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Media, News & Topics on prevention, diagnosis & treatment of cardiovascular disease
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Recommended screenings from AHA

Recommended screenings from AHA | Heart and Vascular Health | Scoop.it
The American Heart Association explains the key to preventing cardiovascular disease (heart disease) is managing your risk factors, such as high blood pressure, high cholesterol or high blood glucose.

"Regular cardiovascular screening is important because it helps you detect risk factors in their earliest stages,”  “This way, you can treat the risk factor with lifestyle changes and pharmacotherapies, if appropriate, before it ultimately leads to the development of cardiovascular disease.”

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Healthier School Lunches Face Student Rejection

Healthier School Lunches Face Student Rejection | Heart and Vascular Health | Scoop.it
Students get more fruits and vegetables under new nutritional requirements for public school lunches, but many children just toss them away.
The Healthy, Hunger-Free Kids Act of 2010, which required public schools to follow new nutritional guidelines this academic year to receive extra federal lunch aid, has created a nationwide version of the age-old parental challenge: persuading children to eat what is good for them.
According to the new restrictions, high school lunches must be no more than 850 calories, middle school lunches no more than 700 calories and elementary school lunches no more than 650. Before, there were no maximums.
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Jenny Sloane's curator insight, December 5, 2013 8:54 PM

Revolutionizing school lunches is clearly a very difficult task. Students are used to eating comfort foods like pizza, fries, chicken tenders, and nachos. It is unrealistic to think that any child would willingly want to give up those delicious foods that they are so used to eating for healthy meals, like sandwiches and green beans. Change is always challanging. However, I believe if schools stick with adopting new, healthy meals younger students will not have the same problem because they will only grow up eating the healthier foods. Therefore, they will never know what they are missing out on and be healthier along the way. With that being said, the transition period will be the most difficult. I am not surprised that this article is about high school kids who went on a strike because they wanted their old meals back. Before reading this article, I had no idea that there are not set calorie restrictions on school lunches. Although I am all for healthier school lunches, there are a couple of arguments made in this article that I do agree with. First of all, high school students are often very active. I personally played a sport every season all four years of high school. That meant practicing every day after school for two hours. If we had lunch at 12:30 and then practice from 4:30-6:30 I would not get home and eat dinner until about 7:15. That is a very long time for any growing teenager to go without eating a solid meal. Therefore, I agree with the fact that many teens do need a lot of food throughout the day that may often exceed the calorie limit. Furthermore, there is no question that most of the time, healthier food options are more expensive. This is also a huge problem for many students and families who simply do not have the resources to afford whatever food they want. I know I am very fortunate and my parents could always provide for me. I also agree that as long as children are still given an option of what they can eat for lunch, they will be unlikely to go for the healthier choice. 

Karla Luetzow's curator insight, December 19, 2013 7:57 PM

 

This news article from the New York Times reflects on the recent protests from high school students against the new school lunches. Rising in price from $2.50 to $2.60, it seems like this ten percent increase would not cause this much commotion. However, it is more about the amount of food and quality of food in each lunch. Due to the Healthy, Hunger Free Kids Act of 2011, an 850 calorie cut off per meal was mandated to all high school lunches. Therefore, as price increased, the portions decreased. All over the country high school students have protested this new lunch claiming that vegetables are “gross.” Researchers in this article claim it will just take time for the students to adjust.

 

Insight:

 

While reading this article, I thought the high school students sounded like snobby, unhealthy, and unrealistic. A quote that especially raveled my bones was by a high schooler who stated,” “Now there’s no taste, no flavor and it’s healthy, which makes it taste even worse.” It bothers me that “healthy” food is considered gross. There are so many healthy, delicious options out there that I believe that this student is being very narrow-minded. To me, it seems more like quote by a seven year old than by a high school senior.

However, after my initial reaction, I remembered saying the same things about my high school cafeteria food. I saw my high school go through a similar shift a few years ago. Pizza and fries were replaced with salads and apples. I have always enjoyed fruits and vegetables. A lot of the time I will choose a yummy, wholesome salad over a greasy pizza. However, this was not the case in my own high school cafeteria. It is pretty difficult to mess up pizza and fries. However, vegetables loaded in grease and cooked down to mush can get disgusting pretty fast. Therefore, I have the preconceived idea that high school cafeterias try to make healthy food but ultimately fail by loading it in grease. The same can be said about the University of Maryland’s dining services. Most of the value meals are cooked in so much grease that the vegetables do not really add nutritional value. 

I really love the idea of adding healthier options. However, the portion size must be able to satisfy the student body. The United States should look at European schools for inspiration. In most European countries, schools must cycle lunches every ten to twenty days. They also are now allowing student and even parent test-tasting before a meal gets approved for a school lunch. With the community working together, I believe this school protests can end and healthier food can be a realistic, yummy, and satisfying option in public high schools.

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After Hospitalization: A Dartmouth Atlas Report on Post-Acute Care for Medicare

After Hospitalization: A Dartmouth Atlas Report on Post-Acute Care for Medicare | Heart and Vascular Health | Scoop.it

In the news this week is the national effort to cut hospital readmissions by penalizing hospitals with high rates.  Dartmouth atlas has published this map of 2009 data showing regional variation in 30-day readmission rates. Hospital readmissions are sentinel events that often signal gaps in the quality of care provided to Medicare patients. There are many different reasons for higher readmission rates across certain regions and hospitals, including differences in patient health status, the quality of inpatient care, discharge planning and care coordination prior to discharge, and the availability and effectiveness of ambulatory services in the community. This report also demonstrates the importance of the general tendency of health care systems to use the hospital as a site of care. The combination of these factors will differ across communities and systems as each faces its own challenges in keeping patients well and out of the hospital.

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Ver2 DigiMed's curator insight, January 7, 2:31 AM

Discharge Planning is proving to be a larger and larger financial burden of hospitals. A comprehensive discharge management program including remote patient monitoring and secure video conferencing between patient and care provider has proven to reduce hospital readmissions and allow patients to be discharged earlier freeing up hospital beds. 

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Benefits of cognitive training after coronary artery bypass

Benefits of cognitive training after coronary artery bypass | Heart and Vascular Health | Scoop.it

My Comment: The idea that the brain needs rehabilitation after major surgery is not been adopted.  It's routine for patient's to have physical rehabilitation after major surgery.  Cognitive & memory training is an area of rapid commercial growth.  Whether this will prove to have real value is uncertian.  Training led to small improvements in time to respond.

Medsacpe's review of this:

The study showed that 65% of the patients showed a cognitive deficit 1 week after surgery, and 41% still showed a deficit 1 month after surgery. However, those who received cognitive training showed significant improvement in performance compared with the control group.

For example, in an assessment of reaction time at 6 months, the mean time for a dual task in the control group was 2108 milliseconds, compared with 1836 for the attention-memory group and 1706 for the memory-attention group.

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Cognitive deficits are frequent after coronary artery bypass graft surgery (CABG) in the elderly population. In fact, memory and attention deficits can persist several months after the surgery. Recent studies with healthy older adults have shown that memory and attention can be improved through cognitive training programs. The present study examined whether memory training (method of loci and story generation) and attentional training (dual-task computerized training) could improve cognitive functions in patients aged 65 years and older who underwent CABG surgery. Participants (n = 51) were assigned to one of three groups: (1) control group (tested at 1, 3 and 6 months after the surgery), (2) attention training followed by memory training, (3) memory training followed by attention training (groups 2 and 3: tested at 1, 2, 3 and 6 months after the surgery). The trainings took place between the 6th and 10th week following the surgery. The three groups were compared before and after each training program using attention and memory tests and neuropsychological tests. The results showed that attention and memory trainings lead to significant improvement in the cognitive domain that was trained. It thus seems that cognitive training can be a promising tool to enhance cognitive functions after a CABG surgery.

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When Doctors Stop Taking Insurance

When Doctors Stop Taking Insurance | Heart and Vascular Health | Scoop.it

My comment: This trend may accelerate in the next several years as ACA enforces physician reimbursement declines.  Unfortunately this will lead to a bifurcated sytem. London's Harley street for some and the rest will wait.

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Private health insurance used to be the ticket to a doctor's appointment. Now, many physicians no longer accept insurance and require upfront payment from patients..

Efforts by insurers to rein in health care costs by holding down physician fees — especially for primary care doctors, who play a critical role in health care though they are among the lowest paid doctors — appear to be accelerating the trend, and some patients say it’s getting harder to find an in-network physician.

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MIT professor proposes cancer ‘megafund’ of up to $30 billion

MIT professor proposes cancer ‘megafund’ of up to $30 billion | Heart and Vascular Health | Scoop.it

Andrew W. Lo, the hedge fund manager and MIT business professor, wants to bring Wall Street-style financial engineering to a crucial social need: curing cancer.

He is proposing an idea that would go beyond his own firm, creating a “megafund” that would flood early-stage research in cancer drugs with $30 billion. By supporting as many as 150 experimental compounds at any one time and bringing in large numbers of investors, he argues, the risk would be spread over a much larger base.

Even if just a few of the treatments prove effective, Lo estimates the fund would be profitable, earning equity investors annual returns of 7 to 10 %

Lo's fund since its start in September 2008, the fund has gained 1.7% on average per year.

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Unpleasant Facts About Atherosclerotic Arterial Disease in US & World

Unpleasant Facts About Atherosclerotic Arterial Disease in US & World | Heart and Vascular Health | Scoop.it
The projected cost for the immense burden of heart disease in the United States during 2006 was between $143 and $258 billion for health care services, medications, and lost productivity. Arteriosclerotic cardiovascular disease is now the most common cause of death in the entire world.
Given the early age for the initiation of the atherosclerotic process and the huge economic burden on the United States of the atherosclerotic disease process, as well as the widespread existence of atherosclerotic risk factors, it is mandatory that widely disseminated and aggressive public health measures be instituted to reduce the burden on our society imposed by atherosclerotic disease. Many primary and secondary lifestyle and medical interventions have been conclusively demonstrated to prevent or ameliorate the devastating effects of atherosclerosis.
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BeSafeRx: Know Your Online Pharmacy

BeSafeRx: Know Your Online Pharmacy | Heart and Vascular Health | Scoop.it
FDA BeSafeRx is a national campaign to raise awareness of the dangers of buying prescription medicines from fake online pharmacies. This campaign provides the resources to help consumers:
Research by the National Association of Boards of Pharmacy, which represents the state pharmacy boards, found that of thousands of online pharmacies it reviewed, only about 3 percent follow state and federal laws. In fact, the group’s website lists only a few dozen Internet pharmacies that it has verified are legitimate and following the rules.
Most consumers don’t know that. An Internet survey, conducted by the FDA in May, questioned 6,090 adults. It found that nearly one in four Internet shoppers has bought prescription drugs online, and nearly three in 10 said they weren’t confident they could do so safely. Many rogue pharmacies claim to be in Canada — because Americans know medicines are cheaper there and assume that’s why they’re getting a deal. Many fraudulent sites even put the word Canada in their name, or display the Canadian flag prominently on the site. Their web storefronts are slick and look professional. And they all offer prices that are unbelievably low.
See related full story at http://www.boston.com/business/technology/2012/09/28/fda-warning-public-risks-online-pharmacies/E7S7HP5oM7uqvUJ861RbbM/singlepage.html
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Heart rate monitor in a mirror

Heart rate monitor in a mirror | Heart and Vascular Health | Scoop.it

My comment: More efforts to develop connected health for consumers. Will this be valuable? Probably not since a mobile health option that allows heart rate assessment at times throughout the day would be more valuable for assessment in health and disease.

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New high-tech mirrors are melding with digital components to act as health-monitoring devices that measure vital signs, in-shop equipment to try on clothes virtually and displays to keep track of news and information. 

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Doctor, heart attack victim film 100th episode of TV show on health

Doctor, heart attack victim film 100th episode of TV show on health | Heart and Vascular Health | Scoop.it

The taping of the 100th episode of our community television program promoting heart and vascular health in our community was profiled in our local newspaper. On air since 2008.
To see an archive of old shows with links for viewing check out: http://pmaonline.com/cardiology_video.htm

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Are Drugs Better Than Carotid Stents?

Are Drugs Better Than Carotid Stents? | Heart and Vascular Health | Scoop.it

My comment: This is an important question for our patients and unfortunately we will porbably never get an answer because the study would be expensive and there is no likely source for funding an outcomes study that would be needed.  With all blocked arteries (heart, head or legs) the options for treatment are medications to control or slow the progression of the blockage OR stents OR surgery.  The benefits and safety hazards are improving for all three so making comparisons using older data is not useful,.  For now we know stents are about equivalent to surgery in blocked carotid arteries.  Is medicine equal or even better? 

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A debate is taking place among physicians over whether drug therapies to prevent stroke have surpassed stents or carotid artery surgery as the best treatment for many patients with artery blockage in the neck.

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ACO part of Obamacare not popular

ACO part of Obamacare not popular | Heart and Vascular Health | Scoop.it

My comment: ACO's (accountability care organizations) are programs only bureaucrats love.  It may not matter if patients, doctors and hospitals hate them; there may not be an option in the near future.

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Those who would be expected to carry out Obamacare are beginning to revolt.

Although it has been championed as a potential model by the Obama administration, the Cleveland Clinic (pictured)  has declined to participate in the administration's "pioneer" ACO progrm. Hospitals & doctors are revolting because ACOs saddle them with significant financial risks and substantial new administrative burdens. Patients won’t like them because they’ll put government bureaucrats — not their doctors — in charge of their care. Ultimately, ACOs will reduce competition throughout the healthcare market place — and raise costs.

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Infographic - Patient Non Adherence in the US

Infographic - Patient Non Adherence in the US | Heart and Vascular Health | Scoop.it

My Comment:  Non adherence and Non compliance are big problems.  It is difficult to solve because its multifactorial.  I beleive that regular phsycian review of the utility of the medications (at each visit) and emphasis on why each drug is important and backing this up with objective measures (Blood pressure, cholesterol results) is the best strategy to improve adherence.  Assuming patuients are taking their medications is definiitely ineefective. The pharma industry can help with education on disease states.

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Did you know that a massive $30 billion in revenue is lost each year due to non-adherence?

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The Deadly Threat of Silent Heart Attacks

The Deadly Threat of Silent Heart Attacks | Heart and Vascular Health | Scoop.it
Silent heart attacks are even more common in older adults than heart attacks that immediately come to the attention of doctors and patients, according to recent study in The Journal of the American Medical Association.
The research underscores the importance of paying attention to lingering, hard-to-pin-down symptoms in older adults, experts say. Many elderly men and women tend to dismiss these; caregivers shouldn’t let that happen.
The JAMA report is based on data from 936 men and women ages 67 to 93 from Iceland who agreed to undergo EKGs and magnetic resonance imaging exams to detect whether heart attacks had occurred. EKGs assess the heart’s electrical activity, while M.R.I.’s look at its mechanical pumping activity.
When results were tallied, silent heart attacks were twice as common (22 percent) among older patients as recognized heart attacks (10 percent). Five years after tests were administered, death rates for patients with both recognized and silent heart attacks were 23 percent, almost double the 12 percent death rate for older adults who’d never experienced a myocardial infarction, the technical name for heart attack.
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U.S. Moves to Shut Down Websites Owned by Canada Drugs

U.S. Moves to Shut Down Websites Owned by Canada Drugs | Heart and Vascular Health | Scoop.it
U.S. officials moved this week to shut down websites owned by Canada Drugs, the Internet pharmacy and drug wholesaler that distributed counterfeit Avastin to U.S. doctors last year.

The decade-old Canada Drugs has prospered by filling millions of prescriptions for American customers with cheaper, price-controlled drugs from Canada and around the world. But the case of the fake Avastin, a cancer treatment, has ratcheted up pressure to rein in a once-bustling business of cross-border pharmaceutical sales, long opposed by the drug industry but popular with some American customers seeking discounted medicine.

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Escape Fire: The Fight to Rescue American Healthcare

Escape Fire: The Fight to Rescue American Healthcare | Heart and Vascular Health | Scoop.it

ESCAPE FIRE:

Escape Fire: The Fight to Rescue American Healthcare – which is scheduled for release this Friday – October 5th (select theaters nationwide, On Demand and on iTunes)

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From Forbes review: http://goo.gl/ILSqd

The filmmakers were so captivated by Escape Fire story that they chose to name the film after it. From here it follows the traditional – and compelling documentary style of threaded narratives. These, in turn, highlight specific ways in which our healthcare system is a raging wildfire driven by perverse economic incentives. A few examples:

The cardiac patient who had 27 cardiac catherizations and more than 7 stents – without regard to her high cholesterol, diabetes and high blood pressure. The immersive lifestyle program pioneered by Dean Ornish for reversing heart disease – which took 16 years to be approved for medicare reimbursement.
The infantryman returning from a 9-month tour in Afghanistan (during which his platoon of 23 was reduced to 8) clearly coming to grips with a new enemy – PTSD
The primary care physician who’s frustrated by the constant demands to “increase her productivity”

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Access to Doctors' Notes Aids Patients' Treatment

Access to Doctors' Notes Aids Patients' Treatment | Heart and Vascular Health | Scoop.it

My comment: Patients care improves when they can collaborate on the health record,  when the data is shared, reviewed and corrected.  

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Patients who have access to doctor's notes in their medical records are more likely to understand their health issues, recall what the doctor told them and take their medications as prescribed, according to a study published Monday.

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Failure to Follow-Up Test Results for Ambulatory Patients

Failure to Follow-Up Test Results for Ambulatory Patients | Heart and Vascular Health | Scoop.it

My comment:: up to 36% of x-ays not being followed up by physicians is so high it is hard to believe.  Even the low end of the range (1%) is too high since patient's can suffer significant consequences with a delay in diagnosis or treatment.  Patient's best treatment is getting a copy of  results for their own review.  Either a paper copy of the report at your office visit or in the future via a patient portal that securely displays results.

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Nineteen studies reviewed and reported wide variation in the extent of tests not followed-up: 6.8% to 62% for laboratory tests; 1.0% to 35.7% for radiology. The impact on patient outcomes included missed cancer diagnoses. Test management practices varied between settings with many individuals involved in the process. There were few guidelines regarding responsibility for patient notification and follow-up. Quantitative evidence of the effectiveness of electronic test management systems was limited although there was a general trend towards improved test follow-up when electronic systems were used. Failure to follow-up test results is an important safety concern which requires urgent attention. Solutions should be multifaceted and include: policies relating to responsibility, timing and process of notification; integrated information and communication technologies facilitating communication; and consideration of the multidisciplinary nature of the process and the role of the patient. It is essential that evaluations of interventions are undertaken and solutions integrated into the work and context of ambulatory care delivery.

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Why do people faint?

Why do people faint? | Heart and Vascular Health | Scoop.it
Fainting, also called syncope, is a sudden and brief loss of consciousness followed by a spontaneous return to wakefulness—people who faint “black out” and then “come to” on their own without outside intervention.

“The elderly have syncope more commonly than any other group,” which can put them at risk of falls and fractures. Often the spells are caused by actions as simple as changing position or eating a meal. When we stand up, “about half a liter of blood immediately goes to the legs and the lower abdomen,” and eating also pulls blood from the brain to the gut. Our bodies compensate by raising the heart rate to get blood to the brain. But elderly people can’t always restore their blood flow, and dehydration or certain medications can exacerbate the problem.

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How Exercise Can Help You Master New Skills

How Exercise Can Help You Master New Skills | Heart and Vascular Health | Scoop.it
Physical exercise may help the brain to consolidate and store muscle memories, a new study found. Learn, then exercise and retain a studier memory.
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Stop Diabetes

Stop Diabetes | Heart and Vascular Health | Scoop.it

Nice list of Myths and assiocated myth busting facts. My favorite myth:" It's possible to have "just a touch" or "a little" diabetes."

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American Diabetes Association ifights against diabetes and builds momentum to end this devastating disease. What will YOU do to Stop Diabetes?

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Sifting Social Media for Early Signs of Adverse Drug Reactions

Sifting Social Media for Early Signs of Adverse Drug Reactions | Heart and Vascular Health | Scoop.it

Collaborators at University of Virginia will analyze social media to identify adverse drug reactions much faster than existing methods.

The promise of social media as an early-warning system for adverse drug reactions. They analyzed four types of public online media (websites, blogs, Web forums and social networking sites) posted from 2000 to early 2012 and were able to identify hundreds of thousands of documents containing adverse drug reaction-related information. The preliminary results suggest that these documents can accurately provide warnings earlier – in some cases, years earlier – than existing channels.

Online medical information is plagued by medical Web spam: countless pages of medical misinformation designed to exploit consumer fears and sell unregulated remedies ranging from herbal remedies for arthritis to anti-aging skin creams. Experts estimate that more than 20% of all medical information on the Web is spam.

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Symplicity HTN-3 Clinical Trial

Symplicity HTN-3 Clinical Trial | Heart and Vascular Health | Scoop.it

Website from the manufacturer Medtronic sponsoring the US trial for renal denervation in resistent hypertension.  This device is available for use in Australia, Canada and Europe, but not yet approved in the US.  The trial Symplicity HTN-3 is a US Pivotal trial for American patients with resistant hypertension defined as blood pressure greater than 160 despite at least 3 maximum dose medications including at least one diuretic.  The trial section http://www.symplifybptrial.com/candidate/ gives patients an opportunity to see if they are candidates fotr the trial.

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How to Fend Off a Food Craving

How to Fend Off a Food Craving | Heart and Vascular Health | Scoop.it
New research challenges the body knows what it needs theory. What the siren call of that cupcake really means—and how to ignore it.

A cupcake is calling you.

Functional MRI scans showed that sensory memory food cravings activate the same parts of the brain that drug and alcohol cravings do, including the hippocampus, which helps store memories; the insula, involved in perception and emotion; and the caudate, which is important for learning and memory. The circuit is driven by dopamine, the neurotransmitter responsible for reward-driven learning.

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How Physicians Interpret Research Funding Disclosures

How Physicians Interpret Research Funding Disclosures | Heart and Vascular Health | Scoop.it

My comment:  Doctors can do a good job distinguishing high quality research from lower quality research, and use this discriminating ability to make wise choices for their patients.  BUT, doctors discount the value of research if it is sponsored by drug companies.  This surprises me.  Are doctors now appropriately cynical after the scandals that occurred with incomplete & fraudulent reporting during Vioxx and Avandia development ? This study implies that doctors don't beleive big pharma can be trusted.

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The 269 respondents (53.5% response rate) perceived the level of study rigor accurately. Physicians reported that they would be less willing to prescribe drugs tested in low-rigor trials than those tested in medium-rigor trials (odds ratio, 0.64; 95% confidence interval [CI], 0.46 to 0.89; P=0.008) and would be more willing to prescribe drugs tested in high-rigor trials than those tested in medium-rigor trials (odds ratio, 3.07; 95% CI, 2.18 to 4.32; P<0.001). Disclosure of industry funding, as compared with no disclosure of funding, led physicians to downgrade the rigor of a trial (odds ratio, 0.63; 95% CI, 0.46 to 0.87; P=0.006), their confidence in the results (odds ratio, 0.71; 95% CI, 0.51 to 0.98; P=0.04), and their willingness to prescribe the hypothetical drugs (odds ratio, 0.68; 95% CI, 0.49 to 0.94; P=0.02). Physicians were half as willing to prescribe drugs studied in industry-funded trials as they were to prescribe drugs studied in NIH-funded trials (odds ratio, 0.52; 95% CI, 0.37 to 0.71; P<0.001). These effects were consistent across all levels of methodologic rigor.

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