Report Examines Need for a Quieter America

Excerpts from the report by the National Academy of Engineering

Exposure to noise is a fact of life. At high levels, noise can damage hearing, and at lower levels it can disrupt sleep patterns, interfere with communications, and even cause accidents. A new National Academy of Engineering report characterizes the most commonly identified sources of noise, looks at efforts that have been made to reduce noise emissions, and suggests ways to decrease exposure in workplaces, schools, recreational environments, and residences.

Development of noise control technology needs immediate attention, said the committee that wrote the report. America should become more competitive in the production of low-noise products, both to improve quality of life and to advance innovation.

The committee recommends that the federal government explore potential engineering solutions along with changes in policy to control negative effects of noise in the workplace, in communities, and at home. These include cost-benefit analysis of noise reduction, especially for road traffic noise; improved metrics for noise control; lower limits for noise exposure in industry; “buy quiet” programs; wider use of international standards for noise emissions; airplane noise reduction technology; and noise control in public buildings. Improved cooperation between industry and government agencies, particularly the U.S. Environmental Protection Agency, is also called for.

Related Resources

• It’s a Noisy Planet can teach you about the causes and prevention of noise-induced hearing loss so that you and your family can enjoy healthy hearing for life. Approximately 26 million Americans have noise-induced hearing loss, but it is completely preventable. (US National Institutes of Health)

How Food Away From Home Affects Children’s Diet Quality

Excerpt from the report by the U.S. Department of Agriculture Economic Research Service

Based on 2 days of dietary data and panel data methods, this study includes estimates of how each child’s consumption of food away from home, food from school (which includes all foods available for purchase at schools, not only those offered as part of USDA reimbursable meals), and caloric sweetened beverages affects that child’s diet quality and calorie consumption. Compared with meals and snacks prepared at home, food prepared away from home increases caloric intake of children, especially older children. Each food-away-from-home meal adds 108 more calories to daily total intake among children ages 13-18 than a snack or meal from home; all food from school is estimated to add 145 more calories. Both food away from home and all food from school also lower the daily diet quality of older children [Flahiff’s emphasis] (as measured by the 2005 Healthy Eating Index). Among younger children, who are more likely than older children to eat a USDA school meal and face a more healthful school food environment, the effect of food from school on caloric intake and diet quality does not differ significantly from that of food from home.

Young Kids Easily Trust What They’re Told

Preschoolers believed adults’ lie about the location of a hidden sticker even after it was proven wrong 8 times

From a Health Day News item

By Robert Preidt
Monday, October 18, 2010

MONDAY, Oct. 18 (HealthDay News) — Very young children are extraordinarily trusting of what adults tell them, even if there is repeated evidence to the contrary, finds a new study.

In what may be little surprise to many parents, University of Virginia researchers found that 3-year-olds placed more trust in information they are told than information conveyed to them without words.

In this study, an adult showed children a red and a yellow cup and then hid a sticker under the red cup. Some children were told (incorrectly) that the sticker was under the yellow cup, while other children saw the adult place an arrow on the yellow cup without saying anything. The children were told they could look under one cup and keep the sticker if they found it. The experiment was repeated eight times with pairs of different colored cups.

The children who saw the adult place the arrow on the incorrect cup quickly learned not to trust this sign. But those who heard the adult say the sticker was under a certain cup continued to believe that’s where they would find the sticker. Of those 16 children, nine never once found the sticker in eight tries. (At the end of the game, all the children were given stickers, whether they found them or not.)

The study appears in the journal Psychological Science. (Flahiff’s note….Article is available online only through paid subscription. It may be available at or through your local public, academic, or medical library. There may be a charge for the article.Ask a reference librarian for details. There may be a charge for the article.)

“Children have developed a specific bias to believe what they’re told. It’s sort of a shortcut to keep them from having to evaluate what people say. It’s useful because most of the time parents and caregivers tell children things that they believe to be true,” study author Vikram K. Jaswal said in a journal news release.

 

 

H1N1 Unlikely to Cause Flu Pandemic in 2010-11

Canadian researchers urge everyone over age 50 to get immunized this fall

From a Health Day News item

By Randy Dotinga
Monday, October 18, 2010

MONDAY, Oct. 18 (HealthDay News) — Canadian researchers say they do not expect the H1N1 virus — the so-called swine flu — to be very severe this year, although they are recommending that everyone over the age of 50, especially those with chronic health conditions, get immunized this fall.

Researchers in British Columbia examined the results of blood tests given to 1,127 people in the province both before and after the 2009 pandemic. Before the pandemic, less than 10 percent of children showed signs of antibodies, which are the “soldiers” in the immune system that develop resistance to specific germs. By contrast, more than three-quarters of people over the age of 80 had the antibodies, suggesting they’d been exposed to the virus before.

This helps explain why children were so severely affected by H1N1 compared to older people, the study authors noted.

In contrast, after the pandemic, 70 percent of people under the age of 20 showed signs of this type of protection, according to the report published online Oct. 18 in the CMAJ.

“The higher percentage with seroprotection [antibodies in blood] we observed in the young may have resulted from higher pandemic H1N1 infection rates and earlier prioritization of pandemic H1N1 vaccine to young children,” said study co-author Dr. Danuta Skowronski, of the BC Centre for Disease Control and University of British Columbia, in a news release from the journal’s publisher.

The researchers wrote that enough people appear to be protected that “these findings reassure against the likelihood of a substantial third pandemic H1N1 wave during the 2010-2011 season, unless there is a significant waning of antibody or change in the virus.”

They also found that “adults 50 to 79 years exhibited the lowest seroprotection and also remain at higher risk of severe outcomes if infected. Our findings support a shift from the prioritized immunization of the young that occurred in fall 2009 to prioritized immunization of older adults for the coming 2010-2011 influenza season to protect against severe outcomes due to both pandemic and seasonal influenza.”

Dr. Peter Katona, associate professor of clinical medicine at the University of California at Los Angeles, cautioned, however, that it’s impossible to know for sure what the flu will do. “Flu is unpredictable regardless of what the models say and what the early surveillance says,” he said in an interview. “It can go in different directions for complicated reasons that you can’t figure out in advance.”

 

Hospital Collaboration May Boost Surgical Patient Safety

Sharing data on successful medical practices helped cut complication rates, study found

From a Health Day News Item

By Robert Preidt
Monday, October 18, 2010

MONDAY, Oct. 18 (HealthDay News) — The rate of surgical complications decreased nearly 10 percent at 16 Michigan hospitals after they began to share information about what methods they use to keep patients safe, a new study has found.

Among the 300,000 study patients who underwent general and vascular surgery between 2005 and 2007, the reduction in ventilator-associated pneumonia alone could save $13 million a year in health care spending, the findings indicated.

The program, called the Michigan Surgical Quality Collaborative, is led by the University of Michigan.

“The collaboration of hospitals in terms of identifying and disseminating information about best practices is actually a much more effective way of improving quality than just relying on each hospital alone to come up with what they think is a way to improve quality,” study author Dr. Darrell A. Campbell Jr., a professor of surgery and chief medical officer at the University of Michigan Health System, said in a university news release.

 

 

Communities Putting Prevention to Work Program Launches New Website

From the US Centers for Disease Control and Prevention (CDC) Web site “Communities Putting Prevention to Work”

CDC’s Communities Putting Prevention to Work program was developed to highly impact the nation’s health by reducing chronic diseases related to obesity and tobacco using a prescribed set of effective strategies to build public health policies, strengthen the community environment to support health, and establish successful and sustainable interventions over the long term.

The Communities Putting Prevention to Work program is focused on preventing chronic disease by producing sustainable, positive and improved health outcomes through the implementation of programmatic efforts through policy, systems, and environmental level change.

Communities of the Communities Putting Prevention to Work program are funded under a 2-year cooperative agreement to implement evidence and practice based MAPPS (Media, Access, Point of decision information, Price, and Social support services) strategies that are expected to have lasting healthful effects in the years following the end of the 2-year funding period.

Highlights from this Web site

Tools and Resources for community planning , including both general information and specific resources on the topics of physical activity, nutrition, obesity, and tobacco

MAPPS Strategies which give advice on how to change individual behaviors through avenues as the media, social support services, and signage (as billboards)

Media Resource Center has specific resources related to physical activity, nutrition, obesity and tobacco

 

 

 

Medical Research Article: Lies, Damned Lies, and Medical Science

Excerpts from the Atlantic October 20 article by David H. Freedman

[Summary] Much of what medical researchers conclude in their studies is misleading, exaggerated, or flat-out wrong. So why are doctors—to a striking extent—still drawing upon misinformation in their everyday practice? Dr. John Ioannidis has spent his career challenging his peers by exposing their bad science.[end of Summary]

…..wasn’t it possible, he asked, that drug companies were carefully selecting the topics of their studies—for example, comparing their new drugs against those already known to be inferior to others on the market—so that they were ahead of the game even before the data juggling began? “Maybe sometimes it’s the questions that are biased, not the answers,”[Flahiff’s emphasis] he said, flashing a friendly smile. Everyone nodded. Though the results of drug studies often make newspaper headlines, you have to wonder whether they prove anything at all. Indeed, given the breadth of the potential problems raised at the meeting, can any medical-research studies be trusted?….

…..

[Biostatistician and physician] Ioannidis was shocked at the range and reach of the reversals he was seeing in everyday medical research. “Randomized controlled trials,” which compare how one group responds to a treatment against how an identical group fares without the treatment, had long been considered nearly unshakable evidence, but they, too, ended up being wrong some of the time. “I realized even our gold-standard research had a lot of problems,” [Flahiff’s emphasis] he says. Baffled, he started looking for the specific ways in which studies were going wrong. And before long he discovered that the range of errors being committed was astonishing: from what questions researchers posed, to how they set up the studies, to which patients they recruited for the studies, to which measurements they took, to how they analyzed the data, to how they presented their results, to how particular studies came to be published in medical journals.[Flahiff’s emphasis]

This array suggested a bigger, underlying dysfunction, and Ioannidis thought he knew what it was. “The studies were biased,” he says.

…….He chose to publish one paper, fittingly, in the online journal PLoS Medicine, which is committed to running any methodologically sound article without regard to how “interesting” the results may be. In the paper, Ioannidis laid out a detailed mathematical proof that, assuming modest levels of researcher bias, typically imperfect research techniques, and the well-known tendency to focus on exciting rather than highly plausible theories, researchers will come up with wrong findings most of the time. Simply put, if you’re attracted to ideas that have a good chance of being wrong, and if you’re motivated to prove them right, and if you have a little wiggle room in how you assemble the evidence, you’ll probably succeed in proving wrong theories right. His model predicted, in different fields of medical research, rates of wrongness roughly corresponding to the observed rates at which findings were later convincingly refuted: 80 percent of non-randomized studies (by far the most common type) turn out to be wrong, as do 25 percent of supposedly gold-standard randomized trials, and as much as 10 percent of the platinum-standard large randomized trials. [Flahiff’s emphasis]
The article spelled out his belief that researchers were frequently manipulating data analyses, chasing career-advancing findings rather than good science, and even using the peer-review process—in which journals ask researchers to help decide which studies to publish—to suppress opposing views. “…

….he peer-review process often pressures researchers to shy away from striking out in genuinely new directions, and instead to build on the findings of their colleagues (that is, their potential reviewers) in ways that only seem like breakthroughs…

…He looked at three prominent health studies from the 1980s and 1990s that were each later soundly refuted, and discovered that researchers continued to cite the original results as correct more often than as flawed—in one case for at least 12 years after the results were discredited…..

…he’s concerned that, like many patients, he’ll end up with prescriptions for multiple drugs that will do little to help him, and may well harm him. “Usually what happens is that the doctor will ask for a suite of biochemical tests—liver fat, pancreas function, and so on,” she tells me. “The tests could turn up something, but they’re probably irrelevant. Just having a good talk with the patient and getting a close history is much more likely to tell me what’s wrong.”[Flahiff’s emphasis] Of course, the doctors have all been trained to order these tests, she notes, and doing so is a lot quicker than a long bedside chat….

…