Fighting Disease with Disease

We are all familiar with recent articles lamenting the speed with which bacterial species responsible for infections have developed resistance to antibiotics. We asked, "What happens when we run out of ways to tweak existing antibiotics?" The prospect of living in a world where bacterial infections triumph over pharmaceutical therapies is a terrifying one.
However, the day that bacterial infections will thrive unhindered by therapy is likely much farther away than those fearing catastrophe propose. While innovations in synthetic antibiotic development have slowed, there are alternatives. Viruses are highly effective at debilitating animals and human beings, why not use viruses to attack and kill bacteria? This article explores a how bacteriophages, or viruses that selectively attack bacteria, can render E. coli defenseless against antibiotic therapy.

Want to swallow this guy?

There is also research using bacteriophages that kill bacteria directly, by lysing bacterial cells they infect, rather than combining forces with antibiotics. (see link) Polish studies demonstrate that this approach has been effective in treating cerebrospinal meningitis in a newborn, dermal infections from E. coli, Staphylococcus, and other bacteria, abscesses under the liver and diaphragm, and various chronic bacterial diseases.

Even more interesting, are attempts to use bacteria to attack and kill. . . other bacteria. This article summarizes attempts to engineer E. coli to produce agents that will selectively kill Pseudomonas aeruginosa, a bacterial species that causes urinary tract infections, pneumonia, skin infections in burn victims and other common infections.

Are we moving from synthetic chemical antibiotics to using living organisms to pathogens?

The Value of Meditation

This article focuses on the effectiveness of meditation in treating issues such as pain, anxiety, and stress.

“According to a new study, even a brief crash course in meditative techniques can sharply reduce a person's sensitivity to pain” (Health Magazine 2010).The study’s results were astonishing; researchers mildly burned 15 men and women on two separate occasions. On the second occasion, the subjects participated in simple meditation techniques and exercises, after which they reported their pain levels. The subjects reported the pain as being 57% less unpleasant and 40% less intense after the meditation, numbers that mirror powerful painkillers such as morphine!

Meditation has also proven effective in treating conditions such as arthritis, anxiety, and mental health problems.  So what about meditation is so effective? Scientists believe that during meditation, the brain’s areas that are responsible for maintaining focus and processing emotions are at a heightened sense; this gives the meditator more control over their physical feelings. “The conventional wisdom has been that meditation relieves pain not by diminishing sensation but by helping people consciously control their perception of pain” (MacLean, Katharine, Ph.D.). Studies also show that in terms of pain relief, meditation changes the nature of pain or stress before it’s perceived by the brain, thus allowing people to better handle the stress.

I chose this article in light of our recently-completed behavior change assignment. Meditation has many health advantages, and it demonstrates the importance of the mind’s control over the health of the body. I believe that this mind-body balance is crucial to maintaining and improving one’s health, and the practice of meditation as a medical prescription may soon become common.

Link: http://www.cnn.com/2011/HEALTH/04/05/meditation.reduce.pain/index.html

Globalization of Disease

The recent outbreak of cholera in Haiti highlights the global connections of disease, as discussed in this article by the bbc.

The links of this disease to South Asian strains of cholera displays how inter-connected the world is. With increasing technological advances, the world is not as isolated from disease as it once was; it's becoming increasingly easier for diseases to spread across continents and borders. I think this example presents how important it is for developed countries to pay attention to the burden of disease in developing countries. While it's a success for those of us in the developed sphere to eradicate certain diseases, if we ignore the plights of the "3rd world" then these diseases can easily be re-introduced into our populations. What we're seeing in Haiti is that this re-introduced disease is actually more virulent than before due to reduced immunization and resistance in the population of Haiti (given that the country had eradicated cholera before).

The recent outbreak of cholera in Haiti also shows that the international community needs to be much more careful in watching the flow of people and disease. Clearly lax approaches regarding oversight of disease allowed cholera to spread form Asia to Haiti. While I think it would be wrong to quarantine areas of the world, I do think certain restrictions should be placed on the movement of people in and out of certain areas - at least ensuring that people who do leave the area do not have the disease, and that people entering the area have proper resistance. In the case of extremely contagious disease this should be vital. Incidents like this should remind us that with an increasingly-connected global community, we should learn to be mindful of our neighbors who suffer from communicable disease not just as a matter of social justice, but also for the benefit within our environs.

Cholera Surge in Haiti

In Haiti, a new concern regarding cholera outbreaks, is placing fear in many people about getting infect. "Health experts in Haiti warned in January when the cholera outbreak began to slow that there could be a surge of new cases in the spring, when rain would help spread contaminated water," says authors of the article affiliated with the Associated Press.

Cholera is an acute intestinal infection caused by ingestion of food or water contaminated with the bacterium Vibrio cholerae. It has a short incubation period, from less than one day to five days, and produces an enterotoxin that causes a large amount of painless, watery diarrhea and vomiting that can quickly lead to severe dehydration and death if treatment is not promptly given (WHO).

Last year, Haiti experienced a total of 160,929 cases of cholera, with 3,573 of those leading to death. WHO and partners, including the GOARN (Global Outbreak Alert and Response Network), have continued to support Haiti in their response to the outbreak. Civil unrest in Haiti has caused a delay in the delivery of supplies for prevention and treatment of patients, particularly in Northern Haiti. Trainings on cholera treatment and initiatives to chlorinate water for 300,000 people had to be postponed because of this, which demonstrates the large effect that an unstable government and civil structure of a nation can have on the ability to promote health. In many other countries, the unrest of the people have caused halts in the prevention methods and treatment dispersal for a various number of diseases. One thing that we, as public health students, must take into account is that tackling the distribution and allocation of supplies is just one aspect of global health that we need to focus on. Beyond that, we must also look into the environmental, political, and social stabilities of the country to determine how to best implement methods in the hopes of improving the health of the community.

Fewer Mammograms Being Done

This article discusses the costs and benefits of annual mammogram screenings of women in their 40s. Studies have shown that fewer women are getting annual mammograms after a report in 2009 said mammograms for these women are not absolutely necessary. This has led to a decrease in the number of women receiving mammograms. There are plenty of arguments from both sides about the necessity of these mammograms, but there is no doubt that the rate of younger women receiving them has decreased dramatically over the past couple of years.

I believe the media and other outlets played an important role in the effect this report had on the population. The report in 2009 said that women should discuss the benefits of screening with their doctor, but in the media, it was portrayed that it is totally unnecessary for women in their 40s to be screened annually. While it may be true that as a whole women do not need to be annually screened this young, it is important to note the effect of the media on our views and beliefs about certain topics. Too often, the media is our source of information that shapes our opinions instead of researching and looking into the topic for ourselves.

Another important issue to consider is the effectiveness of mammograms of younger women. The article says that out of all the biopsies done on women in their 40s at an Ohio hospital, 15% turned out to be cancerous. In public health, it is important for the correct information to be distributed and the article addresses this fact as well. It states that even though the number of mammograms being done has decreased, doctors are now discussing the benefits and risks instead of just recommending mammograms for all women. This is a positive step because universal testing does not always make sense, and giving women the correct information and allowing them to make their own, well informed decision is important.

Topics like this always make me interested in what is the best course of action in these situations. Annual screening of all younger women would undoubtedly save some lives that are lost if they are not tested and the cancer is not caught soon enough. How do medical professionals and public health officials make these decisions about at what point saving the few lives is worth the cost? Overall though, I think doctors discussing issues such as this with their patients and allowing them to make an informed decision is a positive step.

Asthma Numbers Rise in US

I wasn't too surprised to see the article in the New York Times describing the increase in the numbers of asthma sufferers in the United States; it seems like something that you hear mentioned far more now than even a few years ago. However, when looked at in the context of global health, this has significant and dangerous implications.

The levels of asthma in the country have now reached 1 in 10 for children and 1 in 12 for adults according to the most recent figures. Looking at the prevalence of asthma in populations across the country, figures have increased since 2003 for all racial groups as well as gender and age groups. This suggests that the problem of asthma is not just affecting individuals with a particular lifestyle, but everyone.

One of the most alarming parts of this report is that the increased numbers of people with asthma occurred at the same time as a general decrease in the number of smokers in the country. Before this information, many scientists assumed that smoking was the leading cause of asthma increases. What this suggests is that there are environmental triggers causing the disease. These could include environmental pollutants, traffic exhaust, plastics, and use of pesticides.

This has a major tie-in to the topic of environmental health that we looked at in class. When people don't live in a healthy environment, their overall health deteriorates, which also causes a rise in the cost of treating the general population. The article mentioned that people should be better informed about how to treat their asthma, but I consider this to be a very superficial solution. If asthma levels are universally rising, it seems like the root cause of this increase is something that would be work investigating and solving.

Burkina Faso Tests Malaria Vaccine

The African Malaria Network Trust (AMANET), recently embarked on a phase IIb clinical trial of GMZ2, a newly developed vaccine against Malaria. (See article)

Malaria is a major health concern for Burkina Faso. On average, each Burkinbe child under age five will fall ill with Malaria twice a year. On April 29th, Burkina Faso's national malaria research center began vaccinating volunteer subjects. This clinical trial is part of a multi-national program funded by the European an Developing Countries Clinical Trials Partnership (EDCTP). Burkina Faso is the second site in Africa to begin testing the vaccine on human subjects. Clinical testing of the vaccine has been underway in Gabon since November of last year. The next two nations to carry out clinical trials of GMZ2 are Ghana and Uganda.

If effective, vaccinations against malaria could save a significant number of disability-adjusted life years globally. Do you think plasmodium falciparum will mutate too rapidly for the vaccine to be benificial in the long term? After having gained insight from our mock World Health Assembly session on Polio, can you think of any difficulties that might arise if health authorities decide to try to vaccinate all populations at risk for Malaria?

Hormones Create Hope

As we have talked about during many class periods this semester, premature birth is the leading cause of death and illness among new-borns. An article I recently read in the New York Times shed some positive light on this otherwise saddening topic. According to a recent study, a daily dose of hormone gel reduced premature births by nearly half among women at particularly high risk. If proven accurate, this study could turn into an extremely effective world-wide health intervention.

This new treatment is a hormone treatment, taken by the woman daily during the second half of a pregnancy. This treatment is relatively simple yet it could have a great impact on the birth of several babies worldwide. It is estimated that 2% of the nation’s 500,000 annual preterm births could be prevented. Also, it is predicted that screening all women and determining which are at highest risk for delivering pre-term could save the nation’s health system 12 million dollars a year. The treatment is also relatively easy for women to administer to themselves.

As I read this article, I was encouraged by the potential this treatment has for mothers and their children worldwide. However, it left me questioning how this drug would be administered due to the social, culture and financial barriers that could get in the way. It frustrates me that these barriers could prevent the use of a treatment that could significantly reduce the leading cause of infant mortality. I strongly believe that if a distribution program was set up to address these barriers, this hormone treatment could really make a difference. It is inexpensive, relatively easy to use, and overall the perfect candidate for poorer, less educated countries (the countries that need it most). I think the major problem will be the follow up—making sure that the women are taking the hormones every day for the most effect. This could certainly cause any program to lose effectiveness.

The Struggles of Diagnosing Mental Disorders

We discussed in class las week the wide spectrum of mental health problems that millions of people cope with each year. One of the topics analyzed was the difficulty diagnosing a disease of the brain which appears different for each person, with symptoms varying widely. However, the doctors only have symptoms on which to rely, and thus diagnosis can become very inaccurate. This article from the CNN Health blog illustrates a study trying to quantify just how bad our worldwide diagnosis of bipolar disorder is. The researchers found that the United States has the highest incidence rate of the disease out of the 11 nations that were involved in the study. 4.4% of Americans are diagnosed with bipolar disorder in their lifetime, compared to just 0.1% in India.

This study does not reflect in any way the actual prevalence of the disorder in one country compared to another. The data simply shows that there are more psychiatrists trained in the US to diagnose such problems or other doctors are more aware of the possible symptoms of bipolar disorder, and thus more likely to recommend that a patient see a psychiatrist. In addition to these great differences between the two health care systems, the cultural impacts of the disorder are even greater. There is a much higher awareness in the United States of bipolar and its effects. This means that there is a much better chance of a family member, friend, relative or the person themselves realizing they need help and going to seek it in the US than in India. In addition to the high level of health education in this country, there is a much higher chance that someone in India realizing they need help, but choosing not to seek that help because of fear of being outcast.

The authors of the article argue that some heightened exposure to social media, etc. in the US make Americans more disposed to these disorders, but I think that these trends are drastically more impacted by irregularities in diagnosis. The article is another sad reminder of how far we still have to come in dealing with mental health problems, especially in the developing world. Are there any solutions to these daunting statistics?

Aftermath in Japan

When I saw an article about the recovery that's occurring in Japan, I was almost taken aback, because it's an issue that got so much publicity in the direct aftermath of the disaster there, but that I haven't heard about recently. However, this article in the New York Times focused on how people are recovering and still trying to protect themselves by working with government regulations and their own perceptions of what is safe.

The Japanese government has ordered an evacuation within 12 miles of the nuclear power plant site, but what's becoming a problem is deciding what to do for people living beyond that. One family that lives 40 miles away from the site still doesn't feel comfortable going back to their farm because of fear of radiation lingering in the area. Indeed, tests have shown that even beyond the designated 12 mile radius, radiation levels are significantly higher than normal.

Experts still have very limited knowledge of what low-levels of radiation can do to people. Since exposure to radiation is avoided generally, there haven't been direct studies on its effects at a low level such as that around the power plants. Even within Japan's government and scientists, there are huge disagreements right now about where it is safe to inhabit.  This is especially concerning for Japan because of the demographic structure of the cities, with many people of all ages living in very close proximity to each other. Because of this, radiation in a given area has the potential to affect a very large population.

Specific attention is also being paid to areas with children, since most experts agree that radiation exposure should be especially limited for children. As a result, some elementary schools in the area are changing the topsoil on their playgrounds or waiting to allow children back at all.

Issues such as this really emphasize how important it is to have policies in place before disasters strike so that people can be taken care of immediately instead of having disagreements between scientists, politicians, etc. Also though, it shows the different approaches that can be taken towards public health issues. Personally, I would advocate taking a high level of caution until something is definitely known to be safe.

Cultural Health Barriers

This sad article from the New York Times talks about the relationship between culture and health that we have discussed recently in class. The article was written by a Boston pediatrician who was working at a hospital in Haiti when he was faced with trying to save a five-month-old boy who weighed less than four and a half pounds due to severe diarrhea and malnutrition. The boy's mother considered herself to have "bad milk" and was therefore bottle feeding the baby with watered-down 7Up. The boy didn't survive. Here is an instance where the mother was probably doing what she felt was best for the child in not "poisoning" him with her breast milk which was culturally considered bad. At first glance, we might tend to wonder how someone could make such a mistake. With some thought, however, it is easy to see that culture plays a huge role in our own ideas of sickness and health. For example, a single poorly-run study by a doctor who is now banned from practicing medicine showed a link between autism and childhood vaccines. Nearly twenty studies have since proved the link to be false, but suspicion about childhood vaccines still seems to be lingering. The idea that cold temperatures cause illness and that chicken noodle soups help colds are also cultural ideas about illness. What if any of these cultural conceptions (especially concerning the vaccinations) were to be very harmful to society's health? We would have much the same problems as the misconceptions about breast feeding are causing in Haiti. This is yet another reason to realize that culture must be respected and it emphasizes the importance of understanding a culture's role in lifestyles and health decision making.

Beyonce's Creative Campaign Against Childhood Obesity

Today online I found a really interesting article about the singer Beyonce and her campaign with Michelle Obama to fight childhood obesity. The campaigned just launched a music video, starring Beyonce, called "Move Your Body", which comprises of 4 minutes of dancing that incorporates various exercises all in an attempt to get kids more excited about being healthy. The coolest part about the video is that it isn't meant to just sit online and simply motivate people. Schools across the country have signed up to "flashmob" the video and perform the dances in it, and a link is even available online with instructions on the choreography.

This is what I find the most intriguing about the video, and I think it can be applied to a lot of other situations to encourage healthier lifestyles. By using the internet to encourage schools to practice the dance, record it, and upload it to the internet, incentives are created to motivate people to be healthy. What if stars like Beyonce continued to post new dances for schools to learn, or even made an online competition out of it? Although I'm not the biggest fan of dancing, I can't help but to admit that there aren't many other activities that large groups of people can do together that keep everyone in constant motion. If applied to something like gym class, it can really encourage everyone to be active and moving. Also,what if sports stars made online videos encouraging kids and schools to post videos on the internet?

If schools can encourage their students to participate in these kind of online events that encourage healthier behaviors, I think many school children can be challenged to live a healthier and more active lifestyle.

Cigarette Chaos in China

This article was just published in the New York Times this morning, and it illustrates the grim realities that follow a smoking ban as it is attempted in China. Starting on Sunday, all bars, restaurants, hospitals and other public places are mandated to be smoke free inside and out.

Smoking related conditions account for four of the five leading causes of death in China. And, of all of the cigarettes smoked in the world, 1/3 are consumed in China, with both of these statistics according to the World Health Organization.

However, an owner of a cafe in Beijing had only this to say "Our whole restaurant is the smoking section," he said. "Maybe we'll try to ask people to go outside, but in the end, the customer is God."

So, why even make a legislation in the first place? And why had the legislation made great progress in areas like the United States as compared to the speculation around China attempting to install the same practice?

Along with China having the sheer greatest number in its population, there is also as expected the greatest number of smokers. The smoking population in China has reached 300 million at this point. This entire movement was sparked by a treaty that the State Council of China signed with the World Health Organization in 2006, in which they were expected to enact legislation to control the rampant tobacco use within 5 years. However, up until now all campaigns to try and achieve this goal have been overridden by various ill circumstances and excuses. China is already 5 months past this deadline.

The way that this legislation works is that if establishments do not comply with the regulations that take effect tomorrow, then they will be charged 30,000 yuan or $4600. However, the problem with the standing legislation is that restrictions are unclear, and so violations are also unclear. With all of these gray areas, enforcement looks bleak.

Something to consider though is how much smoking is a part of the Chinese culture. In America, the trend had already been dying out a bit before it was mandated in public places. However, in China, this is still a mainstay of business men in their transactions as well as normal people trading cigarettes as gifts because it has been a symbol of class and social settings for a long time. And, education stands to be an issue seeing as according to a survey, only approximately 23% of the adults in China would understand that smoking can lead to cancer and other various illnesses.

It is yet to be determined how individual municipalities will interpret the law, and then how this will be reinforced.

Genital Cutting and its impacts

So in class today we talked about female genital cutting in the context of women's health. This article in the New York Times talks about its impact on young women who have undergone this procedure.

What shocked me about this procedure is the extent to which families would go to have their children receive this "treatment." The article cites numerous cases in which children are flown out of the country; this has been such a problem that laws have been created to prevent this from continuing. I think its also shocking that in many West African villages, the mother's consent is not needed to carry out the procedure. For such a potentially psychologically-harming event to be treated in a cavalier manner, I feel, presents the need to influence cultural perception. This is one of those cases in which public health understands the science, that the treatment is actually not beneficial, but needs to overcome a cultural barrier. That this treatment is already controversial in nations that allow the procedure indicates that cultural norms in around the world are at the very least being challenged.

Another aspect that struck me is the level of psychological trauma many young girls feel regarding this event. Many of them describe it as the worst day of their lives. This trauma could have a severe impact on the future mental health stability of these young women. In addition, these girls could face social stigmatism, especially in the United States, where the cultural norms of other countries may not be understood nor appreciated.

Link Between Women's Poverty and Height Found

There was recently a study published by Harvard that explored the heights of women in developing countries. This was important to their study of the conditions that these women were living in, as height as an adult is often linked to levels of childhood nutrition, poverty, and disease.

As such, it can be used to track the conditions of women in these countries. It found that in 14 African countries, the heights of women have decreased over the past two decades. Additionally, heights have remained the same in 21 countries in both Africa and South America. What this suggested to researchers is that women in these countries were actually worse off and being raised in poorer conditions than their mothers and grandmothers had been.

One Harvard professor involved in the study went as far as saying that the results showed that conditions for women in lower socioeconomic classes are getting worse. This underlies again what we talked about in class regarding the ties between poverty and health. According to the study, these women lacked the economic ability to have proper nutrition at a young age, and as a result of this suffered from lowered height then previous generations. While a little height in and of itself could be seen as benign, the bigger problem is what this says about the health of these women in other areas.

The study covered 54 countries considered "poor to middle class" and looked at the heights of over 365,000 women. Only those between the ages of 25 and 49 were looked at, so that women still growing or women who had started shrinking wouldn't interfere with the data.

One thing that I wish the study had done is examine data from women in countries considered developed as well, so that there would be a basis for saying that women in poor countries deviated strongly from those in other areas. Without this comparison, I don't think that you can cite it as purely an indication of poverty in these countries.

This article was found on the New York Times website

The Importance of Vaccination in Children

The measles, a virus that affects one’s pulmonary system, has long since been eradicated from the Americas. However, recent outbreaks have posed an alarming threat. This article talks about the importance of vaccination in preventing the disease’s comeback.

                The disease was first declared eliminated in the United States in 2000 by the CDC. However, a recent report suggests that measles are on a rise. The primary cause: different strains of the disease are brought into the US from different countries. These cases of “imported measles” tend to target unvaccinated children, in particular. According to the report, the children who had the measles had recently traveled abroad, and none had received their recommended measles, mumps, or rubella vaccinations.

                So what is the cause for these outbreaks? One of the main reasons is a difference in rules and regulations for vaccination between different countries. While one country may require travelling children to be vaccinated starting at age 1, another may not require vaccination and immunization until an age of 4 years. Now, the CDC is recommending that any child over the age of 6 months receive a dose of the MMR (mumps, measles, rubella) vaccine.

                I thought this article was interesting in that it brought up issues mentioned in class, such as the concept of the double burden of disease. As mentioned in the past, with rapid globalization comes some drastic health consequences. One of these consequences includes the spread of disease that was previously thought to be eradicated. This article is a perfect portrayal of the consequences of globalization and the spread of disease, and in this case, it is important for everyone to be vaccinated before traveling to a foreign country so as to prevent the spread of disease.

link: http://thechart.blogs.cnn.com/2011/04/07/kids-traveling-abroad-need-measles-vaccine/

Miracles and Health

When culture and health cross-cut each other, there's often rather treacherous terrain ahead for public health officials. Too often, health officials come in and approach health solely from one end--that being the purely physical side of things. As health treatment methods increasingly learn to adapt to the idea of wellness (complete mental, physical, and spiritual) health, I think the new question is how much credence do we give to each area. This article addresses the role of spiritual prayer in the cure of an infectious disease.

A young boy sustained a minor injury in a basketball game, only to become subject to a bacterial infection caused by "a flesh-eating bacterium called strep A" according to the article. The infection then consumed his flesh at a rapid pace, disfiguring his face. According to medical professionals, the infection was so dire as to be life-threatening and the doctors informed the young boy's family that he might not survive. Shortly thereafter, the family (who was Catholic) brought in a priest to give the boy his last rites and began praying to a Kateri Tekakwitha who according to the article, "was a Mohawk who converted to Catholicism. Her face was scarred by smallpox. Legend has it, when she died, her scars vanished. She was beatified in 1980...". The family and religious officials felt she would be an appropriate person to intercede for the boy due to their shared Native American heritage and similar sufferings.

After news of the boy's illness and prayer intercessions spread through his school and family, others elsewhere took up his cause and began to pray for him. Later, a representative from the Society of Blessed Kateri came to the hospital and gave his family a pendant with Kateri's image on it. Shortly thereafter, the boy began an abrupt and miraculous recovery. After two months, the boy was released and returned home. And now, thanks to the unexplainable alteration in the disease's course, religious officials are investigating the case as a potential miracle.

Reading this, I definitely had my doubts. The article also went on to detail how the Church investigated each individual potential "miracle" and fastidiously rejected nearly 95% of submitted cases and sorted through the rest.

I think the point I took away from this article is how important it is to approach health from all sides--especially when one or another fails. Too often we are uncreative with our approaches or unwilling to try a new method. Prayer, meditation, etc. have all been shown to have effects on issues such as stress, heart rate, etc. Non-traditional medicine such as herbal remedies and acupuncture have also provided new and often reliable treatment avenues. This is not to say though that traditional medicine should be entirely eschewed, but rather perhaps when couple to non-traditional routes we can find better, even more effective cures. If anything, perhaps they will be better-suited to a particular populations' needs and beliefs. Often times too they can be more cost-effective than traditional medicine.

In public health and medicine, perhaps we become a little too jaded after a while as well. Truly, every success against a disease, every prevented death and DALY is a miracle in and of itself. Sometimes we just need to take a step back to see it.

Guidelines Allow Earlier Definition of Alzheimer's

This article discusses the new definition of Alzheimer's recently released which includes an earlier stage of the disease in addition to the other two already in existence. This new stage is necessary because by the time most people today are diagnosed with Alzheimer's, they have been experiencing symptoms for many years and it is too late to treat the disease. The new stage is diagnosed before symptoms start becoming readily visible but changes can be observed withing the brain. Alzheimer's is a disease which very little is still known about and there is not much treatment for it at this time. Another reason for this change in the definition is because of the need for more research on Alzheimer's so effective drugs can be developed. When people today are diagnosed, it is usually too late to do much research about the disease and try to find effective drugs or treatment. The scientists and doctors are hopeful this new definition will allow for better research and subsequent treatments to be discovered.

Alzheimer's disease covers many aspects of global health and is very different than many other mental illnesses. Unlike depression or other mental illnesses, I do not believe that Alzheimer's carries any negative stigma with it whatsoever. Instead, it generates and sympathy because of its long and debilitating nature. This makes it easier in some regards to diagnose patients early. People are going to want to know if they have Alzheimer's as soon as possible so that they can take steps to slow the onset of symptoms. Someone suffering from depression is much less likely to ask the doctor if there is anything that can be done for example. The article talked about the diagnosis of Alzheimer's using biomarkers as a way to predict the onset of Alzheimer's much like is used for heart disease already. The more people researchers can see in the early stages of the disease, the more able they will be to find a treatment.

The search for a cure or effective treatment is very important because the prevalence of Alzheimer's is expected to triple in the next 15 years. With no cure, Alzheimer's could become an even bigger problem than it already is today. It is a helpful step as well that a program has been set up to help fund treatment and research of people diagnosed with Alzheimer's in early stages. This will allow the effort to treat people earlier more effective because many people will likely not want to pay for treatment of a disease that is not affecting them and won't affect them for many years.

It is necessary that the public be educated by doctors about the early signs of Alzheimer's and to not be afraid to ask for tests. The earlier it is detected, the more effective treatment can be. Researchers are expecting to make rapid progress in finding an effective treatment with the cooperation of more patients in the early stages. The funding for this treatment was a great idea and will be very helpful. As more information is discovered about Alzheimer's, this definition will undoubtedly change again. The article talked about how the nature of Alzheimer's is not well understood by the general public but did not answer the question of how doctors and researchers plan to fix this problem so the research can be most effective.

Panic in the Meat Industry?

As I was scrolling through a few of the major online news sources a few days ago, I came across an article on each page about a huge crisis in the meat industry. Here is one example from FoxNews, with the headline exclaiming "Nearly Half of U.S. Meat Tainted With Drug-Resistant Bacteria." The New York Times and CNN.com each published articles with similarly shocking headlines. The information came from a release by the Associated Press after the Translational Genomics Research Institute published a study concerning the contamination.

The researchers announced that 47% of tested meat was found to be contaminated and 52% of the contaminated samples were drug resistant. Clearly, this news is extremely worrisome. My initial reaction to this article was anger. I saw this as another example of a public health category where the US was outspending almost every country on the globe, but not seeing the results. How could we claim to be such a developed country and lag so far behind on the safety of out our meat products? However, upon closer examination, I found several glaring problems with the articles themselves that frightened me even more.

The first problem with the headline published by Fox News is that half of the contaminated samples are drug resistant, not half of all of the samples. How can a "reliable" news source publish a title of a headlined article with such a mathematical error. The difference between "nearly half" and 24% is enormous. How did this error slip past the editors?

Despite this math error, there is another even larger problem that I discovered in the article. The study conducted by these researchers examined only 136 samples of meat. To declare that half of the meat in the US in infected based on this extremely limited sample size seems fairly far fetched to me. There are more than 136 portions of meat consumed in one restaurant in one night, much less the entire country.

I wonder how carefully these news sources inspect releases by the AP before publishing them. It also concerns me how the headline so poorly reflects the actual study being done. Especially on the topics concerning public health, the spread of misinformation can be very costly. The meat industry provides nutrition for much of the country, in addition to creating income and jobs for many people. A simple "math mistake" in this headline could yield very costly health results for these people. In addition, when studies like this create a startling effect, but then are later retracted, the effect of a real scare can be lost on the population when something does need to be done.

How can this misinformation in the media be dealt with? As we have discussed in class, the communication of information in public health is more important than anything else in the field. Misinformation like this can do unimaginable harm for many years to come. What can those in the public health field do now to prevent this nightmare situation from happening in the future? What can we do to limit the damage that has already been done?

Ties Between Suicide Rates and Economy

According to an article found in the New York Times, there is a huge relationship between the number of suicides and the economic trends of a society. The relationship has been tracked since the Great Depression, and shows that in the United States, suicide rates go up the worse the economy is and down the better it is.

Though this trend seems almost common sense to some researchers, what has been mixed are the proposed reasons for it. Some argue that the bad economy causes people to develop depression or mental illness, while others say that the root cause is that the economy pushes already mentally vulnerable people further towards suicide.

Even though this distinction requires a far more elaborate analysis of people's previous and current mental conditions, job description, etc. than is currently available, The American Journal of Public Health published an extensive study to try to track rates among different age groups. It showed that only young to middle-aged adults were affected by the economy in terms of suicide rates, with both children and the elderly being unaffected. 

Also cited in the study were the potential effects that cultural influences could have placed in terms of the transition. For example, the study mentioned that during the sixties, the suicide rates could have been higher because of the increased social tension and unrest, not just the economy.

The article went on the suggest that this sort of research could help doctors treat patients better by taking the economic and cultural conditions into account when screening for mental illness problems. Public health has a role to play here in terms of educating the public, including health workers, about the negative effects that the economy can have on mental health so that there can be increased awareness. Personally, I think that it also has a responsibility to try to influence people to incorporate healthy things such as meditation into their lives, especially in stressful economic ties in light of the relationship that this has to mental health. This can also include eliminating the stigmas surrounding mental health currently in our culture (things like thinking that it's just weakness) so that people feel like it's acceptable to seek our help.

One Well of a Problem

Article

From 2005 to 2009, it has been estimated that oil companies, in well over 13 states in America, have injected millions of gallons of hazardous or carcinogenic chemicals into the wells in the area. These chemicals "used by companies during a drilling process known as hydraulic fracturing, or hydrofracking, which involves the high-pressure injection of a mixture of water, sand and chemical additives into rock formations deep underground," are becoming a public health hazard to the population.

This process of hydrofracking is under investigation by epidemiologist, environmentalists, and policy makers alike. It has been made a concern that the use of these chemicals could potentially find their way out of a well bore, due to events such as above-ground spills, underground failures of well casing, or migration through layers of rock, and into nearby sources of drinking water. Ingredients found in these dumpings were extremely toxic, including benzene and lead. Other harmful fluids that contained at least one toxic or carcinogenic chemical were also found in Colorado, Oklahoma, and Texas in larges volumes.

With the oil shortage occurring in our world today, should oil companies cease to carry out this process? Without it, tapping into large reserves of natural gas in our country will not be possible, thus our economy based upon oil might experience a decline. However, if water is contaminated as a consequence to this action, the endangerment that millions of people will be subjected to can result in serious damages to health. Much of the identified contaminated water has been cycled through waste plants that are not designed to filter out waste containing these such chemicals. The debate still continues in Congress whether or not the hydrofracking has the potential to poison the water supply, and if so, the legislation that needs to be discussed to place regulations on oil companies and the process of hydrofracking.

Sleep Loss (aka College) and Its Effects on Health

There's an interesting article this week in the New York Times that talks about a recent study done to determine how many hours of sleep people actually need to function throughout the week. Since I'm sure some of us are probably not getting 8 hours of sleep each night, I figured this article would apply perfectly to us.

In a study done by David Dinges from the University of Pennslyvania, dozens of people were assigned various hours of sleep for each night (4 hours, 6 hours, and 8 hours) and then tested using the "psychomotor viligance task", which is a fancy term for a test used to measure people's response times. The study showed that those in the 4 hour and 6 hour brackets not only showed lowered scores than those with 8 hours of sleep, they became progressively lower as the week went on. This means that even if you are getting just 6 hours of sleep, your body isn't capable of successfully adapting to this change. Essentially you can't just "get used to it", like so many people would like to think they can do.

The article then compares this study to one done where people were only allowed to sleep for 7 hours. Even after this much sleep, people's reactiveness decreased and decreased even more so over time. The article has a great quote that says, "Americans average 6.9 hours on weeknights, according to the National Sleep Foundation. Which means that, whether we like it or not, we are not thinking as clearly as we could be."

This is why sleep is so important to public health. Not getting the correct amount of sleep affects everything from stress levels and cardiac health to proper decision making and clear thinking. Seeing that so much of public health is about making healthy decisions, there should be a real push to make sure people are getting enough sleep to want to make these decisions. It's pretty easy to visualize. I know that when I'm tired the last thing I want to do is go to the rec center, and the first thing I want to do is eat some Fusz pizza and then take a nap.

If America can begin to shape its culture in a way that encourages a full night's rest every night, the health benefits could be enormous. Yet doing this is clearly not easy task. Can you think of any ways that might get people to just go to bed?

Community Health Workers In the News

Here is an interesting infographic from www.good.is discussing the roles and effects of having well-trained community health workers as part of a health system, particularly in rural or low-income areas. I found two things about this infographic very interesting and neither of them was explicitly stated. First of all, the fact that information about community health workers is being posted on a news outlets is an indication that having community health workers may be gaining the respect and awareness of many people. Secondly, the information for the infographic came from writings released by the Bill and Melinda Gates foundation. After learning in class about how helpful community health workers can be, particularly with maternal and child health, it is encouraging to me to see foundations such as the Bill and Melinda Gates foundation taking a role in helping place community health workers where they are needed. The infographic also listed some simple, but effective tools and medications that community health workers often use to help improve maternal and child health, which is definitely something worth taking a look at.

Success in Zambia

I recently read an article that was an encouragement among many of the depressing stories we read about in the news. This article was a success story having to do with Zambia. According to recent data, Zambia has been able to decrease the incidence of malaria by 66%. This decrease accomplished many of the goals previously set for the country to achieve by 2010. According to this article, the success was largely due to the resource allocation to malaria control programs and the Government’s commitment to fighting the disease.

I think that this article is a great example of what can be accomplished when resources are placed in effective areas and the government is on board for the fight against the disease. I know it is a rare occasion for things to come together this well and have this much success, or at least we do not hear about it too often. I thought it was nice to be able to see what can be accomplished when the pieces fall together properly.

The major interventions used were the distribution of Insecticide Treated Nets and the indoor Residual Spraying. Fortunately, cultural barriers did not inhibit the use of these items as it may in many other countries. Also, there were enough financial resources to make sure these treatments extended to almost all of the population. Again, these blessings assisted the success of the malaria treatment and prevention. However, we must not undermine the contribution of the well-organized team that headed these interventions.

Zambia still has some kinks to work out, such as the potential threat of resistance development because of the continued use of insecticides. However, this story is an inspiration to all interventions worldwide. Change and success are possible, and many lives can be saved.