News Brief: Overweight Doctors Less Likely to Discuss Weight Loss with Patients

Parsa Shahbodaghi

A recent study has shown that doctors who are overweight or obese are less likely to talk to their patients about weight loss. The study took a sample of 498 primary care physicians. Using the body mass index, the composition of they physicians was 47% normal weight, 38% overweight, and 15% obese.

When talking to obese patients, normal weight doctors brought up weight loss 30% of the time. Similarly, doctors who perceived themselves heavier than their patients discussed weight loss 18% of the time. Not only does this show that obese doctors are unwilling to discuss weight loss, but it also shows that most physicians are unwilling to have this conversation.

Solutions to this problem are to make physicians lead healthy and active lives to set an example. Electronic medical records could automatically calculate one’s BMI, so that responsibility does not fall on the doctor.

Reference: Hobson, Katherine. "Overweight Doctors Less Likely to Discuss Weight Loss with Patients" . The Wall Street Journal. Health. Web. http://blogs.wsj.com/health/2012/01/30/overweight-doctors-less-likely-to-discuss-weight-loss-with-patients/

News Brief: US board says censuring research on avian flu was necessary to prevent a potential catastrophe

Enshu Chawla

After research was completed on human to human transmission of the H5N1 avian influenza virus, there was a lot of controversy due to the censuring of the research methods used in this process. This censuring was justified due to the fact that, if an individual with bad intentions had access to the research methods, an extremely dangerous and deadly epidemic could result. The recommendation to censure the research methods was made by the US National Science Advisory Board for Biosecurity, and arguments were made over the right to censor science. The imagined catastrophe drew comparisons to the "Spanish flu" epidemic of 1918. The mortality rate of individuals reported to have been infected with the H5N1avian flu has been greater than 50%, but there have been just a few hundred people known to have it. Also, these people became infected due to close contact with sick birds. The US National Science Advisory Board for Biosecurity has defended their recommendation of censuring the research, due to the great danger posed by human to human transmission of the avian flu. In order to alleviate the problem and to help both the research and field continue to grow, a meeting hosted by the World Health Organization will take place. Despite the concern of the H5N1 avian flu, antibodies to the virus have been found in common quantities in some rural Thai villages. This seems to go against the belief that the H5N1 avian flu is an extremely dangerous and deadly virus. Overall, the censuring of the research methods of discovering human to human transmission of the avian flu is subject to a great deal of controversy and differing beliefs.
Reference:
Roehr, Bob. "US Board Says Censuring Research on Avian Flu Was Necessary to Prevent a Potential Catastrophe." BMJ. British Medical Journal, 2 Feb. 2012. Web. 12 Feb. 2012. .

News Brief: A Spoonful of Health? UCSF Researchers Slam Sugar

Ariel Lefland

Have you ever imagined needing an identification card to buy food? Researchers are advocating for new regulations for foods processed with added sugars that could include taxes and age limits. They propose taxing processed foods that are sweetened with fructose or sucrose, arguing these added sugar compounds are more important additives to focus on than saturated fat and salt. Researchers also advocate taking fructose of the Food and Drug Administration’s (FDA) list of ingredients Generally Recognized as Safe.
Although the FDA is not considering that step at this time, there has been much debate over this research since its recent publication in Nature by Robert Lustig, Laura Schmidt and Claire Brindis of University of California, San Francisco. Researchers cite the growing evidence that connects over-consuming fructose with hypertension and diabetes. It is also possible that cancer and cognitive decline can also result. The Sugar Association argues that the consumption of cane and beet sugar has not been rising with obesity rates and that the data supporting the researchers’ claims is not yet conclusive.
The National Confectioners Association also responded to the report. Eating sweet foods such as candy is okay in moderation, especially in an overall healthy lifestyle. What really should be happening is a plan to help consumers make healthy decisions while also being able to enjoy sweets in their diet. Keeping your sweet tooth in check is something that all of us must do when sugary cereals, candy and other sugary foods are around us; however, obesity and heart disease result from more than just the presence of these foods. We need to effect long term change and healthy habits that include both eating well and exercising. A single food, as the Sugar Association argued, is not the cause for obesity. We cannot put all of the blame on our food; it is also a matter of our dietary behaviors.

Reference: Hobson, Katherine. "A Spoonful of Health? UCSF Researchers Slam Sugar." The Wall Street Journal. Health. Web. http://blogs.wsj.com/health/2012/02/02/a-spoonful-of-bad-health-ucsf-researchers-slam-sugar/. Feb 2, 2012

News Brief: Fighting Cervical Cancer With Vinegar and Ingenuity

Hallie Abelman

Cervical cancer continues to be the number one cancer killer amongst women worldwide. But thanks to a newly approved procedure developed by the Johns Hopkins Medical School, this title might begin to decrease, especially in rural and poor countries. The procedure, known as VIA/cryo for visualization of the cervix with aceditc acid, involves inserting vinegar into a woman’s cervix. The quality of the vinegar causes precancerous spots to turn white, allowing the nurse to detect the spots more readily than if doing a normal pap smear, in which scrapings must be sent to a lab first. The vinegar highlights the tumors because they have more DNA than other tissue. If detected, these spots are then frozen off with a metal probe. This procedure has been adopted most prominently in Thailand, where 500,000 of the 8 million women ages 30 to 44 have already been screened. Although only recently endorsed by the World Health Organization, this relatively simple and inexpensive procedure has the potential to aid poor and developing countries in reducing cervical cancer rates. 85% of the 250,000 women who die from cervical cancer are poor or rural inhabitants. Because cervical cancer takes so long to develop, it is impossible to detect if rates have dropped in Thailand. But 6,000 women involved in the first trial 11 years ago continue to be cancer-free and screening significantly lowers their risk. The freezing process is about 90% effective and is becoming a more popular method worldwide.

Reference: McNeil Jr., Donald G. “Fighting Cervical Cancer With Vinegar and Ingenuity”. The New York Times Health. Web. http://www.nytimes.com/2011/09/27/health/27cancer.html?ref=health. October 30, 2011. 

News Brief: Few Doctors, Nurses Report Asking Patients About What They Expect in Their Care

Enshu Chawla

A study conducted by BMJ Quality & Safety has shown that medical professionals-- specifically nurses and physicians-- tend not to ask patients for their expectations regarding their care. This has shown to be a problem because patients benefit more from medical care if they can trust and communicate with their doctors. While nurses are more likely to talk to patients about their expectations, physicians, too, realize the importance of this communication. However, they do not have the proper training in order to discover what the patients may expect from their care. This trend is prevalent throughout the world. Doctors surveyed at Brigham and Women's Hospital in Boston, along with physicians in Denmark, Israel, and the United Kingdom agree that they lack the training to ask patients about their expectations. Only about 20 percent of those surveyed believe otherwise. So while medical professionals understand that patient expectations should be taken into account, the majority of them do not ask the patients for this information. One way of improving this problem has been the rise of the use of patient satisfaction surveys. David W. Bates and Ronen Rozenblum, who are associated with Brigham and Women's Hospital, are working on the PatientSatisfactive Model. This model is supposed to help medical professionals gain insight on the expectations of their patients through asking the right questions. Although the lack of physicians and nurses who ask their patients what their expectations are has been widespread, steps are being taken towards improving on this problem.

Reference: Conaboy, Chelsea. "Few Doctors, Nurses Report Asking Patients about What They Expect in Their Care." Boston.com. The Boston Globe. . Oct 25 2011.

News Brief: Study Shows Why It's Hard to Keep Off Weight

Alexander Sakers

It is common knowledge that dieters often gain weight back soon after losing it, but up until now, the reason remained elusive. Why is it so hard for people to keep the weight off? A recent australian study showed that after a diet in which a person loses 10% or more of their bodyweight, levels of hormones associated with hunger drastically increase in response to the decrease in body fat. The levels of a key hormone, leptin which increases metabolism and reduces hunger, fell in response to dieting. This explains why immediately after a diet, many feel very hungry and gain their weight back. However, in a recent study, even when dieters kept the weight off for a year, leptin levels were still lower than pre-diet levels, their metabolism was slower than pre-diet, and hunger was elevated. Interestingly, when the dieters gained their weight back, their bodies returned to a more metabolically normal state, with normal levels of leptin and other hormones regulating hunger and metabolism. These results suggest that perhaps supplementing key hormones may help dieters to return to a more metabolically normal state after losing weight. One thing is clear: our bodies want to keep us fat.

Reference: Kolata, Gina. "Study Shows Why It's Hard to Keep Off Weight." The New York Times. Web. http://www.nytimes.com/2011/10/27/health/biological-changes-thwart-weight-loss-efforts-study-finds.html?_r=1&ref=health. Oct 26 2011.

News Brief: Nonprofit's Novel Approach to Food Education

Parsa Shabodaghi

Two former public school teachers founded FoodFight, a program that was designed to change adolescents’ paradigm on food. The goal of the program is to not only teach the political and socioeconomic aspects behind food production, but also teach children on how to live healthy, nutritious lifestyles.

One lesson involved teaching the children when an ad (such as one for a McDonald’s fish sandwich) was being targeted to their demographic. Another involved learning how the food industry lobbyists try to influence federal dietary recommendations.

Another aspect of the program involved teaches students how to read food labels and prepare nutritious and affordable meals.

The program has had a monumental impact on the behavior of some students. One individual switched from a sweetened drink to one without calories. Another person changed his portion sizes and has since lost ten pounds.

Institutionalizing programs like FoodFight may be key in turning the tides of the obesity epidemic.

Reference: Wallace, Hannah. "In High Schools, a Critical Lens on Food." The New York Times. Web. http://www.nytimes.com/2011/10/27/nyregion/foodfight-a-nonprofit-group-works-with-new-york-city-schools.html?_r=1&ref=health. Oct 27 2011.

News Brief: Efforts to Cut Risks to Patients at Cancer Clinics

Ariel Lefland

Due to low white blood cell count, or neutropenia, cancer patients are at heightened risk for infection; nearly 60,000 cancer patients per year must be hospitalized due to infection. Recent concerns regarding outbreaks of infections, including hepatitis B and C, have prompted the Centers for Disease Control and Prevention (CDC) to increase efforts to improve infection control. Targeted specifically at outpatient oncology clinics, a new infection-control guide released Tuesday follows a broader guide issued last summer to better less than satisfactory standards currently in place at many clinics. The new CDC campaign aims to reduce the rate of infection in over one million patients who receive chemotherapy and radiation treatments at outpatient facilities each year.
In the past ten years, the CDC reports, more than 125,000 patients have potentially been exposed to diseases solely from unsafe injection procedures. Other hazardous practices including improper medication preparation in blood-processing areas, common use of saline bags and re-use of single-dose vials led to closure of a New Jersey clinic. Twenty-nine cases of hepatitis B were identified and 2,700 patients total had to be notified of possible exposure to disease. Officials closed a Mississippi chemotherapy clinic this summer after an outbreak of bacterial infections that resulted from reusing needles.
The campaign is a voluntary program for outpatient clinics. It will promote strict observance of hand-hygiene guidelines, sterile procedures for preparing and administering medications and proper and safe injection practices. The CDC has also launched a new website that allows cancer patients to assay their own risk for infection and gain advice on prevention. Additionally, the CDC has reminded patients to ask for the flu shot, as influenza is an especially dangerous infection for cancer patients. Outpatient providers must understand and recognize the important of infection control in cancer patients; providers must be made aware of the risks of using poor sterile techniques and must learn proper procedures.

Reference: Landro, Laura. "Efforts to Cut Risk to Patients at the Cancer Clinic." The Wall Street Journal. Web. http://online.wsj.com/article/SB10001424052970203911804576651243331232116.html. Oct 25 2011.

News Brief: Drugs to Treat A.D.H.D. Reach the Preschool Set

Hallie Abelman

As of last week, the American Academy of Pediatrics revised its guidelines for the treatment of Attention Deficit Hyperactivity Disorder, providing doctors with the opportunity to prescribe A.D.H.D. medication to preschool children if behavioral efforts fail. Parents of children as young as three years old are now allowed to medicate their children whereas they used to be advised towards alternative approaches to treatment such as occupational therapy, diet changes, exercise, and behavior modification until their children reached age six. Although some children might respond positively to the drug therapy, it is difficult to ensure the accuracy of such a strong diagnosis at such a young age. Critics believe that Americans should be more skeptical of medication, especially since the number of children taking A.D.H.D. medication has increased steadily in recent years (as of 2008, 5.1% of children take ADHD medication). One long-term study has been done of young children taking the drug, conducted by the National Institute of Mental Health, in which 303 preschoolers and their parents participated in ten weeks of behavioral training and therapy before getting the option to take medication. This study led one third of the families to refrain from giving their children medication because the child’s behavior had improved so much already. In addition, the trial revealed that older children benefit more from the medication and that younger children were more susceptible to adverse side effects such as weight loss and anxious habits. The changing of guidelines is a controversial issue that will force parents to assess their child-rearing strategies when dealing with young children who are hyperactive. Difficulties emerge in distinguishing a healthy-active child who has a hard time focusing in kindergarten class from a child that deserves mind-altering medication. While the guidelines do not encourage doctors to prescribe drugs to three year olds, it provides a new option that has the potential to change the way our society treats children, suffering and disease.

Reference: Rabin, Caryn Roni. “Drugs to Treat A.D.H.D Reach the Preschool Set”. The New York Times Health. Web. http://www.nytimes.com/2011/10/25/health/25consumer.html?_r=1. October 30, 2011

News Brief: Obesity, Diabetes and Poverty Share a Common Zip Code: Does Your Neighborhood Determine Your Health Outcomes?

MJ Murphy

In a recent large social experiment conducted, researchers concluded that residents of high-poverty areas are more likely to be effected by chronic diseases such as obesity and diabetes. The study, conducted by Jens Ludwig, PhD, of the University of Chicago, found that people who dwell in impoverish areas or less racial separated areas have high body mass indexes than those who live in low poverty areas. The data was collected from three trial groups. One group received vouchers to subsidize relocation costs to a low-poverty area, a second group received vouchers that were not location specific, while the control group received no such vouchers. When the Body Mass Indexes were compared for the female head of households, it was found that the families that were given vouchers to move to a low-poverty area experienced the greatest absolute difference to that of the people living in the high-poverty area. It is unknown how reliable this study may be. It is plagued flaws such as its lack of follow up, baseline health information and randomized testing, because the participants volunteered. It also fails to address what factors are the determinants of the poor health in the impoverished regions. The paper offers lack of poverty and racial separation as correlated factors; however it fails to mention the drivers of the obesity and diabetes, such as healthy food access and density of chain food establishments.

Reference: Fiore, Kristina. "Obesity, Diabetes and Poverty Share a Common Zip Code". MedPage Today. http://www.medpagetoday.com/PublicHealthPolicy/PublicHealth/29130.Oct 19 2011. New England Journal of Medicine.