MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'community health'. Sat, 03 Sep 2011 01:58:46 +0100 http://www.medworm.com/index.php?rid=5169561&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F08%2Fthe-challenge-of-obesity.html For those interested in epidemiology, chronic disease, and obesity. This week's edition of the Lancet has a series of four articles and several commentaries that review the economics, epidemiology, social, and policymaking issues affecting obesity that are well worth reading in full. The take away message is that this is an extremely complicated area. There is an emphasis by the authors and commentators that correction of obesity will take government action. Government action in this area tends to resolve around police actions, and taxation. Taxation policies have worked to a significant extent in reducing tobacco consumption in Europe. However, smoking is not a survival necessity whereas eating is. We have to be very careful about the use of police power for public health policy with the ... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=5169561 Fri, 26 Aug 2011 17:05:04 +0100 5169561 http://www.medworm.com/index.php?rid=5159080&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F08%2Fthe-water-deficit.html In today's TheScientistDaily is an interesting opinion piece about the problem of current farming practices and deficits in fresh water supplies. What isn't mentioned, and should be of increasing concern, is that each specialist group focuses on their own interest without looking at the larger picture. Part of this is the problem of training with use of grant funds, all of which focus on special interests and fail to develop generalists who can look at the big picture. My view of the big picture in relation to this article is that farming is important for the increasing world population resulting from immunization, chronic disease prevention, and in adequate family planning without any reference to the big picture. Without a broader picture of the human ecosystem much of the specialty rese... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=5159080 Tue, 23 Aug 2011 15:53:17 +0100 5159080 http://www.medworm.com/index.php?rid=5159081&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F08%2Fhospitals-seek-more-er-patients.html From today's Washington Post we learn that he learned that “Many hospitals are actively recruiting people to come to the ER fornon-emergency reasons,” said Anthony Keck, South Carolina’s Medicaid director, citing facilities that tout their speedy ER service on highway billboards.“ <strong>Comment</strong>: at a time when many are discussing the problems of the affordable care act and the excess cost of healthcare, hospital self interest has no concern for the community or managing the nation's health care bills. Comments by the president of the emergency physician association is self-serving and it is clear that business ethics does not exist among most health care providers. It is still "caveat emptor" (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=5159081 Tue, 23 Aug 2011 15:26:46 +0100 5159081 http://www.medworm.com/index.php?rid=5158857&cid=t_92698_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F08%2F23%2Fhow-to-guide-improving-transitions-from-the-hospital-to-post-acute-care-settings-to-reduce-avoidable-rehospitalizations%2F Scan or click to download 'How-to Guide Improving Transitions from the Hospital to Post-Acute Care Settings to Reduce Avoidable Rehospitalizations' Title: How-to Guide Improving Transitions from the Hospital to Post-Acute Care Settings to Reduce Avoidable Rehospitalizations The Skinny: Guide from Institute for Health Improvement on avoiding avoidable rehospitalisations as a result of poor co-ordination of care settings. Avoiding this is a key step toward achieving broader delivery system transformation. Based on the healthcare system of the USA this guide is of use to those looking at intermediate care/rehabilitation settings. Publisher: Institute for Health Improvement Published: August 2011 Size: 144p. Filed under: Ooops Missed Category! Tagged: Clinical Governance, finance, Gr... Fade Library blogs http://www.medworm.com/rss/comments.php?id=5158857 Tue, 23 Aug 2011 08:27:37 +0100 5158857 http://www.medworm.com/index.php?rid=5159082&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F08%2Fhealthy-behaviors-will-help-you-live-longer.html Researchers looked at long-term data from Americans aged 17 and older and found that those who embraced four healthy behaviors -- not smoking, eating a healthy diet, getting regular physical activity and avoiding excessive alcohol use -- were 63 percent less likely to die early from any cause than those with none of those healthy habits. Comment: one more piece of confirmatory data that are health relies more behaviors. The problem is that despite many repeated similar studies of population behaviors do not change. Instead of wasting money repeat the same old research. Why not develop methods to change population? If this is much not possible, which I suspect, perhaps we should stop funding ineffectual research. [http://www.cdc.gov/media/releases/2011/p0818_living_longer.htm ] (Source: Dr.... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=5159082 Fri, 19 Aug 2011 15:26:38 +0100 5159082 http://www.medworm.com/index.php?rid=5159083&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F08%2Fbacteria-from-dog-feces-present-in-outdoor-air-in-urban-areas.html A CU-Boulder study showed that of the four Midwestern cities in the experiment, two cities had significant quantities of fecal bacteria in the atmosphere -- with dog feces being the most likely source. Comment: some 40 years ago when I was a health director in Portsmouth, Virginia, based on the number of dogs in the city and following discussion with veterinarians we estimated that is in this city of one hundred thousand people dogs deposited 10 tons of feces every day. As a result we warned people against bathing in ponds and rivers for 48 hours after any rainfall of more than half an inch. The problem with this study is that there were no control cities where the volume of deposit could be validated and no evidence that there was more respiratory or skin diseases among residents of the t... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=5159083 Fri, 19 Aug 2011 15:24:40 +0100 5159083 http://www.medworm.com/index.php?rid=5107551&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F08%2Fpublic-health-pays-for-itself.html An article in Health Affairs this month, sponsored by NACCHO suggests that public health saves lives and money. The authors believe that federal and state money used to support public health has caused a reduction in deaths from chronic diseases.  Comment: As a past state health commissioner I would like to believe this is so. The methodology is poor. The selection of ‘controls’ was inappropriate and the statistical evaluation poor. During the many years of retrospective study there have been significant clinical and pharmaceutical improvements which have contributed to stabilization of many chronic diseases and delay of death.  The effectiveness of these activities was not due to public health funding. If the research had focused on MCH programs, immunization and con... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=5107551 Mon, 08 Aug 2011 21:38:54 +0100 5107551 http://www.medworm.com/index.php?rid=5096251&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F08%2Fhandwashing-in-elementary-schools.html This study showed that after pupils clean their hands with alcohol tissues three times a day that absence fears him and school from risk recovery and gastrointestinal infections decreased significantly. The cost of procedure is far less than the cost of absenteeism both to the schools and parents. It should read replicated the US and if reproducible made a policy. American Journal of Infection Control:  Volume 39, Issue 6, August 2011, Pages 450-455 (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=5096251 Thu, 04 Aug 2011 16:35:17 +0100 5096251 http://www.medworm.com/index.php?rid=5096252&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F08%2Fwasted-research-funds.html According to a story on research in ScienceDaily today, “With Regular Exercise, People with Inactive Lifestyles More at Risk for Chronic Diseases”. I first read about research on this topic when the Alameda study on behavior among men was published in the 1960s. Similar research has been repeated hundreds of times in the intervening years yet the behaviors with which we are all familiar continue. It is high time that those who fund research stop funding issues that have been confirmed and either direct their funds for transitional research that shows that change in behavioral outcome is possible and effective. There have been many behavioral research studies that have shown the ability to change behavior for a few weeks, none that show long-term changes. It is high time to star... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=5096252 Thu, 04 Aug 2011 16:16:56 +0100 5096252 http://www.medworm.com/index.php?rid=5077719&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F07%2Fhow-should-we-define-health.html The British Medical Journal today contains an interesting analysis of the term "Health". Some 14 commentators are concerned that the WHO definition is restrictive and absolute. The authors are also concerned that the current definition leads to medicalization of society and particularly in the US to an inappropriate increase in treatments that produce little benefit a t great cost. This interesting discussion suggests that “health” be a social contract that accepts the current aging society and increases in chronic diseases in functional rather than biologically. This discussion is well worth reading. (BMJ 2011; 343:d4163). (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=5077719 Fri, 29 Jul 2011 16:04:12 +0100 5077719 http://www.medworm.com/index.php?rid=5077720&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F07%2Fcell-phones-childrens-brain-cancer.html The negative studies keep piling up as seen in the latest publication in the Journal of the National Cancer Institute on July 27. While this again shows no change in risk comparing those who use cell phones to those who don't, the data is not convincing either way as we are not told about the amount of time the cell phones were used by children, either from individual calls or minutes per day for those with brain cancer compared to those without it. The risk from cell phones is much greater from accidents caused by inattention while using the phone than it probably is for any cancer that might occur. This is a genie that will not go back into the bottle. (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=5077720 Thu, 28 Jul 2011 15:12:36 +0100 5077720 http://www.medworm.com/index.php?rid=5008235&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F07%2Fpatient-care-in-rural-hospitals.html In this week’s JAMA there’s an interesting article looking at the quality of care delivered in rural hospitals when Medicare patients are treated for heart attacks, congestive heart failure and pneumonia. It appears the rural hospitals with emergency access provide worse care than those seen in large cities with tertiary care hospitals. This is not particularly surprising considering the cost of a fully staffed the emergency room is often greater than the cost of an entire rural hospital. the issue should not be whether rural hospitals should be closed, but whether transportation should be provided to centers more capable of treating the serious conditions. (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=5008235 Fri, 08 Jul 2011 16:30:13 +0100 5008235 http://www.medworm.com/index.php?rid=5008236&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F07%2Fcdc-fears-rising-treatment-resistant-gonorrhea.html According to to the CDC: Neisseria gonorrhoeae is a major cause of pelvic inflammatory disease, ectopic pregnancy, and infertility, and it can facilitate human immunodeficiency virus (HIV) transmission (1). Emergence of gonococcal resistance to penicillin and tetracycline occurred during the 1970s and became widespread during the early 1980s. More recently, resistance to fluoroquinolones developed. Now Gonorrhea may be losing its susceptibility to cephalosporins, the only available antibiotic class remaining to treat the sexually transmitted infection, the CDC is warning. Comment: when I started medical school in 1947 the medical profession had just started using penicillin to treat gonorrhea and syphilis and mistakenly thought STIs were beaten. Just as with the use of contrace... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=5008236 Fri, 08 Jul 2011 16:27:38 +0100 5008236 http://www.medworm.com/index.php?rid=5008237&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F07%2Fhealthy-lifestyle-makes-women-less-likely-to-die-suddenly.html Medpage Today tells us that women who adhered to a healthy lifestyle had as much as a 90% reduction in the risk of sudden cardiac death (SCD) as compared with those with a high-risk profile, data from the Nurses’ Health Study (NHS) showed. The risk of SCD declined linearly as the number of these attributes increased, ranging from a 46% reduction for a woman who had one to 92% for those who had all four. Comment: these results are not surprising as the Alameda study showed more than 40 years ago where health behaviors were studied for some 11 conditions showing a significant increase in longevity for those who followed more than half of them. We have many studies that show that change in behavior can significantly improve health. The problem is we still don’t know how... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=5008237 Wed, 06 Jul 2011 15:28:49 +0100 5008237 http://www.medworm.com/index.php?rid=5008239&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F07%2Fthe-fda-and-food-safety.html In today’s JAMA Larry Gostin and Katie Stuart discuss the need for more clarity in the laws that govern safety of the $1 trillion food industry. While the Food Safety Modernization Act increases the FDA’s authority the FDA shares responsibility with the USDA and many other federal state and local agencies on much of the actual monitoring taking place in every community is done by local health departments. He points to such absurdities as the USDA being responsible for wholesomeness of egg products except that eggs in the shell are the responsibility of the FDA. Congress continues to add burdens and responsibilities to the FDA but fails to give it the resources. This may be the time to clarify the responsibility of both the FDA and the USDA and take most of the actors other t... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=5008239 Wed, 06 Jul 2011 15:26:19 +0100 5008239 http://www.medworm.com/index.php?rid=4992723&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F07%2Fdrug-side-effect-linked-with-increased-health-risks-for-over-65s-1.html More than 13,000 men and women aged 65 and over from across the UK were included in the two-year study from the University of East Anglia. Around half were found to use a medication with potential anticholinergic properties.In the study, each drug taken by the participants was given a ranking based on the strength of its anticholinergic activity, or AntiCholinergic Burden (ACB) - 0 for no effect, 1 for mild effect, 2 for moderate effect and 3 for severe effect.The key findings were:• Twenty per cent of participants taking drugs with a total ACB of four or more had died by the end of the two-year study, compared with only seven per cent of those taking no anticholinergic drugs - the first time a link between anticholinergics and mortality has been shown.• For every additional ACB point ... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=4992723 Fri, 01 Jul 2011 19:56:41 +0100 4992723 http://www.medworm.com/index.php?rid=4992724&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F07%2Ftext-messaging-in-smoking-cessation-the-txt2stop-trial.html From today's Lancet: As with many such trials, the continuous abstinence rate at 6 months in the intervention group, although statistically significant as compared with the control group, was low (10•7%). Data were also missing due to withdrawals and non-completion of self-reported smoking status. However, robust sensitivity analyses were done to account for these losses to follow-up with multiple imputation techniques based on important predictors of missingness, and also by assuming that individuals with missing self-reported smoking status were smokers. Finally, as the investigators acknowledge, to ascertain the mechanism by which the txt2stop intervention actually increased continuous abstinence is difficult. Nonetheless, the abstinence rates in the txt2stop intervention group are br... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=4992724 Fri, 01 Jul 2011 19:55:18 +0100 4992724 http://www.medworm.com/index.php?rid=4992725&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F07%2Flet-science-inform-policy.html An editorial in Science today, written by Dr, Anthony Fauci, discusses the value of preventive antiretroviral therapy for non-infected homosexual couples, the value of condoms for males and females and the value of circumcision to prevent the spread of H IV infection. Despite such evidence the City of San Francisco seeks to outlaw circumcision. As State Health Commissioner in the late 1980s I had to help out state legislature avoid testing premarital couples for HIV infection, Luckily the testimony of the scientists on the HIV Advisory committee was accepted by the legislators (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=4992725 Fri, 01 Jul 2011 19:53:45 +0100 4992725 http://www.medworm.com/index.php?rid=4968530&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F06%2Fnowhere-left-to-hide-the-banishment-of-smoking-from-public-spaces.html In the absence of direct health risks to others, bans on smoking in parks and beaches raise questions about the acceptable limits for government to impose on conduct. In 2008, legal scholar Robert Rabin, the former program director for the Robert Wood Johnson Foundation’s Tobacco Policy Research and Evaluation Program, commented, “We should not lose perspective on the question of how restrictive a society we want to create — that is, how far we want to go in reducing individual autonomy, including what can be perceived as self-destructive behavior.” Comment: while smoking and nutrition are important public health issues this comment in the New England Journal raises the issue of public health rapidly becoming a police system rather than an educational system. We ne... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=4968530 Thu, 23 Jun 2011 17:37:36 +0100 4968530 http://www.medworm.com/index.php?rid=4968532&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F06%2Fiuds-implants-are-most-effective-reversible-contraceptives-available.html "Encouraging the use of [long-acting reversible contraception] methods for appropriate candidates may help lower U.S. unintended pregnancy rates because gaps in use and discontinuation of shorter-acting methods are associated with unintended pregnancy rates in high-risk women," ACOG stated. Practice Bulletin #121 "Long-Acting Reversible Contraception: Implants and Intrauterine Devices" is published in the July 2011 issue of Obstetrics & Gynecology (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=4968532 Thu, 23 Jun 2011 17:33:58 +0100 4968532 http://www.medworm.com/index.php?rid=4911525&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F06%2Flow-t-a-myth.html ScienceDaily - A decline in testosterone levels as men grow older is likely the result -- not the cause -- of deteriorating general health, say Australian scientists, whose new study finds that age, in itself, has no effect on testosterone level in healthy older men. The results were presented June 6 at The Endocrine Society's 93rd Annual Meeting in Boston. Some researchers believe that an age-related testosterone deficiency contributes to the deteriorating health of older men and causes nonspecific symptoms, such as tiredness and loss of libido”. Handelsman and his team, however, found that serum (blood) testosterone levels did not decline with increasing age in older men who reported being in excellent health with no symptoms to complain of. Comment: This is unlikely to affect the ... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=4911525 Wed, 08 Jun 2011 18:28:50 +0100 4911525 http://www.medworm.com/index.php?rid=4911526&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F06%2Fstudy-predicts-up-to-30-of-companies-will-stop-offering-health-insurance-1.html The National Journal (6/7, "The more a company knows about coming changes to the nation's health care laws, the more likely it is to consider radically restructuring the way it provides insurance to employees, according to a study by the consulting firm McKinsey and Co." In fact, "the study, which is being circulated among Republicans, predicts that as many as 30 percent of companies will stop offering health insurance benefits, reduce the level of benefits, or offer benefits only to certain employees." Should this prediction come to pass, "the number of Americans who could see changes to their health insurance would be far more than the 9 million to 10 million estimated by the Congressional Budget Office." Comment, All these companies are doing is asking government to solve their problems... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=4911526 Wed, 08 Jun 2011 18:27:05 +0100 4911526 http://www.medworm.com/index.php?rid=4902449&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F06%2Fis-our-obsession-with-cleanliness-wiping-out-our-immune-system.html Prof Fazekas de St Groth from the Centenary Institute claims that the discovery of a small but absolutely essential subset of T cells within the immune system has been vital. Regulatory T cells or Tregs control unwanted immune responses, such as allergies and autoimmune diseases. Tregs are distributed throughout the body, particularly at points where we are likely to encounter disease-causing microbes. The most important site is the gastrointestinal tract (the GIT) where up to 90% of our immune cells are located. This ties in neatly with the hygiene hypothesis because it explains how an infectious event early in life colonization of the gut with bowel flora) can produce a life-long effect on the immune system. (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=4902449 Mon, 06 Jun 2011 15:08:15 +0100 4902449 http://www.medworm.com/index.php?rid=4872124&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F05%2Fwomen-who-start-prenatal-vitamins-early-are-less-likely-to-have-children-with-autism.html ScienceDaily: Women who reported not taking a daily prenatal vitamin immediately before and during the first month of pregnancy were nearly twice as likely to have a child with an autism spectrum disorder as women who did take the supplements -- and the associated risk rose to seven times as great when combined with a high-risk genetic make-up, a study by researchers at the UC Davis MIND Institute has found. “The good news is that if this finding is replicated, it will provide an inexpensive, relatively simple evidence-based action that women can take to reduce risks for their child, which is to take prenatal vitamins as early as possible in a pregnancy and even when planning for pregnancy,” (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=4872124 Thu, 26 May 2011 14:16:25 +0100 4872124 http://www.medworm.com/index.php?rid=4847979&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F05%2Fburden-of-acute-otitis-externa.html Also, from today's MMWR we are reminded that summer and the swimming season are upon us and that the annual problem of "swimmers ear" can be avoided by careful attention to ear hygiene and keep the ears dry after swimming. Ambulatory-care visits for swimmers ear during 2003--2007 were highest among children aged 5--9 years. (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=4847979 Fri, 20 May 2011 15:55:08 +0100 4847979 http://www.medworm.com/index.php?rid=4847980&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F05%2Fcdc-identifies-10-public-health-achievements-of-first-decade.html The 10 domestic public health achievements are published in today's issue of CDC's MMWR. “Americans are living longer, healthier, and more productive lives than ever before thanks in part to extraordinary achievements in public health over the past decade," said CDC Director Thomas R. Frieden, M.D., M.P.H. The United States has saved billions of dollars in healthcare costs as a result of these achievements. (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=4847980 Fri, 20 May 2011 15:52:41 +0100 4847980 http://www.medworm.com/index.php?rid=4847981&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F05%2Fsteep-price-for-high-rates-of-unintended-pregnancy.html Two new studies taking different methodological approaches arrive at the same conclusion: Unintended pregnancy costs U.S. taxpayers roughly $11 billion each year. Both estimates are conservative in that they are limited to public insurance costs for pregnancy and first-year infant care, and both studies conclude that the potential public savings from reducing unintended pregnancy in the United States would be huge. A related new study provides first-ever estimates of unintended pregnancy for each state, and a starting point for future efforts to monitor states’ progress toward reducing unintended pregnancy. Comment: Yet, as usual, most politicians are blind to data and many want to cut funding for Planned Parenthood! (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=4847981 Fri, 20 May 2011 15:46:55 +0100 4847981 http://www.medworm.com/index.php?rid=4803171&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F05%2Fevidence-contravenes-nuke-plant-leukemia-link.html Children living within 5 kilometers of a nuclear power plant are not at an increased risk for developing leukemia, according to an analysis released last week by an independent government advisory committee in the United Kingdom. The report covered a period of 35 years and studied the incidence of the cancer in children under the age of 5 living in close proximity to the UK’s 13 nuclear power stations. Comment: With all the current anxiety about radiation exposure, this  very long study is well worth waiting for. (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=4803171 Mon, 09 May 2011 22:15:38 +0100 4803171 http://www.medworm.com/index.php?rid=4794871&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F05%2Fonly-a-fifth-of-us-medical-students-choose-primary-care.html Far fewer US medical students plan to go into primary care than two decades ago, a recent analysis shows. Surveys of graduating students in 1990 and 2007 show that although roughly a quarter of graduating medical students in both years planned to go into internal medicine, the proportion planning to go into general internal medicine fell from 9% to 2%. Medical students are increasingly likely to an average educational debt of $158 000 and an overall average debt of $132 000. The Association of American Medical Colleges says that the overall shortage of doctors was already acute before the recent health reforms(ACA), but increased demand from newly insured patients will mean even greater stress on the system. The association projects a shortage of 63 000 doctors by 2015 and 130 600 ... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=4794871 Fri, 06 May 2011 15:58:47 +0100 4794871 http://www.medworm.com/index.php?rid=4775415&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F05%2Fmedical-costs-for-youth-with-diabetes-more-than-9000-a-year.html "Young people with diabetes face medical costs that are six times higher than their peers without diabetes," said Ann Albright, Ph.D., R.D., director of CDC's Division of Diabetes Translation. "Most youth with diabetes need insulin to survive and the medical costs for young people on insulin were almost 65 percent higher than for those who did not require insulin to treat their diabetes." Comment: Early diagnosis and intervention can iimit the cost but this is a lifetime issue for these children. For families without insurance this cost may be insurmountable. (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=4775415 Mon, 02 May 2011 13:36:34 +0100 4775415 http://www.medworm.com/index.php?rid=4768017&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F04%2Fstrengthening-the-regulation-of-herbal-medicines-in-europe.html To protect consumers, the European Parliament and Council adopted the Traditional Herbal Medicinal Products Directive, 2004/24/EC on March 31, 2004. The Directive requires all herbal medicinal products to meet standards of quality, safety, and efficacy before they can be registered and marketed in the European Union (EU).  Comment: It is high time for the U.S. to follow Europe’s lead with all the scams foisted on us by ‘herbal’ and complementary medical advocates. (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=4768017 Sat, 30 Apr 2011 15:47:15 +0100 4768017 http://www.medworm.com/index.php?rid=4768018&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F04%2Fhealth-literacy-tests-underutilized-may-improve-elderly-cancer-patients-care-and-outcomes.html Low health literacy is a significant barrier to quality care, especially among elderly patients, but increased use of simple and effective health literacy assessment tests by nurses and clinicians can help improve communication and health outcomes. Comment: The gap between physicians and their patients has not changes significantly despite exhortation to clinicians to do a better job. Better assessment of patient health literacy needs to be made for all clinical encounters. (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=4768018 Sat, 30 Apr 2011 15:45:56 +0100 4768018 http://www.medworm.com/index.php?rid=4723871&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F04%2Fsteps-to-preserve-privacy-may-compromise-emr-usability.html The Chicago Tribune (4/12) reported that physicians, hospitals, and the "vendors that create the systems" that store EMRs have been "working on preventing breaches and protecting privacy." However, the same safeguards that "keep the world from learning you have a history of mental illness or are at a high risk for uterine cancer might make it harder to deliver critical information about your health" to an emergency department physician. Moreover, as with paper records, "both federal law and institutional policies impose stiff penalties for spying." In clinical care, EMRs can "create a conflict between hassle and security," meaning a physician "might have to enter several commands when consulting on a case by smartphone or other mobile device." (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=4723871 Sun, 17 Apr 2011 22:02:31 +0100 4723871 http://www.medworm.com/index.php?rid=4723872&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F04%2Fdartmouth-researchers-release-report-on-end-of-life-care.html The New York Times (4/12, A22,) reports, "At the end of life, people with chronic diseases like cancer get more aggressive medical care in the New York area than anyplace else in the country, continuing a trend going back decades, according to a report released on Monday by researchers at Dartmouth College." The researchers, who "looked at federal data from 2007, the most recent year available, found that 46 percent of chronically ill patients in the Manhattan hospital region, which also covers most of Brooklyn and Staten Island, were being treated at hospitals when they died, as opposed to dying at home or in hospices or nursing homes. That rate was the highest in the country." (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=4723872 Sun, 17 Apr 2011 22:00:41 +0100 4723872 http://www.medworm.com/index.php?rid=4636618&cid=t_92698_136_f&fid=35316&url=http%3A%2F%2Fnotjustaboutcancer.blogspot.com%2F2011%2F03%2Fgiving-in-to-monkey-brain.html HerceptinI think I'm happy with the outcome of the brouhaha over Herceptin in Ontario. For those of you outside the province or outside the loop. Jill Anzarut, a 35 year old breast woman undergoing treatment for breast cancer made the news last week when she announced that the province had to pay for Herceptin because her Her2+ tumour was less than one centimetre (that's about 1/4 inch) in diameter. The province initially refused to budge but eventually caved after a massive campaign played out in the social and traditional media. Access to Herceptin will now much more room for discretion when it comes to providing access to the drug.I feel good about this. It's not that I think that every drug should be funded for every person. Her2+ cancers are very aggressive and, as best put by Stephen... Not just about cancer blogs http://www.medworm.com/rss/comments.php?id=4636618 Fri, 25 Mar 2011 17:33:00 +0100 4636618 http://www.medworm.com/index.php?rid=4615140&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F03%2Faltered-gene-protects-some-african-americans-from-coronary-artery-disease.html ScienceDaily (Mar. 17, 2011) — A team of scientists at Johns Hopkins and elsewhere has discovered that a single alteration in the genetic code of about a fourth of African-Americans helps protect them from coronary artery disease, the leading cause of death in Americans of all races. Specifically, the study showed that otherwise healthy African-American men and women with the alternative genetic code had a fivefold reduction in the likelihood that their arteries would narrow or clog. (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=4615140 Sun, 20 Mar 2011 16:25:10 +0100 4615140 http://www.medworm.com/index.php?rid=4615141&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F03%2Fchildren-with-a-medical-home-receive-better-health-care.html The "medical home" has been endorsed as a standard of primary care, in which patients have access to health care that is accessible, continuous, comprehensive, family-centered, coordinated, compassionate and culturally effective (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=4615141 Sun, 20 Mar 2011 16:23:29 +0100 4615141 http://www.medworm.com/index.php?rid=4615144&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F03%2Fhigh-volume-portable-music-players-may-impair-ability-to-clearly-discriminate-sounds.html Listening to loud music through earphones for extended periods in noisy surroundings can cause neurophysiological changes related to clear discrimination of sounds, even if the hearing threshold is normal, new research shows. (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=4615144 Sun, 20 Mar 2011 16:16:53 +0100 4615144 http://www.medworm.com/index.php?rid=4600488&cid=t_92698_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F03%2F15%2Fquality-in-primary-care-2010-vol-18-no-6%2F Quality in Primary Care 2010 v. 18(6) Contents Page Fade Fave:Physician-community health worker partnering to support diabetes self-management in primary care Fade Skinny: The role of community health workers (CHWs) has expanded from outreach and education to working within a clinical team in a primary care setting. The aim of this study is to improve self-management among patients with type 2 diabetes incorporating CHWs as members of a clinical team. The article concludes that Physician-CHW partnership had a positive impact on patients’ self-management skills and clinical outcomes. Patients and physicians also had higher satisfaction with overall care. With appropriate training, CHWs can collaborate as team members with primary care providers and with non-medical providers to impro... Fade Library blogs http://www.medworm.com/rss/comments.php?id=4600488 Tue, 15 Mar 2011 11:47:51 +0100 4600488 http://www.medworm.com/index.php?rid=4570563&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F03%2Fmany-with-borderline-hypertension-may-never-develop-life-threatening-problems.html The New York Times (3/9, Parker-Pope) "Well" blog reported, "Millions of people who have been told they are on the path to hypertension may never develop life-threatening problems," according to a study published in the Journal of General Internal Medicine. After reviewing 20 years' worth of blood pressure data on some 20,000 adults, researchers found that people with borderline hypertension, that is, blood pressure slightly above 120/80, "are not any more likely to die prematurely than those with lower blood pressures." The study's lead author stated, "If we intervene with these people who don't have a lot of risk, maybe we're going to cause more harm than benefit." Comment: it is important to keep re-examining our current beliefs about medical care as more and more evidence appears about... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=4570563 Thu, 10 Mar 2011 16:36:25 +0100 4570563 http://www.medworm.com/index.php?rid=4570565&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F03%2Fyoung-adults-with-chronic-illnesses-have-poorer-educational-vocational-and-financial-outcomes.html Most young adults who grow up with chronic illness graduate high school and have employment, but those with cancer, diabetes, or epilepsy are significantly less likely than their healthy peers to achieve important educational and vocational milestones, according to a report in the March issue of Archives of Pediatrics and Adolescent Medicine. (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=4570565 Thu, 10 Mar 2011 16:29:22 +0100 4570565 http://www.medworm.com/index.php?rid=4489700&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F02%2Fvillages-without-doctors.html An exciting article in today’s NYT:  Very appropriate for those study public health.The strategy is to move beyond doctors — to take the work of health care and shift down from doctors and nurses to lay people, peers and family.  In the United States and other wealthy countries, lay people can fill in the gaps in left by doctors’ care.  In poor countries, people with no or little formal medical training are successfully substituting for doctors and nurses. (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=4489700 Thu, 17 Feb 2011 15:59:46 +0100 4489700 http://www.medworm.com/index.php?rid=4399546&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F01%2Fthe-high-risk-of-energy-drinks.html a commentary in JAMA, today, suggests that regular (nonalcoholic) energy drinks might pose just as great a threat to individual and public health and safety at alcohol and other addictive drugs. Energy drinks are beverages that contain modest to relatively high levels and concentrations of caffeine. Energy drink use is highly prevalent, constituting a $5.4 billion market in 2006 in the United States alone. Most concerning is the possibility that caffeine's neuropharmacologic effects might play a role in the propensity for addiction. Comment: almost any TV program today will contain ads for using energy drinks. There's no data to show in fact that these energy drinks produce energy, the data given with them shows only three or 4 Cal per drink. All these drinks can do is make you feel like y... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=4399546 Wed, 26 Jan 2011 17:44:35 +0100 4399546 http://www.medworm.com/index.php?rid=4352734&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F01%2Fcdc-health-disparities-and-inequalities-report-united-states-2011.html Since 1946, CDC has monitored and responded to challenges in the nation's health, with particular focus on reducing gaps between the least and most vulnerable U.S. residents in illness, injury, risk behaviors, use of preventive health services, exposure to environmental hazards, and premature death. We continue that commitment to socioeconomic justice and shared responsibility with the release of CDC Health Disparities and Inequalities in the United States -- 2011, the first in a periodic series of reports examining disparities in selected social and health indicators. (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=4352734 Sat, 15 Jan 2011 17:53:11 +0100 4352734 http://www.medworm.com/index.php?rid=4337980&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F01%2Fthe-cbo-is-telling-us-something-is-anybody-listening.html From the KFF: Under the baseline scenario, deficits are negative or very small from 2015 through 2085. However, to accomplish this balancing of the books, government revenue (taxes) must increase dramatically to keep pace with the growth in spending on health care programs. In fact, tax receipts must roughly double in the next 75 years, growing well beyond the stable postwar level, which has been below about 20.5 percent of the gross domestic product in all years since 1945. Comment: this piece from the KFF is worth reading as it points out some the problems with the CBO data set and the fact that currently there is no effort to control spending in the healthcare field. (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=4337980 Wed, 12 Jan 2011 17:51:29 +0100 4337980 http://www.medworm.com/index.php?rid=4322529&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F01%2Fbritish-medical-journal-declares-mmr-study-an-elaborate-fraud----autism-claims-likened-to-piltdown-m.html (January 6, 2011) -- The British Medical Journal has declared the 1998 Lancet paper that implied a link between the MMR vaccine and autism "an elaborate fraud." Comment: It is unfortunate than a number of major journals still print articles with very poor research data and later have to retract the article. What is even worse is the cost to national health programs around the world that then have to prove to the populations they serve that immunizations work and do not have these unanticipated side effects. I know that when I was Commissioner of health for Virginia we had to perform a number of studies that took away from services to the general population because legislators wanted to know that the activist statements were all crap it were not correct. (Source: Dr. Buttery's Public Health... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=4322529 Fri, 07 Jan 2011 19:16:34 +0100 4322529 http://www.medworm.com/index.php?rid=4322530&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2011%2F01%2Fusing-cassava-to-address-vitamin-a-deficiency.html In ScienceDaily today:  The roots of cassava (Manihot esculenta) serve as the primary source of carbohydrates in the diets of people in many arid regions of the world, including more than 250 million people in sub-Saharan Africa. A collaborative effort led by Professor Peter Beyer from Freiberg University in Germany, studied a naturally arising variant of cassava with yellow roots in order to understand the synthesis of provitamin A carotenoids. This work beautifully combines genetics with biochemistry and molecular biology to deepen our understanding of carotenoid biosynthesis. "It paves the way for using transgenic or conventional breeding methods to generate commercial cassava cultivars containing high levels of provitamin A carotenoids, by the exchange of a single amino acid alrea... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=4322530 Fri, 07 Jan 2011 19:15:32 +0100 4322530 http://www.medworm.com/index.php?rid=4265791&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2010%2F12%2Fe-cigs-less-dangerous.html ScienceDaily (Dec. 16) — In a new report that bucks the concerns raised by the Food and Drug Administration, a Boston University School of Public Health (BUSPH) researcher concludes that electronic cigarettes are much safer than real cigarettes and show promise in the fight against tobacco-related diseases and death. The review, which will be published online ahead of print this month in the Journal of Public Health Policy, is the first to comprehensively examine scientific evidence about the safety and effectiveness of electronic cigarettes, also known as e-cigarettes, said Michael Siegel, professor of community health sciences at BUSPH. “Taking these products off the market would force thousands of users to return to cigarette smoking," Siegel said. "Why would the FDA and the... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=4265791 Fri, 17 Dec 2010 19:21:20 +0100 4265791 http://www.medworm.com/index.php?rid=4249071&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2010%2F12%2Fhospital-admissions-for-dog-bites-increase-86-percent.html A new report from the AHRQ shows that dog bites increased by 86 percent—from 5,100 to 9,500 hospital stays—between 1993 and 2008. Seniors and young children were most likely to be hospitalized for a dog bite, while Rural residents also had 3 times as many hospital admissions. Comment:  This is the tip of the iceberg, dog bites are an increasing public health problem, compounded by many police departments and judges treating the issue lightly. (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=4249071 Fri, 10 Dec 2010 16:10:31 +0100 4249071 http://www.medworm.com/index.php?rid=4162938&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2010%2F11%2Fyoung-unsupervised-children-most-at-risk-for-dog-bites-study-shows-dogs-often-target-a-childs-face-a.html ScienceDaily (Nov. 9, 2010) — As dog bites become an increasingly major public health concern, a new study shows that unsupervised children are most at risk for bites, that the culprits are usually family pets and if they bite once, they will bite again with the second attack often more brutal than the first. The study, the largest of its kind, was done by Vikram Durairaj, MD, of the University of Colorado School of Medicine, who found that dogs usually target a child's face and eyes and most often it's a breed considered 'good' with children, like a Labrador retriever. Durairaj said. "The onus is on parents to recognize aggressive breeds as well as behaviors and never allow their young children to be left unsupervised around any dog." Comment: it is also worth reading today's editor... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=4162938 Fri, 12 Nov 2010 20:24:28 +0100 4162938 http://www.medworm.com/index.php?rid=4155235&cid=t_92698_87_f&fid=39187&url=http%3A%2F%2Fbuzcooper.files.wordpress.com%2F2010%2F11%2Fgrand-junction-comparison.png In a high-profile paper in the September issue of Health Affairs, Thorson and coworkers showed that the care at St. Mary’s Hospital in Grand Junction, CO was superior to that of 20 other unnamed hospitals. Grand Junction is, of course the smal town in SW Colorado that became famous when President Obama visited there during the health care reform debates during the summer of 2009, and here’s what he said: “Hello, Grand Junction! It’s great to be back in Southwest Colorado. Here in Grand Junction, you know that lowering costs is possible if you put in place smarter incentives; if you think about how to treat people, not just illnesses. That’s what the medical community in this city did; now you are getting better results while wasting less money.” So, Grand Junction, a town of 58... Better Health blogs http://www.medworm.com/rss/comments.php?id=4155235 Wed, 10 Nov 2010 22:00:35 +0100 4155235 http://www.medworm.com/index.php?rid=4151821&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2010%2F11%2Fmyth-of-a-germ-free-world.html ScienceDaily (Nov. 9, 2010) — Killing microorganisms has become a national obsession. A pair of antimicrobial compounds known as triclosan and triclocarban are lately the weapons of choice in our war of attrition against the microbial world. Both chemicals are found in an array of personal care products like antimicrobial soaps, and triclosan also is formulated into everyday items ranging from plastics and toys to articles of clothing. Antimicrobials have become a billion dollar a year industry and these chemicals now pervade the environment and our bodies. Levels of triclosan in humans have increased by an average of 50 percent since 2004, according to newly updated data from the Centers for Disease Control and Prevention (CDC).Triclosan and triclocarban are present in 60 percent of... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=4151821 Wed, 10 Nov 2010 17:29:38 +0100 4151821 http://www.medworm.com/index.php?rid=4121852&cid=t_92698_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fsugar-consumption-a-deliciously-disgusting-ad-campaign%2F2010.10.31 New York City’s war on sugary soft drinks had to balance evidence-based medicine with a short, simple message that would go viral in the community. Going viral won, according to e-mails of internal discussions between the city’s health commissioner, his staff, and the ad agency that crafted the campaign. The statement that soda would cause a person to gain 10 pounds a year is contingent upon many factors, argued the staff, but the desire to produce a media message with impact overruled the details. One nutritionist called the campaign “deliciously disgusting.” Chocolate may moderate HDL cholesterol in type 2 diabetics, according to the November issue of Diabetic Medicine. High polyphenol chocolate increased HDL cholesterol in diabetics without affecting weight, insu... Better Health blogs http://www.medworm.com/rss/comments.php?id=4121852 Sun, 31 Oct 2010 12:00:00 +0100 4121852 http://www.medworm.com/index.php?rid=4097987&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2010%2F10%2Ffda-heightens-focus-on-retail-food-safety.html A component of the 10-year study, the 2009 retail food report, found that the presence of a certified food protection manager in four facility types was correlated with statistically significant higher compliance levels with food safety practices and behaviors than in facilities lacking a certified manager. For instance, compliance in full service restaurants was 70 percent with a manager, versus 58 percent without a manager. In delicatessens, compliance was 79 percent with a manager, versus 64 percent without. For seafood markets, compliance with a manager was 88 percent, versus 82 percent without. And in produce markets, compliance was 86 percent with a manager, versus 79 percent without. Comment: it takes a long time for change to take place in the public health arena. When health ... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=4097987 Sat, 23 Oct 2010 19:49:52 +0100 4097987 http://www.medworm.com/index.php?rid=4097939&cid=t_92698_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmore-unvaccinated-children-cause-public-health-fears-to-increase%2F2010.10.22 Dr. Robert Sears’ The Vaccine Book, is, as Dr. Rahul Parikh puts it, “a nightmare for pediatricians like me.” In a piece from Salon, Dr. Parikh brings his issues to the author. The controversy of the book is the so-called “alternative vaccine schedule,” which, as vaccine developer Paul Offit puts it: …is “misrepresentation of vaccine science” that “misinforms parents trying to make the right decision for their children” in the Journal of Pediatrics. And yet, as a pediatrician myself, I have seen an increasing number of caring, reasonable parents hold it up like a bible in my practice (and that of my colleagues). This post, however,  isn’t about the vaccine controversy — I’ll leave you to read Dr. Parikh’s excellent piece for yourself. What I found interest... Better Health blogs http://www.medworm.com/rss/comments.php?id=4097939 Fri, 22 Oct 2010 20:00:28 +0100 4097939 http://www.medworm.com/index.php?rid=4013209&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2010%2F09%2Foverloading-the-emergency-rooms.html In  a letter to the editor of the New York Times (9/28, A28), Angela Gardner, MD, president of the American College of Emergency Physicians, writes in response to a Sept. 22 editorial, saying that it "raises critical issues about the high costs" of the Medicaid "program, but misses an important point and a fundamental problem. That is -- Medicaid pays so poorly in some states that many physicians will not see Medicaid patients."  Comment: In 1968, while director of the Portsmouth City health department, I obtained a grant to study the value of developing counselors for seniors new to the Medicare program, to see if they could encourage seniors to join the program. The most interesting thing about this project was that when seniors who had previously not had medical care entered t... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=4013209 Tue, 28 Sep 2010 16:20:06 +0100 4013209 http://www.medworm.com/index.php?rid=3902918&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2010%2F08%2Fmenu-labeling-provisions-of-section-4205-of-the-patient-protection-and-affordable-care-act-of-2010.html For chain retail food establishments, the provisions that became requirements immediately upon enactment of the law include: (1) Disclosing the number of calories in each standard menu item on menus and menu boards, (2) Making additional written nutrition information available to consumers upon request, (3) Providing a statement on menus and menu boards about the availability of the additional nutrition information, and (4) Providing calorie information (per serving or per food item) for most self-service items and food on display, on a sign adjacent to each food item.   Who would have thought that the recently passed health care program would include instructions for restaurants on the content of their menus? There's probably little doubt that providing calorie values will be helpful... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=3902918 Wed, 25 Aug 2010 16:14:29 +0100 3902918 http://www.medworm.com/index.php?rid=3895834&cid=t_92698_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2010%2F08%2Fmaking-community-health-agency-into.html As we predicted, it seems that the US Internal Revenue Service's (IRS) increased reporting requirements for not-for-profit organizations are leading to more examples of the coziness now prevalent among the top leaders of such organizations.  The latest entry in this new parade comes from a story in the Bradenton (Florida) Herald about a not-for-profit community health agency whose mission is to provide health care to the poor and disenfranchised:Providing medical services to the indigent and uninsured in Manatee and Sarasota counties has financially benefitted some of Manatee County Rural Health Services Inc.’s officers, board members and their families, records show.The nonprofit agency has paid nearly $2 million in recent years to businesses owned by board members, officers, emplo... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=3895834 Mon, 23 Aug 2010 20:30:00 +0100 3895834 http://www.medworm.com/index.php?rid=3895908&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2010%2F08%2Fprimary-care-doctors-saying-no-to-191000-a-year.html From Time Magazine this week: the education pipeline offers no hint of improvement. Less than 2% of current medical students are interested in general internal medicine and 4.9% in family-care practice, says a study by Dr. Karen Hauer, published in the Journal of the American Medical Association. The average medical-school student graduates with $200,000 in loans, according to the American Academy of Family Physicians (AAFP). This doesn't include their debt related to four years of undergraduate study. For some students the total debt burden can reach nearly $500,000 — a daunting sum that puts many of them off family medicine. "Unless more primary-care physicians are recruited, we estimate a shortage of 30,000 doctors by 2015," says Dr. Atul Grover, chief advocacy officer for the AA... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=3895908 Mon, 23 Aug 2010 16:10:30 +0100 3895908 http://www.medworm.com/index.php?rid=3880887&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2010%2F08%2Fhearing-loss-in-us-teens-increased-in-prevalence-in-the-previous-15-years.html Researchers at Brigham and Women’s Hospital determined that hearing loss in adolescents has increased over the past 15 years. The findings are published in the August 18 issue of the Journal of the American Medical Association. Comment: occupational health experts have known for decades that loud noises are injurious to hearing. In the military those exposed to repeated loud noises such as artillery, without a hearing protection, develop hearing loss as do workers in heavy industry and the road work. This is not a new finding and has been reported for at least three decades since the effect of loud music on adolescent hearing has been evaluated. Along with low-level lead poisoning these two problems may be significant enough to lower educational attainment of many young people. (Sour... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=3880887 Wed, 18 Aug 2010 17:35:01 +0100 3880887 http://www.medworm.com/index.php?rid=3872584&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2010%2F08%2Fcan-obesity-prevention-begin-before-birth.html David Ludwig’s research from Children's Hospital, Boston found that women who gain excessive weight during pregnancy tend to give birth to heavier infants.  For example, women gaining 44 to 49 pounds were 1.7 times more likely to have a high birth weight baby than those gaining just 18 to 22 pounds. Women who gained more than 53 pounds were 2.3 times more likely to do so. Because our study involved comparisons of infants born to the same mother, we can be confident that this effect is not due to genetics. (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=3872584 Mon, 16 Aug 2010 16:32:19 +0100 3872584 http://www.medworm.com/index.php?rid=3845121&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2010%2F08%2Ftop-gp-condemns-britons-for-recklessly-neglecting-their-health.html From the Observer newspaper in the UK today, Britain's top GP today launches a scathing attack on widespread reckless public behavior towards food, alcohol and cigarettes, which he claims is causing growing levels of disease and early death. In a dramatic intervention in the public health debate, Professor Steve Field criticizes parents, mothers-to-be, the very overweight, smokers and drinkers for damaging their own health, or their children's, through irresponsible actions. Comment: these comments coincide with the excellent report provided in our local newspaper today by Tammie Smith, on the potential for improving prevention of disease provided by the new health reform programs. (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=3845121 Sun, 08 Aug 2010 19:18:20 +0100 3845121 http://www.medworm.com/index.php?rid=3868825&cid=t_92698_123_f&fid=38598&url=http%3A%2F%2Fwww.pediatricsnow.com%2Fblog%2F2010%2F08%2Ftraffic-school-run-red-yellow-lights%2F I live in an area where there are some fun areas to walk to. To get to my favorite rehydrating spot, I have to first cross one sticky intersection. (Source: Dr. Gwenn Is In) Dr. Gwenn Is In blogs http://www.medworm.com/rss/comments.php?id=3868825 Mon, 02 Aug 2010 14:54:36 +0100 3868825 http://www.medworm.com/index.php?rid=3794816&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2010%2F07%2Faging-population-faces-geriatrician-shortage.html The CBS Evening News (7/25, story) reported, "Another crisis may be brewing at the other end of the age spectrum as baby boomers age by the millions, and the number of doctors trying to care for them shrinks." Notably, "there are just over 7,000 certified geriatricians in the United States. It's estimated" that 16,000 are currently needed and that "by 2030," there will be a need for "36,000 geriatricians to care for an aging population. Still, it's a specialty that attracts few new doctors." Among the factors contributing to the shortage in geriatricians are the "anti-aging" sentiments of society at large, as well as "an average income...much lower than other specialties." Nonetheless, "a study of job satisfaction among doctors showed geriatricians are the most satisfied." Comment: this is... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=3794816 Tue, 27 Jul 2010 17:54:11 +0100 3794816 http://www.medworm.com/index.php?rid=3784282&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2010%2F07%2Fa-worthwhile-link-from-dhhs.html Quick Guide to Healthy Living (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=3784282 Fri, 23 Jul 2010 15:52:50 +0100 3784282 http://www.medworm.com/index.php?rid=3740614&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2010%2F07%2Fscientists-criticize-study-on-genetics-of-old-age.html A study on the genetics of centenarians that was published last week in Science, a leading scientific journal, has come under criticism from geneticists who say it has obvious weaknesses, is probably incorrect and should not have been published in a premier journal. The study, which received broad press coverage, said that 150 genetic variants predictive of longevity had been identified among New England centenarians and that a test based on those variants could predict who would live to extreme old age. Comment: it is interesting that others are also raising the question of the utility of studies published in Science last week on longevity. I think the geneticists criticizing the articles have an excellent point. that a study in New England identified certain genes in older people fails t... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=3740614 Fri, 09 Jul 2010 16:54:32 +0100 3740614 http://www.medworm.com/index.php?rid=3733104&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2010%2F07%2Frestoring-health-the-health-reform.html This article is well worth reading in its entirety as JAMA has become an important public health journal that links medical care and public health care together as a congruent whole. (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=3733104 Wed, 07 Jul 2010 16:21:02 +0100 3733104 http://www.medworm.com/index.php?rid=3721785&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2010%2F07%2Fepigenetics.html Does Methylation of genes really affect human behavior. A fascinating article in this week's science discusses the role of every genetics and differences of social behavior between those two private of stimulation at him falling off and of those not so affected. In other words is there a is there a genetic or epigenetic calls for the difference between different socioeconomic classes. The theory is fascinating there is little evidence that this actually occurs in humans but the article is well worth reading. DOI: 10.1126/science.329.5987.24 (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=3721785 Fri, 02 Jul 2010 16:38:01 +0100 3721785 http://www.medworm.com/index.php?rid=3721786&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2010%2F07%2Fmobile-phone-base-stations-and-early-childhood-cancers.html Another news media driven topic has fallen short of reality. The study reported this week in the BMJ concludes : the there is no association between risk of early childhood cancers and estimates of the mother’s exposure to mobile phone base stations during pregnancy.” BMJ 2010;340:c3077. Comment: physicians are repeatedly hammered with the need to consider ethics in both research and relationships, yet the news media seems to have no ethical standard for reporting anything and rushes to promote anything some activist group propounds. (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=3721786 Fri, 02 Jul 2010 16:36:08 +0100 3721786 http://www.medworm.com/index.php?rid=3714213&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2010%2F06%2Ffindings-make-early-parental-action-with-daughters-even-more-critical.html Survey data released today by the Partnership for a Drug-Free America® and MetLife Foundation found that teenage girls are more likely than teenage boys to perceive potential benefits from drug use and drinking, making teen girls more vulnerable to drug and alcohol abuse.  “Parents of teen girls have to be especially attentive to their daughters’ moods and mental health needs, which can have a direct effect on their child’s decision to risk her health by getting high and drinking,” said Partnership President and CEO Steve Pasierb. (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=3714213 Wed, 30 Jun 2010 18:02:44 +0100 3714213 http://www.medworm.com/index.php?rid=3714214&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2010%2F06%2Ff-as-in-fat-how-obesity-threatens-americas-future-2010.html Trust for America’s health has a new report n the increasing epidemic of obesity in the US, that is worth visiting, the graphics of the statewide differences between adult and juvenile obesity is fascinating. Adult obesity rates increased in 28 states in the past year, and declined only in the District of Columbia (D.C.), according to F as in Fat: How Obesity Threatens America's Future 2010, a report from the Trust for America's Health (TFAH) and the Robert Wood Johnson Foundation (RWJF). More than two-thirds of states (38) have adult obesity rates above 25 percent. In 1991, no state had an obesity rate above 20 percent. The report also includes obesity rates among youths ages 10-17, and the results of a new poll on childhood obesity conducted by Greenberg Quinlan Rosner Re... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=3714214 Wed, 30 Jun 2010 17:58:37 +0100 3714214 http://www.medworm.com/index.php?rid=3706696&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2010%2F06%2Flow-immunization-rates-may-be-linked-to-epidemic-spread-of-whooping-cough-in-california.html California is one of only 11 states that does not require middle school students to receive a booster shot against whooping cough. As a result, just 43.7% of California adolescents had the vaccine for whooping cough, known as Tdap, in 2008, according to the CDC.  What's more, the state is the only one in the nation to report such a dramatic surge in pertussis. Comment: this is not particularly surprising considering the activism about autism on the West Coast and the misinformation engendered by the West Coast media. (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=3706696 Mon, 28 Jun 2010 16:36:17 +0100 3706696 http://www.medworm.com/index.php?rid=3706698&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2010%2F06%2Fimplications-for-framing-health-disparities.html A new report from the IOM released today, Health Disparities, sometimes relate to personal choice but also occur as a result of variations in income, language proficiency, health insurance status, culture, neighborhood features, and many other factors. However, the public, media, and policymakers often see these gaps as a result of individual choice alone. Therefore, public health officials can face difficulties in drawing attention to health disparities or gaining funding for programs to reduce health disparities. Public health officials are searching for ways to encourage people to see reducing health disparities as a matter of social, rather than personal, responsibility. (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=3706698 Mon, 28 Jun 2010 16:31:17 +0100 3706698 http://www.medworm.com/index.php?rid=3702957&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2010%2F06%2Fdeath-rates-for-leading-causes-among-youths-aged-12-to-19-years-us-1999---2006.html Note the that the major causes of death in this age group are violence, see first three columns. (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=3702957 Sun, 27 Jun 2010 23:20:05 +0100 3702957 http://www.medworm.com/index.php?rid=3695593&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2010%2F06%2Fperformance-of-the-us-health-care-system-compared-2010-update.html This report—an update to three earlier editions—includes data from seven countries and incorporates patients' and physicians' survey results on care experiences and ratings on dimensions of care. Compared with six other nations—Australia, Canada, Germany, the Netherlands, New Zealand, and the United Kingdom—the U.S. health care system ranks last or next-to-last on five dimensions of a high performance health system: quality, access, efficiency, equity, and healthy lives. (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=3695593 Thu, 24 Jun 2010 15:34:14 +0100 3695593 http://www.medworm.com/index.php?rid=3676684&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2010%2F06%2Fground-zero-health-deal-faces-hurdles.html The Wall Street Journal, yesterday, discuss details of the payout negotiated for potential have actual losses resulting from working at the two Towers site following the destruction. The biggest problem following many of those with real disease with the help is that much of the money will be spent on people for whom there is no current disease 10 years later, many of for one have no evidence that what they were even at the disaster site. “Comment”: This is one the big problems of occupational health that there are often claims for disease without reasonable documentation of either exposure or a biologically relevant course of disease. (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=3676684 Fri, 18 Jun 2010 22:11:12 +0100 3676684 http://www.medworm.com/index.php?rid=3676685&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2010%2F06%2Fmedical-school-more-interested-in-research-and-community.html Yesterday's NYT article on Health analysis focuses on medical schools’ failure to serve the communities in which they lie, by developing research scientists rather than primary care doctors. The article focuses on research performed by Dr. Fitzhugh Mullan at George Washington school of medicine which shows that “U.S. medical education has drifted over to this highly rarified and specialized focus that has resulted in some major shortfalls.” Comment: There is good evidence that the folks on specialists and research released directed federal programs that fund everything at medical schools accept development of professionals who can look after the average citizen in their own home. (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=3676685 Fri, 18 Jun 2010 22:06:28 +0100 3676685 http://www.medworm.com/index.php?rid=3671732&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2010%2F06%2Fnonprofit-to-begin-testing-vaginal-ring-with-anti-hiv-drug.html The Washington Post (6/15) reported, "The first test of a long-acting vaginal ring loaded with an HIV-preventing drug has begun enrolling women in southern Africa," and "with no prospects for an AIDS vaccine in the next decade or longer, the AIDS community has high hopes for 'microbicides,' the general term for substances that kill viruses or bacteria on contact." This "new study is the 15th undertaken by the International Partnership for Microbicides, a nonprofit group in Silver Spring that has helped lead the search for a discreet, woman-controlled means of protection." (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=3671732 Thu, 17 Jun 2010 00:00:40 +0100 3671732 http://www.medworm.com/index.php?rid=3655610&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2010%2F06%2Frational-use-of-medicines---who-fact-sheet338-may2010-.html •More than 50% of all medicines are prescribed, dispensed or sold inappropriately, and half of all patients fail to take medicines correctly. •The overuse, underuse or misuse of medicines harms people and wastes resources. •More than 50% of all countries do not implement basic policies to promote rational use of medicines. •In developing countries, less than 40% of patients in the public sector and 30% in the private sector are treated according to clinical guidelines. •A combination of health-care provider education and supervision, consumer education, and an adequate medicines supply is effective in improving the use of medicines, while any of these interventions alone has limited impact. (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=3655610 Fri, 11 Jun 2010 23:10:23 +0100 3655610 http://www.medworm.com/index.php?rid=3590360&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2010%2F05%2Fmedicalizing-human-conditions-a-growth-industry.html From Brandeis University: Menopause. Normal pregnancy. Infertility. ADHD. Erectile dysfunction. Over the last several decades, these conditions have come to be defined and treated as medical problems. They've been "medicalized."  Researchers, led by Brandeis sociologist Peter Conrad, evaluated 12 conditions that had been defined as medicalized by physician organizations, and for which there were current medical spending data. The other conditions considered in the study were anxiety and behavioral disorders; body image; male pattern baldness; normal sadness; obesity; sleep disorders, and substance-related disorders.  The robust trend toward ever-greater medicalization of human conditions is undeniable, with an increasing number of medical diagnoses and treatments for behavioral p... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=3590360 Sun, 23 May 2010 15:24:50 +0100 3590360 http://www.medworm.com/index.php?rid=3560348&cid=t_92698_115_f&fid=38592&url=http%3A%2F%2Fwww.radiolopolis.com%2Findex.php%2Fmy-profile%2Fmy-blog%2Fradiolopolis-officially-declared-as-trustworthy-health-information-website.html We can proudly announce that from Mai 2010 on Radiolopolis has been officially declared a site for trustworthy information that complies with the HON standard!  Read More... (Source: Radiolopolis Blogs) Radiolopolis Blogs blogs http://www.medworm.com/rss/comments.php?id=3560348 Thu, 13 May 2010 01:34:48 +0100 3560348 http://www.medworm.com/index.php?rid=3508204&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2010%2F04%2Findulging-in-four-unhealthy-behaviors-may-age-individuals-by-12-years.html People who smoke, don’t exercise, eat poorly, and drink alcohol are three times more likely to die from cardiovascular disease and nearly four times more likely to die of cancer, a new study finds.  Such people also have an overall premature death risk equivalent to being 12 years older, when compared with people who do not engage in these four behaviors, according to the study, reported in the April 26 issue of Archives of Internal Medicine.  Comment: Doesn’t anyone remember Drs. Breslow’s and Somer’s report on the Alameda County study 30 years ago which showed similar findings, while studying an  ecologically intact population? We keep repeating the same studies and get the same results. Isn’t that amazing.. (Source: Dr. Buttery's Public Healt... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=3508204 Tue, 27 Apr 2010 19:05:06 +0100 3508204 http://www.medworm.com/index.php?rid=3508394&cid=t_92698_136_f&fid=36032&url=http%3A%2F%2Fwww.everydayhealth.com%2Fblog%2Flife-with-breast-cancer%2Fwhos-really-controlling-your-health-care%2F For the past year I have been debating health-care reform on the national front at Washingtonpost.com. People in America have been so concerned about big government takeover of health care that their fears have played right into the hands of big business. The practice of targeting and cancelling policies of people diagnosed with serious and chronic illness is well documented. Last week the news agency Reuters reported that WellPoint, the country’s largest insurance agency with nearly 34 million policyholders, had cancelled the policies of at least two women diagnosed with breast cancer [Editor’s note: WellPoint has issued a statement denying these allegations]. This isn’t new — breast cancer is expensive to treat and easy to profile, so insurers know what groups of people are most ... Life with Breast Cancer blogs http://www.medworm.com/rss/comments.php?id=3508394 Mon, 26 Apr 2010 18:30:19 +0100 3508394 http://www.medworm.com/index.php?rid=3490655&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2010%2F04%2Fage-at-initiation-and-frequency-of-screening-to-detect-type-2-diabetes.html The NHANES surveys continues to provide excellent data for policy making as seen in today’s Lancet authored by Richard Kahn et al. [Volume 375, Issue 9723, Pages 1365 - 1374, 17 April 2010] Compared with no screening, all simulated screening strategies reduced the incidence of myocardial infarction (3—9 events prevented per 1000 people screened) and diabetes-related microvascular complications (3—9 events prevented per 1000 people), and increased the number of QALYs (93—194 undiscounted QALYs) added over 50 years. Most strategies prevented a significant number of simulated deaths (2—5 events per 1000 people). There was little or no effect of screening on incidence of stroke (0—1 event prevented per 1000 people). Comment The article shows the cost effecti... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=3490655 Wed, 21 Apr 2010 16:03:31 +0100 3490655 http://www.medworm.com/index.php?rid=3432908&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2010%2F04%2Fassociation-of-socioeconomic-position-with-health-behaviors-and-mortality.html An article published in JAMA today [JAMA. 2010;303(12):1159-1166.] tells us again, what has been studied numerous times over the last 50 years, and repeats the same conclusion, that people with lower social status (Level 1 & 2 on the UK scale) consistently have less education and are more likely to show adverse health behaviors.  However, other than better education in school and home there is no cure for this simple conclusion. Another waste of research money. (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=3432908 Fri, 02 Apr 2010 15:59:43 +0100 3432908 http://www.medworm.com/index.php?rid=3420503&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2010%2F03%2Fprimary-care-shortage-could-crimp-overhaul.html From the Kaiser Health News: All the changes put in motion by the passing health care overhaul, an expansion of coverage for tens of millions of uninsured people raises a really big question: Who will take care of them all? It's already tough to find a primary care doctor in many parts of the country.  CNN profiles Dr. Downs Little, "a primary care internist, [who] closed his Lottsburg Va.-based practice on Dec. 31. Lottsburg, located in Northumberland County, is in one of the nation's designated Health Professional Shortage Areas (HPSA). ... Up until last year, Little said his 'old-fashioned' practice had stayed competitive with the bigger hospitals in the area even though more than 70% of his patients were on Medicare. (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=3420503 Mon, 29 Mar 2010 19:06:57 +0100 3420503 http://www.medworm.com/index.php?rid=3412444&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2010%2F03%2Fapril-22-regulation-aims-at-protecting-children-from-lead-paint-chips-dust.html Dr. Leonard Vance of our department notes that a regulation, which takes effect next month could affect millions of U.S. homes. The regulation  seeks to reduce the amount of lead dust created during home renovations and repairs. Contractors who work in older homes will be required to become certified by a government-approved trainer and follow certain precautions, such as covering floors with plastic sheeting and dressing workers in protective clothing. Comment: Portsmouth, VA passed an ordinance to protect children and others from poor housing after health department investigators showed that most housing health hazards came from rental housing. This code, now 40 years old, requires all rental housing to be checked for building code and health hazards change of occupancy. If there ar... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=3412444 Sat, 27 Mar 2010 20:10:16 +0100 3412444 http://www.medworm.com/index.php?rid=3322378&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2010%2F03%2Fjob-losses-and-program-cuts-in-lhds-continue.html NACCHO has completed the second in a series of surveys measuring the impact of the economic downturn on local health departments (LHDs). This survey found that job losses in LHDs are accelerating and that budget cuts are reducing public health services. In the first half of 2009, approximately 8,000 staff positions in LHDs were lost due to layoffs or attrition. An additional 12,000 LHD employees were subjected to reduced hours or mandatory furloughs. (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=3322378 Tue, 02 Mar 2010 16:03:31 +0100 3322378 http://www.medworm.com/index.php?rid=3302337&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2010%2F02%2Ffront-of-package-food-labels-public-health-or-propaganda.html A Commentary in today’s JAMA is worth reading as it explains the numerous attempts by Congress and the FDA to restrict inappropriate advertising by food companies which are repeatedly knocked down the courts. The commentary could musty as well have been applied to drug company advertising and its often lethal  effects. The commentary clearly identifies the misleading practices of food companies who claim health advantages of their foods without any supporting evidence other than testimonies. (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=3302337 Wed, 24 Feb 2010 16:16:41 +0100 3302337 http://www.medworm.com/index.php?rid=3239709&cid=t_92698_129_f&fid=36038&url=http%3A%2F%2Fwww.everydayhealth.com%2Fblog%2Ftrevis-life-with-multiple-sclerosis-ms%2Fhows-your-ms-today-where-did-january-go-edition%2F It’s one thing for February to fly by at the speed of a cartoon character, but January is a full on all-the-days month; where did it go?!?! Every month we take time out in one of our postings to open the cyber floor 100 percent to your issues.  We begin by asking the title question, “How’s Your MS Today?” and it goes from there. Multiple sclerosis changes seasonally, new treatments come and go from the press, symptoms arise, disease progresses, and every month, we (try to) stay a constant in this post. It gives you a chance to check-in with others in our community and with yourself.  Update us on how things are going with you this month.  We’ll celebrate your successes and commiserate with your losses. How is my MS today? I’m having some old pain in my left foot returning. ... Life with MS blogs http://www.medworm.com/rss/comments.php?id=3239709 Wed, 03 Feb 2010 23:11:29 +0100 3239709 http://www.medworm.com/index.php?rid=3178891&cid=t_92698_123_f&fid=38598&url=http%3A%2F%2Fpediatricsnow.com%2Fblog%2F2010%2F01%2Fhelping-kids-understand-the-disaster-in-haiti%2F The enormity and randomness of natural disasters such as the one that devastated Haiti this week  is truly  overwhelming. If we’re having difficulty coming to terms with the myriad of emotions and paralyzing impressions as adults, you can imagine how challenging this has been for our kids, regardless of age, to start to make sense of. A few years back around a similarly challenging world event, I discussed the issue of talking with kids about tough world events with Dr. Paula Rausch from Massachusetts General Hospital in Boston, Massachusetts. You can my full column with her advice here but the bottom line is to reassure our kids about how rare these events are and that they are currently safe. In addition, it’s important to monitor the news coverage. It’s tempting t... Dr. Gwenn Is In blogs http://www.medworm.com/rss/comments.php?id=3178891 Sat, 16 Jan 2010 12:15:57 +0100 3178891 http://www.medworm.com/index.php?rid=3157498&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2010%2F01%2Fcalorie-information-from-restaurants-packaged-foods.html Researchers at Tufts University analyzed the calorie content of 18 side dishes and entrees from national sit-down chain restaurants, 11 side dishes and entrees from national fast food restaurants and 10 frozen meals purchased from supermarkets. They compared their results to the calorie content information provided to the public by the restaurants and food companies. On average, the calorie content information provided by the restaurants was 18 percent less than the researcher's calorie content analysis. Two side dishes exceeded the restaurant's reported calorie information by nearly 200 percent. Comment: Calorie labeling of food makes good sense but current codes on labeling do not require accuracy/validation that will help us control our weight. (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=3157498 Sun, 10 Jan 2010 15:48:53 +0100 3157498 http://www.medworm.com/index.php?rid=3153393&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2010%2F01%2Fhealth-and-disease-in-people-over-85.html Another important editorial in this week’s BMJ comes from Professor Thomas Peris at U. Boston and describes the growth of the population over 80 and the health of those over 85. Maybe surprising to many is that most consider their health good. [BMJ 2009;339:b4715]  Comment: While this is a study in the UK there is not much doubt that similar findings would appear in a study of the US population. Better training of primary care physician for care of the elderly (>80y) is essential.   (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=3153393 Fri, 08 Jan 2010 16:23:08 +0100 3153393 http://www.medworm.com/index.php?rid=3153395&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2010%2F01%2Fnurse-home-visitation-program-reduces-girls-potential-criminality-later-in-life.html CHICAGO -- Girls whose mothers were visited at home by nurses during pregnancy and the children’s infancy appear less likely to enter the criminal justice system by age 19, according to a report in the January issue of Archives of Pediatrics & Adolescent Medicine. The Nurse-Family Partnership Program costs about $7,000 per child. Benefit-cost analyses for the already published effects of the program have found that it produces total benefits of about $41,000 per child of low-income, unmarried, nurse-visited mothers and about $9,000 per child of lower-risk nurse-visited mothers, a positive benefit-cost ratio in both cases. Comment: Family outcomes in MCH programs where nurses visit the home during pregnancy and following it have been shown beneficial.  The UK Home Visito... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=3153395 Fri, 08 Jan 2010 15:54:05 +0100 3153395 http://www.medworm.com/index.php?rid=3153396&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2010%2F01%2Fobesity-now-poses-as-great-a-threat-to-quality-of-life-as-smoking.html Using data from The 1993-2008 Behavioral Risk Factor Surveillance System (BRFSS), the largest ongoing state-based health survey of US adults, has conducted interviews of more than 3,500,000 individuals; annual interviews started with 102,263 in 1993 and culminated with 406,749 in 2008. Investigators Haomiao Jia, PhD and Erica I. Lubetkin, MD, MPH, state, "Although life expectancy and QALE have increased over time, the increase in the contribution of mortality to QALYs lost from obesity may result in a decline in future life expectancy. Such data are essential in setting targets for reducing modifiable health risks and eliminating health disparities." The article will appear in the American Journal of Preventive Medicine, Volume 38, Issue 2 (February 2010) (Source: Dr. Buttery's Public Heal... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=3153396 Thu, 07 Jan 2010 17:17:39 +0100 3153396 http://www.medworm.com/index.php?rid=3111414&cid=t_92698_87_f&fid=38368&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDisruptiveWomenInHealthCare%2F%7E3%2F8ks0nL41Mmo%2F The following guest post by Malvise A. Scott, Senior Vice President, Partnership and Resource Development at National Association of Community Health Centers (and Former Community Health Center CEO), is part of Disruptive Women’s “The Value of Health: Creating Economic Security in the Developing World” series. Health is an important part of economic security – not only in the developing world, but in the US. No one knows that better than those who, for over 40 years, have worked within Community Health Centers (CHCs) providing primary and preventive care to the medically underserved. These private, not-for-profit corporations are so keenly aware because: Boards of Directors are made up of at least 51% patients, They are located in medically underserved neighborhoods, Their hours... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=3111414 Tue, 22 Dec 2009 14:04:32 +0100 3111414 http://www.medworm.com/index.php?rid=3026696&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2009%2F11%2Fhealthy-people-2020-objectives.html The objectives for Healthy People 2020 are now available for review and comment.  HHS  encourages participation in review and comment at the 2020 Objectives Site.  The site is easy to navigate, commenting is simple. I find many of the objectives grammatically convoluted  and confusing.  I hope the readers of this blog will visit and comment.  (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=3026696 Tue, 24 Nov 2009 18:03:16 +0100 3026696 http://www.medworm.com/index.php?rid=3111541&cid=t_92698_123_f&fid=38598&url=http%3A%2F%2Fpediatricsnow.com%2Fblog%2F2009%2F11%2Fif-you-call-the-wrong-number-how-about-saying-%25e2%2580%259csorry%25e2%2580%259d%2F I experienced a really over the top call the other day. Someone called my cell and started with “Oh, Gwenn, good…we have to talk about the alumni game. It’s a week away and there’s so much to do….” The caller only identified herself by her first name and went on rattling off details for a bit before I finally interrupted her with: Me: “Excuse me, I think you have the wrong person. I honestly don’t know what you are referring to but I’m not involved in any alumni game.” Caller: “No, you’re Gwenn…right? You signed up to help with the alumni game. We talked about it in July at the sports meeting.” Me: “Well, there’s the problem. I didn’t go to a sports meeting in July and am not part of that group. My first name is Gwenn but I suspect you’re looking for a d... Dr. Gwenn Is In blogs http://www.medworm.com/rss/comments.php?id=3111541 Wed, 18 Nov 2009 12:23:00 +0100 3111541 http://www.medworm.com/index.php?rid=3111544&cid=t_92698_123_f&fid=38598&url=http%3A%2F%2Fpediatricsnow.com%2Fblog%2F2009%2F11%2Fwhere%25e2%2580%2599s-the-flu-shot-ask-dr-google%2F   Finding the flu shot lately, seasonal or H1N1, has become a modern day game of Where’s Waldo! In typical fashion, Dr. Google has come to the rescue with a new tool, www.google.com/flushot: Simply type in your location and up comes results for both seasonal and H1N1 clinics in your area, whether they have the vaccines now and when they will have them, if that information is available. For example, if I type in “Boston” in the “Find Flu Shots Near” field, the map looks like this: Most communities are still reporting extreme shortages in the H1N1 vaccine and don’t expect that to change for a few more weeks. It’s amazing to me that some many high risk people, myself including, can’t get this vaccine. At least we now have a tool to help track it down once it finall... Dr. Gwenn Is In blogs http://www.medworm.com/rss/comments.php?id=3111544 Thu, 12 Nov 2009 13:11:00 +0100 3111544 http://www.medworm.com/index.php?rid=2981098&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2009%2F11%2Fgovernments-look-to-community-level-solutions-for-obesity.html The Wall Street Journal (11/10, Dalton) reports that some countries' governments have stopped focusing on individual discipline to combat obesity, and instead are working to make entire communities more healthy by reducing the opportunities to live unhealthily. Laura Kettel Khan, an obesity expert at the CDC, says that "people are finally acknowledging that the obesity problem is so pervasive that it isn't just because people are making bad choices." The Journal describes obesity programs across Europe and in the US, noting that these initiatives are taking off because obesity has become too expensive a problem to handle on an individual basis. (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=2981098 Tue, 10 Nov 2009 17:46:13 +0100 2981098 http://www.medworm.com/index.php?rid=2981099&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2009%2F11%2Fho-finds-hivaids-leading-cause-of-death-among-women-worldwide.html The World Health Organization has discovered that the "AIDS virus is the leading cause of death and disease among women between the ages of 15 and 44." Indeed, "women enjoy a biological advantage because they tend to live six to eight years longer than men," WHO chief Dr. Margaret Chan pointed out. "But in many parts of the world they suffer serious disadvantages because of poverty [and] poorer access to healthcare:. The 91-page report by the organization "lays out the hurdles women face in getting the healthcare they need at various stages of life."  The report said that "accidental injuries take a toll on girls and younger women," while "chronic diseases account for almost half of the deaths among older women." Dr. Chan noted, however, that the "obstacles that stand in the way of be... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=2981099 Tue, 10 Nov 2009 17:43:19 +0100 2981099 http://www.medworm.com/index.php?rid=2901642&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2009%2F10%2Fstatewide-teen-smoking-cessation-trial-is-the-first-to-achieve-significant-increase-in-prolonged-qui.html Researchers at Fred Hutchinson Cancer Research Center have demonstrated that it is possible to successfully recruit and retain a large number of adolescent smokers from the general population into a smoking intervention study and, through personalized, proactive telephone counseling, significantly impact rates of six-month continuous quitting. The trial, funded by the National Institutes of Health, involved 2,151 teenage smokers from 50 high schools in Washington. Half of the schools were randomly assigned to the experimental intervention; teens in these schools were invited to take part in confidential, personalized telephone counseling designed to help motivate them to quit.  COMMENT. Despite the praise for the study, the difference in quit rates for test and control groups was only... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=2901642 Fri, 16 Oct 2009 20:23:03 +0100 2901642 http://www.medworm.com/index.php?rid=2901643&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2009%2F10%2Fdata-indicate-cyclists-experiencing-higher-injuries-rates-longer-hospital-stays.html The Los Angeles Times (10/14, Stein) "Booster Shots" blog reported that as bicycles ride a wave of popularity, "cyclists may be suffering more injuries," according to University of Colorado researchers. After looking at "accident rates and severity from 1996 to 2006," they noted that "among 329 bicycle accident cases admitted to the Rocky Mountain Regional Trauma Center at Denver Health Medical Center, the length of stay increased substantially over those years." What's more, "an increase was seen in chest injuries (up 15 percent), and abdominal injuries tripled over the last five years of the study. About one-third of 118 patients had head injuries." Comment: Cycling is certainly more dangerous in the US than Europe where most roads have dedicated bicycle lanes, There are very few such la... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=2901643 Fri, 16 Oct 2009 20:21:04 +0100 2901643 http://www.medworm.com/index.php?rid=2894521&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2009%2F10%2Fquality-improvements.html The Commonwealth Fund just released its State Scorecard on Health System Performance. The scorecard points to substantial opportunities to improve. If all states could reach the level achieved by the top performing states: •Twenty-nine million more people would have health insurance—cutting the number of uninsured by more than half; •Nearly 78,000 fewer adults and children would die prematurely every year from conditions that could have been prevented with timely and effective health care; •Nine million more adults age 50 and older would receive recommended preventive care, and almost 800,000 more children would receive key vaccinations; •Five billion dollars could be saved annually by avoiding preventable hospital admissions and readmissions for vulnerable elderly and disabl... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=2894521 Wed, 14 Oct 2009 19:08:03 +0100 2894521 http://www.medworm.com/index.php?rid=2846422&cid=t_92698_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2009%2F09%2F30%2Frobert-wood-johnson-rethinking-mental-health%2F This is an interesting contest I thought I’d pass along… For far too long, mental illness has been stigmatized and those stigmas have served as a barrier to innovation. The Robert Wood Johnson Foundation has joined forces with Ashoka’s Changemakers to launch “Rethinking Mental Health: Improving Community Wellbeing”, a competition for new ideas and practices that challenge the status quo in terms of how we think about and address mental health care needs. Robert Wood Johnson Foundation’s “Rethinking Mental Health” competition offers an opportunity for new ideas outside the traditional structures to emerge. To participate, please go to http://www.changemakers.com/en-us/mentalhealth to: Comment on entries from others like you who are deeply con... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=2846422 Wed, 30 Sep 2009 09:30:18 +0100 2846422 http://www.medworm.com/index.php?rid=2803934&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2009%2F09%2Fcomparisons-mortality-and-deprivation-from-the-1900s-and-2001.html In this week’s BMJ we find that despite all the medical, public health, social, economic, and political changes over the 20th century, patterns of poverty and mortality and the relations between them remain firmly entrenched. There is a strong relation between the mortality levels of a century ago and those of today. This goes beyond what would have been expected from the continuing relation between deprivation and mortality and holds true for most major modern causes of death. Comment. Most of these deaths are related to chronic diseases and individual behaviors, which have always had an adverse impact on low income groups that have had poorer education (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=2803934 Wed, 16 Sep 2009 20:00:57 +0100 2803934 http://www.medworm.com/index.php?rid=2778444&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2009%2F09%2Fexcess-cost-of-new-legislation-unhealthy-for-us-all.html Everyone who has an interest on the Congressional approaches to health care reform should read the current issue of ‘Health Affairs’ and note the monetary costs of the various approaches.  In the papers we find the expectation that the reforms would consume more than 50% of GDP, while others show that in 75 years the reforms would cost more than the entire GDP.  It is clear that the various activists have never taken economics 101.  The financial projections indicate totally unrealistic expectations for reform,.  There have to be limits to new expenditures. Anyway you wish to make changes there has to be some form of rationing.  There also has to be some reduction in money devoted to research.  Too much research money funneled to medical schools re... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=2778444 Wed, 09 Sep 2009 18:34:39 +0100 2778444 http://www.medworm.com/index.php?rid=2778443&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2009%2F09%2Fshortage-of-primary-care-physicians-seen-as-driving-many-patients-to-emergency-departments.html USA Today reports, "Uninsured patients aren't the only ones using the [emergency department (ED)] for non-urgent care. With too few primary-care doctors to go around, many patients turn to the [ED] when they can't get an appointment with their regular physician, says Sandra Schneider, president of the American College of Emergency Physicians." Ted Epperly, president of the American Academy of Family Physicians, pointed out that "in some ways, insurance payments contribute to the shortage...by discouraging physicians from going into primary care." Medicare "pays doctors far more to perform procedures than to monitor a patient's overall health, Epperly says. In the past decade, only 10 percent of new doctors -- who graduate from medical school with an average of $140,000 in student loans -- ... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=2778443 Wed, 09 Sep 2009 18:34:39 +0100 2778443 http://www.medworm.com/index.php?rid=2724862&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2009%2F08%2Fmaine-lead-poisonings-due-to-lead-tracked-into-cars.html The AP reports that six cases of childhood lead poisoning "in Maine last year came from an unusual source -- lead dust tracked into the family car." Officials from the CDC and the Maine Department of Health and Human Services said that the cases were "the first ever attributed to lead dust on childhood safety seats. The car seats themselves weren't the source; the inside of family cars were contaminated through a parent's workplace." The CDC explained that children's parents, who worked in paint removal or metals recycling, did not change and shower before going home, and so tracked lead dust into their cars and onto children's car seats. Then, "Kids chew on the sides of those seats ... Or they put a cookie down" on the seat and then eat it, Mary Jean Brown, chief of the CDC's Lead Poisoni... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=2724862 Fri, 21 Aug 2009 15:51:24 +0100 2724862 http://www.medworm.com/index.php?rid=2719723&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2009%2F08%2Fpush-to-expand-coverage-highlights-shortage-of-primary-care-doctors-1.html In Massachusetts, the individual mandate means "97 percent of residents there are covered. But while they have insurance, what some don't have is a doctor." CBS added, "Just having insurance doesn't guarantee access. There aren't enough doctors. It is a real problem. According to the Department of Health and Human Services, we are more than 16,000 primary care doctors short in the United States. About 26,000 new doctors enter the work force every year, but only 6,500 enter primary care. One reason is that starting salaries for primary care doctors are a lot lower than for specialists in radiology, cardiology and urology." But it is "not just the pay...it's the paperwork. Dr. Kate Atkinson is drowning in it and says that's what's keeping doctors away from primary practices." COMMENT: There ... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=2719723 Thu, 20 Aug 2009 19:26:13 +0100 2719723 http://www.medworm.com/index.php?rid=2657765&cid=t_92698_123_f&fid=38598&url=http%3A%2F%2Fwww.drgwennisin.com%2F2009%2F07%2Fposted-rules-at-pools-are-for-everyone.html My health club's outdoor pool's hot tub has a new sign:"No children under 12 allowed in the hot tub...this includes dangling feet and dipping toes!"It's very large and placed in front of the entrance to the hot tub at the stairs. Not only can you not miss it, you can't miss reading it - the letters are huge and neatly written. You only have to be at the club for a few minutes to see why the need for the sign:1. This week, the high heat: in this weather, kids will dehydrate quickly and put themselves at risk for heat-related illnesses. Just not worth the few minutes in the very hot water. Kids may already be relatively dehydrated if not drinking enough in heat waves so time in hot water will hasten the onset of heat illnesses in that situation.2. Parents were already ignoring the smaller po... Dr. Gwenn Is In blogs http://www.medworm.com/rss/comments.php?id=2657765 Thu, 30 Jul 2009 14:02:00 +0100 2657765 http://www.medworm.com/index.php?rid=2639672&cid=t_92698_129_f&fid=36035&url=http%3A%2F%2Fwww.everydayhealth.com%2Fblog%2Flife-with-chronic-pain%2Fastonish-yourself-in-a-life-of-chronic-pain%2F Negativity, like fog, creeps in on little cat’s feet, until one day we are encumbered with it. It’s bad enough we have to feel crummy everyday and put up with something hurting, somewhere on these less than perfect bodies; but the damage to our spirit, our initiative and our joy in life can be far worse. It was Santayana I believe who said, “There is no cure for birth or death save to enjoy the interval.” It’s that in-between part that we get hung up on. I guess it’s like the creamy filling of life wedged between two cookies. It should be the best part. There’s an almost mystical place you can reach when your pain no longer rules your life. Even in the animal world there is dominance demonstrated; top dog and all that. Every relationship we humans experience has that same fac... Life with Chronic Pain blogs http://www.medworm.com/rss/comments.php?id=2639672 Sat, 25 Jul 2009 22:13:38 +0100 2639672 http://www.medworm.com/index.php?rid=2601929&cid=t_92698_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F07%2F15%2Fjournal-of-the-american-medical-association-2009-vol-302-no-3%2F Contents Fade Fave: Integrating clinical care and community health Fade Skinny: Public health professionals generally think about how to improve health at a population level, whereas clinicians generally address the needs of individuals. These streams converge in systems of clinical care and are also embodied in population health principles of measurement, system change, and accountability. Posted in Current Awareness, Journals Tagged: Clinical Care, Clinical Effectiveness, Community Care, Community Health Services (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=2601929 Wed, 15 Jul 2009 08:58:29 +0100 2601929 http://www.medworm.com/index.php?rid=2570510&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2009%2F07%2Fcomparative-effectiveness.html The IOM has just published a monograph on “Comparative Effectiveness Research”.  There are many competing treatments for the major conditions that affect us. There are few studies showing which if any are more effective, other than personal opinions, which doctors and patients can use to choose between them.  This monograph speaks to the need to evaluate the various options to improve the rate of recovery and control for  various disease.  It is worth reading by everyone in public health. (Source: Dr. Buttery's Public Health BLOG) Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=2570510 Thu, 02 Jul 2009 15:54:57 +0100 2570510 http://www.medworm.com/index.php?rid=2561404&cid=t_92698_123_f&fid=38598&url=http%3A%2F%2Fwww.drgwennisin.com%2F2009%2F07%2Fkeep-blasting-to-experts-this-4th-of.html I love 4th of July - it is truly one of my favorite holidays with fireworks, people gathering with their families and the Boston Pops playing on the Esplanade in Boston. Whether we venture into the city to gather with the crowds or watch the event from home, everyone ends up going to bed happily exhausted.For an ER doc, though, 4th of July is also one of the more hazardous holidays to work, and think about. A year ago, I posted a few 4th of July fireworks stories from my life, one of which was of a child I cared for in the ER. I can't get through the holiday without thinking about these kids and the countless others I've seen over the years with fireworks-related injuries.The National Fire Protection Association, reports that "(i)n 2007, U.S. hospital emergency rooms treated an estimated 9... Dr. Gwenn Is In blogs http://www.medworm.com/rss/comments.php?id=2561404 Wed, 01 Jul 2009 11:30:00 +0100 2561404 http://www.medworm.com/index.php?rid=2523039&cid=t_92698_99_f&fid=35342&url=http%3A%2F%2Fblog.vcu.edu%2Fcbuttery%2F2009%2F06%2Fnew-congressional-bill-is-not.html In this report they focus on what is probably the most damaging part of the new FDA/Tobacco bill from a public health perspective -- the section that encourages cigarette manufacturers to manufacture and market "Potentially Reduced Exposure Cigarettes" with absolutely no scientific proof that the "reduced exposure" will reduce risk. This scientifically-unfounded gift to the cigarette makers, combined with the de-facto ban on all new truly reduced risk products should assure high levels of cigarette sales and continuation of high cigarette-related death rates for decades to come.. Comment: despite backing from the AMA and APHA this is not a bill that supports the Public's health. Both these organizations are politically naïve except when it comes to their bottom line. (Source: Dr. Buttery'... Dr. Buttery's Public Health BLOG blogs http://www.medworm.com/rss/comments.php?id=2523039 Fri, 12 Jun 2009 16:00:03 +0100 2523039 http://www.medworm.com/index.php?rid=2464478&cid=t_92698_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2009%2F06%2F09%2Fself-management-follow-up-a-focus-group-study%2F In this study, the focus group participants were only those who had received the stepped care approach. The groups were moderated by an external facilitator, and a simple open-ended semistructured discussion was conducted. Members of the research group were also present to code responses. Although the questions were not specifically about the relationships that people had formed with the care manager or GP, the groups are reported to have raised this relationship often during the course of the discussion. Typically the participants were less than happy with the pain management they had received from their GP, and much more satisfied with the pain management provided during the self management programme. Now, the key differences between the two approaches are summed up as these: time acces... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=2464478 Mon, 08 Jun 2009 19:04:31 +0100 2464478 http://www.medworm.com/index.php?rid=2441688&cid=t_92698_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2009%2F05%2F28%2Fsoldiers-ordered-not-to-kill-themselves%2F Brig. Gen. Stephen J. Townsend, according to CNN, has “in effect ordered his soldiers Wednesday not to commit suicide” in the 101st Airborne at Fort Campbell. Why? After nearly one soldier per week committed suicide at the post between January and mid-March, the Army instituted a suicide prevention program that “seemed to be having good effects” until last week, when two more suicides occurred, he said. Yes, these are not positive numbers and the Army needs to do more to combat the stigma of seeking help for a psychological concern such as depression. They can begin by promising soldiers that such treatment seeking will have no negative effect on their ability to move up in the Army and get promoted in the future. You wouldn’t hold someone from getting a pro... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=2441688 Thu, 28 May 2009 23:41:14 +0100 2441688 http://www.medworm.com/index.php?rid=2367352&cid=t_92698_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F04%2F15%2Fcore-interventions-in-the-treatment-and-management-of-schizophrenia-in-primary-and-secondary-care-update%2F Title: Core interventions in the treatment and management of schizophrenia in primary and secondary care (update) Source: NICE The Skinny: Updates and replaces: Schizophrenia: core interventions in the treatment and management of schizophrenia in primary and secondary care. NICE clinical guideline 1 (2002) Guidance on the use of newer (atypical) antipsychotic drugs for the treatment of schizophrenia. NICE technology appraisal guidance 43 (2002) Documents For healthcare professionals: CG82 Schizophrenia (update): NICE guideline (41p, 256.26 Kb) CG82 Schizophrenia (update): NICE guideline (MS Word format) (41p, 605 Kb) CG82 Schizophrenia (update): full guideline (399p, 3.16 Mb) CG82 Schizophrenia (update): full guideline - clinical evidence summary tables (194p, 2.54 Mb) CG82 Schizophren... Fade Library blogs http://www.medworm.com/rss/comments.php?id=2367352 Wed, 15 Apr 2009 09:38:28 +0100 2367352 http://www.medworm.com/index.php?rid=2260664&cid=t_92698_140_f&fid=35457&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fbattlingforhealthcom%2F%7E3%2Fpb-I6Y42vQE%2F The state of the health care system of the US has always been a subject of great controversy. The recent approval of the Children´s Health Insurance Bill by President Obama which gives health care access to all American children as well as children of legal immigrants was met with mixed reactions. Its proponents were pleased and hope that this is the first step in their goal of having health coverage for everyone. Those against the bill, on the other hand, the bill too closely resembles “socialized medicine” or “government-run health care for every one” that can easily be abused and can cost taxpayers a lot of money. A recent report by the Institute of Medicine (IOM) states that “having health insurance is essential for people’s health and well-being&#8... Battling-Schizophrenia blogs http://www.medworm.com/rss/comments.php?id=2260664 Tue, 10 Mar 2009 10:31:27 +0100 2260664 http://www.medworm.com/index.php?rid=2077112&cid=t_92698_113_f&fid=38130&url=http%3A%2F%2Fwww.tempdev.net%2Fblog%2F%3Fp%3D454 The other day, I posted a guest blog by Dr. Robert Rowley, Chief Medical Officer for Practice Fusion. In his posting, Dr. Rowley explains that Practice Fusion is approaching “EMR 2.0″ while NextGen and other client-server based applications are “dinosaurs”. While I completely agree with Dr. Rowley’s assertion that EMRs must evolve from stand-alone systems to a network of interconnected tools,  I don’t agree that a web-based architecture by itself is indicative of EMR 2.0. For the sake of this posting, I am going to define EMR 2.0 as an electronic medical record system that can share data in real-time with a variety of systems. These other systems should include, at a minimum, a patient portal, major PHR (HealthVault or Google Health), other health syste... Implementing EMRs blogs http://www.medworm.com/rss/comments.php?id=2077112 Wed, 31 Dec 2008 05:00:45 +0100 2077112 http://www.medworm.com/index.php?rid=1888618&cid=t_92698_93_f&fid=36658&url=http%3A%2F%2Fxavier-emmanuelle.blogspot.com%2F2008%2F10%2Faboriginal-health-first-day.html The clinic I'm at for aboriginal health is a health promotion nerd's dream. (I'm the health promotion nerd, just in case that's not abundantly clear). I'm so impressed, I barely even know where to start!The clinic is specifically for aboriginal patients, and it integrates traditional medicine into the western medicine care plan. They have what you'd expect to see at a typical clinic -- exam rooms, doctors, and what not, but they have so much more.There are HIV prevention programs, diabetes prevention programs, addiction prevention and treatment, and whole parts of the building focused on providing support for seniors. They have a huge, lovely kitchen within the building where they host healthy eating classes and community kitchen seminars, with an in-house chef and everything. They hold pr... I'm Not Anti-Social, I'm Just Pre-Med blogs http://www.medworm.com/rss/comments.php?id=1888618 Sat, 18 Oct 2008 15:03:00 +0100 1888618 http://www.medworm.com/index.php?rid=1883926&cid=t_92698_93_f&fid=36658&url=http%3A%2F%2Fxavier-emmanuelle.blogspot.com%2F2008%2F10%2Fthree-midterms-down.html The experiences of illness exam went about as well as could be expected... I think I did okay although it's hard to know for sure, at the moment I'm mainly just thankful that it's over! Unfortunately there were many questions with this format, and they always mess with my head:abca and ba and cnone of the aboveI definitely got the Suchman stages of illness question wrong, but I'm hoping I'll do okay otherwise!My next midterm isn't until next week (thank goodness), so even though I have paper writing and studying to do I've got a little more breathing room! Tonight is going to consist primarily of sleeping, buying groceries (I'm currently in dire need of vegetables), and doing laundry so that I'll have something nice and professional looking to wear to "clinical" tomorrow! (My prof keeps ca... I'm Not Anti-Social, I'm Just Pre-Med blogs http://www.medworm.com/rss/comments.php?id=1883926 Thu, 16 Oct 2008 19:36:00 +0100 1883926 http://www.medworm.com/index.php?rid=1810151&cid=t_92698_93_f&fid=36658&url=http%3A%2F%2Fxavier-emmanuelle.blogspot.com%2F2008%2F09%2Faboriginal-adolescent-health.html I finally got word about my community health project... I got a combination of two things that I'm super interested in: aboriginal health and adolescent health together. AWESOME. I'm going to be working mainly with off-reserve high-risk aboriginal teens... sounds challenging and interesting and full of social justice issues to work on.Part of this project is also going to be teaching aboriginal youth about health care careers, to try to encourage them to consider medicine, nursing, or OT/PT as a career path -- we might even get to take them on tours of the hospital, or take them to the skills lab (aka letting them intubate plastic dummies and other wicked stuff like that). I'm rather keen on the skills lab idea -- I know if I were a teenager I would just about kill for a day in the clinica... I'm Not Anti-Social, I'm Just Pre-Med blogs http://www.medworm.com/rss/comments.php?id=1810151 Fri, 19 Sep 2008 22:22:00 +0100 1810151 http://www.medworm.com/index.php?rid=1170273&cid=t_92698_129_f&fid=36035&url=http%3A%2F%2Fblog.healthtalk.com%2Fchronic-pain%2Flife-with-chronic-pain%2Fhow-to-get-started-on-a-gluten-free-diet%2F I confess, every time I hear the word gluten I am reminded of an experience I had many years ago. I received my first bread machine and was experimenting with recipes. I bought a bag of gluten which spilled onto the counter. That was an interesting, if somewhat frustrating scientific experiment in the sticky, icky staying power of gluten. It remained in the sponge and on the dishtowel as a stringy, gelatinous mess which defied several trips through the washing machine. I’m pretty sure you could use it to lay bricks. Anytime we try to change our eating habits it’s a chore. When we’re hungry we go toward the familiar, the easy and the convenient. I know life is complicated enough without throwing another challenge in the way. So much of who we are is wrapped up in “comfort foods” a... Life with Chronic Pain blogs http://www.medworm.com/rss/comments.php?id=1170273 Tue, 22 Jan 2008 20:55:29 +0100 1170273 http://www.medworm.com/index.php?rid=977292&cid=t_92698_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2007%2F10%2F24%2Fboston-health-network-requires-all-physicians-to-adopt-ehrs-by-2009%2F I recently came across a healthcare IT related blog that I really enjoy called Health Train Express. They recently posted an article about the Boston Health Network requiring all their physicians to adopt EHRs by 2009 or else they’ll be removed from the network. The article then says that they “expect to lose between 15 and 20 primary care physicians this year because of the mandate, and it could lose some patients if those physicians stop referring patients to Partners hospitals.” The article goes on to say that “To retain their network status, about 5,000 physicians in the network will be required to adopt either Partners’ or GE Healthcare’s EHR or sign an agreement that they will adopt EHRs during 2008.” A number of things I’ve read about ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=977292 Thu, 25 Oct 2007 07:45:37 +0100 977292