Health and Medical News and Resources

General interest items edited by Janice Flahiff

New USDA Dietary Guidelines (released January 31, 2011)

The US Dept of Agriculture, Center for Nutrition Policy and Promotion released Dietary Guidelines for Americans, 2010.

Dietary Guidelines for Americans, 2010 - cover

Some excerpts from the Introduction

The ultimate goal of the Dietary Guidelines for Americans is to improve the health of our Nation’s current and future generations by facilitating and promoting healthy eatingand physical activity choices so that these behaviors become the norm among all individuals….

… The recommendations contained in the Dietary Guidelines for Americans traditionally have been intended for healthy Americans ages 2 years and older. However, Dietary Guidelines for Americans, 2010 is being released at a time of rising concern about the health of the American population. Its recommendations accommodate the reality that a large percentage of Americans are overweight or obese and/or at risk of various chronic diseases. Therefore,the Dietary Guidelines for Americans, 2010 is intended for Americans ages 2 years and older, includingthose who are at increased risk of chronic disease….

…Dietary Guidelines for Americans also recognizes that in recent years nearly 15 percent of American households have been unable to acquire adequate food to meet their needs because of insufficient money or other resources for food.10 This dietary guidance can help them maximize the nutritional content of their meals within their resource constraints….

Chapters include Balancing Calories to Lose Weight, Foods and Food Components to Reduce, Foods and Nutrients to Increase, Building Health Eating Patterns, and Helping Americans Make Health Choices.

In the coming days and weeks, links will be added here to related news items, commentaries, and additional informational resources.

Links a few media news items (the author does not endorse the views in these links, they are provided for informational purposes only)

Alex Wong/Getty Images

 

 




February 1, 2011 Posted by | Consumer Health, Public Health | , , , , , , , | Leave a comment

New Chapters for Effective Health Care Program’s Methods Guide for Comparative Effectiveness Reviews

New Chapters for Effective Health Care Program’s Methods Guide for Comparative Effectiveness Reviews

The Agency for Healthcare Research and Quality (AHRQ) ’s Effective Health Care Program has released two new chapters of the Methods Guide for Effectiveness and Comparative Effectiveness Reviews:

·         “Finding Evidence for Comparing Medical Interventions

·         “Assessing the Applicability of Studies When Comparing Medical Interventions

To learn more about the Methods Guide for Effectiveness and Comparative Effectiveness Reviews and to access other chapters in this guide.


February 1, 2011 Posted by | Uncategorized | , , , , , , | Leave a comment

Enabling Personalized Medicine through Health Information Technology: Advancing the Integration of Information

Enabling Personalized Medicine through Health Information Technology: Advancing the Integration of Information

Enabling Personalized Medicine through Health IT

From the Brookings Institute Executive Summary

With federal officials pursuing the goal of a personal human genome map under $1,000 in five years (White House, 2010), it is possible to envision a future where treatments are tailored to individuals’ genetic structures, prescriptions are analyzed in advance for likely effectiveness, and researchers study clinical data in real-time to learn what works. Implementation of these regimens creates a situation where treatments are better targeted, health systems save money by identifying therapies not likely to be effective for particular people, and researchers have a better understanding of comparative effectiveness (President’s Council of Advisors on Science and Technology, 2010).

Yet despite these benefits, consumer and system-wide gains remain limited by an outmoded policy regime.  Federal regulations were developed years before recent advances in gene sequencing, electronic health records, and information technology.  With scientific innovation running far ahead of public policy, physicians, researchers, and patients are not receiving the full advantage of latest developments.  Current policies should leverage new advances in genomics and personalized medicine in order to individualize diagnosis and treatment.  Similarly, policies creating incentives for the adoption of health information technology should ensure that the invested infrastructure is one that supports new-care paradigms as opposed to automating yesterday’s health care practices.

To determine what needs to be done, a number of key leaders from government, academia, non-profit organizations, and business were interviewed about ways to promote a better use of health information technology to enable personalized medicine.  The interviews focused on policy and operational issues surrounding interoperability, standards, data sharing protocols, privacy, predictive modeling, and rapid learning feedback models.

This paper outlines the challenges of enabling personalized medicine, as well as the policy and operational changes that would facilitate connectivity, integration, reimbursement reform, and analysis of information.   Our health system requires a seamless and rapid flow of digital information, including genomic, clinical outcome, and claims data.  Research derived from clinical care must feed back into assessment in order to advance care quality for consumers.  There currently are discrete data on diagnosis, treatment, medical claims, and health outcomes that exist in parts of the system, but it is hard to determine what works and how treatments differ across subgroups.  Changes in reimbursement practices would better align incentives with effective health care practices……

A related commentary…

A commentary featured in the January 19 issue of The Journal of the American Medical Association (JAMA) from AHRQ Health IT grant recipient, Alex Krist, M.D. calls for the design of a patient-centered health information system that goes beyond the Personal Health Record.  Krist explains that in order for technology to be used, a system should be designed to help patients access health information, interpret data from multiple sources and serve as a tool to facilitate action.  Select to access the abstract.
(For suggestions on how to get this article for free or at low cost, click here)

Related articles

Despite increasing Internet availability, the ‘digital divide’ (disparities in access to technology) appears to exist among primary care patients adopting an online personal health record, according to a report in the March 28 issue of Archives of Internal Medicine, one of the JAMA/Archives journals. “The personal health record (PHR) is an Internet-based set of tools that allows people to access and coordinate their lifelong health information,” the authors write as background information in the article..

February 1, 2011 Posted by | Consumer Health, Public Health | , , , , , , , | Leave a comment

Don’t know much about eScience? free recorded online webinar available

From the National Network of Libraries of Medicine (NN/NLM) Greater Midwest Region Online Education Web page

Don’t Know Much About eScience? (January 20, 2011)

  • e-Science is an emerging research methodology with an emphasis upon data and networks. As researchers in biomedicine and other health-related disciplines increasingly utilize today’s technology in their work, they produce immense amounts of data that can, ideally, be shared and repurposed to speed up scientific discovery. Similarly, they use networking tools to find, develop and work in a collaborative environment no longer constrained by geographical limitations. Can health sciences librarians with their skills in information management and organization, as well as success in building partnerships across areas, find a role in this new area? The answer is “YES!” Presenter: Sally Gore.
    Recording: https://webmeeting.nih.gov/p57352616/ External Link Indicator – the audio did not work properly, but it was captioned.
    Resources supplied by Sally Gore: GMR eSciences webiner resources.PDF file

 

February 1, 2011 Posted by | Librarian Resources | , , , | Leave a comment

A deficiency of dietary omega-3 may explain depressive behaviors

Fish Oil May Prevent Brain Damage After Stroke

A deficiency of dietary omega-3 may explain depressive behaviors

Neuroscience of nutrition

 

How maternal essential fatty acid deficiency impact on its progeny is poorly understood. Dietary insufficiency in omega-3 fatty acid has been implicated in many disorders. Researchers from Inserm and INRA and their collaborators in Spain collaboration, have studied mice fed on a diet low in omega-3 fatty acid. They discovered that reduced levels of omega-3 had deleterious consequences on synaptic functions and emotional behaviours. Details of this work are available in the online version of the journal Nature neuroscience, which can be accessed at:http://dx.doi.org/10.1038/nn.2736

In industrialized nations, diets have been impoverished in essential fatty acids since the beginning of the 20th century. The dietary ratio between omega-6 polyunsaturated fatty acid and omega-3 polyunsaturated fatty acid omega-3 increased continuously over the course of the 20th century. These fatty acids are “essential” lipids because the body cannot synthesize them from new. They must therefore be provided through food and their dietary balance is essential to maintain optimal brain functions.

Olivier Manzoni (Head of Research Inserm Unit 862, “Neurocentre Magendie”, in Bordeaux and Unit 901 “Institut de Neurobiologie de la Méditerranée” in Marseille), and Sophie Layé (Head of Research at INRA Unit 1286, “Nutrition et Neurobiologie Intégrative” in Bordeaux) and their co-workers hypothesized that chronic malnutrition during intra-uterine development, may later influence synaptic activity involved in emotional behaviour (e.g. depression, anxiety) in adulthood.

To verify their hypotheses, the researchers studied mice fed a life-long diet imbalanced in omega-3 and omega-6 fatty acids. They found that omega-3 deficiency disturbed neuronal communication specifically. The researchers observed that only the cannabinoid receptors, which play a strategic role in neurotransmission, suffer a complete loss of function. This neuronal dysfunction was accompanied by depressive behaviours among the malnourished mice.

Among omega-3 deficient mice, the usual effects produced by cannabinoid receptor activation, on both the synaptic and behavioural levels, no longer appear. Thus, the CB1R receptors lose their synaptic activity and the antioxidant effect of the cannabinoids disappears.

Consequently, the researchers discovered that among mice subjected to an omega-3 deficient dietary regime, synaptic plasticity, which is dependent on the CB1R cannabinoid receptors, is disturbed in at least two structures involved with reward, motivation and emotional regulation: the prefrontal cortex and the nucleus accumbens. These parts of the brain contain a large number of CB1R cannabinoid receptors and have important functional connections with each other.

“Our results can now corroborate clinical and epidemiological studies which have revealed associations between an omega-3/omega-6 imbalance and mood disorders“, explain Olivier Manzoni and Sophie Layé. “To determine if the omega-3 deficiency is responsible for these neuropsychiatric disorders additional studies are, of course, required”.

In conclusion, the authors estimate that their results provide the first biological components of an explanation for the observed correlation between omega-3 poor diets, which are very widespread in the industrialized world, and mood disorders such as depression.

 


 

 


February 1, 2011 Posted by | Medical and Health Research News | , , , , | Leave a comment

Pitt team grows arteries with most elastic protein reported, big step for living vascular grafts (& a related article on stem cell research breakthrough)

Pitt team grows arteries with most elastic protein reported, big step for living vascular grafts

Arteries cultivated from baboon smooth muscle cells contain 20 percent of the protein elastin found in natural arteries, the most reported in vessels grown outside the body, team reports in the Proceedings of the National Academy of Sciences

Yadong Wang is a researcher at University of Pittsburgh.

From the January 31, 2011 Eureka news alert

PITTSBURGH—University of Pittsburgh researchers have grown arteries that exhibit the elasticity of natural blood vessels at the highest levels reported, a development that could overcome a major barrier to creating living-tissue replacements for damaged arteries, the team reports in the Proceedings of the National Academy of Sciences.***

The team used smooth muscle cells from adult baboons to produce the first arteries grown outside the body that contain a substantial amount of the pliant protein elastin, which allows vessels to expand and retract in response to blood flow. Lead researcher Yadong Wang, a professor of bioengineering in Pitt’s Swanson School of Engineering, his postdoctoral researcher Kee-Won Lee, and Donna Stolz, a professor of cell biology and physiology in Pitt’s School of Medicine, cultured the baboon cells in a nutrient-rich solution to bear arteries with approximately 20 percent as much elastin as an inborn artery.

The Pitt process is notable for its simplicity, Wang said. Elastin—unlike its tougher counterpart collagen that gives vessels their strength and shape—has been notoriously difficult to reproduce. The only successful methods have involved altering cell genes with a virus; rolling cell sheets into tubes; or culturing elastin with large amounts of transforming growth factor, Wang said. And still these previous projects did not report a comparison of elastin content with natural vessels.

Wang and his colleagues had strong, functional arteries in three weeks. The team first seeded smooth-muscle cells from 4-year-old baboons—equivalent to 20-year-old humans—into degradable rubber tubes chambered like honey combs. They then transferred the tubes to a bioreactor that pumped the nutrient solution through the tube under conditions mimicking the human circulatory system—the pump produced a regular pulse, and the fluid was kept at 98.6 degrees Fahrenheit. As the muscle cells grew, they produced proteins that fused to form the vessel.

Mechanical tests revealed that the cultured artery could withstand a burst pressure between 200 and 300 millimeters of mercury (mmHg), the standard unit for blood pressure, Wang said; healthy human blood pressure is below 120 mmHg. In addition to containing elastin, the artery also had approximately 10 percent of the collagen found in a natural vessel, Wang said.

The process the Pitt team used to cultivate the artery resembles how it would be used in a patient, he explained. The cell-seeded tube would be grafted onto an existing artery. As the rubber tube degrades, the vascular graft would develop into a completely biological vessel.

The next steps in the project, Wang said, are to design a vessel that fully mimics the three-layer structure of a human artery and to prepare for surgical trials.

The project received support from the National Heart, Lung, and Blood Institute of the National Institutes of Health.

Related Links

***For suggestions on how to get this article for free or at low cost, click here.

Related Eureka news alert (January 30, 2011) on stem cell research breakthrough

(Scripps Research Institute) Scripps Research Institute scientists have converted adult skin cells directly into beating heart cellsefficiently without having to first go through the laborious process of generating embryonic-like stem cells. The powerful general technology platform could lead to new treatments for a range of diseases and injuries involving cell loss or damage, such as heart disease, Parkinson’s and Alzheimer’s disease.

February 1, 2011 Posted by | Educational Resources (High School/Early College(, Medical and Health Research News | , , , , , , | Leave a comment

Aging safely at home? California’s disabled elderly are barely holding on

Aging safely at home? California’s disabled elderly are barely holding on

From the January 31, 2011 Eureka news alert

The network of public services that supports California’s low-income, disabled elderly is fragile, affecting the ability of these vulnerable residents to live independent lives in their own homes, according to a new study from the UCLA Center for Health Policy Research.

This policy note reports the first findings from a yearlong effort to follow the lives and challenges encountered by several dozen representative older Californians in Los Angeles, San Diego, San Francisco and Santa Clara who are enrolled in Medicare and Medi-Cal and who receive in-home and community care.

The documentary project comes as California lawmakers consider additional cuts to a network of services that help seniors remain “safely in their homes” — the stated goal of these public programs and the way in which an overwhelming number of Americans say they want to age.

The policy note, “Holding On: Older Californians with Disabilities Rely on Public Services to Remain Independent,” shows seniors struggling to live functional lives in the face of already reduced caregiving hours. For example:

Caring for the caregivers

Sara cares for her disabled son and husband, whose heart disease, diabetes, incontinence and limited mobility require 24-hour care. There’s help from In-Home Supportive Services (IHSS) and other family members, but Sara is the primary caregiver. Now, her back is acting up. She’s been delaying seeing a doctor to take care of her own needs — who will care for her family if she’s hospitalized?

Delicate balance

Paralyzed by polio, Mary breathes with the help of a ventilator and gets around in a wheelchair. She needs help to dress, bathe, use the toilet and eat. She’s created an elaborate system to meet her needs, using maximum IHSS hours of support and offering room and board to another caregiver in return for care. Mary’s happy with her life and rates her health as “excellent,” but she knows that even a small change in the delicate balance of her care system will send her to a nursing home.

His choice

Incapacitated by stroke and diabetes and confined to a wheelchair, Jack spent time in a nursing home a couple of years ago, and he’s not in a hurry to go back. In the nursing home, he felt unsafe and more isolated than he does in his own house with support from IHSS. Jack’s a realist. He knows a nursing home may be in his future again, but he wants to choose when and where he’ll go.

According to the researchers, all participants in the study are aware that the networks of care they’ve cobbled together could easily unravel, and most say they’d rather “make do” by eating less often, letting their homes become less safe or allowing their medical conditions to worsen than give up their independence and go to a nursing home — the likely scenario if they lose the in-home services they now rely upon.

“These seniors are using every sort of innovation and self-deprivation to make do,” said Steven P. Wallace, the study’s senior author and associate director of the UCLA Center for Health Policy Research. “They have nowhere to turn if their fragile care systems are further undermined.

“Policymakers need to see the faces of these vulnerable Californians as they crunch the numbers in budget discussions,” Wallace added. “Further cuts are an assault on their independence. Slashing in-home and community care will also increase total health care costs as these seniors increasingly use emergency room care, are hospitalized or enter institutions — under conditions that could have been prevented.”

Budget cuts looming

California, which is home to the largest number of older adults in the country, has several programs funded by federal, state and local dollars to assist low-income adults with disabilities. Proponents of these programs say that while such care isn’t perfect, it is far less expensive and more humane than the alternative — placing seniors in publicly financed nursing homes.

Yet, IHSS program-hours were trimmed by 3.6 percent in January 2011, and they face further across-the-board cuts of 8.4 percent, plus additional targeted reductions in the governor’s proposed budget. Adult day health care centers are slated for elimination, and supplemental security income cash benefits are to be reduced for single low-income aged and disabled individuals.

All the older adults in the study receive IHSS support, ranging from 20 hours of in-home help each month to the maximum of 283 hours per month. Most need help with household tasks, such as cleaning and cooking, and personal tasks like getting dressed or taking medications. Many require help getting in and out of bed, bathing and using the toilet. Some who might benefit from adult day health care or other supportive programs are unable to participate because of limited mobility or lack of transportation.

“California’s current system to support old and young adults with disabilities at home operates in silos and is not person-centered,” said Bruce Chernof, M.D., president and CEO of the SCAN Foundation, which is funding the study. “The Brown administration has an important opportunity to design a more stable, integrated, efficient and person-centered system that can meet the needs of these vulnerable residents throughout the state.”

Related Resources

 

February 1, 2011 Posted by | Uncategorized | , , , , , , , | Leave a comment

Radiologists play key role in teaching physiology to medical students

Radiologists play key role in teaching physiology to medical students

From the February 1 2011 Eureka news alert

In order for medical students to ultimately provide quality patient care medical schools should turn to radiologists to help them teach physiology, one of the core disciplines of medicine, according to a study in the February issue of the Journal of the American College of Radiology (www.jacr.org). Physiology is the science of the function of living systems.

“It is vital that medical schools provide first-rate physiology education for their students. We believe that radiologists have an important role to play in teaching physiology, just as many currently do in the teaching of anatomy,” said Richard B. Gunderman, MD, co-author of the study.

Radiologists created radiologic case studies using pairs of radiologic cases, one illustrating normal physiology and the second illustrating pathophysiology. The two radiologic images (normal and pathophysiology) were then used to focus on four broad physiologic principles that apply across all organ systems — homeostasis, biologic energy use, structure-function relationships, and communication. Two examples were given for each of the principles.

“Radiologic case studies can illustrate physiologic principles in ways that can enhance students’ grasp of both physiology and its role in helping physicians take better care of patients. As our study suggests, two radiologic examples of each principle (normal and pathologic) support the use of radiology to teach physiology,” said Gunderman.

“An understanding of physiology is absolutely vital to the ability to diagnose and treat diseases effectively and efficiently, and it is equally vital that future physicians receive a first-rate education in this discipline. As clinicians, radiologists can help students to appreciate the clinical relevance of their studies, and radiologic images provide powerful, visual illustrations of basic physiologic principles,” he said.

Related Sites

 

 

 

 

February 1, 2011 Posted by | Finding Aids/Directories, Professional Health Care Resources | , , | Leave a comment

   

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