Health and Medical News and Resources

General interest items edited by Janice Flahiff

[Press release] CVI puts research into practice on firearms and domestic violence

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From the 13 November 203 Sam Houston University press release via EurekAlert

HUNTSVILLE, TX (11/13/13) — The Crime Victims’ Institute (CVI) at Sam Houston State University initiated a new series of reports to help victim advocates translate the latest research in the field into practical services and resources for victims, beginning with a study on firearms and intimate partner violence.

The report provides a summary of laws and policies that can be used to better protect victims of domestic violence.

In 2012, 114 women were killed by current or former intimate partners in Texas. Sixty percent of these victims were killed with firearms, and many of the incidents resulted in the death or injury of bystanders, including children.

Research has consistently demonstrated a link between firearms and lethal intimate partner violence. One study showed the most significant factor for predicting homicide in domestic violence cases was gun ownership by the abuser. Another study found that women living with a gun in the home have a significantly higher risk of being murdered, and that risk is 20 times higher when there is a history of abuse combined with gun ownership.

To protect victims of domestic violence, several laws and policies have been enacted. They include:

  • The federal Gun Control Act of 1968 makes it illegal to purchase or possess firearms or ammunition by a person who has been convicted of a felony, who is the subject of a protective order, or who has been convicted of misdemeanor domestic violence.
  • For protective orders to fall under this federal law, several factors have to be met, including a qualifying relationship, a hearing process, and a specific prohibition against the threat or use of force against the petitioner or child. There is an exception for government employees who use firearms to perform their duties, such as law enforcement officers or military personnel.
  • Under the Lautenberg Amendment of 1996, the weapons prohibition was added to the federal law for a misdemeanor domestic violence conviction. Under this provision, the charge must include the threat or use of physical force or a deadly weapon against a spouse, co-habitant, parent or guardian. The law is retroactive, there are no exemptions for those who use weapons in their official duties, and the ban on gun ownership is effective for a lifetime.
  • Texas law is similar to federal statues, but also prohibits concealed handgun licenses.
  • Several Texas judges have required the surrender of firearms in domestic violence cases, verification of compliance by county attorneys, and notification of victims if weapons are returned. Many of these steps are identified in Texas Family Violence Bench Book.
  • A manual published by the National Center on Protective Orders and Full Faith & Credit, “Enforcing Domestic Violence Firearms Prohibitions,” includes a firearms checklist for advocates, law enforcement, prosecutors and judges. It is available at http://www.fullfaithandcredit.org.
  •  As part of safety planning, advocates should discuss issues with victims about the ownership or use of weapons by the abuser.###

A copy of the report is available at http://www.crimevictimsinstitute.org/publications/.

November 16, 2013 Posted by | Public Health | , , , , | Leave a comment

[Press release] Mandatory calorie postings at fast-food chains often ignored or unseen, does not influence food choice

From the NYU Langone Medical Center / New York University School of Medicine 15 November 2013 press release via EurkAlert

Population health expert Brian Elbel of NYU Langone presents findings today at leading scientific conference on obesity

November 15, 2013 – Posting the calorie content of menu items at major fast-food chains in Philadelphia, per federal law, does not change purchasing habits or decrease the number of calories that those customers consume, researchers at NYU Langone Medical Center reported today at the Obesity Society’s annual scientific meeting, held in Atlanta, Georgia. The results echo those conducted by the same researchers among low-income neighborhoods in New York City before and after calorie-labels were mandated there in July 2008.

“What we’re seeing is that many consumers, particularly vulnerable groups, do not report noticing calorie labeling information and even fewer report using labeling to purchase fewer calories,” says lead study author Dr. Brian Elbel, assistant professor of Population Health and Health Policy at NYU School of Medicine. “After labeling began in Philadelphia, about 10 percent of the respondents in our study said that calorie labels at fast-food chains resulted in them choosing fewer calories.”

As part of an effort to encourage people to make healthier food choices, the Patient Protection and Affordable Care Act mandates that restaurant chains with 20 or more locations nationally must post the calorie content of all regular food and drink items on their menu board or printed menus.

Yet there is limited scientific evidence from real-world studies to support calorie labeling. Moreover, little is understood about how calorie labels will impact different populations. Obesity affects more than one third of Americans, but hits low-income, urban neighborhoods hardest. “Studies have not generally examined whether labeling is more or less effective for particular subgroups,” says Dr. Elbel.

Dr. Elbel and team set out to assess the impact of calorie labels at fast-food chains in the wake of the new legislation. In their latest study, conducted in Philadelphia, researchers collected receipts from more than 2,000 customers, ages 18 to 64, who visited McDonald’s and Burger King restaurants during lunch or dinner before and after February 2010, when the calorie-label law went into effect in Philadelphia.

Each customer was asked a short series of questions, including how often they had visited “big chain” fast food restaurants in the last week; whether they noticed calorie information in the restaurant; and if so, whether they used the information to purchase more or less food than they otherwise would have at the restaurant.

The research team also commissioned a professional survey firm to simultaneously conduct a random phone survey of residents within the city limits of Philadelphia. Respondents aged 18 to 64 were asked a series of questions, including whether they had consumed any “big chain” fast food within the last three months. If they had, they were asked a series of additional questions about how often they eat fast food, along with demographic questions and their height and weight.

The researchers found that only 34 percent of McDonald’s customers noticed the labels posted to menu boards, compared to 49 percent of Burger King customers. Respondents with less education (high school or lower) were less likely to notice the labels. Moreover, respondents reported eating fast food more than 5 times a week, both before and after the labels were posted. There was no decrease in visiting fast food restaurants reported after calorie labeling began in Philadelphia.

(As a control, the researchers also surveyed customers of both chains in Baltimore, where calorie-labels are not mandated. About 70% of the customers surveyed in both cities were African American.)

“We found no difference in calories purchased or fast-food visits after the introduction of the policy,” says Dr. Elbel. “Given the limits of labeling reported here and in other studies, it’s clear that just posting calories is often not enough to change behavior among all populations. We need to consider other, more robust interventional policies in places where obesity is most prevalent.”

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Investigators include, Brian D. Elbel, PhD,DPhil, Department of Population Health, NYU School of Medicine, and the Wagner School of Public Service, New York University, New York City; Tod Mijanovich,PhD, L. Beth Dixon,PhD, MPH, and Beth Weitzman, PhD, MPA, of the Steinhardt School, New York University; Rogan Kersh, MA, Department of Politics and International Affairs, Wake Forest University, Winston-Salem, North Carolina; Amy H. Auchincloss, PhD, MPH, Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, Pennsylvania and Gbenga Ogedegbe , MD,MS, MPH, NYU School of Medicine.

This study was funded by National Institutes of Health (R01HL095935). The study sponsor had no role in study design.

About NYU Langone Medical Center

NYU Langone Medical Center, a world-class, patient-centered, integrated, academic medical center, is one on the nation’s premier centers for excellence in clinical care, biomedical research and medical education. Located in the heart of Manhattan, NYU Langone is composed of four hospitals – Tisch Hospital, its flagship acute care facility; the Hospital for Joint Diseases, one of only five hospitals in the nation dedicated to orthopaedics and rheumatology; Hassenfeld Pediatric Center, a comprehensive pediatric hospital supporting a full array of children’s health services; and the Rusk Institute of Rehabilitation Medicine, the world’s first university-affiliated facility devoted entirely to rehabilitation medicine– plus NYU School of Medicine, which since 1841 has trained thousands of physicians and scientists who have helped to shape the course of medical history. The medical center’s tri-fold mission to serve, teach and discover is achieved 365 days a year through the seamless integration of a culture devoted to excellence in patient care, education and research. For more information, go to http://www.NYULMC.org.

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November 16, 2013 Posted by | Nutrition | , , , , , | Leave a comment

[News Report] Cuts to Local Health Departments Hurt Communities

From the 14 November 2013 Science Daily Report

Local health departments (LHDs) can play pivotal roles in U.S. communities by helping to link people with medical services and assuring access to care when it is otherwise unavailable. However, a new study in the American Journal of Preventive Medicine finds that many LHDs aren’t able to meet these goals, which could spell trouble for the uninsured and underinsured.

“Our report shows that in 2010, about 28 percent of LHDs had not conducted any of the three targeted activities in our study,” which looked at how LHDs assessed gaps in care, increased access to health services and used strategies to meet the health needs of the underserved, said lead author Huabin Luo, Ph.D, former research fellow with the Centers for Disease Control and Prevention and assistant professor in the department of public health at the Brody School of Medicine at East Carolina University.

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http://www.sciencedirect.com/science/article/pii/S074937971300487X

In recent years, deep funding cuts have impacted local health departments. For example, between 2008 and 2009 alone, over 23,000 LHD jobs were eliminated. This combined with an increase in demand for health care services can mean an increase in health disparities for those who rely on community health care.

The study found that LHDs with larger budgets in bigger population centers were more likely to provide access to health services compared to smaller LHDs with fewer financial resources, where they may be needed more.

 

Hanen noted that as health insurance coverage becomes more widespread, LHDs will continue to identify and link people without health insurance to programs that provide health care services. “It cannot be overstated enough that poor housing, education, low income, unemployment and lack of transportation in a neighborhood are all interconnected and are all factors that determine health.”

Read the entire article here

November 16, 2013 Posted by | Public Health | , , , , , , , | Leave a comment

[Pew Report] Public Agrees on Obesity’s Impact, Not Government’s Role

Yes to Calories on Menus, No to Soda Limits

From the 12 November  Pew report summary

Most Americans (69%) see obesity as a very serious public health problem, substantially more than the percentages viewing alcohol abuse, cigarette smoking and AIDS in the same terms. In addition, a broad majority believes that obesity is not just a problem that affects individuals: 63% say obesity has consequences for society beyond the personal impact on individuals. Just 31% say it impacts the individuals who are obese but not society more broadly.

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Yet, the public has mixed opinions about what, if anything, the government should do about the issue. A 54% majority does not want the government to play a significant role in reducing obesity, while 42% say the government should play a significant role. And while some proposals for reducing obesity draw broad support, others are decidedly unpopular.

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(The survey was conducted before the Food and Drug Administration’s proposal last Thursday to severely restrict trans fats nationwide.) 1

 

November 16, 2013 Posted by | Public Health | , | Leave a comment

[Magazine article] 1 In 10 People in the World Will Have Diabetes By 2035

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http://www.idf.org/diabetesatlas/data-visualisations

From the 14 November 2013 Time article By  @charlottealter

The International Diabetes Federation released a report Thursday that said that 10% of the global population will have diabetes by 2035.

The report, which was released on International Diabetes Day, said that 382 million people will have diabetes by the end of this year, and that 592 million will be diabetic by 2035, CBS news reports. Many of those millions will be living in developing countries.

The IDF report also estimates that the percentage of diabetic Americans will jump from 8% to 11% by 2035. One person dies from diabetes every six seconds, which amounts to 1.5 million annual deaths.

IDF points out that the number of people with diabetes, especially the Type 2 form, has increased in every country. The number of total diabetes cases have increased 4.4 percent over the last two years, now affecting more than 5 percent of the global population.

“We haven’t seen any kind of stabilizing, any kind of reversal,” Leonor Guariguata, an epidemiologist and project coordinator for IDF’s Diabetes Atlas, said to Businessweek. “Diabetes continues to be a very big problem and is increasing even beyond previous projections.”

According to the report, despite better treatments and improving education strategies, the battle to protect people from diabetes and its complications “is being lost.”

Dr. Juliana Chan, a professor of medicine and therapeutics at the Chinese University of Hong Kong, told the BBC that in China, she feels the rising rates of diabetes are due to different genetic, lifestyle and environmental factors not helped by the fact that the country is becoming modernized rapidly.

China had the highest total number of citizens with the disease, with an estimated 98.4 million to be diagnosed by the end of 2013.

“It is typically an ageing disease, but the data shows that the young and middle-aged are most vulnerable. It is prevalent in obese people but emerging data suggests that for lean people with diabetes the outcome can be worse,” she explained.

Read more: 10% of World Population Will Have Diabetes By 2035 | TIME.com http://healthland.time.com/2013/11/14/1-in-10-people-in-the-world-will-have-diabetes-by-2035/#ixzz2ko5oErTU

November 16, 2013 Posted by | Public Health | , | 2 Comments

[Repost] IPhone App Wipes Out Population to Show Contagion Risks

From the 11 November 2013 Bloomberg article

The plague started in Indonesia. A viral infection, it spread quietly at first, making its way from person to person with coughing and sneezing its only symptoms. Then someone infected with the virus got on a plane.

As the disease spread around the globe, fever gave way to sweating, nausea, vomiting. Hundreds infected turned to thousands. The virus developed drug resistance. Thousands became millions.

It was all part of Ian Lipkin’s plan.

The Columbia University virus hunter wasn’t using his decades of experience researching infectious disease for evil. He was playing Plague Inc., a game for iPhone, iPad and Android. With more than 15 million downloads since its release last year, Plague Inc. has captured the attention of gamers and public health officials alike. The latter see it as a tool for raising awareness of the real-world risk of pandemics at a time when public funding for medical research is under pressure.

 

Read entire article here

 

November 16, 2013 Posted by | Public Health | , , , | Leave a comment

[JAMA Perspective] Dead Man Walking

Whether one is for or against all or parts of Obamacare, surely, we as a country can do better in providing needed health care to the poor, especially the poorest of the poor.

Excerpts from the November 2013  JAMA article by Michael Stillman, M.D., and Monalisa Tailor, M.D.

…For many of our patients, poverty alone limits access to care. We recently saw a man with AIDS and a full-body rash who couldn’t afford bus fare to a dermatology appointment. We sometimes pay for our patients’ medications because they are unable to cover even a $4 copayment. But a fair number of our patients — the medical “have-nots” — are denied basic services simply because they lack insurance, and our country’s response to this problem has, at times, seemed toothless.

In our clinic, uninsured patients frequently find necessary care unobtainable. An obese 60-year-old woman with symptoms and signs of congestive heart failure was recently evaluated in the clinic. She couldn’t afford the echocardiogram and evaluation for ischemic heart disease that most internists would have ordered, so furosemide treatment was initiated and adjusted to relieve her symptoms. This past spring, our colleagues saw a woman with a newly discovered lung nodule that was highly suspicious for cancer. She was referred to a thoracic surgeon, but he insisted that she first have a PET scan — a test for which she couldn’t possibly pay.

However unconscionable we may find the story of Mr. Davis, a U.S. citizen who will die because he was uninsured, the literature suggests that it’s a common tale. A 2009 study revealed a direct correlation between lack of insurance and increased mortality and suggested that nearly 45,000 American adults die each year because they have no medical coverage.1 And although we can’t confidently argue that Mr. Davis would have survived had he been insured, research suggests that possibility; formerly uninsured adults given access to Oregon Medicaid were more likely than those who remained uninsured to have a usual place of care and a personal physician, to attend outpatient medical visits, and to receive recommended preventive care.2 Had Mr. Davis been insured, he might well have been offered timely and appropriate screening for colorectal cancer, and his abdominal pain and obstipation would surely have been urgently evaluated.

 

November 16, 2013 Posted by | health care | , , , , | Leave a comment

   

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