Dr. Buttery's Public Health BLOG

UCSD — In an effort to curb the rising rates of HIV and sexually transmitted infections (STIs) along the Mexico-US border, a binational team of researchers led by the University of California, San Diego School of Medicine have shown that brief but personalized behavioral counseling significantly reduced rates and improved condom use among female sex workers in Tijuana and Ciudad Juarez, Mexico. The researchers observed a 40 percent decline in the combined rate of new STIs (including HIV, syphilis, gonorrhea and Chlamydia) in the group of female sex workers who received the 30-minute one-on-one counseling intervention.

Posted by at 11:34 AM | Permalink | Comments (0)

The AP reports that last year, nearly "100,000 tests for breast cancer gene mutations were done," and as more women undergo the test, parents may now be facing "a tough question: Should we test the kids?" A number of "medical experts advise against such testing before age 25, saying that little can be done to prevent or screen for breast or ovarian cancer until then, so the knowledge would only cause needless worry." But various studies and interviews "show that many people who have BRCA gene mutations -- and even more of their offspring -- disagree." Still, "research...shows there can be benefits to at least talking about testing and inherited cancer risks with teens." This inherited risk could be lowered by taking "anti-estrogen drugs or having [one's] breasts or ovaries removed," but "these drastic measures are not advised for very young women." In fact, "mammograms are not advised till age 25." In light of these facts, some medical groups "say that when the risk of childhood cancer is low and nothing can be done to lower it, children should not be given gene tests."

Posted by at 12:26 PM | Permalink | Comments (0)

ScienceDaily— There may be no such thing as a 'safe' tan based on ultraviolet (UV) radiation, according to a series of papers published in the October issue of Pigment Cell & Melanoma Research, the official journal of The International Federation of Pigment Cell Societies (IFPCS) and the Society for Melanoma Research. The authors of the three review papers – leading researchers in the fields of cell biology, dermatology and epidemiology – have examined the effects on skin of UV radiation, including that from indoor tanning beds. As well as highlighting the need for greater research into this area, they have called for the use of such beds by under-18s to be banned, along with any publicity that claims that tanning beds are safe.

Posted by at 10:45 AM | Permalink | Comments (0)

A number of studies have shown associations between individual lifestyle factors, such as smoking and diet, and risk of chronic diseases, including cardiovascular diseases, type 2 diabetes and various cancers. Few studies, however, have looked at the bottom line -- how a combination of lifestyle factors might influence mortality. A new, large-scale study from researchers at the Harvard School of Public Health (HSPH) shows that women who followed a combination of healthy lifestyle factors -- not smoking, maintaining a healthy weight, regular physical activity and a healthy diet -- had a dramatically lower risk of dying from all causes during the two-and-a-half decades of the study. Furthermore, their risk reduction surpassed that from following any single healthy factor alone. It is the largest and longest-running study to directly estimate the impact of a combination of lifestyle factors on mortality. The study appears in advance online on Wednesday, September 17, 2008 in The British Medical Journal.

Posted by at 11:48 AM | Permalink | Comments (0)

The AP reports, "Far too many Americans are dying of dangerous blood clots that can masquerade as simple leg pain," according to government officials who aim "to get both patients and their doctors to recognize the emergency in time." Acting Surgeon General Steven Galson, M.D., who announced the new campaign on Monday, said, "I don't think most people understand that this is a serious medical problem, or what can be done to prevent it." Dr. Galson "issued a 'call to action' for better education of both consumers and doctors, plus more research." The AP notes, "At issue are clots with cumbersome names: A deep vein thrombosis, or DVT, forms in large veins, usually a leg or the groin. It can quickly kill if it moves up to the lungs, where it goes by the name pulmonary embolism, or PE." Some physicians, however, are also "ill-informed" when it comes to DVT awareness. Research suggests 33 percent "of patients who need protective blood thinners when they enter the hospital for major surgery don't get them."

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In continuing coverage from previous editions of Morning Rounds, the New York Times reports on the front page of its Science Times section that "a vast majority of emergency [department] (ED) patients are discharged without understanding the treatment they received, or how to care for themselves once they get home," according to a study published in the Annals of Emergency Medicine. Investigators "followed 140 English-speaking patients discharged from emergency departments in two Michigan hospitals, and measured their understanding in four areas -- their diagnosis, their [emergency department] treatment, instructions for their at-home care, and warning signs of when to return to the hospital." The researchers "found that 78 percent of patients did not understand at least one area, and about half did not understand two or more areas. The greatest confusion surrounded home care -- instructions about things like medications, rest, wound care, and when to have a follow-up visit with a" physician

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New research at the University of Calgary shows premature infants whose mothers smoked during pregnancy may be at higher risk for Sudden Infant Death Syndrome (SIDS) than preemies whose mothers did not smoke. This is the first study to investigate the effect of low oxygen and cigarette smoke exposure on infants' heart rate and breathing responses. “Smoking during pregnancy has two very serious effects with respect to SIDS,” says Dr. Shabih Hasan, a neonatologist and Professor in the Department of Pediatrics at the Faculty of Medicine, University of Calgary. “Not only does it raise the likelihood of a mother having a preterm baby, who are already among the most vulnerable to SIDS, but it increases those infants’ susceptibility to SIDS even further.”

Posted by at 10:13 AM | Permalink | Comments (0)

ScienceDaily — California's state tobacco control program saved $86 billion -- in 2004 dollars -- in personal healthcare costs in its first 15 years, according to a study by researchers at the University of California, San Francisco. California’s state tobacco control program saved $86 billion--in 2004 dollars--in personal healthcare costs in its first 15 years, according to a study by researchers at the University of California, San Francisco. During the same period, the state spent only a total of $1.8 billion on the program, a 50-to-1 return on investment, according to study findings. The study is the first that has been able to quantifiably connect tobacco control to healthcare savings, say its authors.

Posted by at 10:44 AM | Permalink | Comments (0)

Medscape reported that "for decades, women have been urged to perform a monthly breast self-examination (BSE), but recently, an increasing number of organizations have backed away from recommending routine self-exams." Several "studies evaluating the benefit of BSE have shown decidedly mixed results and, last month, a flurry of media stories reported on a Cochrane analysis that showed that BSE does not improve breast cancer survival and might, in fact, cause harm." But, "Mark Kane Goldstein, Ph.D., and H.S. Pennypacker, Ph.D., both members of the...research team that identified and validated the standards for proficient breast examination, with the support of the National Cancer Institute, pointed out in a detailed response that the media coverage was misleading, contained a number of errors, and omitted critical information."

Posted by at 10:39 AM | Permalink | Comments (0)

ScienceDaily (Aug. 20, 2008) — Chronic lead poisoning, caused in part by the ingestion of contaminated dirt, affects hundreds of thousands more children in the United States than the acute lead poisoning associated with imported toys or jewelry. Could treating contaminated soil with water prevent this public health scourge? In a study appearing in the August issue of the journal Applied Geochemistry, Gabriel M. Filippelli, Ph.D., professor of earth sciences conducted a literature review of studies of urban soils as a persistent source of lead poisoning and also investigated the lead burden in the soils from a number of cities, including Indianapolis. His findings reveal that older cities like Indianapolis have a very high lead burden resulting in a lead poisoning epidemic among their youngest citizens. Comment: The home environment causing lead poisoning is nothing new. #) years ago studies near the I 95 beltway in the region of the Pentagon showed contaminated soil from tetraethyl;l lead, and associated poisoning among children. This study was one of many that lead to the banning of lead in gasoline. There is also the problem of lead paint flaking from houses into the soil, that is well known in urban housing. While the idea of protecting children from soil is useful, it is more important to ensure that lead paint in housing is either removed or protected using rental codes. This has been well demonstrated for more than 40 years, but the realty industry has fought protection of children, usually low income renters, who have little power to protect themselves.

Posted by at 11:10 AM | Permalink | Comments (0)

60 years ago when in medical school I and my fellow students, along with the audience laughed ourselves sick at Roger Livsey (in the movie Dr. in The House) act as a swearing ,scalpel throwing surgeon at the 'Radcliffe' Infirmary in Oxford, particularly those of us training in London. Now, at last, according to the Boston Globe, the Joint Commission (JC), the national group that accredits healthcare organizations, "is requiring all hospitals, nursing homes, and other healthcare facilities to adopt 'zero-tolerance' policies by Jan. 1, including codes of conduct, ways to encourage staff to report bad behavior, and a process for helping and, if necessary, disciplining offenders." An increasing amount of "research suggest[s] that swearing, yelling, and throwing objects are not just rude and offensive to co-workers, but hurt patients by increasing the likelihood of medical errors."

Posted by at 9:44 AM | Permalink | Comments (0)

A wonderful example of how to confuse people. .Food and Drug Administration (FDA) has approved six influenza vaccines intended to target strains that "are likely to cause flu in the United States" during the 2008-09 season. Agency officials explained that every year, the "vaccines are modified to reflect the virus strains most likely to be circulating," and the "closer the match between the circulating strains and the strains in the vaccines, the better the protection." Last year's flu vaccine didn't match two of three main types of flu that sickened people. Still, the "vaccination remains the cornerstone of preventing influenza. Comment: The problem is that the flu virus mutates so rapidly, and dispersion is so simple (with air travel) that it is very difficult to predict what strain will be dominant in the US each fall. It still takes so long to identify and prepare a new targeted vaccine that we will have to wait for improved technology before a real annual match tor currently circulating strains can be developed..

Posted by at 9:39 AM | Permalink | Comments (2)

ACOG recommends routine HIV screening for all women ages 19 to 64, regardless of pregnancy status or what their risk factors might be," Dr. Jamieson said. "ACOG also recommends targeted screening for women outside this age range who are at high risk. For example, all sexually active teenagers under 19 should be tested, as well as women older than 64 who have had multiple partners in recent years."
It is estimated that one-quarter of all Americans with HIV are unaware of their status. Women continue to represent a growing proportion of HIV and AIDS cases, and it's critical that they know their status. According to ACOG, this knowledge can improve women's chances of survival, reduce associated illnesses, help them take steps to avoid unintended pregnancy, protect their sexual partners, and reduce the likelihood of mother-to-child transmission should pregnancy occur.

Posted by at 12:35 PM | Permalink | Comments (1)

In the health care field, activists are those who want a bigger share of the money pie. With the recent news that CDC undercounted the prevalence of HIV positives in the US activists want more money thrown at a program where everything reasonable is already being done. Their complaint is that more money must spent on prevention. Dr, Fauci has laid out in recent articles in "Science" why developing a vaccine is so difficult. For the rest, prevention is based on individual action. HIV infection is 99% preventable by minimizing multiple sex partners, use of condoms, testing for hIV if one's behavior puts you at risk. We do not know how to change sexual behavior. I have seen many groups try since the end of WW II, when we thought penicillin would end STDs, it has not, Instead of activists screaming ar government they must work closely with high risk groups and attempt to change their behaviors. Until they have some success at this they should keep quiet.

Posted by at 10:39 AM | Permalink | Comments (0)

The Agency for Healthcare Research and Quality and the AARP today released two new checklists designed to help men and women over the age of 50 learn how to stay healthy and prevent disease.
AHRQ and AARP also released an accompanying wall chart, the Staying Healthy at 50+ timeline, that provides information about recommended preventive services and can be posted in both clinical and community settings. These three publications Men: Stay Healthy at 50+, Checklists for Your Health; Women: Stay Healthy at 50+, Checklists for Your Health;and the Staying Healthy at 50+ timeline show at a glance the evidence-based recommendations from the U.S. Preventive Services Task Force regarding screening tests, preventive medicines and healthy lifestyle behaviors for people 50 and older.

Posted by at 10:01 AM | Permalink | Comments (2)

From the Wall Street Journal: Killings by home-care providers remain rare, but they are only the most extreme examples of what prosecutors and advocates for the elderly say is a growing number of cases of abuse, neglect or fraud in which home caregivers take advantage of the frail and the ill. And that's prompting calls for better oversight of an industry that's expanding fast as more Americans age and try to avoid nursing homes. Health aides are often certified nursing assistants, who are generally licensed and regulated. But the bulk of the abuse cases involves caregivers hired to provide nonmedical assistance. These caregivers, who aren't required to receive specialized training, are only loosely overseen. Comment: With the increasing size of the elderly population, many of whom need assistance, but are not willing to go into nursing homes, there needs to be stringent oversight for any person willing to provide home assistance services.

Posted by at 11:03 AM | Permalink | Comments (0)

University of British Columbia researchers have invented a sports helmet that reduces direct impact to the neck by up to 56 per cent, according to preliminary tests. “Existing helmets are not designed to protect the neck and the cervical region of the spine, which happens to be the weakest,” says co-inventor Peter Cripton, a Mechanical Engineering assistant professor in the Faculty of Applied Science. Comment: There are many head and neck injuries in sports leading to paralysis, particularly from two wheeled vehicles, horse riding, off road racing for example, all of which would benefit from an improved helmet

Posted by at 9:39 AM | Permalink | Comments (0)

According to the new report—Fertility Regulation Behaviors and Their Costs: Contraception and Unintended Pregnancies in Africa and Eastern Europe and Central Asia — 35 poor countries in Sub-Saharan Africa and other regions (Timor-Leste, Afghanistan, Djibouti, and Yemen) have the world’s highest birth rates (more than five children per mother) while also reflecting some of the world’s poorest social and economic results, with low levels of education, high death rates, and extreme poverty. Moreover, many poor women turn to abortion as a last-resort means of birth control. Some 68,000 women die each year as a result of unsafe abortion, while another 5.3 million suffer temporary or permanent disability as a result.
The report also says that pregnancies which are less than 15 months spaced apart more than double the risk of the mother dying. Children born 3 years after a previous birth are healthier at birth and more likely to survive. Teenage pregnancies carry a higher risk of obstetric complications such as obstructed labor, eclampsia and fistula formation, and yet teenagers are less likely to receive antenatal or obstetric care, making them twice as likely to die during childbirth as women over the age of 20.

Posted by at 11:34 AM | Permalink | Comments (0)

NBC Nightly News reported that "when the pediatricians in this country start talking about cholesterol-lowering medications for children,...it may be one indicator of a very big problem." ABC World News added that U.S. pediatricians have put forth "a new and quite controversial proposal,...calling for an early approach and aggressive approach toward high cholesterol" in children. The Washington Post reports that the "American Academy of Pediatrics (AAP) Committee on Nutrition has updated its 10-year-old cholesterol screening and treatment guidelines." The new guidelines were published in the July issue of Pediatrics. Comment: This a perfect example of “medicalisation’ of health. To start putting 30-40% of youngsters on medicine for the rest of their lives, rather than holding parents responsible for oversight of their children, is the easy way out and very profitable for the drug companies involved. It seesm like a conflict of interest for the pediatric society.

Posted by at 10:51 AM | Permalink | Comments (0)

Reporting on a major success in preventing children from being born with one form of mental deficiency UNICEF has just released a report of international efforts to ensure that all salt, worldwide, is iodized. Similarly flour has had folic acid added to it while early detection of PKU allows nutritional intervention to prevent mental deficiency in children. We do not tell enough about our successes in nutritional intervention, but the media focus in supposed benefits (usually spurious) of over the counter nutritional supplements

Posted by at 9:34 AM | Permalink | Comments (0)

In a study presented at the Annual meeting of the Endocrine Society, Roshney Jacob-Issac, M.D., of George Washington University Hospital, and colleagues, "used 2,690 male diabetic veterans in VA [Veterans Administration] hospitals, most of whom were overweight or obese based on their body mass index (BMI)." Participants "were categorized as having low, moderate, or high fitness level, depending on their performance on a standard treadmill exercise tolerance test." The authors "found that the higher the man's level of fitness, the lower his risk of dying during the study period." Dr. Jacob-Issac concluded that people with diabetes "should improve their fitness level or exercise capacity to at least a moderate level, by being physically active." Comment: I wonder how often we have to repeat research establishing the value of physical fitness in preventing disease and delaying development of disabily.

Posted by at 9:55 AM | Permalink | Comments (0)

From the New York Times today is a story about government action that would be howled down in the US. where we are more interested in 'right' than 'responsibility." Under a national law that came into effect two months ago, companies and local governments must now measure the waistlines of Japanese people between the ages of 40 and 74 as part of their annual checkups. That represents more than 56 million waistlines, or about 44 percent of the entire population. To reach its goals of shrinking the overweight population by 10 percent over the next four years and 25 percent over the next seven years, the government will impose financial penalties on companies and local governments that fail to meet specific targets. Compare this to the US/State efforts to curb obesity (particularly in children) which is mainly health education, which rarely works without back up penalties.

Posted by at 10:06 AM | Permalink | Comments (3)

Each year about 1700 cases of malaria occur in the United Kingdom, 1300 in the United States, and 3000 in France. Less than half of travellers who acquire malaria have taken advice before travelling. Using intervention strategies for travelers visiting friends and relatives—such as increasing awareness in the community, dispelling myths about immunity or subsidizing antimalarials—could considerably reduce imported malaria. From the BMJ [BMJ 2008;336:1362-6]

Posted by at 8:46 PM | Permalink | Comments (0)

Looking at the mutliple research studies on health it becomes clear, despite the poor quality of many studies, there are two consistent messages that should be taken to heart, To grow older and have less likelihood of cancer and improved mental abilities as one ages it is necessary to indulge in regular exercise and learning. The studies show that likelihood of cancer, heart disease, and diabetes, among other chronic diseases, are lower among those who exercise. The likelihood of mental deterioration, Alzheimer's diseases and limited cognitive ability are decreased with lifelong learning. Use your muscles and your brain daily and your health will be enhanced.

Posted by at 11:13 AM | Permalink | Comments (0)

New research suggests that more pregnant women are prediabetic, and that infant health can be improved by evaluating diabetic predisposition. The American Diabetes Association states "The number of pregnant women with pre-existing diabetes is rapidly increasing, leading to increased health risks for both the mothers and their unborn children. The seriousness of this problem was brought home by a new ADA-funded study, which showed a doubling of the number of pregnant women with diabetes over a seven-year period."
Women are at higher risk for diabetes if they:
Are overweight
Are physically inactive
Are over the age of 45
Have a family history of diabetes (parent, brother, or sister)
Are a member of high-risk ethnic population (e.g., African American, Hispanic/Latino, Native American, Asian American, Pacific Islander)
Had gestational diabetes (diabetes during pregnancy) or had a baby weighing more than nine pounds at birth
Have high blood pressure
Have abnormal blood fat levels (cholesterol or triglycerides)
Have been diagnosed with Polycystic Ovarian Syndrome (a condition of irregular periods and infertility)
Have ever been told you have pre-diabetes
Have a history of heart disease or stroke

Posted by at 10:50 AM | Permalink | Comments (0)

The following from Science Daily is an example of the valuable information available from this site, I recommend a daily visit:
Researchers have found that a new obesity prevention program reduced the risk for onset of eating disorders by 61 percent and obesity by 55 percent in young women. These effects continued for as long as 3 years after the program ended. These results are noteworthy because, to date, the idea that we can reduce risk for future onset of eating disorders and obesity has been an unrealized goal: over 80 prevention programs have been evaluated, but no previous program had been found to significantly reduce risk for onset of these serious health problems.
One of the important issues is that few programs touted for schools have had much effect. What we do not know yet is what happens after three years. If all we do is delay obesity a few years it will make little difference over a life span now approaching 80 years. Preventing chronic disease requires lifelong behavioral changes.

Posted by at 9:45 AM | Permalink | Comments (0)

Doctors are trained mainly on younger patients and have little training to cope with older ones. Now from a study at Imperial College, London we learn that lowering the blood pressure of elderly patients could cut their total mortality by a fifth and their rate of cardiovascular events by a third, according to a new study presented today at the American College of Cardiology in Chicago. In the largest ever clinical trial to look at the effects of lowering blood pressure solely in those aged 80 and over, Benefits of treatment include a 21 percent reduction in total mortality rate, a 39 percent reduction in stroke mortality rate, a 64 percent reduction in fatal and non-fatal heart failures and a 34 percent reduction in cardiovascular events. The benefits were apparent within the first year of follow-up.

Posted by at 9:49 AM | Permalink | Comments (1)

In a new study, an international team of heart experts at Johns Hopkins and elsewhere report that rats fed 10 milligrams daily of folate, also known as folic acid or vitamin B9, for a week prior to heart attack had smaller infarcts than rats who took no supplements. On average, researchers say, the amount of muscle tissue exposed to damage and scarred by the arterial blockage was shrunk to less than a tenth. The team's findings, set for publication in the April 8 edition of the journal Circulation, come just weeks after other international studies in humans suggested that low-dose folic acid supplements may prevent dementia in the elderly and premature births.
While people are not rats, study after study has shown that folic acid, found in green leafy vegetables, is one of the few consistent findings about the human diet. Further, this naturally occurring dietary supplement continues to show its value not only during the perinatal period but throughout life. Broccoli and other greens really are worth eating.

Posted by at 9:58 AM | Permalink | Comments (0)

Colorectal Cance interventions have worked well. Death and diability is prevented in most cases when found among asymptomatic individuals. The two new tests, added to five others, are CT colonography (CTC), also known as virtual colonoscopy, and stool DNA-testing. Stool DNA-testing will mainly aid the detection of cancer, similar to testing for faecal occult blood, but without the need for multiple stool samples and without reliance on the non-specific and intermittent occult bleeding. CTC is minimally invasive, allows examination of the entire colon and rectum, and takes only about 10 min to acquire images. Patients undergoing CTC still require full bowel preparation. The Cancer society says the real issue of successful screening, however, remains the dismal uptake—about 30% for colonoscopy and 15% for faecal occult blood-testing in the USA. Colorectal cancer can only be prevented and mortality reduced if all screening tests are offered widely and people are made aware of the importance of screening. If the use of these screening tests is to increase then the discomfort associated with the preparation must decrease. (Volume 371, Issue 9616, 15 March 2008-21 March 2008, Page 872 )

Posted by at 10:54 AM | Permalink | Comments (0)

Secondary Prevention of Sickle Cell crises occur because of failure to use medication. As reported by the AP today. Ten years after government approval of the first sickle cell treatment, only a tiny fraction of patients use the drug — despite new research showing the disease is far more painful than doctors ever suspected.
Ignorance on the part of both physicians and patients is to blame for underuse of hydroxyurea, concludes an expert panel convened by the National Institutes of Health.
Worse, there's no other treatment in the pipeline for a disease that afflicts up to 100,000 Americans, most of them black — not only shortening their lives but causing regular pain.ttacks so severe that they frequently require long hospitalizations. "It's sort of amazing how ignored this disease is," says Dr. Sophie Lanzkron of Johns Hopkins University in Baltimore, which this month opened a special clinic to handle those pain crises that already has begun reducing ER visits. "The whole idea that the first genetic disease described to man has just one FDA-approved medication, it's just amazing."
Hydroxyurea, which costs "less than $100 a month," is the only FDA-approved treatment for the disease. It has been shown "to dramatically reduce sickle cell pain crises, hospitalizations, and some organ damage."

Posted by at 9:39 AM | Permalink | Comments (0)

The National Osteoporosis Foundation (NOF) is releasing its new Clinician’s Guide to Prevention and Treatment of Osteoporosis representing a major breakthrough in the way healthcare providers evaluate and treat people with low bone mass or osteoporosis and the risk of fractures.
The NOF summarizes universal recommendations in its 5 Steps to Bone Health. These 5 Steps advise people to:
1. Get the daily recommended amounts of calcium and vitamin D.
2. Engage in regular weight-bearing and muscle-strengthening exercise.
3. Avoid smoking and excessive alcohol.
4. Talk to your healthcare provider about bone health.
5. Have a bone density test and take medication when appropriate.

Posted by at 11:36 AM | Permalink | Comments (0)

The time has come for breast cancer risk assessment, counseling and genetic testing to move from cancer specialists to the realm of primary care, according to a presentation at the AAAS annual meeting, held this year in Boston.
"A growing body of evidence has documented the benefits of preventive measures for high-risk women including those with mutations in the BRCA1 and BRCA2 genes," said Funmi Olopade, MD. "Referral for cancer-risk assessment and BRCA testing in the primary care setting is a necessary next step towards personalized medicine for women at risk for breast cancer."
Most high-risk women present in the primary care setting. Primary care physicians should learn about the genetics of cancer risk, take a comprehensive personal and family history and advise patients who appear to be at increased risk about the plusses, minuses and limitations of genetic testing and risk-reduction strategies.

Posted by at 11:25 AM | Permalink | Comments (0)

STD infections continue to increase in prevalence inteh U.S. but in Australia a new study indicates that the safe sex message is getting through to Australian women, with nearly 70 per cent of those surveyed currently using contraception and 15 per cent using not one but two contraceptive methods to prevent pregnancy and protect themselves from sexually transmitted diseases.It uses survey data from more than 3000 women aged between 18 and 44 about their contraceptive use. The variation in the seven most prevalent contraceptive practices between different age groups, marital status, parity, education level, place of residence, birthplace, and Aboriginal or Torres Strait Islander descent was examined.
Two-thirds of respondents were using contraception, including more than 15 per cent who used more than one method. The contraceptive pill was the most widely used method (39 per cent), followed by the condom (28 per cent). Interestingly, more than one-quarter of pill users (28 per cent) were using condoms as well.

Posted by at 11:20 AM | Permalink | Comments (0)

A new CDC study reveals that an alarming number of adults fail to recognize heart attack warning signs and symptoms that could, if heeded, save their lives, according to a new Centers for Disease Control and Prevention (CDC) study conducted in 14 states. Men (22.5 percent), blacks (16.2 percent), Hispanics (14.3 percent), and those with less than a high school education (15.7 percent) are less likely to know the major signs of a heart attack. They were also least likely to call for emergency assistance; compared to women (30.8 percent), whites (30.2 percent) and those with higher educations (33.4 percent).

Posted by at 11:54 AM | Permalink | Comments (1)

We are told today about the early stoppage of NIH sponsored research (the ACCORD study) to reduce heart disease deaths among diabetics by strict and aggressive control of blood sugar levels. Early results have shown that aggressive treatment is more harmful than moderate approaches. Now we need to learn why, and how to provide better care of diabetics. Clearly primary prevention by encouraging better weight control, more exercise, and better diets are preferable to fixing the problem after it occurs. It is too bad that behavioral science has so little to offer.

Posted by at 9:04 AM | Permalink | Comments (0)

One more blow for complementary medicines beloved by liberals. Many low income people go to 'Nature foods', 'Herbal' and 'Vitamin' stores in belief that these relatively cheap 'traditional' pills, powders and salves will help them. Here is another piece of evidence that they can cripple and kill, particularly children but often adults. It is really time for federal oversight of 'Herbal' and 'traditional' remedies sold across the counter without any controls.

Posted by at 11:32 AM | Permalink | Comments (0)

CDC "urges all women -- and particularly young women -- to make sure" that they incorporate "400 micrograms of folic acid" into their diets "daily . The value of folic acid in prevention of neural tube defects in newborn has been known for decades, but it is only in the last decade that serious efforts have been made to encourage the use of folic acid among women. In spite of the educational efforts less than 50% of women of childbearing age are taking such supplements regularly

Posted by at 9:23 AM | Permalink | Comments (1)

In an article in Health Affairs this month; Health Affairs, 27, no. 1 (2008): 58-71, the authors from the London School of Hygiene and Tropical Medicine compared 30 conditions in the European Union and the USA that were responsive to preventive interventions. As might be expected in a country where technology is more important than prevention, the U.S. came in last among the 19 countries studied! In a previous study 10 years ago the U.S. was only 15th. It is high time that those suggesting changes in the health care system focused on prevention of diseases that become more prevalent as the population ages, or we will soon bankrupt the health care system..

Posted by at 10:20 AM | Permalink | Comments (0)

Saint Louis University School of Nursing and a member of the university's Pandemic Response Planning Committee say you should:
Get a flu shot
Wash your hands often
Avoid touching your eyes, nose and mouth
Avoid close contact with people who are sick
Get plenty of sleep, eat nutritious food, drink plenty of water and other fluids and learn how to manage your stress
Cover your nose and mouth. If you're about to sneeze or cough
If you're sick - stay home,!

Posted by at 9:43 AM | Permalink | Comments (0)

At a water and health symposium at the Johns Hopkins Bloomberg School of Public Health which focused on developing countries many of the suggestions could apply to areas in the US, for example: while taking a drink of water in the United States no longer carries the threat of cholera or typhoid fever—as it did 100 years ago—Schwab said that new problems pose new risks. Emerging pathogens resistant to chlorine disinfection. Aging water pipes. Agricultural contamination of surface and groundwater. The Center for Water and Health is currently testing the effectiveness of some “point-of-use” water treatment systems—typically meant for use in the home—to provide potable water to isolated and rural communities, One such strategy is the use of ceramic water filters, in the form of pots made from terracotta clay and sawdust. Unclean water is pored through the pot, which is completely porous, to strain potentially deadly bacteria. The filtered water is collected in a container beneath the pot.

Posted by at 10:51 AM | Permalink | Comments (0)

Thanksgiving is nearly here. Turkey preparation, eating out and food poisoning time, both at home and at restaurants will occur. Wash hands, not only after using the restroom and before and after food preparation, but also after handling raw meats and other foods that can contaminate ready-to-eat items. Hand washing also is a good idea after touching telephones, cameras and other frequently used items. Work soap into a lather for 20 seconds, wash around rings and under fingernails. Even better, remove all rings and bracelets before preparing & serving food. Rinse hands thoroughly under running water and use a dry paper towel to turn the faucet off. It doesn't do any good to wash your hands if you touch the knobs everyone turned on with dirty hands. Preventing sickness during the holidays, especially food-borne illness, requires vigilance from both cooks and partygoers, Finally choose your restaurants with care, watch the food handler behaviors. Do not be afraid to get up and leave if you see anything unhygienic.

Posted by at 10:32 AM | Permalink | Comments (0)

This data from the NAMCS survey for 2003-2995 does not suggest that Drs. take obesity seriously, or do not believe that behavioral change is possible.

Posted by at 2:46 PM | Permalink | Comments (1)

A study from Columbia University Mailman School of Public Health and the Virginia Commonwealth University shows that a student graduating from high school after attending smaller-sized classes gains an average of 1.7 quality-adjusted life-years and generates a net $168,431 in lifetime revenue. “Higher earnings and better job quality enhance access to health. Peter A. Muennig, MD, MPH, assistant professor of Health Policy and Management at the Mailman School says,. “Regardless of class size, the net effect of graduating from high school is roughly equivalent to taking 20 years of bad health off of your life." More cost effective than direct health care

Posted by at 9:38 AM | Permalink | Comments (0)

Hospitality workers' exposure to harmful second hand smoke has fallen by 95 per cent since smokefree workplaces were introduced in England on 1 July 2007, according to new research revealed today (Monday) at the National Cancer Research Institute Conference in Birmingham on the three month anniversary of smokefree England. Researchers calculated that on average, employees' exposure was the equivalent to smoking 190 cigarettes a year before the legislation, and this dropped to the equivalent of around 44 cigarettes after.

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On 26 September 2007 Norwegian Prime Minister Jens Stoltenberg unveilled "Deliver Now" during the Clinton Global Initiative annual meeting - part of a series of events to launch the campaign in New York. This is the second initiative of the Global Campaign for the Health MDGs. Prime Minister Stoltenberg will launch a "Network of Global Leaders" to provide political momentum and promote investment in mother and child health services. The global launch will be followed by regional launches and country action to begin in 2008. The campaign is being coordinated by The Partnership for Maternal, Newborn & Child Health.

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