Public Health, Research, Rural Health, Stanford News
on February 19th, 2014
Hikers, beware: Ticks infected with the bacterium at the root of Lyme disease have been found roaming California parks, as described in a study to be published in Emerging Infectious Disease. The same paper by Stanford researchers, including ones associated with the university’s Woods Institute for the Environment, also identified a human pathogen, Borrelia miyamotoi, in black-legged ticks, which are carried by western gray squirrels in California and white-footed mice back east.
From a Stanford Report article:
The findings raise the question of whether B. miyamotoi has gone undetected in California residents. The research results are “an important step toward dispelling the perception that you cannot acquire Lyme disease in California,” said Ana Thompson, the executive director of the Bay Area Lyme Foundation.
B. miyamotoi has been known for some time to infect ticks; the first known human case of B. miyamotoi infection in the U.S. was discovered in 2013. Beyond Lyme-like symptoms such as fever and headache, little is known about its potential health impacts. In the Bay Area, low awareness of tick-borne diseases such as Lyme could heighten the risk of infection with B. miyamotoi for users of the region’s extensive natural areas and trails.
The piece notes that the School of Medicine’s interdisciplinary Lyme Disease Working Group “is exploring ways to improve diagnostic tests and medical understanding, evaluate the effectiveness of innovative therapies, expand clinical services and build greater public awareness.”
Previously: Add a tick check to your vacation checklist, Ask Stanford Med: Answers to your questions about wilderness medicine and Piecing together the clues: Diagnosing and treating autonomic disorders
Photo by Ray Bouknight
Behavioral Science, Nutrition, Parenting, Pediatrics, Public Health, Research
on February 12th, 2014
More than a decade into adulthood, I’m still drawn in to the worlds created by sugar-cereal commercials. Hypnotized by the swirling pattern of Cinnamon Toast Crunch and captivated by the magic of Lucky Charms, I can see how actual kids’ eating behavior could be influenced by cartoon messaging.
So I was interested to read about a pilot study in New York City public school children that examined how reading comics featuring healthy food could have an effect on snack choice.
Science 2.0 reports:
It comprised 57 youth, approximately 11 years of age, nearly 90% of whom were either Black/African American or Hispanic and 54% were female. The school districts in the study had greater percentages of students eligible for free lunch (79 and 96%, respectively) compared to the citywide average of 66%.
After reading either a Manga comic, titled “Fight for Your Right to Fruit,” or a non-health-related newsletter, children were given the choice between a healthy snack (oranges, grapes, apples, strawberries) or an energy-dense snack (cookies, potato chips, nacho chips, and cheese-filled crackers). 61% of children in the comic group chose a healthy snack after reading, opposed to just 35% of the control group.
Regarding the choice of Manga, a Japanese comic form featuring detailed artwork and storytelling, the study notes:
The Transportation-Imagery Model (TIM) explains how Manga comics may contribute to changes in health-related beliefs and behaviors. According to the TIM, persuasion of a story’s messages occurs because an individual is “transported” or immersed into the narrative world.15 The TIM also suggests that images are most impactful when they are embedded in a story, rather than provided in isolation.15 Thus, visual images relevant to the story’s messages, such as those incorporated in Manga comics, may further influence attitudes and beliefs.
The authors write, “Results suggest Manga comics may be a useful format to promote healthy snack selection in urban minority youth.” (Side note: Writing about this pilot study made me want to eat mangoes.)
The research was published in the Journal of Nutrition Education and Behavior.
Previously: Depictions of obesity in children’s movies, No bribery necessary: Children eat more vegetables when they understand how food affects their bodies, Talking to kids about junk food ads, Health experts to Nickelodeon: Please stop promoting unhealthy food to our kids and Researchers find cartoons really do make food taste better (or so kids think)
Photo by North Charleston
Cardiovascular Medicine, In the News, Public Health
on February 11th, 2014
Is there a specific gene that helps determine your risk for heart disease? What are the signs and symptoms of a heart problem? Does fish oil help prevent heart disease?
If you find yourself baffled by these questions, you’re not alone. A recent survey conducted by the Cleveland Clinic found that many Americans are misinformed when it comes to heart health and, as a result, aren’t taking the steps necessary to guard off future heart problems. Health Day reports on the survey results:
Although 64 percent of Americans have heart disease or know someone who does, 70 percent of Americans are unaware of all the symptoms of the condition, the researchers found. Less than a third were able to identify unusual fatigue, sleep disturbances and jaw pain as a few of the possible signs of heart disease.
Meanwhile, Americans also have their vitamin facts wrong. Although there are no vitamins that can promote heart health, the survey found that 44 percent of Americans think vitamins can lower cholesterol and 61 percent wrongly believe that vitamins or supplements can help prevent heart disease.
Even fish oil supplements do little to prevent heart disease, the researchers said. Still, 55 percent of Americans believe taking the recommended daily dose of fish oil can ward off the condition. The researchers also cautioned that seafood could be just as high in cholesterol as red meat. The survey showed, however, that only 45 percent of Americans are aware of this.
Americans are also not up to speed on sources of sodium. When it comes to salt, about 32 percent of people wrongly believe that cheese is the biggest culprit, the survey found. Just 24 percent of Americans were aware that bread products typically have a higher salt content.
The survey also showed that almost 60 percent of Americans think there is a heart disease gene that helps determine their risk for the condition. Scientists have not yet identified any such gene.
In recognition of February being American Heart Health Month, Stanford Hospital & Clinics is issuing weekly challenges to help you take the first steps toward a lifetime of better heart health. Visit the hospital’s website and Facebook page or follow @StanfordHosp on Twitter to learn more about heart disease and ways to keep your heart healthy.
Previously: The exercise pill: A better prescription than drugs for patients with heart problems?, Heart attacks and chest pain: Understanding the signs in young women, Childhood obesity a risk for imminent heart problems, research shows, Ask Stanford Med: Answers to your questions about heart health and cardiovascular research and Ask Stanford Med: Cardiologist Jennifer Tremmel responds to questions on women’s heart health
Photo by samantha celera
Addiction, In the News, Public Health
on February 10th, 2014
Over on Wonkblog, there’s a lengthy discussion between Stanford addiction expert Keith Humphreys, PhD, and Harold Pollack, PhD, on drug overdoses, the recent death of actor Philip Seymour Hoffman, and ways to prevent others from dying. The entire piece is worth a read, but a few parts jumped out at me:
HP: Many people don’t realize that overdose is the leading cause of accidental death in the U.S. I gave a talk about five years ago in Chicago, and I mentioned that we had more overdose deaths than traffic fatalities. My audience literally did not believe me. People were absolutely convinced that I had mis-transcribed the numbers. Every year, America loses a little over 32,000 people in auto crashes, and something like 38,000 from overdose deaths annually.
KH: Yeah, it’s remarkable if you compare overdoses to AIDS, which at its peak was taking about the same number of lives. The difference in reaction is really startling. We appropriately became galvanized about HIV/AIDS, and implemented much better public policy to prevent HIV-related deaths. It’s much harder to get traction on the overdose issue, or even to get people to believe how prevalent the problem actually is.
HP: Just to note the numbers, in 1999 there were about 4,000 prescription opiate overdoses. In 2010, there were about 16,000. By comparison, there are about 10,000 gun homicides in the United States.
KH: It is pretty amazing. Many people are focusing on the return of heroin and saying, “It’s all the fault of criminals.” You’ve got to remember, 4 in 5 of people today who start using heroin began their opioid addiction on prescription opioids. The responsibility doesn’t start today with the stereotypical criminal street dealer. We basically created this problem with legally manufactured drugs that were legally prescribed. This really flies in the face of the argument that if we just had a flow of legal drugs, the harms would be minimal.
HP: Can I ask you an embarrassingly basic question? If someone like Philip Seymour Hoffman presumably had access to all sorts of prescription opioids, why does he end up injecting heroin?
KH: That’s actually a good question. Cost drives many people to heroin. It’s more expensive to buy oxycodone than it is to buy heroin. Presumably that was a less pressing concern for Mr. Hoffman. Perhaps the intensity of the rush of injected heroin was more reinforcing to him than opioid medications were. The prescription medications have a longer, slower cycle of action in the body. His heroin use could also be the result of habit. He had experienced a heroin problem before, many years ago. It could be that that was the drug that he knew best or was available in the networks of dealers he used. I’m speculating about somebody I don’t know, but those are some possible reasons.
For most people it’s cost. Add one other thing; when people lose their health insurance, they may need the opioids to manage their pain. People sometimes end up buying street drugs including heroin to manage their pain because they have lost the insurance that used to cover their pain medication.
Previously: A reminder that addiction is a chronic disease, Is it damaging to refer to addicts as drug “abusers?”, Breaking Good: How to wipe out meth labs, How police officers are tackling drug overdose, Do opium and opioids increase mortality risk? and How to combat prescription-drug abuse
Cancer, NIH, Public Health, Women's Health
on February 7th, 2014
A team of researchers at the National Cancer Institute have conducted the largest study to date assessing the relationship between non-steroidal anti-inflammatory drugs and ovarian cancer risk. Their findings show that taking aspirin daily may lower women’s risk of ovarian cancer; however researchers caution that more studies are needed before clinical recommendations can be made.
In the study, researchers examined a dozen previous epidemiological studies that included roughly 8,000 women diagnosed with ovarian cancer and nearly 12,000 women who did not have the disease. According to an NCI release:
The researchers determined that participants who reported daily aspirin use had a 20 percent lower risk of ovarian cancer than those who used aspirin less than once per week. For non-aspirin NSAIDs (non-steroidal anti-inflammatory drugs), which include a wide variety of drugs, the picture was less clear: the scientists observed a 10 percent lower ovarian cancer risk among women who used NSAIDs at least once per week compared with those who used NSAIDs less frequently. However, this finding did not fall in a range that was significant statistically. In contrast to the findings for aspirin and NSAIDs, use of acetaminophen, which is not an anti-inflammatory agent, was not associated with reduced ovarian cancer risk.
This study comes on the heels of Stanford research showing that aspirin use appears to cut the risk of another type of cancer (melanoma) in women.
Previously: Can repackaging aspirin get more people to take it daily for prevention? and New research shows aspirin may cut melanoma risk
Photo by Chaval Brasil
Public Health, Stanford News, Transplants, Videos
on February 6th, 2014
In the United States, approximately 18 people die each day waiting for a life-saving organ transplant, and every 13 minutes a new name is added to the national waiting list. Those who become organ donors have the opportunity to save up to eight lives and reduce the shortage of organs available for transplant.
To spread the word about how organ donors can save lives, students in a Stanford political science class launched a new public-health awareness campaign. While developing the initiative, called Stanford Life Savers, students polled their peers to understand public perception about organ donation. (They found fear was the number one reason people don’t register as donors; religious concerns also sometimes came into play.) As noted in a Stanford Report story published today, conducting the survey was eye-opening for students:
Nicole DeMont, a master’s student in communication, said she was surprised to discover how much misinformation exists. “It is important that people know the truth about organ donation so they’ll be more willing to register,” she said.
The more people learn, the more likely they are to support organ donations, she said. It helps that now one can register online to make organ donations – in the past in California, one could only do so at the Department of Motor Vehicles, DeMont added.
DeMont and her classmates created more than a dozen videos, such as the one above, to address individuals’ concerns and encourage more people register as organ donors.
Previously: Closing the racial gap for life-saving transplants, Record number of organ transplants saves five lives in a day, Film about twin sisters’ double lung transplants and battle against cystic fibrosis available online and Pediatric social worker discusses the emotional side of heart transplants
Health Disparities, Medical Education, Public Health, SMS Unplugged
on February 5th, 2014
SMS (“Stanford Medical School”) Unplugged was recently launched as a forum for students to chronicle their experiences in medical school. The student-penned entries appear on Scope once a week; the entire blog series can be found in the SMS Unplugged category.
My upbringing and career goals can be summarized as a collection of “in betweens.” I was middle child in a family that was first generation in the United States, and I grew up bridging my parents’ history in Mexico and the American Dream they hoped for. I was raised in Pasadena, Calif., enjoying the perks of an affluent suburbia but witnessing the challenges my parents faced as low-to-middle-income laborers. I had little dental or medical care as a child, as health insurance was inaccessible and my parents were unable to pay out of pocket. I grew up in between socioeconomic lines, blessed by my parents’ sacrifices to support me as the first person in my family to pursue higher education, but aware of the struggles that poverty creates.
One of the reasons I decided to pursue medicine is a desire to serve as a connection between the underserved poor and health care. I wanted to translate my experiences growing up in a Hispanic household without health insurance and with little knowledge of the health-care system into a career meant to empower underserved populations and improve their overall health. However, the image of the health provider I desired to be was at one time very narrow.
Initially, I was focused on making my way into the hospital, unaware of the health impacts that come from other fields. But through a series of undergraduate courses and extracurricular programs, I discovered the impact that public-health interventions, policy and ideology can make. I came to realize that in order to address health-care needs, it’s important to understand the circumstances creating them. It’s not just about dealing with high blood pressure, obesity and mental health – it’s about drawing awareness to their causes and coming up with ways to prevent them. My career goal became to position myself between providing direct patient care and defining health prevention and maintenance practices.
When I was deciding where to go to medical school, I initially dismissed Stanford. I felt its lack of a public health school would hinder my goal of becoming both a health-care provider and a health-care promoter. Second Look Weekend not only dispelled this false vision of Stanford, but also introduced me to the Stanford that I’ve come to value highly: a center of excellence that positions itself between academic medicine and community outreach, and between scientific advancement and public health empowerment. From learning about social determinants of health in the Community Health scholarly concentration, to providing services such as health education through free clinics, Stanford creates an environment to learn about and participate in numerous public-health approaches. In doing so, it exemplifies what I believe is important in defining what the future of medicine is: caring for people and communities before and beyond the hospital.
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Cancer, Infectious Disease, Pediatrics, Public Health, Research, Sexual Health
on February 3rd, 2014
When the first vaccines were introduced against the human papillomavirus, some people worried that this anti-cancer vaccine would give young women the wrong idea. The vaccines, which protect against common cancer-causing strains of HPV, don’t guard against other sexually transmitted infections or unwanted pregnancies. But some parents and physicians thought that vaccine recipients might forgo condoms more often, have more sexual partners or otherwise engage in riskier sexual behaviors than women who were not vaccinated.
However, a study published today in Pediatrics says that’s not the case. According to the new research, young women don’t change their sexual behaviors after receiving the HPV vaccine. The researchers asked more than 300 girls and women, aged 13 to 21, about their risk perception and their sexual behaviors when they received their first dose of the HPV vaccine. They followed the group over time, repeating the questions 2 and 6 months later, when the vaccine’s booster shots were delivered.
“Most participants in this study did not perceive that they had a lower risk for STIs other than HPV, and most believed that safer sexual behaviors were still important,” the study’s authors wrote. Later, they add, “These findings contribute to the growing literature suggesting that HPV vaccination is unlikely to alter sexual risk behaviors in young women.”
I asked Stanford’s Sophia Yen, MD, for her take on the results. Yen provides HPV vaccinations in her role as an adolescent medicine specialist at the Teen and Young Adult Clinic at Lucile Packard Children’s Hospital Stanford. “The findings are not surprising and re-emphasize what other studies have shown,” she told me, adding that she hopes the study will be repeated in males, since boys have now begun receiving the HPV vaccine, too.
In the meantime, Yen plans to continue using this and other scientific evidence to reassure parents about the value of the vaccine. “I hope that the findings of this study and its many other predecessors will become widely known to parents and other non-adolescent medicine specialists who see adolescents, and to policymakers,” she said. “Let’s prevent STDs and cervical cancer together.”
Previously: Study shows racial disparities in HPV vaccination, Packard Children’s adolescent and young-adult specialist offers tips for college-bound students, HPV-associated cancers are rising, HPV vaccination rates still too low, new national report says and Only one-third of teenage girls get HPV vaccine to prevent cervical cancer
Photo by wintersoul1
Chronic Disease, Public Health, Research
on January 30th, 2014
When assessing a patients’ risk of developing Type 2 diabetes, physicians may want to consider expanding their questions about family medical history and lifestyle to include if their spouse has been diagnosed with the disease. A study recently published in BMC Medicine found that partners of individuals with diabetes have a 26 percent increased risk of also developing the condition.
A post published today on Futurity explains the findings (subscription required):
Researchers analyzed results from six selected studies that were conducted in different parts of the world and looked at key outcomes such as age, socioeconomic status, and the way in which diabetes was diagnosed in 75,498 couples.
Most of the studies used in the meta-analysis relied on health records, which may not always accurately record diabetes. Those that used direct blood testing suggested that diabetes risk doubles if your partner has diabetes. They found a strong correlation with pre-diabetes risk.
The study offers more evidence that the lifestyle choices of your friends and family, particularly in your household, influence your health habits. Researchers of the latest study say the findings could help doctors develop strategies to change patient’s health behaviors that involve both partners.
Previously: The scientific importance of social connections for your health, Examining how your friends influence your health and Can good friends help you live longer?
Photo by Bradley Gordon
Health and Fitness, Nutrition, Public Health
on January 28th, 2014
This fascinating (and depressing) chart from the U.S. Department of Agriculture compares Americans’ grocery-store expenditures to the recommended expenditures for several categories of food. It shows that we spend the right proportion of our food budgets in exactly one food category: potatoes.
Otherwise, we spend far too much in basically every unhealthy food category, including red meat, sugar and candies, refined grains and frozen/refrigerated entrees. And we spend too little on healthy foods like fruits and veggies, whole grains, legumes, low-fat dairy products, poultry and fish.
This chart gives me a strange desire to do a bit of research with my own grocery-store receipts. I have a PhD in nutrition, and I make an effort to purchase and cook healthy foods for my family, but I’ve never thought to analyze our diets according to what percentage of our expenditures go toward healthy vs. unhealthy foods.
Previously: Rating my diet: in which I take the Eat Real Quiz, with thought-provoking results, Should the lack of access to good food be blamed for America’s poor eating habits? and Americans still falling short of national nutritional guidelines
Via Food Politics