Health and Medical News and Resources

General interest items edited by Janice Flahiff

Geographic information systems demonstrate links between health and location

From the 10 April 2012 Eureka news alert

San Diego, CA, April 10, 2012 – The neighborhoods in which children and adolescents live and spend their time play a role in whether or not they eat a healthy diet, get enough exercise or become obese, concludes a collection of studies in a special theme issue of the American Journal of Preventive Medicine.

Each of the six studies uses the latest concepts and methods in geographic information systems (GIS)-based research to determine how the geographic location affects physical health. A study titled “Spatial Classification of Youth Physical Activity Patterns” shows, for example, that while rural youth get the largest proportion of their physical activity while at school, urban and suburban youth are most active when commuting. Not only does this finding suggest that the walk to school might be just as important to some children’s health as is the physical education they receive as part of the school curriculum, it is also important given that adolescent health behaviors are predictive of behaviors in adults.

Another study by researchers in the United Kingdom concludes that adolescents in rural areas ate fast food more often when fast-food outlets were easily accessible, whereas the opposite was true for adolescents living in urban areas. The researchers, led by Lorna J. Fraser of the University of Leeds, conclude that although the need continues to exist for nutritional education regarding fast food, placing restrictions on the location of fast-food outlets may not decrease consumption of fast food in the same ways in all areas.

Brian E. Saelens and Lawrence D. Frank, along with their colleagues, authored two papers for the theme issue. “Obesogenic Neighborhood Environments, Child and Parent Obesity: The Neighborhood Impact on Kids Study” evaluated child and parent weight status across neighborhoods in Seattle and San Diego and ultimately found evidence that GIS-based definitions of obesogenic neighborhoods that consider both physical activity and the availability of healthy food options were strongly related to childhood obesity.

In a second study, the researchers used GIS-based measures to determine the ‘walkability’ and proximity to healthy food of certain neighborhoods in the San Diego and Seattle regions. The study recommends that such measures be used to study physical activity, nutrition and obesity outcomes.

In a paper titled “Obesogenic Environments in Youth: Concepts and Methods from a Longitudinal National Sample,” Janne Boone-Heinonen and colleagues describe the challenges inherent to longitudinal neighborhood environment research, as well as the insights they gained and the advances and remaining gaps in study design. The researchers note that understanding which neighborhood environment features influence weight gain in various age groups is essential to effectively prevent and reduce childhood obesity.

Two commentaries included in the theme issue examine the ways that computer-based GIS systems—which transform geospatial data into visual representations of the real world—can help prevent childhood obesity. “Thinking About Place, Spatial Behavior, and Spatial Process in Childhood Obesity” by Stephen A. Matthews, outlines the content of the theme, concluding that although GIS is not a panacea, it “offers an important means of better understanding and dealing with some of the most pressing problems of our time, and provides valuable tools for researchers and policymakers alike.”

The second commentary, providing a perspective from the Robert Wood Johnson Foundation, notes that while GIS is still in the relatively early stages of application in the field, it might one day enhance understanding of the complex and dynamic connections between people, their health and their physical and social environments.

April 10, 2012 Posted by | Public Health | , , , , | Leave a comment

Consumerism and Its Antisocial Effects Can Be Turned On — Or Off

21st Century Materialism

21st Century Materialism (Photo credit: tomislavmedak)

From the 9 April 2012 article at Science News Daily

Money doesn’t buy happiness. Neither does materialism: Research shows that people who place a high value on wealth, status, and stuff are more depressed and anxious and less sociable than those who do not. Now new research shows that materialism is not just a personal problem. It’s also environmental. “We found that irrespective of personality, in situations that activate a consumer mindset, people show the same sorts of problematic patterns in wellbeing, including negative affect and social disengagement,” says Northwestern University psychologist Galen V. Bodenhausen…

April 10, 2012 Posted by | Psychology | , , , | Leave a comment

Simple, Concise Messages About The Benefits Of Phytonutrients Would Help Consumers

From the 12 April 2012 article at Medical News Today

An expert panel at the Institute of Food Technologists’ Wellness 12 meeting urged the food industry to find simple yet powerful language to tell consumers about the many benefits of a diet rich in phytonutrients.

Phytonutrients are plant-based components that are thought to promote health, such as beta carotene and lycopene. They are typically found in fruits, vegetables, grains, legumes, nuts and teas.

During the discussion, the panelists noted that phytonutrients [chemicals from plants] are very complex, and care must be taken when promoting their benefits to avoid the image of a “magic bullet.” At the same time, consumers can grow weary of constantly changing nutritional recommendations, causing them to feel overwhelmed and possibly decide to forgo healthy eating altogether. …

…Diekman suggested promoting “strongly flavored, darkly colored” foods, and taking care to highlight the importance of phytonutrients as part of the whole food. Consumers should be encouraged to choose healthy plant-based foods because of how all the ingredients combine to produce health benefits.
Key Nutrient: Allicin
Sources: Garlic, Onions
Benefits: Heart health; Cancer prevention, helps prevent increased cholesterol
Key Nutrient: Limonin
Sources: Grapefruits, Lemons, Limes, Oranges
Benefits: Cancer prevention, helps prevent increased cholesterol, lung health
Key Nutrient: Lutein
Sources: Broccoli, Spinach, Kiwifruit, Lettuce
Benefits: Eye health…

April 10, 2012 Posted by | Nutrition | , , , , , | Leave a comment

Choosing Wisely – Conversation starters for office visits on choosing health care

From Choosing Wisely – a Web site that aims to “aims to promote conversations between physicians and patients by helping patients choose care that is:

Supported by evidence
Not duplicative of other tests or procedures already received
Free from harm
Truly necessary

 

Nine United States specialty societies representing 374,000 physicians developed lists of “Five Things Physicians and Patients Should Question” in recognition of the importance of physician and patient conversations to improve care and eliminate unnecessary tests and procedures.

These lists represent specific, evidence-based recommendations physicians and patients should discuss to help make wise decisions about the most appropriate care based on their individual situation. Each list provides information on when tests and procedures may be appropriate, as well as the methodology used in its creation.

What tests and procedures should patients and physicians talk about? Read the lists:
[Links at http://choosingwisely.org/?page_id=13]
American Academy of Allergy, Asthma & Immunology
American Academy of Family Physicians
American College of Cardiology
American College of Physicians
American College of Radiology
American Gastroenterological Association
American Society of Clinical Oncology
American Society of Nephrology
American Society of Nuclear Cardiology

April 10, 2012 Posted by | health care | , , , | Leave a comment

What the ‘limits of DNA’ story reveals about the challenges of science journalism in the ‘big data’ age

This journalist ends her post by acknowledging that the medical news readership often bases their decisions on medical and science news articles. She and others strive to report based on sound science, despite current obstacles.

Excerpts from the 6 April 2012 blog post at The Last Word on Nothing

As a science journalist, I sympathize with book reviewers who wrestle with the question of whether to write negative reviews. It seems a waste of time to write about a dog of a book when there are so many other worthy ones; but readers deserve to know if Oprah is touting a real stinker.
On 2 April, Science Translational Medicine published a study on DNA’s shortcomings in predicting disease. My editors and I had decided not to cover the study last week after we saw it in the journal’s embargoed press packet, because my sources offered heavy critiques of its methods..

…I ended up writing about the paper anyway after it made a huge media splash that prompted fury among geneticists. In a thoughtful post at the Knight Science Journalism tracker, Paul Raeburn asked yesterday why other reporters didn’t notice the problems with the study that I wrote about. Having been burned by my own share of splashy papers that go bust, I think the “limits of DNA “ story underscores a few broader issues for our work as science journalists:
1. Science consists of more and more “big data” studies whose findings depend on statistical methods that few of us reporters can understand on our own. I never would have detected the statistical problems with the Vogelstein paper by myself. We can look for certain red flags that a study might not be up to snuff, such as small sample sizes or weak clinical trial designs, but it’s a lot harder to sniff out potential problems with complicated statistical methods.

2. Challenges in the news business are ratcheting up pressure on all of us. Reporters are doing much more work in much less time than we have in the past as we compete with an expanded universe of news providers who have sped up the news cycle. Yet it still takes time and effort to make sense of the developments we cover. It took me about three days to report my piece on the Vogelstein paper while I was simultaneously working on other assignments. That’s probably longer than most reporters can spend on a piece like this…

The article goes on to point out other challenges as

4. It’s becoming more difficult to trust traditional scientific authorities.

5. Beware the deceptively simple storyline.

6. Getting the story right matters more than ever.

Related Resources

April 10, 2012 Posted by | Finding Aids/Directories, Medical and Health Research News | , , | Leave a comment

Employers Tie Financial Rewards, Penalties To Health Tests, Lifestyle Choices

From the 2 April 2012 Kaiser article

Once a year, employees of the Swiss Village Retirement Community in Berne, Ind., have a checkup that will help determine how much they pay for health coverage. Those who don’t smoke, aren’t obese and whose blood pressure and cholesterol fall below specific levels get to shave as much as $2,000 off their annual health insurance deductible…

…Gone are the days of just signing up for health insurance and hoping you don’t have to use it. Now, more employees are being asked to roll up their sleeves for medical tests — and to exercise, participate in disease management programs and quit smoking to qualify for hundreds, even thousands of dollars’ worth of premium or deductible discounts.

Proponents say such plans offer people a financial incentive to make healthier choices and manage chronic conditions such as obesity, high blood pressure and diabetes, which are driving up healthcare costs in the USA. Even so, studies of the effect of such policies on lifestyle changes are inconclusive. And advocates for people with chronic health conditions, such as heart disease and diabetes, fear that tying premium costs directly to test results could lead to discrimination.

Consumer Tips: Workplace Wellness Plans

More and more employers are tying financial reward and penalties to workers completing a set of medical tests. KHN’s Julie Appleby says the tests can include blood pressure, cholesterol and blood sugar. Watch the video.
Employee reaction has also been mixed….

..Some workers complain the programs are an intrusion into their private lives.

“They portrayed it as voluntary, which it isn’t, because if you don’t participate, they fine you every paycheck,” says Seff, the former Broward employee who is suing over the program. He has since retired on disability with back and neck problems. “I don’t think any employer should do it.”

In an effort to slow rising health care costs, Broward County in 2009 began asking workers to fill out a health information form and have a finger-stick blood test each year to check blood sugar and cholesterol levels, according to court filings. Workers who declined were docked $40 a month.

Those who did participate were offered disease management programs if they had asthma, high blood pressure, diabetes, congestive heart failure or kidney disease. The county stopped docking those who declined to participate Jan. 1, 2011, after Seff’s suit was filed, court documents say.

The lawsuit, which argues the county’s program violates the Americans with Disabilities Act, is likely the first of its kind in the nation, says Seff’s attorney Daniel Levine in Boca Raton, Fla. Without ruling on whether the wellness effort was voluntary, a federal district court judge backed the county in April, 2011, saying the plan fell under provisions of the law meant to protect bona fide benefit programs. The case is now on appeal. Broward County attorneys did not return requests for comment.

Some state lawmakers are also concerned about the potential for discrimination. ..

..Given the available data, it’s hard to parse how much of the reported savings from such programs come from improved health, and how much from the frequent pairing of such programs with high deductible policies, which shift more costs onto workers.

“We just don’t know how effective (incentives) are,” says Volpp. There is pretty good evidence they help smokers quit, he says, but less that they prompt workers to lose weight and keep it off.

Weight gain is partly a function of genes and environment, he says, so programs that tie incentives to achieving a particular weight range are “in essence, penalizing people for factors they can’t control or can only partly control” – either because they’ve failed to lose weight or haven’t participated in the program.

Volpp says the medical literature shows that incentives work best when participants have choices: get below a certain BMI, or lose 5 percent of current body weight, for example. And, he says, rewards should be immediate.

“If you want the employee to do a health assessment or (medical) screening, you should give them the reward right after they do it” he says.

At Jones Lang LaSalle, workers who make a pledge — on the honor system — that they don’t smoke, or will take a stop-smoking class, and achieve a healthy weight, get 10 percent off their contribution toward insurance premiums….

Read the entire article here

April 10, 2012 Posted by | health care, Workplace Health | , | Leave a comment

Are Medical Conferences Useful? And for Whom?

Credit: Wikipedia Commons

A medical doctor (who himself is a big draw at medical conferences) has recently questioned the motives and utility of medical conferences. [Mythbuster Ioannidis: Are Medical Conferences Really Useful?]

He believes much of the presented research findings  are not fully peer-reviewed, and thus cannot  fully educate, train, or contribute to evidence-based practice. Often findings at medical conferences are seized upon by the popular press and prematurely promoted as having sound scientific evidence. Quite often these findings change with peer review and are later published with the revisions and modified findings in scientific journals.

Excerpt from the 4 April 2012 JAMA (Journal of the American Medical Association) article
(The full text of this article is by subscription only, these excerpts came from a related posting at HealthNewsReview.org)

An estimate of more than 100 000 medical meetings per year may not be unrealistic, when local meetings are also counted. The cumulative cost of these events worldwide is not possible to fathom.

Do medical conferences serve any purpose? In theory, these meetings aim to disseminate and advance research, train, educate, and set evidence-based policy. Although these are worthy goals, there is virtually no evidence supporting the utility of most conferences. Conversely, some accumulating evidence suggests that medical congresses may serve a specific system of questionable values that may be harmful to medicine and health care.

The availability of a plethora of conferences promotes a mode of scientific citizenship in which a bulk production of abstracts, with no or superficial peer review, leads to mediocre curriculum vita building. Even though most research conferences have adopted peer-review processes, the ability to judge an abstract of 150 to 400 words is limited and the process is more of sentimental value.

Moreover, many abstracts reported at the medical meetings are never published as full-text articles even though abstract presentations can nevertheless communicate to wide audiences premature and sometimes inaccurate results. It has long been documented that several findings change when research reports undergo more extensive peer review and are published as completed articles.* Late-breaker sessions in particular have become extremely attractive prominent venues within medical conferences because seemingly they represent the most notable latest research news. However, it is unclear why these data cannot be released immediately when they are ready and it is unclear why attending a meeting far from home is necessary to hear them. A virtual online late-breaker portal could be established for the timely dissemination of important findings….

…Power and influence appear plentiful in many of these meetings. Not surprisingly, the drug, device, biotechnology, and health care–related industries make full use of such opportunities to engage thousands of practicing physicians. Lush exhibitions and infiltration of the scientific program through satellite meetings or even core sessions are common avenues of engagement. Although many meetings require all speakers to disclose all potential conflicts, the majority of speakers often have numerous conflicts, as is also demonstrated in empirical evaluations of similar groups of experts named on authorship lists of influential professional society guidelines.”

Ioannidis doesn’t discard the entire notion of conferences.  In fact, he projects what “repurposed” conferences might be like:

“Repurposed conferences could be designed to be entirely committed to academic detailing (ed. note: drug company “educational” outreach to physicians). All their exhibitions and satellite symposia would deal with how to prescribe specific interventions appropriately and how to favor interventions that are inexpensive, well tested, and safe. Such repurposed conferences could also focus on how to use fewer tests and fewer interventions or even no tests and no interventions, when they are not clearly needed.”

 

Related Resources

 

April 10, 2012 Posted by | Biomedical Research Resources | , , , , , | Leave a comment

   

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