Female athletes using special program saw all injuries cut by a third, researchers say
FRIDAY, Dec. 12 (HealthDay News) -- A good warm-up program may dramatically reduce sports injuries, a new report says.
A study by the Norwegian School of Sport Sciences found that focusing on strength improvement, balance, core stability and muscular awareness cut injuries by a third among almost 1,900 teenage female football players; severe injuries fell by almost half.
The study is published online in BMJ.
Study participants either did traditional warm-up exercises or the "11+" program, which consists of slow and speed running, strength and balance improvement exercise, and movements that focus on core stability, hip control and knee alignment. The 11+ also emphasized the importance of internal muscular awareness.
The authors concluded by calling for the program to be implemented as a key element of coaching, education and training in football.
While the number of lower leg injuries between the groups were statistically similar, many fewer severe injuries, overuse injuries and overall injuries occurred in players in the 11+ group. The results might have been even more favorable but not all 11+ participants kept up with the program all season.
In an accompanying editorial, John Brooks, an injury expert for the Rugby Football Union, called for people to adopt a warm-up program like the 11+ regardless of what sport or levels they play at, citing the lower incidence of severe injuries.
Monday, December 15, 2008
Regimens: Acupuncture Provides Headache Relief
Acupuncture for the Management of Chronic Headache: A Systematic Review (Anesthesia and Analgesia)
In 1998, the National Institutes of Health accepted acupuncture as a useful alternative treatment for headaches, but warned that there were not enough clinical trials to draw firm conclusions about its efficacy. Now a systematic review of studies through 2007 concludes that acupuncture provides greater relief than either medication or a placebo.
The report, which appears in the December issue of Anesthesia and Analgesia, reviewed 25 randomized controlled trials in adults that lasted more than four weeks. In seven trials comparing acupuncture with medication, researchers found that 62 percent of 479 patients had significant response to acupuncture, and only 45 percent to medicine.
Fourteen of the studies, with a total of 961 patients, compared acupuncture with a placebo, a treatment in which patients were led to believe they were getting acupuncture. Of these, 53 percent found some pain relief with acupuncture, compared with 45 percent who felt better with the placebo. In four studies comparing acupuncture with massage, the massage worked better than acupuncture, but those studies were too small to draw statistically significant conclusions.
“People who get acupuncture prefer it to medication, because of the potential side effects of drugs,” said Dr. Tong J. Gan, a co-author of the review and a professor of anesthesiology at Duke. “This is an alternative treatment that is starting to move into the mainstream.”
In 1998, the National Institutes of Health accepted acupuncture as a useful alternative treatment for headaches, but warned that there were not enough clinical trials to draw firm conclusions about its efficacy. Now a systematic review of studies through 2007 concludes that acupuncture provides greater relief than either medication or a placebo.
The report, which appears in the December issue of Anesthesia and Analgesia, reviewed 25 randomized controlled trials in adults that lasted more than four weeks. In seven trials comparing acupuncture with medication, researchers found that 62 percent of 479 patients had significant response to acupuncture, and only 45 percent to medicine.
Fourteen of the studies, with a total of 961 patients, compared acupuncture with a placebo, a treatment in which patients were led to believe they were getting acupuncture. Of these, 53 percent found some pain relief with acupuncture, compared with 45 percent who felt better with the placebo. In four studies comparing acupuncture with massage, the massage worked better than acupuncture, but those studies were too small to draw statistically significant conclusions.
“People who get acupuncture prefer it to medication, because of the potential side effects of drugs,” said Dr. Tong J. Gan, a co-author of the review and a professor of anesthesiology at Duke. “This is an alternative treatment that is starting to move into the mainstream.”
Wednesday, December 10, 2008
UN: Accidents Kill 800,000 Kids A Year
POSTED: 5:30 am HST December 10, 2008
U.N. officials said simple things like seat belts, childproof medicine caps and fences around pools could save hundreds of thousands of children's lives every year.
A report released Wednesday by the World Health Organization and UNICEF at a conference in Vietnam counts more than 800,000 children who die each year from burns, drowning, car crashes and other accidents. Most of those deaths occur in developing countries.
"Child injuries are an important public health and development issue. In addition to the 830,000 deaths every year, millions of children suffer non-fatal injuries that often require long-term hospitalization and rehabilitation," WHO Director-General Dr. Margaret Chan said in a news release.
Chan said the costs to treat such injuries can throw a family into poverty.
"Children in poorer families and communities are at increased risk of injury because they are less likely to benefit from prevention programs and high-quality health services," she said.
The report said with more safety measures in place, countries could prevent half of those deaths. Suggestions include seatbelt and helmet laws, water heater controls and safer designs for nursery furniture and toys. The report also recommends various traffic safety improvements.
The report said such steps have been taken in many high-income countries and have reduced child injury deaths by up to 50 percent over the last 30 years.
The report found that the top five causes of injury deaths are:
Road crashes: They kill 260,000 children a year and injure about 10 million. They are the leading cause of death among 10- to 19-year-olds and a leading cause of child disability.
Drowning: It kills more than 175,000 children a year. Every year, up to 3 million children survive a drowning incident. Due to brain damage in some survivors, non-fatal drowning has the highest average lifetime health and economic impact of any injury type.
Burns: Fire-related burns kill nearly 96,000 children a year and the death rate is 11 times higher in low- and middle-income countries than in high-income countries.
Falls: Nearly 47,000 children fall to their deaths every year, but hundreds of thousands more sustain less serious injuries from a fall.
Poisoning: More than 45,000 children die each year from unintended poisoning.
Distributed by Internet Broadcasting Systems, Inc. The Associated Press contributed to this report. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
U.N. officials said simple things like seat belts, childproof medicine caps and fences around pools could save hundreds of thousands of children's lives every year.
A report released Wednesday by the World Health Organization and UNICEF at a conference in Vietnam counts more than 800,000 children who die each year from burns, drowning, car crashes and other accidents. Most of those deaths occur in developing countries.
"Child injuries are an important public health and development issue. In addition to the 830,000 deaths every year, millions of children suffer non-fatal injuries that often require long-term hospitalization and rehabilitation," WHO Director-General Dr. Margaret Chan said in a news release.
Chan said the costs to treat such injuries can throw a family into poverty.
"Children in poorer families and communities are at increased risk of injury because they are less likely to benefit from prevention programs and high-quality health services," she said.
The report said with more safety measures in place, countries could prevent half of those deaths. Suggestions include seatbelt and helmet laws, water heater controls and safer designs for nursery furniture and toys. The report also recommends various traffic safety improvements.
The report said such steps have been taken in many high-income countries and have reduced child injury deaths by up to 50 percent over the last 30 years.
The report found that the top five causes of injury deaths are:
Road crashes: They kill 260,000 children a year and injure about 10 million. They are the leading cause of death among 10- to 19-year-olds and a leading cause of child disability.
Drowning: It kills more than 175,000 children a year. Every year, up to 3 million children survive a drowning incident. Due to brain damage in some survivors, non-fatal drowning has the highest average lifetime health and economic impact of any injury type.
Burns: Fire-related burns kill nearly 96,000 children a year and the death rate is 11 times higher in low- and middle-income countries than in high-income countries.
Falls: Nearly 47,000 children fall to their deaths every year, but hundreds of thousands more sustain less serious injuries from a fall.
Poisoning: More than 45,000 children die each year from unintended poisoning.
Distributed by Internet Broadcasting Systems, Inc. The Associated Press contributed to this report. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
Nature and Nurture Contribute to Overeating
By Peggy Peck, Executive Editor, MedPage Today
Published: December 10, 2008
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco Earn CME/CE credit
for reading medical news
DUNDEE, Scotland, Dec. 10 -- The likelihood of craving a couple of calorie-laden burgers and a cupcake or two instead of consuming a simple rice cake may be determined by a genetic mutation associated with obesity, found investigators here.
The effect of the mutation in a subset of children appears to involve control of both the amount of food consumed and the desire to consume dense, high calorie foods, researchers reported in the Dec. 11 issue of the New England Journal of Medicine.
Children who carried a variant of rs9939609, a fat mass and obesity-associated (FTO) gene, consumed more food at test meals than controls (P =0.006) and were also more likely to choose a burger over a rice cake, according to Colin N.A. Palmer, Ph.D., of the University of Dundee's Biomedical Research Institute at Ninewells Hospital and Medical School and colleagues. Action Points
--------------------------------------------------------------------------------
Explain to interested patients that this study suggested that a genetic variant controls both appetite and the types of food consumed.
Explain to interested patients that maintaining normal weight should be a goal regardless of age.
Explain to interested patients that current guidelines recommend a mix of diet and exercise for weight control.
And while total and resting energy expenditures were increased in children who were carriers of the A allele, resting energy expenditure was "identical to that predicted for the age and weight of the child, indicating that there is no defect in metabolic adaptation to obesity," they wrote.
The findings emerged from a study of 2,726 Scots children ages four to 10 who had genotyping and height and weight measurement.
A sub-sample of 97 children who had the A allele variant of rs9939609 were also assessed for adiposity, energy expenditure, and food intake.
"In the total study group, the A allele of rs9939609 was associated with significantly increased weight (P =0.003) and BMI (P =0.003)," they wrote.
And in the subset of 97 children there were similar associations for weight (P =0.049) and BMI (P =0.03) and there was also an association with anthropometric skinfold values (P =0.03).
On the basis of the skinfold measurements, "children who carried the A allele had an estimated fat mass that was 1.78 kg greater than that of non-carriers (P =0.01) and an estimated lean mass that was less than 400 g greater than that of non-carriers ( P =0.46).
The authors said that their data "suggest that the [fat mass and obesity-associated] gene influences the 'input' side of the energy-balance equation," a finding already reported in animal studies.
Thus the key to preventing obesity in people with this genotype, which occurred in 0.385% of the population studied, would be "moderate and controlled restriction of energy intake."
In an editorial, Rudolph L. Leibel, M.D., of Columbia University in New York, wrote that the frequency of the rs9939609 A allele has been estimated as "0.45 in Europeans, 0.52 in West Africans, and 0.14 in Chinese."
And even though the "locus accounts for only a small proportion of differences in BMI in the entire population, it plays a substantial role -- in these people, in these environments -- in conveying the risk of actually becoming overweight or obese."
Although Dr. Leibel said it was too soon to consider genetic screening for obesity risk, but said the data from the school children in Scotland underscore the "important role the environment plays in enabling or resisting such susceptibility."
The study was supported by a grant from the U.K. Biotechnology and Biological Sciences Research Council.
Dr. Palmer had no disclosures. Dr Leibel disclosed consulting fees fro Arisaph, Centocor, Genaera, ImClone, and Merck.
Primary source: New England Journal of Medicine
Source reference:
Cecil JE et al "An obesity-associated FTO gene variant and increased energy intake in children" N Eng J Med 2008: 359: 2558-66.
Additional source: New England Journal of Medicine
Source reference:
Leibel R L "Energy in, energy out, and the effects of obesity-related genes" N Engl J Med 2008; 359: 2603-04.
Additional Obesity Coverage
Earn CME/CE credit
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Published: December 10, 2008
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco Earn CME/CE credit
for reading medical news
DUNDEE, Scotland, Dec. 10 -- The likelihood of craving a couple of calorie-laden burgers and a cupcake or two instead of consuming a simple rice cake may be determined by a genetic mutation associated with obesity, found investigators here.
The effect of the mutation in a subset of children appears to involve control of both the amount of food consumed and the desire to consume dense, high calorie foods, researchers reported in the Dec. 11 issue of the New England Journal of Medicine.
Children who carried a variant of rs9939609, a fat mass and obesity-associated (FTO) gene, consumed more food at test meals than controls (P =0.006) and were also more likely to choose a burger over a rice cake, according to Colin N.A. Palmer, Ph.D., of the University of Dundee's Biomedical Research Institute at Ninewells Hospital and Medical School and colleagues. Action Points
--------------------------------------------------------------------------------
Explain to interested patients that this study suggested that a genetic variant controls both appetite and the types of food consumed.
Explain to interested patients that maintaining normal weight should be a goal regardless of age.
Explain to interested patients that current guidelines recommend a mix of diet and exercise for weight control.
And while total and resting energy expenditures were increased in children who were carriers of the A allele, resting energy expenditure was "identical to that predicted for the age and weight of the child, indicating that there is no defect in metabolic adaptation to obesity," they wrote.
The findings emerged from a study of 2,726 Scots children ages four to 10 who had genotyping and height and weight measurement.
A sub-sample of 97 children who had the A allele variant of rs9939609 were also assessed for adiposity, energy expenditure, and food intake.
"In the total study group, the A allele of rs9939609 was associated with significantly increased weight (P =0.003) and BMI (P =0.003)," they wrote.
And in the subset of 97 children there were similar associations for weight (P =0.049) and BMI (P =0.03) and there was also an association with anthropometric skinfold values (P =0.03).
On the basis of the skinfold measurements, "children who carried the A allele had an estimated fat mass that was 1.78 kg greater than that of non-carriers (P =0.01) and an estimated lean mass that was less than 400 g greater than that of non-carriers ( P =0.46).
The authors said that their data "suggest that the [fat mass and obesity-associated] gene influences the 'input' side of the energy-balance equation," a finding already reported in animal studies.
Thus the key to preventing obesity in people with this genotype, which occurred in 0.385% of the population studied, would be "moderate and controlled restriction of energy intake."
In an editorial, Rudolph L. Leibel, M.D., of Columbia University in New York, wrote that the frequency of the rs9939609 A allele has been estimated as "0.45 in Europeans, 0.52 in West Africans, and 0.14 in Chinese."
And even though the "locus accounts for only a small proportion of differences in BMI in the entire population, it plays a substantial role -- in these people, in these environments -- in conveying the risk of actually becoming overweight or obese."
Although Dr. Leibel said it was too soon to consider genetic screening for obesity risk, but said the data from the school children in Scotland underscore the "important role the environment plays in enabling or resisting such susceptibility."
The study was supported by a grant from the U.K. Biotechnology and Biological Sciences Research Council.
Dr. Palmer had no disclosures. Dr Leibel disclosed consulting fees fro Arisaph, Centocor, Genaera, ImClone, and Merck.
Primary source: New England Journal of Medicine
Source reference:
Cecil JE et al "An obesity-associated FTO gene variant and increased energy intake in children" N Eng J Med 2008: 359: 2558-66.
Additional source: New England Journal of Medicine
Source reference:
Leibel R L "Energy in, energy out, and the effects of obesity-related genes" N Engl J Med 2008; 359: 2603-04.
Additional Obesity Coverage
Earn CME/CE credit
for reading medical news
Add Your Knowledge™
Contribute your own thoughts, experience, questions, and knowledge to this story for the benefit of all MedPage Today readers.
Login to post an Add Your Knowledge™ comment.
Disclaimer
Email:
CME Spotlights | See Complete List
--------------------------------------------------------------------------------
MedPage Today Tools
Guide to Biostatistics
Important epidemiologic concepts and common biostatistical terms to help clinicians translate medical research into everyday practice.
--------------------------------------------------------------------------------
News Feed Widget for Your Website
Place a free, customizable RSS news feed widget on your website or blog. We've created over one-hundred widgets in each of our medical specialties. more about widgets
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Physical therapist
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Family Nurse Practitioner
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Hospital Physical Therapist
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Relient Health
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Scranton, PA
Marywood University
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Annual Report to the Nation Finds Declines in Cancer Incidence and Death Rates
Special Feature Reveals Wide Variations in Lung Cancer Trends across States
A new report from the nation's leading cancer organizations shows that, for the first time since the report was first issued in 1998, both incidence and death rates for all cancers combined are decreasing for both men and women, driven largely by declines in some of the most common types of cancer. The report notes that, although the decreases in overall cancer incidence and death rates are encouraging, large state and regional differences in lung cancer trends among women underscore the need to strengthen many state tobacco control programs. The findings come from the "Annual Report to the Nation on the Status of Cancer, 1975-2005, Featuring Trends in Lung Cancer, Tobacco Use and Tobacco Control" online Nov. 25, 2008, and appearing in the Dec. 2, 2008, Journal of the National Cancer Institute.
Although cancer death rates have been dropping since the publication of the first Annual Report to the Nation 10 years ago, the latest edition marks the first time the report has documented a simultaneous decline in cancer incidence, the rate at which new cancers are diagnosed, for both men and women. Based on the long-term incidence trend, rates for all cancers combined decreased 0.8 percent per year from 1999 through 2005 for both sexes combined; rates decreased 1.8 percent per year from 2001 through 2005 for men and 0.6 percent per year from 1998 through 2005 for women. The decline in both incidence and death rates for all cancers combined is due in large part to declines in the three most common cancers among men (lung, colon/rectum, and prostate) and the two most common cancers among women (breast and colon/rectum), combined with a leveling off of lung cancer death rates among women.
"The drop in incidence seen in this year's Annual Report is something we've been waiting to see for a long time," said Otis W. Brawley, M.D., chief medical officer of the American Cancer Society (ACS). "However, we have to be somewhat cautious about how we interpret it, because changes in incidence can be caused not only by reductions in risk factors for cancer, but also by changes in screening practices. Regardless, the continuing drop in mortality is evidence once again of real progress made against cancer, reflecting real gains in prevention, early detection, and treatment."
The new report shows that, from 1996 through 2005, death rates for all cancers combined decreased for all racial and ethnic populations and for both men and women, except for American Indian/Alaska Native men and women, for whom rates were stable. The drop in death rates has been steeper for men, who have higher rates, than for women. Death rates declined for 10 of the top 15 causes of cancer death among both men and women. However, death rates for certain individual cancers are increasing, including esophageal cancer for men, pancreatic cancer for women, and liver cancer for both men and women. Overall cancer death rates were highest for African-Americans and lowest for Asian American/Pacific Islanders.
Among men, incidence rates dropped for cancers of the lung, colon/rectum, oral cavity, and stomach. Prostate cancer incidence rates decreased by 4.4 percent per year from 2001 through 2005 after increasing by 2.1 percent per year from 1995 to 2001. In contrast, incidence rates increased for cancers of the liver, kidney, and esophagus, as well as for melanoma (2003-2005), non-Hodgkin lymphoma, and myeloma. Incidence rates were stable for cancers of the bladder, pancreas, and brain/nervous system, and for leukemia.
For women, incidence rates dropped for cancers of the breast, colon/rectum, uterus, ovary, cervix, and oral cavity but increased for cancers of the lung, thyroid, pancreas, brain/nervous system, bladder, and kidney, as well as for leukemia, non-Hodgkin lymphoma, and melanoma.
"While we have made progress in reducing the burden of cancer in this country, we must accelerate our efforts, including making a special effort to reach underserved cancer patients in the communities where they live," said National Cancer Institute (NCI) Director John Niederhuber, M.D. "This report gives us a better understanding of where we may need to redouble our efforts and try to find new ways of preventing or reducing the occurrence of kidney, liver, and other cancers that continue to show increases in both mortality and/or incidence."
The Special Feature section of the Report highlights wide variations in tobacco smoking patterns across the United States, which, coupled with differences in smoking behaviors in younger versus older populations, helps explain the delay in an expected decrease in lung cancer deaths among women and a slowing of the decrease in lung cancer deaths among men.
The report finds substantial differences in lung cancer death rate trends by state and geographic region. For example, lung cancer death rates dropped an average of 2.8 percent per year among men in California from 1996 through 2005, more than twice the drop seen in many states in the Midwest and the South. The geographic variation is even more extreme among women, for whom lung cancer death rates increased from 1996 through 2005 in 13 states and decreased only in three. The report also notes that, in five states (Pennsylvania, Illinois, Minnesota, Nebraska, and Idaho), lung cancer incidence among women showed an increasing trend, whereas the mortality trend was level.
"It's very promising to see the progress we are making in our fight against cancer," said Centers for Disease Control and Prevention (CDC) Director Julie Gerberding, M.D. "Unfortunately, tobacco use continues to plague our country, and it's the primary reason why lung cancer continues to rob too many people of a long, productive, and healthy life. We must recommit ourselves to implementing tobacco control programs that we know work if we are truly going to impact the staggering toll of tobacco on our society."
Variation in smoking prevalence among the states is influenced by several factors, including public awareness of the harms of tobacco use, social acceptance of tobacco use, local tobacco control activities, and tobacco industry promotional activities targeted in a geographic area. The 13 states where lung cancer death rates for women are on the rise have higher percentages of adult female smokers, low excise taxes, and local economies that are traditionally dependent on tobacco farming and production. In contrast, California, which was the first state to implement a comprehensive, statewide tobacco control program, was the only state in the country to show declines in both lung cancer incidence and deaths in women.
According to a U.S. Surgeon General's report, cigarette smoking accounts for approximately 30 percent of all cancer deaths, with lung cancer accounting for 80 percent of the smoking-attributable cancer deaths. Other cancers caused by smoking include cancers of the oral cavity, pharynx, larynx, esophagus, stomach, bladder, pancreas, liver, kidney, and uterine cervix and myeloid leukemia.
"We can see that, in areas of the country where smoking and tobacco use are entrenched in daily life, men and women continue to pay a price with higher incidence and death rates from many types of cancer. This type of geographic variation in smoking-related cancers is due to smoking behaviors, not regional environmental factors," said Betsy A. Kohler, M.P.H., executive director of the North American Association of Central Cancer Registries (NAACCR).
"The observed decrease in the incidence and death rates from all cancers combined in men and women overall and in nearly all racial and ethnic groups is highly encouraging," conclude the authors. "However, this must be seen as a starting point rather than a destination." They say a dual effort, combining better application of existing knowledge with ongoing research to improve prevention, early detection, and treatment will be needed to sustain and extend this progress into the future.
The study was conducted by scientists at the ACS, CDC, NCI, which is part of the National Institutes of Health, and the NAACCR.
To view the full report, go to: http://jnci.oxfordjournals.org.
For a Q&A on this Report, go to http://cancer.gov/newscenter/pressreleases/ReportNation2008QandA.
For Spanish translations of this press release and Q&A, go to http://cancer.gov/espanol/noticias/ReportNation2008SpanishRelease.
A new report from the nation's leading cancer organizations shows that, for the first time since the report was first issued in 1998, both incidence and death rates for all cancers combined are decreasing for both men and women, driven largely by declines in some of the most common types of cancer. The report notes that, although the decreases in overall cancer incidence and death rates are encouraging, large state and regional differences in lung cancer trends among women underscore the need to strengthen many state tobacco control programs. The findings come from the "Annual Report to the Nation on the Status of Cancer, 1975-2005, Featuring Trends in Lung Cancer, Tobacco Use and Tobacco Control" online Nov. 25, 2008, and appearing in the Dec. 2, 2008, Journal of the National Cancer Institute.
Although cancer death rates have been dropping since the publication of the first Annual Report to the Nation 10 years ago, the latest edition marks the first time the report has documented a simultaneous decline in cancer incidence, the rate at which new cancers are diagnosed, for both men and women. Based on the long-term incidence trend, rates for all cancers combined decreased 0.8 percent per year from 1999 through 2005 for both sexes combined; rates decreased 1.8 percent per year from 2001 through 2005 for men and 0.6 percent per year from 1998 through 2005 for women. The decline in both incidence and death rates for all cancers combined is due in large part to declines in the three most common cancers among men (lung, colon/rectum, and prostate) and the two most common cancers among women (breast and colon/rectum), combined with a leveling off of lung cancer death rates among women.
"The drop in incidence seen in this year's Annual Report is something we've been waiting to see for a long time," said Otis W. Brawley, M.D., chief medical officer of the American Cancer Society (ACS). "However, we have to be somewhat cautious about how we interpret it, because changes in incidence can be caused not only by reductions in risk factors for cancer, but also by changes in screening practices. Regardless, the continuing drop in mortality is evidence once again of real progress made against cancer, reflecting real gains in prevention, early detection, and treatment."
The new report shows that, from 1996 through 2005, death rates for all cancers combined decreased for all racial and ethnic populations and for both men and women, except for American Indian/Alaska Native men and women, for whom rates were stable. The drop in death rates has been steeper for men, who have higher rates, than for women. Death rates declined for 10 of the top 15 causes of cancer death among both men and women. However, death rates for certain individual cancers are increasing, including esophageal cancer for men, pancreatic cancer for women, and liver cancer for both men and women. Overall cancer death rates were highest for African-Americans and lowest for Asian American/Pacific Islanders.
Among men, incidence rates dropped for cancers of the lung, colon/rectum, oral cavity, and stomach. Prostate cancer incidence rates decreased by 4.4 percent per year from 2001 through 2005 after increasing by 2.1 percent per year from 1995 to 2001. In contrast, incidence rates increased for cancers of the liver, kidney, and esophagus, as well as for melanoma (2003-2005), non-Hodgkin lymphoma, and myeloma. Incidence rates were stable for cancers of the bladder, pancreas, and brain/nervous system, and for leukemia.
For women, incidence rates dropped for cancers of the breast, colon/rectum, uterus, ovary, cervix, and oral cavity but increased for cancers of the lung, thyroid, pancreas, brain/nervous system, bladder, and kidney, as well as for leukemia, non-Hodgkin lymphoma, and melanoma.
"While we have made progress in reducing the burden of cancer in this country, we must accelerate our efforts, including making a special effort to reach underserved cancer patients in the communities where they live," said National Cancer Institute (NCI) Director John Niederhuber, M.D. "This report gives us a better understanding of where we may need to redouble our efforts and try to find new ways of preventing or reducing the occurrence of kidney, liver, and other cancers that continue to show increases in both mortality and/or incidence."
The Special Feature section of the Report highlights wide variations in tobacco smoking patterns across the United States, which, coupled with differences in smoking behaviors in younger versus older populations, helps explain the delay in an expected decrease in lung cancer deaths among women and a slowing of the decrease in lung cancer deaths among men.
The report finds substantial differences in lung cancer death rate trends by state and geographic region. For example, lung cancer death rates dropped an average of 2.8 percent per year among men in California from 1996 through 2005, more than twice the drop seen in many states in the Midwest and the South. The geographic variation is even more extreme among women, for whom lung cancer death rates increased from 1996 through 2005 in 13 states and decreased only in three. The report also notes that, in five states (Pennsylvania, Illinois, Minnesota, Nebraska, and Idaho), lung cancer incidence among women showed an increasing trend, whereas the mortality trend was level.
"It's very promising to see the progress we are making in our fight against cancer," said Centers for Disease Control and Prevention (CDC) Director Julie Gerberding, M.D. "Unfortunately, tobacco use continues to plague our country, and it's the primary reason why lung cancer continues to rob too many people of a long, productive, and healthy life. We must recommit ourselves to implementing tobacco control programs that we know work if we are truly going to impact the staggering toll of tobacco on our society."
Variation in smoking prevalence among the states is influenced by several factors, including public awareness of the harms of tobacco use, social acceptance of tobacco use, local tobacco control activities, and tobacco industry promotional activities targeted in a geographic area. The 13 states where lung cancer death rates for women are on the rise have higher percentages of adult female smokers, low excise taxes, and local economies that are traditionally dependent on tobacco farming and production. In contrast, California, which was the first state to implement a comprehensive, statewide tobacco control program, was the only state in the country to show declines in both lung cancer incidence and deaths in women.
According to a U.S. Surgeon General's report, cigarette smoking accounts for approximately 30 percent of all cancer deaths, with lung cancer accounting for 80 percent of the smoking-attributable cancer deaths. Other cancers caused by smoking include cancers of the oral cavity, pharynx, larynx, esophagus, stomach, bladder, pancreas, liver, kidney, and uterine cervix and myeloid leukemia.
"We can see that, in areas of the country where smoking and tobacco use are entrenched in daily life, men and women continue to pay a price with higher incidence and death rates from many types of cancer. This type of geographic variation in smoking-related cancers is due to smoking behaviors, not regional environmental factors," said Betsy A. Kohler, M.P.H., executive director of the North American Association of Central Cancer Registries (NAACCR).
"The observed decrease in the incidence and death rates from all cancers combined in men and women overall and in nearly all racial and ethnic groups is highly encouraging," conclude the authors. "However, this must be seen as a starting point rather than a destination." They say a dual effort, combining better application of existing knowledge with ongoing research to improve prevention, early detection, and treatment will be needed to sustain and extend this progress into the future.
The study was conducted by scientists at the ACS, CDC, NCI, which is part of the National Institutes of Health, and the NAACCR.
To view the full report, go to: http://jnci.oxfordjournals.org.
For a Q&A on this Report, go to http://cancer.gov/newscenter/pressreleases/ReportNation2008QandA.
For Spanish translations of this press release and Q&A, go to http://cancer.gov/espanol/noticias/ReportNation2008SpanishRelease.
Tuesday, November 18, 2008
Kidney disease takes a growing toll
By DAVID TULLER
Published: November 17, 2008
A SURPRISE: Rita Miller learned in 2005 that she had chronic kidney disease.
In February 2005, Rita Miller, a party organizer in Chesapeake, Va., felt exhausted from what she thought was the flu. She was stunned to learn that persistent high blood pressure had caused such severe kidney damage that her body could no longer filter waste products from her blood.
“The doctor walked over to my bed and said, ‘You have kidney failure — your kidneys are like dried-up peas,’ ” recalled Ms. Miller, now 65, who had not been to a doctor or had her blood pressure checked for years.
“The doctor said, ‘Get your family here right away,’ ” she said. “They were telling me I might not make it. I was in shock. I started dialysis the next day.”
Ms. Miller, who has since moved to Connecticut to be with her children, was one of the millions of Americans unaware that they are suffering from chronic kidney disease, which is caused in most cases by uncontrolled hypertension (as in her case) or diabetes, and is often asymptomatic until its later stages. The number of people with the disease — often abbreviated C.K.D. — has been rising at a significant pace, thanks in large part to increased obesity and the aging of the population.
An analysis of federal health data published last November in The Journal of the American Medical Association found that 13 percent of American adults — about 26 million people — have chronic kidney disease, up from 10 percent, or about 20 million people, a decade earlier.
“We’ve had a marked increase in chronic kidney disease in the last 10 years, and that continues with the baby boomers coming into retirement age,” said Dr. Frederick J. Kaskel, director of pediatric nephrology at the Children’s Hospital at Montefiore in the Bronx. “The burden on the health care system is enormous, and it’s going to get worse.
“We won’t have enough units to dialyze these patients.”
Concerned about the emerging picture, federal health officials have started pilot programs to bolster public awareness, increase epidemiologic surveillance and expand efforts to screen those most at risk — people with high blood pressure, diabetes or a family history of kidney disease.
Those people, and those who already have the disease, can often be helped by the same kinds of medicine and lifestyle changes used in hypertension and diabetes. They are urged to quit smoking, lose weight, exercise regularly, restrict their diets and, if necessary, control their blood pressure and diabetes with medication. But such efforts cannot restore kidney function that has been lost.
The trouble is that most people know very little about chronic kidney disease and rarely ask their doctors about kidney function. And many of those who have it feel relatively well until late in the illness, although they may experience nonspecific symptoms like muscle cramps, loss of energy and poor concentration.
“When most people think of kidney disease, they think of dialysis or transplantation,” said Dr. Joseph A. Vassalotti, chief medical officer for the National Kidney Foundation, a major education and advocacy group. “They don’t understand that it encompasses a spectrum, and that the majority of patients are unaware they have the condition.”
Chronic kidney disease progresses over the course of years, with its phases determined according to two criteria: the presence of protein in the urine, known as proteinuria, and how effectively the kidneys are processing waste products.
Patients get dialysis or a kidney transplant only when they are in the final stage of the disease, also known as kidney failure or end-stage renal disease. But the path to kidney failure can take years. “Only a tiny percentage of patients with kidney disease need dialysis,” said Dr. Stephen Fadem, a Houston nephrologist and vice president of the American Association of Kidney Patients.
Chronic kidney disease itself can damage the cardiovascular system and lead to other serious medical conditions, like anemia, vitamin D deficiencies and bone disorders. Patients are far more likely to die from heart disease than to suffer kidney failure.
Because African-Americans, Latinos and other minority communities suffer disproportionately from hypertension and diabetes, they experience higher rates of kidney disease and kidney failure. Other cases are caused by genetic disorders, autoimmune ailments like systemic lupus erythematosis, prolonged use of certain medications like anti-inflammatory drugs, and a kidney inflammation called glomerulonephritis.
In 2005, more than 485,000 people were living on dialysis or with a transplant, at a total cost of $32 billion. Medicare pays for much of that, because it provides coverage for patients needing dialysis or transplant even if they are not yet 65. In fact, kidney disease and kidney failure account for more than a quarter of Medicare’s annual expenditures.
The National Kidney Foundation, with an annual budget of $85 million, plays a major role in education, policy, research and treatment. The organization provides free screening for adults at risk for kidney disease, publishes a leading journal in the field, lobbies on treatment and policy issues, and conducts extensive public education and outreach.
But it has come under criticism on several fronts, in particular its close financial ties to the pharmaceutical industry. The agency greatly influences clinical care through the development of guidelines to advise doctors on various aspects of the illness. Critics say the guidelines have benefited drug makers, who are major contributors to the foundation.
“These practice guidelines are widely disseminated and heavily influenced by industry, and they come down on the side of recommending higher levels of treatment,” said Dr. Richard Amerling, director of outpatient dialysis at Beth Israel Medical Center in New York.
In 2006, the organization published new guidelines for treating anemia associated with chronic kidney disease. The guidelines were underwritten with support from Amgen, which markets a drug for anemia, and some members of the panel that developed the guidelines had financial ties to the industry.
The kidney foundation guidelines called for raising red blood cell counts to levels higher than those recommended by the Food and Drug Administration, and many nephrologists criticized the guidelines as biased in favor of industry. After new clinical trials suggested that more aggressive treatment could cause an increase in deaths and heart problems, the foundation revised the guidelines.
Ellie Schlam, a spokeswoman for the foundation, said the organization was vigilant “to ensure that no sponsorship funds contributed to the N.K.F.” would influence the content of any guidelines.
The organization has also been criticized by advocates who support financial compensation for organ donors, which the foundation firmly opposes as unethical and unlikely to increase the availability of organs. (In contrast, the American Association of Kidney Patients supports research into how financial incentives would affect organ donation.)
Even the foundation’s classification of chronic kidney disease into five distinct stages, a framework that has been widely accepted, has come under some challenge.
In 2002, the organization published clinical criteria for determining each stage of the disease. But some experts say those guidelines have the effect of overstating the problem by classifying many elderly patients as having the disease when they actually have standard age-related kidney decline. The foundation replies that a reduced kidney function among the elderly should not be accepted as normal just because it is common.
Because of Medicare’s role in paying for dialysis and transplantation, the federal government knows far more about the epidemiology and costs of end-stage renal disease than about chronic kidney disease over all. In recent years, Congress has directed the Centers for Disease Control and Prevention to fill some of these knowledge gaps.
In particular, the centers are seeking to develop a comprehensive surveillance system for the disease, organizing pilot screening projects for people at high risk in California, Florida, Minnesota and New York. The agency is also studying the financial implications of the disease and the cost-effectiveness of various interventions.
The National Kidney Foundation, which has worked closely with the C.D.C. and the National Institutes of Health on initiatives related to chronic kidney disease, has also focused on education and screening, particularly in minority communities. Terri Smith, the urban outreach director at the foundation’s Connecticut affiliate, says she spends a lot of her time going to black churches and community centers to talk about kidney disease, and has been surprised that so few people know anything about it.
“They’re very aware of hypertension and diabetes, but it was a revelation to me that people didn’t get the connection to kidney disease,” she said. “People have no idea they should eat less than a teaspoon of salt a day. I teach them how to read labels; I give them questions they should be asking the doctor.”
In Michigan, the local N.K.F. affiliate reaches out to hair stylists and other salon workers in minority communities, training them in talking to their clients about getting screened. Several years ago, after Mary Hawkins, 61, a nurse who lives in Grand Rapids, received a warning about kidney disease from a masseuse at her local salon, she made an appointment to see her doctor.
Although she did not have kidney disease, she learned that her blood pressure was high. Now she takes three medications to keep it under control, exercises three times a week, takes tai chi classes, no longer smokes and attends a dance class at the same salon.
“I knew kidney disease existed, but I wasn’t in tune with the risk,” she said. “You get so caught up in your own life that the last thing you think about is your health — even though it should be the first thing.”
Published: November 17, 2008
A SURPRISE: Rita Miller learned in 2005 that she had chronic kidney disease.
In February 2005, Rita Miller, a party organizer in Chesapeake, Va., felt exhausted from what she thought was the flu. She was stunned to learn that persistent high blood pressure had caused such severe kidney damage that her body could no longer filter waste products from her blood.
“The doctor walked over to my bed and said, ‘You have kidney failure — your kidneys are like dried-up peas,’ ” recalled Ms. Miller, now 65, who had not been to a doctor or had her blood pressure checked for years.
“The doctor said, ‘Get your family here right away,’ ” she said. “They were telling me I might not make it. I was in shock. I started dialysis the next day.”
Ms. Miller, who has since moved to Connecticut to be with her children, was one of the millions of Americans unaware that they are suffering from chronic kidney disease, which is caused in most cases by uncontrolled hypertension (as in her case) or diabetes, and is often asymptomatic until its later stages. The number of people with the disease — often abbreviated C.K.D. — has been rising at a significant pace, thanks in large part to increased obesity and the aging of the population.
An analysis of federal health data published last November in The Journal of the American Medical Association found that 13 percent of American adults — about 26 million people — have chronic kidney disease, up from 10 percent, or about 20 million people, a decade earlier.
“We’ve had a marked increase in chronic kidney disease in the last 10 years, and that continues with the baby boomers coming into retirement age,” said Dr. Frederick J. Kaskel, director of pediatric nephrology at the Children’s Hospital at Montefiore in the Bronx. “The burden on the health care system is enormous, and it’s going to get worse.
“We won’t have enough units to dialyze these patients.”
Concerned about the emerging picture, federal health officials have started pilot programs to bolster public awareness, increase epidemiologic surveillance and expand efforts to screen those most at risk — people with high blood pressure, diabetes or a family history of kidney disease.
Those people, and those who already have the disease, can often be helped by the same kinds of medicine and lifestyle changes used in hypertension and diabetes. They are urged to quit smoking, lose weight, exercise regularly, restrict their diets and, if necessary, control their blood pressure and diabetes with medication. But such efforts cannot restore kidney function that has been lost.
The trouble is that most people know very little about chronic kidney disease and rarely ask their doctors about kidney function. And many of those who have it feel relatively well until late in the illness, although they may experience nonspecific symptoms like muscle cramps, loss of energy and poor concentration.
“When most people think of kidney disease, they think of dialysis or transplantation,” said Dr. Joseph A. Vassalotti, chief medical officer for the National Kidney Foundation, a major education and advocacy group. “They don’t understand that it encompasses a spectrum, and that the majority of patients are unaware they have the condition.”
Chronic kidney disease progresses over the course of years, with its phases determined according to two criteria: the presence of protein in the urine, known as proteinuria, and how effectively the kidneys are processing waste products.
Patients get dialysis or a kidney transplant only when they are in the final stage of the disease, also known as kidney failure or end-stage renal disease. But the path to kidney failure can take years. “Only a tiny percentage of patients with kidney disease need dialysis,” said Dr. Stephen Fadem, a Houston nephrologist and vice president of the American Association of Kidney Patients.
Chronic kidney disease itself can damage the cardiovascular system and lead to other serious medical conditions, like anemia, vitamin D deficiencies and bone disorders. Patients are far more likely to die from heart disease than to suffer kidney failure.
Because African-Americans, Latinos and other minority communities suffer disproportionately from hypertension and diabetes, they experience higher rates of kidney disease and kidney failure. Other cases are caused by genetic disorders, autoimmune ailments like systemic lupus erythematosis, prolonged use of certain medications like anti-inflammatory drugs, and a kidney inflammation called glomerulonephritis.
In 2005, more than 485,000 people were living on dialysis or with a transplant, at a total cost of $32 billion. Medicare pays for much of that, because it provides coverage for patients needing dialysis or transplant even if they are not yet 65. In fact, kidney disease and kidney failure account for more than a quarter of Medicare’s annual expenditures.
The National Kidney Foundation, with an annual budget of $85 million, plays a major role in education, policy, research and treatment. The organization provides free screening for adults at risk for kidney disease, publishes a leading journal in the field, lobbies on treatment and policy issues, and conducts extensive public education and outreach.
But it has come under criticism on several fronts, in particular its close financial ties to the pharmaceutical industry. The agency greatly influences clinical care through the development of guidelines to advise doctors on various aspects of the illness. Critics say the guidelines have benefited drug makers, who are major contributors to the foundation.
“These practice guidelines are widely disseminated and heavily influenced by industry, and they come down on the side of recommending higher levels of treatment,” said Dr. Richard Amerling, director of outpatient dialysis at Beth Israel Medical Center in New York.
In 2006, the organization published new guidelines for treating anemia associated with chronic kidney disease. The guidelines were underwritten with support from Amgen, which markets a drug for anemia, and some members of the panel that developed the guidelines had financial ties to the industry.
The kidney foundation guidelines called for raising red blood cell counts to levels higher than those recommended by the Food and Drug Administration, and many nephrologists criticized the guidelines as biased in favor of industry. After new clinical trials suggested that more aggressive treatment could cause an increase in deaths and heart problems, the foundation revised the guidelines.
Ellie Schlam, a spokeswoman for the foundation, said the organization was vigilant “to ensure that no sponsorship funds contributed to the N.K.F.” would influence the content of any guidelines.
The organization has also been criticized by advocates who support financial compensation for organ donors, which the foundation firmly opposes as unethical and unlikely to increase the availability of organs. (In contrast, the American Association of Kidney Patients supports research into how financial incentives would affect organ donation.)
Even the foundation’s classification of chronic kidney disease into five distinct stages, a framework that has been widely accepted, has come under some challenge.
In 2002, the organization published clinical criteria for determining each stage of the disease. But some experts say those guidelines have the effect of overstating the problem by classifying many elderly patients as having the disease when they actually have standard age-related kidney decline. The foundation replies that a reduced kidney function among the elderly should not be accepted as normal just because it is common.
Because of Medicare’s role in paying for dialysis and transplantation, the federal government knows far more about the epidemiology and costs of end-stage renal disease than about chronic kidney disease over all. In recent years, Congress has directed the Centers for Disease Control and Prevention to fill some of these knowledge gaps.
In particular, the centers are seeking to develop a comprehensive surveillance system for the disease, organizing pilot screening projects for people at high risk in California, Florida, Minnesota and New York. The agency is also studying the financial implications of the disease and the cost-effectiveness of various interventions.
The National Kidney Foundation, which has worked closely with the C.D.C. and the National Institutes of Health on initiatives related to chronic kidney disease, has also focused on education and screening, particularly in minority communities. Terri Smith, the urban outreach director at the foundation’s Connecticut affiliate, says she spends a lot of her time going to black churches and community centers to talk about kidney disease, and has been surprised that so few people know anything about it.
“They’re very aware of hypertension and diabetes, but it was a revelation to me that people didn’t get the connection to kidney disease,” she said. “People have no idea they should eat less than a teaspoon of salt a day. I teach them how to read labels; I give them questions they should be asking the doctor.”
In Michigan, the local N.K.F. affiliate reaches out to hair stylists and other salon workers in minority communities, training them in talking to their clients about getting screened. Several years ago, after Mary Hawkins, 61, a nurse who lives in Grand Rapids, received a warning about kidney disease from a masseuse at her local salon, she made an appointment to see her doctor.
Although she did not have kidney disease, she learned that her blood pressure was high. Now she takes three medications to keep it under control, exercises three times a week, takes tai chi classes, no longer smokes and attends a dance class at the same salon.
“I knew kidney disease existed, but I wasn’t in tune with the risk,” she said. “You get so caught up in your own life that the last thing you think about is your health — even though it should be the first thing.”
Monday, November 17, 2008
2008 Images in Mosby’s Nursing Consult
You can now search for images in Mosby’s Nursing Consult by using the new Images tab.
The Images tab allows you to quickly search over 5,000 high-quality clinical images from the renowned nursing and medical e-books in Mosby’s Nursing Consult. Images include photos, tables, graphs, and more.
The Images tab allows you to quickly search over 5,000 high-quality clinical images from the renowned nursing and medical e-books in Mosby’s Nursing Consult. Images include photos, tables, graphs, and more.
Friday, November 14, 2008
Bigger Day Care Puts More Stress On Kids
Levels Of Stress Hormone Cortisol Tested
POSTED: 4:13 am HST November 14, 2008
The stress hormone cortisol usually peaks in people in the morning, then decreases through the day.
But researchers have found that some preschoolers' cortisol levels rise through the day when they are in full-day child care.
Children in classes of 10 or less were more likely to show the normal decrease, but those in classes with closer to 20 others tended to show a rise.
The study of 191 preschoolers at 12 places also found that children who were clingier with teachers had more stress. Researchers surveyed students and teachers, and collected saliva samples from the children
"This study sheds additional light on an as-yet incompletely understood phenomenon among many young children attending full-day child care," wrote lead author Jared A. Lisonbee of Washington State University. "Additionally, the study begins to situate child care-cortisol research in the context of a broader literature on the role of relationships in shaping how children function and how they react to stress."
A news release on the study did not indicate what changes in health or behavior could be expected from children with higher cortisol levels.
The study appears in the November/December 2008 issue of Child Development.
Distributed by Internet Broadcasting. This material may not be published, broadcast, rewritten or redistributed.
POSTED: 4:13 am HST November 14, 2008
The stress hormone cortisol usually peaks in people in the morning, then decreases through the day.
But researchers have found that some preschoolers' cortisol levels rise through the day when they are in full-day child care.
Children in classes of 10 or less were more likely to show the normal decrease, but those in classes with closer to 20 others tended to show a rise.
The study of 191 preschoolers at 12 places also found that children who were clingier with teachers had more stress. Researchers surveyed students and teachers, and collected saliva samples from the children
"This study sheds additional light on an as-yet incompletely understood phenomenon among many young children attending full-day child care," wrote lead author Jared A. Lisonbee of Washington State University. "Additionally, the study begins to situate child care-cortisol research in the context of a broader literature on the role of relationships in shaping how children function and how they react to stress."
A news release on the study did not indicate what changes in health or behavior could be expected from children with higher cortisol levels.
The study appears in the November/December 2008 issue of Child Development.
Distributed by Internet Broadcasting. This material may not be published, broadcast, rewritten or redistributed.
Florence S. Wald, American Pioneer in End-of-Life Care, Is Dead at 91
Published: November 14, 2008
Florence S. Wald, whose vision of bringing the terminally ill peace of mind and, to whatever extent possible, freedom from pain led to the opening of the first palliative care hospice in the United States, died on Saturday at her home in Branford, Conn. She was 91. Her death was confirmed by her son, Joel.
Michael Okoniewski/Associated Press
Mrs. Wald, who was dean of the Yale University School of Nursing from 1959 to 1966, was the prime mover, in 1974, in starting the Connecticut Hospice, the nation’s first home-care program for the terminally ill. Six years later, a 44-patient hospice — where the dying could be comforted by their loved ones around the clock and where the staff would do what it could to alleviate suffering — opened in Branford.
“This hospice became a model for hospice care in the United States and abroad,” the publication Yale Nursing Matters said this week, adding that Mrs. Wald’s role “in reshaping nursing education to focus on patients and their families has changed the perception of care for the dying in this country.”
There are now more than 3,000 hospice programs in the United States, serving about 900,000 patients a year.
In recent years, Mrs. Wald had concentrated on extending the hospice care model to dying prison inmates.
“People on the outside don’t understand this world at all,” Mrs. Wald told The New York Times in 1998. “Most people in prison have had a rough time in life and haven’t had any kind of education in how to take care of their health.”
And, she added, “There is the shame factor, the feeling that dying in prison is the ultimate failure.”
Part of Mrs. Wald’s solution was to train inmate volunteers to care for the dying. Besides comforting the terminally ill, she said, the program would save taxpayers’ money and “have rehabilitative qualities for these volunteers.”
More than 150 inmate volunteers in Connecticut prisons have since been trained, and the model is now being molded for residents of veterans’ homes in the state.
Mrs. Wald’s work brought her many honors. In 1998, she was inducted into the National Women’s Hall of Fame in Seneca Falls, N.Y., along with Madeleine K. Albright, Maya Angelou and Beverly Sills. She was also named a Living Legend by the American Academy of Nursing, and received the Founder’s Award of the American Hospice Association.
Florence Sophie Schorske was born in the Bronx on April 19, 1917, one of two children of Theodore and Gertrude Goldschmidt Schorske. Her husband, Henry Wald, died in 2000. In addition to her son, she is survived by a daughter, Shari Vogler; a brother, Carl Schorske, a Pulitzer Prize-winning historian; and five grandchildren.
As a child, Mrs. Wald was often hospitalized because of a chronic respiratory ailment. The care she received, she said, inspired her to go into nursing. After graduating from Mount Holyoke College in 1938, she received a master’s degree in nursing from Yale in 1941. During World War II, while working as a research technician for the Army Signal Corps, she met a young engineering student — Mr. Wald. Soon after, she turned down his marriage proposal.
She returned to Yale, earned a master’s degree in mental health nursing, and became an instructor in the nursing program. In 1958, at 41, she was appointed dean of the school of nursing.
Mr. Wald, by then a widower, read of her appointment in the newspaper. He got in touch, they started dating, and a year later, she accepted his new proposal.
Four years later, in 1963, a friend at Yale persuaded Mrs. Wald to attend a lecture by Dame Cicely Saunders, a British physician who was then planning to open the world’s first hospice, in Sydenham, south of London. Inspired, Mrs. Wald soon resigned as dean of the Yale nursing school to work on creating a similar center in the United States. She was troubled by a medical ethic that insisted on procedure after procedure.
“In those days, terminally ill patients went through hell, and the family was never involved,” she said. “No one accepted that life cannot go on ad infinitum.”
Dr. Saunders’s hospice, St. Christopher’s, opened in 1967, and Mrs. Wald went there to work and learn. After returning, she and several Yale colleagues joined forces to establish an American hospice. In 1971, Mr. Wald left his engineering firm and returned to Columbia University to earn a degree in hospital planning. His master’s thesis became the proposal for the Connecticut Hospice.
When Mrs. Wald received an honorary doctorate from Yale in 1996, she was introduced as “the mother of the American hospice movement.”
“That’s a completely incorrect description,” she said. “There were many, many people in those days who were just as inspired and motivated as I was.”
Florence S. Wald, whose vision of bringing the terminally ill peace of mind and, to whatever extent possible, freedom from pain led to the opening of the first palliative care hospice in the United States, died on Saturday at her home in Branford, Conn. She was 91. Her death was confirmed by her son, Joel.
Michael Okoniewski/Associated Press
Mrs. Wald, who was dean of the Yale University School of Nursing from 1959 to 1966, was the prime mover, in 1974, in starting the Connecticut Hospice, the nation’s first home-care program for the terminally ill. Six years later, a 44-patient hospice — where the dying could be comforted by their loved ones around the clock and where the staff would do what it could to alleviate suffering — opened in Branford.
“This hospice became a model for hospice care in the United States and abroad,” the publication Yale Nursing Matters said this week, adding that Mrs. Wald’s role “in reshaping nursing education to focus on patients and their families has changed the perception of care for the dying in this country.”
There are now more than 3,000 hospice programs in the United States, serving about 900,000 patients a year.
In recent years, Mrs. Wald had concentrated on extending the hospice care model to dying prison inmates.
“People on the outside don’t understand this world at all,” Mrs. Wald told The New York Times in 1998. “Most people in prison have had a rough time in life and haven’t had any kind of education in how to take care of their health.”
And, she added, “There is the shame factor, the feeling that dying in prison is the ultimate failure.”
Part of Mrs. Wald’s solution was to train inmate volunteers to care for the dying. Besides comforting the terminally ill, she said, the program would save taxpayers’ money and “have rehabilitative qualities for these volunteers.”
More than 150 inmate volunteers in Connecticut prisons have since been trained, and the model is now being molded for residents of veterans’ homes in the state.
Mrs. Wald’s work brought her many honors. In 1998, she was inducted into the National Women’s Hall of Fame in Seneca Falls, N.Y., along with Madeleine K. Albright, Maya Angelou and Beverly Sills. She was also named a Living Legend by the American Academy of Nursing, and received the Founder’s Award of the American Hospice Association.
Florence Sophie Schorske was born in the Bronx on April 19, 1917, one of two children of Theodore and Gertrude Goldschmidt Schorske. Her husband, Henry Wald, died in 2000. In addition to her son, she is survived by a daughter, Shari Vogler; a brother, Carl Schorske, a Pulitzer Prize-winning historian; and five grandchildren.
As a child, Mrs. Wald was often hospitalized because of a chronic respiratory ailment. The care she received, she said, inspired her to go into nursing. After graduating from Mount Holyoke College in 1938, she received a master’s degree in nursing from Yale in 1941. During World War II, while working as a research technician for the Army Signal Corps, she met a young engineering student — Mr. Wald. Soon after, she turned down his marriage proposal.
She returned to Yale, earned a master’s degree in mental health nursing, and became an instructor in the nursing program. In 1958, at 41, she was appointed dean of the school of nursing.
Mr. Wald, by then a widower, read of her appointment in the newspaper. He got in touch, they started dating, and a year later, she accepted his new proposal.
Four years later, in 1963, a friend at Yale persuaded Mrs. Wald to attend a lecture by Dame Cicely Saunders, a British physician who was then planning to open the world’s first hospice, in Sydenham, south of London. Inspired, Mrs. Wald soon resigned as dean of the Yale nursing school to work on creating a similar center in the United States. She was troubled by a medical ethic that insisted on procedure after procedure.
“In those days, terminally ill patients went through hell, and the family was never involved,” she said. “No one accepted that life cannot go on ad infinitum.”
Dr. Saunders’s hospice, St. Christopher’s, opened in 1967, and Mrs. Wald went there to work and learn. After returning, she and several Yale colleagues joined forces to establish an American hospice. In 1971, Mr. Wald left his engineering firm and returned to Columbia University to earn a degree in hospital planning. His master’s thesis became the proposal for the Connecticut Hospice.
When Mrs. Wald received an honorary doctorate from Yale in 1996, she was introduced as “the mother of the American hospice movement.”
“That’s a completely incorrect description,” she said. “There were many, many people in those days who were just as inspired and motivated as I was.”
Monday, November 3, 2008
Keep the Germs Away: Tips for Staying Healthy
There are many ways to prevent the spread of germs and infectious diseases. The Ounce of Prevention campaign was created to give health educators and consumers practical and useful tips.
In preparation for cold and flu season, there are a few things you can do to keep you and your family healthy throughout the winter months. Take time to do an "Ounce of Prevention!" Here are a few tips.
Clean Hands
Keeping hands clean is one of the most important steps we can take to avoid getting sick and spreading germs to others. It is best to wash your hands with soap and clean running water for 20 seconds. However, if soap and clean water are not available, use an alcohol-based product to clean your hands. Alcohol-based hand rubs significantly reduce the number of germs on skin and are fast acting.
When should you wash your hands?
Before preparing or eating food
After going to the bathroom
After changing diapers or cleaning up a child who has gone to the bathroom
Before and after tending to someone who is sick
After blowing your nose, coughing, or sneezing
After handling an animal or animal waste
After handling garbage
Before and after treating a cut or wound
Disinfect Surfaces
Cleaning removes germs from surfaces and disinfecting destroys germs from surfaces. Disinfecting after cleaning gives an extra level of protection from germs. Areas with the largest amounts of germs and frequently used areas—such as the kitchen and bathroom—should be disinfected with a bleach solution or another disinfectant as often as possible to avoid the spread of germs.
Prepare Food Safely
Handle and prepare food safely to prevent the spread of harmful bacteria and germs and reduce the risk of foodborne illness. There are four simple daily practices to food safety and protection from food borne bacteria:
Clean hands and surfaces often.
Separate and don't cross-contaminate one food with another.
Cook foods to proper temperatures by using a food thermometer and observing recommended internal cooking temperatures.
Chill or refrigerate foods promptly by storing leftovers at a temperature of 40°F or below in the refrigerator and 0°F or below in the freezer.
Get Immunizations
Getting immunizations are easy and low-cost ways to save lives. CDC recommends a yearly flu vaccine as the first and most important step in protecting against this serious disease. The vaccine can protect you from getting sick from these three viruses or it can make your illness milder if you get a different flu virus.
Get Smart
Many cold, flu, and sore throats are caused by viruses. Antibiotics do not work on viruses. Antibiotics, when used appropriately, can treat certain bacterial infections. Taking antibiotics when you have a virus may do more harm than good and may increase your risk of getting an infection later that is resistant to antibiotic treatment.
In preparation for cold and flu season, there are a few things you can do to keep you and your family healthy throughout the winter months. Take time to do an "Ounce of Prevention!" Here are a few tips.
Clean Hands
Keeping hands clean is one of the most important steps we can take to avoid getting sick and spreading germs to others. It is best to wash your hands with soap and clean running water for 20 seconds. However, if soap and clean water are not available, use an alcohol-based product to clean your hands. Alcohol-based hand rubs significantly reduce the number of germs on skin and are fast acting.
When should you wash your hands?
Before preparing or eating food
After going to the bathroom
After changing diapers or cleaning up a child who has gone to the bathroom
Before and after tending to someone who is sick
After blowing your nose, coughing, or sneezing
After handling an animal or animal waste
After handling garbage
Before and after treating a cut or wound
Disinfect Surfaces
Cleaning removes germs from surfaces and disinfecting destroys germs from surfaces. Disinfecting after cleaning gives an extra level of protection from germs. Areas with the largest amounts of germs and frequently used areas—such as the kitchen and bathroom—should be disinfected with a bleach solution or another disinfectant as often as possible to avoid the spread of germs.
Prepare Food Safely
Handle and prepare food safely to prevent the spread of harmful bacteria and germs and reduce the risk of foodborne illness. There are four simple daily practices to food safety and protection from food borne bacteria:
Clean hands and surfaces often.
Separate and don't cross-contaminate one food with another.
Cook foods to proper temperatures by using a food thermometer and observing recommended internal cooking temperatures.
Chill or refrigerate foods promptly by storing leftovers at a temperature of 40°F or below in the refrigerator and 0°F or below in the freezer.
Get Immunizations
Getting immunizations are easy and low-cost ways to save lives. CDC recommends a yearly flu vaccine as the first and most important step in protecting against this serious disease. The vaccine can protect you from getting sick from these three viruses or it can make your illness milder if you get a different flu virus.
Get Smart
Many cold, flu, and sore throats are caused by viruses. Antibiotics do not work on viruses. Antibiotics, when used appropriately, can treat certain bacterial infections. Taking antibiotics when you have a virus may do more harm than good and may increase your risk of getting an infection later that is resistant to antibiotic treatment.
Friday, October 31, 2008
New Cases of Diagnosed Diabetes on the Rise
State-specific data provide glimpse into geographical differences
For Immediate Release: October 30, 2008
The rate of new cases of diagnosed diabetes rose by more than 90 percent among adults over the last 10 years, according to a study by the Centers for Disease Control and Prevention (CDC).
The data, published in CDC′s Morbidity and Mortality Weekly Report, show that in the past decade, the incidence (new cases) of diagnosed diabetes has increased from 4.8 per 1,000 people during 1995-1997 to 9.1 per 1,000 in 2005-2007 in 33 states.
“This dramatic increase in the number of people with diabetes highlights the increasing burden of diabetes across the country,” says lead author Karen Kirtland, Ph.D., a data analyst with CDC′s Division of Diabetes Translation. “This study demonstrates that we must continue to promote effective diabetes prevention efforts that include lifestyle interventions for people at risk for diabetes. Changes such as weight loss combined with moderate physical activity are important steps that individuals can take to reduce their risk for developing diabetes.”
The study used data from CDC′s Behavioral Risk Factor Surveillance System, and provides incidence rates of diabetes for 43 states and two U.S. territories. Only 33 states had data for both time periods, but 43 states collected data in 2005-2007.
State-specific, age-adjusted estimates of new cases of diabetes ranged from 5 per 1,000 people in Minnesota to 12.7 per 1,000 in West Virginia. The number of news cases was highest in Puerto Rico at 12.8 per 1,000. States with the highest age-adjusted incidence were predominately Southern states: Alabama, Florida, Georgia, Kentucky, Louisiana, South Carolina, Tennessee, Texas and West Virginia.
“This report documents the geographic distribution of new cases of diabetes and is consistent with previous studies showing an increase in new diabetes cases,” said Kirtland. “We must step up efforts to prevent and control diabetes, particularly in the Southern U.S. region where we see higher rates of diabetes, obesity and physical inactivity.”
CDC, through its Division of Diabetes Translation, funds diabetes prevention and control programs in all 50 states, including the District of Columbia, and seven U.S. territories and island jurisdictions. The National Diabetes Education Program, co-sponsored by CDC and the National Institutes of Health, provides diabetes education to improve treatment for people with diabetes, promote early diagnosis and prevent or delay the onset of diabetes.
For more information about diabetes, visit www.cdc.gov/diabetes. The MMWR report is available at www.cdc.gov/mmwr.
For Immediate Release: October 30, 2008
The rate of new cases of diagnosed diabetes rose by more than 90 percent among adults over the last 10 years, according to a study by the Centers for Disease Control and Prevention (CDC).
The data, published in CDC′s Morbidity and Mortality Weekly Report, show that in the past decade, the incidence (new cases) of diagnosed diabetes has increased from 4.8 per 1,000 people during 1995-1997 to 9.1 per 1,000 in 2005-2007 in 33 states.
“This dramatic increase in the number of people with diabetes highlights the increasing burden of diabetes across the country,” says lead author Karen Kirtland, Ph.D., a data analyst with CDC′s Division of Diabetes Translation. “This study demonstrates that we must continue to promote effective diabetes prevention efforts that include lifestyle interventions for people at risk for diabetes. Changes such as weight loss combined with moderate physical activity are important steps that individuals can take to reduce their risk for developing diabetes.”
The study used data from CDC′s Behavioral Risk Factor Surveillance System, and provides incidence rates of diabetes for 43 states and two U.S. territories. Only 33 states had data for both time periods, but 43 states collected data in 2005-2007.
State-specific, age-adjusted estimates of new cases of diabetes ranged from 5 per 1,000 people in Minnesota to 12.7 per 1,000 in West Virginia. The number of news cases was highest in Puerto Rico at 12.8 per 1,000. States with the highest age-adjusted incidence were predominately Southern states: Alabama, Florida, Georgia, Kentucky, Louisiana, South Carolina, Tennessee, Texas and West Virginia.
“This report documents the geographic distribution of new cases of diabetes and is consistent with previous studies showing an increase in new diabetes cases,” said Kirtland. “We must step up efforts to prevent and control diabetes, particularly in the Southern U.S. region where we see higher rates of diabetes, obesity and physical inactivity.”
CDC, through its Division of Diabetes Translation, funds diabetes prevention and control programs in all 50 states, including the District of Columbia, and seven U.S. territories and island jurisdictions. The National Diabetes Education Program, co-sponsored by CDC and the National Institutes of Health, provides diabetes education to improve treatment for people with diabetes, promote early diagnosis and prevent or delay the onset of diabetes.
For more information about diabetes, visit www.cdc.gov/diabetes. The MMWR report is available at www.cdc.gov/mmwr.
FDA Creates Task Force on International Food Contamination
By Emily P. Walker, Washington Correspondent, MedPage Today
Published: October 31, 2008
GAITHERSBURG, Md., Oct. 31 -- Pointing to the hazards of melamine-containing products from China, the FDA said today it is creating an internal science and policy workgroup to keep a critical eye on the international food supply.
Detecting contamination in the increasingly international food supply is "a necessary job of the FDA," said Randall Lutter, Ph.D., the agency's deputy commissioner for policy, at a meeting of the agency's science board.
And after the melamine contaminations from China -- first in pet food last year, and more recently in milk -- it is vital to develop a strategy for identifying and preventing potential illnesses, he said. (See: FDA Finds Melamine in Asian Milk Drinks)
The workgroup will have the assignment of pinpointing companies that appear to be at a high risk for contaminating the food supply with chemicals.
"There is a fundamental need for us to understand better the economic incentives and cultural norms in other countries," said Dr. Lutter. This, he added, means recognizing when spiking the food supply with chemicals is likely when it means enough extra profit for a manufacturer so that it offsets any potential penalties.
During the recent melamine outbreak, FDA officials suspect that melamine may have been added to infant formula to inflate protein levels cheaply.
In some sectors of the food industry in China, manufacturers are paid by the amount of protein in a product. Melamine costs about $1.20 per each protein count per ton, while legitimate protein costs about $6 per protein count per ton.
Melamine, which is used in some pharmaceuticals, dyes, glues and plastics, is normally not harmful to humans, but when it commingles with cyanuric acid, it becomes insoluble and can cause kidney failure.
"The suggestion is that some clever scientist used a high-quality melamine that did not have cyanuric acid," said Dr. Lutter. "It was only later that the melamine was commingled with the cyanuric acid."
But "forecasting economic infiltration is hard," Dr. Lutter said, and food coming across U.S. borders is shipped from countries with disparate regulatory requirements.
The United States virtually eliminated problem of economically motivated contamination of food produced in its own borders, largely through the creation of the FDA, Dr. Lutter said.
"It's an old problem, but fortunately it was successfully remedied during the early part of the 20th Century," he said.
But then came globalization of the food market.
"It's a symbol that the world we lived in changed, and there is a new vulnerability," Dr. Lutter said.
President Bush signed an executive order last year to establish a task force that recently issued an import safety action plan, Dr. Lutter said.
Dr. Lutter declined to comment on the specifics of the workgroup, but said it will consist of FDA employees. It is unclear whether the workgroup will also monitor possible contamination of foreign drugs.
Published: October 31, 2008
GAITHERSBURG, Md., Oct. 31 -- Pointing to the hazards of melamine-containing products from China, the FDA said today it is creating an internal science and policy workgroup to keep a critical eye on the international food supply.
Detecting contamination in the increasingly international food supply is "a necessary job of the FDA," said Randall Lutter, Ph.D., the agency's deputy commissioner for policy, at a meeting of the agency's science board.
And after the melamine contaminations from China -- first in pet food last year, and more recently in milk -- it is vital to develop a strategy for identifying and preventing potential illnesses, he said. (See: FDA Finds Melamine in Asian Milk Drinks)
The workgroup will have the assignment of pinpointing companies that appear to be at a high risk for contaminating the food supply with chemicals.
"There is a fundamental need for us to understand better the economic incentives and cultural norms in other countries," said Dr. Lutter. This, he added, means recognizing when spiking the food supply with chemicals is likely when it means enough extra profit for a manufacturer so that it offsets any potential penalties.
During the recent melamine outbreak, FDA officials suspect that melamine may have been added to infant formula to inflate protein levels cheaply.
In some sectors of the food industry in China, manufacturers are paid by the amount of protein in a product. Melamine costs about $1.20 per each protein count per ton, while legitimate protein costs about $6 per protein count per ton.
Melamine, which is used in some pharmaceuticals, dyes, glues and plastics, is normally not harmful to humans, but when it commingles with cyanuric acid, it becomes insoluble and can cause kidney failure.
"The suggestion is that some clever scientist used a high-quality melamine that did not have cyanuric acid," said Dr. Lutter. "It was only later that the melamine was commingled with the cyanuric acid."
But "forecasting economic infiltration is hard," Dr. Lutter said, and food coming across U.S. borders is shipped from countries with disparate regulatory requirements.
The United States virtually eliminated problem of economically motivated contamination of food produced in its own borders, largely through the creation of the FDA, Dr. Lutter said.
"It's an old problem, but fortunately it was successfully remedied during the early part of the 20th Century," he said.
But then came globalization of the food market.
"It's a symbol that the world we lived in changed, and there is a new vulnerability," Dr. Lutter said.
President Bush signed an executive order last year to establish a task force that recently issued an import safety action plan, Dr. Lutter said.
Dr. Lutter declined to comment on the specifics of the workgroup, but said it will consist of FDA employees. It is unclear whether the workgroup will also monitor possible contamination of foreign drugs.
Halloween Candy: It's Not How Much Kids Eat, It's When
Prolonged exposure to acid in the mouth is the culprit, pediatric dentist says
THURSDAY, Oct. 30 (HealthDay News) -- Halloween and its avalanche of candy is coming, making it the worst time of year for children's teeth, right?
Not necessarily, says a dentist who contends that parents can make a big difference by monitoring when their kids eat their sweets.
"Parents need to know that frequency is far more important than amount when it comes to taking in" sugars, said Dr. Mark Helpin, acting chairman of Temple University's Department of Pediatric Dentistry. "It's not how much we eat but how often we eat these kinds of things that will place us at increased risk of dental decay and cavities."
Candy remains a huge part of Halloween for tens of millions of American kids and their candy-buying -- or candy-pilfering -- parents. The National Confectioners Association says 93 percent of children in the United States go trick-or-treating, and the group estimates that Halloween candy sales this year will top $2.26 billion.
But children -- and adults -- are less at risk of developing tooth decay if they eat sweets -- or even carbohydrate-heavy foods like potato chips and crackers -- at mealtimes, Helpin said.
Cavities are most likely to develop when your mouth is exposed to the acid created by bacteria during eating, Helpin said. "When we eat [at meals], the flow of saliva increases. We're also taking in other liquids that will help wash the mouth out," he said.
But if you snack during the day, the teeth are continuously bathed in acid, he said. "If I have four pieces of candy, and I eat all four at one time, my mouth will have acid in it for 30 to 60 minutes. If I eat one each hour, my mouth can be exposed to acid for four hours," he added.
So what should you do? The worst time to give kids sweets is right before bedtime, Helpin said. As for mealtimes -- like lunchtime at school -- it's wise for children to swish a liquid in their mouths to wash away acid, he said.
When it comes to Halloween, Helpin recommends that parents not get overly concerned about candy and their kids. "I don't think Halloween week is going to be the make-or-break factor in whether someone will get a number of new cavities," he said.
Helpin recommends that parents have their kids brush their teeth after eating candy. If that's not possible, have them rinse their mouth with water three or four times after eating. This will help cut down on acidity in the mouth, he said.
There can be special concerns about Halloween treats if your child is among the 3 million American boys and girls with food allergies.
"Candy products frequently include ingredients like peanuts, tree nuts, milk and egg, some of the most common food allergens in children," Dr. Jacqueline A. Pongracic, an official with the Milwaukee-based American Academy of Allergy, Asthma & Immunology, said in a news release issued by the organization. "Peanuts and tree nuts are common causes of severe, life-threatening reactions, and children and their parents need to be aware of this and check ingredients for all treats. This can be especially tricky with Halloween candies, which often do not have ingredients listed on their labels."
According to the AAAAI, parents of children with food allergies should do the following:
Before Halloween, ask your neighbors to give out safe snacks, even distributing some to them to hand out specifically to your child.
Be aware that the smaller candy bars usually passed out to trick-or-treaters may have different ingredients than their regular-size counterparts.
Teach your child to politely refuse offers of home-baked goodies like cookies or cupcakes.
THURSDAY, Oct. 30 (HealthDay News) -- Halloween and its avalanche of candy is coming, making it the worst time of year for children's teeth, right?
Not necessarily, says a dentist who contends that parents can make a big difference by monitoring when their kids eat their sweets.
"Parents need to know that frequency is far more important than amount when it comes to taking in" sugars, said Dr. Mark Helpin, acting chairman of Temple University's Department of Pediatric Dentistry. "It's not how much we eat but how often we eat these kinds of things that will place us at increased risk of dental decay and cavities."
Candy remains a huge part of Halloween for tens of millions of American kids and their candy-buying -- or candy-pilfering -- parents. The National Confectioners Association says 93 percent of children in the United States go trick-or-treating, and the group estimates that Halloween candy sales this year will top $2.26 billion.
But children -- and adults -- are less at risk of developing tooth decay if they eat sweets -- or even carbohydrate-heavy foods like potato chips and crackers -- at mealtimes, Helpin said.
Cavities are most likely to develop when your mouth is exposed to the acid created by bacteria during eating, Helpin said. "When we eat [at meals], the flow of saliva increases. We're also taking in other liquids that will help wash the mouth out," he said.
But if you snack during the day, the teeth are continuously bathed in acid, he said. "If I have four pieces of candy, and I eat all four at one time, my mouth will have acid in it for 30 to 60 minutes. If I eat one each hour, my mouth can be exposed to acid for four hours," he added.
So what should you do? The worst time to give kids sweets is right before bedtime, Helpin said. As for mealtimes -- like lunchtime at school -- it's wise for children to swish a liquid in their mouths to wash away acid, he said.
When it comes to Halloween, Helpin recommends that parents not get overly concerned about candy and their kids. "I don't think Halloween week is going to be the make-or-break factor in whether someone will get a number of new cavities," he said.
Helpin recommends that parents have their kids brush their teeth after eating candy. If that's not possible, have them rinse their mouth with water three or four times after eating. This will help cut down on acidity in the mouth, he said.
There can be special concerns about Halloween treats if your child is among the 3 million American boys and girls with food allergies.
"Candy products frequently include ingredients like peanuts, tree nuts, milk and egg, some of the most common food allergens in children," Dr. Jacqueline A. Pongracic, an official with the Milwaukee-based American Academy of Allergy, Asthma & Immunology, said in a news release issued by the organization. "Peanuts and tree nuts are common causes of severe, life-threatening reactions, and children and their parents need to be aware of this and check ingredients for all treats. This can be especially tricky with Halloween candies, which often do not have ingredients listed on their labels."
According to the AAAAI, parents of children with food allergies should do the following:
Before Halloween, ask your neighbors to give out safe snacks, even distributing some to them to hand out specifically to your child.
Be aware that the smaller candy bars usually passed out to trick-or-treaters may have different ingredients than their regular-size counterparts.
Teach your child to politely refuse offers of home-baked goodies like cookies or cupcakes.
Thursday, October 23, 2008
Workout regimens you can live with
NO LOITERING Exercise classes are a good way for older adults to meet new federal guidelines on exercise; children should get 60 minutes of activity daily. Weights increase intensity of training.
By JOHN HANC
Published: October 22, 2008
SWIM, bike, run, rake leaves. Climb monkey bars if you’re a child, do water aerobics if you’re older. Do whatever you like. Just keep moving.
What is different is the emphasis on the variety of activities — including daily chores — that can reap the profound health benefits of exercise.
There is no “one size fits all.” Instead, the guidelines are broken into specific recommendations for adults, children, people over 65 and others. And while sustained aerobic activities are the foundation, there are other types of activities — muscle-building and flexibility-enhancing — that are also important.
Here are some ideas on filling your own exercise prescription.
For the Time-Crunched
Can’t find five days a week to exercise? Train three days instead, but pick up the pace. Richard Cotton, an exercise physiologist with the American College of Sports Medicine, recommends a Wednesday-Saturday-Sunday routine. That way, he said, “you’re only getting into one of your workdays, but you don’t have any more than two days off at a time.”
Training for 30 minutes three times a week may fall short of the 150-minute goal, but the guidelines allow for as little as 75 minutes of exercise a week, provided the activities are higher in intensity. Mr. Cotton called that high-return-on-investment activity, and suggested using interval training to achieve it. Here’s how:
After a five-minute warm-up (on a treadmill or stationary bike, in a pool or even walking or jogging around a park), pick up the pace for five minutes, then go a little easier for three minutes. Repeat that pattern for the rest of the 30 minutes, making sure to end with an easy-effort, three- to four-minute cool-down. On an intensity scale of 1 to 10 (with 1 being the easiest effort, and 10 being all-out), your hardest intervals should be at 7 to 8, and recoveries at 5 to 6.
The same is true with strength training. Work the major muscles groups during at least two sessions a week. Mr. Cotton said you can begin to meet that part of the guidelines through a 10-minute workout using just three bodyweight exercises — abdominal crunches, back extensions and push-ups. For details on the program, visit www.myexerciseplan.com/assessment. Look for the Basic Bodyweight Strength Plan under “Keep It Simple.”
The Older Set
Older adults should try to get in 150 minutes of moderately intense activity and at least two sessions of strength training a week. You can accumulate those minutes by walking or joining an exercise class for older adults. For strength training, work with resistance bands, do bodyweight exercises or just climb stairs.
One key change in these guidelines is the stipulation that older adults should do exercises to maintain or improve their balance and to help avoid falls. Walking backward or on your toes can do that. In her forthcoming book, “Fitness After 40” (Amacom), Dr. Vonda Wright of the University of Pittsburgh Medical Center recommends a body movement that she calls “the stork.” Stand with your feet slightly apart. Raise one knee, while keeping your arms to the sides or your hands on your hips. Hold for 30 seconds, then switch legs. Repeat. If you have trouble at first, place your fingertips on a hard surface until you can balance.
For Children
The guidelines stipulate at least 60 minutes a day of moderate or vigorous activity for children from the ages of 6 to 17. That may sound like a challenge for parents whose children seem to prefer Xbox to exercise. But Stephen J. Virgilio, chairman of the physical education department at Adelphi University in Garden City, N.Y., said that is an obstacle that can be overcome.
“Research shows that when kids are given the opportunity to be physically active, they will be,” Dr. Virgilio said. “It’s up to adults to create that opportunity.”
But don’t expect your children to work out the way you do. “Children are intermittent learners and intermittent exercisers,” said Dr. Virgilio, author of the book “Active Start for Healthy Kids” (Human Kinetics). “They tend to start and rest and then start up again.”
Children can accumulate exercise minutes in various ways over a typical day. A younger child could walk to school and back (20 minutes), kick a ball around after school (20 minutes), climb the monkey bars on the playground (10 minutes) and ride a bike with friends (10 minutes).
By JOHN HANC
Published: October 22, 2008
SWIM, bike, run, rake leaves. Climb monkey bars if you’re a child, do water aerobics if you’re older. Do whatever you like. Just keep moving.
What is different is the emphasis on the variety of activities — including daily chores — that can reap the profound health benefits of exercise.
There is no “one size fits all.” Instead, the guidelines are broken into specific recommendations for adults, children, people over 65 and others. And while sustained aerobic activities are the foundation, there are other types of activities — muscle-building and flexibility-enhancing — that are also important.
Here are some ideas on filling your own exercise prescription.
For the Time-Crunched
Can’t find five days a week to exercise? Train three days instead, but pick up the pace. Richard Cotton, an exercise physiologist with the American College of Sports Medicine, recommends a Wednesday-Saturday-Sunday routine. That way, he said, “you’re only getting into one of your workdays, but you don’t have any more than two days off at a time.”
Training for 30 minutes three times a week may fall short of the 150-minute goal, but the guidelines allow for as little as 75 minutes of exercise a week, provided the activities are higher in intensity. Mr. Cotton called that high-return-on-investment activity, and suggested using interval training to achieve it. Here’s how:
After a five-minute warm-up (on a treadmill or stationary bike, in a pool or even walking or jogging around a park), pick up the pace for five minutes, then go a little easier for three minutes. Repeat that pattern for the rest of the 30 minutes, making sure to end with an easy-effort, three- to four-minute cool-down. On an intensity scale of 1 to 10 (with 1 being the easiest effort, and 10 being all-out), your hardest intervals should be at 7 to 8, and recoveries at 5 to 6.
The same is true with strength training. Work the major muscles groups during at least two sessions a week. Mr. Cotton said you can begin to meet that part of the guidelines through a 10-minute workout using just three bodyweight exercises — abdominal crunches, back extensions and push-ups. For details on the program, visit www.myexerciseplan.com/assessment. Look for the Basic Bodyweight Strength Plan under “Keep It Simple.”
The Older Set
Older adults should try to get in 150 minutes of moderately intense activity and at least two sessions of strength training a week. You can accumulate those minutes by walking or joining an exercise class for older adults. For strength training, work with resistance bands, do bodyweight exercises or just climb stairs.
One key change in these guidelines is the stipulation that older adults should do exercises to maintain or improve their balance and to help avoid falls. Walking backward or on your toes can do that. In her forthcoming book, “Fitness After 40” (Amacom), Dr. Vonda Wright of the University of Pittsburgh Medical Center recommends a body movement that she calls “the stork.” Stand with your feet slightly apart. Raise one knee, while keeping your arms to the sides or your hands on your hips. Hold for 30 seconds, then switch legs. Repeat. If you have trouble at first, place your fingertips on a hard surface until you can balance.
For Children
The guidelines stipulate at least 60 minutes a day of moderate or vigorous activity for children from the ages of 6 to 17. That may sound like a challenge for parents whose children seem to prefer Xbox to exercise. But Stephen J. Virgilio, chairman of the physical education department at Adelphi University in Garden City, N.Y., said that is an obstacle that can be overcome.
“Research shows that when kids are given the opportunity to be physically active, they will be,” Dr. Virgilio said. “It’s up to adults to create that opportunity.”
But don’t expect your children to work out the way you do. “Children are intermittent learners and intermittent exercisers,” said Dr. Virgilio, author of the book “Active Start for Healthy Kids” (Human Kinetics). “They tend to start and rest and then start up again.”
Children can accumulate exercise minutes in various ways over a typical day. A younger child could walk to school and back (20 minutes), kick a ball around after school (20 minutes), climb the monkey bars on the playground (10 minutes) and ride a bike with friends (10 minutes).
Food allergies up 18% among U.S. children
Reactions lead to higher risk for asthma, other respiratory problems, CDC report says
Wednesday, October 22, 2008
WEDNESDAY, Oct. 22 (HealthDay News) -- The number of American kids with food allergies has soared 18 percent in the last decade, with an estimated 4 percent of children and teens now affected with the condition, a new federal report says.
In 2007, approximately 3 million children under the age of 18 were reported to have had a food or digestive allergy in the previous 12 months, compared to slightly more than 2.3 million children (3.3 percent) in 1997, according to the report from the U.S. Centers for Disease Control and Prevention.
Eight types of foods account for 90 percent of all food allergies -- milk, eggs, peanuts, tree nuts, fish, shellfish, soy, and wheat. Allergic reactions to these foods can range from a tingling sensation around the mouth and lips, to hives and even death, depending on the severity of the reaction, the report's authors said.
The report also said that children with food allergies are two to four times more likely to have asthma or other allergies, compared to children without food allergies.
It's not really known how a person develops a food allergy. They are more common in children than adults, and the majority of children with food allergies will "outgrow" them as they get older. But for some, a food allergy can become a lifelong concern, the report said.
Other highlights in the report:
Rates of food allergy were similar for boys and girls -- 3.8 percent for boys and 4.1 percent for girls.
Approximately 4.7 percent of children younger than 5 years of age had a reported food allergy, compared to 3.7 percent of children and teens aged 5 to 17 years.
Hispanic children had lower rates of reported food allergy (3.1 percent) than non-Hispanic white (4.1 percent) or non-Hispanic black children (4 percent.)
In 2007, 29 percent of children with food allergies also had reported asthma, compared to 12 percent of children without food allergy. And an estimated 27 percent of children with food allergies had reported eczema or skin allergy, compared to 8 percent of children without food allergies.
Slightly more than 30 percent of children with a food allergy also had reported respiratory allergy, compared with 9 percent of children with no food allergy.
From 2004 to 2006, there were approximately 9,537 hospital discharges annually for children from birth to 17 years of age who were diagnosed with a food allergy. Hospital discharges with a diagnosed food allergy increased significantly from the period 1998-2000 to 2004-2006. This finding could owe to increased awareness, reporting, and use of specific medical diagnostic codes for food allergies. Or it could represent a real increase in children who are experiencing food-allergic reactions.
The findings in the report, titled Food Allergy Among U.S. Children: Trends in Prevalence and Hospitalizations, were derived from statistics from the National Health Interview Survey and the National Hospital Discharge Survey, both conducted by CDC's National Center for Health Statistics.
Wednesday, October 22, 2008
WEDNESDAY, Oct. 22 (HealthDay News) -- The number of American kids with food allergies has soared 18 percent in the last decade, with an estimated 4 percent of children and teens now affected with the condition, a new federal report says.
In 2007, approximately 3 million children under the age of 18 were reported to have had a food or digestive allergy in the previous 12 months, compared to slightly more than 2.3 million children (3.3 percent) in 1997, according to the report from the U.S. Centers for Disease Control and Prevention.
Eight types of foods account for 90 percent of all food allergies -- milk, eggs, peanuts, tree nuts, fish, shellfish, soy, and wheat. Allergic reactions to these foods can range from a tingling sensation around the mouth and lips, to hives and even death, depending on the severity of the reaction, the report's authors said.
The report also said that children with food allergies are two to four times more likely to have asthma or other allergies, compared to children without food allergies.
It's not really known how a person develops a food allergy. They are more common in children than adults, and the majority of children with food allergies will "outgrow" them as they get older. But for some, a food allergy can become a lifelong concern, the report said.
Other highlights in the report:
Rates of food allergy were similar for boys and girls -- 3.8 percent for boys and 4.1 percent for girls.
Approximately 4.7 percent of children younger than 5 years of age had a reported food allergy, compared to 3.7 percent of children and teens aged 5 to 17 years.
Hispanic children had lower rates of reported food allergy (3.1 percent) than non-Hispanic white (4.1 percent) or non-Hispanic black children (4 percent.)
In 2007, 29 percent of children with food allergies also had reported asthma, compared to 12 percent of children without food allergy. And an estimated 27 percent of children with food allergies had reported eczema or skin allergy, compared to 8 percent of children without food allergies.
Slightly more than 30 percent of children with a food allergy also had reported respiratory allergy, compared with 9 percent of children with no food allergy.
From 2004 to 2006, there were approximately 9,537 hospital discharges annually for children from birth to 17 years of age who were diagnosed with a food allergy. Hospital discharges with a diagnosed food allergy increased significantly from the period 1998-2000 to 2004-2006. This finding could owe to increased awareness, reporting, and use of specific medical diagnostic codes for food allergies. Or it could represent a real increase in children who are experiencing food-allergic reactions.
The findings in the report, titled Food Allergy Among U.S. Children: Trends in Prevalence and Hospitalizations, were derived from statistics from the National Health Interview Survey and the National Hospital Discharge Survey, both conducted by CDC's National Center for Health Statistics.
Monday, October 13, 2008
Study Rooms
Atherton Library offers study rooms for both individuals and groups. The five Individual Study Rooms accommodate a single person and come equipped with a small desktop, chair and electrical outlet. Our Group Study Room is furnished with a small conference table, 6 chairs, white board, multimedia projector and a projection screen. This room is available for groups with a minimum of 3 people. Individual Study Rooms are available on a first-come, first-served basis while the Group Study Room can be reserved up to a week in advance. A valid HPU ID card is required to use the study rooms. Please stop by the library front desk to sign in or to make a reservation.
Atherton Library offers study rooms for both individuals and groups. The five Individual Study Rooms accommodate a single person and come equipped with a small desktop, chair and electrical outlet. Our Group Study Room is furnished with a small conference table, 6 chairs, white board, multimedia projector and a projection screen. This room is available for groups with a minimum of 3 people. Individual Study Rooms are available on a first-come, first-served basis while the Group Study Room can be reserved up to a week in advance. A valid HPU ID card is required to use the study rooms. Please stop by the library front desk to sign in or to make a reservation.
Wednesday, September 24, 2008
HPU Common Book - The Omnivore's Dilemma
This year's Common Book, The Omnivore's Dilemma: A Natural History of Four Meals, by Michael Pollan is an exploration of the different methods of food production found in the United States today. The author takes us behind the scenes of today's industrial monoculture and shows us how the crops and animals raised by today's farmers and agricultural corporations ends up as food on our dinner tables. Especially enlightening is his description of the consequences of the agricultural subsidies promoting the growing of corn. This corn is found in the majority of the food products we consume each day. It turns out that Americans, not Mexicans, are the true "people of the corn."
Copies of the Common Book are available for 3 day loan at Atherton and Meader Libraries. Go to the Circulation Desk to check it out.
Copies of the Common Book are available for 3 day loan at Atherton and Meader Libraries. Go to the Circulation Desk to check it out.
Tuesday, September 23, 2008
The Doctor’s Hands Are Germ-Free. The Scrubs Too?
By TARA PARKER-POPE
Published: September 22, 2008
Many hospitals have stepped up efforts to encourage regular hand washing by doctors. But what about their clothes?
Amid growing concerns about hospital infections and a rise in drug-resistant bacteria, the attire of doctors, nurses and other health care workers — worn both inside and outside the hospital — is getting more attention. While infection control experts have published extensive research on the benefits of hand washing and equipment sterilization in hospitals, little is known about the role that ties, white coats, long sleeves and soiled scrubs play in the spread of bacteria.
The discussion was reignited this year when the British National Health Service imposed a “bare below the elbows” rule barring doctors from wearing ties and long sleeves, both of which are known to accumulate germs as doctors move from patient to patient.
(In the United States, hospitals generally require doctors to wear “professional” dress but have no specific edicts about ties and long sleeves.)
But while some data suggest that doctors’ garments are crawling with germs, there’s no evidence that clothing plays a role in the spread of hospital infections. And some researchers report that patients have less confidence in a doctor whose attire is casual. This month, the medical journal BJU International cited the lack of data in questioning the validity of the new British dress code.
Still, experts say the absence of evidence doesn’t mean there is no risk — it just means there is no good research. A handful of reports do suggest that the clothing of health workers can be a reservoir for risky germs.
In 2004, a study from the New York Hospital Medical Center of Queens compared the ties of 40 doctors and medical students with those of 10 security guards. It found that about half the ties worn by medical personnel were a reservoir for germs, compared with just 1 in 10 of the ties taken from the security guards. The doctors’ ties harbored several pathogens, including those that can lead to staph infections or pneumonia.
Another study at a Connecticut hospital sought to gauge the role that clothing plays in the spread of methicillin-resistant Staphylococcus aureus, or MRSA. The study found that if a worker entered a room where the patient had MRSA, the bacteria would end up on the worker’s clothes about 70 percent of the time, even if the person never actually touched the patient.
“We know it can live for long periods of time on fabrics,” said Marcia Patrick, an infection control expert in Tacoma, Wash., and co-author of the Association of Professionals in Infection Control and Epidemiology guidelines for eliminating MRSA in hospitals.
Hospital rules typically encourage workers to change out of soiled scrubs before leaving, but infection control experts say enforcement can be lax. Doctors and nurses can often be seen wearing scrubs on subways and in grocery stores.
Ms. Patrick, who is director of infection prevention and control for the MultiCareHealth System in Tacoma, says it’s unlikely that brief contact with a scrub-wearing health care worker on the subway would lead to infection. “The likelihood is that the risk is low, but it’s also probably not zero,” she said.
While the role of clothing in the spread of infection hasn’t been well studied, some hospitals in Denmark and Europe have adopted wide-ranging infection-control practices that include provisions for the clothing that health care workers wear both in and out of the hospital. Workers of both sexes must change into hospital-provided scrubs when they arrive at work and even wear sanitized plastic shoes, also provided by the hospital. At the end of the day, they change back into their street clothes to go home.
The focus on hand washing, sterilization, screening and clothing control appears to have worked: in Denmark, fewer than 1 percent of staph infections involve resistant strains of the bacteria, while in the United States, the numbers have surged to 50 percent in some hospitals.
But American hospitals operate on tight budgets and can’t afford to provide clothes and shoes to every worker. In addition, many hospitals don’t have the extra space for laundry facilities.
Ann Marie Pettis, director of infection prevention for the University of Rochester Medical Center, says most hospitals are focusing on hand washing and equipment sterilization, which are proven methods known to reduce the spread of infection. But she adds that her hospital, like many others, has a policy against wearing scrub attire to and from work, even though there is no real evidence that dirty scrubs pose a risk to people in the community.
“Common sense tells us that the things we are wearing as health care providers should be freshly laundered,” Ms. Pettis said. After all, she went on, the wearing of scrubs in public “raises fear” among consumers.
“I don’t think we should feed into that,” she said. “Scrubs shouldn’t be worn out and about.”
well@nytimes.com
More Articles in Health » A version of this article appeared in print on September 23, 2008, on page F5 of the New York edition.
Published: September 22, 2008
Many hospitals have stepped up efforts to encourage regular hand washing by doctors. But what about their clothes?
Amid growing concerns about hospital infections and a rise in drug-resistant bacteria, the attire of doctors, nurses and other health care workers — worn both inside and outside the hospital — is getting more attention. While infection control experts have published extensive research on the benefits of hand washing and equipment sterilization in hospitals, little is known about the role that ties, white coats, long sleeves and soiled scrubs play in the spread of bacteria.
The discussion was reignited this year when the British National Health Service imposed a “bare below the elbows” rule barring doctors from wearing ties and long sleeves, both of which are known to accumulate germs as doctors move from patient to patient.
(In the United States, hospitals generally require doctors to wear “professional” dress but have no specific edicts about ties and long sleeves.)
But while some data suggest that doctors’ garments are crawling with germs, there’s no evidence that clothing plays a role in the spread of hospital infections. And some researchers report that patients have less confidence in a doctor whose attire is casual. This month, the medical journal BJU International cited the lack of data in questioning the validity of the new British dress code.
Still, experts say the absence of evidence doesn’t mean there is no risk — it just means there is no good research. A handful of reports do suggest that the clothing of health workers can be a reservoir for risky germs.
In 2004, a study from the New York Hospital Medical Center of Queens compared the ties of 40 doctors and medical students with those of 10 security guards. It found that about half the ties worn by medical personnel were a reservoir for germs, compared with just 1 in 10 of the ties taken from the security guards. The doctors’ ties harbored several pathogens, including those that can lead to staph infections or pneumonia.
Another study at a Connecticut hospital sought to gauge the role that clothing plays in the spread of methicillin-resistant Staphylococcus aureus, or MRSA. The study found that if a worker entered a room where the patient had MRSA, the bacteria would end up on the worker’s clothes about 70 percent of the time, even if the person never actually touched the patient.
“We know it can live for long periods of time on fabrics,” said Marcia Patrick, an infection control expert in Tacoma, Wash., and co-author of the Association of Professionals in Infection Control and Epidemiology guidelines for eliminating MRSA in hospitals.
Hospital rules typically encourage workers to change out of soiled scrubs before leaving, but infection control experts say enforcement can be lax. Doctors and nurses can often be seen wearing scrubs on subways and in grocery stores.
Ms. Patrick, who is director of infection prevention and control for the MultiCareHealth System in Tacoma, says it’s unlikely that brief contact with a scrub-wearing health care worker on the subway would lead to infection. “The likelihood is that the risk is low, but it’s also probably not zero,” she said.
While the role of clothing in the spread of infection hasn’t been well studied, some hospitals in Denmark and Europe have adopted wide-ranging infection-control practices that include provisions for the clothing that health care workers wear both in and out of the hospital. Workers of both sexes must change into hospital-provided scrubs when they arrive at work and even wear sanitized plastic shoes, also provided by the hospital. At the end of the day, they change back into their street clothes to go home.
The focus on hand washing, sterilization, screening and clothing control appears to have worked: in Denmark, fewer than 1 percent of staph infections involve resistant strains of the bacteria, while in the United States, the numbers have surged to 50 percent in some hospitals.
But American hospitals operate on tight budgets and can’t afford to provide clothes and shoes to every worker. In addition, many hospitals don’t have the extra space for laundry facilities.
Ann Marie Pettis, director of infection prevention for the University of Rochester Medical Center, says most hospitals are focusing on hand washing and equipment sterilization, which are proven methods known to reduce the spread of infection. But she adds that her hospital, like many others, has a policy against wearing scrub attire to and from work, even though there is no real evidence that dirty scrubs pose a risk to people in the community.
“Common sense tells us that the things we are wearing as health care providers should be freshly laundered,” Ms. Pettis said. After all, she went on, the wearing of scrubs in public “raises fear” among consumers.
“I don’t think we should feed into that,” she said. “Scrubs shouldn’t be worn out and about.”
well@nytimes.com
More Articles in Health » A version of this article appeared in print on September 23, 2008, on page F5 of the New York edition.
Tuesday, September 16, 2008
Stem Cells Ease Stroke-Like Brain Damage in Mice
The strategy might someday help humans recover from similar events, scientists say
Monday, September 15, 2008
MONDAY, Sept. 15 (HealthDay News) -- Human stem cells derived from bone marrow can cut the brain damage caused by an interruption in blood supply, such as what happens after a heart attack, scientists report.
Although these initial results were seen in mice, researchers are hopeful the breakthrough will one day help humans struck by cardiac arrest or stroke.
The human cells did not trigger the development of new brain cells, as previously believed. Instead, they switched on and off different genes, essentially turning down inflammation and immune system reactions that were harmful to the brain.
"This is the first time that interactions between the two kinds of cells [injected cells and host cells] worked out," said Dr. Darwin Prockop, senior author of the study, which appears in this weeks issue of the Proceedings of the National Academy of Sciences.
The study was completed while Prockop was with Tulane University's Center for Gene Therapy. He recently accepted a post as Stearman Chair in Genomic Medicine at Texas A&M Health Science Center College of Medicine and is director of the Institute for Regenerative Medicine at Scott & White.
"The big thing was finding out how these cells were helping," Prockop elaborated. "This dramatic crosstalk was very surprising. The human cells specifically turned down immune and inflammatory reactions."
The finding "goes along with the argument that something here could be used in human therapy. Even though this is a short-term fix, it might be sufficient to have a reparative function," added Dr. Robert Schwartz, director of the Texas A&M Health Science Center Institute of Biosciences and Technology, in Houston.
For this study, Prockop's team at Tulane injected human mesenchymal stromal cells (hMSCs) into the brains of adult mice one day after blood flow to the rodents' brains had been temporarily blocked.
"The blood supply was tied off for just 15 minutes and then restored," Prockop explained. "That causes massive damage to the brain. It's the sort of thing that happens when you have a cardiac arrest ... It's not quite a stroke because you're cutting off the blood supply then returning it."
Although the human cells disappeared within about a week, they nevertheless exerted dramatic effects upon the brain. "The number of dead neurons dropped off about 60 percent. It was quite amazing," Prockop said. "And the motor responses of mice improved dramatically."
Further analysis revealed that the human and mouse cells were actually signaling to each other, with the human cells changing the way certain genes were expressed. This meant that certain harmful immune and inflammatory responses were considerably suppressed, the researchers said.
"These hMSCs are really blood cells and they have effects on vascular formation and angiogenesis [new blood vessel growth] and they also produce a fair number of growth factors and signaling factors that seem to ameliorate the disease process," Schwartz explained.
Ideally, the results would one day be translated into stroke and other therapies for humans, an area which is sadly lacking in options.
"This could be a therapy for patients who have had cardiac arrest either by itself or after surgery," Prockop said. "But the next step is to find out what human cells are producing to make all these effects."
"This is a really good study," Schwartz added. "It has a lot of value. Now the question is, can you move it eventually into the clinic and how do you go forward with the next set of studies involving large mammals and getting it generally approved by the FDA [U.S. Food and Drug Administration] as a methodology and treatment?"
HealthDay
Copyright (c) 2008 ScoutNews, LLC. All rights reserved.
Monday, September 15, 2008
MONDAY, Sept. 15 (HealthDay News) -- Human stem cells derived from bone marrow can cut the brain damage caused by an interruption in blood supply, such as what happens after a heart attack, scientists report.
Although these initial results were seen in mice, researchers are hopeful the breakthrough will one day help humans struck by cardiac arrest or stroke.
The human cells did not trigger the development of new brain cells, as previously believed. Instead, they switched on and off different genes, essentially turning down inflammation and immune system reactions that were harmful to the brain.
"This is the first time that interactions between the two kinds of cells [injected cells and host cells] worked out," said Dr. Darwin Prockop, senior author of the study, which appears in this weeks issue of the Proceedings of the National Academy of Sciences.
The study was completed while Prockop was with Tulane University's Center for Gene Therapy. He recently accepted a post as Stearman Chair in Genomic Medicine at Texas A&M Health Science Center College of Medicine and is director of the Institute for Regenerative Medicine at Scott & White.
"The big thing was finding out how these cells were helping," Prockop elaborated. "This dramatic crosstalk was very surprising. The human cells specifically turned down immune and inflammatory reactions."
The finding "goes along with the argument that something here could be used in human therapy. Even though this is a short-term fix, it might be sufficient to have a reparative function," added Dr. Robert Schwartz, director of the Texas A&M Health Science Center Institute of Biosciences and Technology, in Houston.
For this study, Prockop's team at Tulane injected human mesenchymal stromal cells (hMSCs) into the brains of adult mice one day after blood flow to the rodents' brains had been temporarily blocked.
"The blood supply was tied off for just 15 minutes and then restored," Prockop explained. "That causes massive damage to the brain. It's the sort of thing that happens when you have a cardiac arrest ... It's not quite a stroke because you're cutting off the blood supply then returning it."
Although the human cells disappeared within about a week, they nevertheless exerted dramatic effects upon the brain. "The number of dead neurons dropped off about 60 percent. It was quite amazing," Prockop said. "And the motor responses of mice improved dramatically."
Further analysis revealed that the human and mouse cells were actually signaling to each other, with the human cells changing the way certain genes were expressed. This meant that certain harmful immune and inflammatory responses were considerably suppressed, the researchers said.
"These hMSCs are really blood cells and they have effects on vascular formation and angiogenesis [new blood vessel growth] and they also produce a fair number of growth factors and signaling factors that seem to ameliorate the disease process," Schwartz explained.
Ideally, the results would one day be translated into stroke and other therapies for humans, an area which is sadly lacking in options.
"This could be a therapy for patients who have had cardiac arrest either by itself or after surgery," Prockop said. "But the next step is to find out what human cells are producing to make all these effects."
"This is a really good study," Schwartz added. "It has a lot of value. Now the question is, can you move it eventually into the clinic and how do you go forward with the next set of studies involving large mammals and getting it generally approved by the FDA [U.S. Food and Drug Administration] as a methodology and treatment?"
HealthDay
Copyright (c) 2008 ScoutNews, LLC. All rights reserved.
Thumbs Down on Beta Blockers for High Blood Pressure
No more effective than other drugs, increased stroke risk, study finds
Monday, September 15, 2008
MONDAY, Sept. 15 (HealthDay News) -- Beta blocker drugs don't prevent development of heart failure in people with high blood pressure and should not be used as first-line treatment for the condition, an analysis of studies indicates.
"For heart failure, beta blockers clearly are an integral therapy," said Dr. Marrick Kukin, a professor of clinical medicine at Columbia University's College of Physicians and Surgeons, and a member of the team reporting the results in the Sept. 16 issue of the Journal of the American College of Cardiology. "But it has never been proven that they have a role for hypertension in preventing heart failure," Kukin said.
Hypertension is the medical term for high blood pressure. One major goal in treating hypertension is to prevent heart failure, the progressive loss of the heart's ability to pump blood, which can be fatal. Kukin was one of a group led by Dr. Franz H. Messerli, a Columbia cardiologist, that analyzed the results of 12 controlled trials in which 112,177 people were treated for high blood pressure.
"Our meta-analysis showed that compared to placebo, beta blockers offered a benefit," Kukin said. "But when compared to other medications, such as ACE inhibitors, there was no difference. Also, there was an increased risk of stroke with beta blockers in older patients, which has been shown in other trials."
The risk of stroke in elderly people was increased by 19 percent in those taking beta blockers.
Beta blockers help the heart by limiting the effect of adrenaline. Diuretics lower blood pressure by draining fluid from the body, while ACE inhibitors block production of an enzyme that constricts blood vessels.
This is one of a series of studies that have cast doubt on the use of beta blockers as the first line of treatment of high blood pressure. Studies done in Europe led British authorities to issue guidelines recommending against use of beta blockers as first-line hypertension therapy two years ago.
But Kukin, who described himself as "the heart failure person" in the group that produced the report, said that beta blockers "unequivocally are part of the therapy for someone with heart failure." They also are essential in treatment of heart attacks, he said. The new report simply emphasizes that they have no benefit over other blood pressure medications but do carry the extra risk of stroke, he said.
Another report in the same issue of the journal is the latest to describe an advantage of drug-coated stents over the bare-metal kind inserted to keep arteries open. Physicians at the Cleveland Clinic compared 6,053 patients who received drug-coated stents with 1,983 who were given bare-metal stents.
The death rate from all causes was about a third lower in the coated stent group, the report said. Adjustments for other accompanying conditions such as anemia, depression and socioeconomic status found the death rate for the coated stent group was almost 50 percent lower than for the bare-metal stent recipients.
HealthDay
Copyright (c) 2008 ScoutNews, LLC. All rights reserved.
Monday, September 15, 2008
MONDAY, Sept. 15 (HealthDay News) -- Beta blocker drugs don't prevent development of heart failure in people with high blood pressure and should not be used as first-line treatment for the condition, an analysis of studies indicates.
"For heart failure, beta blockers clearly are an integral therapy," said Dr. Marrick Kukin, a professor of clinical medicine at Columbia University's College of Physicians and Surgeons, and a member of the team reporting the results in the Sept. 16 issue of the Journal of the American College of Cardiology. "But it has never been proven that they have a role for hypertension in preventing heart failure," Kukin said.
Hypertension is the medical term for high blood pressure. One major goal in treating hypertension is to prevent heart failure, the progressive loss of the heart's ability to pump blood, which can be fatal. Kukin was one of a group led by Dr. Franz H. Messerli, a Columbia cardiologist, that analyzed the results of 12 controlled trials in which 112,177 people were treated for high blood pressure.
"Our meta-analysis showed that compared to placebo, beta blockers offered a benefit," Kukin said. "But when compared to other medications, such as ACE inhibitors, there was no difference. Also, there was an increased risk of stroke with beta blockers in older patients, which has been shown in other trials."
The risk of stroke in elderly people was increased by 19 percent in those taking beta blockers.
Beta blockers help the heart by limiting the effect of adrenaline. Diuretics lower blood pressure by draining fluid from the body, while ACE inhibitors block production of an enzyme that constricts blood vessels.
This is one of a series of studies that have cast doubt on the use of beta blockers as the first line of treatment of high blood pressure. Studies done in Europe led British authorities to issue guidelines recommending against use of beta blockers as first-line hypertension therapy two years ago.
But Kukin, who described himself as "the heart failure person" in the group that produced the report, said that beta blockers "unequivocally are part of the therapy for someone with heart failure." They also are essential in treatment of heart attacks, he said. The new report simply emphasizes that they have no benefit over other blood pressure medications but do carry the extra risk of stroke, he said.
Another report in the same issue of the journal is the latest to describe an advantage of drug-coated stents over the bare-metal kind inserted to keep arteries open. Physicians at the Cleveland Clinic compared 6,053 patients who received drug-coated stents with 1,983 who were given bare-metal stents.
The death rate from all causes was about a third lower in the coated stent group, the report said. Adjustments for other accompanying conditions such as anemia, depression and socioeconomic status found the death rate for the coated stent group was almost 50 percent lower than for the bare-metal stent recipients.
HealthDay
Copyright (c) 2008 ScoutNews, LLC. All rights reserved.
Friday, September 12, 2008
Atherton Library Fall 2008 Hours
~ Fall 2008 Library Hours ~
September 2 - December 14, 2008
Sunday 12:00 p.m. - 7:00 p.m.
Monday - Thursday 8:00 a.m. - 9:00 p.m.
Friday 8:00 a.m. - 7:00 p.m.
Saturday 9:00 a.m. - 5:00 p.m.
Library Closings / Special Hours
Veteran's Day Tuesday, November 11, 2008
Thanksgiving Holiday Thursday - Friday, November 27 - 28, 2008
Last Day of Finals Sunday, December 14, 2008: closed 6:00 p.m.
FALL 2008
ATHERTON LIBRARY
September 2 - December 14, 2008
Sunday 12:00 p.m. - 7:00 p.m.
Monday - Thursday 8:00 a.m. - 9:00 p.m.
Friday 8:00 a.m. - 7:00 p.m.
Saturday 9:00 a.m. - 5:00 p.m.
Library Closings / Special Hours
Veteran's Day Tuesday, November 11, 2008
Thanksgiving Holiday Thursday - Friday, November 27 - 28, 2008
Last Day of Finals Sunday, December 14, 2008: closed 6:00 p.m.
FALL 2008
ATHERTON LIBRARY
Monday, August 25, 2008
Home Smoking Ban Keeps Teens From Lighting Up
But parental behavior remains strong influence on kids' attitudes, study says
HealthDay
By Kevin McKeever
FRIDAY, Aug. 22 (HealthDay News) -- A new study finds that parents who enforce a no-smoking ban at home are less likely to have teens who experiment with cigarettes.
The Massachusetts study, which followed more than 2,200 children, ages 12 to 17, for four years, also found that teens living in households that allowed smoking were more likely to find smoking as socially acceptable. Teens whose parents allowed smoking at home also tended to think a higher percentage of local adults smoked, compared to teens with household bans.
"This basic intervention -- implementing a household smoking ban -- has the potential to promote antismoking norms and to prevent adolescent smoking," lead study author Alison Albers, an assistant professor at Boston University School of Public Health, said in a news release issued by the Center for the Advancement of Health.
The findings are published in the October issue of the center's American Journal of Public Health.
Forbidding smoking at home appeared to reduce the incidence of smoking experimentation, although this only occurred in children who lived with nonsmokers. The teens who lived with nonsmokers but did not have a household smoking ban were nearly twice as likely to try cigarettes, compared to those whose parents banned smoking.
"This study provides evidence that even in a smoke-free home environment, parental behavior remains a strong influence on teen smoking attitudes and behavior," Mary Hrywna, manager of the Center for Tobacco Surveillance and Evaluation Research at the University of Medicine and Dentistry and New Jersey School of Public Health in New Brunswick, said in the same news release.
"These bans send a strong message to teens that it's not OK to smoke, and in the face of so many other external factors that may influence teens to smoke -- peers, advertising -- a home smoking policy is one thing that parents can control to some extent."
Copyright (c) 2008 ScoutNews, LLC. All rights reserved.
HealthDay
By Kevin McKeever
FRIDAY, Aug. 22 (HealthDay News) -- A new study finds that parents who enforce a no-smoking ban at home are less likely to have teens who experiment with cigarettes.
The Massachusetts study, which followed more than 2,200 children, ages 12 to 17, for four years, also found that teens living in households that allowed smoking were more likely to find smoking as socially acceptable. Teens whose parents allowed smoking at home also tended to think a higher percentage of local adults smoked, compared to teens with household bans.
"This basic intervention -- implementing a household smoking ban -- has the potential to promote antismoking norms and to prevent adolescent smoking," lead study author Alison Albers, an assistant professor at Boston University School of Public Health, said in a news release issued by the Center for the Advancement of Health.
The findings are published in the October issue of the center's American Journal of Public Health.
Forbidding smoking at home appeared to reduce the incidence of smoking experimentation, although this only occurred in children who lived with nonsmokers. The teens who lived with nonsmokers but did not have a household smoking ban were nearly twice as likely to try cigarettes, compared to those whose parents banned smoking.
"This study provides evidence that even in a smoke-free home environment, parental behavior remains a strong influence on teen smoking attitudes and behavior," Mary Hrywna, manager of the Center for Tobacco Surveillance and Evaluation Research at the University of Medicine and Dentistry and New Jersey School of Public Health in New Brunswick, said in the same news release.
"These bans send a strong message to teens that it's not OK to smoke, and in the face of so many other external factors that may influence teens to smoke -- peers, advertising -- a home smoking policy is one thing that parents can control to some extent."
Copyright (c) 2008 ScoutNews, LLC. All rights reserved.
Healthy Lunches Help Kids' Concentration in School
Sunday, August 24, 2008
SUNDAY, Aug. 24 (HealthDay News) -- Healthy foods should be included on the list of back-to-school supplies for your children, says a University of Michigan Health System expert.
Dietitian Catherine Kraus explained that a healthy, balanced diet enables neurotransmitters (chemical messengers in the brain) to function more efficiently, resulting in improved concentration and memory.
"Childhood is a crucial time when bodies are growing and brains are developing. Its so important to fuel the body with good nutrition, and teaching children smart eating habits at a young age is a great idea. It starts with the parents serving as the role model," Kraus said in a university news release.
She suggested a number of ways for parents to provide well-balanced meals and snacks to give children the energy and nutrition they need to perform well at school.
Make sure children eat breakfast. Research has shown that children who skip breakfast don't do as well in school as students who eat breakfast. A healthy breakfast includes a whole grain cereal, oatmeal or bread with a protein such as peanut butter or a hard-boiled egg. Including whole fruit instead of fruit juice adds more vitamins, minerals and fiber into the diet. Dairy products are acceptable as long as they're in the form of fat-free or low-fat milk, yogurt or cheese.
While many schools are striving to include healthier items on their lunch menus, there are still plenty of unhealthy items such as pizza, nachos, and sweetened drinks.
"When children consume a high-fat, high-sugar meal, their bodies will crash, and they will become very tired and lethargic -- which is not going to help them perform at their best level in school," Kraus said.
If you're concerned about the cafeteria choices at school, give your child packed lunches that include a type of whole grain, such as bread or tortillas, with a lean protein, such as tuna, turkey or chicken. Include assortments of fruits and vegetables in various colors and sizes. Healthy beverage choices include water, fat-free or low-fat milk, or 100-percent fruit juice.
At dinner, half of your child's plate should include vegetables and fruit, one-quarter should consist of a lean protein, and one-quarter should contain whole grains, such as brown rice or whole wheat pasta.
"A smart dinner will help your child's brain function. If they are satisfied after dinnertime, then they will sleep through the night, and a child needs at least eight to nine hours of sleep a night in order to function while in the school the next day," Kraus said.
SUNDAY, Aug. 24 (HealthDay News) -- Healthy foods should be included on the list of back-to-school supplies for your children, says a University of Michigan Health System expert.
Dietitian Catherine Kraus explained that a healthy, balanced diet enables neurotransmitters (chemical messengers in the brain) to function more efficiently, resulting in improved concentration and memory.
"Childhood is a crucial time when bodies are growing and brains are developing. Its so important to fuel the body with good nutrition, and teaching children smart eating habits at a young age is a great idea. It starts with the parents serving as the role model," Kraus said in a university news release.
She suggested a number of ways for parents to provide well-balanced meals and snacks to give children the energy and nutrition they need to perform well at school.
Make sure children eat breakfast. Research has shown that children who skip breakfast don't do as well in school as students who eat breakfast. A healthy breakfast includes a whole grain cereal, oatmeal or bread with a protein such as peanut butter or a hard-boiled egg. Including whole fruit instead of fruit juice adds more vitamins, minerals and fiber into the diet. Dairy products are acceptable as long as they're in the form of fat-free or low-fat milk, yogurt or cheese.
While many schools are striving to include healthier items on their lunch menus, there are still plenty of unhealthy items such as pizza, nachos, and sweetened drinks.
"When children consume a high-fat, high-sugar meal, their bodies will crash, and they will become very tired and lethargic -- which is not going to help them perform at their best level in school," Kraus said.
If you're concerned about the cafeteria choices at school, give your child packed lunches that include a type of whole grain, such as bread or tortillas, with a lean protein, such as tuna, turkey or chicken. Include assortments of fruits and vegetables in various colors and sizes. Healthy beverage choices include water, fat-free or low-fat milk, or 100-percent fruit juice.
At dinner, half of your child's plate should include vegetables and fruit, one-quarter should consist of a lean protein, and one-quarter should contain whole grains, such as brown rice or whole wheat pasta.
"A smart dinner will help your child's brain function. If they are satisfied after dinnertime, then they will sleep through the night, and a child needs at least eight to nine hours of sleep a night in order to function while in the school the next day," Kraus said.
Thursday, August 21, 2008
Friday, August 15, 2008
Checklists Help Men and Women Stay Healthy at 50-Plus
By Carolyn M. Clancy, M.D.
August 5, 2008
As we get ready to watch the upcoming Olympic Games, several athletes in their 40s and 50s will be taking part, including a 41-year-old U.S. swimmer and a 53-year-old Israeli marathoner.
These days, many people over age 50 are staying fit, even if they don't plan to compete at an elite level. But some men and women aren't sure how they can take care of themselves so they can stay healthy and keep doing the activities they enjoy.
My Agency, the Agency for Healthcare Research and Quality (AHRQ), and AARP developed two new checklists that outline the steps men and women over age 50 need to take to stay healthy and prevent disease.
The checklists are based on recommendations from the U.S. Preventive Services Task Force. This is an independent panel of experts in primary care and prevention that reviews medical evidence to determine which tests and medicines have consistently been proven to work.
AHRQ and AARP, the leading consumer group for people over age 50, worked together on this project for a simple but important reason: the U.S. population is getting older. In the next 10 years, 77 million Baby Boomers will turn 65. As we get older, what we need to do to stay healthy changes.
For both men and women over 50, the daily steps to good health are ones we've probably heard before. The checklists remind us of these steps that have been scientifically proven to work.
Men and women age 50 and older should make sure they:
Are tobacco free. Tobacco use is a leading cause of heart disease and cancer. For tips on how to quit, go to resources that have helped other people kick the habit.
Stay physically active. If you are not active now, work up to 30 minutes of moderate physical activity most days of the week. Walking briskly, swimming, dancing, and mowing the lawn are good examples of moderate exercise.
Eat a healthy diet. Include generous amounts of fruits, vegetables, whole grains, and low-fat milk products in your daily diet. Limit your intake of foods that are high in fat, salt, and added sugar.
Stay at a healthy weight. Keep in mind that the calories (or energy) you consume must be burned off with activity so you don't gain weight. Check with your doctor if you start to gain or lose weight, as this can be a sign of a medical condition.
Drink alcohol moderately, if at all. This means no more than one drink per day for women and two for men. If you are older than age 65, have no more than one drink per day.
The checklists, which are available in English and Spanish, can be taken to medical appointments. In addition to providing daily health steps, the checklists can help you and your doctor talk about which preventive screening tests you need.
Unlike diagnostic tests, which help confirm if you have a disease, screening tests are used to check for problems before symptoms appear. Examples of preventive screening tests that both men and women should get after age 50 include those that check blood pressure and cholesterol levels. Women should get breast and cervical cancer screening tests, and both men and women should be tested for colorectal cancer.
The checklists can help you keep track of the date and results of your last screening tests, when you should have the test next, and questions for your next doctor visit.
Men and women over age 50 should also discuss with their doctor or nurse whether they need to take medicines to stay healthy. For example, taking an aspirin every day can prevent heart disease in some men and stroke in some women.
As you watch athletes in the Olympics compete for gold medals, remember there are steps you can take to stay healthy. The checklists for men and women over 50 can help remind you of the simple steps to follow to stay healthy for years to come.
I'm Dr. Carolyn Clancy and that's my advice on how to navigate the health care system.
More Information
Agency for Healthcare Research and Quality
AHRQ and AARP Team to Help Adults Over 50 Stay Healthy
http://www.ahrq.gov/news/press/pr2008/ppip50pr.htm
Men: Stay Healthy at 50-Plus: Checklists for Your Health
http://www.ahrq.gov/ppip/men50.htm
Women: Stay Healthy at 50-Plus: Checklists for Your Health
http://www.ahrq.gov/ppip/women50.htm
Current as of August 2008
--------------------------------------------------------------------------------
Internet Citation:
Checklists Help Men and Women Stay Healthy at 50-Plus. Navigating the Health Care System: Advice Columns from Dr. Carolyn Clancy, August 5, 2008. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/consumer/cc/cc080508.htm
--------------------------------------------------------------------------------
August 5, 2008
As we get ready to watch the upcoming Olympic Games, several athletes in their 40s and 50s will be taking part, including a 41-year-old U.S. swimmer and a 53-year-old Israeli marathoner.
These days, many people over age 50 are staying fit, even if they don't plan to compete at an elite level. But some men and women aren't sure how they can take care of themselves so they can stay healthy and keep doing the activities they enjoy.
My Agency, the Agency for Healthcare Research and Quality (AHRQ), and AARP developed two new checklists that outline the steps men and women over age 50 need to take to stay healthy and prevent disease.
The checklists are based on recommendations from the U.S. Preventive Services Task Force. This is an independent panel of experts in primary care and prevention that reviews medical evidence to determine which tests and medicines have consistently been proven to work.
AHRQ and AARP, the leading consumer group for people over age 50, worked together on this project for a simple but important reason: the U.S. population is getting older. In the next 10 years, 77 million Baby Boomers will turn 65. As we get older, what we need to do to stay healthy changes.
For both men and women over 50, the daily steps to good health are ones we've probably heard before. The checklists remind us of these steps that have been scientifically proven to work.
Men and women age 50 and older should make sure they:
Are tobacco free. Tobacco use is a leading cause of heart disease and cancer. For tips on how to quit, go to resources that have helped other people kick the habit.
Stay physically active. If you are not active now, work up to 30 minutes of moderate physical activity most days of the week. Walking briskly, swimming, dancing, and mowing the lawn are good examples of moderate exercise.
Eat a healthy diet. Include generous amounts of fruits, vegetables, whole grains, and low-fat milk products in your daily diet. Limit your intake of foods that are high in fat, salt, and added sugar.
Stay at a healthy weight. Keep in mind that the calories (or energy) you consume must be burned off with activity so you don't gain weight. Check with your doctor if you start to gain or lose weight, as this can be a sign of a medical condition.
Drink alcohol moderately, if at all. This means no more than one drink per day for women and two for men. If you are older than age 65, have no more than one drink per day.
The checklists, which are available in English and Spanish, can be taken to medical appointments. In addition to providing daily health steps, the checklists can help you and your doctor talk about which preventive screening tests you need.
Unlike diagnostic tests, which help confirm if you have a disease, screening tests are used to check for problems before symptoms appear. Examples of preventive screening tests that both men and women should get after age 50 include those that check blood pressure and cholesterol levels. Women should get breast and cervical cancer screening tests, and both men and women should be tested for colorectal cancer.
The checklists can help you keep track of the date and results of your last screening tests, when you should have the test next, and questions for your next doctor visit.
Men and women over age 50 should also discuss with their doctor or nurse whether they need to take medicines to stay healthy. For example, taking an aspirin every day can prevent heart disease in some men and stroke in some women.
As you watch athletes in the Olympics compete for gold medals, remember there are steps you can take to stay healthy. The checklists for men and women over 50 can help remind you of the simple steps to follow to stay healthy for years to come.
I'm Dr. Carolyn Clancy and that's my advice on how to navigate the health care system.
More Information
Agency for Healthcare Research and Quality
AHRQ and AARP Team to Help Adults Over 50 Stay Healthy
http://www.ahrq.gov/news/press/pr2008/ppip50pr.htm
Men: Stay Healthy at 50-Plus: Checklists for Your Health
http://www.ahrq.gov/ppip/men50.htm
Women: Stay Healthy at 50-Plus: Checklists for Your Health
http://www.ahrq.gov/ppip/women50.htm
Current as of August 2008
--------------------------------------------------------------------------------
Internet Citation:
Checklists Help Men and Women Stay Healthy at 50-Plus. Navigating the Health Care System: Advice Columns from Dr. Carolyn Clancy, August 5, 2008. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/consumer/cc/cc080508.htm
--------------------------------------------------------------------------------
National Birth Defects Prevention Study Finds Pre-pregnancy Diabetes Increases Risk for Multiple Types of Birth Defects
July 30, 2008
Study first to show range and severity of birth defects associated with Type 1 and Type 2 diabetes
Women who receive a diagnosis of diabetes before they become pregnant are three to four times more likely to have a child with one or even multiple birth defects than a mother who is not diabetic, according to a study by the Centers for Disease Control and Prevention (CDC), released in the American Journal of Obstetrics and Gynecology.
The article from the National Birth Defects Prevention Study (NBDPS), “Diabetes Mellitus and Birth Defects,” shows that pregnant women with pre-gestational diabetes mellitus (pre-pregnancy diagnosis of diabetes, such as type 1 or type 2 diabetes) are more likely than a mother with no diabetes or a mother with gestational diabetes mellitus (pregnancy-induced diabetes) to have a child with various types of individual or multiple birth defects. This includes heart defects, defects of the brain and spine, oral clefts, defects of the kidneys and gastrointestinal tract and limb deficiencies. This study is the first to show the broad range and severity of birth defects associated with type 1 and type 2 diabetes.
“The continued association of diabetes with a number of birth defects highlights the importance of increasing the number of women who receive the best possible preconception care, especially for those women diagnosed with diabetes,” says Adolfo Correa, M.D., M.P.H., Ph.D., lead author and epidemiologist at CDC’s National Center on Birth Defects and Developmental Disabilities. “Early and effective management of diabetes for pregnant women is critical in helping to not only prevent birth defects, but also to reduce the risk for other health complications for them and their children.”
Researchers also found that some of the pregnant women with gestational diabetes were more likely to have a child with birth defects. Because birth defects associated with diabetes are more likely to occur during the first trimester of pregnancy and before a diagnosis of gestational diabetes is made, the observed associations suggest that some of the mothers with it probably had undiagnosed diabetes before they became pregnant. However symptoms went unnoticed until pregnancy.
Further, the associations of gestational diabetes with various birth defects were noted primarily among women who had pre-pregnancy obesity, which is a known risk factor for both diabetes and birth defects. Preconception care also should be considered and promoted for women with pre-pregnancy obesity to prevent birth defects and reduce the risk for health complications.
The NBDPS is a population-based, case-control study that incorporates data from nine birth defect centers in the United States—Arkansas, California, Georgia, Iowa, Massachusetts, New York, North Carolina, Texas and Utah. These centers have been working on the largest study of birth defects causes ever undertaken in the United States. Researchers have gathered information from more than 30,000 participants and are using this information to look at key questions on potential causes of birth defects.
Birth defects affect one in 33 infants and are a leading cause of infant mortality. For some birth defects, some risk factors or causes have been identified; however, for the majority of birth defects the causes remain unknown.
In the United States, the prevalence of gestational diabetes has been increasing in recent years and currently affects about seven percent of all pregnancies, resulting in more than 200,000 cases annually. While it is usually resolved shortly after delivery, women who have had gestational diabetes are at increased risk of developing type 2 diabetes in the future.
For more information about birth defects, please visit http://www.cdc.gov/ncbddd/bd/facts.htm. For more information on diabetes, please visit http://www.cdc.gov/diabetes/, or call toll-free 1-800-CDC-INFO.
###
(Centers for Disease Control and Prevention)
Study first to show range and severity of birth defects associated with Type 1 and Type 2 diabetes
Women who receive a diagnosis of diabetes before they become pregnant are three to four times more likely to have a child with one or even multiple birth defects than a mother who is not diabetic, according to a study by the Centers for Disease Control and Prevention (CDC), released in the American Journal of Obstetrics and Gynecology.
The article from the National Birth Defects Prevention Study (NBDPS), “Diabetes Mellitus and Birth Defects,” shows that pregnant women with pre-gestational diabetes mellitus (pre-pregnancy diagnosis of diabetes, such as type 1 or type 2 diabetes) are more likely than a mother with no diabetes or a mother with gestational diabetes mellitus (pregnancy-induced diabetes) to have a child with various types of individual or multiple birth defects. This includes heart defects, defects of the brain and spine, oral clefts, defects of the kidneys and gastrointestinal tract and limb deficiencies. This study is the first to show the broad range and severity of birth defects associated with type 1 and type 2 diabetes.
“The continued association of diabetes with a number of birth defects highlights the importance of increasing the number of women who receive the best possible preconception care, especially for those women diagnosed with diabetes,” says Adolfo Correa, M.D., M.P.H., Ph.D., lead author and epidemiologist at CDC’s National Center on Birth Defects and Developmental Disabilities. “Early and effective management of diabetes for pregnant women is critical in helping to not only prevent birth defects, but also to reduce the risk for other health complications for them and their children.”
Researchers also found that some of the pregnant women with gestational diabetes were more likely to have a child with birth defects. Because birth defects associated with diabetes are more likely to occur during the first trimester of pregnancy and before a diagnosis of gestational diabetes is made, the observed associations suggest that some of the mothers with it probably had undiagnosed diabetes before they became pregnant. However symptoms went unnoticed until pregnancy.
Further, the associations of gestational diabetes with various birth defects were noted primarily among women who had pre-pregnancy obesity, which is a known risk factor for both diabetes and birth defects. Preconception care also should be considered and promoted for women with pre-pregnancy obesity to prevent birth defects and reduce the risk for health complications.
The NBDPS is a population-based, case-control study that incorporates data from nine birth defect centers in the United States—Arkansas, California, Georgia, Iowa, Massachusetts, New York, North Carolina, Texas and Utah. These centers have been working on the largest study of birth defects causes ever undertaken in the United States. Researchers have gathered information from more than 30,000 participants and are using this information to look at key questions on potential causes of birth defects.
Birth defects affect one in 33 infants and are a leading cause of infant mortality. For some birth defects, some risk factors or causes have been identified; however, for the majority of birth defects the causes remain unknown.
In the United States, the prevalence of gestational diabetes has been increasing in recent years and currently affects about seven percent of all pregnancies, resulting in more than 200,000 cases annually. While it is usually resolved shortly after delivery, women who have had gestational diabetes are at increased risk of developing type 2 diabetes in the future.
For more information about birth defects, please visit http://www.cdc.gov/ncbddd/bd/facts.htm. For more information on diabetes, please visit http://www.cdc.gov/diabetes/, or call toll-free 1-800-CDC-INFO.
###
(Centers for Disease Control and Prevention)
Thursday, July 31, 2008
Cardiovascular disease led Hawaii deaths in '05
Honolulu Advertiser Staff
February 6, 2008
HONOLULU – More than 2,900 people in Hawai'i died from cardiovascular disease in 2005, making it the leading cause of death in the state, according to a new report titled "The Burden of Cardiovascular Disease in Hawai'i – 2007."
The report, which was released today by the Hawai'i State Department of Health Community Health Division, represents the most recent compilation of data on cardiovascular disease in the state, according to a news release.
Cardiovascular disease is a group of diseases that affect the heart and blood vessels, the two most common forms being heart disease and stroke.
The Department of Health hopes this report can be used to provide updated data to community programs that address CVD issues, educate the public on CVD health disparities, and encourage partnerships with chronic disease programs and groups that are closely linked to CVD, such as diabetes and tobacco prevention, according to the release.
"Cardiovascular disease is a serious, common and very costly disease," said health director Dr. Chiyome Fukino. "This report provides healthcare partners as well as individuals with updated data that can be used to help take tailored steps to minimize the risk and impact of cardiovascular disease."
This technical report presents data on CVD mortality, prevalence, hospitalizations and associated risk factors. The report was completed in collaboration with a number of community partners. Highlights of the report include findings that known risk factors for CVD include high blood pressure, diabetes, and smoking. Another risk factor is low socioeconomic status, which is defined as adults who have an annual household income below $15,000, less than a high school education or are unemployed.
"While Hawai'i as a whole has a relatively low rate of cardiovascular disease in relation to the rest of the country, there are widespread disparities within our population that must be addressed," said Dr. Kalani Brady, American Heart Association O'ahu Metro board member. "If we don't address those risk factors and turn the tide, we could see death rates again increase."
The "Burden of Cardiovascular Disease in Hawai'i – 2007" is available at www.hawaii.gov/health.
February 6, 2008
HONOLULU – More than 2,900 people in Hawai'i died from cardiovascular disease in 2005, making it the leading cause of death in the state, according to a new report titled "The Burden of Cardiovascular Disease in Hawai'i – 2007."
The report, which was released today by the Hawai'i State Department of Health Community Health Division, represents the most recent compilation of data on cardiovascular disease in the state, according to a news release.
Cardiovascular disease is a group of diseases that affect the heart and blood vessels, the two most common forms being heart disease and stroke.
The Department of Health hopes this report can be used to provide updated data to community programs that address CVD issues, educate the public on CVD health disparities, and encourage partnerships with chronic disease programs and groups that are closely linked to CVD, such as diabetes and tobacco prevention, according to the release.
"Cardiovascular disease is a serious, common and very costly disease," said health director Dr. Chiyome Fukino. "This report provides healthcare partners as well as individuals with updated data that can be used to help take tailored steps to minimize the risk and impact of cardiovascular disease."
This technical report presents data on CVD mortality, prevalence, hospitalizations and associated risk factors. The report was completed in collaboration with a number of community partners. Highlights of the report include findings that known risk factors for CVD include high blood pressure, diabetes, and smoking. Another risk factor is low socioeconomic status, which is defined as adults who have an annual household income below $15,000, less than a high school education or are unemployed.
"While Hawai'i as a whole has a relatively low rate of cardiovascular disease in relation to the rest of the country, there are widespread disparities within our population that must be addressed," said Dr. Kalani Brady, American Heart Association O'ahu Metro board member. "If we don't address those risk factors and turn the tide, we could see death rates again increase."
The "Burden of Cardiovascular Disease in Hawai'i – 2007" is available at www.hawaii.gov/health.
Most in Isles skimp on exercise and nutrition
Honolulu Advertiser
Posted on: Wednesday, March 19, 2008
Most in Isles skimp on exercise and nutrition
By Dan Nakaso
Advertiser Staff Writer
For more tips on getting fit, quitting smoking and healthy eating, go to www.healthyhawaii.com
START WALKING
The state Department of Health's recommendations on starting a walking program to get fit:
How far and how fast you walk is not an issue in the beginning. Recommendations:
• Walk 10+ minutes 5+ days a week.
• Walk briskly, and with a purpose.
• Work your way up to 30+ minutes 5+ days a week.
Walking can be done:
• With one piece of equipment: good walking shoes.
• To music, to nature or to conversation.
• In groups or alone. You can decide each day which suits you.
Fitness level does not matter. Simply get off the couch.
Begin with the end in mind. Good health and happiness will result from placing one foot in front of the other on a regular basis.
Enlisting support has been shown to drastically increase your chances of success. Talk about the fact that you're walking. Others will ask how it's going, which keeps you motivated.
Don't let the weather stop you. Find favorite walking routes for both sunny and rainy weather.
Sign up for a walking event like a 5K walk. Just remember you don't need to walk a marathon to be healthy.
Join a walking club. Commit to at least one group workout a week.
Plan a walking or hiking vacation (and get in shape for it).
Make walking a part of your routine. Walk to work, walk during breaks, take the stairs, walk the kids to school, etc.
The first comprehensive report on Hawai'i's nutrition and physical activity covers more than a hundred pages with statistics and charts but can be summarized simply:
Most children and adults need to get more exercise every day. And everyone can benefit from increasing the amount of fruits and vegetables they eat each day.
"The changes don't have to be dramatic," Lt. Gov. James "Duke" Aiona said yesterday at the state Capitol in releasing the report. "One more fruit and vegetable improves health. ... Eliminate one cookie, one chocolate candy and one soda" per day.
And exercise can come easily, too, Aiona said. Adults can break down their 30 minutes of recommended daily exercise into three separate, simple activities like walking up the stairs at work.
"It can be as easy as flying a kite, walking the dog or walking down the street to buy a newspaper," Aiona said.
Most of the data in the Hawaii Physical Activity and Nutrition Surveillance Report 2008 has been reported before and covers information for 2005:
One in five people in Hawai'i were considered obese.
In 2005, 2,900 people in Hawai'i died of heart disease.
Most middle and high school students did not meet the daily recommendations for physical activity. And almost half of adults were not physically active enough.
An estimated $140 million in inpatient hospital charges related to heart disease, stroke and diabetes could have been prevented in 2005 if more adults were regularly physically active.
"We know that walking for at least 30 minutes per day can lower risks of obesity, heart disease and stroke and some cancers," said Dr. Chiyome Fukino, director of the state Department of Health. "This report will be our guide to improving physical activity and nutrition in our community."
Some 750 copies were published at a cost of $12,345 from Hawai'i's tobacco settlement funds. The report also is available at www.healthyhawaii.com; click on the link "Pan plan."
Reach Dan Nakaso at dnakaso@honoluluadvertiser.com.
Posted on: Wednesday, March 19, 2008
Most in Isles skimp on exercise and nutrition
By Dan Nakaso
Advertiser Staff Writer
For more tips on getting fit, quitting smoking and healthy eating, go to www.healthyhawaii.com
START WALKING
The state Department of Health's recommendations on starting a walking program to get fit:
How far and how fast you walk is not an issue in the beginning. Recommendations:
• Walk 10+ minutes 5+ days a week.
• Walk briskly, and with a purpose.
• Work your way up to 30+ minutes 5+ days a week.
Walking can be done:
• With one piece of equipment: good walking shoes.
• To music, to nature or to conversation.
• In groups or alone. You can decide each day which suits you.
Fitness level does not matter. Simply get off the couch.
Begin with the end in mind. Good health and happiness will result from placing one foot in front of the other on a regular basis.
Enlisting support has been shown to drastically increase your chances of success. Talk about the fact that you're walking. Others will ask how it's going, which keeps you motivated.
Don't let the weather stop you. Find favorite walking routes for both sunny and rainy weather.
Sign up for a walking event like a 5K walk. Just remember you don't need to walk a marathon to be healthy.
Join a walking club. Commit to at least one group workout a week.
Plan a walking or hiking vacation (and get in shape for it).
Make walking a part of your routine. Walk to work, walk during breaks, take the stairs, walk the kids to school, etc.
The first comprehensive report on Hawai'i's nutrition and physical activity covers more than a hundred pages with statistics and charts but can be summarized simply:
Most children and adults need to get more exercise every day. And everyone can benefit from increasing the amount of fruits and vegetables they eat each day.
"The changes don't have to be dramatic," Lt. Gov. James "Duke" Aiona said yesterday at the state Capitol in releasing the report. "One more fruit and vegetable improves health. ... Eliminate one cookie, one chocolate candy and one soda" per day.
And exercise can come easily, too, Aiona said. Adults can break down their 30 minutes of recommended daily exercise into three separate, simple activities like walking up the stairs at work.
"It can be as easy as flying a kite, walking the dog or walking down the street to buy a newspaper," Aiona said.
Most of the data in the Hawaii Physical Activity and Nutrition Surveillance Report 2008 has been reported before and covers information for 2005:
One in five people in Hawai'i were considered obese.
In 2005, 2,900 people in Hawai'i died of heart disease.
Most middle and high school students did not meet the daily recommendations for physical activity. And almost half of adults were not physically active enough.
An estimated $140 million in inpatient hospital charges related to heart disease, stroke and diabetes could have been prevented in 2005 if more adults were regularly physically active.
"We know that walking for at least 30 minutes per day can lower risks of obesity, heart disease and stroke and some cancers," said Dr. Chiyome Fukino, director of the state Department of Health. "This report will be our guide to improving physical activity and nutrition in our community."
Some 750 copies were published at a cost of $12,345 from Hawai'i's tobacco settlement funds. The report also is available at www.healthyhawaii.com; click on the link "Pan plan."
Reach Dan Nakaso at dnakaso@honoluluadvertiser.com.
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