Researchers clear up the confusion over whether fat is really good for the heart or not
There’s no question that nutrition studies tend to whipsaw—a lot—between telling you something is good for your health and warning against it.
In recent months, the news over dietary fat certainly fell into this category. While for decades doctors warned us about the dangers of too much saturated fat—the kind found in red meat, dairy and fried foods—some studies seemed to suggest that people who cut back on these verboten foods didn’t have any lower risk of heart problems than those who didn’t. That prompted advice to stick to butter over margarine, and not to worry too much about fat.
#PublicHealth challenges, progress & successes #HealthImprovement #HealthProtection #QualityImprovement A focus on equity, reducing health inequalities, tackling poverty A multidisciplinary profession #APHCentury While focusing on 1906-2006 the story of course started earlier and continues...
The high prevalence of cigarette smoking and tobacco related morbidity and mortality in people with chronic mental illness is well documented. This review summarizes results from studies of smoking cessation treatments in people with schizophrenia, depression, anxiety disorders, and post-traumatic stress disorder. It also summarizes experimental studies aimed at identifying biopsychosocial mechanisms that underlie the high smoking rates seen in people with these disorders. Research indicates that smokers with chronic mental illness can quit with standard cessation approaches with minimal effects on psychiatric symptoms. Although some studies have noted high relapse rates, longer maintenance on pharmacotherapy reduces rates of relapse without untoward effects on psychiatric symptoms. Similar biopsychosocial mechanisms are thought to be involved in the initiation and persistence of smoking in patients with different disorders. An appreciation of these common factors may aid the development of novel tobacco treatments for people with chronic mental illness. Novel nicotine and tobacco products such as electronic cigarettes and very low nicotine content cigarettes may also be used to improve smoking cessation rates in people with chronic mental illness.
We’ve all heard the reports that children today spend too much time in front of TVs and computers, and therefore are less physically fit compared to children in decades past. But what does the evidence say on the matter?
A new systematic review presented last month at the annual meeting of the American Heart Association offers an interesting new analysis on the topic. For the review, Australian researchers analyzed 50 studies conducted between 1964 and 2010 that measured the running fitness of 25 million kids ages 9 to 17. The studies included children living in 28 countries.
Researchers compared cardiovascular endurance of the children by measuring how long they could run in a given time period, or how far it took them to run a specific distance (ranging from a half mile to two miles.)
What if the media covered alcohol like it does other drugs? This was a question that came up in my coverage of flakka, a synthetic drug that made headlines after law enforcement blamed it for people running in the streets naked in delusional paranoia. What follows is a satirical attempt at capturing that same type of alarmist reporting, but for a substance that really causes widespread and severe problems.
NEW ORLEANS — An ongoing drug epidemic has swept the US, killing hundreds and sickening thousands more on a daily basis.
The widespread use of a substance called "alcohol" — also known as "booze" — has been linked to erratic and even dangerous behavior, ranging from college students running naked down public streets to brutal attacks and robberies.
OBJECTIVES: The purpose of this article is to review all randomized control trials (RCTs) that have looked at the health effects of yoga on pregnancy, and to present their evidence on the specific ways in which pregnant women, and their infants can benefit from yoga intervention. The purpose is also to determine whether yoga intervention during pregnancy is more beneficial than other physical exercises. METHODS: Four databases were searched using the terms yoga and (pregnancy or pregnant or prenatal or postnatal or postpartum). Databases were searched from January 2004 to February 2014. RESULTS: Ten randomized controlled trials were evaluated. The findings consistently indicate that yoga intervention presented with lower incidences of prenatal disorders (p<0.05), and small gestational age (p<0.05), lower levels of pain and stress (p<0.05), and higher score of relationship (p<0.05). In addition, yoga can be safely used for pregnant women who are depressed, at high-risk, or experience lumbopelvic pain. Moreover, yoga is a more effective exercise than walking or standard prenatal exercises. CONCLUSIONS: The findings suggest that yoga is a safe and more effective intervention during pregnancy. However, further RCTs are needed to provide firmer evidence regarding the utility and validity of yoga intervention.
Research into the effectiveness of comic books as health education tools overwhelmingly consists of studies evaluating the information learnt as a result of reading the comic, for example using preintervention and postintervention questionnaires. In essence, these studies evaluate comics in the same way in which a patient information leaflet might be evaluated, but they fail to evaluate the narrative element of comics. Health information comics have the potential to do much more than simply convey facts about an illness; they can also support patients in dealing with the social and psychological aspects of a condition. This article discusses how some common elements of educational comics are handled in a selection of comics about diabetes, focusing on the more personal or social aspects of the condition as well as the presentation of factual information. The elements examined include: fears and anxieties; reactions of friends and family; interactions with medical professionals; self-management; and prevention. In conclusion, the article argues that comics, potentially, have many advantages over patient information leaflets, particularly in the way in which they can offer ‘companionship’, helping patients to address fears and negative feelings. However, empirical studies are required to evaluate educational comics in a way which takes account of their potential role in supporting patients in coming to terms with their condition, as well as becoming better informed.
Babies born too soon or too small face many difficulties, including increased rates of mortality and lifelong disability.1 The 2012 Global Action Report on Preterm Birth ‘Born Too Soon’ presents a sobering picture: 15 million (1 in 10) babies every year are born too soon, with these rates appearing to be rising globally.1 Low levels of maternal education have been clearly associated with adverse birth outcomes such as preterm birth and low birth weight.2–4 While education is only one risk factor—alongside other critical factors such as maternal age, birth order and spacing, multiple pregnancies, body weight, chronic disease, mental health, infectious diseases, health risk behaviours such as smoking, intimate partner violence, and access to screening and health services1,5—it matters, because education enables girls and women to make informed decisions about their reproductive health and interactions with the healthcare system.6 Increasing education levels is a key component of programmes directed at reducing adverse birth outcomes.1
While the prevalence (and burden) of preterm birth is highest in the poorest countries, namely sub-Saharan Africa and southern Asia, it also affects richer countries including those in the Americas and Europe. More country-specific data are needed to assist our understanding of the extent of the problem and the complex interplay of contributory risks. This is why the paper by Ruiz et al7 is a welcome addition to the literature. The authors examine the association between attained educational qualifications of mothers and two adverse birth outcomes (preterm birth, low for gestational age birth weight) in their infants. Conducted as part of the ‘DRIVERS for Health Equity’ research programme, this meta-analysis has systematically analysed data from studies of over 75 000 babies in 12 countries across Europe (France, the Netherlands, the UK, the Czech Republic, Ukraine, Finland, Norway, Sweden, Greece, Italy, Portugal and Spain). Notably, these countries represent the northern, western, southern and central/eastern parts of Europe, thus providing a more complete picture of how maternal education may influence disparities in pregnancy duration and infant birth weight.
Questo è un post sgarbato. Nella passata notte di San Lorenzo di cadente c'era ben altro che le stelle: (s)cadenti il buon senso, la responsabilità per la propria salute, la logica del gruppo (o branco?) e la premura verso i propri figli. Scadente, tutto sommato, l'amore per la vita. Nella sola notte di ieri, il Servizio 118 della mia Asl è stato costretto a intervenire in 11 casi per stato di ebbrezza: 11 potenziali tragedie ma anche 11 ambulanze sottratte a chi poteva seriamente averne bisogno per stati di malattia. Degli 11 ben 6 erano minorenni... I pochi denari che lo Stato mi passa mi servono per curare malati di cancro, persone con disabilità, pazienti cronici e non autosufficienti. Possibilmente non i "bimbominkia" grandi e piccini in cerca del fottutissimo quarto d'ora indimenticabile. Avviso ai naviganti delle terre e dei mari di agosto: chi beve non è FIGO, è un COGLIONE!
Is running really a better form of exercise than walking, given that running can lead to more injuries?At Vox, I sit next to health reporter Sarah Kliff, who trains for half-marathons and triathlons with a casualness most people reserve for grocery shopping. But in the year I’ve known Sarah, she’s suffered plantar fasciitis and a stress fracture. She’s hobbled around in running shoes for months because everything else hurt too much, and she’s currently sporting a big blue brace on her left leg to help cushion the tiny cracks in the bones of her foot brought on from too much wear and tear.
In many ways, Sarah is a perfect case study in how to think about the benefits and risks of running versus walking. Running has greater health benefits than walking (Sarah is super fit), but it also carries a much bigger risk of injury (see Sarah’s foot brace). So which effect dominates? To find out, I first searched for "randomized control trials" and "systematic reviews" on running, walking, and exercise at PubMedhealth (a free search engine for health research) and inGoogle Scholar. I wanted to see what the highest-quality evidence — trials and reviews are thegold standard— said about the relative risks and benefits of these two forms of exercise.
17-year-olds are the ones that are really affected when 18 is the minimum age to drinkShould the minimum drinking age be lowered to 18 from the national mandate of 21, established by the National Minimum Drinking Age Act of 1984? Debate has ebbed and flowed, but many people believe that if a person can fight for their country and vote at 18, what’s a swig of booze?
A lot, argues Andrew Plunk, assistant professor of pediatrics at Eastern Virginia Medical School and lead author of a studypublished Monday in the Journal of Studies on Alcohol and Drugs. The study shows that in the run-up to the landmark 1984 act, states with lower minimum drinking ages saw higher high school dropout rates—in addition to what’s been already documented as other effects, such as lower educational attainment, higher substance abuse, and more. (The research was supported by grants from the National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism.)
Le campagne di educazione di massa continuano a basarsi sul presupposto che la causa ultima delle malattie, e l’obiettivo su cui agire, risieda nei singoli individui e nelle libere scelte che essi compiono. Focalizzarsi sulla responsabilità individuale fornisce un’efficace copertura alle industrie del tabacco, alimentari, di bevande zuccherate e alcolici tese a difendere i loro profitti contro la minaccia di regolamentazioni o restrizioni governative.
Nonostante il messaggio della Commissione dell’Organizzazione Mondiale della Sanità (OMS) sui determinanti sociali della salute e il dibattito sulla “determinazione sociale della salute” abbiano ormai raggiunto aziende sanitarie, assessorati alla sanità e forse anche qualche reparto ospedaliero, la visione dominante della promozione della salute tra gli operatori del settore sembra rimanere inesorabilmente fossilizzata sul cambiamento dello “stile di vita” che il singolo individuo è sollecitato a compiere. Un’immagine forse semplicistica della situazione è data dalla frequenza con cui compaiono le espressioni “determinanti sociali” e “stile/i di vita” nel testo del Piano Nazionale della Prevenzione 2014-2018 del Ministero della Salute: due volte la prima, ventisei volte la seconda.
Alcohol consumption is proposed to be the third most important modifiable risk factor for death and disability. However, alcohol consumption has been associated with both benefits and harms, and previous studies were mostly done in high-income countries. We investigated associations between alcohol consumption and outcomes in a prospective cohort of countries at different economic levels in five continents.
We included information from 12 countries participating in the Prospective Urban Rural Epidemiological (PURE) study, a prospective cohort study of individuals aged 35–70 years. We used Cox proportional hazards regression to study associations with mortality (n=2723), cardiovascular disease (n=2742), myocardial infarction (n=979), stroke (n=817), alcohol-related cancer (n=764), injury (n=824), admission to hospital (n=8786), and for a composite of these outcomes (n=11 963).
We included 114 970 adults, of whom 12 904 (11%) were from high-income countries (HICs), 24 408 (21%) were from upper-middle-income countries (UMICs), 48 845 (43%) were from lower-middle-income countries (LMICs), and 28 813 (25%) were from low-income countries (LICs). Median follow-up was 4·3 years (IQR 3·0–6·0). Current drinking was reported by 36 030 (31%) individuals, and was associated with reduced myocardial infarction (hazard ratio [HR] 0·76 [95% CI 0·63–0·93]), but increased alcohol-related cancers (HR 1·51 [1·22–1·89]) and injury (HR 1·29 [1·04–1·61]). High intake was associated with increased mortality (HR 1·31 [1·04–1·66]). Compared with never drinkers, we identified significantly reduced hazards for the composite outcome for current drinkers in HICs and UMICs (HR 0·84 [0·77–0·92]), but not in LMICs and LICs, for which we identified no reductions in this outcome (HR 1·07 [0·95–1·21]; pinteraction<0·0001).
Current alcohol consumption had differing associations by clinical outcome, and differing associations by income region. However, we identified sufficient commonalities to support global health strategies and national initiatives to reduce harmful alcohol use.
Population Health Research Institute, the Canadian Institutes of Health Research, Heart and Stroke Foundation of Ontario, AstraZeneca (Canada), Sanofi-Aventis (France and Canada), Boehringer Ingelheim (Germany and Canada), Servier, GlaxoSmithKline, Novartis, King Pharma, and national or local organisations in participating countries.
Researchers have said for years that alcohol is more dangerous than marijuana. But what does that mean, exactly? And how do we know?
It's certainly not because of any government-acknowledged evaluation. The federal government's scheduling system evaluates drugs by medical value, first, and abuse potential, which is poorly defined under the law, second — but it excludes alcohol and tobacco altogether. Even if the federal classifications included alcohol and tobacco, both would likely fall in the same category as marijuana — schedule 1 — since they have no acknowledged medical use and some potential for abuse, making it hard to compare the drugs based off that.
This has left it up to researchers and drug experts to evaluate which drugs are truly the most dangerous. A 2010 study published in The Lancet, led by drug expert David Nutt, evaluated the use of 20 drugs in the UK, putting alcohol at the top of its harms rankings and hallucinogens at the bottom. Here at Vox, I've pointed out that alcohol is one of the three deadliest drugs in America.
BackgroundThe input of youth with intellectual disabilities in health promotion and health disparities research is essential for understanding their needs and preferences. Regular physical activity (PA) is vital for health and well-being, but levels are low in youth generally, including those with intellectual disabilities. Understanding the perceptions of and barriers to PA as reported by youth with intellectual disabilities themselves is important for designing effective interventions.
Materials and methods
We developed a structured interview that queried youth with intellectual disabilities and typically developing youth (ages 13–21 years) about their enjoyment, preferences and perceived barriers to PA. We describe the development of this interview and present its test–retest reliability on 15 youth with intellectual disabilities and 20 typically developing youth.
Twenty-three of 33 questions were reliable in both groups. The results suggest that youth with intellectual disabilities can reliably report activities that they do or do not enjoy, as well as their beliefs and perceived benefits of PA.
Self-reported information on the experiences, preferences, beliefs and perceptions about among youth with intellectual disabilities is key for research efforts in health promotion and health disparities.
The NHS recommends that men should not regularly drink more than three to four units (two cans of 4.5% lager) a day and women two to three units (two small glasses of 12% wine) a day - although these drinking guidelines are currently under review and so could change.
In the American studies, light to moderate drinking was defined as up to 15g alcohol (a small glass of wine) per day for women and up to 30g alcohol (two 355ml bottles of beer) per day for men.
For women, the researchers observed, the risk of alcohol-related cancers - mainly breast cancer - increased even after one alcoholic drink a day.
No significant link was found in men who had never smoked, but among men who were current or ex-smokers, light or moderate drinking appeared to increase the risk of certain cancers.
The purpose of this systematic review is to identify, describe and assess the potential effectiveness of strategies to respond to issues of vaccine hesitancy that have been implemented and evaluated across diverse global contexts.
A systematic review of peer reviewed (January 2007–October 2013) and grey literature (up to October 2013) was conducted using a broad search strategy, built to capture multiple dimensions of public trust, confidence and hesitancy concerning vaccines. This search strategy was applied and adapted across several databases and organizational websites. Descriptive analyses were undertaken for 166 (peer reviewed) and 15 (grey literature) evaluation studies. In addition, the quality of evidence relating to a series of PICO (population, intervention, comparison/control, outcomes) questions defined by the SAGE Working Group on Vaccine Hesitancy (WG) was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria; data were analyzed using Review Manager.
Across the literature, few strategies to address vaccine hesitancy were found to have been evaluated for impact on either vaccination uptake and/or changes in knowledge, awareness or attitude (only 14% of peer reviewed and 25% of grey literature). The majority of evaluation studies were based in the Americas and primarily focused on influenza, human papillomavirus (HPV) and childhood vaccines. In low- and middle-income regions, the focus was on diphtheria, tetanus and pertussis, and polio. Across all regions, most interventions were multi-component and the majority of strategies focused on raising knowledge and awareness. Thirteen relevant studies were used for the GRADE assessment that indicated evidence of moderate quality for the use of social mobilization, mass media, communication tool-based training for health-care workers, non-financial incentives and reminder/recall-based interventions.
Overall, our results showed that multicomponent and dialogue-based interventions were most effective. However, given the complexity of vaccine hesitancy and the limited evidence available on how it can be addressed, identified strategies should be carefully tailored according to the target population, their reasons for hesitancy, and the specific context.
Blame your glucose-deprived brain for your rotten mood.
Long-term couples know all too well the perils of the early evening hours: that touchy time after work but before dinner hits the table.
It’s prime time for getting “hangry”, a handy portmanteau for hungry and angry. People commonly feel an uptick in anger or aggression when they’re hungry, says Dr. Brad Bushman, a professor of psychology at Ohio State University. “The brain needs fuel to regulate emotions, and anger is the emotion people have the most difficulty regulating,” he explains.
To understand the growth of income inequality—and the disappointing increases in workers’ wages and compensation as well as middle-class incomes—it is crucial to understand the divergence of pay and productivity.
Productivity growth, which is the growth of the output of goods and services per hour worked, provides the basis for the growth of living standards. Productivity and compensation (wages and benefits) of the typical worker grew in tandem over the early postwar period until the 1970s. In contrast, over the last few decades, productivity has grown substantially, but the hourly compensation of the typical worker has grown much less, especially in the last 10 years or so. In fact, the gap between productivity and compensation growth for the typical worker has been larger since the early 2000s than at any point in the post–World War II period. As such, the last 10 years have been a “lost decade” for American workers. In this light, it is more accurate to say that productivity provides the potential for growing living standards because there is no guarantee that productivity gains will be widely shared.
One key factor in the divergence between pay and productivity is the widespread erosion of collective bargaining that has diminished the wages of both union and nonunion workers. This will be demonstrated below by showing that the productivity–pay gap grew most in those states where collective bargaining coverage declined the most.
Un nouveau rapport publié dans la Revue canadienne de santé publique cerne les coûts annuels de soins de santé par individu qui fume, qui souffre d'obésité ou qui ne fait pas d'exercice.
Robert Strang, médecin en chef de la santé publique de la Nouvelle-Écosse, dit que ces statistiques sont utiles pour prendre des décisions quant au financement des programmes de prévention en santé.
Il n'a pas été surpris de constater qu'un fumeur coûte annuellement 3071 $ à l'État, qu'une personne obèse coûte 1453 $ et qu'une autre inactive coûte 712 $.
Il ne pense cependant pas que cela va changer le comportement de ces personnes.
« Je ne crois pas que les gens vont s'attarder à l'argument comme quoi ces facteurs coûtent cher à l'État. Par contre, les chiffres sont importants pour nous, pour le gouvernement, afin que l'on continue à investir dans la prévention.
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