What's on the Menu? Food Facts
Don Sapatkin
(The Philadelphia Inquirer, January 31, 2010)
"Philadelphia begins phasing in enforcement of its strictest-in-the-nation menu-labeling law tomorrow. This first part, requiring chain restaurants to list calories on food tags and menu boards, is a relatively simple proposition that research shows can influence ordering habits...and dozens of such bills are pending around the country…What's different in Philadelphia will become apparent on April 1, when restaurants with individual menus must list saturated fats, trans fats, carbohydrates, and sodium, in addition to calories, with every item. No one really knows what will come of this broader experiment in attempted behavioral change…Restaurants initially fought all efforts to mandate labels on menus. As the movement spread, with dozens of variations proposed across the country, the industry switched its goal to uniformity: calories, yes; sodium, no. It has won that fight everywhere except Philadelphia. City Council approved the measure in 2008, after viewing data that showed the impact of chronic diseases related to diet...broken down by district…Both [carbohydrates and sodium] are listed on the familiar nutrition-facts label on all prepackaged goods. 'But it is really hard for people, if they eat out, to know about the sodium content,' city Health Commissioner Donald Schwarz said…'Back in the 1970s, eating out was a special occasion. What people ate didn't matter as much,' said Margo G. Wootan, nutrition-policy director at the Center for Science in the Public Interest. Americans now get an estimated one-third of their calories from meals outside the home. And though FDA serving sizes haven't changed, restaurant portions, especially fast food, have doubled or tripled. Skyrocketing obesity rates -- one-third of Americans are obese, about the same as in Philadelphia -- defied every big fix attempted. In 2003, an influential study examined long-term trends and calculated that a difference of 100 calories a day, either ingested or spent, could tip the balance from national weight gain to weight loss. This, the researchers concluded in the journal Science, could be accomplished through small changes that the public would be more likely to embrace. Wootan's Washington center, meanwhile, had been pondering how to get people to eat better…Wootan developed a model menu-labeling law and started calling dozens of policymakers around the country: Maine (the first to introduce a bill), New York City (the first to pass it), Philadelphia (the fourth to implement it)."
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Calorie Counters
Editorial
(The New York Times, February 2, 2010)
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Delaware Health: Senator Wants Calories Counted
Esteban Parra
(The News Journal, Delaware, January 30, 2010)
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Stanford University Report: Calorie Posting in Chain Restaurants
Obesity coverage
Consumer & Food Safety coverage
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Anna Wilde Mathews
(The Wall Street Journal, New York, February 2, 2010)
"With the fate of a national health care overhaul unclear, state legislators are pushing their own bills aimed at expanding coverage, though tight budgets are likely to hinder many of these efforts. Lawmakers in at least two states, California and Missouri, have introduced legislation for the current session to create government-backed coverage for state residents. In others, including Virginia and New Jersey, legislators are hoping to tweak existing state programs to include more people. In 11 states, lawmakers have proposed bills for this year aimed at improving access to health care, said the National Conference of State Legislatures. Spurred by continued voter discontent with the status quo, both Republicans and Democrats in state legislatures aim to advance their own proposals, particularly if a national overhaul remained stalled or was scaled back."
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Editorial
(The Des Moines Register, January 31, 2010)
"Neither of the health reform bills passed by the House or Senate adds to the federal deficit. Both also would expand health coverage to millions of people and prohibit insurers from wronging consumers. But apparently that isn't enough for many Americans. Polls show support for reform has dwindled. The annual survey released last week by the Pew Research Center for People & the Press found respondents considered deficit reduction a higher priority than health care (60 percent versus 57 percent). Fortunately, the health bills will reduce the deficit as well -- a fact that hasn't gotten enough attention and may help boost public support for getting reform done…Of course, getting the country's fiscal house in order is no simple matter, and there are only two options: Cutting spending and raising taxes. The health legislation does both."
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Robert Pear
(The New York Times, January 30, 2010)
"The Obama administration issued new rules on Friday that promise to improve insurance coverage of mental health care for more than 140 million people insured through their jobs. In general, under the rules, employers and group health plans cannot provide less coverage for mental health care than for the treatment of physical conditions like cancer and heart disease. Insurers cannot set higher co-payments and deductibles or stricter limits on treatment for mental illness and addiction disorders. Nor can they establish separate deductibles for mental health care and for the treatment of physical illnesses. Such disparities are common in the insurance industry. By sweeping away such restrictions, doctors said, the rules will make it easier for people to obtain treatment for a wide range of conditions, including depression, autism, schizophrenia, eating disorders and alcohol and drug abuse. For decades, many health plans have had limits on hospital inpatient days and outpatient visits for mental health treatments, but not for other types of care."
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Bonnie Rochman
(TIME, February 8, 2010)
"The day that Dave deBronkart learned he had Stage 4 kidney cancer, his doctor handed him a prescription slip. On it, he'd scribbled ACOR.org. Within 11 minutes of submitting his first post to the Association of Cancer Online Resources, deBronkart...received recommendations for top specialists -- with links included -- from patients on the site's kidney-cancer list. Within half an hour, an e-mail arrived from an ACOR member suggesting which scans might be appropriate and offering details about interleukin-2, the only treatment at the time that resembled a cure…Thousands of patients like deBronkart are learning as much online -- and from one another -- as they are from their doctors. These laypeople are banding together and starting websites to help figure out which practitioners to see and which hospitals to avoid, which clinical trials show promise and which experimental treatments are bunk. But as people take more control of their health care -- joining an empowerment movement many are calling Patient 2.0 -- plenty of doctors are worried about the quality of the information that is being assessed as well as patients' ability to understand it."
Noam N. Levey
(Los Angeles Times, February 4, 2010)
"In a stark reminder of growing costs, the government has released a new estimate that healthcare spending grew to a record 17.3% of the U.S. economy last year, marking the largest one-year jump in its share of the economy since the government started keeping such records half a century ago. The almost $2.5 trillion spent in 2009 was $134 billion more than the previous year, when healthcare consumed 16.2% of the gross domestic product, according to an annual report by independent actuaries at the federal Centers for Medicare and Medicaid Services, or CMS, scheduled for release Thursday. The nonpartisan accounting agency also projected that as early as next year, the country could mark another milestone as government picks up more than half of the nation's total healthcare tab for the first time."
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Rosalind S. Helderman
(The Washington Post, February 2, 2010)
"Virginia's Democratic-controlled state Senate passed measures Monday that would make it illegal to require individuals to purchase health insurance, a direct challenge to the party's efforts in Washington to reform health care. The bills, a top priority of Virginia's 'tea party' movement, were approved 23 to 17 as five Democrats who represent swing areas of the state joined all 18 Republicans in the chamber in backing the legislation. The votes came less than a week after President Obama implored Democrats in Washington not to abandon their health-care efforts, urging them in his State of the Union address not to 'run for the hills' on the issue. But the action in Virginia, a state that backed Obama in 2008, could indicate that the president is failing to reassure members of his own party that current reform efforts remain worthwhile. The votes also suggest that Democrats on the state level fear that supporting health-care reform could be politically damaging, and their action could put pressure on members of the state's congressional delegation who have been behind the effort."
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Cari Tuna
(The Wall Street Journal, New York, February 1, 2010)
"Companies' efforts to reduce health-care costs by nudging employees into wellness programs are clashing with a federal law designed to prevent discrimination based on genetics. Many employers offer workers cash incentives or insurance-premium reductions to fill out health surveys and some use that information to offer health advice or direct at-risk employees to disease-management programs. But the Genetic Information Nondiscrimination Act, which took effect last year, restricts employers' and health insurers' ability to collect and disclose genetic information. That includes not only genetic-test results, but family medical history, too. Some employers say the law is stymieing their efforts to promote employee wellness because it bars them from offering workers financial incentives to complete health surveys that ask about family history. Generally, the law prohibits insurers and employers from using genetic information for coverage and employment decisions, such as hiring, firing and promotion. Employers say financial incentives are needed to boost participation in wellness programs, which can reduce overall health-care costs."
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Opinion, Valerie Ulene
(Los Angeles Times, February 1, 2010)
"These days, there's a good chance that my personal physician wouldn't care for me if I were hospitalized. In some cases, primary care physicians are opting to stay out of the hospital; in others, hospitals simply insist that such care be handled by a hospital-based physician, or hospitalist. These doctors work in collaboration with (or sometimes for) the hospital. They forgo the practice of outpatient medicine, choosing to care exclusively for acutely ill, hospitalized patients. The vast majority are trained in internal medicine, although some have a background in family practice or pediatrics. Use of hospitalists has grown increasingly popular over the last 15 years; in fact, hospital medicine is now the fastest-growing medical specialty in the United States, says the Society of Hospital Medicine. In 1996, there were only a few hundred hospitalists scattered across the country; currently, the organization estimates that there are more than 30,000. This trend could ultimately free up more primary care physicians to do what they do best -- keep us out of the hospital -- while streamlining the hospital-care experience."
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Peter Slevin
(The Washington Post, February 3, 2010)
"Children are increasingly suffering health problems in Port-au-Prince's crowded encampments, say international medical workers, who predict the situation will worsen as Haiti continues to reel from the Jan. 12 earthquake. Food remains scarce, water is often impure and thousands upon thousands of families are living side by side in makeshift shelters that rarely consist of more than a synthetic tarpaulin and walls of thin cloth. Worried about the potential for disease, medical teams launched a major campaign Tuesday to vaccinate children in the capital. In a project expected to last about two weeks, the goal is to protect as many as several hundred thousand children against measles, tetanus and diphtheria, UNICEF spokeswoman Roshan Khadivi said…U.S. officials said Tuesday that three weeks after the earthquake destroyed Haiti's capital, international food aid had reached at least 1 million people -- but another million were estimated to need such assistance."
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Damien Cave and Ginger Thompson
(The New York Times, February 2, 2010)
"Four days into a new food distribution program from the United Nations that aims to repair a faltering aid effort, paper coupons that can be redeemed for 55 pounds of rice have become more valuable than Haitian money. The food coupons are akin to diamonds: they are precious because sustenance is scarce. For three weeks since the international effort to feed millions of Haitians has been dogged by confusion, transportation snags, security problems and a lack of coordination. Before the coupon program started on Saturday, food giveaways had become a Darwinian sport — with biscuits and bottles of canola oil or biscuits thrown like footballs from the backs of trucks to masses of men jockeying for position. Many are still hungry. As of Sunday, 639,200 people had received a meal from the United Nations’ World Food Program, 32 percent of the two million estimated to be in need."
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Foreign Food Aid Trickles into Haiti's Black Market
(Reuters, February 4, 2010)
Brian MacQuarrie
(The Boston Globe, February 1, 2010)
"While tens of thousands of people are fed daily in Haiti’s teeming capital, the mammoth life-saving effort has yet to reach countless places like this fetid patch of makeshift housing, just 18 miles of nearly impassable roads away…The problem is that Haiti has no working government, its already hobbled infrastructure obliterated by the earthquake, which destroyed the buildings that housed the corridors of power and scattered the bureaucrats who now are tending to their own shattered families. The mayor of Leogane, where at least 3,300 people were killed, has driven past the shantytown without stopping, its residents said. And the Canadian troops who are based here have been patrolling but are not supposed to distribute food directly, said Master Corporal Jacques Bisson of the Canadian army. 'Nobody is coming to see them,' said Sam Moly, 31, a US citizen born in Haiti who returned to Leogane from Florida to help his native country. 'No one is coming to do anything.'"
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Peter Baker and Joseph Berger
(The New York Times, February 1, 2010)
"The federal government announced on Monday that it would reimburse American hospitals who treat Haitian earthquake victims with life-threatening injuries, making it possible for more hospitals in states outside Florida to consider taking those patients…The military medical evacuation flights had been suspended for five days after Florida officials complained that their hospitals were being overwhelmed with patients suffering from devastating burns, head and spinal cord trauma, amputations and other wounds, and that no plan had been put in place to reimburse the hospitals for the care they were providing. Federal and state officials worked through the weekend to address these concerns. The resumption of flights was announced by the White House Sunday evening, though word about the reimbursement plan did not come until Monday."
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Shan Juan and Wang Yan
(China Daily, February 2, 2010)
"China launched a 10-day inspection to track and destroy melamine-tainted milk products nationwide as a 2008 contamination scandal continued to haunt the country. The National Food Safety Rectification Office led by Health Minister Chen Zhu ordered the move following reports that leftovers from the melamine-laced milk powder that had killed six children and sickened 300,000 in 2008 resurfaced on the market, mostly in the form of processed food like ice cream and condensed milk. 'Some unscrupulous food companies processed and resold the melamine-laced milk powder that was recalled but not destroyed by dairy companies, which has posed great health risks to consumers,' Chen said at a teleconference over the weekend. 'It's an uncompleted task that has to be completed. Through the campaign, all melamine-tainted milk products will be found and destroyed to eliminate potential health risks facing the public,' he said, adding that enterprises are the first in line to be accountable for product safety and quality."
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Karen Weintraub
(The Boston Globe, February 1, 2010)
"[H]ealth departments and advocacy groups around the country are pressuring restaurants and food manufacturers to cut back. Last month, the National Salt Reduction Initiative, which includes the Massachusetts Department of Public Health and the Boston Public Health Commission, announced it hoped to reduce Americans’ total salt intake by at least 20 percent over the next five years. At the same time, some researchers are questioning whether cutting salt consumption for everyone is necessary or even wise. To meet its 20 percent goal, the national initiative has set two- and four-year voluntary targets for gradually reducing salt levels in 61 categories of packaged food and 25 classes of restaurant food. Americans eat at least twice as much salt as they should, according to the initiative. By slowly dialing back the salt content of foods, consumers won’t even notice the difference, public health officials promise."
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Sharon Begley
(Newsweek, February 8, 2010)
"'There is no question that the safety and efficacy of antidepressants rest on solid scientific evidence,' as psychiatry professor Richard Friedman of Weill Cornell Medical College recently wrote in The New York Times. But ever since a seminal study in 1998, whose findings were reinforced by landmark research in The Journal of the American Medical Association last month, that evidence has come with a big asterisk. Yes, the drugs are effective, in that they lift depression in most patients. But that benefit is hardly more than what patients get when they, unknowingly and as part of a study, take a dummy pill -- a placebo...Hence the moral dilemma. The placebo effect -- that is, a medical benefit you get from an inert pill or other sham treatment…That first analysis, in 1998, examined 38 manufacturer-sponsored studies involving just over 3,000 depressed patients. The authors, psychology researchers Irving Kirsch and Guy Sapirstein of the University of Connecticut…that patients did improve, often substantially, on…[nearly all types of] antidepressants…This improvement, demonstrated in scores of clinical trials, is the basis for the ubiquitous claim that antidepressants work. But when Kirsch compared the improvement in patients taking the drugs with the improvement in those taking dummy pills…he saw that the difference was minuscule. Patients on a placebo improved about 75 percent as much as those on drugs."
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A Doctor Disagrees
Opinion, Robert Klitzman, psychiatrist, author, and director of the Master's of Bioethics program at Columbia University
(Newsweek, February 8, 2010)
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Adam Gabbatt
(The Guardian, online, London, February 3, 2010)
"British psychologists have found evidence of a link between excessive internet use and depression, research published today has shown. Leeds University researchers, writing in the Psychopathology journal, said a small proportion of internet users were classed as internet addicts and that people in this group were more likely to be depressed than non-addicted users. The article on the relationship between excessive internet use and depression, a questionnaire-based study of 1,319 young people and adults, used data compiled from respondents to links placed on UK-based social networking sites. The respondents answered questions about how much time they spent on the internet and what they used it for; they also completed the Beck Depression Inventory -- a series of questions designed to measure the severity of depression. The report, by the university's Institute of Psychological Sciences, said 18 of the people who completed the questionnaire -- 1.4% of the total -- were internet addicts."
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Alice Park
(TIME.com, February 3, 2010)
"Getting a cancer diagnosis is a stressful and shocking experience. But is it stressful enough to increase a patient's risk of suicide and heart attack? That's the question that an international group of researchers from the U.S., Sweden and Iceland set out to answer when they launched the largest study ever to examine the specific effect of cancer diagnosis on suicide risk. Researchers analyzed data gathered between 1979 and 2004 on 342,000 men who were recently told they had prostate cancer. Compared to death rates among a similar group of men without cancer, men who received a cancer diagnosis were 90% more likely to commit suicide in the following year. Overall, the authors point out, the absolute risk of suicide was small; among the more than 340,000 cases studied, 148 men died of suicide. But the relative risk was still quite large, says study co-author Lorelei Mucci, an epidemiologist at Brigham and Women's Hospital in Boston. The men who had prostate cancer, particularly those who had advanced disease, were also at a slightly higher risk of dying from a heart attack or another cardiovascular event within the first year. The risk was highest during the first month after diagnosis."
Julie Robotham
(The Sydney Morning Herald, January 30, 2010)
"Measures to contain the runaway cost of Medicare-funded psychological treatment have failed, costs spiralling 26 per cent last year, according to new analysis. Spending will blow out to $1.5 billion by next year, twice its budget allocation. But despite the huge investment the Federal Government has not released any evidence that mental health is improving. Experts say the therapies are failing to reach those whose access to treatment is already poorest: men, young people and people living outside cities. The analysis, by the Mental Health Council, shows moves last year to rein in the Better Access to Mental Health Care scheme have failed to contain escalating costs. The blowout will put extra pressure on health spending in this year's budget."
Carolyn Lochhead
(San Francisco Chronicle, February 3, 2010)
"First lady Michelle Obama jumped into the policy arena Tuesday, meeting with several Cabinet secretaries and congressional committee chairs in the White House's Old Family Dining Room to strategize on a national campaign against childhood obesity set to kick off in a week. Obesity has become a leading cause of preventable death in the United States, killing an estimated 100,000 Americans a year. It is a key driver of soaring health care costs, underlying a host of chronic diseases including heart disease, diabetes and some cancers. One in 3 children is overweight or obese. Since she started a vegetable garden at the White House nearly a year ago, the first lady has become seriously engaged in issues surrounding food and health…On Tuesday, she spoke about 'food deserts' in urban areas with the conviction of a farmers' market convert…The first lady said the effort will focus on four areas: improving health at schools, increasing children's physical activity, improving access to healthy food and making it more affordable to poor children -- a challenge she described as difficult -- and teaching people to make better choices about what they eat."
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Marni Jameson
(Los Angeles Times, February 1, 2010)
"While experts argue over whether to blame individuals, society, fast food or families for the rapid rise in obesity rates, the perhaps more pressing question is what to do about it…Some companies and institutions have moved to hold individuals specifically accountable for their weight…Another plan of attack is to tax those foods that many feel contribute to the problem…Dr. Reed Tuckson, chief of medical affairs for the UnitedHealth Group, opposes the tax for a different reason: 'We want the food and beverage industry to be part of the solution. If we stick them with taxes, we won't get cooperation.' However, Dr. Deborah Cohen, senior natural scientist at Rand Corp. in Santa Monica and a physician who specializes in public health, is all for the tax, especially if the levy goes toward health initiatives…That's not to say pressure can't work. Employers of the overweight and normal weight co-workers have managed to nudge overweight colleagues toward healthier behaviors, if not actual weight loss…Cohen says the blame for obesity is misplaced. 'Much obesity is the result of genetics and the environment. Yet we're blaming individuals when the food environment is the problem.' Twenty years ago, the Rand specialist said, you didn't find food everywhere…Meanwhile, the fat rights community adamantly argues that obesity isn't the issue and that many heavy people are healthy and active."
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Fed Up with Fat and Saying Something About It
Marni Jameson
(Los Angeles Times, February 1, 2010)
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(Associated Press, February 1, 2010)
"Like nearly one-third of American teens, Paris Woods is overweight. Her doctor worries her weight will creep up into the obesity range. One out of four black girls her age is obese. The more than 11 million U.S. teens who are overweight or obese face an increased risk for diseases once confined to adults, like diabetes, artery damage and liver trouble. Those problems along with high blood pressure and high cholesterol are showing up increasingly in kids. Paris' pediatrician urged her to take part in an intensive experiment. The goal? To see if a yearlong program of weekly sessions with a nutritionist, exercise trainer and doctor, all preaching major lifestyle changes, could keep the 14-year-old from becoming obese. It's the kind of intensive help that the influential U.S. Preventive Services Task Force said last month can work for teens. Through successes, setbacks and even a bout with swine flu, Paris tried sticking with it. Skipped sessions stretched the program from 12 months into 20, but she didn't quit. Did it work? Stay tuned -- her experience is a reflection of many families' struggles with obesity."
See also:
SickKids First to Offer Teens Surgery for Obesity
Carly Weeks
(The Globe and Mail, Toronto, February 5, 2010)
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Geoff Cumming
(The New Zealand Herald, January 30, 2010)
"They are meat cuts affluent New Zealanders feed only to their pets: lamb and mutton flaps laden with fat. Yet for decades, our sheep farmers have been free to maximise returns by selling these potentially harmful cuts to Pacific and Third World markets, where they've become a human staple. It seems not to matter to our Government that Tongans and others who grow fat on these products may then clog our health system with diabetes and heart-related problems. Individual responsibility has been the mantra of successive governments challenged to limit this unsavoury trade. There's a local market for flaps too -- mainly to low-income Pacific Islanders and Maori families where obesity-related diseases are soaring. A new book on the issue is set to reignite debate about whether regulation is needed to limit consumption of this high-fat food in addition to public health education. New Zealand exported nearly 40,000 tonnes of flaps -- high-fat trimmings from the sheep's belly -- in 2007, 19 per cent going to Pacific countries where obesity rates are the highest in the world. (Until recently, the Pacific took a far higher proportion but China is now the leading market.) 'We don't make any money by not selling the whole sheep,' says Ben O'Brien, Meat and Wool NZ's general manager of market access."
Opinion
Christian Thurstone, psychiatrist and federal researcher on marijuana addiction in teens
(The Denver Post, January 31, 2010)
"In the last three months, I have seen more than a dozen young people -- all between the ages of 18 and 25 and with histories of substance abuse -- who received from other doctors what are essentially permission slips to smoke pot. Some of my colleagues recently reported seeing a young, pregnant woman who was granted a license to smoke marijuana because of her nausea. (Yes, you read that right.) Kids without licenses tell me about the potent pot they buy from from caregivers whose plants yield enough supply to support sales on the side. Colorado schools are also scrambling to make sense of our muddled public policies. Educators ask me how to deal with students who have marijuana prescriptions for their attention-deficit/hyperactivity disorder and with the "medical marijuana specialists" seen passing out business cards in student parking lots. Here's what I tell them: Good research shows that using marijuana makes anxiety, depression and ADHD worse, so let's stop prescribing marijuana to our youth."
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Scientific Proof for Medical Pot
Editorial
(The Denver Post, January 31, 2010)
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Sarah Boseley
(The Guardian, London, February 2, 2010)
"The Lancet today finally retracted the paper that sparked a crisis in MMR vaccination across the UK, following the General Medical Council's decision that its lead author, Andrew Wakefield, had been dishonest. The medical journal's editor, Richard Horton, told the Guardian today that he realised as soon as he read the GMC findings that the paper, published in February 1998, had to be retracted…Many in the scientific and medical community have been pressing for the paper, linking the MMR (measles, mumps and rubella) jab to bowel disease and autism, to be quashed. But Horton said he did not have the evidence to do so before the end of the GMC investigation last Thursday. In 2004, when concerns were first raised about the conduct of the study, the Lancet asked the Royal Free hospital, where Wakefield and his fellow authors worked, to investigate. But Professor Humphrey Hodgson, then vice-dean of the Royal Free and University College school of medicine, wrote to the journal to say it had found no problems…The GMC last week disagreed…Wakefield 'was dishonest,' said Horton. 'He deceived the journal.' The Lancet had done what it could to establish that the research was valid, by having it peer-reviewed. But there is a limit, he said, to what peer-review can ascertain."
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The Damage of the Anti-Vaccination Movement
Opinion, Michael Fumento, director of the Independent Journalism Project
(Los Angeles Times, February 5, 2010)
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The Lancet's Vaccine Retraction
Editorial
(The Wall Street Journal, New York, February 3, 2010)
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Melinda Beck
(The Wall Street Journal, New York, February 1, 2010)
"Researchers from Columbia University, in a study published in the current Journal of Health & Place, identified an area including West Hollywood, Beverly Hills and some less posh neighborhoods that accounted for 3% of the state's new cases of autism every year from 1993 to 2001, even though it had only 1% of the population. Another recent study, from the University of California, Davis, published in Autism Research, also found high rates of autism in children born around Los Angeles, as well as nine other California locations. Autism, usually diagnosed before a child is 3 years old, is a developmental disorder characterized by impaired social interaction and communication and repetitive behavior. Both of the California-based studies suggest that local environmental or social factors are driving the high autism-diagnosis rates. And they conclude that childhood vaccinations -- which some people fear is a factor behind rising autism -- are not to blame. Otherwise, diagnoses of the disorder would be more evenly dispersed, they say. The studies also disagree on some points…In Los Angeles itself, residents have a variety of explanations for the high autism rates, ranging from a family's affluence and the activity of autism-advocacy groups to past air and water pollution."
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(Associated Press, February 3, 2010)
"Expectant mothers are getting a new tool to help keep themselves and their babies healthy: pregnancy tips sent directly to their cell phones. The so-called text4baby campaign is the first free, health education program in the U.S. to harness the reach of mobile phones…Wireless carriers…have agreed to waive all fees for receiving the texts. Organizers say texting is an effective means of delivering wellness tips because 90 percent of people in the U.S. have cell phones. 'Especially if you start talking about low-income people, cell phones are the indispensable tool for reaching them and engaging them about their health,' said Paul Meyer, president of Voxiva, a company which operates health texting programs in Africa, Latin America and India. Studies in those countries have shown that periodic texts can reduce smoking and other unhealthy behaviors in pregnant mothers. Meyer said the U.S. program, run by Voxiva, will be the largest health-related texting program ever undertaken."
Thomas H. Maugh II
(Los Angeles Times, February 2, 2010)
"An infection of the uterine cavity during pregnancy combined with premature birth doubles the risk that an African American child will develop asthma, researchers have found. The combination also increases risk for some other ethnicities, though less severely. About 8% of pregnancies are marked by such bacterial infections, called chorioamnionitis, but it is not yet clear what proportion of asthma is induced by them, said the lead author, Dr. Darios Getahun of Kaiser Permanente's Department of Research and Evaluation in Pasadena. Nor is it clear whether the duration of the infection influences the risk and why different ethnicities respond differently, he said…They reported Monday in the journal Archives of Pediatric and Adolescent Medicine that chorioamnionitis had no apparent effect on the rate of asthma when the fetuses were carried full term."
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Rob Stein
(The Washington Post, February 2, 2010)
"Sex education classes that focus on encouraging children to remain abstinent can persuade a significant proportion to delay sexual activity, researchers reported Monday in a landmark study that could have major implications for U.S. efforts to protect young people against unwanted pregnancies and sexually transmitted diseases. Only about a third of sixth- and seventh-graders who completed an abstinence-focused program started having sex within the next two years, researchers found. Nearly half of the students who attended other classes, including ones that combined information about abstinence and contraception, became sexually active. The findings are the first clear evidence that an abstinence program could work…The research, published in the Archives of Pediatric & Adolescent Medicine, comes amid intense debate over how to reduce sexual activity, pregnancies, births and sexually transmitted diseases among children and teenagers. After falling for more than a decade, the numbers of births, pregnancies and STDs among U.S. teens have begun increasing."
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Sex Ed in Washington
Opinion, Russ Douthat
(The New York Times, January 31, 2010)
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A Troubling Uptick
Editorial
(The New York Times, January 30, 2010)
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Beth Daley
(The Boston Globe, January 31, 2010)
"The nuclear industry, once an environmental pariah, is recasting itself as green as it attempts to extend the life of many power plants and build new ones. But a leak of radioactive water at Vermont Yankee, along with similar incidents at more than 20 other US nuclear plants in recent years, has kindled doubts about the reliability, durability, and maintenance of the nation’s aging nuclear installations. Vermont health officials say the leak, while deeply worrisome, is not a threat to drinking water supplies or the Connecticut River, which flows beside the 38-year-old plant, nor is it endangering public health. But the controversy is threatening to derail the nuclear plant’s bid, now at a critical juncture, for state approvals to extend its operating life by 20 years when its license expires in two years. Nuclear Regulatory Commission inspectors, Vermont Yankee’s owners, and state officials are tracing the source of the radioactivity and searching for other leaks in the labyrinth of below-surface pipes on the plants’ property about 10 miles from the Massachusetts border."
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Tritium Leaks
Ed Weiderer
(The Boston Globe, January 31, 2010)
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Critics Press for More Testing at Pilgrim Plant
Robert Knox
(The Boston Globe, January 31, 2010)
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Donald G. McNeil Jr.
(The New York Times, February 1, 2010)
"There is now so much unused swine flu vaccine in the world that rich nations, including the United States, are trying to get rid of their surpluses. But the world’s poorest countries -- a few still facing the brunt of the pandemic -- are receiving very little of it. Of the 95 countries that told the World Health Organization last year that they had no means of getting flu vaccine, only two, Azerbaijan and Mongolia, have received any so far. Afghanistan is expected to be next. Early last month, W.H.O. officials said they hoped to have shipped vaccine to 14 countries by now, and even then it would have been only enough to protect 2 percent of the countries’ populations. While the flu has waned in North America, it is still affecting North Africa, Central Asia and parts of Eastern Europe. This imbalance between rich and poor countries, and the inefficiency of global vaccine transfers, frustrate many experts."
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Cindy George
(Houston Chronicle, January 30, 2010)
"Overwhelmed emergency rooms are so 2009. That's the case so far this year, anyway. H1N1 -- the flu virus that proved dangerous and deadly for the pregnant, ill and young -- has backed off so much that major Houston emergency centers report lower-than-usual volumes in recent months, when upswings were expected…But Houston residents shouldn't get comfortable. Houston's flu guru, Dr. Paul Glezen, cautions that if history repeats itself, a third wave of illness could strike in late winter or this spring. The H1N1 virus, which has continued to circulate since April and spread worldwide, could roar back. 'The usual peak is in the middle of February, but it looks like it will be a little later than that, if we have one,' said Glezen, the lead epidemiologist at Baylor College of Medicine's Influenza Research Center. He predicts H1N1 will stick around while H3N2 -- a seasonal flu that circulated in the southern hemisphere during our summer -- could head north in the coming months."
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Opinion
Thomas Abraham, head of the public health communication program at the University of Hong Kong’s Journalism and Media Studies Center
(The New York Times, January 30, 2010)
"Not for the first time, the World Health Organization is under fire for its handling of the current H1N1 influenza pandemic. Initially, it was criticized for being too slow to alert the world when the disease, often called swine flu, first broke out in Mexico. Now, the organization faces a diametrically opposite charge: that it was influenced by the pharmaceutical industry to create a false pandemic when none existed, so that drug companies could sell more vaccines. The W.H.O.’s critics are barking up the wrong tree. This is a real influenza pandemic, not an imaginary disease cooked up by public health agencies around the world and the pharmaceutical industry. Though for the vast majority of people the disease has been mild, it has killed small children, pregnant mothers and otherwise healthy teenagers. This is not an innocuous disease. Take a look at the lungs of those whom it as killed: The virus has turned them into a wasteland of devastated tissue, in a way that the normal flu virus never can. The world has been fortunate that this virus has not mutated to cause more severe illness in larger numbers of people. This could still happen."
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Opinion
Terence Stephenson, president of the Royal College of Paediatrics and Child Health and Nuffield professor of child health, Institute of Child Health, University College London
(The Guardian, London, February 3, 2010)
"Children who have a healthy start in life, especially the early years, grow up to be healthier adults. However, an Audit Commission report, Giving Children a Healthy Start, says that the health outcomes for under-5s have improved only marginally since 1999. The inequalities gap between under-5s from rich and poor families has barely changed over the last decade, and despite the government investing £10.9bn, some indicators -- such as obesity and dental health -- have worsened. The first thing we need is a cultural change that makes children in our society a priority…The Audit Commission report makes a plea for integrated child health services, with seamless working between primary and secondary care -- something the Royal College of Paediatrics and Child Health (RCPCH) has long been in favour of…We need more 'smart' targeted interventions, using IT and electronic records to identify children who would benefit most from help or who are missing out on available services…Many things that are good for society will also be good for young children -- for example, higher levels of education, healthy environments, reduced pollution. However, some interventions have early and direct benefits for young children."
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Nicholas Bakalar
(The New York Times, February 1, 2010)
"A vaccine introduced in 2000 has been highly effective in reducing the number of severe lung, blood and brain infections in infants and children. But at the same time, a serious and sometimes fatal complication has become more common. Researchers report that the rate of the complication, pneumococcal empyema (pronounced em-pye-EE-ma), an accumulation of dense pus between the outer surface of the lung and the chest wall, increased after the vaccine came into widespread use. The infected material is so thick that it interferes with breathing; surgery is often required. Before the 7-valent pneumococcal conjugate vaccine, or PCV7, was available, pneumococcal disease in the United States annually caused more than 700 cases of meningitis in children, 13,000 blood infections, about 5 million ear infections and 200 deaths…The analysis appears in the January issue of Pediatrics. One reason, the scientists believe, is that other known strains of pneumococcus have flourished without competition from the seven covered by the vaccine. Dr. Su-Ting T. Li, the lead author of the study, said newly evolving pneumococcal strains might also be a problem."
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Opinion
Terry L. Schraeder, MD, clinical assistant professor at Warren Alpert School of Medicine at Brown University and internist
(The Boston Globe, February 1, 2010)
"From anxiety and hormonal disorders to high blood pressure and type II diabetes, doctors are treating boys and girls for numerous medical conditions that were once uncommon or never seen in children -- and many are preventable…While working as a physician at a summer camp a few summers ago, I was struck by how many children were on prescription medications for all sorts of ailments. Of the 850 children in attendance, more than one-third would line up daily to receive medication they had brought from home -- and this was a camp for healthy kids. Medications for anxiety, asthma, gastric problems, blood pressure, blood sugar, skin disorders, and weight issues were handed out three times a day…I wondered if this was an example of the pharmaceutical industry exploiting children or if this represented truly necessary medication being prescribed for real disorders. Or was it a sad commentary on the health of our children (and the dependency on prescriptions over prevention) - as well as the overall health of our society? I concluded that maybe all these reasons might be true."
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Kounteya Sinha
(The Times of India, January 31, 2010)
"A vaccine to protect HIV patients from contracting tuberculosis (TB) and ultimately dying of it has finally become a reality. After a seven-year-long trial in Africa, scientists have for the first time developed a vaccine that was succesful in reducing the rate of definite TB infection by almost 39% among 2,000 HIV-infected patients in Tanzania. TB is the biggest killer of HIV-infected patients in the world. In India, over 60% of HIV-infected patients with a weak immunity system get infected with TB and ultimately die of it. Scientists from Dartmouth Medical School (DMS) have reported results of their clinical trial of this new vaccine against TB -- Mycobacterium vaccae (MV) -- in the January 29 online issue of the journal AIDS. The study will be published in the March print issue of the journal. Principal investigator Ford von Reyn from DMS said, 'Since development of a new vaccine against TB is a major international health priority, especially for patients with HIV infection, we and our Tanzanian collaborators are very encouraged by the results of the study.' The vaccine is a type known as an inactivated, whole-cell mycobacterial vaccine and is expected to be economical to produce and distribute."
Michael Allen
(The Wall Street Journal, New York, January 30, 2010)
"Seven years after the U.S. launched its widely hailed program to fight AIDS in the developing world, the battle is reaching a critical turning point. The growth in U.S. funding, which underwrites nearly half the world's AIDS relief, has slowed dramatically. At the same time, the number of people requiring treatment has skyrocketed. And lately, the global campaign to prevent new infections has suffered some reversals. In Uganda, a lush East-African country that once stood out as a shining star in the fight against AIDS, the rate of HIV in the population has begun to tick up again after a long decline. That's putting an even greater strain on a health system that's struggling to cope with the hundreds of thousands who already have the disease and could be a harbinger of what's to come in the rest of Africa…The most immediate concern is getting enough lifesaving drugs to all those who need them. Under the Bush administration, the President's Emergency Plan for AIDS Relief, or Pepfar, set aggressive goals for getting people with HIV, the virus that causes AIDS, into drug therapy, eventually enrolling some 2.4 million by the end of last year. The Obama administration, which plans to expand international AIDS treatment to at least 4 million by 2013, nevertheless has signaled nearly flat budgets through fiscal 2011. Critics are questioning whether the reduced spending pace means the administration doesn't plan to use the full $48 billion authorized by Congress by 2013."
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How the Aged and Frail Are Exploited in Washington's Adult Family Homes
(The Seattle Times, January 30, 2010)
"Twenty years ago, the state Department of Social and Health Services began licensing homeowners to provide spare bedrooms and care for the old or frail who might otherwise have to live in nursing homes. These private residences -- called adult family homes -- were marketed as opportunities for seniors to live in cozy settings and familiar neighborhoods, close to family and friends, with more freedom and superior care. The owners were given freedom, as well. To encourage this new industry, the state imposed few regulations -- no requirements for a minimum level of employees or even, for many years, liability insurance. Today, Washington is lauded nationally as a leader in community care options for seniors. But inside the state's 2,843 adult homes, thousands of vulnerable adults have been exploited by profiteers or harmed by amateur caregivers, an investigation by The Seattle Times has found…About 11,200 people reside in adult family homes across the state. About three out of five residents are private pay. There are about 1,100 homes in King County alone, more than three times the number of Starbucks stores."
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Related story:
Fragile, Pushed Out and Paying a Price: State Saves Millions by Relocating Poorest Patients
(The Seattle Times, February 1, 2010)
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State-Required Training for Prospective Owners Has Serious Flaws
(The Seattle Times, January 30, 2010)
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Opinion
Lance Armstrong, athlete and founder of LIVESTRONG and
Michael Bloomberg, mayor of New York City
(Newsweek Web Exclusive, February 4, 2010)
"The problem of preventable deaths is most prevalent in developing nations, where those with curable cancers simply don't get the medicine they need to live, because they either don't have access to care or they're diagnosed too late. And others, sadly, fight not only a disease but the prejudice and stigma that go hand in hand with it in many cultures…But the problem isn't isolated to developing nations. Even in America, the wealthiest country in the world, too many are dying needlessly from cancer every year, and the No. 1 cause of cancer is the same here as it is around the world: tobacco. Nearly 20 percent of all deaths in the United States every year result from tobacco use. The human costs of cancer are heartbreaking, but the economic costs are nearly as staggering…The Economist estimates that new diagnoses alone cost our global economy more than $300 billion last year…But in coming years, new cancer cases will hit the global economy -- and the global community -- even harder. In fact, according to a study published in the Journal of the American Medical Association, cancer survivors in the U.S. and Europe were 37 percent more likely to be unemployed than those who have not been affected by the disease. Simply put, we face a looming global health and economic disaster unlike any the world has seen. But it is an avoidable disaster, if we take a few basic steps."
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Liz Szabo
(USA Today, February 1, 2010)
"Concerned that Americans may be accumulating too much lifetime radiation exposure from medical tests, doctors at the National Institutes of Health will begin recording how much radiation patients receive from CT scans and other procedures in their electronic medical records. A study in the Archives of Internal Medicine in December estimated that radiation from such procedures, whose use has grown dramatically in recent years, causes 29,000 new cancers and 14,500 deaths a year. A second Archives study that month said the problem could be even worse, calculating that patients get four times as much radiation from imaging tests as previously believed. Children are particularly vulnerable because they're small and still growing. These exposures do not include the rare cases of machine malfunctions or mistakes…Even though most machines function properly, hospitals rarely record how much radiation patients receive. Doses can vary, depending on the size of the patient, how large of an area is scanned or the number of scans performed. At NIH, doctors now will routinely record such information in records that patients can take with them, according to an announcement today in the Journal of the American College of Radiology."
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Joy Wanja
(Daily Nation on the Web, Kenya, January 31, 2010)
"Kenya is currently carrying a heavy cancer burden which has largely been triggered by a shortage of cancer specialists. Dr Anselmy Opiyo, head of the cancer treatment centre at the only public hospital with a functional radiotherapy unit, the Kenyatta National Hospital (KNH) in Nairobi, says the country's disease burden has gone up because the population has increased but the number of specialists and machines needed for treatment have stagnated. 'There are only four cancer specialists (oncologists) countrywide, whereas the number of patients grows every day,' Dr Opiyo told the Daily Nation during an interview. KNH also serves patients from other East African countries and parts of Central Africa, leading to long queues every day…Medical statistics show that the global cancer burden surpasses that of malaria, tuberculosis and HIV combined."
Kay Lazar
(The Boston Globe, February 2, 2010)
"The NFL has recently begun airing commercials warning young athletes of potentially permanent memory problems, a remarkable turnabout, given the league’s long reluctance to acknowledge the link between head trauma and later disease, although retired players appear to suffer unusually high rates of dementia. The league announced new rules [last year and]…encouraged current and retired players to participate in the BU [Boston University] center’s research [to study chronic traumatic encephalopathy, or CTE] and pledged $1 million to fund the work. Sixty players have agreed to donate their brains for autopsies upon their death...To bring about the league’s high-profile capitulation, the BU center borrowed a page from the playbook of other public health crusades that ultimately changed attitudes: It combined painstaking research with a relentless media campaign. But the speed of the BU center’s early success is surprising, said David Hemenway, a Harvard University health policy professor who has traced the arduous paths of dozens of other public health campaigns...Each year, an estimated 135,000 children between the ages of 5 and 18 are treated in emergency rooms for sports and recreation-related brain injuries, according to the US Centers for Disease Control and Prevention. Athletes who have had a concussion are at increased risk for another one, leaving them vulnerable to potentially longlasting or permanent damage."
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Erin Allday
(San Francisco Chronicle, February 2, 2010)
"Smart phones and laptops, handheld video games and MP3 players…the latest technology is great, but it is also a literal pain in the neck, doctors say. And not just the neck, either. All these newfangled gadgets also are hurting our backs, shoulders, arms and hands. The kids are suffering from 'text thumb' and their parents are getting 'BlackBerry neck'…Strains and pains caused by modern technology are hardly new - workplace ergonomics is a multimillion-dollar industry, and pretty much anyone who's ever typed on a computer keyboard knows all about carpal tunnel syndrome. But orthopedists and others who specialize in muscle and joint injuries say there's no question that the surge of handheld technology is leading to a new wave of aches and pains. Doctors say they struggle now to keep up with the latest equipment and what it might mean for their patients."
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Laura Landro
(The Wall Street Journal, New York, February 2, 2010)
"Risk calculators, used by heart surgeons for several years, are now being developed for other surgical specialties. The American College of Surgeons recently introduced calculators for surgery of the colon and pancreas, and is designing similar tools for 18 other procedures, including gastric bypass, hernia repair and prostate surgery. The calculators use data from more than one million patient records gathered as part of the group's National Surgical Quality Improvement Program, which works with hospitals to reduce surgical errors and complications. More than 30 million operations are performed in the U.S. annually to remove deadly cancers, repair diseased organs and replace worn-out joints. Yet going under the knife can be risky, leading to serious infections, blood clots, heart attacks and pneumonia. Those risks increase with age and for patients who are obese, smoke, abuse alcohol or have medical conditions such as diabetes and hypertension…While some complications are unavoidable, surgical teams often make mistakes, such as leaving a surgical sponge in a patient, or fail to take steps known to prevent complications, such as delivering antibiotics to a patient within one hour before beginning surgery, which can dramatically cut infection rates."
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André Picard
(The Globe and Mail, Toronto, February 2, 2010)
"Wearing a helmet while skiing or snowboarding reduces the risk of head injury by 35 per cent, new research shows. 'That’s significant and we’re probably looking at the lower end of the protective effect,' Brent Hagel, an assistant professor of pediatrics at the University of Calgary, said in an interview. In fact, the meta-analysis -- a compilation and analysis of earlier research -- showed that helmets can reduce the risk of head injury by as much as 60 per cent in some settings and as little as 15 per cent in others…(In Canada, there are no legislated standards for ski helmets the way there are for hockey helmets. There are also no laws that make ski helmets mandatory, as there are with bicycle helmets in some jurisdictions.) The new research, published in Tuesday’s edition of the Canadian Medical Association Journal, compiled and analyzed 12 studies of recreational skiers and snowboarders in North America, Europe and Asia."
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Kris Maher
(The Wall Street Journal, New York, February 1, 2010)
"For the 18 million people with obstructive sleep apnea, the remedy is far from perfect: bulky and expensive masks that some compare to sleeping in scuba gear. As the number of people with sleep apnea is expected to rise, doctors and medical device makers are trying new treatments…Aging and obesity both can contribute to sleep apnea; research suggests the number of people with the condition will grow, as the population ages. Some experts believe that lack of awareness among some patients and doctors has led to underdiagnosis and that the number of patients actually is closer to 30 million. The most common symptom is snoring; daytime sleepiness is another sign. Sleep apnea heightens a patient's risk of hypertension, diabetes and heart attacks, because it heightens carbon-dioxide levels in the blood stream and stresses the cardiovascular system. Last fall, the National Transportation Safety Board recommended that drivers and pilots of commercial buses, trucks, airplanes and ships be screened for the condition, citing several accidents in which undiagnosed sleep apnea was thought to play a role."
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Erin Allday
(San Francisco Chronicle, February 1, 2010)
"Paul Williams has only run one marathon in his life, but by his own research, he could probably benefit from running a few more. A scientist at Lawrence Berkeley National Laboratory, Williams has put together the world's largest study on runners, and the evidence found over 20 years of research points to an important conclusion: When it comes to exercise, more is almost always better. 'When I started my study, everybody sort of knew exercise was beneficial. The government was saying you get benefits by walking three or four times a week. My data has shown the more you do, the greater the benefits,' Williams said. 'I've had people doing 100 miles a week of running, and you could see benefits up to that level.' To be sure, Williams is not suggesting that everyone try to run 100 miles a week, or even half of that. But for years, he's been a critic of national guidelines that recommend people get at least 150 minutes of exercise a week, or about 30 minutes a day, five days a week…Williams' catalog of more than 100,000 runners has produced dozens of scientific and medical papers looking at the effect of running on everything from heart disease and stroke to vision problems and arthritis."
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Opinion
Alfred Sommer, dean emeritus of the Johns Hopkins Bloomberg School of Public Health
(The Washington Post, February 2, 2010)
"For the first two weeks, we watched the aftermath of the Haitian earthquake with a combination of horror and hope: horror over the widespread devastation and hope whenever one more living soul was retrieved from the rubble. Captivated as we'd been by the individual rescue, we also learned that as many as 20,000 people could be dying in Haiti every day…Those of us in public health refer to this as the 'girl in the well' phenomenon. The world will watch with baited breath through a four-day rescue ordeal, while at the same time hundreds of millions of people go to bed hungry each night, more than 6 million children die unnecessarily every year, and the Millennium Development goals go unmet in those countries that most need to achieve them. So it goes in Haiti. After the search for survivors slowed and the humanitarian operation intensified, questions began mounting about the adequacy of our response and whether it can be sustained. Our focus on those being rescued stimulated an outpouring of aid. But now, as with past disasters at home and abroad, we are beginning to forget."
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Betsy McKay
(The Wall Street Journal, New York, January 31, 2010)
"The Obama administration is expected to propose in its fiscal 2011 budget Monday new funding to combat preventable and tropical diseases, malnutrition and other conditions afflicting the world's poor, as part of a strategy to broaden its approach to global health. The new policy, details of which the administration plans to release along with the budget, retains HIV/AIDS as the administration's top funding priority, but will devote new funding to reducing deaths from complications related to pregnancy or childbirth, poor nutrition and common treatable illnesses that kill millions every year, particularly women and children, according to people familiar with the new plan. The strategy also seeks to work more closely with individual countries to help strengthen their own health-care systems, and to integrate programs that are now focused on individual diseases. The hope is to make care more efficient and easy, so that, for example, a woman doesn't have to go to one clinic for AIDS treatment, another for prenatal care, and still another for her young child's care, people familiar with the plan say."
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James Sturcke and agencies
(The Guardian, online, London, February 3, 2010)
"Britain's dementia crisis is worse than feared and costs Britain £23bn a year -- more than cancer and heart disease combined -- but receives a fraction of the funding, according to a study published today. The number of people with dementia, at 822,000, is 17% higher than has previously been estimated and will pass the 1 million mark before 2025, the Oxford university study has found. Researchers calculated that for every pound spent on dementia studies, £12 is spent on investigating cancer and £3 on heart disease. They said the ageing population was largely behind the rise in dementia and public attitude contributed to the relative lack of research funding. 'People do consider dementia as an inevitable part of getting old. People who reach the age of 65 have a one in three chance of having dementia before they die,' said the report's author, Professor Alastair Gray of the university's Health Economics Research Centre…The Dementia 2010 report compares the condition's overall annual cost of £23bn with £12bn for cancer care and the £8bn for heart disease…The health minister, Phil Hope, said dementia was 'one of the most important issues we face as a population.'"
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