education initiatives. For example, a recent presentation and exhibit at the Joint Conference of Librarians of Color highlighted our services and resources for public and academic libraries.
Other libraries have found ways to advance health equity, in keeping with objectives set by our National Partnership for Action (NPA). As an NPA partner, the University of Maryland Health Sciences and Human Services Library developed a health advocates program for local high school students (read more about the program.)
With 35 languages represented in our collection, the Knowledge Center is open to the public for research about a variety of diseases and health topics and you can search the database right from your desktop.
We invite you to take a look at our online catalog and conduct a search. Enter the search terms “Affordable Care Act” and discover what OMHRC has to offer you.
For questions or search assistance, please contact us at KnowledgeCenter@minorityhealth.hhs.gov.
Originally posted on Public Health--Research & Library News:
Do you want to be a disease detective? the Centers for Disease Control and Prevention (CDC) have released a new app, Solve the Outbreak.
New outbreaks happen every day and CDC’s disease detectives are on the front lines, working 24/7 to save lives and protect people. When a new outbreak happens, disease detectives are sent in to figure out how outbreaks are started, before they can spread. with this new, free app for the iPad, you can play the role of an Epidemic Intelligence Service agent. Find clues about outbreaks and make tough decisions about what to do next: Do you quarantine the village? Talk to people who are sick? Ask for more lab results?
With fictional outbreaks based on real-life cases, you’ll have to puzzle through the evidence to earn points for each clue. The better your answers, the higher your score – and the more quickly you’ll save lives…
View original 33 more words
Let Patients Help: A New Book Authored by e-Patient Dave deBronkart | ScienceRoll.
From the 20 March 2013 post at Science Roll
Posted by Dr. Bertalan Meskó in e-patient, Health 2.0, My Bookshelf, Web 2.0.
I was very glad to see the new book authored by e-Patient Dave deBronkart, whose thoughts I describe to medical students as a part of the official curriculum at Semmelweis Medical School, just became available.
Medical professionals must let patients help and become equal partners in the treatment! A must-read book!
Concise reasons, tips & methods for making patient engagement effective.
Third book by e-Patient Dave, cancer beater, blogger, internationally known keynote speaker and advocate for patient engagement; co-founder and past co-chair of the Society for Participatory Medicine. Profile:http://www.ePatientDave.com/about-dave
From the 25 January 2013 US Centers for Disease Control and Prevention (CDC) press release
The first set of national prevalence data on intimate partner violence (IPV), sexual violence (SV), and stalking victimization by sexual orientation was released today by the Centers for Disease Control and Prevention (CDC). The study found that lesbians and gay men reported IPV and SV over their lifetimes at levels equal to or higher than those of heterosexuals; with sexual orientation based on respondents’ identification at the time of the survey.
The survey also found that bisexual women (61.1 percent) report a higher prevalence of rape, physical violence, and/or stalking by an intimate partner compared to both lesbian (43.8 percent) and heterosexual women (35 percent). Of the bisexual women who experienced IPV, approximately 90 percent reported having only male perpetrators, while two -thirds of lesbians reported having only female perpetrators of IPV.
The data presented in this report do not indicate whether violence occurs more often in same-sex or opposite sex couples. Rather, the data show the prevalence of lifetime victimization of intimate partner violence, sexual violence and stalking of respondents who self-identified as lesbian, gay or bisexual at the time of the survey and describe violence experienced with both same-sex and opposite-sex partners. …
Other key findings include:
- The majority of women who reported experiencing sexual violence, regardless of their sexual orientation, reported that they were victimized by male perpetrators.
- Nearly half of female bisexual victims (48.2 percent) and more than one-quarter of female heterosexual victims (28.3 percent) experienced their first rape between the ages of 11 and 17 years.
CDC will work to create resources to bring attention to these issues within lesbian, gay, bisexual, and transgender communities.
For more information about NISVS, including study details, please visit http://www.cdc.gov/violenceprevention/nisvs/index.html.
To watch webinars that discuss the NISVS 2010 Summary findings, please visit PreventConnect, a national online project dedicated to the primary prevention of sexual assault and domestic violence.
From the post by Leslie Kernisan at The Health Care Blog
My questions when considering a new technology
To begin with, here are the questions that I think about when considering a new technology:
Does it help me do something I’m already trying to do for clinical reasons? Examples include tracking the kind of practical data I describe here (sleep, pain, falls, etc), helping patient keep track of — and take — medications, helping caregivers monitor symptoms, coordinating with other providers…my list goes on and on, although I’ll admit that I prioritize management of medical conditions, with issues like social optimization being secondary. (Social optimization is crucial, it’s just not what physicians are best at, although I certainly weigh in on how an elder’s dementia or arthritis might affect their social options.)
What evidence is there that using it will improve the health and wellbeing of an older adult (or of a caregiver)? Granted, the vast majority of interesting new tech tools will not have been rigorously tested in of themselves. Still, there is often related and relevant published evidence that can be considered. For instance, studies have generally found that there’s no clear clinical benefit in having non-insulin dependent Type 2 diabetics regularly self-monitor blood glucose. (And it is certainly burdensome for older people with lots of medical problems.) Hence I would be a bit skeptical of a new technology whose purpose is to make it easier for older adults to track their blood sugar daily, unless it were targeted towards elders on insulin or otherwise at high risk for hypoglycemia.
How does the data gathering compare to the gold standard? Many new tech tools gather data about a person. If we are to use this information for clinical purposes, then we clinicians need to know how this data gathering compares to the gold standard, or at least to a commonly used standard. For instance, if it’s a consumer wrist device to measure sleep, how does it compare in accuracy to observation in a sleep lab? Or to the actigraphy used in peer-reviewed sleep research? If it’s a sensor system to monitor gait, how does it compare to the gait evaluation of a physical therapist? If it’s the Scanadu Scout Tricorder, which measures pulse transit time as a proxy for systolic blood pressure, where is data validating that pulse transit time as measured by this device accurately reflects blood pressure? (BTW I can’t take such a tricorder seriously if it doesn’t provide a blood pressure estimate that I can have confidence in; blood pressure is essential in internal medicine.)
How exactly does it work? Especially when it comes to claims that the product will help with clinical care, or with healthcare, I want to know exactly how that might work. In particular, I want to know how the service loops in the clinician, or will facilitate the work the clinician and patient are collaborating on.
How easy is it to use? Tools and technologies need to be easy to use. Users of interest to me include older adults, caregivers, and the clinician that they’ll be interfacing with. BTW, all those med management apps that require users to laboriously enter in long drug names are NOT easy to use in my book.
How easy is it to try? Let’s assume a new technology is proposing a service to the patient (or to me) that offers plausible benefits, either because it’s a tech delivery of a clinically validated service, or because it passes my own internal common sense filters. How easy is it to actually set up and try? I’m certainly more inclined to explore a tool that doesn’t require a large financial investment, or training investment.
How cost-effective is using this technology? I’m interested both in cost-effectiveness for the patient & family, and also for the healthcare system. Sometimes we have simpler and cheaper ways to get the job done almost as well.
Can this technology provide multiple services to the patient? My patients are all medically complex, and have lots going on. Products that can provide multiple services (such as socializing with family off-site AND monitoring symptoms), or that can coordinate with another product — perhaps by allowing other services to import/export data — are a big plus.
Does this technology work well for someone who has lots of medical complexity? I always want to know if the product is robust enough to be usable by someone who has a dozen chronic conditions and at least 15 medications.
What I’d like to see on the websites
These days, a website is the generally the place to start when looking into a product or service.
It’s a great help to me when a product’s website addresses the questions I list above. Specifically, I find it very helpful when websites:
Have a section formatted for clinicians in particular. I’m afraid I don’t have much time for gauzy promises of fostering a happier old age. I just want to know how this will help me help my patients. Specific examples are very very helpful.
Have a “how it works” section with screenshots and concise text. Personally, I have limited tolerance for video (videos can’t be skimmed the way text and pictures can) and find it a little frustrating when most information is in videos. Note that it’s probably best to have separate “how it works” sections for clinicians and for patients/caregivers.
Provide a downloadable brochure for patients/families, and another for clinicians.Although it’s annoying when information is presented ONLY in a pdf brochure, I’ve discovered that I quite like having the option of a brochure. Brochures are much easier to read than websites, in that you don’t have mentally decide how to navigate them, or search through them in quite the way you do with websites. Also, brochures can be conveniently emailed to colleagues or patients, which is nice when you want to suggest that your patient try something new…..
Read the entire blog post here
From the 15th January 2013 article at Medical News Today
A nationwide survey ***of US adults finds that 1 in 3 of Americans say they have used the internet to help them diagnose a medical condition, either for themselves or someone else. But, when asked who they turned to for help with a serious health issue, either online or offline, the majority said they turned to a doctor or other health professional…
…when these “online diagnosers” were asked who they turned to for information, care or support the last time they had a serious health problem, either online or offline:
- 70% said they got it from a health professional,
- 60% turned to family and friends, and
- 24% said they got it from others with the same condition.
When the survey asked online diagnosers if the information they found online had led them to think they needed to see a doctor, 46% said yes, while 38% said they could take care of it themselves and 11% said it was a case of both or something in between.
Read the entire article here
***The full Pew Internet report Health Online 2013 may be found here
Practical ways parents and others can help children in the days, weeks, and months after traumatic events.
From the US National Institute on Mental Health.
Tips are practical and some are arranged by age groups.
An excerpt from the booklet
How Parents Can Help:
After violence or a disaster parents and family should:
- Identify and address their own feelings — this will allow them to help others
- Explain to children what happened
- Let children know:
- You love them
- The event was not their fault
- You will take care of them, but only if you can; be honest
- It’s okay for them to feel upset
- Allow children to cry
- Allow sadness
- Let children talk about feelings
- Let them write about feelings
- Let them draw pictures
- Expect children to be brave or tough
- Make children discuss the event before they are ready
- Get angry if children show strong emotions
- Get upset if they begin:
- Acting out
- If children have trouble sleeping:
- Give them extra attention
- Let them sleep with a light on
- Let them sleep in your room (for a short time)
- Try to keep normal routines (such routines may not be normal for some children):
- Bed-time stories
- Eating dinner together
- Watching TV together
- Reading books, exercising, playing games
- If you can’t keep normal routines, make new ones together
- Help children feel in control:
- Let them choose meals, if possible
- Let them pick out clothes, if possible
- Let them make some decisions for themselves, when possible.
(And no, I am not advertising these books, or endorsing the contents of these books, only pointing to a trend!)
From the 4 January 2013 Huffington Post article by Riva Greenberg
Today, more and more books are being written by patients — well-educated, informed patients who manage their illness successfully and have experience, practical knowledge and insights to share with other patients.
As the new year incites a rush to become a “new, better and healthier you,” we often do so learning from our peers. When it comes to illness-warranted behavior changes, as like seeks like, it’s often easier to make changes learned from fellow patients with whom you share the experience of a disease. Like support groups and mentor programs, this is fertile soil for positive behavior change. So, I applaud the rise of patient-authors.
Patient-authors also narrate the experience of illness. That is why I hope health care professionals (HCPs) are also reading books written by patients. A book like No-Sugar Added Poetry, for example, can give HCPs immediate access to some of the emotional landscape of living with diabetes.
There is, in my mind, no easier or quicker way to tap into the experience of illness — what patients grapple with, how they feel, and the practical things that must be managed every day — than by reading a patient-written book.
When clinicians do, I believe they will become more mindful and compassionate and the relationship with their patients more trusting. And that can lead to better outcomes for both….
Read the entire article here
Did a test drive…While it is indeed “written” at a 5th grade level, it does not talk down to adults.
Worth checking out/recommending.
From the 4 January 2013 EurkAlert
San Francisco VA Medical Center and UCSF develop user-friendly online tool for advance care planning
A new patient-friendly online resource called PREPARE has been developed to help people make complex medical decisions. The website was developed by researchers from the San Francisco VA Medical Center, UCSF, and NCIRE – The Veterans Health Research Institute.
The PREPARE website incorporates content identified in new research to address key patient- and surrogate-identified aspects of preparing for advance care planning and decision making. The site provides concrete examples through videos and other mechanisms on how to identify what is most important in life, how to communicate that with family and friends and doctors, and how to make informed medical decisions….
There are few resources which can adequately prepare patients and their families to face serious illness or a medical crisis – situations which often involve complex decisions over time,” said lead study author Rebecca Sudore, MD, SFVAMC geriatrician and palliative medicine physician and associate professor medicine at the UCSF School of Medicine.
“Advance directives are important, but they are just one piece of the puzzle,” she said. “We wanted to develop a value-driven, easy-to-use tool to prepare people to make medical decisions that reflect their values and needs while preparing them to effectively communicate these wishes with others.”
This study identified key themes critical to successful advance care planning that go beyond completing an advance directive form. These include successful surrogate selection and communication with the surrogate, determination of the surrogate’s role, and communication with family and doctors.
The website’s audio-visual interface is tailored to typically underserved populations (including users with low health or computer literacy and/or visual or hearing impairment) and aims to incorporate a patient-centered, comprehensive and manageable approach.
The PREPARE website is written at a fifth-grade reading level, and includes voice-overs of all text, closed-captioning for the hearing impaired, and large font for the visually impaired. In preliminary pilot testing, older adults from diverse backgrounds rated PREPARE a nine out of a 10- point-scale for ease of use, according to Sudore.
“We wanted to make the website free and easy-to-use by everyone,” she said. “We made sure to take advice given to us by patients and surrogates. The site doesn’t merely ask people to do advance care planning, but actually shows people, through videos and a step-by-step process, how to actually have the conversation and make informed medical decisions.”
The study included 69 English and Spanish-speaking patients and surrogate decision makers who reported having to make serious medical decisions for themselves or loved ones. The mean age of patients was 78 years and 61 percent were non-white. The mean age of the surrogate decision makers was 57 years, and 91 percent were non-white.
Qualitative analysis revealed that advance directives were not enough to prepare patients and surrogates for medical decision making. Many participants stated that solely focusing on treatments, such as mechanical ventilation, was not sufficient to help with the “many decisions” with which they were facing…
Read the entire article here
“When I started, we had a stand-alone science/health section
and several people covering various aspects of the beat—health
policy/insurance, consumer health, and biosciences. Now
there’s only one person left with any medical journalism
training and that person is covering higher education.”
–15-year newspaper reporter laid off in 2008
“The pressure to produce from my editor blunts your ambition
because you know if you have a choice of a story you can turn
around in a week as opposed to one that may take 2- 3 times
as long, you have to juggle. You make choices based on the
stories you choose not to pursue. And that’s where readers
come out losers. That’s particularly true on health policy
and insurance. How ambitious am I going to be on this
story? Do I feel encouraged to do this kind of reporting
or” not? Those are dilemmas I face regularly.
–Major-market newspaper reporter
From the summary
This report provides a snapshot of the current state of health journalism in the U.S. today. It is based on a literature review of more than 100 published pieces of research on health journalism; on a survey of members of the Association of Health Care Journalists (AHCJ), conducted by the Foundation and AHCJ; and on informal one-on-one interviews conducted by the author of this report with more than 50 journalists who work (or worked) for newspapers, radio and TV stations, magazines, and Web sites in small and large markets.
Excerpts from the report
The cuts in budget and personnel that so many newsrooms are facing contribute to several troubling trends in the content of health journalism:
- An emphasis on stories that can be produced quickly—often meaning more stories on medical studies, and sometimes sacrificing on quality.
- Fewer in-depth or complex stories, especially about health policy, and more “hyper-local” stories along with stories variously described as lifestyle, consumer, or news-you-can-use.
- Reliance on stories produced and syndicated elsewhere, by non-traditional news sources.
- The influence of commercial interests on health news, through video news releases (VNRs), sponsored news segments, free syndicated news segments from health providers, and the influence of PR firms steering the news.
[Janice's note...I am thinking of local hospitals who provide articles and interviews on the latest (expensive) procedures to the local media. Yes, hospitals are commercial interests. Seldom do these articles or interviews go into details about evidence, cost, or appropriateness.]
There is an undeniably widespread trend in TV news—often in health news—to label
as news some content which has been provided by industry sources who covet publicity in news programming. This practice takes several forms:
- Video news releases (VNRs) – produced and distributed by those promoting a product or cause. They are produced to look exactly like high-quality TV news packages. They are usually supplied on videotape or via satellite feed along with a script so that stations can put their own reporter’s face and voice on the story.
- Sponsored health news – usually paid for by a local medical center and featuring professionals from that medical center. The fact that these segments are paid for, and that they include only certain perspectives, is usually not disclosed.
- Free news segments from health providers – produced by medical centers, featuring only professionals from that organization.
“My biggest challenge? …Trying to figure who’s paying for what
pitch, who’s paying for what health campaign. There’s dollars
attached to everything.”
What’s a reader to do? Start by reading articles thoughtfully. Look for clues for completeness, strength of evidence, conflicts of interest, and authorship.
A few good resources on how to analyze medical and health news stories.