Author: Dannielle Kelley

TV and cognitive function later in life

A little Netflix binge here and there is probably OK, but if you watch TV more than three hours a day you may be setting yourself up for lower cognitive function later in life, according to a new study published in JAMA Psychiatry.

In a longitudinal study of over 3,000 people followed for 25 years (1985-2011), researchers found significant associations with higher levels of TV watching and poor cognitive performance (speed, memory, and executive functioning). Low physical activity was also associated with poor cognitive performance. Adjusted analyses revealed that those who consistently had high levels of TV viewing, and low levels of physical activity were twice as likely to have poor cognition scores relative to those who don’t watch much TV and are physically active.

While the study has its limitations, (no baseline measure of cognitive performance and data is completely self-report),these findings suggest that you can be proactive in maintaining your cognitive function by cutting back TV time and getting a bit more exercise.

Is sex scarier than driving a car?

First, think about the following two scenarios:

  1. Imagine that a thousand people—randomly selected from the U.S. population—had unprotected sex yesterday. How many of them will eventually die from contracting HIV from that single sexual encounter?
  2. Now, imagine a different thousand people. These people will drive from Detroit to Chicago tomorrow—about 300 miles. How many will die on the trip as a result of a car crash?

Risk perception is a an important thing to understand when developing communication campaigns and interventions. Understanding how to counter misguided risk perceptions is just as important, but very tricky.

 

In a study led by Dr. Terri Conley at the University of Michigan, people thought that in the HIV scenario 71/1,000 people would contract HIV, while only 4/1,000 would die as the result of a car crash…but these estimates are WAY wrong.

You’re actually 20 times more likely to die from a car crash than contract HIV. So why are people so wrong?

STIGMA.

Societal messages about most STDs are blown way out of proportion. The stigma surrounding most STDs is so bad, people feel uncomfortable talking about it, so these myths continue, and people are unfairly labeled. Of course, practicing safe sex is CRUCIAL and you and your person should be able to have a mature conversation, free of judgement, before engaging in any unprotected sexual act.

And of course, be a courteous and alert driver.

Happy holidays!

 

http://www.theatlantic.com/health/archive/2015/11/the-stigma-of-sex-related-health-risks/415518/

Snake Venom (in the operating room!?)

While blood loss is inevitable for just about any surgical procedure, post-operative bleeding can be a serious issue for many, especially those on anti-clotting drugs used to prevent heart attacks and strokes. For most people, blood loss is contained by natural mechanisms, and by preparations made by the surgical team which may include applying pressure to the wound and adhesives. But for those who need something more, one doctor thinks he has found the answer in snake venom…

Jeffrey Hartgerink, a chemist at Rice University in Houston, Texas, believes the mechanism through which venomous snakes kill their prey, may be harnessed to prevent post-operative bleeding. The bite from a spearhead pit viper turns the blood of its prey into jello, which is fatal for obvious reasons as it obstructs blood flow. Dr. Hartgerink experimented with using venom to promote controlled blood clotting (only to specific areas) on rats. He mixed the venom with hydrogel, a substance that traps water, allowing the venom to leak out a slow rate – slow enough to not escape into the blood stream, but fast enough to seal the wound. This worked. Next Dr. Hartgerink tested this substance on rats that had been treated with anticoagulants, and rats that had not been treated, and found results to be the same, regardless of whether or not the rats were given an anticoagulant.

This gel has not yet been used in an actual surgical procedure, but according to this study, published in Biomaterials Science and Engineering, snake venom may be a useful tool in the operating room.

Speaking two languages may help restore brain function after stroke

A recent study published in Stroke, a journal sponsored by the American Heart Association, found that patients who spoke two languages experienced better recovery after having a stroke, compared to patients who only spoke one language.

The study, which took place in Hyderbad, India, evaluated 608 patients who had experienced a stroke between 2006 and 2013 – more than half of these patients spoke at least two languages. Even after controlling for demographic and lifestyle factors such as age, smoking, chronic disease, and education, results showed that 40% those who spoke more than one language had normal cognitive function after stroke, whereas only 20% of patients who spoke only one language had the same outcome. Patients who spoke more than one language also had better attention, post-stroke.

When interviewed by Reuters, the lead researchers on this study offered an explanation for why speaking two languages may help recovery, post-stroke:

“Using multiple languages challenges the brain, as it can be harder to find a particular word switching between languages, and this challenge promotes neuroplasticity or ‘cognitive reserve,’ which prepares the brain to deal with new challenges, like disease, she said.”

The original research article, and data supplement, is available free here.

Decline in Prostate Screening and Cancer

The availability of cancer screening is a great thing, under the right circumstances, but there is a danger to over-screening. While screening tests are useful tools, they are not always necessary to improve someone’s quality of life and sometimes lead to misdiagnosis. The U.S. Preventive Services Task Force tries to aid the screening process by creating recommendations based on peer-reviewed research. As medical knowledge continues to grow and tests improve, these recommendations are subject to change over time.

In 2012, the USPSTF recommended against screening for prostate cancer for men 75 years old and older. Considering the slow pace at which most prostate cancers progress, the implications of a positive screen for prostate cancer can be worse than living with the disease, unaffected. With a positive test, comes a biopsy, which may lead to surgery, radiation, or hormone therapy, all of which come with their own set of challenges and complications – not to mention all of the psychological consequences that come with a positive cancer screening.

Two recent studies show that the American public and healthcare providers actually listened to the USPSTF guidelines, showing a significant decline in screening and prostate cancer diagnoses. 33,519 fewer men per year (since 2012) were diagnosed with prostate cancer.

Not everyone is on board with this new recommendation, however. Some fear that the drastic decline in screening may lead to more prostate cancer- related deaths. For more information about this debate, please see NPR’s report.

Music and Medicine

Music is a form of communication that is more expressive than the words which may, or may not be, present in its verses. Music has the ability to bring people together, to incite movements, progress, riots, and celebration. With such a diverse profile, music’s role as an aid in the healing process is not surprising.

A recent systematic review and meta-analysis published in The Lancet illustrates the benefits of music during postoperative recovery. The researchers looked at 73 randomized controlled trials of the use of music initiated before, during or after surgery for adult patients. Results suggest music is effective in reducing post-operative pain and anxiety, and also improved patient satisfaction. Results were best when music was played preoperatively. Interestingly, being able to choose the music did not significantly improve patient outcomes compared to when the music was chosen for patients.

The authors conclude that music is an effective intervention to improve postoperative patient outcomes by reducing pain and anxiety. They also offer a few explanations for why music is effective in their discussion:

  1. Pain is affected by physical and psychological factors, thus music can affect perceptions of pain and intensity.
  2. Reduced autonomic nervous system activity.
  3. In certain contexts, more relaxed and attentive medical teams if played intraoperatively (*if the music is something the team enjoys listening to. Music could have a negative effect if the procedure requires doctor-patient communication, so, intraoperative music should only be used if the medical team approves).

Music may not work for everyone, but its potential as an aid in the postoperative healing process is promising. However, its use should be the choice of the patient and should not be used if it would interfere with the surgical procedure.

5 Gaps in Clinical Preventive Services for Women

The U.S. Preventive Services Task Force (USPSTF) recently released its fifth annual report to Congress on high-priority evidence gaps for clinical preventive services. This report is a requirement of The Patient Protection and Affordable Care Act, Sec. 4003 (F):

“The submission of yearly reports to Congress and related agencies identifying gaps in research such as preventive services that receive an insufficient evidence statement, and recommending priority areas that deserve further examination, including areas related to populations and age groups not adequately addressed by current recommendations.”

The USPSTF does not conduct it’s own research, but reviews existing peer-reviewed evidence to make these recommendations. These recommendations are not based on costs or insurance coverage decisions. For more information on the Task Force process for making recommendations, please see the full report here.

The five gaps the Task Force identified the following as areas in need of improvement:

  1. Screening for Intimate Partner Violence, Illicit Drug Use, and Mental Health Conditions
  2. Screening for Thyroid Dysfunction
  3. Screening for Vitamin D Deficiency, Vitamin D and Calcium Supplementation to Prevent Fractures, and Screening for Osteoporosis
  4. Screening for Cancer
  5. Implementing Clinical Preventive Services

 

Scary movies: “the horror paradox”

When you were a kid, did you love watching scary movies? Or were you like me, and hid under the covers, covering your ears saying “LALALALALA” and asking your friend if “it was over yet”?

The research on the effects of watching horror movies is mixed.

On one side, research suggests that these films should be avoided, claiming violent depictions in horror movies are likely to make people more hostile and to see the world as a violent, hostile place. Also, the physical effects of being scared may create a “negative trace,” similar to experiencing actual trauma and possibly leading to more issues later in life.

On the other side, research suggests that scary movies may not be such a bad thing. Such movies may provide an opportunity to practice and master responses to fearful situations, while in the comfort and safety of your home. These movies may also provide satisfaction for those who crave intense emotional experiences.

Both sides make some pretty convincing points. But personally, I think I’ll just stick to comedy – grad school is scary enough 😉

Travel safe: health prep before you jet

Are you planning any extravagant trips this holiday season? Maybe exploring the ancient city of Petra, or hiking through the steep ridges of Patagonia, or testing your bargaining skills in shops found in the Colaba Causeway in Mumbai. Wherever you are set to go, make sure you and your traveling buddies and hosts get the most out of the experience by finding out what you need to do to prepare your body for foreign territories and tasty treats. Some countries will provide a detailed list of all the vaccinations and recommended medicines to carry with you before you enter or acquire your visa, but always double check sources you trust.

The CDC’s Travelers’ Health page is a great up-to-date resource for all your health travel advice. The World Health Organization also has some helpful tips. Also, make sure you are aware of any recent outbreaks or health concerns your destination is dealing with around the time of your travel. Try to identify key resources (your country’s Embassy, trusted health clinics, and pharmacies) in your immediate area, in case of an emergency.

And as always – be a courteous traveler. Recognize that you are no longer in your own country and things may be very different. Be respectful of the people and local customs and you will surly have a great time! The Lonely Planet is a fun source of information about all things historical and cultural – just one example of many.

Happy traveling! 🙂

Non-vaccinators: Implications for Health Communication Intervention

If you wanted to deliver an effective and persuasive message to an audience, what are some of the things you may consider well before broadcasting your message? Certainly you would want to be sure you understood the history of the topic, the pros, the cons, and alternative solutions/courses of action. But before even crafting your message, it would be wise to understand your audience. An audience is rarely just one cohesive body of like-minded individuals who hold the same attitudes, beliefs, and values regarding a particular issue. An audience often has multiple segments, each with a unique profile. This idea of segmentation was first introduced into the marketing field as a way to increase return on investment by tailoring a product to the unique needs and desires of subgroups of people (for a review of audience segmentation and how it relates to health campaigns see Slater, 1996).

Segmentation has been a useful tool for communicating issues related to health. Although segmenting audiences is as much a science as it is an art form, tailoring communication interventions with audience segments in mind increases the likelihood of a campaigns success.

Researchers from Rutgers University and Aachen University and the University of Erfurt, both in Germany, teamed up to offer a segmentation strategy on an international issue: delay in acceptance or refusal of vaccination. In their article, the researchers review reasons why people do not vaccinate, and offer an addition to the World Health Organization- SAGE vaccine hesitancy working group’s “Three C Model” (complacency, lack in confidence, and convenience issues).

  1. Complacency “perceived risks of vaccine-preventable diseases are low and vaccination is not deemed a necessary preventive action” (SAGE vaccine hesitancy working group, 2013)
  2. Convenience: “The quality of the service (real and/or perceived) and the degree to which vaccination services are delivered at a time and place and in a way that is considered appealing, affordable, convenient and comfortable, also affects the decision to vaccinate. Vaccination convenience and complacency are also determined by the priority that an individual places on vaccination.” (SAGE vaccine hesitancy working group, 2013)
  3. Confidence: “Trust in the effectiveness and safety of vaccines and in the system that delivers them, including the reliability and competence of the health services and health professionals and having trust in the motivations of the policy‐makers who decide which vaccines are needed and when they are needed. Vaccination confidence exists on a continuum, ranging from zero‐to‐100% confidence. Vaccination confidence is only one of a number of factors that affect an individual’s decision to accept a vaccine.” (SAGE vaccine hesitancy working group, 2013)
  4. Calculation: This C, added by Betsch and colleagues, refers to those who do not have strong preexisting attitudes regarding vaccination, thus seek out information about the pros and cons to ultimately make a decision that leads to a decision. For example, calculators may choose not to vaccinate if harm from infection is perceived to be lower than harm from vaccination, or if they have conflicting information (See Betsch et al., 2015 for more information).

The researchers then developed a table highlighting ways to effectively intervene by audience segment (the Four C’s). You can view the table here. The table is nicely organized into different types of intervention (informational interventions (i.e. health communication campaigns); structural interventions; and interventions to support self-control and implementation).

As the authors’ state in their article, more research is needed to determine which types of interventions are most effective by group, which is an effort that is strongly supported by this audience segmentation work.