Category Archives: Research
CDC Flu Reports to Resume Later Today
The U.S. Centers for Disease Control and Prevention (CDC) reported late yesterday that it has resumed analysis of influenza surveillance data and testing of influenza laboratory specimens collected during the 16-day government shut-down. An abbreviated FluView report summarizing the data for the most recent week (October 6-12) will be posted on Friday, October 18. At a later date, reports summarizing influenza surveillance data for September 22-October 5 will also be posted. Weekly Friday posting of the full FluView report for the 2013-2014 season will begin again on October 25. In the United States, flu season typically runs September through April and both private doctors and public health clinics currently have large supplies of this year’s flu vaccine on hand. Find a flu shot in your neighborhood by using the Health Map Vaccine Finder, run by Boston Children’s Hospital. Read more on flu.
Brain May Flush Out Toxins During Sleep
A new study funded by the U.S. National Institutes of Health finds that a good night’s rest may literally clear the mind. The study, conducted in mice, showed—for the first time, according to the researchers—that the space between brain cells may increase during sleep, allowing the brain to flush out toxins that build up during waking hours. The researchers say that suggests a new role for sleep in health and disease. The study, published in Science, shows that during sleep a plumbing system called the glymphatic system may open, letting fluid flow rapidly through the brain. The researchers studied the system by injecting dye into the cerebrospinal fluid of mice and watching it flow through their brains while simultaneously monitoring electrical brain activity. The dye flowed rapidly when the mice were either asleep or anesthetized, but barely flowed when the same mice were awake. The researchers also inserted electrodes into the brains of the mice to directly measure the space between brain cells and found it increased by 60 percent when the mice were asleep or anesthetized. Researchers say the applications may apply to general health as well as have implications for neurological disorders. Read more on research.
New Report Offers Suggestions for Creating Healthier Neighborhoods
Again and again, research shows that our environment—where we live and what behaviors it fosters—has a profound impact on our health. Realizing this, a new report from the Prevention Institute offers interviews with fifty leaders in multiple sectors, including transportation, housing and public health on how to create healthy, safe and equitable neighborhoods. The goal of the report, Towards a 21st Century Approach: Advancing a Vision of Prevention and Public Health, is to spark an active and ongoing national dialogue about the subject. It was made possible through funding from the Robert Wood Johnson Foundation. Read more on smart growth.
Average Monthly Cost of Mid-tier Insurance Under Affordable Care Act Estimated at $328
The average monthly cost of a mid-tier health insurance plan under the Affordable Care Act will be $328, and government subsidies will also help reduce that cost for most Americans, according to a new report from the U.S. Department of Health and Human Services. The health exchanges open for enrollment next week and the federal government hopes to enroll as many as 7 million people within the first year. The cost varies from state to state, with Minnesota projected to have the least expensive plan at $192 per month and Wyoming projected to have the highest at $516. Read more on access to health care.
NIH Initiative Will Help Move Science from the Laboratories to the Commercial Sector
The U.S. National Institutes of Health (NIH) has awarded $31.5 million in grants to establish three inaugural NIH Centers for Accelerated Innovations that will work to improve how basic science discoveries move from laboratories to commercial products. The Centers are funded by NIH’s National Heart, Lung and Blood Institute (NHLBI) and will focus on technologies to improve the diagnosis, treatment, management and prevention of heart, lung, blood and sleep disorders and diseases. “These centers essentially will offer a one-stop shop to accelerate the translation of early-stage technologies for further development by the private sector and ultimate commercialization,” said Gary H. Gibbons, MD, director of NHLBI. As a result, the public will gain access sooner to new biomedical products that improve human health while also benefiting from the economic growth associated with the creation of new companies and the expansion of existing ones.” Read more on research.
‘Cycling’ Drugs Could Help Combat Antibiotic-resistant Bacteria
“Cycling” between antibiotics may extend their life and effectiveness, while also enabling doctors to stay ahead of drug-resistant bacteria, according to a new study in the journal Science Translational Medicine. "You cycle between drugs that have reciprocal sensitivities," said study co-author Morten Sommer, a lead researcher with the Novo Nordisk Foundation Center for Biosustainability at the Technical University of Denmark. "If you become resistant to drug A, you will become more sensitive to drug B. That way, you can cycle between drug A and drug B without increasing resistance in the long term.” With the increased use—and overuse—of antibiotics, antibiotic-resistant bacteria are becoming an increasingly serious public health problem, leading researchers and health care professionals in search of new ways to combat the problem. More than 2 million people are made ill and more than 23,000 people die every year in the United States due to antibiotic-resistant infections, according to the U.S. Centers for Disease Control and Prevention. Read more on prescription drugs.
Study: 40 Percent of Antibiotics Released from 1980-2009 Withdrawn from Market
Safety concerns, lack of effectiveness when compared to existing drugs and weak sales led more than 40 percent of the antibiotics released between 1980 and 2009 to be withdrawn from the market, according to a new study in the Journal of Law, Medicine and Ethics. The rate was three times as high as that for any other type of drug. “This study raises the question whether or not money would be better spent on higher quality antibiotics, rather than a larger quantity” and whether “approving a flood of new lower-quality antibiotics might actually trigger much higher levels of resistance,” said author Kevin Outterson, JD, LLM, professor at Boston University School of Law and co-director of the Boston University Health Law Program. Antibiotic use can lead to bacteria becoming resistant to a strain. A recent report from the U.S. Centers for Disease Control and Prevention found that as many as 50 percent of prescriptions for antibiotics are either not needed or prescribed inappropriately. Antibiotic-resistant infections sicken more than two million Americans each year, killing more than 23,000 in the process. Read more on prescription drugs.
Locations of Drinking Can Influence Types of Partner Violence
Where and when a person drinks can affect the type of partner violence that can follow, according to a new study from the journal Addiction. The study looked at six drinking locations: restaurants, bars, parties at someone else's home, quiet evenings at home, with friends in one's own home and in parks/other public places. Researchers from the Prevention Research Center in California and Arizona State University found that men drinking in bars and at partners away from home and women drinking in parks/other public places were linked with an increased rate of male-to-female violence. They also found that men drinking during quiet evenings at home was associated with increased female-to-male violence. The findings could help prevent partner violence by encouraging people in risky relationships not to drink in particular places/situations, which could prove more effective than counseling people simply to drink less. Read more on alcohol.
Multiple Myeloma Group Hopes Opening Records to Hundreds of Patients Will Advance Research
The Multiple Myeloma Research Foundation's (MMRF) Researcher Gateway is opening global online access to genetic and research data on hundreds of patients in an effort to help identify biological targets for future treatments, improve enrollment in studies by pairing them with the right patients and enhance researcher collaboration. The MMRF Research Gateway is a $40-million program funding by the foundation and drug company partners. The main component of the effort will be the Commpass study which will enroll 1,000 new multiple myeloma patients and monitor them throughout the course of the disease; cancer tissue banks typically include only one sample per patient. "There is going to be new information generated there that you would never get unless you followed patients through first relapse and second relapse and beyond," said George Mulligan, director of translational medicine for Millennium Pharmaceuticals, Japan's Takeda Pharmaceutical Co.’s oncology unit, which is one of the co-sponsors. "The size of it in patient numbers and the breadth and richness of it on a biological level, it's going to grow over time and mushroom into something that's going to be really special.” About 86,000 people are diagnosed with multiple myeloma each year, with about 20,000 of those from the United States. Read more on research.
CDC: ‘Tips From Former Smokers’ Campaign Created Spikes in Quitline Calls, Website Visits
An additional 150,000 U.S. smokers called the tobacco cessation helpline 1-800-QUIT NOW as a direct result of the U.S. Centers for Disease Control and Prevention's (CDC) 2013 “Tips From Former Smokers” campaign, which ran for 16 weeks, according to CDC’s latest Morbidity and Mortality Weekly Report. That’s an increase of about 75 percent. It also generated approximately 2.8 million visits to the campaign website, or a nearly 38-fold increase. "The TIPS campaign continues to be a huge success, saving tens of thousands of lives and millions of dollars; I wish we had the resources to run it all year long," said CDC Director Tom Frieden, MD, MPH. "Most Americans who have ever smoked have already quit, and most people who still smoke want to quit. If you smoke, quitting is the single most important thing you can do for your health – and you can succeed!" A recent study in The Lancet concluded that the campaign helped as many as 100,000 people quit smoking permanently. Read more on tobacco.
FDA, NIH Award as Much as $53M for 14 Tobacco Regulation Research Centers
The U.S. Food and Drug Administration (FDA) and the National Institutes of Health (NIH) have joined together to award as much as $53 million in funding to create 14 Tobacco Centers of Regulatory Science (TCORS). The first-of-its-kind program will bring together a diverse array of scientists, public health experts, communications veterans and marketing experts to generate research to inform the regulation of tobacco products to protect public health. “While we’ve made tremendous strides in reducing the use of tobacco products in the U.S., smoking still accounts for one in five deaths each year, which is far too many,” said NIH Director Francis S. Collins, MD, PhD. “FDA/NIH partnerships like the Tobacco Centers of Regulatory Science keep us focused on reducing the burden and devastation of preventable disease caused by tobacco use.” Read more on research.
Overweight, Underweight Pregnant Women See More Complications and Longer Hospital Stays
Pregnant women who are either too thing or too heavy as measured by body-mass index (BMI) are at increased risk for complications and additional hospitalization, according to a new study in BJOG: An International Journal of Obstetrics and Gynaecology. Women with higher BMIs saw increased complications; severely obese women were three times as likely as normal weight women to have high blood pressure and gestational diabetes, as well as longer overall hospitalizations. Lower-weight women also had higher rates of additional hospitalization (8 percent) compared to normal-weight women, though not as high as the rates for overweight and obese women. The findings indicate the need to fine and implement new approaches to combating obesity. "Longer-term benefits of reducing maternal obesity will show improvements, not only in the health outcomes of mothers and their babies, but the workload and cost to current maternity services," said study co-author Fiona Denison, MD, of Queens's Medical Research Institute in Edinburgh. Read more on maternal and infant health.
Critical Opportunities: New Journal Article, Videos Offer Proposed Legal and Policy Changes that Can Impact Public Health
Ten new videos released today by Public Health Law Research (PHLR), a national program of the Robert Wood Johnson Foundation, with direction and technical assistance from Temple University, offer suggestions of proposed changes to laws and policies that can impact public health, such as fortifying corn masa flour to prevent neural tube defects and increasing taxes on alcohol to reduce consumption. The five-minute videos offer examples of PHLR’s “Critical Opportunities” initiative—brief presentations which showcase legal approaches to improving public health.
“Laws can be cost-efficient and popular tools for achieving public health goals. This initiative captures specific actionable, evidence-based ideas for creative ways of using law or legal interventions to improve a public health problem,” said Scott Burris, JD, director of the PHLR program.
The release of the videos is accompanied by an article published this week in the American Journal of Public Health, “Critical Opportunities for Public Health Law: A Call to Action.” It outlines five high-priority areas where evidence suggests legal interventions can have big impacts on health, and calls for a national conversation to continue to identify and prioritize opportunities for legal and policy action.
“The Centers for Disease Control and Prevention, the Institute of Medicine, and others have called for better, smarter use of legal interventions to advance public health,” said Michelle Mello, JD, PhD, the lead author of the article and professor of law and public health at Harvard University. “That’s no small task, but there’s a treasure trove of great ideas to draw on and evidence to back them up.”
PHLR has also developed a toolkit for use by organizations or instructors to host Critical Opportunities sessions at their meetings or in classrooms. The toolkit offers a how-to guide for using the format to identify ways laws can be used to address public health issues.
All ten of the new Critical Opportunities videos are available here. To highlight just one of the presentations, NewPublicHealth recently spoke with Adam Finkel, ScD, of the University of Pennsylvania Law School, about his Critical Opportunity presentation on the benefit and limitations of “smart disclosures,” an alternative to regulations and laws for improving public health.
Preschoolers’ Stuttering Does Not Hurt Social, Emotional Development
Stuttering is a common issue and does not negatively impact the social and emotional development of preschoolers, according to a new study in the journal Pediatrics. Sheena Reilly, associate director of clinical and public health research at Murdoch Children’s Research Institute in Australia and the study's lead author, called the study’s conclusion that stuttering or stammering did not serve to make kids more withdrawn a “very positive finding” and said that parents "can be reassured that developmental stuttering is not associated with a range of poorer outcomes in the preschool years." Researchers found that the rate of kids stuttering by age four was 11 percent and the recovery rate from stuttering after 12 months was 6.3 percent. The former was higher than previous studies have indicated and the latter was lower than the researchers expected; Reilly said further research into recovery is needed. The study also found that children who stutter had higher verbal and non-verbal scores. Read more on pediatrics.
NIH: Parents Fully Informed on Blood Transfusion Trial on Premature Infants
The U.S. National Institutes of Health (NIH) late last week responded to an advocacy group’s call for the end of a government study of blood transfusion levels in premature infants with firm insistence that parents are given complete and accurate information about the risks. The organization, Public Citizen, contends that the study exposes the infants to risks without giving parents full information and should be stopped. Under the study, half of the children will receive transfusions at a high hemoglobin level and half at a low level; according to Public Citizen, a restrictive approach risks serious complications such as neurological injury. As reported by Reuters, "The NIH said it is committed to ensuring that prospective research participants — and the people who speak for and love them — are given clear complete, and accurate information about the risks and benefits of participating in research." Public Citizen earlier called for a closer look at a previous NIH study on the effectiveness of different levels of oxygen in the treatment of premature infants. Read more on research.
Report: Most Medications Safe to Take While Breastfeeding
Most medications taken by breastfeeding moms will have no harmful impact on nursing infants, according to a new report from the American Academy of Pediatrics in consultation with the U.S. Food and Drug Administration (FDA). The study appears in the journal Pediatrics. "Because we know that breast-feeding has both developmental and health benefits for the mom and the baby, we are encouraging research in this area so physicians can make informed decisions about how best to treat their patients," said study author Hari Cheryl Sachs, MD, a pediatrician and leader of the pediatric and maternal health team within the FDA's Center for Drug Evaluation and Research. FDA is proposing new regulations that would replace “Nursing Mothers” sections on drug labels with a “Lactation” section that would provide more detailed information about potential effects on a nursing infant. Most drugs currently carry a blank legal statement warning against any use by breastfeeding mothers. "The general takeaway message—that most drugs are compatible with breast-feeding, that mothers don't have to wean to take drugs and that the labels should accurately reflect the science—is really great news and progress for breast-feeding mothers," said Diana West, a lactation consultant and spokesperson for La Leche League International. Read more on maternal and infant health.
The National Institutes of Health’s Office of Emergency Care Research (OECR), established in 2012, will now be under the leadership of Jeremy Brown, MD. Brown was recently appointed as the first permanent director of OECR, which is housed in NIH’s National Institute of General Medical Sciences.
Before joining NIH, Brown was an associate professor of emergency medicine and chief of the clinical research section in the Department of Emergency Medicine at The George Washington University. Additionally, he served as an attending physician in the emergency department of the Washington, D.C., VA Medical Center. According to the acting director of the National Institute of General Medical Sciences, Judith H. Greenberg, PhD, “Brown brings an impressive mix of clinical expertise, research experience, management abilities and communication skills to this important new position.”
Part of Brown’s research includes how to introduce routine HIV screening—a public health intervention—in hospital emergency departments. Previous studies have found these screenings to be cost-effective and frequently welcomed by patients. This is just one of the many ways in which steps could be taken in the emergency room setting to help improve the data available to assist public health efforts across the country. By using emergency departments as sites for collecting data on the status of the public’s health, more targeted efforts for prevention can be implemented.
NewPublicHealth spoke with Dr. Brown on the evidence that shows support for the collaboration between emergency departments and efforts to improve public health, as well as his new role and what he sees for the future of emergency departments.
NewPublicHealth: How is the transition into this new position going so far and how are you pulling from previous experiences to help with new challenges in this position?
Jeremy Brown: This is the beginning of my fourth week here; it is a new program and a new project really for both me as its first permanent director and for the NIH as well. They’ve never had an office that has addressed this particular part of our nation’s health and I think it’s going to be a learning experience on both sides.
So far, I’ve been really struck by the extremely warm reception that I’ve had from people within institutes and centers with whom I’ve had meetings. Currently, my agenda is really to meet with as many people as possible within NIH whose work touches on emergency medicine and other time sensitive medical issues.
In terms of the latter, I started a brand new HIV screening project from scratch at GW, it hadn’t been done there previously and it really had only been done in a couple of places in the U.S. before. That required the marshaling of a lot of different aspects of both the hospital, the nursing staff, and emergency physicians to get that up and running.
NPH: What other public health initiatives do you think emergency departments can take the lead on to improve public health?
NCI Releases Massive Data Set to Help Cancer Researchers
The National Cancer Institute (NCI) has released a massive data set of cancer-specific genetic variations to help the cancer research community gain a better understanding or both drug response and drug resistance to cancer treatments. The data set was published in Cancer Research, a journal of the American Association for Cancer Research. The database—the largest worldwide—includes 6 billion data points connecting “drugs with genomic variants for the whole human genome across cell lines from nine tissues of origin, including breast, ovary, prostate, colon, lung, kidney, brain, blood, and skin,” said Yves Pommier, MD, PhD, NCI’s chief of the Laboratory of Molecular Pharmacology. “Opening this extensive data set to researchers will expand our knowledge and understanding of tumorigenesis [the process by which normal cells are transformed into cancer], as more and more cancer-related gene aberrations are discovered,” he said. “This comes at a great time, because genomic medicine is becoming a reality, and I am very hopeful this valuable information will change the way we use drugs for precision medicine.” Read more on cancer.
FDA Approves Device that Uses the Brain’s Electrical Impulses to Diagnose ADHD
The U.S. Food and Drug Administration (FDA) has approved the marketing of the first medical device that will look at a brain’s electrical impulses to help determine whether children and adolescents have attention-deficit/hyperactivity disorder (ADHD). The 15-20 minute test for people ages 6 to 17, which utilizes electroencephalogram technology, can be used to confirm an ADHD diagnosis or help health professionals decide whether further testing should focus on ADHD. “Diagnosing ADHD is a multistep process based on a complete medical and psychiatric exam,” said Christy Foreman, director of the Office of Device Evaluation at the FDA’s Center for Devices and Radiological Health. “The NEBA System along with other clinical information may help health care providers more accurately determine if ADHD is the cause of a behavioral problem.” Read more on technology.
Study: Divorce When a Child is Young Negatively Impacts Later Parental Relationship Security
Young children whose parents divorce may have more difficult and less secure relationships with their parents later in life, according to a new study in the journal Personality and Social Psychology Bulletin. Researchers looked at date from 7,335 men and women with the average age of 24, finding those whose parents divorced when they were age 5 or younger had less secure parental relationships as adults. A secure relationship means that the child feels “they can trust them and depend on them and that the parent will be available psychologically,” according to HealthDay. The negative effect was especially true for relationships with the father. The study found that participants were more likely to have a “strained” relationship with the parent they did not live with after the divorce; about 74 percent of the participants lived with their mothers and only 11 percent lived with their fathers. Omri Gillath, an associate professor of social psychology at the University of Kansas, said the results demonstrate the need for divorcing parents to be as civilized as possible. Read more on pediatrics.
Hospital Inpatient Discharge Data Can Help Prepare for Future Patient ‘Safety Events’
Hospital administration data—specifically inpatient discharge data—can be used to track the incidence of patient “safety events” now so that physicians and other health care providers are better able to treat them in the future, according to a new study in the Journal of Healthcare Risk Management. The study found that an average of 9 percent of inpatient discharges in the sample experienced a safety event, which increased the cost of a hospital stay by about $35,000. “While this figure may be a bit startling, it is not a cause for alarm, in that many of the events that we found are adverse events for which there are no known prevention strategies,” said Jennifer Taylor, MD, an assistant professor in the Department of Environmental and Occupational Health in Drexel University’s School of Public Health. “While such events may not be deemed to be preventable now, we need to start tracking them so our research and development colleagues know what’s next in the prevention pipeline.” Read more on research.
Over-Testing of Cholesterol Levels Wastes Time, Money
One-third of people with heart disease have their cholesterol levels checked too often, which can waste time, cost unneeded money and not actually improve their health, according to a new study in JAMA Internal Medicine. Possible reasons for the over-testing include the desired to reach or exceed American Heart Association performance measures, as well as the additional payment that comes with running a cholesterol panel. "I think a lot of it is because of the habit of (ordering) labs on patients…without really thinking about, ‘What am I going to do with this information with someone who is at target for cholesterol?'" said Salim Virani, MD, of the Michael E. DeBakey Veterans Affairs Medical Center in Houston. Michael Johansen, MD, of The Ohio State University in Columbus, said physicians might be better off placing patients with heart disease on a statin, while ensuring they eat properly and get the right amount of exercise. Read more on heart health.
‘Active’ Video Gaming Boosts Kids’ Physical Activity
While playing most video games is not more physically stimulating than watching television, newer-generation “active” games may in fact boost a kid’s physical activity in the home, according to a new study in the journal BMJ Open. The study first removed all games from the home for eight weeks, then had eight weeks of passive gaming followed by eight weeks of active gaming. While the positive findings were only minor, the researchers said they could prove significant because of kids’ increased exposure to technology. "Therefore small changes across a variety of these platforms could result in a more substantial clinical impact. While our study focused on the home setting, school offers another opportunity for more active technologies such as sit-stand desks or active-input electronic media as part of lessons.” Read more on technology.
A major theme at this year’s AcademyHealth Annual Research Meeting was the need to become more aggressive on translating and disseminating health research. Just last month, the Mailman School of Public Health at Columbia University announced that is was becoming the first school at the university and one of the first of U.S. schools of public health to adopt an open access resolution. The resolution calls for faculty and other researchers at the school to post their papers in openly available online repositories such as Columbia’s Academic Commons, where content is available free to the public, or in another open access repository, such as the National Institutes of Health’s PubMed Central.
“A wider dissemination of research and information has been a number one priority of our faculty, who are motivated by the belief that scientific knowledge belongs to everyone,” said Linda P. Fried, MD, MP, the dean at Mailman. “It is in the interest of all of us to take every measure possible to improve and simplify the process of gaining access to our research findings,” Fried said.
NewPublicHealth spoke with Bhaven N. Sampat, PhD, Assistant Professor of health policy and management at Mailman and a lead faculty member on the open access endeavor.
NewPublicHealth: Why haven’t many journals been open access before and what is making researchers, particularly in the field of public health, interested in more widely disseminating their research?