The National Center for Complementary and Alternative Medicine (NCAAM) is now the National Center for Complementary and Integrative Health, or NCCIH.
According to the NIH Web page explaining the name change , “[t]he change was made to more accurately reflect the Center’s research commitment to studying promising health approaches that are already in use by the American public. Since the Center’s inception, complementary approaches have grown in use to the point that Americans no longer consider them an alternative to medical care. For example, more than half of Americans report using a dietary supplement, and Americans spend nearly four billion dollars annually on spinal manipulation therapy. The name change is in keeping with the Center’s existing Congressional mandate and is aligned with the strategic plan currently guiding the Center’s research priorities and public education activities.
The Center’s mission is unchanged.”The Center’s research priorities include the study of complementary approaches, such as spinal manipulation, meditation, and massage, to manage pain and other symptoms that are not well-addressed by conventional treatments, to encourage self-care methods that support healthier lifestyles, and to uncover potential usefulness and safety issues of natural products. The practices and products that will continue to be studied by the Center are prioritized by four guiding principles: scientific promise, amenability to be studied using the highest quality research methods, use by the American public, and the potential impact on public health.”
Just 30 percent of Americans with HIV had the virus under control in 2011, and approximately two-thirds of those whose virus was out of control had been diagnosed but were no longer in care, according to a new Vital Signs report published today by the Centers for Disease Control and Prevention. The new study underscores the importance of making sure people with HIV receive ongoing care, treatment, and other information and tools that help prevent transmission to others, as well as the need to reach more people with HIV testing. Among those whose infection was not under control, more than three times the proportion (66 percent) were no longer in care as had never been diagnosed (20 percent).
The HIV epidemic continues to threaten the health and well-being of many Americans – with more than one million people living with the disease in the U.S. and 50,000 new infections each year.
When used consistently, antiretroviral medication can keep HIV controlled at very low levels in the body (known as viral suppression), allowing people with HIV to live longer, healthier lives and reducing the likelihood they will transmit HIV to others. Treatment has been shown to reduce sexual transmission of HIV by 96 percent, and U.S. clinical guidelines now recommend that everyone diagnosed with HIV receive treatment, regardless of their CD4 cell count or viral load.
“For people living with HIV, it’s not just about knowing you’re infected – it’s also about going to the doctor for medical care,” said CDC Director Tom Frieden, M.D., M.P.H. “And for health care facilities, it’s not just about the patients in your care – it’s every person diagnosed, and every person whose diagnosis has not yet been made. Key to controlling the nation’s HIV epidemic is helping people with HIV get connected to – and stay in – care and treatment, to suppress the virus, live longer and help protect others.”
The new study estimates that of the 1.2 million Americans living with HIV in 2011, 70 percent did not have their virus under control. Among the nearly 840,000 people who had not achieved viral suppression:
66 percent had been diagnosed but were not engaged in regular HIV care,
20 percent did not yet know they were infected,
4 percent were engaged in care but not prescribed antiretroviral treatment, and
10 percent were prescribed antiretroviral treatment but did not achieve viral suppression.
The percentage of Americans with HIV who achieved viral suppression remained roughly stable (26 percent in 2009 vs. 30 percent in 2011).
CDC focus on stopping HIV transmission through treatment
CDC has increased the focus on diagnosing people with HIV, supporting linkage to ongoing care and treatment, provision of risk reduction information, and increasing medication adherence. By making the most of these strategies for those who are HIV-positive, as well as other high impact strategies to protect those who remain uninfected but are at highest risk for HIV, CDC believes substantial progress can be made in reducing new infections.
“There is untapped potential to drive down the epidemic through improved testing and treatment, but we’re missing too many opportunities,” said Jonathan Mermin, M.D., director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and Tuberculosis Prevention. “Treatment is crucial. It is one of our most important strategies for stopping new HIV infections.”
Current initiatives to promote HIV testing and treatment include innovative partnerships to make HIV testing simple, accessible and routine; programs to help health departments identify and reach out to infected individuals who have fallen out of care; and public awareness campaigns to urge testing and encourage people with HIV to seek ongoing care.
These efforts are an essential component of the National HIV/AIDS Strategy, launched in 2010. Key goals of the strategy include reducing HIV incidence, increasing access to care and optimizing health outcomes, and reducing HIV-related health disparities.
Younger adults with HIV least likely to have virus under control
Today’s study also found that viral suppression increased with age, with young people significantly less likely than older age groups to have their virus under control – only 13 percent of people aged 18-24 were virally suppressed, compared to 23 percent among those aged 25-34, 27 percent among those aged 35-44, 34 percent among those aged 45-54, 36 percent among those aged 55-64, and 37 percent among those aged 65 and older. The researchers attribute the disparity in large part to the fact that fewer than half (49 percent) of 18- to 24-year olds with HIV have been diagnosed, underscoring the need for more HIV testing in this population.
“It’s alarming that fewer than half of HIV-positive young adults know they are infected,” said Eugene McCray, M.D., director of CDC’s Division of HIV/AIDS Prevention. “Closing that gap could have a huge impact on controlling HIV – knowing your status is the first critical step toward taking care of your own health and avoiding transmission to others.”
The study did not find statistically significant differences in viral suppression by race or ethnicity, sex, or risk group.
For additional resources on today’s analysis, visitwww.cdc.gov/nchhstp/newsroom.
UN Secretary General Dr Ban Ki-moon today presented his synthesis report on the post-2015 Development Agenda. Entitled “The Road to Dignity by 2030: Ending Poverty, Transforming All Lives and Protecting the Planet”, this is Ban Ki-moon’s updating of the Millennium Development report (which Kofi Annan rather more modestly called “We the Peoples – The Role of the United Nations in the 21st Century).
I note in passing that the former penchant for having development “Decades” covering distinct topics has now swollen into a 15-year catch-all cycle. WHO’s Health for All, which all of us were supposed to be enjoying by the year 2000, was taken over by the UN and prolonged into 2015 in the Millennium Development Goals (MDGs). This is now being extended to 2030 in a new set of Sustainable Development Goals (SDGs) launched by the Secretary General’s report.
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Over a million US military veterans lacked healthcare coverage in 2012, according to new estimates published in The Lancet. While many people believe that all veterans are covered by the Veterans Affairs health care system, less than half (8.9 million) of the 22 million veterans in the US are covered by VA health benefits, and most veterans are covered by private health insurance. Uninsured veterans are more likely to be young, single, African American, and veterans of Iraq and Afghanistan.
However, the authors of this viewpoint estimate that universal health coverage for veterans is within reach, thanks to the Affordable Care Act and its Medicaid expansion and subsidies for private health care. According to the authors, 87% of currently uninsured veterans could be eligible for health coverage through the Medicaid expansion, via the subsidized private health insurance market, or by enrolling in VA health benefits. Uninsured veterans are more likely to be clustered in states that have rejected the ACA’s Medicaid expansion. Of the top five states with the highest number of uninsured veterans, four  are states that have rejected the expansion (the fifth, California, has accepted the expansion, but is also the most populous state in the union).
“Largely on account of the Affordable Care Act, the goal of universal health coverage for veterans is closer than ever,”* explains author Dave A Chokshi. “There remain political hurdles to achieving this goal, both in the false impression that the VA already provides universal coverage, and the decision by several states to reject the ACA’s Medicaid expansion. While eligibility for insurance is not tantamount to access to care, universal coverage is an important first step towards high-quality healthcare.”*
NOTES TO EDITORS:
*Quotes direct from author and cannot be found in text of Article
 There are an estimated 126000 uninsured veterans in Texas, 95000 in Florida, 54000 in North Carolina, and 53000 in Georgia
Flexible electronic sensors based on paper — an inexpensive material — have the potential to some day cut the price of a wide range of medical tools, from helpful robots to diagnostic tests. Scientists have now developed a fast, low-cost way of making these sensors by directly printing conductive ink on paper. They published their advance in the journal ACS Applied Materials & Interfaces.
Anming Hu and colleagues point out that because paper is available worldwide at low cost, it makes an excellent surface for lightweight, foldable electronics that could be made and used nearly anywhere. Scientists have already fabricated paper-based point-of-care diagnostic tests and portable DNA detectors. But these require complicated and expensive manufacturing techniques. Silver nanowire ink, which is highly conductive and stable, offers a more practical solution. Hu’s team wanted to develop a way to print it directly on paper to make a sensor that could respond to touch or specific molecules, such as glucose.
The researchers developed a system for printing a pattern of silver ink on paper within a few minutes and then hardening it with the light of a camera flash. The resulting device responded to touch even when curved, folded and unfolded 15 times, and rolled and unrolled 5,000 times. The team concluded their durable, lightweight sensor could serve as the basis for many useful applications.
Spices and herbs are rich in antioxidants, which may help improve triglyceride concentrations and other blood lipids, according to Penn State nutritionists.
Triglyceride levels rise after eating a high-fat meal — which can lead to an increased risk of heart disease. If a high-antioxidant spice blend is incorporated into the meal, triglyceride levels may be reduced by as much as 30 percent when compared to eating an identical meal without the spice blend. The spiced meal included garlic powder, rosemary, oregano, cinnamon, cloves, paprika, turmeric, ginger and black pepper.
Sheila G. West, professor of biobehavioral health and nutritional sciences, and Ann C. Skulas-Ray, research associate in nutritional sciences, reviewed a variety of research papers that focused on the effects that spices and herbs have on cardiovascular disease risk. They published their findings in a supplement to the current issue of the journal Nutrition Today, based on papers presented at the McCormick Science Institute Summit held in May 2014.
“The metabolic effects of spices and herbs and their efficacy and safety relative to traditional drug therapy represent an exciting area for future research given the public health significance of cardiovascular disease,” the researchers wrote.
West and Skulas-Ray looked at three categories of studies — spice blends, cinnamon and garlic.
“We live in a world where people consume too many calories every day,” said West. “Adding high-antioxidant spices might be a way to reduce calories without sacrificing taste.”
West and Skulas-Ray reviewed several cinnamon studies that looked at the effect of the spice on both diabetics and non-diabetics. Cinnamon was shown to help diabetics by significantly reducing cholesterol and other blood lipids in the study participants. However, cinnamon did not appear to have any effect on non-diabetics.
The garlic studies reviewed were inconclusive, but this is likely because the trials had a wide range of garlic doses, from nine milligrams of garlic oil to 10 grams of raw garlic. The reviewers noted that across the studies there was an eight percent decrease in total cholesterol with garlic consumption, which was associated with a 38 percent decrease in risk of heart problems in 50-year-old adults.
Commercially available datasets containing a wealth of information about food and alcohol establishments differ significantly, raising concerns about their reliability as sources of information that could be used to set public policy or conduct scientific research, according to a University of Pittsburgh Graduate School of Public Health investigation.
The analysis, funded by the Aetna Foundation, will be presented Monday at the American Public Health Association’s (APHA) annual meeting in New Orleans. It examined systematic differences in two commercially available datasets when they were used to determine the relationship between neighborhood socioeconomic characteristics and the density of food and alcohol establishments.
“If we’re making decisions about setting public policy to improve public health – such as incentives for grocery stores that offer fresh produce in economically depressed areas – then we need to be making these decisions based on accurate data to back up the need for such incentives,” said lead investigator Dara Mendez, Ph.D., M.P.H., an epidemiologist at Pitt Public Health. “Our study found that relying on just one of these commercially available datasets likely wouldn’t provide robust information.”
There are numerous datasets available for a fee that give detailed information about food and alcohol establishments across the U.S. Typically, these datasets are purchased by companies that use them for marketing purposes.
Dr. Mendez and her team used two different commercially available datasets containing information about food and alcohol establishments in Allegheny County, which includes Pittsburgh. The information was divided into the 416 distinct census tracts in the county as a means to define neighborhoods. Each census tract consists of an average of 4,000 people.
Both of the datasets showed that the density of alcohol outlets increased as neighborhood poverty increased. However, the datasets differed when it came to grocery stores. One showed that as poverty increased, the number of grocery stores increased. The other showed no association.
“This is a perplexing disagreement that likely comes down to the datasets using different classification systems and also not accurately capturing all the information. For example, because we are familiar with Allegheny County, my team was able to determine that some of the key grocery stores in our area were not included,” said Dr. Mendez. “However, if we were doing a similar analysis for a city we were not familiar with, we likely wouldn’t catch the discrepancy and could come to an inaccurate conclusion.”
The Aetna Foundation funded the study as part of a larger grant to Pitt Public Health to study the potential influence of living in stressful neighborhoods on the health of African-American mothers and their babies.
Additional researchers on this study include Anthony Fabio, Ph.D., M.P.H., and Kevin H. Kim, Ph.D., both of Pitt; and Cecily Hardaway, Ph.D., of Duke University.
The science of psychology is often associated with either carefully controlled lab experiments or the soft-spoken tones of a therapist’s office. But psychologists actually study a huge range of behavioral phenomena. This site from the American Psychological Association (APA) focuses on work and work environments, asking questions such as: What makes work meaningful? How can companies help people love their jobs? And what’s in it for the companies if they invest in making the workplace healthier? There is a lot to discover here, including the Articles & Research section, which links readers to coverage of workplace research by such media outlets as USA Today and Market Watch. The Good Company section is another great find and features Podcasts as well as a Newsletter and Blog that provide focused, research-based content for both employers and workers. Company executives may also want to look into the Psychologically Healthy Workplace Award, which has been “shining the spotlight on exemplary organizations” since 1999. [CNH]
As discussed in one of my previous posts, the promotion of quackery is so ubiquitous in my town it’s become white noise for me. I mostly tune it out unless I’m personally asked my opinion. Often this promotion comes in the weekly newspaper, in the advertising-disguised-as-advice page “Ask the Expert.” Occasionally there are columns by financial advisors and home improvement experts, but by far the majority of “expert advice” comes from chiropractors, naturopaths, Chinese Medicine practitioners, and holistic nutritionists. One regular advertiser is a local who calls herself a “Divine Healer”. She has some initials after her name, none of which I can trace back to any actual licenced health profession, degree or diploma. Her services include reflexology, mediumship, craniosacral therapy, aromatherapy and card-reading. She also offers a special massage called “vibrational raindrop technique” which apparently involves the use of essential oils and tuning forks or singing bowls.
This actually sounds like it might be kind of relaxing and entertaining. Something I would personally never pay the money for, but harmless, right? Earlier this year, however, a local public health nurse who I consider a kindred spirit based on our views of alternative medicine contacted me about the weekly claim. In the wake of a severe local flu outbreak and depletion of vaccine supply, the healer recommended an essential oil called “Thieves” claiming that “research shows that it has a 99.96 percent kill rate against airborne bacteria – interrupting the life cycle and interfering with the ability of viruses to replicate.” Further information available on her website goes on to describe how you can boost your immune system by placing a few drops on your feet every morning (this old wives’ tale makes me shake my head, every time I read it – which is too often).
Also provided are several recipes for making your own capsules with various essential oils which you should then take three times a day if you actually become sick. In bold, she warns that you must never take essential oils internally unless they are Young Living brand, which of course, is the brand that she represents. I found that information to be very interesting, considering the Health Canada guidelines for approval for aromatherapy essential oils clearly states that they are for topical or inhalation only. Also interesting is the fact that Young Living doesn’t appear to have an NPN for Thieves.
Young Living has also been under fire recently from the FDA for boldly claiming that Thieves can kill Ebola. While the letter from the FDA may prompt some correction at their top level, I doubt the message has trickled down to their thousands of distributors who will still likely be selling it any way they can, and that really is the modus operandi of all multi-level marketing schemes. Dr. Harriet Hall discussed a similar MLM company, and states:
A high milk intake in women and men is not accompanied by a lower risk of fracture and instead may be associated with a higher rate of death, suggests observational research. Women who drank more than three glasses of milk a day had a higher risk of death than women who drank less than one glass of milk a day.
“there may be a link between the lactose and galactose content of milk and risk, although causality needs be tested.
“Our results may question the validity of recommendations to consume high amounts of milk to prevent fragility fractures,” they write. “The results should, however, be interpreted cautiously given the observational design of our study. The findings merit independent replication before they can be used for dietary recommendations.”
Michaëlsson and colleagues raise a fascinating possibility about the potential harms of milk, says Professor Mary Schooling at City University of New York in an accompanying editorial. However, she stresses that diet is difficult to assess precisely and she reinforces the message that these findings should be interpreted cautiously.
“As milk consumption may rise globally with economic development and increasing consumption of animal source foods, the role of milk and mortality needs to be established definitively now,” she concludes.”
A glass of milk Français : Un verre de lait (Photo credit: Wikipedia)
The systematic neglect of culture is the single biggest barrier to advancing the highest attainable standard of health worldwide, say the authors of a major new report on culture and health, led by Professor David Napier, a leading medical anthropologist from University College London (UCL), UK, and published in The Lancet.
Bringing together experts from many different fields, including anthropologists, social scientists, and medics, the Commission is the first ever detailed appraisal of the role of culture in health. The authors argue that cultures of all kinds – not only people’s religious or ethnic identity, but also professional and political cultures – have been sidelined and misunderstood by both medical professionals and society as a whole.
Until now, culture has largely been conceived of as an impediment to health, rather than a central determining feature of it. However, the Commission makes a powerful case to the contrary, showing that culture not only determines health – for example, through its influence on behaviours such as smoking and unhealthy eating – but also defines it through different cultural groups’ understandings of what it means to be well.
Culture is often blamed for clinical malpractice,…
Aneroid sphygmomanometer with stethoscope, used for auscultatory blood pressure measurement. (Photo credit: Wikipedia)
From the 18 September 2014 post at iMedicalapps
A recent trial published in the Journal of the American Medical Association has demonstrated the efficacy of self-titration of blood pressure medications by patients with hypertension.
Personally, I’m a proponent of giving patients self-titration schedules, particularly in my patients with systolic heart failure in whom I’m trying to maximize medical therapy. It’s a strategy I use somewhat sparingly though in part because of the difficulty to follow the home monitoring these patients are doing between clinic visits.
In this study, the self-titration plan was agreed upon in a clinic visit and then transcribed onto a paper given to the patient. The patient then used an unconnected blood pressure cuff at home with pre-set parameters for the patient to notify their primary care physician if their readings were too high or too low. Notifications of self-titration were accomplished by having the patient send in paper notifications to their primary care physician.
There are clearly a number of opportunities here to streamline the process to help make it less cumbersome for the patient and improve the monitoring of patients undertaking this kind of self-titration strategy. There are a number of wireless blood pressure cuffs on the market as well as wired devices that can transmit data through USB connections to a computer.
Ever wondered how people figure out what is fair? Look to the brain for the answer. According to a new Norwegian brain study, people appreciate fairness in much the same way as they appreciate money for themselves, and also that fairness is not necessarily that everybody gets the same income.
Economists from the Norwegian School of Economics (NHH) and brain researchers from the University of Bergen (UiB) have worked together to assess the relationship between fairness, equality, work and money. Indeed, how do our brains react to how income is distributed?
More precisely, the interdisciplinary research team from the two institutions looked at the striatum; or the “reward centre” of the brain. By measuring our reaction to questions related to fairness, equality, work and money, this part of the brain may hold some answers to the issue of how we perceive distribution of income.
“The brain appreciates both own reward and fairness. Both influence the activation of the striatum,” says Professor Alexander W. Cappelen. “This may explain why a lot of people are willing to sacrifice monetary rewards when this results in a fairer balance.”
Inequality vs. fairness
Cappelen works at the Department of Economics at NHH and is co-director of the Choice Lab, which consists of researchers devoted to learning more about how people make economic and moral choices.
Along with his NHH Choice Lab colleagues Professor Bertil Tungodden and Professor Erik Ø. Sørensen, Cappelen wanted to explore how the brain’s reward system works. To help them answer this question, the NHH team got in touch with brain researchers Professor Kenneth Hugdahl, Professor Karsten Specht and Professor Tom Eichele, all from the Bergen fMRI Group and UiB’s Department of Biological and Medical Psychology.
Together, the NHH and UiB researchers set out to prove that the brain accepts inequality as long as this inequality is considered fair. The researchers published their results in the article Equity theory and fair inequality: A neuroeconomic study, which was published in the scientific journal PNAS on 13 October 2014.
People’s preferences for income distribution fundamentally affect their behaviour and contribute to shaping important social and political institutions. The study of such preferences has become a major topic in behavioural research in social psychology and economics.
“Our research showed that the striatum shows more activity to monetary rewards when the reward was judged to be fair,” says Kenneth Hugdahl.
IMAGE:Here are five of the six NHH and UiB researchers behind the new study that shows how the brain responds to questions regarding fairness and inequality. Left to right: Bertil…
Despite the large literature studying preferences for income distribution, there has so far been no direct neuronal evidence of how the brain responds to income distributions when people have made different contributions in terms of work effort.
Inspired by an article in Nature
The background for the joint study between the NHH and UiB researchers was an article in Nature in February 2010, where an interdisciplinary team of American researchers found evidence that people’s brains react negatively to inequality. The American researchers reached their conclusion by studying how the striatum responded to different levels of inequality in a situation where everyone had made the same contribution….
Many military personnel and veterans experience chronic pain, a condition that can be debilitating and is often difficult to treat. Post-traumatic stress, traumatic brain injury, depression, and substance use are other conditions that tend to co-occur in these same service members and are also challenging to treat. Opioid medications are often prescribed for chronic pain conditions, but use and misuse of opioids resulting in hospitalizations and death has been on the rise. A study published in the journal JAMA Internal Medicine examined the prevalence of chronic pain and opioid use among U.S. soldiers following deployment. The researchers found that of the more than 2,500 participants surveyed, 44 percent had chronic pain and 15 percent regularly used opioids—rates much higher than the general population.
Many military, veterans, and their families turn to complementary and integrative health approaches such as mindfulness meditation and other practices in an effort to enhance the options for the management of pain and associated problems. This page provides resources and information on health conditions of special concern to military, veterans, and their families and the complementary and integrative health practices being studied for this population.
For benign ovarian surgery, conventional laparoscopy causes fewer complications, is less expensive, than robot-assisted surgery
NEW YORK, NY (October 8, 2014)—For benign gynecologic conditions, robot-assisted surgery involves more complications during surgery and may be significantly more expensive than conventional laparoscopic surgery, according to a study by researchers at Columbia University Medical Center (CUMC). The results were published online today in Obstetrics & Gynecology.
Robot-assisted surgery was first widely used for radical prostatectomy. For procedures such as prostatectomy, where there were previously no minimally invasive options, robot-assisted laparoscopy often offered a dramatic improvement. But in the two gynecologic surgeries looked at in this study—oophorectomy (removal of one or both ovaries) and cystectomy (removal of an ovarian cyst) —surgeons already had laparoscopic options. The rate of robot-assisted surgery increased from 3.5 percent in 2009 to 15.0 percent in 2012 for oophorectomy and from 2.4 percent in 2009 to 12.9 percent in 2012 for cystectomy.
The CUMC researchers analyzed data on conventional laparoscopic and robot-assisted procedures performed on 87,514 women for benign gynecologic conditions between 2009 and 2012. The procedures took place at 502 U.S. hospitals.
The study showed a small but statistically significant overall increase in intraoperative (during surgery) complications, mainly ureteral and bladder injuries, with the robot-assisted procedures—3.4 percent for robot-assisted oophorectomy vs. 2.1 percent for conventional laparoscopic oophorectomy; 2.0 percent for a robot-assisted cystectomy vs. 0.9 percent for a conventional laparoscopic cystectomy. It is possible that the rate of complications will decline as surgeons become more experienced in robotic technology.
“The findings raise questions about the potential utility of robotic-assisted surgery for ovarian cancer and suggest that further studies are needed prior to considering these procedures as a standard of care,” said co-author Jason Wright, MD, Sol Goldman Associate Professor of Gynecologic Oncology and chief, Division of Gynecologic Oncology, Columbia University College of Physicians and Surgeons.
The researchers also found robot-assisted procedures to be more expensive. The median total cost for robot-assisted oophorectomy was $7,426, while for conventional laparoscopic oophorectomy it was $4,922. The median total cost for robot-assisted cystectomy was $7,444; for conventional laparoscopic cystectomy it was $4,133.
“With the rapid rise in the cost of cancer care, we need to make sure that public policies encourage comparative studies prior to widespread dissemination of new technologies,” said another co-author, Dawn L. Hershman, MD, MS, associate professor of medicine at the College of Physicians and Surgeons, associate professor of epidemiology at Columbia’s Mailman School of Public Health, and leader of the Breast Cancer Program at the Herbert Irving Comprehensive Cancer Center at NewYork-Presbyterian/Columbia.
The paper is titled, “Comparative Effectiveness of Robotic-Assisted Compared to Laparoscopic Adnexal Surgery for Benign Gynecologic Disease.” The other authors are: Alessandra Kostolias, MD (CUMC), Cande V. Ananth, PhD, MPH (CUMC), William M. Burke, MD (CUMC), Ana I. Tergas, MD (CUMC), Eri Prendergast, MS (CUMC), Scott D. Ramsey, MD, PhD (Fred Hutchinson Cancer Research Center), and Alfred I. Neugut, MD, PhD (CUMC).
Dr. Wright (R01CA169121-01A1) and Dr. Hershman (R01 CA166084) are recipients of grants and Dr. Tergas is the recipient of a fellowship (R25 CA094061-11) from the National Cancer Institute.
The authors declare no financial or other conflicts of interest.
Columbia University Medical Center provides international leadership in basic, preclinical, and clinical research; medical and health sciences education; and patient care. The medical center trains future leaders and includes the dedicated work of many physicians, scientists, public health professionals, dentists, and nurses at the College of Physicians and Surgeons, the Mailman School of Public Health, the College of Dental Medicine, the School of Nursing, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. Columbia University Medical Center is home to the largest medical research enterprise in New York City and State and one of the largest faculty medical practices in the Northeast. For more information, visit cumc.columbia.edu or columbiadoctors.org.
The latest edition of the Taking Stock report details pollutant releases and transfers across the region from 2005 through 2010, with an in-depth review of releases from the pulp and paper industry.
Montreal, 1 October 2014—The Commission for Environmental Cooperation (CEC) has released a comprehensive report on the changing face of industrial pollution in North America, covering the years 2005 through 2010. This is the first time an edition of the CEC’s Taking Stock series, which gathers data from pollutant release and transfer registers (PRTRs) in Canada, Mexico and the United States, has analyzed North American pollutant information over an extended timeframe.
This volume of Taking Stock documents pollutant releases and transfers reported over the six-year period by approximately 35,000 industrial facilities across the region. Key findings include:
Total reported amounts of pollutants increased by 14 percent (from over 4.83 billion kilograms in 2005 to more than 5.53 billion kilograms in 2010), driven by releases to land (108-percent increase) and off-site disposal (42-percent increase). These increases reflect the introduction of Canada’s more comprehensive reporting requirements on tailings and waste rock, as well as on total reduced sulfur (TRS), resulting in more complete reporting by the metal ore mining and oil and gas extraction sectors in Canada.
Most other types of releases and transfers declined over this period—including releases to air from electric utilities, mainly in the United States, which declined by 36 percent. Changes in regulations for fossil fuel–based power plants, along with facility closures, were the drivers of these decreases.
There was also a 38-percent decrease in releases to air of substances in four categories that have significant potential to cause harm to human health or the environment: known or suspected carcinogens, developmental or reproductive toxicants, persistent, bioaccumulative and toxic (PBT) substances, and metals.
By providing details at the country level, Taking Stock also highlights the gaps in the picture of North American industrial pollution that are created by differences in national PRTR reporting requirements and practices. For example:
Of the more than 500 pollutants reported across the region every year, only 60 are common to all three PRTRs.
Oil and gas extraction, a key sector tracked in Canada and that ranks among the top sectors for reported releases and transfers each year, is not subject to reporting in the United States. Mexican data show a low level of reporting by oil and gas extraction facilities.
Compared to the United States and Canada, Mexican data show wider fluctuations in reporting between 2005 and 2010, reflecting the fact that Mexico’s PRTR is relatively new.
“As a result of ongoing collaboration among the three countries’ PRTR programs and the CEC, we are now able to track industrial pollutant releases and transfers across North America and over time to identify tendencies, as well as important gaps, in reporting. By establishing linkages between PRTR data and facilities’ environmental sustainability efforts, Taking Stock supports the needs of the private sector, governments, citizens, and communities concerned with and affected by North American industrial pollution,” said Irasema Coronado, CEC Executive Director.
Decreases in pollutant releases from pulp and paper mills—a look at the driving factors
This year’s report also takes advantage of six years of North American PRTR data to examine releases reported by pulp and paper mills—which have consistently ranked among the top sectors for releases to air and water in North America. The data show that between 2005 and 2010, the sector’s releases to air decreased by 19 percent and releases to water by 6 percent. Taking Stock identifies the drivers of these decreases, through data analyses, a survey of mills, and information from industry representatives. Among the findings:
A key driver of the decreases seen over this period has been the shutdown of several facilities in Canada and the United States (the two countries with the most reporting from this sector).
Emissions typically associated with pulp and paper mills include volatile organic compounds (VOCs), methanol, hydrogen sulfide, phosphorous, and formaldehyde, among others. However, some of these pollutants are not subject to reporting in one or more of the three countries (e.g., methanol in Mexico), creating challenges when analyzing the pollution profiles of pulp and paper mills.
While factors such as new emissions regulations have played a role in the decline in releases over this period, the report also shows that facilities’ own environmental engagement, as well as customer demand for environmentally-friendly products, have had impacts—with mills adopting environmental management decisions that include pollution prevention and mitigation practices.
Explore North American PRTR data online
The data presented in the Taking Stock report can be searched using the CEC’s Taking Stock Onlinetool, which is updated annually with data from North America’s three PRTRs. It allows users to:
explore information on industrial pollutant releases and transfers;
generate reports in a variety of formats, including pie charts and spreadsheets;
create maps and view them using Google Earth; and
analyze PRTR data with respect to other information, such as locations of watersheds, rivers, lakes, and population centers, using geospatial data from the North American Environmental Atlas.
Anyone who operates a vehicle of any type—car, bus, train, plane, or boat—needs to know there are over-the-counter medicines that can make you drowsy and can affect your ability to drive and operate machinery safely.
Over-the-counter medicines are also known as OTC or nonprescription medicines. All these terms mean the same thing: medicines that you can buy without a prescription from a healthcare professional. Each OTC medicine has a Drug Facts label to guide you in your choices and to help keep you safe. OTC medicines are serious medicines and their risks can increase if you don’t choose them carefully and use them exactly as directed on the label.
According to Ali Mohamadi, M.D., a medical officer at FDA, “You can feel the effects some OTC medicines can have on your driving for a short time after you take them, or their effects can last for several hours. In some cases, a medicine can cause significant ‘hangover-like’ effects and affect your driving even the next day.” If you have not had enough sleep, taking medicine with a side effect that causes drowsiness can add to the sleepiness and fatigue you may already feel. Being drowsy behind the wheel is dangerous; it can impair your driving skills.
Choosing and Using Safely
You should read all the sections of the Drug Facts label before you use an OTC medicine. But, when you know you have to drive, it’s particularly important to take these simple steps:
First, read the “active ingredients” section and compare it to all the other medicines you are using. Make sure you are not taking more than one medicine with the same active ingredient. Then make sure the “purpose” and “uses” sections of the label match or fit the condition you are trying to treat.
Next, carefully read the entire “Warnings” section. Check whether the medicine should not be used with any condition you have, or whether you should ask a health care professional whether you can use it. See if there’s a warning that says when you shouldn’t use the medicine at all, or when you should stop using it.
The “When using this product” section will tell you how the medicine might make you feel, and will include warnings about drowsiness or impaired driving.
Look for such statements as “you may get drowsy,” “marked drowsiness will occur,” “Be careful when driving a motor vehicle or operating machinery” or “Do not drive a motor vehicle or operate machinery when using this product.”
Other information you might see in the label is how the medicine reacts when taken with other products like alcohol, sedatives or tranquilizers, and other effects the OTC medicine could have on you. When you see any of these statements and you’re going to drive or operate machinery, you may want to consider choosing another medicine for your problem this time. Look for an OTC medicine that treats your condition or problem but has an active ingredient or combination of active ingredients that don’t cause drowsiness or affect your ability to drive or operate machinery.
Talk to your healthcare professional if you need help finding another medicine to treat your condition or problem. Then, check the section on “directions” and follow them carefully.
Here are some of the most common OTC medicines that can cause drowsiness or impaired driving:
Antihistamines: These are medicines that are used to treat things like runny nose, sneezing, itching of the nose or throat, and itchy or watery eyes. Some antihistamines are marketed to relieve cough due to the common cold. Some are marketed to relieve occasional sleeplessness. Antihistamines also can be added to other active ingredients that relieve cough, reduce nasal congestion, or reduce pain and fever. Some antihistamines, such as diphenhydramine, the active ingredient in Benadryl, can make you feel drowsy, unfocused and slow to react.
Antidiarrheals: Some antidiarrheals, medicines that treat or control symptoms of diarrhea, can cause drowsiness and affect your driving. One of these is loperamide, the active ingredient in Imodium.
Anti-emetics: Anti-emetics, medicines that treat nausea, vomiting and dizziness associated with motion sickness, can cause drowsiness and impair driving as well.
“If you don’t read all your medicine labels and choose and use them carefully,” says Dr. Mohamadi, “you can risk your safety. If your driving is impaired, you could risk your safety, and the safety of your passengers and others.”
$29 million awarded to expand NCATS’ collaborative Rare Diseases Clinical Research Network
Physician scientists at 22 consortia will collaborate with representatives of 98 patient advocacy groups to advance clinical research and investigate new treatments for patients with rare diseases. The collaborations are made possible through awards by the National Institutes of Health — totaling about $29 million in fiscal year 2014 funding — to expand the Rare Diseases Clinical Research Network (RDCRN), which is led by NIH’s National Center for Advancing Translational Sciences (NCATS).
There are several thousand rare diseases, of which only a few hundred have any treatments available. Combined, rare diseases affect an estimated 25 million Americans. Some obstacles to developing rare disease treatments include difficulties in diagnosis, widely dispersed patients and scientific experts, a perception of high risk, and a lack of data from natural history studies, which follow a group of people with a specific medical condition over time.
“NCATS seeks to tackle these challenges in an integrated way by working to identify common elements among rare diseases,” said NCATS Director Christopher P. Austin, M.D. “The RDCRN consortia provide a robust data source that enables scientists to better understand and share these commonalities, ultimately allowing us to accelerate the development of new approaches for diagnosing and treating rare diseases.”
Many patients with rare diseases often struggle to obtain an accurate diagnosis and find the right treatments. In numerous cases, RDCRN consortia have become centers of excellence for diagnosing and monitoring diseases that few clinicians see on a regular basis.
These latest awards establish six new RDCRN consortia:
Lead Institution/ Principal Investigator
Disease Areas of Study
Brittle Bone Disorders Consortium of the Rare Diseases Clinical Research Network
Baylor College of Medicine, Houston/ Brendan Lee, M.D., Ph.D.
Bone diseases (e.g., osteogenesis imperfecta)
Clinical Research in Amyotrophic Lateral Sclerosis (ALS) and Related Disorders for Therapeutic Development
University of Miami Miller School of Medicine/Michael Benatar, M.B.Ch.B., M.S., D.Phil.
SAMHSA News Release Date: 9/4/2014 9:30 AM Report reveals the scope of substance use and mental illness affecting the nation Released in conjunction with the 25th anniversary of National Recovery Month
A new report by the Substance Abuse and Mental Health Services Administration (SAMHSA) provides insight into the nature and scope of substance use and mental illness issues affecting America. Today, 2013 national survey data as well as information on the efforts and resources being taken to address these problems is being released in conjunction with the 25th annual observance of National Recovery Month.
The report shows that 24.6 million Americans aged 12 or older were current (past month) illicit drug users – 9.4 percent of this age group.
Marijuana was by far the most commonly used illicit drug with approximately 19.8 million current users aged 12 and older.
In terms of other illicit drugs, the report indicates that among those aged 12 and older, there were 4.5 million current nonmedical users of prescription pain relievers (1.7 percent), 1.5 million current cocaine users (0.6 percent), 595,000 methamphetamine users (0.2 percent), and 289,000 current heroin users (0.1 percent). Although an estimated 22.7 million persons aged 12 or older needed treatment for an illicit drug or alcohol use problem, only 2.5 million persons received treatment at a specialty facility.
The SAMHSA report also shows that 34.6 million adults aged 18 or older (14.6 percent of the population aged 18 or older) received mental health treatment or counseling during the past 12 months. Nearly one in five American adults (18.5 percent), or 43.8 million adults, had a mental illness in 2013. Ten million adults (4.2 percent of the adult population) had a serious mental illness in the past year. Serious mental illness is defined as mental illness that resulted in serious functional impairment, which substantially interfered with, or limited, one or more major life activities.
The Society for Public Health Education (SOPHE) has announced the publication of Health Education & Behavior (HE&B) supplement devoted to the latest research and practice to promote healthy aging. All articles in the HE&B supplemental issue are provided through open access.
A recent study has found a disturbing exposure of the germ-killing chemical triclosan to the fetuses of pregnant women in Brooklyn.
Triclosan has been linked to reproductive and development issues in animal testing. It is often used as the active ingredient in antibacterial soaps and appears in more than 2,000 consumer products including toothpastes, body washes, school supplies and toys.
In the study, scientists tested 181 pregnant Brooklyn women, most of them black. Half tested positive for triclosan in their umbilical cord blood samples, signifying triclosan was being transferred to fetuses.
Scientists also discovered that 100 percent of the mothers contained triclosan in their urine, while 86 percent tested positive for another antibacterial chemical, triclocarban, said co-author Benny Pycke. The levels are higher than the national U.S. average and are also the first to present “body burden” data for the ways triclosan and triclocarban can remain in the body during…
The Doctor Is In is an occasional series where JHU Press authors discuss the latest developments and news in health and medicine.
Guest post by Susan Noonan, M.D., M.P.H.
On August 11, 2014, the world learned that we had lost a dearly beloved, charismatic human being to the devastating illness and consequences of depression. To most of us, the actor Robin Williams was the dynamic, clever man who made us laugh in hundreds of ways. He had the uncanny ability to take us out of our doldrums and bring a moment of joy to our lives through his many creative performances, from Mork & Mindy to Good Morning, Vietnam, Mrs. Doubtfire, and many others. His talents extended to the dramatic as well when he won an Academy Award for Good Will Hunting.
We watched, but did not know that underneath, Williams was in emotional pain, suffering so much that, despite…
Somewhere in the midst of reconciling the parts of me that are physician, public health professional and African-American male, I realized that I don’t have the luxury to simply review the medical aspects of gunshot wounds. As an African-American, I have lived my entire life learning and having it reinforced that I and others of my kind are a misunderstanding or inappropriate interaction away from becoming a statistic. As a physician I get to treat, and as a public health professional I get to report and fashion broad solutions to various challenges, but as an African-American, I get to live a certain reality that for me began when my father died from a gunshot wound when I was a small child.
We live in a country that is without debate the most violent country on earth, both outside of and within all parts of our borders. From the individual’s rights to bear militia levels of arms to the police’s increasing position as military units, from the contradictions of allowing both “Open Carry” and “Stand Your Ground,” we are spiraling toward an inevitable conclusion.
You want to participate in a challenge? Stop being so deficient of attention about what’s happening before our eyes, and think and ask what the inevitable conclusion of all of this is going to be. Regardless of your political persuasion, there are issues to be addressed.
Consider the following facts from the Children’s Defense fund,
approximately 2900 children and teens died from guns in the US in both 2008 and 2009. (Does anyone think the numbers have declined since then?) That’s one child or teen every 3 hours. That’s eight children or teens every day. That’s 55 children or teens every week for two years. What is our country’s response to this? What are you specifically doing to contribute to a solution to this?
Young Blacks are being exterminated by gunshot wounds in this country.
When it comes to quenching your thirst, water rules. But when it comes to knowing how much water you should drink every day, opinions are all over the map.
Should you buy a 2-liter water bottle to get your 8 ounces in every day? Or is drinking when you’re thirsty enough to satisfy your fluid needs?
We asked three Cleveland Clinic experts.
“The range of fluid intake needs is quite broad, depending on your metabolism, activitylevel, ambient temperature and age,” says preventive medicine specialist Roxanne Sukol, MD. “It’s better to focus on urine output: if it’s almost clear, you’re good. If it’s dark yellow or has a strong odor, try fixing it with a couple of glasses of water.”
Your diet also matters, adds registered dietitian Mira Ilic, RD, LD. “Nutritional guidelines cover all fluids, including the water found in food, juice, tea and milk,” she says. “Fruits and vegetables alone can meet 20 percent of your fluid needs when you eat a lot of produce.”
Your health is another key factor, notes internist Melissa Klein, MD. “Fluid needs increase when you’re sweating from a fever because you lose more water through your skin,” she says. “When you lose a lot fluid, whether it’s from sweating or diarrhea, we encourage you to drink fluids with water, salt and sugar to keep your body balanced.”
The fact that Cuba has already developed four cancer vaccines undoubtedly is big news for humanity if you bear in mind that according to the World Health Organization nearly 8 million people die from that disease every year. However, the monopoly media have completely ignored this reality.
One side of the vaccine controversy Americans are extremely unlikely to hear about concerns the safest, cheapest and most widely used vaccine in the world – against tuberculosis (TB). Every country in the world, except the US and the Netherlands (where TB is extremely rare), uses or has used the TB vaccine (known as Bacillus Calmette Guerin or BCG) in public vaccination programs. The BCG controversy was my first introduction (in 1971) to the US government propensity to engage in conspiracies and cover-ups. This happened during my second year of medical school, in the TB module taught by University of Wisconsin infectious disease researcher Dr Donald Smith. Smith had grave concerns about disadvantaged US communities with high rates of tuberculosis infection, as well as the nurses and doctors who looked after them.
Prior to World War II, TB epidemics infected industrialized countries at levels comparable to the current…
Long before the first towns were built, before written language was invented, and even before plants were cultivated for food, the basic human desires to relieve pain and prolong life fueled the search for medicines. No one knows for sure what the earliest humans did to treat their ailments, but they probably sought cures in the plants, animals, and minerals around them.
…Crews is among a new breed of researchers delving into a growing scientific area called chemical genetics (see main text). Taking this approach, scientists use chemistry to attack biological problems that traditionally have been solved through genetic experiments such as the genetic engineering of bacteria, yeast, and mice. Crews’ goal is to explore how natural products work in living systems and to identify new targets for designing drugs. He has discovered how an inflammation-fighting ingredient in the medicinal herb feverfew may work inside cells.
He found that the ingredient, called parthenolide, appears to disable a key process that gets inflammation going. In the case of feverfew, a handful of controlled scientific studies in people have hinted that the herb, also known by its plant name “bachelor’s button,” is effective in combating migraine headaches, but further studies are needed to confirm these preliminary findings….
From Health-related Millennium Development Goals – Summary of Status and Trends:
With one year to go until the 2015 target date for achieving the MDGs, substantial progress can be reported on many health-related goals. The global target of halving the proportion of people without access to improved sources of drinking water was met in 2010, with remarkable progress also having been made in reducing child mortality, improving nutrition, and combating HIV, tuberculosis and malaria.
Between 1990 and 2012, mortality in children under 5 years of age declined by 47%, from an estimated rate of 90 deaths per 1000 live births to 48 deaths per 1000 live births. This translates into 17 000 fewer children dying every day in 2012 than in 1990. The risk of a child dying before their fifth birthday is still highest in the WHO African Region (95 per 1000 live births) – eight times higher than that in the WHO European Region (12 per 1000 live births). There are, however, signs of progress in the region as the pace of decline in the under-five mortality rate has accelerated over time; increasing from 0.6% per year between 1990 and 1995 to 4.2% per year between 2005 and 2012. The global rate of decline during the same two periods was 1.2% per year and 3.8% per year, respectively.
Nevertheless, nearly 18 000 children worldwide died every day in 2012, and the global speed of decline in mortality rate remains insufficient to reach the target of a two-thirds reduction in the 1990 levels of mortality by the year 2015.
The Toxic Substance Control Act of 1976 should be revisited to provide Americans greater protection from toxic chemicals that diminish health and result in disability.
The House of Representatives’ Energy and Commerce Subcommittee on Trade and Consumer Protections held an oversight hearing on the Toxic Substance Control Act of 1976 (TSCA). Presenters at the forum were representatives from the chemical industries, members from the General Accountability Office, researchers, policy experts and consumer advocates for effective public health policies.
There are 80,000 chemicals for which the toxic content is unknown. Thus, there are unidentified toxic chemicals in products and the environment that have not been identified and appropriately regulated, and these chemicals can adversely affect the health of Americans. In addition, there are 700 new chemicals introduced each year. Classified information masks risks to the public. If there are no data there is no risk. One of the problems that…
In estimated 1.1 million community health center patients are left without the benefits of health coverage simply because they live in one of 24 states that have opted out of the Medicaid expansion, a key part of the Affordable Care Act (ACA), according to a new report.
The research, by the Geiger Gibson/RCHN Community Health Foundation Research Collaborative at Milken Institute School of Public Health (Milken Institute SPH) at the George Washington University also shows that the vast majority (71 percent) of the 1.1 million patients left behind live in just 11 southern states (AL, FL, GA, LA, MS, NC, OK, SC, TN, TX, VA).
Still think of TB, typhoid and gonorrhoea as infections from the past? WHO’s terrifying report will make you think again.
Diseases we thought were long gone, nothing to worry about, or easy to treat could come back with a vengeance, according to the recent World Health Organisation report on global antibiotic resistance. Concern at this serious threat to public health has been growing; complacency could result in a crisis with the potential to affect everyone, not just those in poor countries or without access to advanced healthcare. Already diseases that were treatable in the past, such as tuberculosis, are often fatal now, and others are moving in the same direction. And the really terrifying thing is that the problem is already with us: this is not science fiction, but contemporary reality. So what are some of the infections that could come back to haunt us?
One year after the fertilizer facility explosion in West, Texas, which destroyed and severely damaged nearby schools, an analysis by the Center for Effective Government finds that nearly one in ten American schoolchildren live and study within one mile of a potentially dangerous chemical facility.
The analysis, displayed through an online interactive map, shows that 4.6 million children at nearly 10,000 schools across the country are within a mile of a facility that reports to the U.S. Environmental Protection Agency’s (EPA) Risk Management Program. Factories, refineries, and other facilities that report to the program produce, use, and/or store significant quantities of certain hazardous chemicals identified by EPA as particularly risky to human health or the environment if they are spilled, released into the air, or are…
Ever been told that eating superfoods prevents cancer? Or the one about sharks not being able to get cancer? If you’ve wondered how much truth is behind these ‘facts’ you should follow this link. Cancer Research have put out a fantastic blogpost debunking these cancer myths amongst others. Well worth a quick read!
One major statement that stuck out to me from Ida Susser’s discussion of her book AIDS, Sex and Culture was that “anthropology starts where public health ends.” In her lecture she discussed how easy it is to switch hats from public health to anthropologist. Susser was able to emphasize the fact that public health professionals must understand how data frames ideas. For example, an HIV mortality rate men to women of 10:1 is looked at differently from a public health eye then from an anthropologist eye. Public health would put more funding and research into men and would discount women since they are dying at a lesser rate than men. Anthropology would look deeper at similarities and differences, both within and among societies, and would pay attention to race, sexuality, class, gender, and nationality.
Public health addresses infectious disease epidemiology. However, anthropology can help inform public health about other components…
Cigarette smoking is a leading risk factor for morbidity and premature mortality in the United States, yet information about smoking prevalence and trends is not routinely available below the state level, impeding local-level action.
We used data on 4.7 million adults age 18 and older from the Behavioral Risk Factor Surveillance System (BRFSS) from 1996 to 2012. We derived cigarette smoking status from self-reported data in the BRFSS and applied validated small area estimation methods to generate estimates of current total cigarette smoking prevalence and current daily cigarette smoking prevalence for 3,127 counties and county equivalents annually from 1996 to 2012. We applied a novel method to correct for bias resulting from the exclusion of the wireless-only population in the BRFSS prior to 2011.
Results Total cigarette smoking prevalence varies dramatically between counties, even within states, ranging…
We sought to better understand acts of self-harm among inmates in correctional institutions.
We analyzed data from medical records on 244 699 incarcerations in the New York City jail system from January 1, 2010, through January 31, 2013.
In 1303 (0.05%) of these incarcerations, 2182 acts of self-harm were committed, (103 potentially fatal and 7 fatal). Although only 7.3% of admissions included any solitary confinement, 53.3% of acts of self-harm and 45.0% of acts of potentially fatal self-harm occurred within this group. After we controlled for gender, age, race/ethnicity, serious mental illness, and length of stay, we found self-harm to be associated significantly with being in solitary confinement at least once, serious mental illness, being aged 18 years or younger, and being Latino or White, regardless of gender.
We provide empirical evidence of crime’s impact on the mental wellbeing of both victims and non-victims. We differentiate between the direct impact to victims and the indirect impact to society due to the fear of crime. The results show a decrease in mental wellbeing after violent crime victimization and that the violent crime rate has a negative impact on mental wellbeing of non-victims. Property crime victimization and property crime rates show no such comparable impact. Finally, we estimate that society-wide compensation due to increasing the crime rate by one victim is about 80 times more than the direct impact on the victim.
AIDSVu is an interactive online map illustrating the prevalence of HIV in the United States. The state- and county-level data on AIDSVu come from the U.S. Centers for Disease Control and Prevention’s (CDC) national HIV surveillance database, which is comprised of HIV surveillance reports from state and local health departments. ZIP code and census tract data come directly from state, county and city health departments, depending on which entity is responsible for HIV surveillance in a particular geographic area.
Uses can search through HIV prevalence data by race/ethnicity, sex and age, and see how HIV prevalence is related to various social determinants of health, such as educational attainment and poverty.
As one can see, HIV prevalence in the United States is concentrated in the South highlighting one of the many health disparities in the North-South divide in the United States.
Tel Aviv University research shows fat mass in cells expands with disuse
Over 35 percent of American adults and 17 percent of American children are considered obese, according to the latest survey conducted by the Centers for Disease Control and Prevention. Associated with diabetes, heart disease, stroke, and even certain types of cancer, obesity places a major burden on the health care system and economy. It’s usually treated through a combination of diet, nutrition, exercise, and other techniques.
To understand how obesity develops, Prof. Amit Gefen, Dr. Natan Shaked and Ms. Naama Shoham of Tel Aviv University’s Department of Biomedical Engineering, together with Prof. Dafna Benayahu of TAU’s Department of Cell and Developmental Biology, used state-of-the-art technology to analyze the accumulation of fat in the body at the cellular level. According to their findings, nutrition is not the only factor driving obesity. The mechanics of “cellular expansion” plays a primary role in fat production, they discovered.
By exposing the mechanics of fat production at a cellular level, the researchers offer insight into the development of obesity. And with a better understanding of the process, the team is now creating a platform to develop new therapies and technologies to prevent or even reverse fat gain. The research was published this week in the Biophysical Journal.
Getting to the bottom of obesity
“Two years ago, Dafna and I were awarded a grant from the Israel Science Foundation to investigate how mechanical forces increase the fat content within fat cells. We wanted to find out why a sedentary lifestyle results in obesity, other than making time to eat more hamburgers,” said Prof. Gefen. “We found that fat cells exposed to sustained, chronic pressure — such as what happens to the buttocks when you’re sitting down — experienced accelerated growth of lipid droplets, which are molecules that carry fats.
“Contrary to muscle and bone tissue, which get mechanically weaker with disuse, fat depots in fat cells expanded when they experienced sustained loading by as much as 50%. This was a substantial discovery.”
The researchers discovered that, once it accumulated lipid droplets, the structure of a cell and its mechanics changed dramatically. Using a cutting-edge atomic force microscope and other microscopy technologies, they were able to observe the material composition of the transforming fat cell, which became stiffer as it expanded. This stiffness alters the environment of surrounding cells by physically deforming them, pushing them to change their own shape and composition.
“When they gain mass and change their composition, expanding cells deform neighboring cells, forcing them to differentiate and expand,” said Prof. Gefen. “This proves that you’re not just what you eat. You’re also what you feel — and what you’re feeling is the pressure of increased weight and the sustained loading in the tissues of the buttocks of the couch potato.”
The more you know …
“If we understand the etiology of getting fatter, of how cells in fat tissues synthesize nutritional components under a given mechanical loading environment, then we can think about different practical solutions to obesity,” Prof. Gefen says. “If you can learn to control the mechanical environment of cells, you can then determine how to modulate the fat cells to produce less fat.”
The team hopes that its observations can serve as a point of departure for further research into the changing cellular environment and different stimulations that lead to increased fat production.
March 24, 2014
Evidence increasingly suggests that insufficient or disturbed sleep is associated with metabolic disorders such as type 2 diabetes and obesity, and addressing poor quality sleep should be a target for the prevention — and even treatment — of these disorders. Addressing some types of sleep disturbance — such as sleep apnea — may have a directly beneficial effect on patients’ metabolic health, say the authors. But a far more common problem is people simply not getting enough sleep, particularly due to the increased use of devices such as tablets and portable gaming devices.
Addressing some types of sleep disturbance — such as sleep apnea — may have a directly beneficial effect on patients’ metabolic health, say the authors. But a far more common problem is people simply not getting enough sleep, particularly due to the increased use of devices such as tablets and portable gaming devices.
Furthermore, disruption of the body’s natural sleeping and waking cycle (circadian desynchrony) often experienced by shift workers and others who work outside daylight hours, also appears to have a clear association with poor metabolic health, accompanied by increased rates of chronic illness and early mortality.
As social inequalities in health in the U.S. and international evidence continue to increase, disparities in income and wealth widened the gap making social class as a key determinant of population health. The gap is widening between upper-middle-class Americans and middle class Americans. Health and longevity are determined by the access of advances in medicine and disease prevention. These benefits are disproportionately delivered to individuals who have more education, connections, money, and good jobs. They are the ones in the best position to learn new information early, modify their behavior, take advantage of the latest treatments and have the cost covered by insurance. Since 1911, mortality statistics in Britain have consistently shown an inverse relation between measures of socio-economic status and mortality. While social class has been a less popular topic in the United States, this has been a trend in Europe since George III. Socio-economic…
When I had a routine health checkup eight years ago, my cholesterol was so high that the laboratory thought there had been a mistake. I had 9.3 millimoles of cholesterol in every litre of blood — almost twice the recommended maximum.
It was quite a shock. The general practitioner instantly prescribed statins, the cholesterol-lowering drugs that are supposed to prevent heart disease and strokes. For eight years, I faithfully popped my 20mg atorvastatin pills, without side effects. Then, one day last May, I stopped. It wasn’t a snap decision; after looking more closely at the research, I’d concluded statins were not going to save me from a heart attack and that my cholesterol levels were all but irrelevant.
[np_storybar title=”Red-faced drinkers have spiked risk of high blood pressure, study says” link=”http://life.nationalpost.com/2013/11/20/red-faced-drinkers-have-spiked-risk-of-high-blood-pressure-study-says/”] That uncle or aunt who turns beet red after a few beers or a couple of glasses of wine?…
The latest Journal of American Medical Association published a longitudinal analysis evaluating the smoking cessation rates in close to 1600 current smokers using electronic cigarettes. The authors stated that the study did not achieve statistical power, but contributed to the building evidence that e-cigarettes do not increase smoking cessation rates, as often suggested by manufacturers. What is your experience with e-cigarettes – personally or with your patients? Would your current recommendations change after reading this survey?
In new estimates released today, WHO reports that in 2012 around 7 million people died – one in eight of total global deaths – as a result of air pollution exposure. This finding more than doubles previous estimates and confirms that air pollution is now the world’s largest single environmental health risk. Reducing air pollution could save millions of lives.
Social justice is where the rights of every person in a community are considered in a fair and equitable manner. Consider these facts in relation to alcohol-related violence, when evaluating the relation of this issue to social justice:
People who are younger, from lower socioeconomic areas, and of lower education status are more likely to use and abuse alcohol and be involved with violent behaviours; meaning these groups are particularly vulnerable to experiencing alcohol-related violence.
Victims of alcohol-related violence are often young men, but men and women from all ages can be affected directly or indirectly, including children.
The victims of alcohol-related violence can be killed by a single punch, often in unprovoked or unexpected attacks. Those that live often have expensive hospitalisations, severe morbidities and long recoveries.
For health, social justice revolves around four key ideas; access, equity, rights and participation. The statements above establish that there is inequality…
This blog presents a sampling of health and medical news and resources for all. Selected articles and resources will hopefully be of general interest but will also encourage further reading through posted references and other links. Currently I am focusing on public health, basic and applied research and very broadly on disease and healthy lifestyle topics.
Several times a month I will post items on international and global health issues. My Peace Corps Liberia experience (1980-81) has formed me as a global citizen in many ways and has challenged me to think of health and other topics in a more holistic manner. (For those wishing to see pictures of a 2009 Friends of Liberia service trip to this West African country, please visit www.fol.org. My photo album is included).
Do you have an informational question in the health/medical area?
Email me at firstname.lastname@example.org I will reply within 48 hours.
My professional work experience and education includes over 10 years experience as a medical librarian and a Master’s in Library Science. In my most recent position I enjoyed contributing to our library’s blog, performing in depth literature searches, and collaborating with faculty, staff, students, and the general public.
While I will never be be able to keep up with the universe of current health/medical news,
I subscribe to the following to glean entries for this blog
Krafty (Medical)Librarian,” a collection of writings from Michelle Kraft on items of interest to medical librarians. She tends to write on technology and medical libraries but she also writes about things in general on librarianship, medicine and health”
Research Buzz, “news about search engines, digital archives, online museums, databases, and other Internet information collections since 1998″
Free Government Information, a “place for initiating dialogue and building consensus among the various players (libraries, government agencies, non-profit organizations, researchers, journalists, etc.) who have a stake in the preservation of and perpetual free access to government information”
Scout Report, a “weekly publication offering a selection of new and newly discovered Internet resources of interest to researchers and educators”