A couple links for the day

1. This article discusses a newly-developed pandemic planning tool that will help health officials "quickly analyze pandemics and craft better response strategies." The author also says, "these results could be valuable in developing an aggressive preventive strategy and deciding how best to use limited resources."
2. Second, the health world today is discussing a new study that shows the overuse of CT scans can lead to cancer deaths, says this article. "Widespread overuse of CT scans and variations in radiation doses caused by different machines... are subjecting patients to high radiation doses that will ultimately lead to tens of thousands of new cancer cases and deaths," says the study. The article emphasizes that the risk for any one individual is relatively small, but the overall risk for the population is much larger.
3. Finally, in breaking news from the NYT, a million doses of infant H1N1 vaccine have been recalled, apparently because they are slightly less potent than recommended. Unfortunately, this slip-up will probably mean even more negative publicity for the vaccine and for public health. Oh, boy.
   

Some recent links

1. This interesting article discuses evidence-based medicine and the recent mammogram recommendations (I know, they're still talking about it.) Take a look and see what you think.
2. As I've discussed before, climate change is expected to have a major impact on health and public health. This article is about its impact on mental health specifically. The point that makes the most sense is that climate change is expected to bring more natural disasters, bringing more life upheaval and therefore more stress and mental health issues.
3. Cancer death rates are declining, according to this article. Researchers who found this statistic examined colorectal cancer as an example, and found that the decline was mostly due to better screening. Here is the study from which the article draws, which is worth a read - interesting.
4. The CDC has reported that the death toll from H1N1 is at 10,000, but also suggests that the number of new cases could be trickling off. It says one in five Americans have had H1N1. Mike Osterholm says, in my opinion accurately, that this pandemic is not over:
   

   “So the C.D.C. says 50 million have been infected so far,” he said. “Another 50 million have been vaccinated. And maybe 20 million have got innate immunity because of their age. You do the math — that’s 120 million who are immune out of 320 million, so two-thirds of the population is still not immune. It’s amazing how many people are acting as if this is all wrapped up. The numbers could still go up dramatically.”

5. This article describes the dismal state of public health and its critical understaffed numbers. It's a great article.
   

   "If swine flu is a test of public health, we've already flunked. And we have only ourselves -- and the political leaders who have been disinvesting in public health since 1980 -- to blame."

6. Finally, a new report from the Institute of Medicine about the National Vaccine Plan seeks to elevate vaccines to a higher public health priority, increase funding, and other recommendations. This article explains the highlights of the report. The updated plan is expected to take effect in 2010. However, the development of this plan does not ensure its implementation:
   

   "Siegel has doubts that the proposed policy can be implemented and enforced. 'There are extremely difficult obstacles -- fear, noncompliance, media hype and poor government choices,' he said."

   
   

Recent cancer screening guidelines reveal delicate balance between public health, private practice

Recent cancer screening guidelines reveal delicate balance between public health, private practice

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Once again - some links for you

1. I wrote a few weeks ago about unsexy health threats, and chronic disease could probably fit under that category. Certainly the Global Alliance for Chronic Disease thinks so. This organization, founded in June, is trying to increase awareness of the prevalence of chronic disease around the world, even in developing countries. This article details more about this organization and this issue.
2. Food safety legislation has been given the next push forward in the Senate. This article says that the full Senate won't take up the legislation until 2010, but Congress is certainly looking to move on food safety legislation of some sort this session. "The Senate bill would expand U.S. Food and Drug Administration (FDA) oversight of the food supply and shift its focus toward preventing, rather than reacting, to foodborne outbreaks. FDA would have the power to order recalls, increase inspection rates and require all facilities to have a food safety plan."
3. I have briefly mentioned the economy's effect on public health, and this article repeats that message - the economy has affected the public's health and well-being. Respondents to a recent survey indicated that they were more likely to overeat and less likely to exercise due to stress about the economy. Respondents were also less likely to take care of health problems in a timely manner. And, last but certainly not least, emotional health was adversely affected by the economy.
4. And finally, our favorite topic du jour - the recent change in the U.S. Preventive Services Task Force's recommendations on breast cancer screenings.
   
   This article provides a good, solid perspective on the recommendation change, explaining a bit about why the public has a hard time accepting the fact that screenings are not always in our best interests: "Statisticians and epidemiologists know this for a fact. The problem is, there's no way to tell which of the tumors are dangerous and need to be treated and which are harmless and would be best left alone. So all of them get treated, often aggressively. The medical establishment calls this overdiagnosis."
   
   This article's title, "New mammogram guidelines are confusing, but here's why they make sense," says it all. The article notes that the new guidelines are in line with international recommendations and goes through the recommendation in a detailed manner, explaining each point. The potential harms from widespread mammogram screening include radiation exposure, false-positives, and the incorrect notion that early detection is always a good thing. It's a good article.
   
   This NY Times op-ed piece by Robert Aronowitz has an interesting premise: "Why do we keep coming around to the same advice — but never comfortably follow it?" The column details some of the history of cancer screening and treatment and how increased diagnoses of cancer led to increased pressure to screen earlier and diagnose earlier and more often. He makes a very good point:
   

   "You need to screen 1,900 women in their 40s for 10 years in order to prevent one death from breast cancer, and in the process you will have generated more than 1,000 false-positive screens and all the overtreatment they entail. This doesn’t make sense. We could do more research and hold more consensus conferences. I suspect it would confirm the data we already have. But history suggests it would never be enough to convince many people that we are screening too much."

   
   And, finally, "What watching ESPN could teach us about mammograms" - this title immediately caught my eye. Basically, this article says that statistical data are presented in the sports world every day and understood - why can't the same thing be done in public health? Why is the message clouded? Great question! The answer is that we have messaging problems, we public health professionals. It's true. It also gives a link to the National Cancer Institute's breast cancer assessment tool - interesting.
   

Some links for you

1. Massachusetts public health officials explain the dissemination of their H1N1 vaccine allotment. Patience, all you patients out there!
2. The WHO has discovered new data that show that 1.2 million people over the age of 5 die of foodborne illness each year in Southeast Asia and Africa. That number is significantly higher than previously estimated, providing new reason to address this issue in the developing world.
3. In case you're one who needs everything, check out these iPhone apps about H1N1.
4. There is a new tool to show where AIDS treatment and care in San Francisco is lacking. Click here for the map itself.
5. Obesity is an alarming public health issue, and this latest article has alarming numbers. If trends stay as they are now, 43% of adults will be obese in 2018. Wow.
6. This article highlights that many public health professionals around the country are being reassigned from their normal job duties to work on H1N1 assignments. This is disrupting usual public health activities that address ongoing problems that are not going away simply because this pesky flu virus has shown up. It's a problem, but it doesn't appear it will be solved.
7. Representative David Camp says in this article about the breast cancer screening recommendations: "I mean, let the rationing begin. This is what happens when bureaucrats make your health care decisions." Right, the U.S. Preventive Services Task Force is bureaucrats. They're not experienced physicians and trained professionals. Sure.
8. Lots of money is being poured into fighting healthcare-associated infections. This article details the stimulus funding being given to the issue.
   

Cancer screenings - new research

Check out this article in today's New York Times. It questions the benefit of prostate and breast cancer screening. Anything else I might say would just be reiterating the article, so I'll refer you directly to it.

Cost effectiveness of Gardasil for boys

This article discusses the (non) cost-effectiveness of the Gardasil vaccine among boys. It's an interesting read. A previous post discusses cost-effectiveness, that post specifically about cancer screening. What do you think?

A couple more links

This senior in high school won an award for an epidemiology paper she wrote. Great job, Marilyn! Go epidemiology! Now go to college, get your MPH in epi, and work to improve capacity at the state level!

French kissing can give you infectious diseases. Apparently (duh) saliva transmits some infectious diseases. Is it worth the risk? That's not for me to say...

Counterintuitive: This article reports on a study that says the addition of healthy menu choices can lead to unhealthier decisions. Huh? Apparently when a side salad was an option, consumers were more likely to choose french fries. Why would that be? Maybe I shouldn't comment since I love french fries, but it doesn't seem to make sense to me.

Colon cancer prevention: According to this article, colon cancer prevention in Utah is about to get a big boost. Generally chronic disease and cancer are getting a lot of attention these days, as Obama has highlighted it. Rightly so - both are huge public health issues, and it's about time they get addressed as a national priority!