Protecting health, saving lives—millions at a time” is the motto of the Johns Hopkins Bloomberg School of Public Health. Although not the principal motivation for or lesson from the assessment by Chetty and colleagues published in JAMA,1 encouraging prospects for community health strategies are suggested by the findings in this article on income and life expectancy.
In an impressive analysis based on mortality data and deidentified tax records with more than 1.4 billion person-year observations and nearly 7 million deaths among individuals living in the United States during the 15 years between 1999 and 2014, Chetty et al confirm the long-observed association between higher income and longer life expectancy, as well as the recent increase in the gap in life expectancy between the richest and poorest 5% of the US population.1 Looking specifically at the lowest income quartile, Chetty et al also found little association between life expectancy and various measures of access to medical care, physical environments, employment conditions, or levels of income inequality.
James discusses conceptual models to understand health promotion. This includes Tannahill's model, Beattie's model and Naidoo and Wills' typology of health promotion. Other conceptual models in health promotion are available!
University of Melbourne Professor Rob Moodie and colleagues from the Obesity Policy Coalition and The Australian Health Policy Collaboration have issued a frank assessment of the health promotion landscape in today’s Medical Journal of Australia. The authors say Australia is losing the war against alcohol and weight-related illnesses and lacks a comprehensive approach to prevention.
Objective To investigate the amount of sugars in fruit juices, juice drinks and smoothies (FJJDS) marketed to children.
Design We surveyed the sugars content (per 100 ml and standardised 200 ml portion) of all FJJDS sold by seven major UK supermarkets (supermarket own and branded products). Only products specifically marketed towards children were included. We excluded sports drinks, iced teas, sugar-sweetened carbonated drinks and cordials as being not specifically marketed towards children.
Results We identified 203 fruit juices (n=21), juice drinks (n=158) and smoothies (n=24) marketed to children. Sugars content ranged from 0 to 16 g/100 ml. The mean sugars content was 7.0 g/100 ml, but among the 100% fruit juice category, it was 10.7 g/100 ml. Smoothies (13.0 g/100 ml) contained the highest amounts of sugars and juice drinks (5.6 g/100 ml) contained the lowest amount. 117 of the 203 FJJDS surveyed would receive a Food Standards Agency ‘red’ colour-coded label for sugars per standardised 200 ml serving. Only 63 FJJDS would receive a ‘green’ colour-coded label. 85 products contained at least 19 g of sugars—a child's entire maximum daily amount of sugars. 57 products contained sugar (sucrose), 65 contained non-caloric sweeteners and five contained both. Seven products contained glucose-fructose syrup.
Conclusions The sugars content in FJJDS marketed to children in the UK is unacceptably high. Manufacturers must stop adding unnecessary sugars and calories to their FJJDS.
An updated Cochrane Review, published today in the Cochrane Library, says that the benefits of a variety of interventions intended to reduce sitting at work are very uncertain.
Millions of people worldwide sit at a desk all day, and over recent years this has led to increased levels of physical inactivity in the work place. Health experts have warned that long periods of sitting can increase the risk of heart disease and obesity. There are a number of different approaches to reduce the amount of time we spend sitting down while at work. One option that is increasing in popularity is the sit-stand desk. These are desks that are designed to allow you to work at your desk sitting down or standing up.
A team of Cochrane researchers updated a systematic review that looked at the effects of different strategies to encourage people to reduce the amount of time they spend sitting at work. They looked at 20 studies with a total of 2,174 participants from the US, the UK and Europe. They included evidence from both randomized and non-randomized studies.
This article criticizes the predominant use of fear appeals in social marketing. Laboratory studies, which have been the basis for most of the research on fear appeals and which generally suggest that high fear works, have limitations that include forced exposure, short-term measurement, and an overdependence on student samples. Although, unfortunately, field research evaluations of fear appeals are few, they usually reveal that fear has both weaker effects and unintended deleterious effects in real-world social marketing campaigns. Ethical concerns about fear appeals include maladaptive responses such as chronic heightened anxiety among those most at risk and, paradoxically, complacency among those not directly targeted, and increased social inequity between those who respond to fear campaigns, who tend to be better off, and those who do not, who tend to be the less educated and poorer members of society. Alternatives to fear appeals are the use of positive reinforcement appeals aimed at the good behavior, the use of humor, and, for younger audiences, the use of postmodern irony.
"Mad Men" is famous for illuminating a bygone era, replete with three-martini lunches, glamorous clothing, and, of course, casual sexism.
The rampant sexism in "Mad Men" was typical of the 1960s, when the outlook for women in America was just beginning to change. While the "second wave" of feminism began in the '60s, mainstream America was still very much a "man's world."
The World Economic Forum’s Global Agenda Council on Social innovationdefines social innovation as “the application of innovative, practical, sustainable, market-based approaches to benefit society in general, and low-income or under-served populations in particular”.
Traditionally associated with social entrepreneurs, this tool is increasingly being adopted by business. This is a trend to be welcomed, supported and replicated as companies - big or small, multinational or national - can contribute to taking the practice of social innovation to a significantly larger scale. And the world needs solutions at scale to tackle key societal challenges of our age, as Zia Khan, VP of Initiatives and Strategy at The Rockefeller Foundation, explains in this video.
A culturally sensitive lifestyle intervention showed promise at motivating Latinas living in the U.S. to eat better and exercise more by connecting healthy-living behaviors with the lives of saints and prominent religious figures, new studies found.
Several recent papers about the project, including a new study published in the Journal of Aging and Health, add to a growing body of research that indicates health interventions may have greater success promoting lifestyle changes among the nation’s rapidly growing Latino population if the content is culturally sensitive, integrating the spiritual and family values that are central to these women’s lives.
Objective To determine whether increasing calcium intake from dietary sources affects bone mineral density (BMD) and, if so, whether the effects are similar to those of calcium supplements.
Design Random effects meta-analysis of randomised controlled trials.
Data sources Ovid Medline, Embase, Pubmed, and references from relevant systematic reviews. Initial searches were undertaken in July 2013 and updated in September 2014.
Eligibility criteria for selecting studies Randomised controlled trials of dietary sources of calcium or calcium supplements (with or without vitamin D) in participants aged over 50 with BMD at the lumbar spine, total hip, femoral neck, total body, or forearm as an outcome.
Results We identified 59 eligible randomised controlled trials: 15 studied dietary sources of calcium (n=1533) and 51 studied calcium supplements (n=12 257). Increasing calcium intake from dietary sources increased BMD by 0.6-1.0% at the total hip and total body at one year and by 0.7-1.8% at these sites and the lumbar spine and femoral neck at two years. There was no effect on BMD in the forearm. Calcium supplements increased BMD by 0.7-1.8% at all five skeletal sites at one, two, and over two and a half years, but the size of the increase in BMD at later time points was similar to the increase at one year. Increases in BMD were similar in trials of dietary sources of calcium and calcium supplements (except at the forearm), in trials of calcium monotherapy versus co-administered calcium and vitamin D, in trials with calcium doses of ≥1000 versus <1000 mg/day and ≤500 versus >500 mg/day, and in trials where the baseline dietary calcium intake was <800 versus ≥800 mg/day.
Conclusions Increasing calcium intake from dietary sources or by taking calcium supplements produces small non-progressive increases in BMD, which are unlikely to lead to a clinically significant reduction in risk of fracture.
Le premier geste du matin ? Aller sur Facebook pour 48 % des 18-34 ans. En moyenne pour les utilisateurs du réseau social, ce sera 14 connexions chaque jour. Et, au total, 1 h 45 sera, là aussi en moyenne, passée sur les réseaux sociaux, de Twitter à Snapchat. Dans une courte vidéo, la chaîne YouTube Maître Chat revient sur cette addiction qu’on connaît tous. Et propose des pistes quant à une explication scientifique de cette forme de dépendance virtuelle.
The WHO Health Behaviour in School-aged Children (HBSC) study has influenced policy and legislation across the WHO European Region for over 30 years. The latest update of the study, based on a survey of over 200 000 young people in 42 countries, has been published.
So much of the discussion around positioning is around the ‘right’ way, the ‘best’ way. Like different sects within a religion, there is often little difference in a meaningful sense between the philosophies, but great difference between the practitioners.
In fact, we believe the resolution lies in what positioning is ‘for’ and when it is done…
We are in the middle of an explosion in the amount of data that exists about the health of individuals.
This data is coming in via smartphones, wearables such as Fitbits, personal genomics and the digitisation of health records. Its volume will soon dwarf that held by universities and institutes, and I believe it will, in time, become a great engine of medical discovery. From the telescope to the MRI machine, new sources of data are often what catapults science forward.
In particular, this rich data can help us understand more clearly the huge variation in response to treatment that individuals display.
The same pill, therapy or diet will often have widely different effects from person to person. If we can understand and predict this more clearly, then we can target care where it will do most good, leading to a more effective healthcare system, as well as improving efficiency. Traditional research techniques are mainly focused on examining average responses but with this richer data we can begin to understand variation.
- See more at: http://www.nesta.org.uk/2016-predictions/patients-become-citizen-scientists#sthash.eXZSHXFb.dpuf
Sitting for eight hours a day is bad for our health, this we know. But there's not enough evidence to prove standing is any better for our wellbeing, according to one meta-analysis.
In recent years, an entire industry has been trying to find a solution to counteract this health scare. After all, premature death from an increased risk of diabetes and cardiovascular problems aren't something to be taken lightly. However, a meta-analysis published in the Cochrane Database of Systematic Reviewslooked at 20 studies which touted the benefits of standing. These findings may have been overstated.
Scientists have linked physical exercise to brain health for many years.
In fact, there’s compelling evidence that physical exercise helps build a brain that not only resists shrinkage, but increases cognitive abilities1 by promoting neurogenesis, i.e. your brain’s ability to adapt and grow new brain cells.
In essence, physical activity produces biochemical changes that strengthen and renew not only your body but also your brain — particularly areas associated with memory and learning.
The converse is also true. Researchers have shown a sedentary lifestyle correlates to brain shrinkage, which increases your risk of memory loss and other cognitive problems.
“A new study3 published ... in Neurology links low levels of physical fitness in midlife to lower brain tissue volume two decades later. These findings affirm the role physical fitness plays in protecting the brain as we age.
‘Brain volume is one marker of brain aging...and this atrophy is related to cognitive decline and increased risk for dementia,’ says lead author Nicole Spartano ...
‘So it is important to determine the factors — especially modifiable factors, such as fitness — that contribute to brain aging.’”
Chrono Therapeutics, the maker of a wearable, smartphone-connected drug delivery device for smoking cessation, has completed a small randomized trial that shows that nicotine replacement therapy delivered with its device can reduce cravings to a statistically significant degree compared to a placebo delivered the same way.
The trial was a randomized, double-blinded study of 24 adult men who smoked more than 10 cigarettes per day. After 30 hours using the device, either with nicotine replacement therapy or with a placebo, users were polled about their cravings during the day using three different validated outcome measures. The group getting the drug had fewer cravings, and those results were both statistically significant and clinically meaningful according to all three tests.
"Before we got the results we spoke with one of our clinical advisors," Chrono CEO Alan Levy told MobiHealthNews. "...He said 'Don’t expect to see a difference because in the phase one study, when the subjects are not being stressed at all, their cravings are very low. So don’t expect to see a difference between the placebo, because you don’t see that against the dumb patches or the drugs that are used for smoking cessation.' When we got the results, not only did we see a difference, but we saw one that was statistically significant and … clinically meaningful as well."
Chrono delivers nicotine replacement therapy in a similar manner as nicotine patches. But, rather than a gradual, timed release, Chrono's device delivers the drugs at particular times that coordinate with the user's cravings. At first, the drug is delivered at times when cravings are most likely -- like first thing in the morning and before meals. A companion app also delivers coaching to help users cope with cravings, and these messages are also timed to coincide with cravings and with drug delivery. In other words, it treats both the psychological and physiological symptoms of addiction.
"One of the major problems with all of these products is very poor adherence," Levy told MobiHealthNews. "With our product, it's the only product where we can measure whether they’re actually using the product. If someone buys one of the other patches, or a gum, you have no idea if they're actually using it. With us, there’s a sensor and we know if they’re using it and we can provide realtime reminders. And the other part of it is behavioral support. Providing encouragement, providing recognition, setting up networks -- all of those things significantly improve patients’ quit rates if they use them. We believe our compliance will be much higher, so in addition to a smart way of delivering the drug we’ll have improved adherence and a behavioral support that is much more effective."
Chrono has received at least $32.1 million in funding from Canaan Partners, 5 am Ventures, Fountain Healthcare Partners, Rock Health, and two strategic investors: GE Ventures and the Mayo Clinic. The company has also received NIH grants totaling $4.5 million to support research into its drug delivery system.
The company is still preparing to file for its FDA clearance, but predicts it will be cleared by the end of 2018. The next step will be to do a two-week trial in a real world setting where the device is actually compared against the status quo -- existing patches, gums, and behavioral programs. Once the system is cleared, it will be sold at a midrange price point for the market, according to Levy, around $500 for a 10-week course.
If smoking cessation is a successful use case, the company also intends to explore use cases in Parkinson's disease and opioid addiction.
"It is an epidemic," Levy said. "More people are dying from opioid overdose than automobile accidents and there is currently no FDA-approved approach to weaning people off of opioids, the way our system weans people off of nicotine."
Sazi da morire. Un’inchiesta dedicata alle cattive abitudini alimentari e al racconto di quanto queste incidono sulla nostra salute. Il Servizio Sanitario Nazionale non riesce ad affrontare la spesa crescente, allora come fare?
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