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.
The United States Environmental Protection Agency (EPA) declared a public health emergency in the Montana towns of Libby and Troy on June 17, 2009. An investigation into the alarming rate of asbestos-related illnesses in the town is what prompted the announcement. Libby is the site of the largest vermiculite deposit in the world and and produced around 80% of the world's vermiculite, the vermiculite was contaminated with tremolite asbestos, well known as a cause of Mesothelioma. Based on a rigorous re-evaluation of the situation on the ground, The EPA will move aggressively on the cleanup efforts and protect the health of the people. $130 million will be spent by the government on asbestos cleanup efforts and also to improve the community health care system for those with asbestos-related illnesses. Approximately $125 million will come from the EPA over the next five years to clean up both Libby and Troy. An extra $6 million will be spent by the Health and Human Services Department (HSS) on medical assistance.
The AP reports, "The world's 65-and-older population will triple by mid-century to 1 in 6 people, leaving the US and other nations struggling to support the elderly." In fact, the "number of senior citizens has already jumped 23 percent since 2000 to 516 million, according to census estimates released on Tuesday. That's more than double the growth rate for the general population." Currently, seniors "comprise just under 8 percent of the world's 6.8 billion people. But, demographers warn the biggest shift is yet to come. They cite a coming wave of retirements from baby boomers and China's Red Guard generation that will shrink pensions, and add to rising healthcare costs." Data show that, in the US for instance, "residents who are 65 and older currently make up 13 percent of the population, but that will double to 88.5 million by mid-century. In two years, the oldest of the baby boomers will start turning 65. The baby boomer bulge will continue padding the senior population year after year, growing to 1 in 5 US residents by 2030."
The New York Times reports, "Contrary to the popular assumption that the new swine flu pandemic arose on factory farms in Mexico, federal agriculture officials now believe that it most likely emerged in pigs in Asia, but then traveled to North America in a human." However, "they emphasized that there was no way to prove their theory and only sketchy data underpinning it." Officials note the lack of evidence that the virus "has ever circulated in North American pigs, while there is tantalizing evidence that a closely related 'sister virus' has circulated in Asia." Dr. Amy L. Vincent, a swine flu specialist at the Department of Agriculture, said, "The most likely scenario is that it came over in the mammalian species that moves most freely around the world," people.
New research shows that physicians failed to report clinically significant abnormal test results to patients -- or to document that they had informed them -- in one out of every 14 cases of abnormal results. In some medical groups, the failure rate is close to zero; in others it is as high as one in four abnormal results.
The study suggests that five simple, common-sense processes are useful for dealing with test results:
1. All test results are routed to the responsible physician
2. The physician signs off on all results;
3. The practice informs patients of all results, normal and abnormal, at least in general terms;
4. The practice documents that the patient has been informed; and
5. Patients are told to call after a certain time interval if they have not been notified.
And if you did not think going to college was perilous, just from acquired STDs, now a new study has found substantial reductions in binge drinking since the national drinking age was set at 21 two decades ago, with one exception: college students. The rates of binge drinking in male collegians remain unchanged, but the rates in female collegians have increased dramatically.
A new article "American Healthy Homes Survey: A National Study of Residential Pesticides Measured from Floor Wipes." Environmental Science & Technology, 2009; 43 (12): 4294 tell us that technology can ,measure past use/abuse of pesticides in homes. Comment: However being able to measure a compound at parts per billion or less tell us nothing about possible causes/effects. It become one more tool for the EPA to use to get more funds because of potential peril.
The U.S. Food and Drug Administration today advised consumers to stop using three products marketed over-the-counter as cold remedies because they are associated with the loss of sense of smell (anosmia). Anosmia may be long-lasting or permanent.
The products are:
--Zicam Cold Remedy Nasal Gel
--Zicam Cold Remedy Nasal Swabs
--Zicam Cold Remedy Swabs, Kids Size (a discontinued product)
The FDA has received more than 130 reports of loss of sense of smell associated with the use of these three Zicam products. In these reports, many people who experienced a loss of smell said the condition occurred with the first dose; others reported a loss of the sense of smell after multiple uses of the products.
"Loss of sense of smell is a serious risk for people who use these products for relief from cold symptoms," said Janet Woodcock, M.D., director of the FDA's Center for Drug Evaluation and Research (CDER). "We are concerned that consumers may unknowingly use a product that could cause serious harm, and therefore we are advising them not to use these products for any reason."
Comment: One more OTC product found sufficiently harmful to withdraw from stores. It is one more example of a highly advertised product that not only does not perform as touted but is in fact dangerous.
The Chicago Tribune (6/18) reports, "Probiotics...have broken out of the dairy case and are colonizing other areas of the supermarket" because they are "thought to aid digestion and support the immune system." But as more manufacturers fortify their foodstuffs, experts are beginning to "caution that the word 'probiotic' is widely misused by the industry and misunderstood by consumers." Currently, "there is no standard definition of probiotics, according to the" FDA. "But scientists generally say the term refers to foods, beverages, or supplements containing live microorganisms that studies show promote health when people take enough of them. Without studies, products shouldn't be called probiotic." Comment: one more piece of false advertising, usually from Dannon for their Yogurt, who are currently being investigated by the European Union for false statements.. There are a number of beliefs among credible clinicians, for specific purposes but few if any clinical studies that support these beliefs.
A new study by Indiana University-Purdue University Indianapolis (IUPUI) researchers contradicts the conventional wisdom that living near a fast food outlet increases weight in children and that living near supermarkets, which sell fresh fruit and vegetables as well as so-called junk food, lowers weight. The IUPUI investigators in economics, pediatrics, geography and urban planning compared children's weights over time before and after one of these food purveyors moved near the childrens' residences. Living near a fast food outlet had little effect on weight and living near a supermarket did not lower it. Comment: One more study contradicting a long held belief by many behaviorists.
