Public Health

World Cancer Day: Foods That Prevent Cancer

World Cancer Day’ is celebrated annually on 4th of February to deepen our understanding of this killer disease. There has been enough research to validate that food acts as the most promising ammunition to fight the battle against cancer.

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1) What is the most common cause of cancer?

Cancer is the abnormal growth of cells. There are around 100 types of cancer. The most common types of cancer are – Men: Lung, esophagus, stomach, oral and pharyngeal cancers. Women: Cervix and breast cancers.

Cancer has many possible causes, the prominent ones being –

Genetics: Certain cancers run in families. For example, certain mutations in the BRCA1 or BRCA2 genes greatly increase a person’s risk of developing breast and ovarian cancer.

Smoking: Cigarette smoking accounts for around 30% of all cancer deaths. It is linked with increased risk of these cancers – lungs, larynx, oral cavity, nose and sinuses, esophagus, stomach, pancreas, cervix, kidney, bladder, ovary, colon, rectum and acute myeloid leukemia. Chewing of tobacco, a carcinogen, is linked to dental caries, gingivitis, oral leukoplakia, and oral cancer.

Diet and Lifestyle: Research shows that a poor diet and not having an active lifestyle are the key factors that can increase a person’s risk of developing cancer.

Three things to keep in mind in order to stay cancer free:

  • – Get to and stay at a healthy weight throughout your life.
  • – Be physically active on a regular basis.
  • – Make healthy food choices with a focus on plant-based foods.

2) What are the foods that up the risk of developing cancer?

Some cancers like that of the stomach have a more direct relationship with food. Foods which should be consumed in moderation to avoid the incidence of cancer are –

  • Processed meats such as bacon, sausages, lunch meats and hot dogs.
  • Choose fish, poultry, or beans instead of red meat (beef, pork, and lamb).
  • If you eat red meat, choose lean cuts and eat smaller portions.
  • Prepare meat, poultry, and fish by baking, broiling, or poaching rather than by frying or charbroiling.

3) What are the preventive foods that guard against cancer?

In accordance with the most common types of cancers that our country suffers from, the following foods can help:

Oral Cancer: A diet rich in green and yellow vegetables and proper oral hygiene has been shown to offer protection against oral cancer.

Breast Cancer: Reduction of high calorie foods, increased intake of fruits and vegetables and regular physical activity is preventive.

Lung Cancer: Avoid tobacco and stay free from environmental pollutants. Increase intake of vegetables, fruits and beta carotene.

Stomach Cancer:Diets high in fruits and vegetables particularly raw vegetables, citrus fruits, and possibly allium vegetables (onions, leeks, garlic etc.), foods with high levels of carotenoid, high vitamin C intake and consumption of green tea helps prevent stomach cancers.

4) What foods help in healing cancer and how?

Good nutrition is a key to good health. Foods which are rich in Vitamin C, Beta-carotene and Lycopene are known to protect DNA from damages. Research proves that these foods help in healing cancer –

Apple: Apple contains quercetin, epicatechin, anthocyanins and triterpenoids which have anti-inflammatory and antioxidant properties that help to lower the risk of cancer specifically Colorectal cancers. The apple peel is the most nutritious as the majority of Quercetin (80%) is found in it. Other cancers in which apples are known to heal are lungs, breast and stomach.

Blueberries :Blueberries have great antioxidant power, due to the presence of many phytochemicals and flavonoids like Anthocyanins, Ellagic acid and Urolithin. These are known to decrease free radical damage to DNA that leads to cancer. They also decrease the growth and stimulate self-destruction of mouth, breast, colon and prostate cancer cells.

Broccoli, Brussels sprouts, Green Cabbage, Cauliflower, White Turnip, Kale, Green Collard: The Glucosinolates is converted into isothiocyanates and indoles on consumption, which decreases inflammation, one of the risk factors of cancer. Beta-carotene promotes cell communication that helps control abnormal cell growth.

Cherries: Both sweet and tart cherries are a good source of fiber, vitamin C, and potassium. The dark red color comes from anthocyanins, which are antioxidants.

Cranberries: They are high on dietary fiber and vitamin C. They’re very high in antioxidant power, most of which comes from phytochemicals like anthocyanins, proanthocyanidins and flavonols, ursolic acid, benzoic acid and hydroxycinnamic acid. Proanthocyanidins and ursolic acid decrease growth and increase self-destruction of several types of cancer in cell studies.

Grapefruit: An 18th century hybrid of the pummelo and sweet orange. It is grown mainly in the Americas. Its name derives from the fruit’s appearance as it grows: grape-like clusters on trees. Grapefruit contains these naringenin and other flavonoids like limonin and other limonoids, beta-carotene and lycopene (pink and red varieties). Foods containing lycopene lower the risk of prostate cancer.

Green Tea: Since ancient times, tea has been used as both beverage and medicine. Both black and green teas contain numerous active ingredients, including polyphenols and flavonoids, which are potent antioxidants. One class of flavonoids called catechins has recently become the focus of widespread study for their anti-cancer potential. Tea is the best source of catechins in the human diet, and green tea contains about three times the quantity of catechins found in black tea. In laboratory studies, green tea has been shown to slow or completely prevent cancer development in colon, liver, breast and prostate cells. Other studies involving green tea have shown similar protective effects in tissues of the lung, skin and digestive tract.

Winter Squash/Pumpkins: They contain Alpha and Beta carotene which is converted to Vitamin A inside the body. The yellow pigmented lutein, zeaxanthin helps to filter high energy ultra violet rays that can damage our eye’s lens and retina. Lab studies suggest that dietary intake decreases the chances of skin cancer related to exposure from sun.

Walnuts: The major actives found in walnut are – Elligtannins, Gamma-tocopherol, Alpha-linolenic acid, phytosterols and Melatonin. Laboratory studies show that consuming walnuts helps in breast cancer, colon tumor and prostate cancer. The studies also show decreased damage to DNA by regular consumption of walnut.

Source: NDTV

Hookah smoking’s dangers lead to bans

Do you smoke cigarettes? What about marijuana? Many doctors, including myself, routinely ask patients these questions. Over the years, fewer and fewer people say yes. But if you — like me — thought Canada was winning the war on smoking, look again.

New data suggests young Canadians are turning to waterpipes, also called shisha or hookah — and the fumes they’re inhaling may be even more toxic than cigarettes.

Traditionally, hookah smokers use harsh flavourless tobacco, but flavours like fruit, chocolate and even bubble gum are now popular.

Almost 10 per cent of Ontario students between Grades 7 and 12 smoked a hookah in the last year, according to the 2013 Ontario Drug Use and Health Survey performed by the Centre for Addiction and Mental Health (CAMH). That’s one and a half per cent more than reported cigarette use in this age group.

A similar trend is occurring across the country. According to a study published in Preventing Chronic Disease in May, researchers from the University of Waterloo found that the number of Grade 9 to 12 students in Canada reporting ever using a hookah increased from 9.5 per cent in 2006 to 10.1 per cent in 2010, while cigarette use declined during that time.

Hookah bars in Canada aren’t required to have age restrictions because they serve tobacco-free herbal hookah — which for the most part, isn’t prohibited by anti-tobacco smoking laws. But hookah smoke can be just as dangerous as cigarette smoke because the charcoal used to heat tobacco in waterpipes emits high levels of carbon monoxide, metals, and cancer-causing chemicals. And that’s now prompting lawmakers across Canada to look at ways to curb the practice.

Alberta passed a law in November that bans hookah smoking in public places altogether. Many Ontario towns and cities like Barrie, Peterborough, Brantford, and Orillia have put similar bylaws in place, despite no province-wide action. Toronto alone has more than 80 hookah bars.

Hookah originated in the Middle East and India in the 16th century. Waterpipes burn charcoal to heat tobacco or herbs, producing smoke. The pipe then bubbles the smoke through water to cool it before inhalation.

Traditionally, hookah smokers use harsh flavourless tobacco. But mixing tobacco with flavours like fruit, chocolate and even bubble gum is now popular. Since smoking tobacco indoors is not allowed in most places in Canada — bars serve herbal hookah instead. “Herbal” tobacco-free hookah uses a mixture of flavours and herbs.

Hookah poses health hazards to smokers and those exposed to second hand smoke, says Roberta Ferrence. (CBC)

Appealing flavours are pulling in users far beyond Arab communities. In fact, the latest Canadian Youth Smoking Survey funded by Health Canada showed that young people of African, Latin American and Asian descent were the most likely to use the pipes.

Because hookah smokers share a pipe, “it’s a great way to spend time with friends,” says Anton Volov, a first-year undergraduate student at York University – adding that “my friends have told me it’s healthier than cigarettes.”Volov smokes hookah at bars twice a week and enjoys trying new flavours each time.

Hookah poses serious potential health hazards to smokers and those exposed to second hand smoke — just like cigarettes, says Dr. Roberta Ferrence, the senior scientific advisor to the Ontario Tobacco Research Unit, a lead research agency funded by the Ontario government. Hookah smokers are at increased risk for heart and lung disease and cancer, she adds.

Herbal hookah’s hazards

The United States Centers for Disease Control and Prevention explains that hookah users may absorb higher concentrations of toxins than cigarette users — because they puff more often, inhale more deeply and smoke for longer periods of time in each session. A typical 1-hour hookah session involves 200 puffs, while an average cigarette is 20 puffs.

Thus far, Alberta is the only province to take action and ban hookah smoking. “The evidence for the hazardous effects of hookah, even herbal hookah, is clear. We have to protect our youth,” says Fred Horne, Alberta’s Minister of Health.

Now, the Ontario Campaign for Action on Tobacco wants the Government of Ontario to bring “tobacco-like” products under existing Smoke-Free legislation, which would make it illegal to serve even herbal hookah in public areas.

Ontario is committed to ensuring tobacco-containing hookah is not smoked in public areas, as already prohibited by law, says David Jensen, spokesperson for the Ontario Ministry of Health and Long Term Care. But Ontario is not planning to outright ban hookah use in public areas — because research showing the harmful effects of herbal hookah is limited and smoking hookah “is a social or cultural activity for some people,” Jensen says.

Michael Perley, the director of the Ontario Campaign for Action on Tobacco, disagrees. “This is clearly not a cultural activity anymore,” he says. The hazardous health effects of herbal hookah are well known, he adds.

In a study published in Tobacco Control in September, researchers in Alberta found that smoke from herbal hookah contained levels of toxic substances equal to or in excess of cigarette smoke. Ferrence performed a similar study published in Tobacco Control in September that examined the air quality of 12 hookah bars in Toronto — where only herbal hookah was allowed. The air contained much higher levels of cancer-causing particulate matter and carbon monoxide than those found in smoking rooms of bars.

They also found high air nicotine levels in most of these hookah bars, suggesting hookah with tobacco was still being served. Many bars claim they serve herbal hookah to get around tobacco-free legislation — but we know this isn’t true, Perley says. But it doesn’t matter whether hookah contains tobacco or is herbal — the health risks are still there, Ferrence says.

Donald Martin, a consultant lobbyist with Safe Shisha — a group that promotes safe and responsible hookah use on behalf of bar owners in Alberta — argues against banning hookah. Instead, he wants hookah bar regulations like age restrictions, special licenses, and ventilation standards. “Anybody can just set up shop, why not introduce some regulations to ensure hookah is smoked safely,” Martin says. “How is this different than licensing alcohol?” he asks.

Simply regulating hookah bars would leave Canada behind Lebanon, Turkey, and parts of Saudi Arabia and India — where governments have banned the indoor smoking of hookah, Perley says. “Even countries where hookah is traditionally used are banning it,” he says.

People need to know how harmful hookah can be, Ferrence says. In Beijing, people are told to stay in their homes when particulate matter levels in the air due to smog exceed 500 micrograms per cubic meter. “We consistently measured levels of 1500 in hookah bars, that’s three times the amount,” she says. “In one bar, levels were as high as 17,000,” she adds.

Source: CBC news

Red light, green labels: Food choice made easier

In March 2010, Massachusetts General Hospital’s cafeteria got an overhaul. Healthy items were labeled with a “green light,” less healthy items were labeled with a “yellow light,” and unhealthy items were labeled with a “red light.” Healthier items were also placed in prime locations throughout the cafeteria, while unhealthy items were pushed below eye level.

The “Green Light, Red Light, Eat Right” method is a favorite among experts fighting childhood obesity. But doctors at Massachusetts General wanted to know if the colors could really inspire healthier eating habits among adults long-term.

The results of their study were published Tuesday in the American Journal of Preventive Medicine.

The study

A cash register system tracked all purchases from the hospital’s large cafeteria between December 2009 and February 2012. The first three months of data were used as a baseline for comparison purposes. In March 2010, all food and beverages were labeled with a visible green, yellow or red sticker. Those with a green sticker were put at eye level and in easier-to-reach places.

Signs, menu boards and other promotions were used to explain the changes around the hospital.

The cafeteria had an average of 6,511 transactions daily. Approximately 2,200 of those were from hospital employees who used the cafeteria regularly. Twelve months into the study, researchers analyzed the number of purchases from each color group, and compared them to the baseline totals. They did the same at the end of the 24-month period.

The results

The number of red items purchased during the study period decreased from 24% at the baseline to 21% at both the 12 and 24-month follow-ups. The biggest decrease was seen in red-labeled beverages (such as regular soda) – from 27% at baseline to 18% at 24 months.

Sales of green items increased from 41% to 46%.

In other words, cafeteria-goers bought more water and purchased healthier food items during the study period than they did before the traffic light system went into place.

Employees showed the biggest improvement; their purchases of red items decreased by about 20%.

Takeaway

“These results suggest that simple food environment interventions can play a major role in public health policies to reduce obesity,” the study authors write.

Lead study author Dr. Anne Thorndike wasn’t sure that the changes seen early in the study would last over the two-year period. The consistent results at 24 months suggest people won’t grow tired of or immune to helpful food labels, she says.

Thorndike does not believe the color coding system can replace more detailed nutrition information, but says the labels “convey some basic nutrition information in a format that can be quickly interpreted and understood by individuals from diverse backgrounds.”

It’s unclear if the traffic light system produced the change in consumers’ behavior or if it was the rearrangement of items in the cafeteria.

Use it at home

“Families could utilize this concept by categorizing foods in the household as ‘green’ or red,'” Thorndike says. “For example, you could have a ‘green’ snack drawer or shelf on the refrigerator that the kids could freely choose from, and you could designate a ‘red’ drawer in which the kids would need to ask permission before taking a snack.”

Parents can also rearrange their cupboards to put healthier snacks front and center. Sorry, cookies – it’s the dark corner up top for you.

Source: the chart

New technique enables patient with ‘Word Blindness’ to read again

In the journal Neurology, researchers report a novel technique that enables a patient with “word blindness” to read again.

Word blindness is a rare neurological condition. (The medical term is “alexia without agraphia.”) Although a patient can write and understand the spoken word, the patient is unable to read.

The article is written by Jason Cuomo, Dr Murray Flaster and Dr Jose Biller of Loyola University Medical Centre.

Here’s how the technique works: When shown a word, the patient looks at the first letter. Although she clearly sees it, she cannot recognize it. So beginning with the letter A, she traces each letter of the alphabet over the unknown letter until she gets a match. For example, when shown the word Mother, she will trace the letters of the alphabet, one at a time, until she comes to M and finds a match. Three letters later, she guesses correctly that the word is Mother.

“To see this curious adaption in practice is to witness the very unique and focal nature” of the deficit, the authors write.

The authors describe how word blindness came on suddenly to a 40-year-old kindergarten teacher and reading specialist. She couldn’t make sense of her lesson plan, and her attendance sheet was as incomprehensible as hieroglyphs. She also couldn’t tell time.

The condition was due to a stroke that probably was caused by an unusual type of blood vessel inflammation within the brain called primary central nervous system angiitis.

Once a passionate reader, she was determined to learn how to read again. But none of the techniques that she had taught her students — phonics, sight words, flash cards, writing exercises, etc — worked. So she taught herself a remarkable new technique that employed tactile skills that she still possessed.

The woman can have an emotional reaction to a word, even if she can’t read it. Shown the word “dessert,” she says, “Oooh, I like that.” But when shown “asparagus,” she says, “Something’s upsetting me about this word.”

Shown two personal letters that came in the mail, she correctly determined which was sent by a friend of her mother’s and which was sent by one of her own friends. “When asked who these friends were, she could not say, but their names nevertheless provoked an emotional response that served as a powerful contextual clue,” the authors write.

What she most misses is reading books to children. She teared up as she told the authors: “One day my mom was with the kids in the family, and they were all curled up next to each other, and they were reading. And I started to cry, because that was something I couldn’t do.”

Source: India medical times

E-cigarette vapor contains nicotine, not other toxins

People standing near someone using an e-cigarette will be exposed to nicotine, but not to other chemicals found in tobacco cigarette smoke, according to a new study.
E-cigarettes, or electronic cigarettes, create a nicotine-rich vapor that can be inhaled, or ‘vaped.’

Researchers and regulators have questioned whether e-cigarettes are a smoking cessation aid or may lure more young people toward smoking, as well as what effects they have on health.

“There is ongoing public debate whether e-cigarettes should be allowed or prohibited in public spaces,” study co-author Maciej Goniewicz told Reuters Health in an email.

Goniewicz is a cancer researcher in the Department of Health Behavior at the Roswell Park Cancer Institute in Buffalo, New York.

“E-cigarettes contain variable amounts of nicotine and some traces of toxicants. But very little is known to what extent non-users can be exposed to nicotine and other chemicals in situations when they are present in the same room with users of e-cigarettes,” Goniewicz said.

He and his colleagues conducted two studies of secondhand exposure to e-cigarette vapors in a laboratory. Their results were published in Nicotine and Tobacco Research.

In the first study, the researchers used an electronic smoking machine to generate vapor in an enclosed space. They measured the amount of nicotine as well as carbon monoxide and other potentially harmful gases and particles in the chamber.

The second study included five men who regularly smoked both tobacco cigarettes and e-cigarettes. Each man entered a room and smoked his usual brand of e-cigarette for two five-minute intervals over an hour while the researchers measured air quality. The room was cleaned and ventilated and the experiment was repeated with tobacco cigarettes.

The researchers measured nicotine levels of 2.5 micrograms per cubic meter of air in the first study. Nicotine levels from e-cigarettes in the second study were slightly higher at about 3.3 micrograms per cubic meter. But tobacco cigarette smoking resulted in nicotine levels ten times higher at almost 32 micrograms per cubic meter.

“The exposure to nicotine is lower when compared to exposure from tobacco smoke. And we also know that nicotine is relatively safer when compared to other dangerous toxicants in tobacco smoke,” Goniewicz said.

E-cigarettes also produced some particulate matter, but regular cigarettes produced about seven times more. E-cigarettes didn’t change the amount of carbon monoxide or other gases in the air.

“What we found is that non-users of e-cigarettes might be exposed to nicotine but not to many toxicants when they are in close proximity to e-cigarette users,” said Goniewicz.

“It is currently very hard to predict what would be the health impact of such exposure,” he added.

He said more research is needed to find out how the current findings correspond to “real-life” situations, when many people might be using e-cigarettes in a room with restricted ventilation.

Source: Ahram online

Birth control type tied to time between pregnancies

Women using intrauterine devices (IUDs) and other types of long-term reversible birth control after having a baby are less likely to get pregnant again quickly, a new study suggests.

Women who used those methods were four times more likely to wait more than 18 months between pregnancies compared to those relying on condoms, researchers found.

The World Health Organization endorses a two-year period between birth and a woman’s next conception.

Still, one third of all repeat pregnancies in the U.S. occur within 18 months of the previous child’s birth. And a growing body of evidence shows this close timing increases the risk a baby will be born early or at a low birth weight.

The time between pregnancies “cannot be explained only by the mother’s preferences,” Heike Thiel de Bocanegra said.

She and her colleagues from the University of California, San Francisco investigated the link between access to birth control or family planning services and pregnancy spacing.

In the current study of 117,644 California women who’d had at least two children, 64 percent waited 18 months or more between pregnancies and the rest did not.

All women included in the study filed claims through the state’s Medicaid program for the poor, called Medi-Cal, or through health providers offering state-funded family planning services.

The researchers matched data on claims for contraceptives to California’s birth registry.

“We assumed that access to contraception . . . would improve birth spacing,” Dr. Anitra Beasley wrote in an email to Reuters Health.

“This study actually examines this assumption,” she said.

Beasley, who studies family planning at Baylor College of Medicine in Houston, was not part of the current research.

Women who used long-acting reversible contraception, including IUDs or implants, were four times more likely to wait at least 18 months to conceive again, compared to those who only used “barrier” contraceptives like condoms or spermicide.

More than half of women started using birth control pills, the ring or the patch after giving birth. They were twice as likely to wait at least 18 months between pregnancies as condom users.

Those relationships stood firm even when the researchers looked at possible influences like the mother’s race, education, age and whether she was born in the U.S., according to the report published in the American Journal of Obstetrics and Gynecology.

Women in the study counseled by a certified family planning service provider were 67 percent more likely to wait 18 months between pregnancies, compared with women who utilized Medi-Cal services only.

“Low-income women are sometimes seen only once after giving birth,” Thiel de Bocanegra said.

“Some women receive contraception – some do not,” she said.

Women in the study received four months worth of covered contraceptives, on average. That number was dragged down by the one third of women in the study who had no contraceptive claims at all.

For Meredith Matone, a researcher with PolicyLab at Children’s Hospital of Philadelphia, the study’s large size helps build a better understanding of how public health initiatives work in the real world.

“The results we find in clinical trials do not always translate well when implemented on a large scale, where they are subject to challenges that include provider performance, patient compliance and operational hurdles,” Matone wrote in an email to Reuters Health.

“Under health care reform, there are opportunities to continue to support such evidence-based public health programs for families,” said Matone, who was not involved in the new research.

“Health care providers should know that the optimal pregnancy interval is 18 months or more, and should encourage the use of highly effective contraception during this period,” Thiel de Bocanegra said.

“Pediatricians can help, too, by asking the mother what type of contraception she is using,” she said.

Scientists discover new way of overcoming human stem cell rejection

Human embryonic stem cells have the capacity to differentiate into a variety of cell types, making them a valuable source of transplantable tissue for the treatment of numerous diseases, such as Parkinson’s disease and diabetes.

But there’s one major issue: Embryonic stem cells are often rejected by the human immune system.

Now, researchers from the University of California San Diego may have found an effective way to prevent this rejection in humans. Utilizing a novel humanized mouse model, the scientists have revealed a unique combination of immune suppressing molecules that stop the immune system from attacking the injected stem cells – without shutting the system down completely.

This discovery could ultimately help resolve some of the major problems currently limiting the use of embryonic stem cells for certain conditions, paving the way for the development of more effective human stem cell therapies.

“This is a generic way of immune suppression, so it could potentially be applied not just for stem cells therapies, but for organ transplants as well,” Yang Xu, a professor of biology at UC San Diego and lead author of the study, told FoxNews.com. “It can be very broad.”

Embryonic stem cells are different from the other cells in a patient’s body, making them “allogenic.” This means the immune system will recognize them as foreign agents and attack them.

One way of overcoming this rejection problem is to give patients immunosuppressant drugs, which suppress the entire immune system. While short term use of immunosuppressants has been successful for many organ transplants, embryonic stem cell therapies for chronic diseases require long term use of these drugs – which can often be very toxic and increase the risk of cancer.

“In order for the patient to really use this therapy, they have to decide: Do they want a lifelong use of immunosuppressant drugs, or are they willing to live with the symptoms of their disease,” Xu said.

Source: news.nom

Study Finds Texting, Dialing Dangerous While Driving, Talking Less So

A sophisticated, real-world study confirms that dialing, texting or reaching for a cellphone while driving raises the risk of a crash or near-miss, especially for younger drivers. But the research also produced a surprise: Simply talking on the phone did not prove dangerous, as it has in other studies.

This one did not distinguish between handheld and hands-free devices — a major weakness.

And even though talking doesn’t require drivers to take their eyes off the road, it’s hard to talk on a phone without first reaching for it or dialing a number —things that raise the risk of a crash, researchers note.

Earlier work with simulators, test-tracks and cellphone records suggests that risky driving increases when people are on cellphones, especially teens. The 15-to-20-year-old age group accounts for 6 percent of all drivers but 10 percent of traffic deaths and 14 percent of police-reported crashes with injuries.

For the new study, researchers at the Virginia Tech Transportation Institute installed video cameras, global positioning systems, lane trackers, gadgets to measure speed and acceleration, and other sensors in the cars of 42 newly licensed drivers 16 or 17 years old, and 109 adults with an average of 20 years behind the wheel.

The risk of a crash or near-miss among young drivers increased more than sevenfold if they were dialing or reaching for a cellphone and fourfold if they were sending or receiving a text message. The risk also rose if they were reaching for something other than a phone, looking at a roadside object or eating.

Among older drivers, only dialing a cellphone increased the chances of a crash or near miss. However, that study began before texting became more common, so researchers don’t know if it is as dangerous for them as it is for teens.

Engaging in distractions increased as time went on among novice drivers but not among experienced ones.

The National Institutes of Health and the National Highway Traffic Safety Administration paid for the research. Results are in Thursday’s New England Journal of Medicine.

David Strayer, a University of Utah scientist who has done research on this topic, said the findings that merely talking on a phone while driving was not dangerous is “completely at odds with what we found.”

The study methods and tools may have underestimated risks because video cameras capture wandering eyes but can’t measure cognitive distraction, he said.

“You don’t swerve so much when you’re talking on a cellphone; you just might run through a red light,” and sensors would not necessarily pick up anything amiss unless a crash occurred, Strayer said.

As for texting, “we all agree that things like taking your eyes off the road are dangerous,” he said.

At least 12 states ban the use of hand-held cellphones while driving and 41 ban text messaging. All cellphone use is banned by 37 states for novice or teen drivers, says the National Conference of State Legislatures, citing information from the Governor’s Highway Safety Administration.

Source: NBC Bay area

Medicaid expansion increased visits to emergency rooms

People newly enrolled in a health insurance program for the poor were more likely to visit the emergency department for care than people who remained uninsured, Boston-area researchers have found, providing the best evidence to date that the national Medicaid expansion that began this week is unlikely to lead to a decline in costly emergency services.

The study was published online Thursday by the journal Science, just as millions of Americans have become newly eligible for Medicaid coverage under the Affordable Care Act. Some politicians have suggested that people who were uninsured and didn’t have a regular doctor or put off basic treatment until their condition became serious, would, once they had coverage, get the primary care they needed to avoid trips to the emergency department.

Previous research on what happened to ER usage in Massachusetts, which expanded its Medicaid program and mandated that most residents have health insurance in 2006, have reached conflicting conclusions. But the new study, of about 25,000 low-income adults randomly selected in 2008 to enroll in Oregon’s Medicaid program, found that the newly insured increased their use of all types of medical care, including prescription drugs, hospital stays, and outpatient visits. Emergency department visits were no exception.

Over an 18-month period, about 42 percent of the new Medicaid enrollees visited the emergency department. In the same period, about 35 percent of those who did not receive Medicaid visited the emergency department.

“Basic economic theory is, if you lower the price, people use it more,” said Amy Finkelstein, a Massachusetts Institute of Technology economist and a senior author on the paper.

It was not a foregone conclusion in this case, however, that reducing the cost of an emergency room visit would increase use, she said, because the cost of a visit to a primary care doctor and of preventive services that may have helped them avoid the emergency room also decreased with insurance coverage.

Yet, emergency department use among those on Medicaid increased during businesses hours, nights, and weekends. While there was no increase in visits classified as non-preventable emergencies, there was an increase for visits deemed preventable or treatable by a primary care doctor.

A 2011 study found that overall emergency department visits increased in Massachusetts in the two years after the state expanded insurance coverage under the 2006 state health care law, though visits for “low severity” problems declined slightly. Dr. Peter Smulowitz, an emergency physician at Beth Israel Deaconess Medical Center and lead author on that study, said he and colleagues have more recently reviewed emergency department use across Massachusetts and found a small increase in pockets of the state that had seen the largest gains in insurance coverage. The study is pending publication.

Data published in the New England Journal of Medicine in 2011, however, found that ER usage was already increasing in Massachusetts and nearby states before the expansion of health insurance coverage here, and that the law did not change the trend in Massachusetts when compared to the other states.

The Oregon study is unique in that it is a randomized controlled study, considered the gold standard in medical research but rarely feasible in health policy research. The state of Oregon created a valuable study scenario when, because the state had money only for a small expansion of the program, it held a lottery for Medicaid coverage, providing insurance to some people and leaving others uninsured.

Past work by principal investigators Finkelstein and Katherine Baicker, a professor of health economics at Harvard School of Public Health, and their colleagues at the National Bureau of Economic Research in Cambridge has found that the lottery winners were more likely to report feeling better about their mental and physical health and had less financial strain, including fewer bills sent to collection. But there was no improvement in key health factors, such as blood pressure or blood sugar levels, as compared with the uninsured.

With the latest study, Baicker said, the body of research out of Oregon has disproved both the worst and best predictions for Medicaid — that it is an expensive program that does little to improve access to care and overall health, or alternatively, that it is a money-saving program that clearly improves health. The results are far more nuanced.

“Policymakers should make decisions based on this evidence that the program has real costs. It’s not free,” she said. “And, it has real benefits. Beneficiaries are clearly better off.”

Source: the boston globe

Jahi McMath family, hospital to meet for settlement talks

A federal magistrate has ordered settlement talks between attorneys for Children’s Hospital Oakland and the family of a 13-year-old girl who has been declared brain dead.

U.S. Magistrate Donna Ryu will meet in her Oakland courtroom Friday with both sides in hopes of brokering a deal in the ongoing legal fight over Jahi McMath. A separate hearing has been scheduled Friday before Judge Evelio Grillo of Alameda County Superior Court in Oakland.

Jahi’s family has accused the hospital of denying the girl a tracheostomy tube that is required to transfer her to another site, as well as withholding the insertion of a feeding tube that will provide her nutrition. They maintain that she is not dead because her heart is still beating and she is hooked up to a ventilator.

Hospital representatives have said that they’ve never objected to the girl receiving a tracheostomy but would not allow the procedure done in its hospital or performed by its staff because of the ethical and legal issues related to operating on a deceased person.

The hospital’s doctors declared Jahi dead on Dec. 12, three days after she underwent a tonsillectomy that resulted in complications.

The hospital would arrange for Jahi to be moved to another site for the procedure, or for long-term care, but has not heard from any facility, doctor or medical transport service regarding her case, hospital spokesman Sam Singer said.

Christopher Dolan, attorney for Jahi’s family, has filed requests in three separate courts seeking orders to force the hospital to insert tracheostomy and feeding tubes, but judges have declined to do so.

In court papers filed in federal court Thursday, Dolan again asked for an order for the tubes to be inserted.

“At this point, Jahi has not had nutrition for nearly three weeks,” he wrote. “She is in desperate need of a tracheostomy tube and a gastric tube.. This court should grant plaintiff the relief to allow for Jahi’s transport.”

Grillo has issued a restraining order that prevents the hospital from disconnecting Jahi from a ventilator until at least 5 p.m. Tuesday.

At 1 p.m. on Tuesday, U.S. District Judge Saundra Brown Armstrong in Oakland is expected to hear arguments about possible violations of Jahi’s civil rights, and the rights of families – not doctors, lawyers or politicians – to determine a loved one’s death, based on their religious or personal beliefs.

Source: SF gate