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In The News
Abortion
Pear, Robert; Herszenhorn, David. House Haggles over Abortion in Health Care Bill. The New York Times. 4 November 2009.
http://www.nytimes.com/2009/11/05/health/policy/05health.html
WASHINGTON — House Democratic leaders struggled Wednesday to strike a deal that would restrict the use of federal money to pay for abortions under sweeping health care legislation headed for debate on the House floor this week.
Animal Issues
Rohrer, Finlo. The rise of the non-veggie vegetarian. BBC News Magazine. 5 November 2009.
http://news.bbc.co.uk/2/hi/uk_news/magazine/8341002.stm
Vegetarianism used to be simple - its protagonists foreswore the flesh of any dead animal. Today there are "veggies" who eat fish, and people who eat no meat but don't call themselves vegetarians. What happened? The conversation usually goes something a bit like this: "Yeah, I'm a vegetarian." "But that looks like fish you're eating." "Oh yeah, I eat fish." Confusion, perplexity and occasionally heated debate can follow as the "vegetarian" and their interrogator cover the issue of what is an animal and whether fish feel pain. But the Vegetarian Society, which has acted as the custodian of British vegetarianism since 1847, has a simple definition.
Children’s Issues
Tarkan, Laurie. Fathers Gain Respect from Experts (and Mothers). The New York Times. 2 November 2009.
http://www.nytimes.com/2009/11/03/health/03dads.html
As much as mothers want their partners to be involved with their children, experts say they often unintentionally discourage men from doing so. Because mothering is their realm, some women micromanage fathers and expect them to do things their way, said Marsha Kline Pruett, a professor at the Smith College School for Social Work at Smith College and a co-author of the new book “Partnership Parenting,” with her husband, the child psychiatrist Dr. Kyle Pruett (Da Capo Press).
Environmental Issues
Wong, Edward. Groups Press U.S. and China on Carbon. The New York Times. 3 November 2009.
http://www.nytimes.com/2009/11/04/science/earth/04carbon.html
BEIJING — Three prominent American research organizations that are pushing for greater cooperation between the Obama administration and China on the issue of climate change say the two governments should make a priority of supporting the use of carbon capture technology and the creation of a market for carbon.
Food and Nutrition
Rabin, Roni Caryn. How Posted Calories Affect Food Orders. The New York Times. 2 November 2009.
http://www.nytimes.com/2009/11/03/health/03nutrition.html?ref=science
Just a few weeks ago, independent researchers reported that New York City’s ground-breaking calorie labeling law had had absolutely no effect on the caloric content of meals bought at chain restaurants in poor neighborhoods. Last week, city health officials delivered a more upbeat assessment, saying New Yorkers ordered fewer calories at four chains — Au Bon Pain, KFC, McDonald’s and Starbucks — after the law went into effect last year.
Health Care
Kolata, Gina. For Gene Therapy, Seeing Signs of a Resurgence. The New York Times. 5 November 2009.
http://www.nytimes.com/2009/11/06/health/06gene.html?ref=health
Not long ago, gene therapy seemed troubled by insurmountable difficulties. After decades of hype and dashed hopes, many who once embraced the still-experimental idea of correcting genetic disorders by giving people new genes all but gave up the idea. But scientists say gene therapy might be on the edge of a resurgence.
Mental Health
Cave, Damien. A Combat Role, and Anguish, Too. The New York Times. 31 October 2009.
http://www.nytimes.com/2009/11/01/us/01trauma.html
Post-traumatic stress disorder distorts personalities: some veterans who have it fight in their sleep; others feel paranoid around children. And as women return to a society unfamiliar with their wartime roles, they often choose isolation over embarrassment.
Wallis, Claudia. A Powerful Identity, a Vanishing Diagnosis. The New York Times. 2 November 2009.
http://www.nytimes.com/2009/11/03/health/03asperger.html
It is one of the most intriguing labels in psychiatry. Children with Asperger’s syndrome, a mild form of autism, are socially awkward and often physically clumsy, but many are verbal prodigies, speaking in complex sentences at early ages, reading newspapers fluently by age 5 or 6 and acquiring expertise in some preferred topic — stegosaurs, clipper ships, Interstate highways — that will astonish adults and bore their playmates to tears.
Public Health
Duggar, Celia. Zuma Rallies S. Africa to Fight AIDS. The New York Times. 31 October 2009.
http://www.nytimes.com/2009/11/01/world/africa/01zuma.html
JOHANNESBURG — In a culmination of his party’s major shift on AIDS, a disease that has led to plunging life expectancies here, President Jacob Zuma last week definitively rejected his predecessor’s denial of the viral cause of AIDS and of the critical role of antiretroviral drugs in treating it.
McNeil, Donald. AIDS: Panel Warns That Without New Direction, Epidemic Will Remain Out of Control at 50. The New York Times. 2 November 2009.
http://www.nytimes.com/2009/11/03/health/03global.html
Unless there is a drastic change in approach, the AIDS epidemic will still be out of control on its 50th anniversary in 2031, a panel of AIDS experts predicted in an analysis being published Tuesday in the journal Health Affairs.
Greenhouse, Steven. House Bill would Assure Workers Paid Sick Days. The New York Times. 3 November 2009.
http://www.nytimes.com/2009/11/04/health/policy/04sick.html
In an effort to rein in the spread of the H1N1 flu, Representative George Miller, the chairman of the House Education and Labor Committee, introduced legislation on Tuesday that would guarantee five paid sick days for workers sent home by their employers with a contagious illness.
Women’s Issues
Conde, Carlos. Bill to Increase Access to Contraception Is Dividing Filipinos. The New York Times. 25 October 2009.
http://www.nytimes.com/2009/10/26/world/asia/26iht-phils.html?hp
Abortion is illegal in the Philippines. Birth control and related health services have long been available to those who can afford to pay for them through the private medical system, but 70 percent of the population is too poor and depends on heavily subsidized care. In 1991, prime responsibility for delivering public health services shifted from the central government to the local authorities, who have broad discretion over which services are dispensed.
In The Journals
The Journal of the American Medical Association
White, Douglas B and Derek C. Angus. “Preparing for the Sickest Patients With 2009 Influenza A(H1N1)” The Journal of American Medical Association. 302.17 (17 November 2009): 1905-6.
http://jama.ama-assn.org/cgi/content/full/302/17/1905
Despite an enormous global investment in preparing for the reemergence of 2009 influenza A(H1N1), preparations proceeded largely without empirical data about the nature and severity of disease. This paucity of data is particularly problematic for clinicians in intensive care units (ICUs), who will shoulder a heavy burden for the clinical response to H1N1. In this issue of JAMA, 3 reports provide data that begin to fill this empirical void.
The New England Journal of Medicine
Drazen, Jeffrey M. “Uniform Format for Disclosure of Competing Interests in ICMJE Journals” The New England Journal of Medicine. 361.19 (5 November 2009): 1896-7.
http://content.nejm.org/cgi/content/full/361/19/1896
Disclosure of financial associations of authors of articles published in biomedical journals has become common practice. The information provided in these disclosures helps the reader to understand the relationships between the authors and various commercial entities that may have an interest in the information reported in the published article. At present, many journals ask authors to report such relationships by completing a form with information about their financial associations. The journals then either post the complete information online or create a summary of the information and publish it with the article in question. Although efforts are under way to establish uniform reporting systems, there is currently no uniform vehicle for the disclosure of financial associations.
Iglehart, John K. “Reform and the Health Care Workforce – Current Capacity, Future Demand” The New England Journal of Medicine. 361.16 (5 November 2009): e38.
http://content.nejm.org/cgi/content/full/361/19/e38
As Democrats press to enact health care reform legislation, they have emphasized their commitment to greatly expanding coverage, slowing the growth of medical spending, and more tightly regulating private insurers, if not also creating a competing public insurance option. But among the major questions that their policy prescription leaves unanswered is, How would a health care workforce that many (though not all) observers agree is already inadequate in some regions and specialties provide medical care to an additional 30 million newly insured people? After all, early lessons from health care reform in Massachusetts include the recognition that, as Dr. Mario Motta, president of the Massachusetts Medical Society, recently put it, "universal coverage doesn't equate with universal access."
Wang, Jason C. et al. “Payment Reform for Safety-Net Institutions – Improving Quality and Outcomes” The New England Journal of Medicine. 361.19 (5 November 2009): 1821-3.
http://content.nejm.org/cgi/content/full/361/19/1821
In the U.S. health care system today, many hospitals have the market power to raise the prices of their services without showing evidence of improvements in the quality of care. In an effort to realign incentives, health care reformers are now proposing to link provider payments to quality of care and health outcomes. As we move toward such a payment system, however, we must ensure that reimbursement is adjusted for patients' coexisting conditions so that hospitals cannot get high marks for quality by choosing to treat only patients who are considered to be at low risk.
The Lancet
“Breast Cancer in Developing Countries” The Lancet. 374.9701 (7 November 2009): 1567.
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)61930-9/fulltext
Globally, breast cancer is the most common cause of cancer-related death in women, with some 327,000 deaths each year. There are 1·35 million new cases every year, and about 4·4 million women are believed to be living with breast cancer. An estimated 1·7 million women will be diagnosed with breast cancer in 2020—a 26% increase from current levels—mostly in the developing world. Breast cancer is already the leading cause of cancer in southeast Asian women, and is second only to gastric cancer in east Asian women, and to cervical cancer in women in south-central Asia.
“The FDA’s Poor Oversight of Postmarketing Studies” The Lancet. 374.9701 (7 November 2009): 1568.
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)61932-2/fulltext
The US Food and Drug Administration (FDA) prefers to approve drugs with a proven, clinically relevant endpoint (eg, prevention of stroke), but also considers surrogate endpoints (eg, reduction in blood pressure). This approach can be a double-edged sword. Although it might accelerate the approval of new treatment options for life-threatening illnesses, because of the uncertainty around clinical benefits, drugs could turn out to be ineffective or harmful to patients. Follow-up is crucial to ascertain whether a drug is actually clinically beneficial.
British Medical Journal
Bland, Ben. “Commercial Solutions to Malnutrition” BMJ. 339.b4482 (4 November 2009).
http://www.bmj.com/cgi/content/full/339/nov04_1/b4482
Bangladesh has one of the highest rates of child malnutrition in the world, but with the government and international organizations unable to come up with a unified strategy, progress has been limited. Now the government and non-governmental organizations are looking to work with business in an attempt to find cost effective and scaleable solutions to an enduring problem that is putting great pressure on the country’s overstretched health system and underperforming economy.
“Smoking Cessation Agents and Suicide” BMJ. 339.b4360 (5 November 2009).
http://www.bmj.com/cgi/content/full/339/nov05_1/b4360
Success in giving up smoking can be improved through social support, problem solving or skills training, and various drugs. A combination of drugs and other treatments is most effective. Drugs include nicotine replacement products, varenicline (Champix), and bupropion (Zyban and generics). Varenicline and bupropion inhibit the craving to smoke through unknown mechanisms. Both drugs influence the dopamine system, which regulates cognition, mood, and behavior. Both varenicline and bupropion have been associated with "changes in behaviour, agitation, depressed mood, suicidal ideation, and attempted and completed suicide" in patients who had no psychiatric history and were not taking psychotropics. Nicotine replacement products have no such known associations. In the linked study, Gunnell and colleagues report the first retrospective cohort study to examine suicidal thoughts and behaviors after exposure to smoking cessation products.
Opinion
Boston Globe
Loth, Renee. Barriers to abortion rise, even in Brookline. Boston Globe. 30 October 2009.
http://www.boston.com/bostonglobe/editorial_opinion/oped/articles/2009/10/30
A reminder: Abortion is still legal in the United States. And yet, 36 years after Roe v. Wade, a safe, legal abortion is harder and harder to obtain. Regulation and intimidation have sharply reduced the number of clinics, doctors, and hospitals willing to engage in the procedure, or medical schools to train the next generation of providers. Today, it is not possible to obtain a legal abortion in 87 percent of US counties.
Editorial. Police these pills and powders. Boston Globe. 2 November 2009.
http://www.boston.com/bostonglobe/editorial_opinion/editorials/articles/2009/11/02
The US Food and Drug administration is virtually powerless in regulating the $25 billion dietary supplements industry, even though many of its products contain illegal synthetic steroids that can damage livers or kidneys and cause strokes or lung blood clots. Yet the unregulated supplements are hugely popular among young people in the Boston area who are intent on bulking up and improving their athletic performance. Congress should give the agency the power and the money to police the industry.
Editorial. Swine flu: Firms shouldn’t hoard drugs. Boston Globe. 3 November 2009.
http://www.boston.com/bostonglobe/editorial_opinion/editorials/articles/2009/11/03
From the corner office of the law firm Ropes & Gray, stockpiling medication for swine flu to limit absenteeism among its workers must look like a no-brainer. But for public health officials, this practice raises the prospect that the drug Tamiflu will be used in cases where it really isn’t needed, increasing the risk of drug-resistant strains of the swine flu virus. Such stockpiles could also lead to shortages of the medication, although its maker, Roche, says supplies are ample.
Chicago Tribune
Will, George. A bit of reality on drug use from the new drug czar. Chicago Tribune. 30 October 2009.
http://www.chicagotribune.com/news/opinion/chi-oped1030willoct30,0,2775642.column
During his immersion in his new job, Gil Kerlikowske attended a focus group of 7-year-old girls and was mystified by their talk about "farm parties." Then he realized they meant "pharm parties" -- sampling pharmaceuticals from their parents' medicine cabinets. What he learned -- besides that young humans have less native sense than young dachshunds -- is that his job has wrinkles unanticipated when he became director of the Office of National Drug Control Policy.
Moffett, Shannon. Unnecessary tests: What your health-care tax dollars are paying for. Chicago Tribune. 1 November 2009.
http://www.chicagotribune.com/news/opinion/chi-perspec1101medicalnov
I am a doctor in the last year of my residency at a community hospital in northern California, and as President Barack Obama detailed his health care plan before Congress in September, I was waiting for the results of a CT scan (also called a CAT scan) of a patient's abdomen and pelvis. I actually knew what the results were going to be. In fact, it was a completely unnecessary test and I knew it -- and that it would cost around $2,000.
Los Angeles Times
Fry, Michael. Wind power might blow a hole in bird populations. Los Angeles Times. 2 November 2009.
http://www.latimes.com/news/opinion/la-oe-fry2-2009nov
Each spring, sage grouse gather on their "lekking" grounds to engage in a cacophonous courtship ritual. Males inflate large orange air sacs on their chests and boom out eerie calls to attendant females, sounding like a bizarre orchestra of distant foghorns. The song was once familiar across the Great Basin, but in recent decades, cattle grazing, oil and gas exploration and the spread of invasive species have put a huge dent in sage grouse habitat.
Dugan, Judy. Medical tourism: Outsourcing your health. Los Angeles Times. 3 November 2009.
http://www.latimes.com/features/health/medicine/la-oe-dugan3-2009nov
At a luxury hotel conference center in Century City last week, "international hospitals" from Singapore to South America set up half an acre of colorful display booths in an attempt to attract more business from American insurers and employers. Glossy brochures and videos offered hip replacements, cancer treatments and cardiac care in Turkey, Thailand or Costa Rica. Send a patient and a companion on business class, the basic pitch went, and we'll give them deluxe private rooms, a concierge and a driver. You'll still save half or more of the U.S. cost -- tens of thousands of dollars.
Editorial. Food labels and unwise 'Smart Choices'. Los Angeles Times. 29 October 2009.
http://www.latimes.com/news/opinion/editorials/la-ed-choices29-2009oct
Until a few days ago, the food industry was moving ahead with its program to label products such as Lucky Charms cereal and Ritz Bits Peanut Butter Chocolatey Blast crackers as nutritionally "Smart Choices." But the U.S. Food and Drug Administration made threatening noises, and the industry has backed off for now. That indeed was a smart choice.
New York Times
Hahn Niman, Nicolette. The Carnivore’s Dilemma. New York Times. 30 October 2009.
http://www.nytimes.com/2009/10/31/opinion/31niman.html
Is eating a hamburger the global warming equivalent of driving a Hummer? This week an article in The Times of London carried a headline that blared: “Give Up Meat to Save the Planet.” Former Vice President Al Gore, who has made climate change his signature issue, has even been assailed for omnivorous eating by animal rights activists.
Kristof, Nicholas. New Life for the Pariahs. New York Times. 31 October 2009.
http://www.nytimes.com/2009/11/01/opinion/01kristof.html
Perhaps the most wretched people on this planet are those suffering obstetric fistulas.
Wall Street Journal
Lomborg, Bjorn. Climate Change and Malaria in Africa. Wall Street Journal. 1 November 2009.
http://online.wsj.com/article_email/SB10001424052748703
When he first got sick, Samson Banda didn't realize he had malaria. Only after he came down with a serious fever did he end up at a clinic in the Bauleni slum compound in Lusaka, Zambia. The clinic has just a few nurses and staff with basic medical skills. Locals can wait for an entire day to be seen.
Washington Post
Marsden, N.E. What TV shows are really selling. Washington Post. 30 October 2009.
http://www.washingtonpost.com/wp-dyn/content/article/2009/10/29
After a U.S. senator was shot on Fox's drama "24" this year, another character blurted out the make and model of the assassin's submachine gun. The German brand had been prominent in so many episodes of "24" that gun-enthusiast bloggers, among others, speculated whether the company was paying to advertise on the show.
