U.S. Panel Recommends Delaying Regular Mammograms Until Age 50
"A U.S. government group recommends that women delay getting regular mammograms until age 50, instead of 40, the age at which the American Cancer Society (ACS) has long advised women to begin screening for breast cancer. The government group issued its new guidelines Monday, citing evidence that the benefits of regular screening do not justify the potential harms in younger women. The U.S. Preventive Services Task force (USPSTF), funded by the Agency for Healthcare Research and Quality, published its recommendations in Annals of Internal Medicine; its decision was based on an analysis of existing trials that looked at the impact of mammography on breast-cancer deaths. The task force further recommended that women between ages 50 and 74 get screened every two years instead of annually, and that doctors no longer urge women to conduct monthly breast self-exams, since the practice does not appear to significantly reduce the risk of death from breast cancer. Although the relative benefits of routine breast-cancer screening have been increasingly questioned by many within the cancer community, not everyone agrees that reducing mammography is the answer…So where does this division leave American women, who have been instructed for nearly two decades to get yearly mammograms starting at age 40? That depends on whether patients and their doctors prefer their screening guidelines to be conservative or not…It should be noted that the new guidelines apply to women who are at average risk of breast cancer, not to women who are considered high risk, such as those with a genetic or familial history of the disease."
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Kevin Sack
(The New York Times, November 20, 2009)
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Testing Our Patients
Editorial
(The Philadelphia Inquirer, November 20, 2009)
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White House Backs Off Cancer Test Guidelines
Rob Stein and Dan Eggen
(The Washington Post, November 19, 2009)
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Anger, Shock at New U.S. Mammogram Guidelines
Victoria Colliver
(San Francisco Chronicle, November 18, 2009)
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Calm in a Cancer Storm
Opinion, Kathleen Parker
(The Washington Post, November 18, 2009)
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New Mammogram Advice Finds a Skeptical Audience
Jennifer Steinhauer
(The New York Times, November 17, 2009)
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New Mammogram Advice Raises Questions, Concerns
(Associated Press, November 17, 2009)
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Robert Pear and David M. Herszenhorn
(The New York Times, November 18, 2009)
"Democratic leaders in the Senate on Wednesday unveiled their proposal for overhauling the health care system, outlining legislation that they said would cover most of the uninsured while reducing the federal budget deficit. Senator Harry Reid of Nevada, the majority leader, said at an evening news conference that the legislation, embodying President Obama’s signature domestic initiative, would impose new regulations on insurers, extend coverage to 31 million people who currently do not have any and add new benefits to Medicare…Under Mr. Reid’s bill, the government would establish a new public insurance plan, which would compete with private insurers. States could opt out of the public plan by passing legislation…Though broadly similar to the House bill, Mr. Reid’s proposal differs in important ways. It would, for example, increase the Medicare payroll tax on high-income people and impose a new excise tax on high-cost 'Cadillac health plans' offered by employers to their employees. Mr. Reid’s bill would not go as far as the House bill in limiting access to abortion. And while he would require most Americans to obtain health insurance, he would impose less stringent penalties on people who did not comply."
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(Associated Press, November 17, 2009)
"When it comes to paying for a health care overhaul, Americans see just one way to go: Tax the rich. That finding from a new Associated Press poll will be welcome news for House Democrats, who proposed doing just that in their sweeping remake of the U.S. medical system, which passed earlier this month and would extend coverage to millions of uninsured Americans. The poll, conducted by Stanford University with the nonpartisan Robert Wood Johnson Foundation, found participants sour on other ways of paying for the health overhaul that is being considered in Congress, including taxing insurers on high-value coverage packages derided by President Barack Obama and Democrats as 'Cadillac plans.' That approach is being weighed in the Senate. It is one of the few proposals in any congressional legislation that analysts say would help reduce the nation's health expenditures, but it has come under fire from organized labor and has little support in the House."
Opinion, Robert J. Samuelson
(The Washington Post, November 16, 2009)
"There is an air of absurdity to what is mistakenly called 'health-care reform.' Everyone knows that the United States faces massive governmental budget deficits as far as calculators can project, driven heavily by an aging population and uncontrolled health costs. As we recover slowly from a devastating recession, it's widely agreed that, though deficits should not be cut abruptly (lest the economy resume its slump), a prudent society would embark on long-term policies to control health costs, reduce government spending and curb massive future deficits. The administration estimates these at $9 trillion from 2010 to 2019. The president and all his top economic advisers proclaim the same cautionary message…So what do they do? Just the opposite. Their far-reaching overhaul of the health-care system -- which Congress is halfway toward enacting -- would almost certainly make matters worse."
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Reform and Medical Costs
Editorial
(The New York Times, November 15, 2009)
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Duff Wilson
(The New York Times, November 15, 2009)
"Even as drug makers promise to support Washington’s health care overhaul by shaving $8 billion a year off the nation’s drug costs after the legislation takes effect, the industry has been raising its prices at the fastest rate in years. In the last year, the industry has raised the wholesale prices of brand-name prescription drugs by about 9 percent, according to industry analysts. That will add more than $10 billion to the nation’s drug bill, which is on track to exceed $300 billion this year. By at least one analysis, it is the highest annual rate of inflation for drug prices since 1992. The drug trend is distinctly at odds with the direction of the Consumer Price Index, which has fallen by 1.3 percent in the last year. Drug makers say they have valid business reasons for the price increases. Critics say the industry is trying to establish a higher price base before Congress passes legislation that tries to curb drug spending in coming years."
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Rising Prices of Drugs Lead to Call for Inquiry
Duff Wilson
(The New York Times, November 18, 2009)
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The Drug Industry Cashes In
Editorial
(The New York Times, November 17, 2009)
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Lori Montgomery
(The Washington Post, November 15, 2009)
"A plan to slash more than $500 billion from future Medicare spending -- one of the biggest sources of funding for President Obama's proposed overhaul of the nation's health-care system -- would sharply reduce benefits for some senior citizens and could jeopardize access to care for millions of others, according to a government evaluation released Saturday. The report, requested by House Republicans, found that Medicare cuts contained in the health package approved by the House on Nov. 7 are likely to prove so costly to hospitals and nursing homes that they could stop taking Medicare altogether. Congress could intervene to avoid such an outcome, but 'so doing would likely result in significantly smaller actual savings' than is currently projected, according to the analysis by the chief actuary for the agency that administers Medicare and Medicaid. That would wipe out a big chunk of the financing for the health-care reform package, which is projected to cost $1.05 trillion over the next decade."
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Opinion,
Max Mehlman and Dale Nance, law professors at Case Western Reserve University and authors
Opinion,
Roy H. Thomas, M.D., president of the Ohio State Medical Association
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(Associated Press, November 17, 2009)
"Uninsured patients with traumatic injuries, such as car crashes, falls and gunshot wounds, were almost twice as likely to die in the hospital as similarly injured patients with health insurance, according to a troubling new study. The findings by Harvard University researchers surprised doctors and health experts who have believed emergency room care was equitable. 'This is another drop in a sea of evidence that the uninsured fare much worse in their health in the United States,' said senior author Dr. Atul Gawande, a Harvard surgeon and medical journalist. The study, appearing in the November issue of Archives of Surgery, comes as Congress is debating the expansion of health insurance coverage to millions more Americans. It could add fodder to that debate. The researchers couldn't pin down the reasons behind the differences they found. The uninsured might experience more delays being transferred from hospital to hospital. Or they might get different care. Or they could have more trouble communicating with doctors. The hospitals that treat them also could have fewer resources."
(Associated Press, November 16, 2009)
"Immigrant girls and women will no longer have to be vaccinated against a sexually transmitted virus to get their green cards. Starting Dec. 14, the HPV, or human papillomavirus vaccine will no longer be on the list of immunizations immigrant females ages 11 to 26 must receive before becoming legal permanent residents. The U.S. Centers for Disease Control and Prevention made the change on Friday. In a Federal Register entry, the CDC said it will require immunizations for which there is a public health need at the time the person immigrates or changes their status to green card holder…Attempts to require the vaccine for American girls has brought emotional debate and complaints that such mandates intrude on family decisions about sex education."
Josh Goldstein
(The Philadelphia Inquirer, November 15, 2009)
"More than a year after the Philadelphia VA Medical Center said it had given substandard care to nearly 100 veterans with prostate cancer, the list of sanctions is sparse…Several lawmakers who have investigated the cases said that the Department of Veterans Affairs' actions were both anemic and late, and that the agency had acted only after prominent newspaper articles appeared in the summer, detailing radiation overdoses and underdoses. 'They ought not have to wait for a front-page newspaper article or a Senate committee hearing to do what they should have done on their own,' said Sen. Arlen Specter (D., Pa.), one of the lawmakers who feels the VA has been slow to respond. 'I think that it is regrettably necessary to keep pressure on them to follow up.' Newly obtained documents shed more light on the program, showing that the mistakes began with the earliest cases, starting in 2002, and that the hospital missed numerous opportunities to catch them."
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NRC Cites VA Clinic for Radioactive-Treatment Violations
Josh Goldstein and Marie McCullough
(The Philadelphia Inquirer, November 18, 2009)
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(Associated Press, November 15, 2009)
"The government paid more than $47 billion in questionable Medicare claims including medical treatment showing little relation to a patient's condition, wasting taxpayer dollars at a rate nearly three times the previous year. Excerpts of a new federal report, obtained by The Associated Press, show a dramatic increase in improper payments in the $440 billion Medicare program that has been cited by government auditors as a high risk for fraud and waste for 20 years. It's not clear whether Medicare fraud is actually worsening. Much of the increase in the last year is attributed to a change in the Health and Human Services Department's methodology that imposes stricter documentation requirements and includes more improper payments -- part of a data-collection effort being ordered government-wide by President Barack Obama this coming week to promote 'honest budgeting' and accurate statistics."
Steve Lohr
(The New York Times, November 15, 2009)
"The nation is set to begin an ambitious program, backed by $19 billion in government incentives, to accelerate the adoption of computerized patient records in doctors' offices and hospitals, replacing ink and paper. There is wide agreement that the conversion will bring better care and lower costs, saving the American health care system up to $100 billion a year by some estimates. But a new study comparing 3,000 hospitals at various stages in the adoption of computerized health records has found little difference in the cost and quality of care. 'The way electronic medical records are used now has not yet had a real impact on the quality or cost of health care,' said Dr. Ashish K. Jha, an assistant professor at the Harvard School of Public Health, who led the research project.
The research is to be presented on Monday at a conference in Boston. It is a follow-on study to a survey of hospitals' adoption of electronic health records, published this year and financed by the federal government and the Robert Wood Johnson Foundation. Dr. Karen Bell, a former senior official in the Department of Health and Human Services and an expert in health technology, said she was not surprised by the research. 'Very few hospitals today are effectively using the capabilities of electronic health records,' she observed."
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Meredith Simons
(Houston Chronicle, November 14, 2009)
"This is the 'have-it-your-way' era, a time when everything from fast food to four-course meals can be customized, personalized and engineered to your specifications. But it isn't limited to edible items -- even cancer treatments can now be made to order. 'This is a fascinating time to be involved in science,' National Institutes of Health Director Francis Collins said of 'personalized medicine,' a mushrooming field that uses individuals' unique genetic profiles to prevent, diagnose and treat potential health threats. Personalized medicine is already revolutionizing treatment for cancer and other conditions, allowing doctors to quickly and accurately diagnose congenital conditions and make treatment decisions based on their knowledge of how certain drugs interact with specific genes. It means faster, better results for patients who don't have to waste valuable time on treatments that won't work with their DNA. Houston researchers are leading the way in the field, which is still largely limited to academic medical centers."
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Steve Mills
(Chicago Tribune, November 18, 2009)
"Even as tainted food causes thousands each year to endure long-lasting illnesses, health agencies are having a difficult time finding the cause of the problem, and a push is on at the federal level to better trace suspected pathogens…Of an estimated 76 million food-borne illness victims each year, some 300,000 are hospitalized and close to 5,000 die…It also is often assumed that the cause of these illnesses is eventually tracked down -- and often connected to a major outbreak, like the ones that tainted spinach in 2006 and caused three deaths. In fact, in nearly 60 percent of outbreaks, a source of the pathogen is never found; the illness remains a public health mystery, according to the Centers for Disease Control and Prevention. In cases not tied to an outbreak, determining the source of a pathogen can prove even tougher. It is difficult, if not impossible, to recall a week of meals and snacks eaten during a food-borne illness's incubation period, much less find what remained from the tainted meal or unused ingredients to test. 'Really, the only time you nail these things down with any satisfaction is when you have a really, really large outbreak,' said Dr. Glenn Morris, director of the Emerging Pathogens Institute at the University of Florida. 'With an individual patient, it's exceedingly difficult to identify the source.' There are obstacles to identifying the food source of a pathogen throughout the food safety system."
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Senate Bill Would Require E. Coli Testing
Michael Moss
(The New York Times, November 18, 2009)
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Carly Weeks
(The Globe and Mail, Toronto, November 17, 2009)
"More questions are being raised about the safety of folic acid supplementation after new research has found links between the B vitamin and increased cancer risk. Researchers in Norway found that heart-disease patients treated with a combination of folic acid and vitamin B12 had an increased risk of cancer and death compared to patients who didn't receive the vitamins as treatment. Unlike Canada and the United States, Norway doesn't require folic acid to be added to any food. The market for vitamin supplements is also relatively small and study participants were discouraged from taking them, which gave researchers a unique ability to assess the effect folic acid could have on a group who receive it in high doses. The study, appearing Nov. 18 in the Journal of the American Medical Association, fuels fears that mandatory fortification of the food supply with folic acid could yield unintended consequences."
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Shari Roan
(Los Angeles Times, November 17, 2009)
"The number of children who have food allergies is not only increasing, it now encompasses 4% of all kids in the United States, according to an analysis of four large, national surveys published Monday in the journal Pediatrics. The study -- the first to make a broad estimate about the prevalence of food allergies among U.S. children -- supports previous studies suggesting that allergy rates are rising rapidly, for reasons that are unclear. Government researchers found that self-reported food allergies increased 18% between 1997 and 2007. Healthcare visits for food allergies in children nearly tripled between two time periods studied: 1992 through 1997 and 2003 through 2006. In the later period, U.S. children had an average of 317,000 visits to healthcare settings per year for food allergies. The data suggest a real surge in illnesses and not just better awareness and diagnosis, said the study's lead author, Amy M. Branum, a statistician with the National Center for Health Statistics."
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Editorial
(The Boston Globe, November 16, 2009)
"The next time pharmaceutical companies raise dire warnings about federal proposals to measure the cost-effectiveness of their products, they should be required to read the recent study in the New England Journal of Medicine about a kidney drug called Aranesp. For decades, doctors have prescribed this drug or others like it to patients with type 2 diabetes and kidney disease in the belief that the drugs would prevent heart disease and combat fatigue in patients. The result of a randomly assigned clinical trial of more than 4,000 patients in 24 countries? Aranesp did no better than a placebo in preventing heart disease, reduced fatigue only modestly, and nearly doubled a patient’s risk of a stroke…This is the kind of effectiveness testing that the government should be sponsoring more of, with an eye toward guiding a new Medicare oversight commission with real powers over treatment decisions."
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Stephen Smith
(The Boston Globe, November 18, 2009)
"Lower income Massachusetts smokers have dramatically abandoned their habit amid a major state campaign that vigorously promotes and pays for tobacco addiction treatment, according to a report scheduled to be released this morning. Smoking rates among the poor plummeted 26 percent in the first two years of the ongoing state program, a striking result that is already drawing national attention to the effort. Officials targeted a population that historically had the highest smoking rates in Massachusetts. The study, issued by the Department of Public Health, found early indications that the tobacco cessation efforts -- aimed at patients enrolled in the state’s medical insurance for the poor, MassHealth -- are reaping immediate health benefits…The stop-smoking initiative, which covers virtually all the costs of cessation counseling and drugs, was ordered by the Legislature as part of the landmark health care overhaul in 2006 with a dual purpose: saving lives and money. National health leaders plan to point to the Massachusetts experiment to bolster efforts to expand tobacco cessation services as part of federal health care legislation."
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Helena Merriman
(BBC News, Online, November 17, 2009)
"At Jeevanjee gardens in Nairobi, smokers gather during their lunch hour to read, chat and light up. It is one of the few zones in the Kenyan capital where people can smoke in public, since the ban on smoking in public came into effect in 2007…[however] According to some researchers, tobacco addiction is rapidly increasing in Africa. Dr Twalib Ngoma, president of the African Organisation for Research and Training in Cancer (AORTIC), says that Africa is on the brink of a smoking epidemic…Tobacco-related cancer was one of the key topics discussed at a recent international cancer conference in Tanzania. One of the reports presented there warns that African nations are set to undergo the highest increase in the rate of tobacco use among developing countries. The report, released jointly by the American Cancer Society and the Global Smokefree Partnership, says that more than half of African countries will double tobacco use within 12 years if current trends continue. But the authors say that there is still time to do something about it."
Dan McDougall
(The Sunday Times, London, November 15, 2009)
"A Sunday Times investigation in the southern African state of Malawi has uncovered an environmental travesty that is being inflicted by the tobacco industry on some of the continent’s poorest people…Even more alarming, however, is that in a community already plagued by Aids, cholera, malnutrition and one of the highest infant mortality rates in the world, toxic tobacco waste is being dumped by contractors in open landfill sites where hundreds of children are picking through the remnants. The children try to sell the waste for fertiliser or for use in cheap black-market cigarettes bound for Zimbabwe. But they pay a heavy price by risking their health."
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Editorial
(Pittsburgh Post-Gazette, November 15, 2009)
"They should have learned by now. American cigarette smokers should have learned that their toxic, smelly habit is the leading preventable cause of death and sickness in the United States. That's right. Cancer, heart disease, emphysema and other vicious maladies wouldn't claim as many victims if so many people weren't bent on smoking. For almost 15 years, it seemed people got the message and the numbers were going the right way. According to the U.S. Centers for Disease Control, smoking among adults had been flat or declining since 1994. But the latest survey, released last week, showed that in 2008 just under 21 percent of American adults said they smoked. That's a tad up -- not down -- from the year before, when 19.8 said they were smokers."
(Bloomberg.com, November 20, 2009)
"Kidney stones, malaria, Lyme disease, depression and respiratory illness all may increase with global warming, researchers at Harvard Medical School said. Climate change from the burning of fossil fuels will add to risks to public health, said Paul Epstein, associate director of Harvard’s Center for Health and the Global Environment in Boston. The center and groups led by the American Medical Association are presenting data at a briefing today in Washington as a call for action to curb emissions…Warming causes flooding, heat waves and wildfires that worsen health, especially for children and the elderly, according to the Harvard researchers…The Chicago-based AMA, the largest U.S. doctor’s group, sent a letter to President Barack Obama this week citing the 'significant public health impacts' of climate change, Wilson said. The Nov. 17 letter said children, the elderly, people suffering from chronic diseases and the poor will be most affected."
Opinion
Bjorn Lomborg, director of the Copenhagen Consensus Center and author
(The Wall Street Journal, New York, November 15, 2009)
"Poor families in Ethiopia struggle to survive, and global warming will make it tougher for them. In some of the poorest areas on earth, global warming is expected to increase hunger in the future…Global food aid is at a 20-year low. Prices soared in 2008, partly because rich countries' biofuel mandates -- designed to fight global warming -- have meant that land once used to grow crops to feed people is now being used to grow crops to feed cars. Investing in malnutrition assistance helps countries like Ethiopia because it reduces the burden that malnourished people place on health systems. Spending money on HIV prevention and treatment is a highly effective use of aid money. In economic terms, these investments have benefits that far outstrip their costs. Malnutrition should not be neglected as developed countries concentrate on global warming. Oxfam has warned that at least 4.5 million children could die and 8.6 million fewer people could have access to HIV/AIDS treatment if rich countries divert aid to help poor countries tackle climate change instead of malnutrition as part of an agreement to be negotiated in Copenhagen next month."
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Opinion
James E. McWilliams, associate professor of history at Texas State University at San Marcos and author
(The Washington Post, November 16, 2009)
"We know more than we've ever known about the innards of the global food system. We understand that food can both nourish and kill. We know that its production can both destroy and enhance our environment. We know that farming touches every aspect of our lives -- the air we breathe, the water we drink, and the soil we need. So it's hard to avoid concluding that eating cannot be personal. What I eat influences you. What you eat influences me. Our diets are deeply, intimately and necessarily political."
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Kay Lazar
(The Boston Globe, November 16, 2009)
"The products are spreading like kudzu through retirement communities and senior centers, as older Americans search for ways to stay mentally sharp. Researchers, however, have yet to determine whether these brain games, targeted to seniors and now an $80 million-a-year market, deliver what they promise. 'The jury is still very much out,' said Peter Snyder, a brain researcher at Brown University’s Alpert Medical School, who analyzed 10 studies on the issue and came away unimpressed by the quality and quantity of research. In an article published earlier this year in the journal Alzheimer’s & Dementia, Snyder concluded there was no evidence the products, typically computer software costing several hundred to a couple of thousand dollars, stave off dementia in healthy elders. Snyder did not delve into the effect of brain exercises on adults who already have cognitive impairments. 'We are going to have a tidal wave of people with dementia as baby boomers continue to age,' Snyder said, 'I really worry these companies are taking advantage of the average consumer’s concerns about their own health.' It wouldn’t be the first time products boasting brain benefits surged in popularity before research raised questions about the claims."
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Gabriella Boston
(The Washington Times, November 15, 2009)
"What do American kids ages 2 to 5 do an average of 32 hours a week? It's not napping, playing outside or building spaceships out of Legos. It's watching TV, according to a new report released by Nielsen, the ratings company…So, what's the problem with all this television -- not to mention all the other media available?.. [D]igital media is an ineffective teaching tool for the youngest viewers. It takes six repetitions for a toddler to start mimicking an action displayed on a screen; in real life, the child will mimic an action after seeing it once. Instead, what the intellect of a toddler really thrives on is open-ended problem solving, such as building with blocks, and social interaction, including learning how to relate to other people."
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Benny Evangelista
(San Francisco Chronicle, November 15, 2009)
"In today's fast-paced, multitasking world, it's easy to get hooked on technology that's always online, delivering a steady stream of texts and tweets. But some mental health experts fear that a growing technology addiction, perhaps accelerated by the popularity of smart phones and social networks, will lead to a breakdown of interpersonal relationships and an increase in attention deficit disorder. 'If our attention span constricts to the point where we can only take information in 140-character sentences, then that doesn't bode too well for our future,' said Dr. Elias Aboujaoude, director of Stanford University's Impulse Control Disorders Clinic at Stanford University…Dr. John Ratey, an associate clinical professor of psychiatry at Harvard Medical School, uses the term 'acquired attention deficit disorder' to describe the way technology is rewiring the modern brain. He noted that reliance on even the simplest programs -- such as a spell-checker in a word-processing program or a contact list that memorizes all your phone numbers for you -- are short-circuiting the brain's ability to process details."
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Internet Addiction Can Harm Real Relationships
Benny Evangelista
(San Francisco Chronicle, November 15, 2009)
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Opinion
Timothy Baker, professor of medicine at the University of Wisconsin school of medicine and public health,
Richard McFall, professor emeritus of psychology at Indiana University-Bloomington, and Varda Shoham, professor of psychology at the University of Arizona
(The Washington Post, November 15, 2009)
"The practice of clinical psychology -- which includes psychotherapy -- is akin to medicine as it was practiced a century ago. For at least 2,000-years, medicine was locked in a struggle between those who viewed it as an art and those who saw it as a science. Until the last century, most medical practitioners were guided by intuition and tradition, not by science. Healers commonly used ineffective and often injurious practices such as blistering, purging and bleeding. Such techniques were used year after year, and century after century, with physicians firmly convinced that they were helping their patients. While psychologists certainly do not use such harmful practices, a similar dynamic appears to be at work in clinical psychology today. Many psychotherapists openly state that scientific research is largely irrelevant to their practice. Most say that their clinical techniques largely reflect their own insights and experience; they tend not to use the most effective types of treatments available; and they admit to little in the way of scientific training."
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Yochi J. Dreazen
(The Wall Street Journal, New York, November 14, 2009)
"The Army has a serious shortage of mental-health workers in Afghanistan, where morale has fallen among soldiers charged with beating back the resurgent Taliban, according to a new survey. The Army has roughly 43 psychiatrists, psychologists and other counselors in Afghanistan, but estimates that it needs at least 60 more to ensure that soldiers serving there have ready access to help. Those shortfalls will likely worsen if President Barack Obama decides to order tens of thousands of fresh troops to Afghanistan next year…The repeated deployments of soldiers to both war zones is significantly affecting their overall mental health, according to the surveys. More-experienced soldiers used antidepressants and other medications at a 'significantly higher rate' than soldiers doing their first tours, the surveys said. The surveys come as the military's mental-health system is facing new scrutiny in the wake of last week's lethal shootings at Fort Hood, Texas, which left 13 people dead and dozens wounded."
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Charles Ornstein and Tracy Weber
(Los Angeles Times, November 20, 2009)
"In a major shift, California will impose tough new standards on drug-abusing health professionals, strictly scrutinizing those in treatment and immediately removing from practice anyone who relapses. 'The bottom line is we're in the business of protecting consumers,' said Brian Stiger, director of the state Department of Consumer Affairs, which announced the rules Thursday. 'We're not in the business of rehabilitation.' The rules will require nurses, dentists and other health workers in state-run recovery programs to take at least 104 drug tests in their first year -- more than double any current requirement. Health professionals will be automatically pulled from practice, at least temporarily, after a single positive result. And any restrictions to their licenses will be listed on public websites, easing the long-standing confidentiality protections that have shielded participants and kept their patients in the dark."
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Shari Roan
(Los Angeles Times, November 16, 2009)
"'We're on the cusp of some major advances in how we conceptualize alcoholism,' says Dr. Mark Willenbring, director of treatment and recovery research at the National Institute on Alcohol Abuse and Alcoholism. The institute is the nation's leading authority on alcoholism and the major provider of funds for alcohol research. 'The focus now is on the large group of people who are not yet dependent. But they are at risk for developing dependence.' Many of these people need not give up alcohol altogether. The concept of so-called controlled drinking -- that people with alcohol-use disorders could simply curb, or control, their drinking -- has existed for many years. Evidence now exists that such an approach is possible for some people, although abstinence is still considered necessary for those with the most severe disease. The overall reassessment has been fueled by the groundbreaking National Epidemiologic Survey on Alcohol and Related Conditions, the largest and most comprehensive look at alcohol use in America...This survey alone has been enough to convince even national addiction experts that they've been too narrow in their approach to alcohol disorders. But the findings are being further bolstered by research in genetics and psychology."
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(The Economist, November 14, 2009)
"In a state that pioneered bans on smoking tobacco, smoking cannabis is now easier than almost anywhere in the world. California, with its network of pot-friendly physicians, offers the most visible evidence of a tentative worldwide shift towards a more liberal policy on drugs. Although most countries remain bound by a trio of United Nations conventions that prohibit the sale and possession of narcotics, laws are increasingly being bent or ignored. That is true even in the United States…From heroin 'shooting galleries' in Vancouver to Mexico’s decriminalisation of personal possession of drugs, the Americas are suddenly looking more permissive. Meanwhile in Europe, where drugs policy is generally less stringent, seven countries have decriminalised drug possession, and the rest are increasingly ignoring their supposedly harsh regimes. Is the 'war on drugs' becoming a fiction? Reformers are in a bold mood. Earlier this year a report by ex-presidents of Brazil, Colombia and Mexico called for alternatives to prohibition…Though many European countries still have prison as an option for convicted drug users, in reality only a fraction end up in jail…Elsewhere in Europe, the law itself is softer…Experiments like these seem to have been noted in the White House."
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Alfred Lubrano
(The Philadelphia Inquirer, November 17, 2009)
"America is hungry and getting hungrier, with 49 million people -- 17 million of them children -- last year unable to consistently get enough food to eat, according to a report released yesterday by the U.S. Department of Agriculture. These figures represent 14.6 percent of all households, a 3.5-percentage-point jump over 2007, and they are the largest recorded since the agency began measuring hunger in 1995. Of those 49 million, 12 million adults and 5.2 million children reported experiencing the country's most severe hunger, possibly going days without eating. Among the children, nearly half a million in the developmentally critical years under age 6 were going hungry. That's three times the number in 2006…Experts attributed the harsh statistics to the recent recession and to an American poverty that has persisted despite economic growth earlier in the decade."
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USDA report
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Hunger in the United States
Editorial
(The New York Times, November 17, 2009)
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(Associated Press, November 16, 2009)
"Pope Benedict XVI decried the steadily worsening tragedy of world hunger on Monday after a global summit rebuffed a U.N. call to commit billions of dollars a year for a new strategy to help poor countries feed themselves. The meeting at the U.N. Food and Agriculture Organization did unite nearly 200 countries behind a pledge to increase aid to farmers in poor countries to help the developing world lessen its dependence on foreign food aid. Only hours after the three-day summit began, some 60 heads of state and dozens of ministers rejected the U.N.'s call to commit $44 billion annually for agricultural development in these nations. The final declaration also omitted a pledge, sought by the United Nations, to eradicate hunger by 2025…U.N. officials say roughly 1 billion people -- one of every six people on the planet -- don't get enough to eat. As the conference opened, U.N. Secretary-General Ban Ki-moon told participants it was unacceptable that so many go hungry even though the world has enough food."
Alice Park
(TIME.com, November 18, 2009)
"For the second straight year, the U.S. earned dismal marks in its effort to reduce the national rate of premature births. The March of Dimes, which issues an annual state-by-state report card on the problem, gave the U.S. an overall D on Monday. That grade was based on figures from 2007, which show that 12.7% of U.S. births were preterm. Those figures, which have remained constant in recent years, also earned the U.S. a D last year, when the March of Dimes began compiling its report card. The objective, set by federal health experts in the Healthy People 2010 program, is a preterm birth rate of 7.6%. Worldwide, the preterm birth rate is estimated at 9.6%, accounting for 12.9 million babies per year…The rate of preterm births, which measures the proportion of babies born before 37 weeks' gestation, is a reflection of a number of factors, both biological and cultural."
(BBC News, Online, November 16, 2009)
"Chemicals in plastics alter the brains of baby boys, making them 'more feminine,' say US researchers. Males exposed to high doses in the womb went on to be less likely to play with boys' toys like cars or to join in rough and tumble games, they found. The University of Rochester team's latest work adds to concerns about the safety of phthalates, found in vinyl flooring and PVC shower curtains. The findings are reported in the International Journal of Andrology. Phthalates have the ability to disrupt hormones, and have been banned in toys in the EU for some years. However, they are still widely used in many different household items, including plastic furniture and packaging. There are many different types and some mimic the female hormone oestrogen. The same researchers have already shown that this can mean boys are born with genital abnormalities. Now they say certain phthalates also impact on the developing brain, by knocking out the action of the male hormone testosterone."
Jeremy Laurance
(The Independent, London, November 16, 2009)
"One of the world’s oldest controversies -- over the nature of female sexual desire -- is set to be reopened today by the discovery of a drug described as 'Viagra for women.' Doctors testing a new anti-depressant found it was useless as a mood brightener -- but was unexpectedly effective at boosting the female libido. Now three clinical trials have shown that the drug fibanserin significantly improved sexual desire and satisfaction in women. The accidental discovery mirrors that of Viagra, which was being tested as a heart medicine in the 1990s when the male subjects prescribed it discovered it had a pleasing side effect. However, fibanserin is different in that it works on the brain rather than on the genitals, according to John Thorp, professor of obstetrics and gynaecology at the University of North Carolina."
Denis Campbell
(The Guardian, London, November 19, 2009)
"Until now, studies have pinpointed moderate drinking as being beneficial to heart health. But research reported today in the journal Heart found that men who consume large or very large amounts of alcohol are least at risk of developing the condition, which kills more than 90,000 Britons a year. Men who drink regularly, even in small quantities, are more than 30% less likely to suffer from heart disease, it found. But those who drink the most cut their risk by the most. Those classed as high consumers of alcohol, between 30 and 90 grams per day, had 54% less chance of getting the disease, while those deemed to have a very high intake, of more than 90 grams or at least eight glasses of wine a day, were 50% less likely. Alcohol is thought to enhance heart health by keeping cholesterol levels down and so stopping arteries from clogging up. Medical professionals warned that while alcohol might reduce the risk of heart attacks, it could damage the heart in other ways while harming other organs, including the liver…The research is based on the experience of 15,500 men and 26,000 women aged 26-69 in Spain, which has one of the world's highest intakes of alcohol per head and one of the lowest death rates from chronic heart disease."
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Ron Winslow
(The Wall Street Journal, New York, November 18, 2009)
"Researchers said they found evidence of hardening of the arteries in Egyptian mummies dating as far back as 3,500 years, challenging longstanding assumptions that cardiovascular disease is mainly a malady of modern societies. The research was presented Tuesday at the American Heart Association scientific meeting here. A report is also scheduled to appear in Wednesday's issue of the Journal of the American Medical Association. Heart disease is the world's leading killer, and it is increasingly common in developing countries such as China, India and in Latin America. The growing prevalence of the disease is often attributed to urbanization, fast-food diets, smoking and sedentary lifestyles characteristic of Western societies…[T]he findings suggest 'we have to look beyond risk factors to explain why atherosclerosis occurs and why it progresses.'"
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Ron Winslow
(The Wall Street Journal, New York, November 16, 2009)
"Researchers said men at age 40 in the U.S. have a one-in-eight chance of suffering sudden cardiac death over the rest of their lives, a stark indication of the toll cardiovascular disease exacts on society. For women, researchers said, the risk is 1 in 24. The prevalence has long been of concern to heart and public-health experts, but lifetime risks for the condition haven't previously been estimated, researchers said. Some 300,000 Americans a year suffer sudden cardiac death, an event generally defined as death resulting from coronary heart disease within an hour of the onset of symptoms. Heart attack is the most common cause, but valve disease, infections and heart-beat irregularities can also result in sudden cardiac death…Dr. Lloyd-Jones noted that causes for sudden cardiac death, as in the case of heart attack, are largely preventable and include eating healthfully, quitting smoking and getting exercise as well as taking medicines when necessary to reduce blood pressure and cholesterol levels that are important risk factors for cardiovascular disease."
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(Associated Press, November 18, 2009)
"Malaria. Tuberculosis. Alzheimer's disease. AIDS. Pandemic flu. Genital herpes. Urinary tract infections. Grass allergies. Traveler's diarrhea. You name it, the pharmaceutical industry is working on a vaccine to prevent it. Many could be on the market in five years or less. Contrast that with five years ago, when so many companies had abandoned the vaccine business that half the U.S. supply of flu shots was lost because of factory contamination at one of the two manufacturers left. Vaccines are no longer a sleepy, low-profit niche in a booming drug industry. Today, they're starting to give ailing pharmaceutical makers a shot in the arm. The lure of big profits, advances in technology and growing government support has been drawing in new companies, from nascent biotechs to Johnson & Johnson. That means recent remarkable strides in overcoming dreaded diseases and annoying afflictions likely will continue."
(Reuters, November 18, 2009)
"The price of a vaccine that helps babies fight off killer diseases has been forced down, thanks to a co-ordinated buying policy to meet the growing demand from developing countries, a U.N.-backed health alliance said on Wednesday. Data from the United Nations children's fund (UNICEF) and Global Alliance for Vaccines and Immunisation (GAVI) showed average prices for the shots, which protect against five infant diseases, will have fallen by 22 percent over eight years by 2012. 'This price drop is no accident, but...the result of a strategy to leverage the purchasing power of hundreds of millions of people,' UNICEF Deputy Executive Director Saad Houry said in statement. 'Clearly, industry understands and responds to a market, regardless of whether that market is in poor or rich countries.'"
(Associated Press, November 19, 2009)
"Health experts say extraordinary measures against swine flu -- most notably quarantines imposed by China, where entire planeloads of passengers were isolated if one traveler had symptoms -- have failed to contain the disease. Despite initially declaring success, Beijing now acknowledges its swine flu outbreak is much larger than official numbers show. China's official count of nearly 70,000 reported illnesses with 53 deaths is dwarfed by estimates of millions of cases with nearly 4,000 deaths in the United States, a nation with about a third of China's population. Dr. Michael O'Leary, WHO's top representative in China, says there has been a dramatic spike in Chinese swine flu cases recently and those reported by the government are only 'minimum numbers.'"
(Associated Press, November 19, 2009)
"China's health minister said Wednesday his country is vaccinating 1.5 million people a day against swine flu, part of a mammoth effort to reach nearly 7 percent of inhabitants of the world's most populous country by year's end. Chen Zhu told The Associated Press that more than 15 million Chinese have been immunized so far. He also defended China's aggressive quarantine of foreigners with flulike symptoms as well as health detentions of its own citizens. 'With initial efforts of containment, actually we not only reduced the impact of the first wave to China, but we also won time for us to prepare the vaccine' now being given to China's people, Chen said in an interview during the Havana meeting of the Global Forum for Health Research."
Opinion
Alan Sipress, economics editor of The Washington Post and author
(The Washington Post, November 15, 2009)
"When swine flu erupted this spring in the southwestern United States and Mexico, it had been 40 years since the last flu pandemic. The outbreak has dispelled any illusion that pandemic influenza belonged to a bygone era, like smallpox, polio or scarlet fever. But we haven't seen how bad things might yet get. What's the worst-case scenario? It could be a continuing vaccine shortage. It might be a mutation in the swine flu virus that suddenly makes the strain resistant to Tamiflu, as some seasonal flu strains already are. Or it could be that hospital ICUs become so overwhelmed that people who could have been saved die. These are all unnerving possibilities. Yet many flu specialists say their real nightmare is that swine flu could meet up and swap genetic material -- or reassort, as these scientists say -- with another, deadlier flu strain, breeding a new virus that is as contagious as H1N1 but far more savage. Such a strain is already circulating in Asia and Africa, and it could be ready for a chance encounter with swine flu. It is called bird flu."
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Ellen Barry
(The New York Times, November 14, 2009)
"Early findings [from the Ukraine] are that serious cases [of H1N1] mounted because the sick avoided hospitalization until their illness was dangerously advanced, stockpiles of Tamiflu were locked in centralized locations and the supply of ventilators fell short, said David Mercer, of the World Health Organization’s European regional office…With the worst of the health care crisis here past, many in Ukraine’s western provinces are trying to puzzle out what led to it. Doctors blame the news media and politicians for spreading fear and misinformation. The mayors of Ternopyl and Lviv, which reported their first deaths from atypical pneumonia on Oct. 12 and 19, have complained that the federal epidemiological service refused to act without laboratory confirmation that the virus was present, delaying serious measures by nearly two weeks. Others point to more remote causes, among them the desperate poverty of Ukraine’s health care system 20 years after the Soviet Union collapsed."
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See also:
Ukraine’s Outbreak of Ineptitude
Opinion,
Michael Bociurkiw, management team member of the HUM news agency and author
(The Globe and Mail, Toronto, November 17, 2009)
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Rob Stein
(The Washington Post, November 20, 2009)
"Women can delay having their first Pap test for cervical cancer until they turn 21 and many can wait longer to go back for follow-up screenings, according to new guidelines released Friday by a major medical group. The American College of Obstetrics and Gynecologists (ACOG) recommended the change after concluding that more frequent testing did not catch significantly more cancers and often resulted in girls and young women experiencing unnecessary stress, anxiety and sometimes harmful treatments because of suspicious growths that would not cause problems…The change comes amid sharp controversy over new recommendations from a federal task force that women wait until age 50 before they begin having routine mammograms and that women age 50 to 74 scale back to getting the exams routinely every two years."
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Heidi Hall
(The Tennessean, November 14, 2009)
"Tennesseans die of cancer at the fifth-worst rate in the nation. What kills them most frequently is cigarettes, but a powerful mix of misinformation and denial also drives up the death count. A Tennessean examination that included dozens of interviews with doctors, cancer experts and patients across the state found health professionals frequently encounter people who have ignored symptoms for months or even years before going to a doctor. A lack of urgency or confusion about routine cancer screenings, coupled with misconceptions about treatment and even a fatalistic acceptance of the disease, leads to cancers being diagnosed too late to be treated successfully…Lung, breast, prostate and colorectal cancers are the most commonly diagnosed in the state. In the 2001-05 reporting period, more Tennesseans died from lung cancer -- 20,629 victims -- than from the other three combined…And because Tennesseans smoke at a much higher rate than the rest of the nation, they die of lung cancer at a higher rate, driving that fifth-place cancer mortality ranking, said Bill Blot, a Vanderbilt researcher whose specialty is cancer epidemiology…But Blot is also concerned about an emerging risk factor for the other big three cancers -- obesity. Tennessee ranks fourth in the nation for percentage of the population that is overweight or obese. Either obesity in general or eating too much red meat or animal fat is listed by the American Cancer Society as a risk factor for breast, colorectal cancer and prostate cancer."
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Related story:
Tennessean in-Depth Special: Needless Deaths
Heidi Hall
(The Tennessean, November 14, 2009)
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Opinion
Rebecca Richards-Kortum, Stanley C. Moore Professor of Bioengineering and the founding director of Rice 360º: Institute for Global Health Technologies at Rice University,
and Lauren Vestewig, executive director of Rice 360º
(Houston Chronicle, November 14, 2009)
"Recently, UNICEF announced that child mortality has dropped below nine million deaths per year for the first time in recorded history. The drop can be attributed, in part, to the fact that health technologies like vaccines are reaching more children in the developing world, where the vast majority of these deaths occur. Many leaders in global health, including philanthropic powerhouse Bill Gates, have encouraged researchers to focus on creating health technologies for the developing world, where function outweighs form and prices get too expensive very quickly. By injecting capital into the field of global health technology, philanthropists like Gates have created a counterbalance to traditional market forces, which do not provide financial rewards for investments in global health technology. The critical need for appropriate technology -- or technology designed to work in the face of limited resources -- in the developing world is clear. Seldom, however, do we hear calls to develop low-cost, high-performance health technologies for our own country, even now, in the midst of the national health care debate."
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