Healthhttp://www.justmeans.com/editorials/health/210.htmlJustmeans's blogs for HealthSun, 21 Mar 2010 16:02:25 GMThttp://www.justmeans.com en hourly 1 Pulse of health research: Strange sexism of science http://www.justmeans.com/Pulse-of-health-research-Strange-sexism-of-science/11348.html Sun, 21 Mar 2010 13:57:55 GMT Ano Lobb Ano Lobb http://www.justmeans.com/Pulse-of-health-research-Strange-sexism-of-science/11348.html It's probably not news to you that science in general, and health and medicine in particular, are struggling to increase the numbers of women practicing at the highest levels. Male domination of these fields has of course nothing to do with any innately superior male aptitude for sciences, but rather societal tendencies to view science as a male rather than female domain.  It's probably also no surprise that women are underrepresented as subjects in medical research, especially late stage trial Read Full Article ]]> It's probably not news to you that science in general, and health and medicine in particular, are struggling to increase the numbers of women practicing at the highest levels. Male domination of these fields has of course nothing to do with any innately superior male aptitude for sciences, but rather societal tendencies to view science as a male rather than female domain.  It's probably also no surprise that women are underrepresented as subjects in medical research, especially late stage trials of new medications. The typical depression drug, for example, is studied in middle-aged white males (MWMs) who are not suffering from any other condition, even though women are more likely to be afflicted by depression, and most patients in general suffer from multiple conditions at the same time. The elderly and children, meanwhile, are treated as if they are smaller versions of MWMs, despite biological evidence to the contrary.

While none of this is news, I was appalled to learn that male preferences in the health sciences extend beyond humans to encompass rats, mice and other lab animals as well. An article in the well-respected scientific publication Nature reports on the bizarre practice of lab researchers to prefer male mice, even when performing early stage animal trials of medicines for diseases that may only effect women. A study of the use of male versus female lab animals across 10 disciplines and 42 journals in 2009 found that 80% of disciplines favored the use of male animals. Why this bias? Since female mice ovulate, their hormonal cycles could confound study findings. A major problem with that logic: If mouse hormones influence treatment, wouldn't you want to know that, since it suggests that human hormones might have similar effects?

Funding and oversight agencies, including the Food and Drug Administration, National Institutes of Health, and General Accounting Office, have recognized this bias for years, enacting policies or recommendations to correct it. But such policies are either having no effect, or making very slow progress. And editors at scientific journals have only recently begun to ponder the disparity. Published studies in neuroscience research, for example, are still five times more likely to examine men rather than women. Many clinical trial results are not analyzed for differences among their male and female participants. And early stage safety trials typically enroll only a quarter as many women as men.

This foolish assumption that women are just smaller men has a number of troubling effects: Women's care can suffer when we don't know enough about how treatments effect them, which is often quite different than the effects in men; and both men and women's care can suffer when drug's aren't approved because regulators don't see enough data about drug safety and efficacy in women. This strange sexism is a reminder that even in professions such as health science that value objectivity, social values of sex-preference continue to have powerful effects, and need aggressive policy implementation to be overcome.

Photo credit: The author]]> MTV's surprisingly sensitive health programming http://www.justmeans.com/MTV-s-surprisingly-sensitive-health-programming/11329.html Sat, 20 Mar 2010 19:54:00 GMT Sara Libby Sara Libby http://www.justmeans.com/MTV-s-surprisingly-sensitive-health-programming/11329.html [caption id="attachment_11330" align="alignleft" width="281" caption="Photo courtesy of MTV"][/caption] Sensitivity and responsibility aren't generally words that come to mind when one thinks of MTV's programming. And make no mistake, the network certainly indulges in programs and videos that promote unhealthy behavior like drinking and smoking. But many of its recent shows and awareness campaigns are confronting and examining health-related issues in a surprisingly refreshing way. Though it ha Read Full Article ]]> [caption id="attachment_11330" align="alignleft" width="281" caption="Photo courtesy of MTV"][/caption]

Sensitivity and responsibility aren't generally words that come to mind when one thinks of MTV's programming. And make no mistake, the network certainly indulges in programs and videos that promote unhealthy behavior like drinking and smoking. But many of its recent shows and awareness campaigns are confronting and examining health-related issues in a surprisingly refreshing way. Though it has always taken the lead in addressing issues affecting you - Pedro Zamora of "The Real World" became a bona fide celebrity as an AIDS activist back in 1994 - the recent spate of health-related programming is refreshing particularly because it stands in such stark contrast to shows like "Jersey Shore" and "The Hills" that emphasize excess and irresponsible behavior. Let's take a look:

True/Life: The opening episode of the most recent season of "True/Life," MTV's documentary series, followed two young people in need of transplants in order to survive. One needed a kidney; the other, bone marrow. Both patients were shown unflinchingly - Morgan, the girl in need of a kidney transplant, was racked with guilt after shirking her medication, and as a result, wearing out the kidney that had already been donated to her by her father. Previous episodes of the show have followed those overcoming addiction; people struggling with obesity; and athletes recovering from serious injuries.

16 and Pregnant/Teen Mom: Though it has been suggested that the recently reported uptick in teen pregnancies could be at least tangentially related to programs that chronicle teen pregnancy, "16 and Pregnant" is far from a show that glamorizes young motherhood. The program is brutally honest in its depictions of girls stuck in tough situations, as they grapple with everything from unsupportive parents, disinterested boyfriends/fathers and serious health calamities. Some of the babies born to the moms on the show had serious complications at birth, an issue that most girls don't consider a possibility given that they themselves are young and healthy. The follow-up series "Teen Mom," similarly does a good job of depicting the realities of raising a child while the moms are still struggling to grow up themselves.

Gone Too Far: Though "Gone Too Far" is mostly remembered because of the ironic twist that its host, DJ A.M., died from a drug overdose himself, the program deals head-on with drug addiction. Since he had himself struggled with drugs for so long, A.M. is able to bring a special kind of empathy to the kids he befriends and supports on the show. The program does a good job of revealing the impact of addiction on families and friends of those who struggle with it.
Like I said, MTV certainly contains its share of unhealthy behavior. But lately, it's done a remarkable job of choosing shows that tackle weighty subject matter and presenting them to young people in a realistic and honest way.
]]> Bananas may help in fight against HIV http://www.justmeans.com/Bananas-may-help-in-fight-against-HIV/11188.html Fri, 19 Mar 2010 21:00:47 GMT Alisa Ulferts Alisa Ulferts http://www.justmeans.com/Bananas-may-help-in-fight-against-HIV/11188.html I have to admit I did a double take when this email reached my inbox: Researchers say bananas could be the next tool in the arsenal against HIV in women.  You have to skip the obvious line of thought here: The reason for bananas' effectiveness is not because they are a powerhouse of nutrients that can bolster the body's natural defenses, although that is certainly true. The reason, according to this recent report, is that there is a natural chemical in bananas that may actually block HIV's entr Read Full Article ]]> I have to admit I did a double take when this email reached my inbox: Researchers say bananas could be the next tool in the arsenal against HIV in women.  You have to skip the obvious line of thought here: The reason for bananas' effectiveness is not because they are a powerhouse of nutrients that can bolster the body's natural defenses, although that is certainly true. The reason, according to this recent report, is that there is a natural chemical in bananas that may actually block HIV's entry into the body when used in a microbicide.

In laboratory tests, researchers with the University of Michigan Medical School found that a certain banana lectin (called BanLec) was as potent as two current HIV drugs. Lectins, which are sugar-binding proteins found in plants, can identify and attach to foreign invaders. By binding to a sugar-rich HIV-1 protein, researchers say, BanLec can blocks HIV's entry into the body. The study findings were published in the March 19 issue of the Journal of Biological Chemistry, and its authors suggest that BanLec could become a less expensive and highly effective new component of vaginal microbicides,

"The problem with some HIV drugs is that the virus can mutate and become resistant, but that's much harder to do in the presence of lectins," study author Michael D. Swanson, a doctoral student in the university's graduate program in immunology, said in a news release from the school. "Lectins can bind to the sugars found on different spots of the HIV-1 envelope, and presumably it will take multiple mutations for the virus to get around them."

Wow. I certainly hope that the results researchers found in the lab ultimately turn out to work for humans as well. As a believer in the healing power of foods, I cheer every time I hear about a new discovery that links a specific food to a specific health condition, with positive results. (I've written before that I've found relief from some of my asthma symptoms by loading up on raspberries, apples and onions, known for their anti-inflammatory properties). But what I find so interesting about this study is that the banana lectin appears to have barrier qualities of a true medication (think of all those allergy medications that "block" the brain's response to allergens) rather than the healing qualities of an orange or chicken soup (or apples, or raspberries). In other words, researchers aren't suggesting that women ingest bananas to protect themselves against HIV, they are suggesting the women use a microbicide that includes the banana compound.

I'm impressed. What about you?

Photo Credit: ian ransley]]> Healthy tech: E-prescribing reduces prescribing errors http://www.justmeans.com/Healthy-tech-E-prescribing-reduces-prescribing-errors/11268.html Fri, 19 Mar 2010 17:50:39 GMT Ano Lobb Ano Lobb http://www.justmeans.com/Healthy-tech-E-prescribing-reduces-prescribing-errors/11268.html A study published this month in the Journal of General Internal Medicine suggests that some of the $1 billion that the Obama administration wants to spend on health IT may be well spent. Researchers analyzed prescriptions written by 15 doctor's practices that adopted e-prescribing and 15 practices that continued to use paper, eventually comparing 1543 paper prescriptions with 2305 electronic ones. Among those that adopted e-prescribing they found a huge decrease in errors: From 42.5% to 6.6% at Read Full Article ]]> A study published this month in the Journal of General Internal Medicine suggests that some of the $1 billion that the Obama administration wants to spend on health IT may be well spent.

Researchers analyzed prescriptions written by 15 doctor's practices that adopted e-prescribing and 15 practices that continued to use paper, eventually comparing 1543 paper prescriptions with 2305 electronic ones. Among those that adopted e-prescribing they found a huge decrease in errors: From 42.5% to 6.6% at years end. Among the paper-based prescriptions the error rate remained statistically constant: 37% at the study outset and 38% at study end. Naturally the endemic problem of illegible doctor scrawl was entirely eliminated with the e-upgrade.

The offices that were studied where community-based facilities, they type that prescribe over 2 billion drugs are prescribed each year in the US. The e-prescribing systems used were stand-alone, meaning they were not necessarily part of a larger electronic health record. Compared to an entirely e-record keeping upgrade, these systems are obviously much cheaper and easier to integrate in medical practice. In addition to warning doctors when a dosage seems out of the ordinary or missing on the form, or when a new drug could potentially interact with another medication that the patient is taking, such systems can remind providers when refills need to be ordered. But some health safeguards are also needed. Pharmaceutical manufacturers, for example, have developed and offered such systems to doctors free of charge. The catch being that clinical options are programmed to preferentially display the manufacturers products, or query the prescriber to consider their drug over a competitors. Many states have implemented laws to ban such marketing, but they aren't universal yet. As with many technologies, a lack of adequate safeguards can cause marketing opportunities to clash with public health.

In the meantime, this study adds to a substantial body of evidence showing that e-prescribing may be just what the doctor ordered for reducing drug errors.

Photo credit: The author]]> Second hand smoke more harmful to kids' health than thought http://www.justmeans.com/Second-hand-smoke-more-harmful-kids-health-than-thought/11077.html Fri, 19 Mar 2010 09:37:14 GMT Alisa Ulferts Alisa Ulferts http://www.justmeans.com/Second-hand-smoke-more-harmful-kids-health-than-thought/11077.html If you live in New York City, you are treated every couple of weeks to a powerful new television ad highlighting the different ways smoking harms your health. The most visceral ad, the one that really makes my stomach turn, is the one where surgeons remove a piece of plaque build-up from a smoker's artery. Grasping the eggshell-colored gristle with a metal tong, the surgeon's gloved hand wiggles the bloody plaque free and turns it so the camera can get a better shot. That commercial has always h Read Full Article ]]> If you live in New York City, you are treated every couple of weeks to a powerful new television ad highlighting the different ways smoking harms your health. The most visceral ad, the one that really makes my stomach turn, is the one where surgeons remove a piece of plaque build-up from a smoker's artery. Grasping the eggshell-colored gristle with a metal tong, the surgeon's gloved hand wiggles the bloody plaque free and turns it so the camera can get a better shot. That commercial has always hit me in the gut, but the results of a new study give me even more reason to feel sick when I see it: the arterial damage depicted is happening to kids who inhale the second-hand smoke of their parents.

A group of Finnish researchers has found that the health of kids as young as 13 can be seriously harmed: They can develop early signs of hardened and clogged arteries as a result of second-hand smoke exposure. Those kids are also more likely to have other health risk factors, such as for heart disease, the researchers said. The authors of the new study examined 494 children and found that those exposed to secondhand smoke between the ages of 8 and 13 were more likely to show thickening of blood vessel walls, a precursor to hardening and clogging of arteries. The researchers also found that the kids who were exposed to the most tobacco smoke had higher levels of apolipoprotein B, which contributes to "bad" cholesterol, another heart disease risk factor. The findings will be published in an upcoming issue of the journal Circulation: Cardiovascular Quality and Outcomes.

"Although previous research has found that passive smoke may be harmful for blood vessels among adults, we did not know until this study that these specific effects also happen among children and adolescents," study author Dr. Katariina Kallio, research fellow at the Research Center of Applied and Preventive Cardiovascular Medicine at Finland's University of Turku, said in a news release from the American Heart Association. "These findings suggest that children should not face exposure to tobacco smoke at all," Kallio said.

It's been known for some time that children living in homes with smokers face greater health risks for allergies and asthma, but this is the first time I've heard of evidence showing risk for vascular damage in kids as well. And that to me is actually scarier. As an ex-smoker myself, I've read plenty of research that suggests the lungs have the admirable ability to heal themselves and become healthy after enduring the abuse of smoking. Whew. But the blood vessels aren't quite so flexible - a fact which played a significant role in my decision to embrace health and put cigarettes down for good three years ago. When I read that each nicotine molecule acts like a little razor blade, slicing and dicing its way through my arteries and leaving behind a trail of scars that invite hardening and clogging, I was done. Overall, it wasn't that hard of a choice, though quitting a pack a day habit wasn't a walk in the park.

At least I had the option of choosing health - something not available to kids who live in homes with smokers. What's the right solution to protect the health of these children? How do we balance the individual rights of smokers with the need to shield children? And is it fair to come down harder on parents who are smokers compared to parents who feed their kids an ocean of trans fats, which also wreak havoc on arteries?

What do you think?

Photo Credit: Saudi...]]> World Water Day highlights link between quality water, human health http://www.justmeans.com/World-Water-Day-highlights-link-between-quality-water-human-health/11073.html Fri, 19 Mar 2010 09:35:48 GMT Alisa Ulferts Alisa Ulferts http://www.justmeans.com/World-Water-Day-highlights-link-between-quality-water-human-health/11073.html The statistics on water quality's impact on human health speak for themselves: worldwide, 2.2 million people die each year due to diarrhea and other water-based diseases. The vast majority of those deaths are children who have not seen five birthdays. They die because the developing countries they live in are urbanizing faster than their governments can build adequate sewage treatment facilities. As a result, drinking water is contaminated and becomes a major threat to human health - rather than Read Full Article ]]> The statistics on water quality's impact on human health speak for themselves: worldwide, 2.2 million people die each year due to diarrhea and other water-based diseases. The vast majority of those deaths are children who have not seen five birthdays. They die because the developing countries they live in are urbanizing faster than their governments can build adequate sewage treatment facilities. As a result, drinking water is contaminated and becomes a major threat to human health - rather than a factor contributing to it. They die because they live in rural farming communities that lack means to properly dispose of agricultural waste. And they die because their countries lack or ignore stringent environmental controls, and hazardous chemical and manufacturing waste are simply dumped into rivers.

So this year's theme for the United Nations' World Water Day, which will be celebrated March 22 in Kenya, is water quality. (Past themes have been trans-boundary waters, sanitation, and coping with water scarcity). Sufficient quality of water is critical to ensure a healthy environment and human health. According to the UN, the basic requirement per person per day is 20 to 40 liters of water free from harmful contaminants and pathogens for the purposes of drinking and sanitation. This rises to 50 liters when you factor in water for bathing and cooking. But the UN wants the rest of the world to know that in the most affected parts of the world, sub-Saharan Africa, and to a lesser extent Western Asia and Eurasia, water often isn't available in that quantity - much less quality.

Here's one thing that will be discussed in Kenya next week: According to the UN, providing safe water and sanitation to large parts of the human population remains a challenge. Today, 1.1 billion people around the world still lack access to improved water supply and more than 2.6 billion people lack access to improved sanitation. Improvements in sanitation in rural areas have lagged well behind urban areas, and there has been even a decline in the provision of sanitation services in rural areas of Oceania and the former Soviet Union.

This may seem unfathomable to those of us who live in cities or towns where we can take water quality for granted, with the occasional boil water notice when a main breaks. Some of us wrinkle our noses at the chlorinated smell that comes from the tap and rush to install filters on the tap. Others among us eschew the drinking of tap water at all and prefer to fill our landfills with the bottles we toss aside after drinking our fill. What really bothers me are the people who live in environments naturally hostile to the growth of lawns and yet who still ruin quality water by pouring it on their lawns, where it mixes with nitrogen fertilizer before running off into the aquifer. Is this you? Is this your neighbor? If so, the UN wants you to download the handy posters and fliers it provides and start tucking them under the windshield wipers of the cars on your block.

As the UN points out, there's not enough quality water to go around in the first place to ensure human health. Let's not ruin more.

Photo Credit: darkpatator]]> Health Reform Is Not The End http://www.justmeans.com/Health-Reform-Is-Not-End/11165.html Fri, 19 Mar 2010 03:57:47 GMT Sam Wertheimer Sam Wertheimer http://www.justmeans.com/Health-Reform-Is-Not-End/11165.html In today's Wall Street Journal, Op-Ed author Fred Barnes laments the imminent passage of health reform legislation led by President Obama (Slate's Timothy Noah and Chris Wilson give the bill a 75% chance of passage). Mr. Barnes even compares the dreaded event to Pearl Harbor. He bemoans increased government involvement in the health care sector and warns that passing the bill will only cause greater political infighting. Barnes thinks that this rancor will increase the number of critics for "Oba Read Full Article ]]> In today's Wall Street Journal, Op-Ed author Fred Barnes laments the imminent passage of health reform legislation led by President Obama (Slate's Timothy Noah and Chris Wilson give the bill a 75% chance of passage). Mr. Barnes even compares the dreaded event to Pearl Harbor. He bemoans increased government involvement in the health care sector and warns that passing the bill will only cause greater political infighting. Barnes thinks that this rancor will increase the number of critics for "ObamaCare" and lead to Congress overturning the legislation. While Mr. Barnes correctly assumes that passing President Obama's health reform package will result in continued debate, he overstates the likelihood of repeal. This is because he ignores the large populations of Americans that will appreciate the bill's outcomes.

Those that will appreciate ObamaCare include the millions of currently uninsured Americans. This population continues to grow as insurance costs climb. Justmeans Health blogger Sara Libby reported this morning that the number of Californians without health insurance has ballooned from 6.7 million to 8.2 million since 2007. Enacting health reform legislation will allow most of these uninsured Americans to gain coverage and they will resist repeal as they seek to avoid returning to the status quo. Others will join the rank of ObamaCare supporters when they find government involvement in health care less odious than advertised. Critics - like Mr. Barnes - often suggest that passage of the bill will cause the American health care to resemble the dreaded NHS in Britain. Yet UK health care is better according to many metrics, and government involvement in health care already works in the U.S. Veterans cared for by the VA and seniors that enjoy federally-subsidized Medicare benefits will attest to this. This group that will develop positive opinions of ObamaCare might currently doubt the President's plans but they will resist repeal in the long term.

Passing ObamaCare will not resolve the problems in American health care. Increasing the number of Americans with insurance will only tangentially address other problems related to increasing costs of care and uneven quality. Although critics will remain and political disputes will continue, policymakers striving for greater government involvement in the health sector are doing good work. The millions of Americans who stand to gain coverage under the President's plan hold this view. And the President might win converts after the legislation passes. These advocates will voice their appreciation for the government's involvement in health care at the polls. If the bill passes (and this remains a big IF) these advocates will stand in the way of repeal.

Photo credit: BrokenSphere]]> California's uninsured numbers swell as health care reform vote nears http://www.justmeans.com/California-s-uninsured-numbers-swell-as-health-care-reform-vote-nears/11136.html Thu, 18 Mar 2010 19:37:59 GMT Sara Libby Sara Libby http://www.justmeans.com/California-s-uninsured-numbers-swell-as-health-care-reform-vote-nears/11136.html One in four California residents are currently living without health care insurance, according to a study by the UCLA Center for Health Policy Research. The research finds that the huge jump in people who are uninsured is mostly due to people who lost their jobs, and with them, employer-provided coverage plans. It's a situation I know too well, since that's where I've found myself since last September. Somehow, being young and healthy doesn't provide much comfort in this situation. The UCLA stu Read Full Article ]]> One in four California residents are currently living without health care insurance, according to a study by the UCLA Center for Health Policy Research. The research finds that the huge jump in people who are uninsured is mostly due to people who lost their jobs, and with them, employer-provided coverage plans. It's a situation I know too well, since that's where I've found myself since last September. Somehow, being young and healthy doesn't provide much comfort in this situation.

The UCLA study found 8.2 million individuals lacking insurance, compared with 6.4 million in 2007. The number makes California home to the largest population of uninsured citizens in the country - quite the dubious honor. If all that weren't terrible enough, the rolls of the unemployed are only likely to swell more, now that companies like Anthem Blue Cross have decided to hike premiums considerably - a move the company insists is necessary but that the Obama administration has said deserves a better explanation.

The study, of course, comes at a time when Congress is making a last push toward voting on a health care reform package. President Obama announced today that he was postponing a trip to Asia yet again in order to help the bill reach the finish line. In California, some lawmakers have made an attempt to go it alone on health care reform in case Congress can't get it done: State Senate Bill 810, introduced by Sen. Mark Leno, would "make all California residents eligible for specified health care benefits under the California HealthCare System, which would, on a single-payer basis, negotiate for or set fees for health care services provided through the system and pay clients for those services."

It also says: "It is the intent of the Legislature to establish a system of universal health care coverage in this state that provides all residents with comprehensive health care benefits, guarantees a single standard of care for all residents, stabilizes the growth in health care spending, and improves the quality of health care for all residents." Leno represents San Francisco, a city that already has its own universal health care system. Unfortunately, with California politics operating at a virtual standstill almost 100 percent of the time, there's basically no chance that such a measure would ever pass. California Gov. Arnold Schwarzenegger has, however, endorsed Obama's health care plan. Back in October 2009, he issued the following statement: "Our principal goals, slowing the growth in costs, enhancing the quality of care delivered, improving the lives of individuals, and helping to ensure a strong economic recovery, are the same goals that the president is trying to achieve. I appreciate his partnership with the states and encourage our colleagues on both sides of the political aisle at the national level to move forward and accomplish these vital goals for the American people."

Photo credit: Flickr user Ambidanze]]> Yawning doctors: Harmful to your health? http://www.justmeans.com/Yawning-doctors-Harmful-your-health/11067.html Wed, 17 Mar 2010 18:19:14 GMT Ano Lobb Ano Lobb http://www.justmeans.com/Yawning-doctors-Harmful-your-health/11067.html A study in this month's Pediatrics examines communication lapses during shift changes that can have serious consequences for the health and safety of patients. Researchers at the University of Chicago observed first-year residents spending 10 to 15 minutes at the end of their shift informing members of the next shift about their patients. Frighteningly, the information that the outgoing residents identified as being most important was not successfully relayed 60% of the time. This included key p Read Full Article ]]> A study in this month's Pediatrics examines communication lapses during shift changes that can have serious consequences for the health and safety of patients. Researchers at the University of Chicago observed first-year residents spending 10 to 15 minutes at the end of their shift informing members of the next shift about their patients. Frighteningly, the information that the outgoing residents identified as being most important was not successfully relayed 60% of the time. This included key points such as why certain patients where taking specific medications. Despite these shortcomings, both incoming and outgoing residents characterized their communications as effective.

Below the surface of these findings lurks a worrisome political subtext. The issue of limiting the length of shifts that residents are required to work weighs heavily on this research. In the US, 30-hour shifts are the norm, even though New Zealand has limited them to a maximum of 16 hours, and the EU to 13. Sleepy doc's are more likely to harm patients and themselves, and suffer from impaired judgment. Apparently the white coat doesn't make doctors any more impervious to old-fashioned fatigue than you or me. But despite ongoing reforms, America's medical education culture is unwilling to reduce work hours for residents. Often justified as necessary due to a physician shortage that we may or may not be experiencing, this new paper raises the possibility that shorter shifts may in fact create new harms.

"When resident hours are shortened, you have more hand-offs," says co-author Vineet Arora, MD. "You could have concerns about either a tired physician who knows the patient or a well-rested physician that may not know the patient. The tradeoff is between fatigue and familiarity."

But a third option is not mentioned: Taking steps to improve care coordination. I find it worrisome that the statement of trade-off is made with such finality. We already know that care coordination is one of the biggest problems in American health care today. And the efforts of pioneers including my former professor Dr. Paul Batalden prove that quality improvement efforts can lead to drastic reductions in medical errors and improvements in outcomes.

Dr. Batalden asserts that quality improvement is everyone's job, and constant development and training of the workforce is a necessary part of health care. Not only does this refine skills and identify opportunities for improvement, it empowers professionals with the ethic that they can and must improve what they do. That's why I find the assertion that "fatigue and familiarity" are the only two options during health care shift changes to be reprehensible. Not only is it not true, it's disempowering. We already have to worry about whether we'll be able to afford to pay for our stay, or whether we'll catch infections while in the hospital. Should we also have to worry about how sleepy the doctor is? And might doc's who are fresher on their feet also be able to communicate better at shift changes?

Photo Credit: The author.]]> Woman's obesity quest sends the wrong message http://www.justmeans.com/Woman-s-obesity-quest-sends-wrong-message/10977.html Tue, 16 Mar 2010 15:46:53 GMT Sara Libby Sara Libby http://www.justmeans.com/Woman-s-obesity-quest-sends-wrong-message/10977.html The subject of obesity is one that grabs the headlines often. In the last six months alone, for example, consider some of the obesity-related news that has cropped up: Lincoln University in Pennsylvania came under intense scrutiny because of a policy measuring students' body mass indexes (BMI) and requiring those with a BMI over 30 to take a special fitness class in order to graduate. Michelle Obama launched an initiative to eliminate childhood obesity; and that program was criticized on many fr Read Full Article ]]> The subject of obesity is one that grabs the headlines often. In the last six months alone, for example, consider some of the obesity-related news that has cropped up: Lincoln University in Pennsylvania came under intense scrutiny because of a policy measuring students' body mass indexes (BMI) and requiring those with a BMI over 30 to take a special fitness class in order to graduate. Michelle Obama launched an initiative to eliminate childhood obesity; and that program was criticized on many fronts, with people saying that it overstates the seriousness of the childhood obesity epidemic, and that it could create a culture of shame where children eventually come to hate fat people. Then there is the case of Gabourey Sibide, the plus-sized actress nominated for an Oscar for "Precious," who drew nasty comments from Howard Stern and others, who said she'd never work again because she's so "enormous."

But perhaps all of these stories pale in comparison to the latest obesity headline - this one involving a woman who is actively trying to become more obese than she already is in order to earn the title of World's Fattest Woman. Donna Simpson, a New Jersey mother who already holds the dubious title "World' Fattest Mother" says she wants to pack on about 400 pounds in order to weigh in at 1,000 pounds. She has two children; and operates a Web site where people (mostly men, she says) pay per view in order to watch her eat. Therefore, her bizarre aspiration is apparently motivated by both a desire for fame and attention as well as financial reasons.

Simpson's story, and the widespread attention it has been generating, illustrates the tenuous line the media must toe in covering obesity. On the one hand, ever person, no matter his or her size, deserves to be treated with dignity and compassion, and to be given the same opportunities as everyone else. Obesity in American culture is often associated with a person being lazy, wasteful, overindulgent, lacking self control, etc., and all of those are unfair associations. On the other hand, obesity is a serious and dangerous health condition that shouldn't be glamorized or fetishized to the point that people actually want to become obese. Simpson might cherish her title as World's Fattest Mother, but in doing so, she is likely setting a dangerous precendent for her kids that being morbidly obese is OK for one's health.

Obesity puts a person at risk for a multitude of various health problems, and almost certainly cuts a person's life expectancy. It's one thing to be comfortable and secure in not succumbing to the pressures of being rail-thin that the media projects; it's quite another to actually try to make oneself obese.

Photo credit: Aspen04]]> Healthy tools improve medical imaging http://www.justmeans.com/Healthy-tools-improve-medical-imaging/10973.html Tue, 16 Mar 2010 15:42:23 GMT Ano Lobb Ano Lobb http://www.justmeans.com/Healthy-tools-improve-medical-imaging/10973.html New evidence suggests that imaging technology may be getting ahead of our ability to manage it. The research, presented at the American Orthopedic Society for Sports Medicine annual conference this week, found that medical imaging showed hip abnormalities in 70% of professional and collegiate hockey players, even though only 2 of the 39 actually experienced mild pain. Similar findings have been published before, most notably in the spine. In fact, if you randomly x-rayed people off the street, Read Full Article ]]> New evidence suggests that imaging technology may be getting ahead of our ability to manage it. The research, presented at the American Orthopedic Society for Sports Medicine annual conference this week, found that medical imaging showed hip abnormalities in 70% of professional and collegiate hockey players, even though only 2 of the 39 actually experienced mild pain.

Similar findings have been published before, most notably in the spine. In fact, if you randomly x-rayed people off the street, most would have spinal abnormalities show up on the radiographs, even if they had no pain or impaired movement. Shouldn't this be good news? Yes, except that patient reports of pain in the back or joints is often investigated using some form of imaging technology. And when the images reveal abnormalities it is often assumed that they are the cause of the pain, which can lead to surgical fixes. What outcomes research in spinal surgery is finding is that often the repair corrects the abnormality, but not the pain.

One solution is the development of better assessment tools that can work alongside imaging to help with health decision-making.  Researchers at Intermountain Health Care in Utah appear to have done just that in the area of angiography, or vascular imaging. The current gold standard for assessing coronary risk is known as the Framingham Risk Score, which combines total cholesterol, HDL ("good") cholesterol, blood pressure, diabetes risk, age and gender into a score that predicts your risk of heart attack. By adding two additional measures of risk (complete blood count and metabolic profiles) to Framingham, Intermountain researchers were able to increase the precision of that gold standard in predicting the likelihood of death within 30 days of angiography by 30% in women, and 57% in men. After 5 years, the new score still outscored the gold standard in predicting death by 29% in women and 25% in men. This was a large study, following 5,000 patients. Using such a health decision-making tool could help reduce the number of people who get angiography in the first place. This is an area especially ripe for such decision support, since it has been estimated that 30% of angiograms are unnecessary.

Together, these findings sound a further call for more research and guidelines in the rational use of imaging technologies. We also need more patient-centered approaches that avoid a hasty rush to imaging-induced surgery by carefully assessing whether pain is manageable with conservative measures, and fully informing patients about what is known and unknown about the effectiveness of available treatment options. Its a hard lesson for American health care to learn, but in addition to being financially unsustainable, often more care isn't necessarily better.
Photo credit: The author
]]> Telemonitoring your health: The (virtual) doctor will see you (online) http://www.justmeans.com/Telemonitoring-your-health-virtual-doctor-will-see-you-online/10883.html Mon, 15 Mar 2010 23:59:20 GMT Ano Lobb Ano Lobb http://www.justmeans.com/Telemonitoring-your-health-virtual-doctor-will-see-you-online/10883.html Electronic medical records (EMR) are widely debated, studied, promoted, and slowly being implemented. A new review published in Deutsches Arzteblatt International looks at a related practice: Telemonitoring, or using technology to monitor patient health status from home. This ranges from a phone call to ask "how are you feeling?" to more sophisticated transmission of vital sign readings via the internet. The German review revealed some promising findings, as well as noticeable knowledge gaps. A Read Full Article ]]> Electronic medical records (EMR) are widely debated, studied, promoted, and slowly being implemented. A new review published in Deutsches Arzteblatt International looks at a related practice: Telemonitoring, or using technology to monitor patient health status from home. This ranges from a phone call to ask "how are you feeling?" to more sophisticated transmission of vital sign readings via the internet.

The German review revealed some promising findings, as well as noticeable knowledge gaps. A host of studies have looked at the monitoring of heart failure patients, mostly via telephone. Overall, monitoring reduced mortality and rehospitalization by 20% for up to 16 months after initial hospitalization. A separate, smaller review found hospitalization rates reduced by up to 40%, and mortality reductions as high as 56%. Other conditions have not received as much study. Heart failure is a good candidate for such an intervention since it is exceedingly common, and can be difficult and expensive to treat.

Cost effectiveness data lacks the consistency necessary to combine multiple studies to reach more solid conclusions. Improvements in patient quality of life could not be assessed since it hasn't been a primary endpoint in enough studies. Whether telemonitoring would receive widespread acceptance by providers has not been assessed, at least not in the US. Though only 50 to 60% of patients are willing to participate in the practice, those who do express 90 to 95% acceptance rate for the practice.

One country where telemonitoring is widely used is Denmark, widely regarded as the most wired healthcare systems on the planet. A recent report claimed that all Danish primary care providers have electronic medical records. Danish docs save themselves about 50 minutes of paperwork a day, and their economy $120 million a year thanks to their highly digitized records. Compelling stories have emerged showing patients transmitting their vitals to the doctor via the internet from the comforts of their own home. This is a tempting vision to be sure, though safe guards are needed. Along with the normal protections from hackers and other criminals, patient's need to feel that digitally sowing their health information across the fertile plains of the world-wide-web won't lead to unhealthy crops in the future. For example, will medical device and pharmaceutical manufacturers mine the data to identify your doctor for temptation with the newest (and least tested, highest priced) treatments? Will your health status, or unusual yet benign elevations in vital signs or biomarkers be used in the future to deny you access to health coverage or employment?

The Danes also have a national, government run patient registry that helps inform them about the overall health of their population. This is something that most American's, and many others as well, would likely oppose on privacy grounds. "As long as you are a healthy man, you fear for your privacy," the director of Denmark's health information reminds us, "It is when you are sick that you wish people knew what your problem was."

Photo credit: The author]]> Unhealthy promotion: Are alcohol ads targeting kids? http://www.justmeans.com/Unhealthy-promotion-Are-alcohol-ads-targeting-kids/10846.html Mon, 15 Mar 2010 01:46:24 GMT Ano Lobb Ano Lobb http://www.justmeans.com/Unhealthy-promotion-Are-alcohol-ads-targeting-kids/10846.html Television advertising is driven by many factors, most of all by data. Marketers for both television ad space and the products being sold are well informed by enviously detailed data on the demographics of viewers, the likelihood that they'll respond to marketing messages, and performance of past campaigns. It's the kind of data that public health professionals trying to raise awareness about HIV, for example, can only dream about. Little is left to chance, and by correlation, it's unlikely that Read Full Article ]]> Television advertising is driven by many factors, most of all by data. Marketers for both television ad space and the products being sold are well informed by enviously detailed data on the demographics of viewers, the likelihood that they'll respond to marketing messages, and performance of past campaigns. It's the kind of data that public health professionals trying to raise awareness about HIV, for example, can only dream about. Little is left to chance, and by correlation, it's unlikely that the link between an ad campaign and increases in product sales are mediated by dumb-luck or coincidence.

So what is driving the increase in underage drinking, especially binge drinking and consumption of spirits and alcopops (sweet, typically fruity flavored malt beverages) among girls? Could it be the result of industry advertising reaching under-aged drinkers, either by choice or happenstance? It appears likely.

A new RAND study published in the American Journal of Public Health analyzed all of over 600,000 alcohol industry advertisements placed on national cable networks from 2001 to 2006. In time slots where the under-aged viewership was 30% or less, researchers found that each 1% increase in adolescent viewers was associated with a 7% increase in beer ads, 15% increase in spirit ads, and 22% increase in ads for alcopops. Larger female viewership was associated with more spirit and alcopop advertising. The wine industry, however, appears to take a different marketing strategy, reducing ad incidence by 8% for each percentage point increase in underage viewers.

What's so magical about the 30% number? At the end of 2003, the liquor industry adopted voluntary guidelines to limit advertising during time periods were >30% of viewership were underage. How did the industry respond? The RAND researchers found that the number of ads in time slots actually increased after the adoption of those guidelines: 16% for beer and a whopping 1658% for spirits. In a data-driven industry well aware of ad-campaign outcomes, these figures don't seem coincidental.

Alcohol consumption among minors has numerous health consequences. Problems with addiction; risk taking, including drunk driving and unwise sexual choices; and chronic disease such as depression are all encouraged by drinking, especially bingeing, among youth. Not that legal adults necessarily make better choices, but so long as the law forbids drinking by minors, the alcohol beverage industry should avoid marketing to youngsters. The tobacco industry has been hammered on for decades because of their use of tactics aimed at youngsters, such as the use of cartoon mascots. I enjoy my beer and wine as much as the next adult, but as a public health professional, a parent, and law abiding citizen, I find it exceedingly unappetizing that buzz-pushers are preying on our kids. Come on guys, grow up.
Photo credit: The author
]]> Federal court deals another blow to autism-vaccine link http://www.justmeans.com/Federal-court-deals-another-blow-autism-vaccine-link/10788.html Sat, 13 Mar 2010 19:53:51 GMT Sara Libby Sara Libby http://www.justmeans.com/Federal-court-deals-another-blow-autism-vaccine-link/10788.html When a decade-old study from the medical journal The Lancet linking vaccinations to autism was retracted last month, the medical community breathed a sigh of relief. But, as Alisa has pointed out, parental fears over vaccinating children still exist, despite overwhelming evidence of their usefulness and protection of kids from preventable diseases. But this week yet another blow was struck to parents who are hesitant to vaccinate their children because of perceived risks involved - this time by Read Full Article ]]> When a decade-old study from the medical journal The Lancet linking vaccinations to autism was retracted last month, the medical community breathed a sigh of relief. But, as Alisa has pointed out, parental fears over vaccinating children still exist, despite overwhelming evidence of their usefulness and protection of kids from preventable diseases. But this week yet another blow was struck to parents who are hesitant to vaccinate their children because of perceived risks involved - this time by the federal "vaccine court," a branch of the U.S. Court of Appeals that exists solely to govern litigation involving vaccinations.

The vaccine court rulings also dealt with the link between vaccines and autism, and it found in three separate cases that thimerosal, a preservative that contains mercury and is found in some vaccines, does not cause autism - a controversial conclusion that upset many parents who have long insisted otherwise. The court had previously come to a similar conclusion in a case involving the measles-mumps-reubella (MMR) vaccine, declaring that the thimerosal in that vaccine does not cause autism. Combined, the rulings are likely to end the wave of litigation on the subject.

The anger from the rulings, however, isn't likely to end anytime soon. J.B. Handley, a founder of the nonprofit Generation Rescue, told the Los Angeles Times, "Find me another industry where the U.S. government defends their product in court and funds the science that exonerates them. ... The average citizen has no hope." Generation Rescue is fronted by actress Jenny McCarthy, whose son has autism. Since The Lancet study was retracted (and even before), the actress and other parents with autistic children have come under fire for believing in the vaccine-autism link. According to a TIME magazine article on McCarthy, "McCarthy claims Evan was healed through a range of experimental and unproved biomedical treatments; even more controversially, she blames the MMR (measles, mumps and rubella) vaccine for giving her son autism. And yet research conclusively shows that vaccines are safe for children; just last month, the U.K. scientist who had published a study linking the MMR shot to autism was found by a British medical panel to have acted unethically."

Though the federal vaccine court has largely found against parents claiming their children's autism was caused by vaccines, it has on occasion found in favor of parents who were able to show that their children were harmed in other ways by vaccinations - whether physically, neurologically, or otherwise. The court was established in 1986 through the National Childhood Vaccine Injury Act, mostly over fears related to the DPT vaccine, which guards againt three infectious diseases: diptheria, whooping cough and tetanus. Though most of the claims surrounding the DPT vaccine were later discredited, most manufacturers of the vaccine stopped producing it.]]> Social media campaign raises HIV awareness http://www.justmeans.com/Social-media-campaign-raises-HIV-awareness/10741.html Fri, 12 Mar 2010 23:37:20 GMT Alisa Ulferts Alisa Ulferts http://www.justmeans.com/Social-media-campaign-raises-HIV-awareness/10741.html Fearing that too many young African-Americans are becoming complacent about HIV, public health officials have launched a new social media effort intended to help that at-risk population learn the facts about the virus. "i know", a new social media effort of the Centers for Disease Control and Prevention (CDC), is designed to encourage young African-American men and women aged 18-24 to talk openly and often about HIV/AIDS with their peers, partners, and families. Just by texting iknow to 44144, y Read Full Article ]]> Fearing that too many young African-Americans are becoming complacent about HIV, public health officials have launched a new social media effort intended to help that at-risk population learn the facts about the virus. "i know", a new social media effort of the Centers for Disease Control and Prevention (CDC), is designed to encourage young African-American men and women aged 18-24 to talk openly and often about HIV/AIDS with their peers, partners, and families. Just by texting iknow to 44144, young people can get updates about risk, statistics, testing and treatment. People can also connect via Facebook, Twitter and other social media tools by visiting the CDC's Division of HIV/AIDS Prevention site.

"i know" is the latest installment of the CDC's five-year communication campaign, Act Against AIDS, which aims to combat complacency about the HIV crisis in the United States. The campaign - which highlights the alarming statistic that every 9½ minutes another person in United States becomes infected with HIV - features targeted messages and outreach to the populations most severely affected by HIV, beginning with African-Americans. While accounting for just 12 percent of the U.S. population, blacks represent roughly half of new HIV infections and AIDS deaths every year, according to the CDC.

I'm glad to see the CDC reach out this way for a number of reasons. First of all, and by all means feel free to disagree with me, it does seem like the wonderful medications that have made living longer with HIV possible may also have had the unintended side effect of making some people too lax about sexual safety and HIV. I remember the early 80s, when a lack of understanding of HIV and AIDS led to fear and even paranoia. I certainly don't want to return to those days. But when I went to college in the early 90s, there simply wasn't any question among my peers that one chose one's partners with some caution, after asking some questions, and always, always, with protection. Did that mentality help slow the spread of HIV? I don't know, but I've seen too many pregnant girls this year at the high school where I teach to believe the ethos remains in place among many young people today.

Lest that last paragraph made me sound too much the old fogy, let me add here another reason I'm glad to see the CDC reach out in this fashion: it's using social media to spread the word. That makes the targeted audience - in this case young African-Americans - partners in the effort, rather than just passive receivers of the information. That can have a powerful effect and, hopefully, act as a deterrent to high-risk behavior.

What do you think about the CDC's "i know" launch? Will it be a useful tool to combat the spread of HIV, or just a cool new concept that will soon fade away? Share your thoughts.

Photo Credit: jonrawlinson]]> Bacterial- beverages: Obesity not the only fast-food health risk http://www.justmeans.com/Bacterial-beverages-Obesity-not-only-fast-food-health-risk/10697.html Fri, 12 Mar 2010 14:45:57 GMT Ano Lobb Ano Lobb http://www.justmeans.com/Bacterial-beverages-Obesity-not-only-fast-food-health-risk/10697.html Add bacterial infection to the list of health risks associated with eating and drinking at your local fast food joint. A new study published in the International Journal of Food Microbiology found that nearly half (48%) of the beverages dispensed from fast-food restaurants contained coliform bacteria, and 11% contained E coli. While a positive coliform bacteria test isn't necessarily dangerous, it is an indicator of poor sanitation. (Coliform can refer to a number of specific bacteria, some of w Read Full Article ]]> Add bacterial infection to the list of health risks associated with eating and drinking at your local fast food joint. A new study published in the International Journal of Food Microbiology found that nearly half (48%) of the beverages dispensed from fast-food restaurants contained coliform bacteria, and 11% contained E coli. While a positive coliform bacteria test isn't necessarily dangerous, it is an indicator of poor sanitation. (Coliform can refer to a number of specific bacteria, some of whom may come from municipal water supplies). E. coli, when ingested in sufficient quantities, can cause diarrhea, stomach distress, and in serious cases lead to hospitalization and death. Young children, and others with weakened immunity due to advanced age or illness are especially susceptible.

Eating calorie-dense fast-food, and drinking soft-drinks  has previously been associated with increasing the risk of obesity and associated conditions such as diabetes and heart disease. In fact, eating healthier meals at home is considered a leading strategy for reducing childhood obesity. And previous outbreaks of E. coli infection have been traced to improperly cooked, stored or handled meats from fast-food establishments. But this new study appears to be the first of its kind to look at the potential of getting infected from what you drink at such restaurants. Researchers from Hollins University in Roanoke Virginia tested not only regular soda-beverages, but also diet soft-drinks and water, for a total of 90 beverages all dispensed by machines in 30 establishments. They then double-checked their findings by analyzing an additional 27 beverages from 9 other machines. In the end the likelihood of contamination remained the same regardless of what type of beverage was tested, or whether it was dispensed by restaurant employees behind a counter or by patrons at a "self-serve" kiosk.

The problem? Poor cleaning practices. While this is only one small study, its clearly a wake up call that establishments using such beverage dispensers need to ensure that they are cleaning them appropriately, and local health officials need to take note. We all know fast-food is generally an unhealthy, unsustainable choice, so for the millions of people who still frequent such restaurants, perhaps this is another good reason to choose healthier fare. Like slow-food, for example.
Photo credit: The author
]]> Technology and volunteers strengthen health of disabled athletes http://www.justmeans.com/Technology-volunteers-strengthen-health-of-disabled-athletes/10577.html Fri, 12 Mar 2010 12:01:02 GMT Alisa Ulferts Alisa Ulferts http://www.justmeans.com/Technology-volunteers-strengthen-health-of-disabled-athletes/10577.html Last November, as I stood on the sidelines of the ING New York City Marathon cheering on a friend, I noticed small teams of people seeking their health, fitness and possibly spiritual goals in distinctive red T-shirts.  I wrote off the first few pairs as a coincidence, or friends supporting each other, or maybe even spouses. But when the third red-clad pair passed by I took a good look. I noticed that one member of the pair ran slightly behind and to the side of the other. Each held the end of Read Full Article ]]> Last November, as I stood on the sidelines of the ING New York City Marathon cheering on a friend, I noticed small teams of people seeking their health, fitness and possibly spiritual goals in distinctive red T-shirts.  I wrote off the first few pairs as a coincidence, or friends supporting each other, or maybe even spouses. But when the third red-clad pair passed by I took a good look. I noticed that one member of the pair ran slightly behind and to the side of the other. Each held the end of a short tether. Only one runner actually saw the racecourse; the other felt, heard, smelled and maybe tasted it. Both faces were set in the grim, unmistakable expression runners wear when completing a race is no longer a matter of energy but of sheer psychological will. Up close, I saw that the lettering on their shirts identified them as members of Achilles International, an organization dedicated to helping people with disabilities achieve health through fitness and adaptive technology.

For the rest of the race I kept an eye out for more of these runners.  I saw a woman who appeared to be about 70, jogging determinedly next to her volunteer. More visually impaired runners streamed past, their hands lightly grasping the rope that connected them to their sighted partners. And soon I saw 20-somethings, mostly male with strengthened and sculpted upper bodies, head toward the finish line in hand-crank wheelchairs. They were members of Achilles' Freedom Team of Wounded Veterans, a program Achilles developed in 2004 in partnership with Walter Reed Army Medical Center.

When I got home I looked up the organization. Achilles was founded in 1983 by Dick Traum, the first amputee to run the New York City Marathon. It now has chapters and members in over 70 countries. Every day, in parks, gyms, and tracks all over the world, Achilles provides athletes with disabilities with a community of support and in many cases the right technology some athletes need in order to improve their health and confidence through walking or running. It also trains athletes to use the technology: at first to walk (or roll), then to run and finally to race.

I appreciate that Achilles is out there fighting the good fight. Supporting athletes with disabilities should be a no-brainer, but the issue is surprisingly controversial. In 2008 South African runner Oscar Pistorius, a double amputee, fought for the right to run in the 2008 Beijing Olympics. The International Association of Athletics Federations (IAAF) ruled against Pistorius, saying his Cheetah Flex-Foot prostheses gave him an unfair advantage over non-amputee athletes.  Ultimately, the IAAF ruling was reversed. While eligible, Pistorius didn't compete that year because he didn't quality for the South African team, which pretty much shoots a hole in the unfair advantage theory.

This weekend I will join Achilles for my first group workout as a volunteer. On Sunday in Central Park I will gather with a group of people seeking better health through running. While I am in no way an advanced runner, I might make a decent guide for a beginning runner who needs a sighted partner. Or maybe I can help serve juice and water afterward. The New York chapter of Achilles has graciously allowed me to participate, and I look forward to learning more about the organization and the technology it uses to improve the health and fitness of athletes. I'll keep you posted.

Photo Credit: U.S. Army]]> Light drinking can protect women's health - and their waistline http://www.justmeans.com/Light-drinking-can-protect-women-s-health-their-waistline/10426.html Thu, 11 Mar 2010 11:02:55 GMT Alisa Ulferts Alisa Ulferts http://www.justmeans.com/Light-drinking-can-protect-women-s-health-their-waistline/10426.html I haven't been this excited since the Atkins diet promised me all the butter and cheese I could eat: Researchers have added one more health benefit to the occasional glass of wine. Apparently, it helps keep off the pounds. That is, for women at least. Men: You'll have to cry in your beer over this one. A group of researchers found that women who drank the equivalent of one to two drinks a day were least likely to gain weight - 30 percent less likely, in fact, than women who did not drink at all. Read Full Article ]]> I haven't been this excited since the Atkins diet promised me all the butter and cheese I could eat: Researchers have added one more health benefit to the occasional glass of wine. Apparently, it helps keep off the pounds. That is, for women at least. Men: You'll have to cry in your beer over this one. A group of researchers found that women who drank the equivalent of one to two drinks a day were least likely to gain weight - 30 percent less likely, in fact, than women who did not drink at all. And, as we all know, keeping off unwanted pounds is a prerequisite to good health.

"Our study results showed that middle-age and older women who have normal body weight initially and consume light-to-moderate amounts of alcohol could maintain their drinking habits without gaining more weight, compared with similar women who did not drink any alcohol," said study author Dr. Lu Wang, an epidemiologist with the division of preventive medicine at Brigham & Women's Hospital in Boston. Within reason, the more women drank the less weight they gained as they aged, researchers found. Women who didn't drink at all gained the most weight. The findings are published in the March 8 issue of Archives of Internal Medicine.

Sheesh. And to think I waste my time running to stay slim and healthy, when I could just be kicking back on the sofa with a glass of merlot, or shiraz, or... you get the picture. (Although relaxing with the occasional and responsible glass of wine has always been a part of my mental health plan). Researchers say there could be any number of reasons for their findings, including different ways that women metabolize alcohol, compared with men. Also, researchers say, women tend to substitute alcohol for other foods, whereas men tend to simply add alcohol to everything else they eat.

I know there are some cultures that regularly drink wine with dinner (and lunch, and brunch) and yet still don't measure up to Americans when it comes to obesity. So it's not like the premise for this study is coming completely out of nowhere. I still think, however, that before we down a martini each night instead of doing our ab crunches we should consider this study in the context of the current pile of confusing and at times contradictory health studies involving alcohol. Some research has found that men and, to a lesser extent, women who drink moderately over the long-term have a lower risk for heart disease. But another study has found that even moderate drinking might raise the risk for breast, liver and other cancers in women. If that study is true, then we women might be gaining one health benefit - a lower percentage of body fat - but at the cost of increasing our risk of developing other conditions most definitely harmful to our health.

Whom do we believe? It's a good question. I don't advocate that the National Institutes of Health or some other public health agency establish a "Truth-O-Meter" to help us wade through the confusion that spills across the pages of medical journals. But maybe the government could pay for each of us to spend an hour with a medical actuary, someone who could calculate our personal risk and advise us to follow the findings of Study X but ignore Study Y for optimal health and longevity. I'm kidding, of course, but how do you suggest we get clarity? Put down your beer and tell me your ideas.

Photo Credit: yashima]]> Privacy vs. efficiency as Britain moves to electronic health records http://www.justmeans.com/Privacy-vs-efficiency-as-Britain-moves-electronic-health-records/10546.html Wed, 10 Mar 2010 23:04:10 GMT Sara Libby Sara Libby http://www.justmeans.com/Privacy-vs-efficiency-as-Britain-moves-electronic-health-records/10546.html The dueling priorities of the convenience and efficiency of digitalized health records and the significance of patient privacy is one that is looming as health care reform continues its long, slow slog through Congress. But it's possible that we are getting a preview of potential problems to come with recent events in England. A new electronic medical records database is causing quite a stir: among the complaints about the system are that the system is being pushed through too quickly, and that Read Full Article ]]> The dueling priorities of the convenience and efficiency of digitalized health records and the significance of patient privacy is one that is looming as health care reform continues its long, slow slog through Congress. But it's possible that we are getting a preview of potential problems to come with recent events in England.

A new electronic medical records database is causing quite a stir: among the complaints about the system are that the system is being pushed through too quickly, and that health officials will potentially have access to patients' sensitive health information without their knowledge or consent. Indeed, the British Medical Association admitted that some patients' records might have gone into the system without the appropriate 12 weeks' prior notice - time that was intended for patients to decide whether to opt-out of participating in the system.

According to the BBC, so far a little more than 1 million records have been entered into the system; and 50 million are projected to go in by 2014. Reports the BBC: "Before a patient's details go into the database, they will receive a pack containing information about the Summary Care Record. If they decide they do not want to be on the database, the pack contains an order form and pre-paid envelope which they can use to order an opt-out form."

According to Sky News, the database system was settled over a different option, wherein patients would have their own personal "smart card" containing their medical records, that could be easily accessed if necessary. Officials ultimately believed that system would be too unreliable.

Digital medical records were brought up several times during the 2008 presidential campaign by both Barack Obama and John McCain. President Bush at one point also identified a goal of every citizen having his or her own electronic medical record by 2014. But initiating such a system can be extremely costly - although it would likely save money in the long term, in addition to improving preventative care and reducing errors. The New England Journal of Medicine estimated in 2008 that initial costs of implementing electronic records can be as high as $36,000 per doctor, because of the computers, servers and software required.

Though the U.S. lags behind other countries in many health-related areas, electronic records included, USA Today suggests that the model for a digitalized system is in our own backyard: "One needs to look at the Department of Veterans Affairs for an optimal model. All of the VA's primary care physicians, specialists and hospital-based doctors across the country use the same electronic record system. It has played a significant role in the reduction of medical errors, optimization of cost efficiency, and attainment of high scores in preventive care measures."]]> The key to health? Sleep on it http://www.justmeans.com/-key-health-Sleep-on-it/10429.html Tue, 09 Mar 2010 05:20:17 GMT Sara Libby Sara Libby http://www.justmeans.com/-key-health-Sleep-on-it/10429.html Following a recent study showing that natural light exposure affects teens' body clocks and their ability to function well in the mornings comes a sleep-related poll shows problems not just among young adults but people of all ages, races and backgrounds. The National Sleep Foundation's "Sleep in America" poll did, however, suggest that getting a good night's rest might be affected by racial and cultural differences.This was the first time the study investigated sleeping patterns by ethnic group Read Full Article ]]> Following a recent study showing that natural light exposure affects teens' body clocks and their ability to function well in the mornings comes a sleep-related poll shows problems not just among young adults but people of all ages, races and backgrounds. The National Sleep Foundation's "Sleep in America" poll did, however, suggest that getting a good night's rest might be affected by racial and cultural differences.This was the first time the study investigated sleeping patterns by ethnic groups, including Asians, Hispanics, African Americans and whites.

According to USA Today, "That African Americans report the least amount of sleep and that they report needing less sleep each night to perform best during the day bears more research, [foundation chair Thomas] Balkin says. He points out that inadequate sleep is starting to be associated with obesity, heart disease and diabetes, diseases that are more prevalent among African Americans." The poll found that African Americans reported getting the least amount of sleep during the week (a little more than six hours); Asians were the least likely to be diagnosed with sleeping disorders; and whites were the most likely to sleep alone.

In addition to affecting people's enjoyment of their waking hours because of decreased concentration and lower productivity, sleeplessness can manifest itself in the form of physical health problems as well. According to USA Today, lack of sleep means one is "More likely to suffer from pain conditions and gastrointestinal distress. Sufferers are at higher risk for hypertension and heart disease. Also a risk factor for developing diabetes. Sleep loss is associated with reduced insulin sensitivity." Doctors have also started seeing a possible correlation between inadequate sleep and diseases like heart disease and diabetes.

Children, teenagers and pregnant women need more sleep than the average adult. Adults typically need about seven to eight hours of sleep per night, although some people can handle as few as five hours per night. "The amount of sleep a person needs also increases if he or she has been deprived of sleep in previous days. Getting too little sleep creates a "sleep debt," which is much like being overdrawn at a bank. Eventually, your body will demand that the debt be repaid. We don't seem to adapt to getting less sleep than we need, while we may get used to a sleep-depriving schedule, our judgment, reaction time, and other functions are still impaired," according to Web MD.

Sleep deprivation is becoming relatively en vogue these days, it seems. The New York Times has recently launched an insomnia-themed health blog, which so far has covered late-night Facebook status updating, power napping, and sleep-related literature.]]>