Wednesday, January 27, 2010

The Scales Can Lie: Hidden Fat

New Study Argues Even Thin People Can Face Health Risks From Fat; It's 'Normal Weight Obesity'

Among some of the Mayo Clinic study's findings: High body fat among normal-weight men and women was associated with a nearly four-fold increase in the risk for metabolic syndrome—a cluster of abnormalities including elevated blood sugar and blood pressure. This syndrome is common among people who are obese and is an increasingly important precursor to diabetes and cardiovascular disease. For women, high body fat meant a heightened risk of being diagnosed with cardiovascular disease over the course of the study. Both men and women had a higher risk of abnormal cholesterol and men with high body fat were more likely to develop high blood pressure. 


The findings of the Mayo study, which was published in November in the European Heart Journal, suggest that reducing heart risk requires increasing the percentage of lean muscle mass at the expense of body fat. That underscores the importance of exercise in maintaining cardiovascular health—including weight lifting and other resistance training, which helps build lean body mass.

Sunday, January 24, 2010

What Could You Live Without?

Another thought provoking editorial from Nicholas Kristof
 While waiting at a traffic light, they saw a black Mercedes coupe on
“Dad, if that man had a less nice car, that man there could have a meal,” Hannah protested. The light changed and they drove on, but Hannah was too young to be reasonable. She pestered her parents about inequity, insisting that she wanted to do something.

“What do you want to do?” her mom responded. “Sell our house?”
Warning! Never suggest a grand gesture to an idealistic teenager. Hannah seized upon the idea of selling the luxurious family home and donating half the proceeds to charity, while using the other half to buy a more modest replacement home.
Eventually, that’s what the family did. The project — crazy, impetuous and utterly inspiring — is chronicled in a book by father and daughter scheduled to be published next month: “The Power of Half.” It’s a book that, frankly, I’d be nervous about leaving around where my own teenage kids might find it. An impressionable child reads this, and the next thing you know your whole family is out on the street.
“No one expects anyone to sell a house,” said Hannah, now a high school junior who hopes to become a nurse. “That’s kind of a ridiculous thing to do. For us, the house was just something we could live without. It was too big for us. Everyone has too much of something, whether it’s time, talent or treasure. Everyone does have their own half, you just have to find it.”
As for Kevin Salwen, he’s delighted by what has unfolded since that encounter at the red light.
“This is the most self-interested thing we have ever done,” he said. “I’m thrilled that we can help others. I’m blown away by how much it has helped us.”

Sunday, January 17, 2010

Botswana Music Guitar "Muhurutsi"

Our Basic Human Pleasures: Food, Sex and Giving

But in any case, nobility can lead to happiness. Professor Haidt notes that one thing that can make a lasting difference to your contentment is to work with others on a cause larger than yourself.

I see that all the time. I interview people who were busy but reluctantly undertook some good cause because (sigh!) it was the right thing to do. Then they found that this “sacrifice” became a huge source of fulfillment and satisfaction.

Brain scans by neuroscientists confirm that altruism carries its own rewards. A team including Dr. Jorge Moll of the National Institutes of Health found that when a research subject was encouraged to think of giving money to a charity, parts of the brain lit up that are normally associated with selfish pleasures like eating or sex.

Friday, January 15, 2010

A Blind Mother of Two Who Makes Her Own Way

Rahkiya Rawlins, legally blind since birth, has found ways of navigating the world. 
She has a liquid level indicator, which emits a sound when she’s filling a glass and about to reach the brim. When sweeping the floor, she starts from the corners and works her way to the middle, following set choreography because she cannot see the dirt. She has the layout of at least three supermarkets memorized so she can move from aisle to aisle with no surprises.

The Underlying Tragedy

The first of those truths is that we don’t know how to use aid to reduce poverty. Over the past few decades, the world has spent trillions of dollars to generate growth in the developing world. The countries that have not received much aid, like China, have seen tremendous growth and tremendous poverty reductions. The countries that have received aid, like Haiti, have not.
In the recent anthology “What Works in Development?,” a group of economists try to sort out what we’ve learned. The picture is grim. There are no policy levers that consistently correlate to increased growth. There is nearly zero correlation between how a developing economy does one decade and how it does the next. There is no consistently proven way to reduce corruption. Even improving governing institutions doesn’t seem to produce the expected results.

Sunday, January 10, 2010

How lists of the ‘dumb stuff’ can save us from disaster

I am a checklist fanatic and really appreciate Atul Gawande's persistent attempts to push this idea, especially in health care...

A recent study in the journal Science showed that rats stop thinking and resort to habit when they are under extreme stress. Humans might well do the same.

Nonetheless we appear to believe that in our professional lives, such stress will produce an adrenalin-fuelled surge of clear and brilliant thought. It doesn’t. And in the ensuing muddle, mistakes – sometimes fatal – are made.

Atul Gawande, a surgeon, Harvard Medical School professor and staff writer for The New Yorker, has written a welcome book to convince us of the distinction between un avoidable failures and those we can avert. The Checklist Manifesto is a slim volume but it is packed with vivid writing heart-stopping anecdotes and statistical surprises.

Saturday, January 09, 2010

TRIAGE : Dr. James Orbinski's Humanitarian Dilemma

Medicare and the Mayo Clinic

President Obama last year praised the Mayo Clinic as a "classic example" of how a health-care provider can offer "better outcomes" at lower cost. Then what should Americans think about the famous Minnesota medical center's decision to take fewer Medicare patients?
Specifically, Mayo said last week it will no longer accept Medicare patients at one of its primary care clinics in Arizona. Mayo said the decision is part of a two-year pilot program to determine if it should also drop Medicare patients at other facilities in Arizona, Florida and Minnesota, which serve more than 500,000 seniors.
Mayo says it lost $840 million last year treating Medicare patients, the result of the program's low reimbursement rates. Its hospital and four clinics in Arizona—including the Glendale facility—lost $120 million. Providers like Mayo swallow some of these Medicare losses, while also shifting the cost by charging more to private patients and insurers.
Of course, only governments can lose that much money and pretend they don't have to change. "Mayo Clinic loses a substantial amount of money every year due to the reimbursement schedule under Medicare," the institution said. "Decades of underfunding and paying for volume rather than value in Medicare have led us to this decision."

Mayo is probably a leading indicator of where other hospitals and doctors are headed. Physicians on average earn 20% to 30% less from Medicare than they do from private patients, and many are dropping out of the program. While about 92% of family physicians participate in Medicare, only about 73% of those are now accepting new patients. In some specialties—neurology, oncology, gynecology—in places like Manhattan and Washington, patients can struggle to find any doctor who'll accept Medicare.

7 Secret Benefits Of Exercise

Everybody knows that aerobic exercise builds endurance and strengthens the heart, and strength training builds muscles. But did you know that exercise creates new brain cells? Or that it can help ward off cancer and diabetes? Or that it can keep you from accumulating the wrong kind of body fat?

My colleague David Schardt, senior nutritionist at the Center for Science in the Public Interest, examines the many health benefits of exercise in depth in the current issue of Nutrition Action Healthletter. Here is some of what he found:

Friday, January 08, 2010

Graphing The Cost of Health Care

Great post on charting cost and outcomes on healthcare in various countries here.. 

The New Chart

The best way to show correlation between two variables is in an XY chart. I got into Chart Busters mode, and plotted X=spending and Y=life expectancy in the following chart. The US and Mexico are colored differently to highlight their non-universal-coverage status, and data points are sized to reflect the number of doctor visits.

Treat Me, but No Tricks Please

My doctor at the Hospital for Special Surgery in New York, Joseph Feinberg, seems to share my opinion. “Very often, I think the hot packs, cold packs, ultrasound and electrostimulation are unnecessary,” he said, adding, “For sure, in many cases these modalities are a waste of time.”
So has physical therapy been tested for garden-variety sports injuries like tendinosis? Or is it just accepted without much question by people who urgently want to get better?

New Happiness Research From The UK

There’s a new research study out of the UK on what makes people happy, and it has some interesting results.

Thursday, January 07, 2010

UPI's top 50 images of 2009

Pakistani internally displaced children queue for food at a makeshift camp in Swabi, Pakistan, on May 25, 2009. Pakistan's military said Monday it was facing "stiff resistance" as it battled to wrest Swat valley out of Taliban hands, in an offensive that has now scattered 2.38 million civilians. (UPI Photo/Sajjad Ali Qureshi)

UPI 2009 Top 50 News Pictures (50 images)

Cheap Mobile Calls, Even Overseas

What my parents did not realize was that they could have nearly eliminated those charges if they had set up their (in this case) iPhone and BlackBerry to take advantage of mobile Internet calling services: That $1.29-a-minute charge would have gone down to a much more reasonable 2.4 cents a minute (or nothing at all if they were on a Wi-Fi network).

10 Ways to Cut Your Travel Costs This Year

Here are 10 simple steps you can take to help cut your travel costs in 2010.

Blame It on the Brain

The latest neuroscience research suggests spreading resolutions out over time is the best approach.

Given its limitations, New Year's resolutions are exactly the wrong way to change our behavior. It makes no sense to try to quit smoking and lose weight at the same time, or to clean the apartment and give up wine in the same month. Instead, we should respect the feebleness of self-control, and spread our resolutions out over the entire year. Human routines are stubborn things, which helps explain why 88% of all resolutions end in failure, according to a 2007 survey of over 3,000 people conducted by the British psychologist Richard Wiseman. Bad habits are hard to break—and they're impossible to break if we try to break them all at once.
There's something unsettling about this scientific model of willpower. Most of us assume that self-control is largely a character issue, and that we would follow through on our New Year's resolutions if only we had a bit more discipline. But this research suggests that willpower itself is inherently limited, and that our January promises fail in large part because the brain wasn't built for success.
Since the most popular New Year's resolution is weight loss, it's important to be aware that starving the brain of calories—even for just a few hours—can impact behavior. Skipping meals makes it significantly harder to summon up the strength to, say, quit cigarettes. Even moderation must be done in moderation.

The final piece of the willpower puzzle is distraction. Research by Walter Mischel at Columbia University and others has demonstrated that people who are better at delaying gratification don't necessarily have more restraint. Instead, they seem to be better at finding ways to get tempting thoughts out of their minds.

A Tale of Two Flagella

I first remembered learning about dinoflagellates, and being fascinated by them, in college zoology...

They are the best of beings; they are the worst of beings. They are animals; they are plants. They are saviors; they are killers. They are predators; they are parasites. They are, in short, dinoflagellates — a large, diverse and eccentric group of (usually) single-celled organisms that are as celebrated as they are feared. And I hereby nominate them for Life-form of the Month: January.

Some dinoflagellates have eyes. Others give off light. Some, like plants, make energy from the sun; others, like animals, capture and eat their prey. Some do both. Funky.

But even if you’ve never seen a dinoflagellate and wouldn’t recognize one if it waved its flagella at you, you’ve probably come across them, for they impinge on our lives in two important ways, one good, one bad.

Most dinoflagellates are small — you need a microscope to see them — and even the biggest ones are no bigger than a piece of caviar. But they have gigantic genomes. Some dinoflagellates have genomes containing around 67 times more DNA than the human genome, and 10 times more than the most extravagantly endowed plants. That’s colossal. (Note that lots of DNA doesn’t necessarily mean lots of genes; in terms of gene numbers, it remains to be seen if dinoflagellates are exceptional.)

Even more peculiar is the way they store their DNA. The usual way is to wrap it around molecular spools known as histones. Dinoflagellates don’t have histones. Instead, their genome appears to exist as a liquid crystal matrix. Wackier still: dinoflagellates have unconventional DNA. In most organisms, DNA is composed of the molecules adenine, guanine, cytosine and thymine. Dinoflagellates often replace thymine with something called hydroxymethyluracil. It’s all most bizarre.

Wednesday, January 06, 2010

Study Says Women With Mate Get Heavier

It is widely known that women tend to gain weight after giving birth, but now a large study has found evidence that even among childless women, those who live with a mate put on more pounds than those who live without one.

The differences, the scientists found, were stark.

Where Did the Time Go? Do Not Ask the Brain

Either way, studies find, this biological pacemaker has a poor grasp of longer intervals. Time does seem to slow to a trickle during an empty afternoon and race when the brain is engrossed in challenging work. Stimulants, including caffeine, tend to make people feel as if time is passing faster; complex jobs, like doing taxes, can seem to drag on longer than they actually do.
And emotional events — a breakup, a promotion, a transformative trip abroad — tend to be perceived as more recent than they actually are, by months or even years.

Now researchers are finding that the reverse may also be true: if very few events come to mind, then the perception of time does not persist; the brain telescopes the interval that has passed.

Popular Drugs May Help Only Severe Depression

Some widely prescribed drugs for depression provide relief in extreme cases but are no more effective than placebo pills for most patients, according to a new analysis released Tuesday.

Taken together, previous studies have painted a confusing picture. On one hand, industry-supported trials have generally found that the drugs sharply reduce symptoms. On the other, many studies that were not initially published, or were buried, showed no significant benefits compared with placebos

Tuesday, January 05, 2010

Willpower as a muscle

Willpower as a muscle

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Letter From London--My American Friends

The first thing I ever heard about Americans was that they all carried guns. Then, when I came across people who’d had direct contact with this ferocious-sounding tribe, I learned that they were actually rather friendly.
Granted, these visiting Americans often seem to have loud voices, but on closer examination, it’s a little subtler than that. Americans have no fear of being overheard. Civic life in Britain is predicated on the idea that everyone just about conceals his loathing of everyone else. To open your mouth is to risk offending someone. So we mutter and mumble as if surrounded by informers or, more exactly, as if they are living in our heads. In America the right to free speech is exercised freely and cordially. The basic assumption is that nothing you say will offend anyone else because, deep down, everyone is agreed on the premise that America is better than anyplace else. No such belief animates British life.

South Koreans experience what it's like to die -- and live again

Across South Korea, entrepreneurs are holding controversial forums aimed at teaching clients how to better appreciate life by simulating death. They use mortality as a personal motivator.
Across South Korea, a few entrepreneurs are conducting controversial forums designed to teach clients how to better appreciate life by simulating death. Equal parts Vincent Price and Dale Carnegie, they use mortality as a personal motivator for a variety of behaviors, from a healthier attitude toward work to getting along with family members.

Many firms here see the sessions as an inventive way to stimulate productivity. The Kyobo insurance company, for example, has required all 4,000 of its employees to attend fake funerals like those offered by Jung.

There's another motivation: South Korea has the highest suicide rate in the developed world.

Sunday, January 03, 2010

Pirate cash suspected cause of Kenya property boom

NAIROBI, Kenya – Property prices in Nairobi are soaring, and Somali pirates are getting the blame.

The hike in real estate prices in the Kenyan capital has prompted a public outcry and a government investigation this month into property owned by foreigners. The investigation follows allegations that millions of dollars in ransom money paid to Somali pirates are being invested in Kenya, Somalia's southern neighbor and East Africa's largest economy.

Even as housing prices have dropped sharply in the United States, prices in Nairobi have seen two- and three-fold increases the last half decade.

Saturday, January 02, 2010

Dave Barry's year in review: 2009

Dave Barry's Hilarious Year End Review Here

To be sure, it was a year that saw plenty of bad news. But in almost every instance, there was offsetting good news:
BAD NEWS: The economy remained critically weak, with rising unemployment, a severely depressed real-estate market, the near-collapse of the domestic automobile industry and the steep decline of the dollar.
GOOD NEWS: Windows 7 sucked less than Vista.
BAD NEWS: The downward spiral of the newspaper industry continued, resulting in the firings of thousands of experienced reporters and an apparently permanent deterioration in the quality of American journalism.
GOOD NEWS: A lot more people were tweeting.
BAD NEWS: Ominous problems loomed abroad as -- among other difficulties -- the Afghanistan war went sour, and Iran threatened to plunge the Middle East and beyond into nuclear war.
GOOD NEWS: They finally got Roman Polanski.
In short, it was a year that we will be happy to put behind us. But before we do, let's swallow our anti-nausea medication and take one last look back, starting with. . . .link

Mammography Screening Is Saving Thousands of Lives, but Will It Survive Medical Malpractice?

There are some very important points made by Dr. Kopans here, especially near the end of  the article in which he discusses  the vagaires of human perception, standard of care, and expert witnesses..

RSNA, 2004
Screening mammograms are saving lives, but the number of radiologists who are willing to read mammograms is decreasing because of their fear of being sued.

There have been recent efforts to highlight the cost of medical malpractice and to try to find ways to reduce these costs (1). However, it is not just the cost of malpractice insurance that is a problem. What I believe is being overlooked is the unjustified psychologic damage that is being inflicted on some physicians, as well as the failure of the legal system to recognize science, with particular emphasis on the detection of breast cancers with mammography. Screening mammograms are saving lives, but the number of radiologists who are willing to read mammograms is decreasing because of their fear of being sued.
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