Health and Medical News and Resources

General interest items edited by Janice Flahiff

[News release] ​ Workplace Lifestyle Intervention Program Improves Health, Reduces Diabetes and Heart Disease Risks

In the past I’ve posted items that argue against workplace health programs. Perhaps some programs are better than others.

From the 6 March 2015 University of Pittsburg news release

A healthy lifestyle intervention program administered at the workplace and developed by the University of Pittsburgh Graduate School of Public Healthsignificantly reduces risk factors for diabetes and heart disease, according to a study reported in the March issue of the Journal of Occupational and Environmental Medicine.
The program was well-received by participants at Bayer Corp., who lost weight and increased the amount of physical activity they got each day, when compared with a control group in the study, which was funded by the National Institutes of Health.
“Health care expenditures associated with diabetes are spiraling, causing widespread concern, particularly for employers who worry about employee health and productivity,” said lead author M. Kaye Kramer, Dr.P.H., assistant professor in Pitt Public Health’sDepartment of Epidemiology and director of the school’s Diabetes Prevention Support Center. “This leads to an interest in workplace health promotion; however, there are very few evidence-based programs that actually demonstrate improvement in employee health. This study found that our program not only improves health, but also that employees really like it.”
This demonstration program is based on the U.S. Diabetes Prevention Program (DPP), a national study that found people at risk for diabetes who lost a modest amount of weight through diet and exercise sharply reduced their chances of developing diabetes, outperforming people who took a diabetes drug instead.

March 10, 2015 Posted by | Workplace Health | , , , , , , , | Leave a comment

[Press release] Carnegie Mellon, Pitt Ethicists Question Impact of Hospital Advertisi

About 20 years ago I started thinking along similar lines. Now I am at a point questioning if it is ethical to profit from health care. Two years as a Peace Corps volunteer (back in 1980/81 in Liberia, West Africa) changed my views on many topics considerably. Also I think it was the wonderful humanistic/social justice  tone of grade school religious textbooks, notably 8th grade back in 1969.

Summary (from EurkAlert!)
Ethicists question the impact of health information that is available online, specifically hospital advertisements, and argue that while the Internet offers patients valuable data and tools — including hospital quality ratings and professional treatment guidelines – that may help them when facing decisions about where to seek care or whether to undergo a medical procedure, reliable and unbiased information may be hard to identify among the growing number of medical care advertisements online.

From the 30 January 2015 Carnegie Mellon press release

In a commentary piece published in JAMA Internal Medicine, Carnegie Mellon University’s Alex John London and the University of Pittsburgh’s Yael Schenkerquestion the impact of health information that is available online, specifically hospital advertisements. London and Schenker argue that while the Internet offers patients valuable data and tools — including hospital quality ratings and professional treatment guidelines — that may help them when facing decisions about where to seek care or whether to undergo a medical procedure, reliable and unbiased information may be hard to identify among the growing number of medical care advertisements online.

“The marketing objective of selling services by making them seem attractive to consumers can create tensions or outright conflict with the ethical imperative of respect for persons, since the latter requires that patients make medical decisions in light of balanced information about the full range of risks and benefits associated with their care,” said London, professor of philosophy in CMU’s Dietrich College of Humanities and Social Sciences and director of the Center for Ethics and Policy.

Referencing a research article in the same journal issue that found hospital websites failed to disclose risk information for transaortic valve replacement (TAVR), a recently approved procedure to treat patients whose aortic valve does not open fully, London and Schenker pinpoint four risk concerns for patients seeking medical information online:

1. Identifying Advertising — Hospital websites often have the appearance of an education portal, leaving patients to assume that the information presented is informational, not persuasive.

2. Finding Unbiased Information — Unlike FDA-regulated direct-to-consumer advertising for prescription drugs, hospital advertising is overseen by the Federal Trade Commission and subject to the same “reasonable” standards applied to advertisements for common consumer goods such as cars and cereal. While hospital advertisements may describe specific medical interventions that entail significant
risks, there is no legal requirement that these risks be disclosed.

3. Recognizing Incomplete or Imbalanced Information — Poor-quality medical information is hard to recognize unless the person reading it is a trained clinician.

4. Influence on Health Care Decisions — As patients seek out information online, the quality of their decision-making and care choices will be influenced by the accuracy or inaccuracy of the information they are likely to encounter.

To begin to fix the risk to patients seeking medical information online, London and Schenker recommend to clearly label hospital websites as advertisements; allocate resources to created balanced online informational tools; and focus future attention on not only the content of health care advertising but its impact.

For more information, visit http://www.hss.cmu.edu/philosophy/faculty-london.php.

 

Related Resource

  • Evaluating Health Information (Health Resources for All, Edited by JaniceFlahiff)
    • The Penn State Medical Center Library has a great guide to evaluate health information on the Internet.

      The tips include

      • Remember, anyone can publish information on the internet!
      • If something sounds too good to be true, it probably is.
        If the Web site is primarily about selling a product, the information may be worth checking from another source.
      • Look for who is publishing the information and their education, credentials, and if they are connected with a trusted coporation, university or agency.
      • Check to see how current the information is.
      • Check for accuracy. Does the Web site refer to specific studies or organizations?
    • How to Evaluate Health Information on the Internet (US National Cancer Institute)

January 31, 2015 Posted by | Medical and Health Research News | , , , , , , , , , , | Leave a comment

Pitt Team Treats Gum Disease by Using Homing Beacon to Bring Needed Immune Cells to Inflamed Area

From the 1 November 2013 University of Pittsburgh press release

 
PITTSBURGH, Nov. 1, 2013 – The red, swollen and painful gums and bone destruction of periodontal disease could be effectively treated by beckoning the right kind of immune system cells to the inflamed tissues, according to a new animal study conducted by researchers at the University of Pittsburgh. Their findings, published this week in the early online version of the Proceedings of the National Academy of Sciences, offer a new therapeutic paradigm for a condition that afflicts 78 million people in the U.S. alone.
Periodontal disease currently is treated by keeping oral bacteria in check with daily brushing and flossing as well as regular professional deep cleaning with scaling and root planing, which remove tartar above and below the gum line. In some hard-to-treat cases, antibiotics are given. These strategies of mechanical tartar removal and antimicrobial delivery aim to reduce the amount of oral bacteria on the tooth surface, explained co-author and co-investigator Charles Sfeir, D.D.S., Ph.D., director, Center for Craniofacial Regeneration and associate professor, Departments of Periodontics and Oral Biology, Pitt’s School of Dental Medicine.
“Currently, we try to control the build-up of bacteria so it doesn’t trigger severe inflammation, which could eventually damage the bone and tissue that hold the teeth in place,” Dr. Sfeir said. “But that strategy doesn’t address the real cause of the problem, which is an overreaction of the immune system that causes a needlessly aggressive response to the presence of oral bacteria. There is a real need to design new approaches to treat periodontal disease.”
In the healthy mouth, a balance exists between bacteria and the immune system response to forestall infection without generating inflammation, said senior author Steven Little, Ph.D., associate professor and chair of the Department of Chemical and Petroleum Engineering, Pitt’s Swanson School of Engineering. But in many people, a chronic overload of bacteria sets up the immune system to stay on red alert, causing harm to the oral tissues while it attempts to eradicate germs.
“There is a lot of evidence now that shows these diseased tissues are deficient in a subset of immune cells called regulatory T-cells, which tells attacking immune cells to stand down, stopping the inflammatory response,” Dr. Little said. “We wanted to see what would happen if we brought these regulatory T-cells back to the gums.”
To do so, the researchers developed a system of polymer microspheres to slowly release a chemokine, or signaling protein, called CCL22 that attracts regulatory T-cells, and placed tiny amounts of the paste-like agent between the gums and teeth of animals with periodontal disease. The team found that even though the amount of bacteria was unchanged, the treatment led to improvements of standard measures of periodontal disease, including decreased pocket depth and gum bleeding, reflecting a reduction in inflammation as a result of increased numbers of regulatory T-cells. MicroCT-scanning showed lower rates of bone loss.
“Mummified remains from ancient Egypt show evidence of teeth scraping to remove plaque,” Dr. Little noted. “The tools are better and people are better trained now, but we’ve been doing much the same thing for hundreds of years. Now, this homing beacon for Treg cells, combined with professional cleaning, could give us a new way of preventing the serious consequences of periodontal disease by correcting the immune imbalance that underlies the condition.”
Next steps include developing the immune modulation strategy for human trials. In addition to Drs. Sfeir and Little, the research team included Ph.D. candidate Andrew J. Glowacki,, Sayuri Yoshizawa, D.D.S., Ph.D., Siddharth Jhunjhunwala, Ph.D., all of the University of Pittsburgh; and Andreia E Vieira, Ph.D., and Gustavo P. Garlet, D.D.S., Ph.D., of Sao Paulo University, Brazil.
The project was funded by National Institutes of Health Grants 1R01DE021058-01 A1, 1R56DE021058-01, the Wallace H. Coulter Foundation, the Camille and Henry Dreyfus Foundation, the Arnold and Mabel Beckman Foundation and the Commonwealth of Pennsylvania.

 

November 3, 2013 Posted by | Consumer Health, Medical and Health Research News | , , , , | Leave a comment

   

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