(HealthDay News) -- Older adults should take additional precautions to preserve their health and safety during winter, according to the American Geriatric Society's Foundation for Health in Aging.
The foundation has released a checklist of safety steps seniors can take to avoid the ill effects of colder weather.
Hypothermia, frostbite, falls, injury while shoveling snow, carbon-monoxide poisoning and driving accidents are on the list of dangers to look out for.
The foundation reminds older adults to dress for the weather. As people age, metabolisms slow and produce less body heat, but older adults may still have a hard time determining whether they are feeling the chill, says the foundation. Wearing two or three layers of loose-fitting clothing, as well as a hat, mittens, a coat, boots and a scarf to provide cover for the face are among the group's suggestions.
Older adults should stay indoors when it's very cold outside, especially if it is windy and wet. The foundation recommends keeping the thermostat indoors set to at least 65 degrees Fahrenheit.
Hypothermia is a condition in which the core body temperature drops to unhealthy levels. It can be fatal. The warning signs of hypothermia include: lots of shivering; cold skin that is pale or ashy; feeling very tired, confused and sleepy; feeling weak; problems walking; slowed breathing or heart rate. Unfortunately, older people do not shiver as much as they used to, so it is best to look for other warning signs, according to foundation recommendations.
Frostbite may also result from exposure to cold weather. Nose, ears, cheeks, chin, fingers and toes are all at risk. Keep an eye out for skin that is turning red or darkening and beginning to hurt. That's a sign to go inside. When skin is already frostbitten, it is often white, ashy or yellowish and feels numb and waxy. Immediate help is needed.
Aging bones may be more at risk during the winter, when icy sidewalks increase the chance of slipping and falling. The foundation recommends seeking out dry areas to walk if possible, putting new rubber tips on any canes or walkers, and wearing boots with non-skid soles.
Older people may find themselves shoveling snow, but the foundation suggests checking in with a physician before the season starts. Shoveling is heavy work that can affect older hearts. Hiring someone to shovel the snow may be a healthier option.
Indoors, fires can create an undetectable hazard: carbon monoxide. The odorless gas can build up with fatal results, according to the foundation. Before the season starts, people should have their chimneys cleaned and checked out. Opening a window a crack for circulation is also helpful.
People who are relying on space heaters for warmth should keep them at least three feet from anything flammable, such as curtains and furniture. Make sure all smoke detectors and fire extinguishers are ready for use.
Finally, winterizing cars and stocking them for bad weather can help reduce the risk of accidents. Emergency supplies inside the car should include a first-aid kit, blankets, extra warm clothes, a windshield scraper, rock salt, a bag of sand or cat litter, a shovel, booster cables, a flashlight and some water and food. Above all, drive carefully and slowly, after checking the weather reports, the foundation says.
More information
To learn more about how to stay safe in cold weather, visit the U.S. Centers for Disease Control and Prevention.
Senin, 31 Desember 2007
Jumat, 28 Desember 2007
Brain Turns to Positive Thoughts When Faced With Death
(HealthDay News) -- When thoughts of death intrude, the human mind isn't paralyzed with negativity or fear. Instead, the brain instinctively moves toward happier notions and images, a new study suggests.
The finding supports the notion that people are stronger, emotionally, when faced with their own or a loved one's death than they may have ever thought possible.
"It again speaks to how resilient humans are and how this tendency to cope with threats is some sort of indicator of mental health," said study co-author Nathan DeWall, assistant professor of psychology at the University of Kentucky.
DeWall and co-researcher Roy Baumeister, of Florida State University, published their findings in a recent issue of Psychological Science.
Humans are the only animal known to have a clear understanding that their life will end. On the surface, this knowledge could prove psychologically paralyzing -- why compete, learn and grow if these achievements will end?
However, DeWall and other scientists believe that as humans developed an awareness of death, they also evolved what's been called the "psychological immune system."
During crisis, this mechanism tilts thoughts and attitudes toward the positive -- even when the grimmest of events intervene. This mental shift is typically unconscious, DeWall said.
"That's why, when you ask people to predict how they'll respond to something negative, they usually say, 'Oh, it will be horrible, and it will last a long time,' " he said. However, studies don't bear that out -- research involving people stricken with disease or disability show that people tend to bounce back emotionally much more rapidly than they would have expected.
In evolutionary terms, "how and when this came about, we don't know for sure," DeWall said. "I suspect that this capacity to cope with potentially disastrous events in a relatively easy way really did aid our survival."
In their latest experiments, DeWall and Baumeister first primed more than 100 healthy young adult volunteers to think about death as a reality. They asked them to imagine the process of their own death, as well as what it might be like to be dead.
Another group of young adults was asked to think about an unpleasant event -- a trip to the dentist's office -- but not death.
Immediately after the priming exercise, the researchers had all of the participants undergo standard word tests that tapped into unconscious emotional states. In one test, participants were give a word stem -- "jo-" for example and asked to complete it to form a word ( i.e., "job", "jog", "joy").
According to the researchers, individuals primed to think about death were much more likely than the other participants to choose the word "joy," compared to more neutral or negative words.
In another word test, the participants were offered a word and asked to pair it with one of two other words. One of the words was similar to the target word in its meaning, while the other word was more emotionally similar. For example, "puppy" might be paired with either "beetle" (another many-legged animal), or "parade" (not an animal, but fun, enjoyable, as puppies are).
Again, people primed to think about death were much more likely to choose "parade" over "beetle" compared to the other participants. This suggests they were unconsciously preferring the positive emotion embedded in that choice, the researchers said.
"People really don't know that they do this," DeWall said. "It's actually very counterintuitive. This picks up on the idea that when people are confronted with their own mortality, these sorts of concepts -- positive emotion words -- become readily accessible to them."
Another expert agreed that humans may be hardwired to "go to their happy place" when thoughts of death intrude.
"This is interesting work, because what it's really saying is that once you are primed with this idea that you're going to die, it sets off this automatic network," said Todd Kashdan, an expert in the psychology of positive emotions and an assistant professor of psychology at George Mason University, in Fairfax, Va.
The findings suggest that, in the face of death, "I'm going to grab onto something that I know I can hang on to. It's not going to be negative things, I can't really hold on to that," Kashdan said. "So, I'm going to focus on these positive things."
"These things are happening below the level of awareness," he added.
The new findings dovetail with much of the research on how people survive -- and even thrive -- after some of life's most difficult events. In fact, people's tendency to think sunny thoughts actually increases with age and with their proximity to the end of life, DeWall said.
"As people grow older, they become more focused on positive emotions," he said.
There's one exception to that rule, however: Clinically depressed individuals tend not to think positively when confronted with the idea of death, suggesting that their psychological immune system may have gone off-track, DeWall said.
In contrast, the minds of healthy, non-depressed people typically balance darker imaginings with more hopeful images, he said.
Kashdan stressed that the Kentucky experiments focused on the very short-term, however. Coping over the longer term may be much tougher, he said.
"What's going to happen to these people -- not over the next few minutes but rather the next two weeks, six months? Do they end up reorganizing or shifting their life projects? There's research to show that for some people, it does, and for some people, it doesn't," he said.
More information
For more on positive psychology, visit the University of Pennsylvania.
The finding supports the notion that people are stronger, emotionally, when faced with their own or a loved one's death than they may have ever thought possible.
"It again speaks to how resilient humans are and how this tendency to cope with threats is some sort of indicator of mental health," said study co-author Nathan DeWall, assistant professor of psychology at the University of Kentucky.
DeWall and co-researcher Roy Baumeister, of Florida State University, published their findings in a recent issue of Psychological Science.
Humans are the only animal known to have a clear understanding that their life will end. On the surface, this knowledge could prove psychologically paralyzing -- why compete, learn and grow if these achievements will end?
However, DeWall and other scientists believe that as humans developed an awareness of death, they also evolved what's been called the "psychological immune system."
During crisis, this mechanism tilts thoughts and attitudes toward the positive -- even when the grimmest of events intervene. This mental shift is typically unconscious, DeWall said.
"That's why, when you ask people to predict how they'll respond to something negative, they usually say, 'Oh, it will be horrible, and it will last a long time,' " he said. However, studies don't bear that out -- research involving people stricken with disease or disability show that people tend to bounce back emotionally much more rapidly than they would have expected.
In evolutionary terms, "how and when this came about, we don't know for sure," DeWall said. "I suspect that this capacity to cope with potentially disastrous events in a relatively easy way really did aid our survival."
In their latest experiments, DeWall and Baumeister first primed more than 100 healthy young adult volunteers to think about death as a reality. They asked them to imagine the process of their own death, as well as what it might be like to be dead.
Another group of young adults was asked to think about an unpleasant event -- a trip to the dentist's office -- but not death.
Immediately after the priming exercise, the researchers had all of the participants undergo standard word tests that tapped into unconscious emotional states. In one test, participants were give a word stem -- "jo-" for example and asked to complete it to form a word ( i.e., "job", "jog", "joy").
According to the researchers, individuals primed to think about death were much more likely than the other participants to choose the word "joy," compared to more neutral or negative words.
In another word test, the participants were offered a word and asked to pair it with one of two other words. One of the words was similar to the target word in its meaning, while the other word was more emotionally similar. For example, "puppy" might be paired with either "beetle" (another many-legged animal), or "parade" (not an animal, but fun, enjoyable, as puppies are).
Again, people primed to think about death were much more likely to choose "parade" over "beetle" compared to the other participants. This suggests they were unconsciously preferring the positive emotion embedded in that choice, the researchers said.
"People really don't know that they do this," DeWall said. "It's actually very counterintuitive. This picks up on the idea that when people are confronted with their own mortality, these sorts of concepts -- positive emotion words -- become readily accessible to them."
Another expert agreed that humans may be hardwired to "go to their happy place" when thoughts of death intrude.
"This is interesting work, because what it's really saying is that once you are primed with this idea that you're going to die, it sets off this automatic network," said Todd Kashdan, an expert in the psychology of positive emotions and an assistant professor of psychology at George Mason University, in Fairfax, Va.
The findings suggest that, in the face of death, "I'm going to grab onto something that I know I can hang on to. It's not going to be negative things, I can't really hold on to that," Kashdan said. "So, I'm going to focus on these positive things."
"These things are happening below the level of awareness," he added.
The new findings dovetail with much of the research on how people survive -- and even thrive -- after some of life's most difficult events. In fact, people's tendency to think sunny thoughts actually increases with age and with their proximity to the end of life, DeWall said.
"As people grow older, they become more focused on positive emotions," he said.
There's one exception to that rule, however: Clinically depressed individuals tend not to think positively when confronted with the idea of death, suggesting that their psychological immune system may have gone off-track, DeWall said.
In contrast, the minds of healthy, non-depressed people typically balance darker imaginings with more hopeful images, he said.
Kashdan stressed that the Kentucky experiments focused on the very short-term, however. Coping over the longer term may be much tougher, he said.
"What's going to happen to these people -- not over the next few minutes but rather the next two weeks, six months? Do they end up reorganizing or shifting their life projects? There's research to show that for some people, it does, and for some people, it doesn't," he said.
More information
For more on positive psychology, visit the University of Pennsylvania.
Selasa, 25 Desember 2007
Playing Catch in Winter Could Save Kids' Pitching Arms
(HealthDay News) -- Playing catch with your young pitcher months before baseball season can help prevent an increasingly common pediatric pitching pitfall: torn rotator cuff injuries, according to doctors at Methodist Hospital in Houston.
The data suggest that two factors - a high pitch count and throwing curve balls -- increases the risk of shoulder pain in young pitchers. Easing into baseball season by beginning practice in December may help reduce the risk of such shoulder injuries.
"Most high school athletes go from football to basketball and then start throwing a baseball at full speed," Dr. David Lintner, an orthopedic surgeon who serves as head team physician for the Houston Astros, said in a prepared statement. Lintner reported seeing more and more high school pitchers with torn rotator cuffs. "The problem is that their arms are not in baseball shape, and they open themselves up to serious rotator cuff problems."
The rotator cuff is a group of four muscles and their tendons that connect the shoulder blade to the upper arm bone. Pain and/or weakness in the shoulder as well as difficulty raising an arm over the head may signal damage to the rotator cuff, which in turn can lead to problems with the rest of the pitching arm.
"Pitchers should play catch, not pitch off the mound, for a few minutes every day beginning in December, and gradually increase throwing as it gets closer to the start of spring training," recommended Lintner.
Lintner also suggested that young pitchers start a weight-training program focusing on multiple repetitions of three- to five-pound weights, aiming for flexibility and strength, not bulk. Pitchers will also benefit from strengthening their upper body and legs, adding speed to their fastball but reducing stress on their arm, he said.
More information
To learn more about rotator cuff injuries, visit the U.S. National Library of Medicine.
more discussion: Forum
· Addiction Forum · Ask the Doctors Forum · Ayurveda Forum · Ayurvedic & Thai Herbs Forum · Colon Cleansing Forum · Dental Forum · Diabetes Forum · Diet Forum · General Cleansing Forum · Hepatitis A, B. C Forum · Integrated Medicine Forum · Live Blood Analysis Forum · Ozone-Oxygen-Forum · pH - Alkaline - Acidity Forum · Weight Loss Forum
The data suggest that two factors - a high pitch count and throwing curve balls -- increases the risk of shoulder pain in young pitchers. Easing into baseball season by beginning practice in December may help reduce the risk of such shoulder injuries.
"Most high school athletes go from football to basketball and then start throwing a baseball at full speed," Dr. David Lintner, an orthopedic surgeon who serves as head team physician for the Houston Astros, said in a prepared statement. Lintner reported seeing more and more high school pitchers with torn rotator cuffs. "The problem is that their arms are not in baseball shape, and they open themselves up to serious rotator cuff problems."
The rotator cuff is a group of four muscles and their tendons that connect the shoulder blade to the upper arm bone. Pain and/or weakness in the shoulder as well as difficulty raising an arm over the head may signal damage to the rotator cuff, which in turn can lead to problems with the rest of the pitching arm.
"Pitchers should play catch, not pitch off the mound, for a few minutes every day beginning in December, and gradually increase throwing as it gets closer to the start of spring training," recommended Lintner.
Lintner also suggested that young pitchers start a weight-training program focusing on multiple repetitions of three- to five-pound weights, aiming for flexibility and strength, not bulk. Pitchers will also benefit from strengthening their upper body and legs, adding speed to their fastball but reducing stress on their arm, he said.
More information
To learn more about rotator cuff injuries, visit the U.S. National Library of Medicine.
more discussion: Forum
· Addiction Forum · Ask the Doctors Forum · Ayurveda Forum · Ayurvedic & Thai Herbs Forum · Colon Cleansing Forum · Dental Forum · Diabetes Forum · Diet Forum · General Cleansing Forum · Hepatitis A, B. C Forum · Integrated Medicine Forum · Live Blood Analysis Forum · Ozone-Oxygen-Forum · pH - Alkaline - Acidity Forum · Weight Loss Forum
Jumat, 21 Desember 2007
Breast Cancer Surgeons Don't Discuss Reconstruction Options
(HealthDay News) -- Only a third of breast cancer patients get to discuss their breast reconstruction options with their general cancer surgeon before the tumor is removed, new research finds.
In the study, more than 70 percent of general surgeons who removed the cancer did not talk over options for reconstruction -- which is typically done by a plastic surgeon -- before the woman underwent cancer surgery.
"It's disappointing," said lead researcher Dr. Amy K. Alderman, assistant professor of plastic surgery at the University of Michigan Medical School, Ann Arbor.
These discussions do matter: Women who discussed their options for reconstructing the breast beforehand with their physician were four times more likely to have a mastectomy (versus lumpectomy) compared to those who did not talk about the option, the researchers noted.
Th findings were published online Dec. 21 in Cancer and were expected to be published in the journal's Feb. 1 print edition.
Alderman and others contend it's crucial for a woman to understand all surgical options, and that includes reconstruction, so they can better choose the best treatment for them. About 180,000 women will be diagnosed with breast cancer this year, according to the American Cancer Society.
Long-term outcomes are equal, Alderman said, regardless of whether a woman is treated with lumpectomy or mastectomy. Knowing initially about the option to reconstruct definitely affects a woman's decision, as the study showed.
Alderman and her colleagues looked at almost 1,200 women, average age 59. The women were diagnosed with breast cancer and lived in the Detroit and Los Angeles areas. All were candidates for either mastectomy or breast-conserving surgery. They had all undergone breast cancer surgery and were contacted about three months after their diagnosis.
Alderman's team asked them: Did you discuss reconstruction with your surgeon before the cancer surgery?
Just one-third of patients did, with younger, more educated women more likely to hear about the options from their general surgeon. Those with larger tumors were also more likely to hear about reconstruction options.
The operation to reconstruct a breast can be done right after mastectomy, in which the entire breast is removed, or it can be delayed. Immediate reconstruction offers a better cosmetic outcome and is psychologically better, Alderman said.
"It's helpful if they know all their options at that initial decision-making process," Alderman said. "There's no right or wrong answer."
Women will choose their course, she said, based on a number of factors, including their fear of cancer recurrence, their body image, and other factors.
"What we need to get across to consumers is, they need to be educated consumers of their own health care," Alderman said. If the surgeon doesn't bring up the topic of reconstruction, a woman should, she said, and the sooner the better.
The study didn't delve into why the surgeons didn't talk about the reconstruction option or refer the women to plastic surgeons. But Alderman suspected the "hassle" factor may play a role. The general surgeon must make sure, she said, that the women get in to see the surgeon who will do the reconstruction in a timely manner. "And then the general surgeon and the plastic surgeon have to coordinate their operating room schedules," she said.
Women themselves may be so focused on eliminating the cancer that they don't even broach the topic of reconstruction, Alderman said.
Another expert agreed that the small number of surgeons who initially discussed the reconstruction option was surprising.
"It's very sad that that so few surgeons are sending women for reconstructive appointments," said Dr. Mehra Golshan, director of Breast Surgical Services at the Dana-Farber/Brigham and Women's Cancer Center, Boston, who reviewed the study.
An initial meeting with a surgeon who does reconstruction will provide a woman with information on all options, "even if they decide to do [reconstruction] down the road," he said.
Like Alderman, Golshan couldn't say for sure why such a low number of surgeons referred their breast cancer patients to plastic surgeons for reconstruction discussions, but he speculated on a few possible reasons. "They may think complication rates are too high with immediate reconstruction," he said.
In truth, Golshan said, complications can be higher with immediate reconstruction if post-mastectomy radiation is required. "But not always," he said. And, "when there is no post-mastectomy radiation, the complications rates are equal between immediate reconstruction and delayed."
It's also possible that surgeons may be so focused on cancer elimination that they may not think about referring the patients for reconstruction information, Golshan added.
More information
To learn more about breast reconstruction, visit the American Society of Plastic Surgeons.
In the study, more than 70 percent of general surgeons who removed the cancer did not talk over options for reconstruction -- which is typically done by a plastic surgeon -- before the woman underwent cancer surgery.
"It's disappointing," said lead researcher Dr. Amy K. Alderman, assistant professor of plastic surgery at the University of Michigan Medical School, Ann Arbor.
These discussions do matter: Women who discussed their options for reconstructing the breast beforehand with their physician were four times more likely to have a mastectomy (versus lumpectomy) compared to those who did not talk about the option, the researchers noted.
Th findings were published online Dec. 21 in Cancer and were expected to be published in the journal's Feb. 1 print edition.
Alderman and others contend it's crucial for a woman to understand all surgical options, and that includes reconstruction, so they can better choose the best treatment for them. About 180,000 women will be diagnosed with breast cancer this year, according to the American Cancer Society.
Long-term outcomes are equal, Alderman said, regardless of whether a woman is treated with lumpectomy or mastectomy. Knowing initially about the option to reconstruct definitely affects a woman's decision, as the study showed.
Alderman and her colleagues looked at almost 1,200 women, average age 59. The women were diagnosed with breast cancer and lived in the Detroit and Los Angeles areas. All were candidates for either mastectomy or breast-conserving surgery. They had all undergone breast cancer surgery and were contacted about three months after their diagnosis.
Alderman's team asked them: Did you discuss reconstruction with your surgeon before the cancer surgery?
Just one-third of patients did, with younger, more educated women more likely to hear about the options from their general surgeon. Those with larger tumors were also more likely to hear about reconstruction options.
The operation to reconstruct a breast can be done right after mastectomy, in which the entire breast is removed, or it can be delayed. Immediate reconstruction offers a better cosmetic outcome and is psychologically better, Alderman said.
"It's helpful if they know all their options at that initial decision-making process," Alderman said. "There's no right or wrong answer."
Women will choose their course, she said, based on a number of factors, including their fear of cancer recurrence, their body image, and other factors.
"What we need to get across to consumers is, they need to be educated consumers of their own health care," Alderman said. If the surgeon doesn't bring up the topic of reconstruction, a woman should, she said, and the sooner the better.
The study didn't delve into why the surgeons didn't talk about the reconstruction option or refer the women to plastic surgeons. But Alderman suspected the "hassle" factor may play a role. The general surgeon must make sure, she said, that the women get in to see the surgeon who will do the reconstruction in a timely manner. "And then the general surgeon and the plastic surgeon have to coordinate their operating room schedules," she said.
Women themselves may be so focused on eliminating the cancer that they don't even broach the topic of reconstruction, Alderman said.
Another expert agreed that the small number of surgeons who initially discussed the reconstruction option was surprising.
"It's very sad that that so few surgeons are sending women for reconstructive appointments," said Dr. Mehra Golshan, director of Breast Surgical Services at the Dana-Farber/Brigham and Women's Cancer Center, Boston, who reviewed the study.
An initial meeting with a surgeon who does reconstruction will provide a woman with information on all options, "even if they decide to do [reconstruction] down the road," he said.
Like Alderman, Golshan couldn't say for sure why such a low number of surgeons referred their breast cancer patients to plastic surgeons for reconstruction discussions, but he speculated on a few possible reasons. "They may think complication rates are too high with immediate reconstruction," he said.
In truth, Golshan said, complications can be higher with immediate reconstruction if post-mastectomy radiation is required. "But not always," he said. And, "when there is no post-mastectomy radiation, the complications rates are equal between immediate reconstruction and delayed."
It's also possible that surgeons may be so focused on cancer elimination that they may not think about referring the patients for reconstruction information, Golshan added.
More information
To learn more about breast reconstruction, visit the American Society of Plastic Surgeons.
Rabu, 19 Desember 2007
Many States Still Fall Short in Emergency Preparedness: Report
(HealthDay News) -- Most Americans don't feel safer now than they did before 9/11, and their fears might be justified, a new report claims.
For example, seven states have not purchased antiviral medications in the event of a pandemic, 13 states don't have effective plans to distribute vaccines, antidotes and medical supplies in a public health emergency, and seven states and the District of Columbia don't have the ability to test for biological threats.
The report, compiled by the Trust for America's Health and released Tuesday, says that while many states have made progress in preparing for a potential public health disaster, much more needs to be done, and cuts in federal funding for state and local preparedness programs "threaten the nation's safety."
"Sept. 11, the anthrax attacks, Hurricane Katrina and the growing threat of a pandemic flu outbreak have all been wake-up calls to the country revealing gaps in our public health system's ability to respond to major crises," Jeffrey Levi, executive director of the trust, said during a midmorning teleconference.
Some important lessons have been learned from these events, Levi said. "Significant progress has been made in the nation's health emergency preparedness effort, but a number of areas still require serious attention."
That concern is heightened by the continual cuts in state, local and federal funding for preparedness, Levi added. "All Americans have the right to expect fundamental health protection during public health emergencies, no matter where they live," he said.
The report evaluates each state on 10 indicators of health emergency preparedness. Among the states, 35 plus Washington, D.C., scored eight or higher. Illinois, Kentucky, Nebraska, New Jersey, Pennsylvania, Tennessee and Virginia scored 10 out of 10, while Arkansas, Iowa, Mississippi, Nevada, Wisconsin and Wyoming scored the lowest, with six out of 10.
To remedy some of these problems, Levi's group is calling upon the federal government to increase public health and disaster preparedness funding. In addition, the U.S. Department of Health and Human Services should be expanding efforts to improve hospital surge capacity and community and hospital preparedness for public health emergencies, Levi said.
A public survey of more than 1,000 adults included in the report found that six years after 9/11, 54 percent of Americans believe the United States is not as safe as it was before 9/11, and two years after Hurricane Katrina, almost 60 percent of Americans do not think their community is prepared to respond to a natural disaster.
The survey also found that nine out of 10 Americans would accept a voluntary quarantine and stay home in the case of a pandemic flu. But of the 10 percent who would not adhere to a voluntary quarantine, 64 percent said they could not stay home because of lost income, and 39 percent feared losing their jobs altogether.
The report also evaluated progress by the U.S. government in preparing for bioterrorism, disasters and disease. The Pandemic and All-Hazards Preparedness Act of 2006, issuance of presidential directives, and the new Office of the Assistant Secretary for Preparedness and Response are all important steps, the report said.
However, challenges remain, including adequate funding for the Biomedical Advanced Research and Development Authority and increasing "transparency and accountability in all federally funded preparedness programs."
Other findings in the report include:
For example, seven states have not purchased antiviral medications in the event of a pandemic, 13 states don't have effective plans to distribute vaccines, antidotes and medical supplies in a public health emergency, and seven states and the District of Columbia don't have the ability to test for biological threats.
The report, compiled by the Trust for America's Health and released Tuesday, says that while many states have made progress in preparing for a potential public health disaster, much more needs to be done, and cuts in federal funding for state and local preparedness programs "threaten the nation's safety."
"Sept. 11, the anthrax attacks, Hurricane Katrina and the growing threat of a pandemic flu outbreak have all been wake-up calls to the country revealing gaps in our public health system's ability to respond to major crises," Jeffrey Levi, executive director of the trust, said during a midmorning teleconference.
Some important lessons have been learned from these events, Levi said. "Significant progress has been made in the nation's health emergency preparedness effort, but a number of areas still require serious attention."
That concern is heightened by the continual cuts in state, local and federal funding for preparedness, Levi added. "All Americans have the right to expect fundamental health protection during public health emergencies, no matter where they live," he said.
The report evaluates each state on 10 indicators of health emergency preparedness. Among the states, 35 plus Washington, D.C., scored eight or higher. Illinois, Kentucky, Nebraska, New Jersey, Pennsylvania, Tennessee and Virginia scored 10 out of 10, while Arkansas, Iowa, Mississippi, Nevada, Wisconsin and Wyoming scored the lowest, with six out of 10.
To remedy some of these problems, Levi's group is calling upon the federal government to increase public health and disaster preparedness funding. In addition, the U.S. Department of Health and Human Services should be expanding efforts to improve hospital surge capacity and community and hospital preparedness for public health emergencies, Levi said.
A public survey of more than 1,000 adults included in the report found that six years after 9/11, 54 percent of Americans believe the United States is not as safe as it was before 9/11, and two years after Hurricane Katrina, almost 60 percent of Americans do not think their community is prepared to respond to a natural disaster.
The survey also found that nine out of 10 Americans would accept a voluntary quarantine and stay home in the case of a pandemic flu. But of the 10 percent who would not adhere to a voluntary quarantine, 64 percent said they could not stay home because of lost income, and 39 percent feared losing their jobs altogether.
The report also evaluated progress by the U.S. government in preparing for bioterrorism, disasters and disease. The Pandemic and All-Hazards Preparedness Act of 2006, issuance of presidential directives, and the new Office of the Assistant Secretary for Preparedness and Response are all important steps, the report said.
However, challenges remain, including adequate funding for the Biomedical Advanced Research and Development Authority and increasing "transparency and accountability in all federally funded preparedness programs."
Other findings in the report include:
- Twenty-one states don't have laws that protect health-care volunteers from liability during emergencies.
- Twelve states don't have disease surveillance systems that work with the U.S. Centers for Disease Control and Prevention's National Electronic Disease Surveillance System.
- Another speaker focused on the lack of preparedness of U.S. hospitals to handle public health emergencies.
"To get hospitals up to speed in terms of their disaster responsibility would require an initial investment of $5 billion and about $1 billion a year to maintain that level of preparedness," Dr. Irwin Redlener, director of the National Center for Disaster Preparedness at Columbia University's Mailman School of Public Health in New York City, said during the teleconference.
The funding for hospitals, which started at $500 million dollars, has dropped to around $400 million. "It's a situation that's going in reverse," Redlener noted.
One expert thinks progress has been made, but much more is needed to maintain and improve emergency preparedness in the United States.
"The report readily captures the breadth and complexity of the many dimensions involved in emergency preparedness," said Dr. Howard Koh, director of the Harvard School of Public Health Center for Public Health Preparedness, and the former Commissioner of Public Health of Massachusetts.
Preparedness is not an endpoint but rather a process of continuous improvement, Koh said.
"By that measure, the country has made advances in planning and coordination, but there are still many areas in need of improvement. For example, the broad challenge of surge capacity, that is the need to mobilize additional staff, supplies and space in the event of an emergency, remains a major issue, especially when the health-care system is already severely stretched," he said.
Because disasters are uncommon events, there should be greater emphasis on rigorous drills and exercises that demonstrate effective coordination and mobilization of the many partners involved, Koh said.
In addition, public trust is essential, Koh said. "We need to sustain a long-term public health commitment to build an enduring system that will protect people and communities against all threats," he said.
More information
To see the full report, visit Trust for America's Health.
Kamis, 13 Desember 2007
Report Finds 'Widespread Steroid Use in Baseball'
(HealthDayNews) -- New York Yankees pitchers Roger Clemens and Andy Pettitte, Houston Astros All-Star shortstop Miguel Tejada and home run king Barry Bonds are among the big-name players cited in a highly anticipated report into the use of performance-enhancing drugs in Major League Baseball.
The report climaxed a 20-month probe by former U.S. Senate Majority Leader George Mitchell, who was hired by baseball Commissioner Bud Selig to examine the use of performance-boosting drugs during the so-called "steroids era," which began in the mid-1990s and was marked by record-shattering performances by many players.
"For more than a decade, there has been widespread anabolic steroid use in baseball," Mitchell said, adding that all 30 major-league teams have players involved with drugs, ESPN.com reported.
"Everyone involved in baseball over the past two decades -- commissioners, club officials, the players' association and players -- shares to some extent the responsibility for the steroids era,'' said Mitchell, who called for stricter drug testing. "There was a collective failure to recognize the problem as it emerged and to deal with it early on."
It was not clear if the report would result in any penalties or suspensions, the Associated Press reported.
Clemens was one of the most prominent names in the report. Others include Most Valuable Player award-winners Barry Bonds, the late Ken Caminiti, Jose Canseco, Jason Giambi, Juan Gonzalez, Mo Vaughn and Tejada. The report also includes the names of three of the top 10 home-run leaders of all time: Bonds, Mark McGwire and Rafael Palmiero, The New York Times reported.
Anabolic-androgenic steroids are man-made substances that help build muscle tissue and increase body mass by acting like the body's natural male hormone, testosterone. But they can produce a variety of dangerous side effects, including heart trouble.
According to the U.S. National Institute on Drug Abuse, the major side effects can include high blood pressure; increases in LDL (bad cholesterol) and decreases in HDL (good cholesterol); liver tumors and cancer; kidney tumors; severe acne; and trembling. There are also some gender-specific side effects:
The report climaxed a 20-month probe by former U.S. Senate Majority Leader George Mitchell, who was hired by baseball Commissioner Bud Selig to examine the use of performance-boosting drugs during the so-called "steroids era," which began in the mid-1990s and was marked by record-shattering performances by many players.
"For more than a decade, there has been widespread anabolic steroid use in baseball," Mitchell said, adding that all 30 major-league teams have players involved with drugs, ESPN.com reported.
"Everyone involved in baseball over the past two decades -- commissioners, club officials, the players' association and players -- shares to some extent the responsibility for the steroids era,'' said Mitchell, who called for stricter drug testing. "There was a collective failure to recognize the problem as it emerged and to deal with it early on."
It was not clear if the report would result in any penalties or suspensions, the Associated Press reported.
Clemens was one of the most prominent names in the report. Others include Most Valuable Player award-winners Barry Bonds, the late Ken Caminiti, Jose Canseco, Jason Giambi, Juan Gonzalez, Mo Vaughn and Tejada. The report also includes the names of three of the top 10 home-run leaders of all time: Bonds, Mark McGwire and Rafael Palmiero, The New York Times reported.
Anabolic-androgenic steroids are man-made substances that help build muscle tissue and increase body mass by acting like the body's natural male hormone, testosterone. But they can produce a variety of dangerous side effects, including heart trouble.
According to the U.S. National Institute on Drug Abuse, the major side effects can include high blood pressure; increases in LDL (bad cholesterol) and decreases in HDL (good cholesterol); liver tumors and cancer; kidney tumors; severe acne; and trembling. There are also some gender-specific side effects:
- For men -- shrinking of the testicles, reduced sperm count, infertility, baldness, development of breasts, and increased risk for prostate cancer.
- For women -- growth of facial hair, male-pattern baldness, changes in or cessation of the menstrual cycle, enlargement of the clitoris, a deepened voice.
- For teens -- growth halted prematurely through premature skeletal maturation and accelerated puberty changes. This means that adolescents risk remaining short for the remainder of their lives if they take anabolic steroids before the typical adolescent growth spurt.
"For males in the U.S., heart disease is the number one cause of death, and steroid abuse makes heart disease even worse," Dr. Linn Goldberg, a professor at Oregon Health and Science University, and an expert on steroid abuse, told HealthDay following the 2004 heart-attack death of Caminiti, who had admitted to abusing both steroids and cocaine.
Dr. Nieca Goldberg, a spokeswoman for the American Heart Association and medical director of the Women's Heart Program at New York University School of Medicine, said steroids raise almost all heart disease risk factors.
"One, steroid use raises blood pressure," she told HealthDay. "Two, it can also alter your sugar metabolism, so you have an increased risk of diabetes. Three, it makes the arteries vulnerable since, because of elevated cholesterol, you get cholesterol plaque buildup."
Steroid abuse can also cause a dangerous thickening of heart muscle called hypertrophy --- the same kind of heart-muscle enlargement seen in patients with congestive heart failure, experts warn.
Linn Goldberg (no relation to Nieca Goldberg) said his biggest concern remains the health risks to America's teenagers, who are increasingly influenced by the behaviors of their favorite sports stars.
"These are very dangerous drugs, and their effects on children are even greater than on adults, because they affect all their biological systems," he said. "It's a shock to their body, because the hormones are so powerful."
More information
To learn more about steroid dangers, visit the American Academy of Pediatrics.
Selasa, 11 Desember 2007
Good Physical Function Halves Stroke Risk
(HealthDay News) -- Being in good physical form appears to protect middle-aged and older men and women from stroke, a new British study suggests.
The finding highlights an apparent association -- rather than a direct cause-and-effect -- between the physical ability to function well and a reduced risk for stroke.
After sifting through thousands of quality-of-life reports provided by patients themselves, the research team found that those functioning at the higher end of the physical capacity spectrum appear to have half the risk for stroke as their poorest functioning compatriots, independent of other risk factors.
"We were surprised at the magnitude of the relationship, as this is comparable to established stroke risk factors such as smoking," noted study author Dr. Phyo Kyaw Myint, who works with the Clinical Gerontology Unit at Addenbrooke's University Hospital in Cambridge.
The findings are published in the Dec. 11 issue of Neurology.
Myint and his colleagues uncovered an apparent stroke-physical function connection by analyzing data concerning more than 13,600 British men and women between the ages of 40 and 79.
All the participants first completed a health examination and questionnaire between 1993 and 1997. At that time, patient blood pressure, body-mass index, respiratory capacity, and cholesterol levels were assessed. Researchers also noted any history of diabetes, smoking and alcohol consumption.
None of the patients had experienced any incidence of cancer, stroke or heart attack before their initial exam.
Eighteen months after the initial exam, patients completed a follow-up questionnaire by mail, in which patients were asked to indicate their degree of physical and social functioning; their mental health status; any physical and/or emotional limitations on carrying out routines; energy levels; experiences of pain; and self-perceptions regarding their overall health.
All participants were followed until 2005, by which point 244 strokes were recorded.
The researchers found that those men and women who reported better physical function had a considerably lower risk for stroke.
After adjusting for all other observed characteristics -- including gender and age -- Myint and his team found that patients in the top quarter of physical function capacity had half the risk of stroke when compared with patients in the lowest quarter of physical function.
The authors concluded that poor physical function could indicate a high risk for stroke, thereby highlighting a specific segment of the general population that could derive particular benefit from some form of intervention.
Myint stressed, however, that to date his team has simply conducted a hands-off review of patient self-reports regarding their physical capacity and lined those reports up against stroke incidence records. At no time were patients assessed for their ability to follow a prescribed physical activity routine of varying intensities and durations.
He cautioned against leaping to the notion that greater physical function or activity directly causes a drop in the risk for stroke.
"We don't know whether physical function per se is causally related to stroke or simply a good marker for other factors that influence stroke risk," Myint noted. "These findings need confirmation from other studies. However, there is already a substantial body of evidence for public health recommendations to increase physical activity."
In the meantime, Alice H. Lichtenstein, director of the Cardiovascular Nutrition Lab at Tufts University in Boston, said that people should not sit idly by while investigators continue to unravel the complex web of factors related to stroke risk.
"This study does not show causation, but clearly, individuals who follow current guidelines for decreasing risk for stroke and general cardiovascular risk -- including keeping physically active -- have better outcomes," she said. "So, in terms of both physical function and activity, what people need to try to do is go from where they are to more."
"For some people, doing more may literally mean just walking around the block once, or picking up the pace, or adding extra time moving," said Lichtenstein. "For others, it can even be something like doing the housecleaning. And it can be cumulative: 10 minutes at one point, 10 minutes at another. Because although we'd like everyone to set aside special time just for physical activity every day, we know that for a lot of people, it's just not going to happen. So, any increase is going in the right direction, and that should be the goal."
This week, the American Society for Nutrition is poised to issue a new set of national recommendations regarding both physical activity and nutrition.
The recommendations are described as "comprehensive, scientific guidelines on physical activity for all Americans." According to the U.S. Department of Health and Human Services, the guidelines will gather together the latest knowledge on both healthy eating and regular physical activity.
More information
To learn about stroke risk, visit the American Heart Association.
The finding highlights an apparent association -- rather than a direct cause-and-effect -- between the physical ability to function well and a reduced risk for stroke.
After sifting through thousands of quality-of-life reports provided by patients themselves, the research team found that those functioning at the higher end of the physical capacity spectrum appear to have half the risk for stroke as their poorest functioning compatriots, independent of other risk factors.
"We were surprised at the magnitude of the relationship, as this is comparable to established stroke risk factors such as smoking," noted study author Dr. Phyo Kyaw Myint, who works with the Clinical Gerontology Unit at Addenbrooke's University Hospital in Cambridge.
The findings are published in the Dec. 11 issue of Neurology.
Myint and his colleagues uncovered an apparent stroke-physical function connection by analyzing data concerning more than 13,600 British men and women between the ages of 40 and 79.
All the participants first completed a health examination and questionnaire between 1993 and 1997. At that time, patient blood pressure, body-mass index, respiratory capacity, and cholesterol levels were assessed. Researchers also noted any history of diabetes, smoking and alcohol consumption.
None of the patients had experienced any incidence of cancer, stroke or heart attack before their initial exam.
Eighteen months after the initial exam, patients completed a follow-up questionnaire by mail, in which patients were asked to indicate their degree of physical and social functioning; their mental health status; any physical and/or emotional limitations on carrying out routines; energy levels; experiences of pain; and self-perceptions regarding their overall health.
All participants were followed until 2005, by which point 244 strokes were recorded.
The researchers found that those men and women who reported better physical function had a considerably lower risk for stroke.
After adjusting for all other observed characteristics -- including gender and age -- Myint and his team found that patients in the top quarter of physical function capacity had half the risk of stroke when compared with patients in the lowest quarter of physical function.
The authors concluded that poor physical function could indicate a high risk for stroke, thereby highlighting a specific segment of the general population that could derive particular benefit from some form of intervention.
Myint stressed, however, that to date his team has simply conducted a hands-off review of patient self-reports regarding their physical capacity and lined those reports up against stroke incidence records. At no time were patients assessed for their ability to follow a prescribed physical activity routine of varying intensities and durations.
He cautioned against leaping to the notion that greater physical function or activity directly causes a drop in the risk for stroke.
"We don't know whether physical function per se is causally related to stroke or simply a good marker for other factors that influence stroke risk," Myint noted. "These findings need confirmation from other studies. However, there is already a substantial body of evidence for public health recommendations to increase physical activity."
In the meantime, Alice H. Lichtenstein, director of the Cardiovascular Nutrition Lab at Tufts University in Boston, said that people should not sit idly by while investigators continue to unravel the complex web of factors related to stroke risk.
"This study does not show causation, but clearly, individuals who follow current guidelines for decreasing risk for stroke and general cardiovascular risk -- including keeping physically active -- have better outcomes," she said. "So, in terms of both physical function and activity, what people need to try to do is go from where they are to more."
"For some people, doing more may literally mean just walking around the block once, or picking up the pace, or adding extra time moving," said Lichtenstein. "For others, it can even be something like doing the housecleaning. And it can be cumulative: 10 minutes at one point, 10 minutes at another. Because although we'd like everyone to set aside special time just for physical activity every day, we know that for a lot of people, it's just not going to happen. So, any increase is going in the right direction, and that should be the goal."
This week, the American Society for Nutrition is poised to issue a new set of national recommendations regarding both physical activity and nutrition.
The recommendations are described as "comprehensive, scientific guidelines on physical activity for all Americans." According to the U.S. Department of Health and Human Services, the guidelines will gather together the latest knowledge on both healthy eating and regular physical activity.
More information
To learn about stroke risk, visit the American Heart Association.
Kamis, 06 Desember 2007
Common Household Chemical Could Raise Breast Cancer Risk
(HealthDay News) -- A chemical found in many plastic products used in households caused accelerated breast development and genetic changes in newborn female lab rats, a condition that might predispose the animals to breast cancer later in life, a new study says.
Butyl benzyl phthalate (BBP) is commonly used to soften polymers and plastics. It's found in everything from plastic pipes, vinyl floor tiles and carpet backing to lipstick. BBP has also been found to be an endocrine disruptor, which mimics the effect of hormones. Endocrine disruptors are known to damage wildlife and have also been implicated in reduced sperm counts and neurological problems in humans, the researchers said.
"Our study is the first one demonstrating that exposure to this compound (BBP) soon after birth results in alterations in the expression of genes present in the mammary gland," said lead researcher Dr. Jose Russo, a breast cancer expert at the Fox Chase Cancer Center, in Philadelphia.
The findings are important, Russo said, because the researchers are studying the lifetime effect of BBP on the mammary gland, long before it starts developing under the influence of the hormones of puberty, and the potential implications on humans.
Because of lasting genetic changes in the breast, exposure to BBP could increase the risk for developing breast cancer later in life, Russo said.
"To prevent breast cancer in adulthood, it is necessary to protect both the newborn child and the mother from exposure to this compound that has an estrogenic effect and could act as an endocrine disruptor," he added.
For the study, Russo's team fed lactating rats BBP, which their offspring absorbed through breast milk. The rat pups received levels of the chemical equivalent to the U.S. Environmental Protection Agency's safe dose limit for humans, according to the report in the Dec. 5 online issue of BMC Genomics.
The researchers found that BBP affected characteristics of the female offspring of the rats, such as more rapid breast development and changes in the genetic profile of the mammary glands.
While these effects wore off after exposure to BBP was stopped, the changes caused by the chemical might have an effect later in life, the researchers said.
"Our original observations are that the genomic changes induced by BBP occur very early in life, and they could result in significant modifications in the risk of the mammary gland to develop cancer later on in life," Russo said.
Russo said he and his colleagues are currently evaluating how changes in gene expression caused by BBP respond to cancer-causing chemicals given to adult rats.
"We are also studying the effects of exposure to BBP before birth. In addition, we are following a cohort of girls entering puberty for determining the tempo of breast development and their first menstrual period and associating these events with exposure to environmental agents such as BBP," Russo said.
One expert said scientists are only beginning to learn how many genes are affected by exposure to chemicals early in life.
"The early exposure to BBP altered breast development and may therefore alter the susceptibility to breast cancer," said Dr. Ted Schettler, science director at the Science and Environmental Health Network, in Ames, Iowa.
Schettler thinks people need to be aware of the possible effects of chemicals on genes during early life, and how these changes can influence susceptibility to disease in adulthood.
"People are finally getting the idea that early life events can matter later in life," Schettler said.
"When people see that commonly encountered environmental agents like BBP can cause genetic changes, it's of public health interest."
However, Dr. Jonathan Borak, a clinical professor of environmental medicine at Yale University School of Public Health, said there's no evidence that exposure to BBP increases the risk of breast cancer.
"To date, studies have failed to find an association between BBP and breast cancer," Borak said. "This study doesn't add specific information on breast cancer and environmental interactions."
Efforts to reach the American Chemistry Council, a chemical industry group, for comment on the study were unsuccessful.
In October, California adopted a law that will ban trace amounts of BBP in toys and baby products such as teething rings, according to published reports.
And in March, a study published in the journal Environmental Health Perspectives suggested that exposure to phthalates could be fueling the obesity epidemic by contributing to abdominal obesity and insulin resistance in men.
More information
For more on breast cancer, visit the American Cancer Society.
Butyl benzyl phthalate (BBP) is commonly used to soften polymers and plastics. It's found in everything from plastic pipes, vinyl floor tiles and carpet backing to lipstick. BBP has also been found to be an endocrine disruptor, which mimics the effect of hormones. Endocrine disruptors are known to damage wildlife and have also been implicated in reduced sperm counts and neurological problems in humans, the researchers said.
"Our study is the first one demonstrating that exposure to this compound (BBP) soon after birth results in alterations in the expression of genes present in the mammary gland," said lead researcher Dr. Jose Russo, a breast cancer expert at the Fox Chase Cancer Center, in Philadelphia.
The findings are important, Russo said, because the researchers are studying the lifetime effect of BBP on the mammary gland, long before it starts developing under the influence of the hormones of puberty, and the potential implications on humans.
Because of lasting genetic changes in the breast, exposure to BBP could increase the risk for developing breast cancer later in life, Russo said.
"To prevent breast cancer in adulthood, it is necessary to protect both the newborn child and the mother from exposure to this compound that has an estrogenic effect and could act as an endocrine disruptor," he added.
For the study, Russo's team fed lactating rats BBP, which their offspring absorbed through breast milk. The rat pups received levels of the chemical equivalent to the U.S. Environmental Protection Agency's safe dose limit for humans, according to the report in the Dec. 5 online issue of BMC Genomics.
The researchers found that BBP affected characteristics of the female offspring of the rats, such as more rapid breast development and changes in the genetic profile of the mammary glands.
While these effects wore off after exposure to BBP was stopped, the changes caused by the chemical might have an effect later in life, the researchers said.
"Our original observations are that the genomic changes induced by BBP occur very early in life, and they could result in significant modifications in the risk of the mammary gland to develop cancer later on in life," Russo said.
Russo said he and his colleagues are currently evaluating how changes in gene expression caused by BBP respond to cancer-causing chemicals given to adult rats.
"We are also studying the effects of exposure to BBP before birth. In addition, we are following a cohort of girls entering puberty for determining the tempo of breast development and their first menstrual period and associating these events with exposure to environmental agents such as BBP," Russo said.
One expert said scientists are only beginning to learn how many genes are affected by exposure to chemicals early in life.
"The early exposure to BBP altered breast development and may therefore alter the susceptibility to breast cancer," said Dr. Ted Schettler, science director at the Science and Environmental Health Network, in Ames, Iowa.
Schettler thinks people need to be aware of the possible effects of chemicals on genes during early life, and how these changes can influence susceptibility to disease in adulthood.
"People are finally getting the idea that early life events can matter later in life," Schettler said.
"When people see that commonly encountered environmental agents like BBP can cause genetic changes, it's of public health interest."
However, Dr. Jonathan Borak, a clinical professor of environmental medicine at Yale University School of Public Health, said there's no evidence that exposure to BBP increases the risk of breast cancer.
"To date, studies have failed to find an association between BBP and breast cancer," Borak said. "This study doesn't add specific information on breast cancer and environmental interactions."
Efforts to reach the American Chemistry Council, a chemical industry group, for comment on the study were unsuccessful.
In October, California adopted a law that will ban trace amounts of BBP in toys and baby products such as teething rings, according to published reports.
And in March, a study published in the journal Environmental Health Perspectives suggested that exposure to phthalates could be fueling the obesity epidemic by contributing to abdominal obesity and insulin resistance in men.
More information
For more on breast cancer, visit the American Cancer Society.
Sabtu, 01 Desember 2007
FDA Report Says Nation's Health at Risk
(HealthDay News) -- A new report by a U.S. Food and Drug Administration subcommittee says the agency can no longer adequately protect the nation's food and drug supply.
The Subcommittee on Science and Technology lays the blame squarely on inadequate funding, which it says has not kept pace with increasing demands on the agency.
"This imbalance is imposing a significant risk to the integrity of the food, drug, cosmetic and device regulatory system, and hence the safety of the public," the report states.
And things could get worse, the report stresses: "...the Agency suffers from serious scientific deficiencies and is not positioned to meet current or emerging regulatory responsibilities."
William Hubbard, a former FDA associate commissioner and an advisor to the Coalition for a Stronger FDA, a group that lobbies on behalf of the agency, called the report "one of the most remarkable reports I've ever seen. They are basically saying the FDA can't protect the public, and they are saying that our future competitiveness in new technology, emerging science and pharmaceuticals and devices is seriously threatened."
Hubbard also thinks that more money is needed for the FDA to do its job. "The number doesn't matter -- it just needs to be a lot," he said. "You would need a steady increase over five years to fix the FDA."
The report started as a review of the science at the FDA, Hubbard said, and mushroomed into something more.
"The committee was horrified that the science wasn't there, then they were horrified that the capabilities weren't there -- and the only way to fix that is funding," he said.
The FDA budget request for 2008 is $1.74 billion, plus another $444 million in user fees. These fees are paid by drug makers and medical device makers to underwrite the approval process of their products.
Another expert thinks that the FDA needs more money, but to really protect the public the agency's culture also needs changing.
"You need not only an overhaul of resources but an overhaul of philosophy on what safety and efficacy really means," said Dr. A. Mark Fendrick, a professor of internal medicine and professor of health management and policy at the University of Michigan.
"While a substantial increase in resources will enhance the scientific capabilities and capacity of the FDA, funding alone will not address the inherent tension between America's insatiable demand for immediate access for innovative products and an unwillingness to tolerate products that are anything but perfectly safe," Fendrick explained.
Another FDA supporter also thinks that improving the FDA starts with money.
"There are a lot of problems in the FDA that can't be solved without more resources," said Steven Grossman, a spokesman for the FDA Alliance, which lobbies on behalf of the agency. "All the problems don't go away if you have more money, but there are a whole lot of problems you can't confront without money."
Grossman thinks there is need for another $450 million in unrestricted spending to start bringing the agency up to snuff. That request is currently winding its way through Congress. "We hope to get at least a third of that," he said. It's going to take several years of increased funding to get the FDA to where it should be, he added.
According to the report, the FDA's "inability to keep up with scientific advances means that American lives are at risk." The committee noted that while science had undergone radical changes, the agency' evaluation methods haven't hanged in more than 50 years.
In addition, the food supply is at risk, the report said: "Crisis management in [the] FDA's two food safety centers, [the] Center for Food Safety and Applied Nutrition (CFSAN) and [the] Center for Veterinary Medicine (CVM), has drawn attention and resources away from FDA's ability to develop the science base and infrastructure needed to efficiently support innovation in the food industry, provide effective routine surveillance, and conduct emergency outbreak investigation activities to protect the food supply."
The report also calls for better-trained FDA scientists and improvements in the agency's computer technology. The full report will be presented at a meeting of the FDA's Science Board on Monday.
In recent years, numerous food recalls and the withdrawal from the market of popular medications -- the removal of the painkiller Vioxx in 2004 was one of the most high-profile examples -- have eroded public confidence in the FDA. A recent survey found that 47 percent of Americans rated its performance as fair or poor.
And a study published in September found the number of serious adverse drug events more than doubled between 1998 and 2005 in the United States, as did the number of related deaths. From 1998 to 2005, the number of reported serious adverse drug events increased from 34,966 to 89,842. The number of fatal adverse drug events almost tripled during the same time period, from 5,519 in 1998 to 15,107 in 2005.
The number of adverse events increased four times faster than the total number of outpatient prescriptions, which rose from 2.7 billion to 3.8 billion during that time frame, according to the study, which was published in the Archives of Internal Medicine.
Dr. Sidney M. Wolfe, director of Public Citizen's Health Research Group, called the new FDA report a "partial and simplistic view of what is wrong with the FDA."
"There seems to be more importance placed on satisfying industry [at the FDA]. It's not an atmosphere where people are free to express their differing opinions," he said.
Wolfe thinks the agency needs to be changed substantially, including new legislation that would strengthen its ability to regulate food additives, drugs and dietary supplements. He also thinks user fees should be abolished, because the fees make the relationship between the agency and drug companies too close.
More information
For more on what the FDA is doing about drug safety, visit the Food and Drug Administration.
more discussion: Forum
· Addiction Forum · Ask the Doctors Forum · Ayurveda Forum · Ayurvedic & Thai Herbs Forum · Colon Cleansing Forum · Dental Forum · Diabetes Forum · Diet Forum · General Cleansing Forum · Hepatitis A, B. C Forum · Integrated Medicine Forum · Live Blood Analysis Forum · Ozone-Oxygen-Forum · pH - Alkaline - Acidity Forum · Weight Loss Forum
The Subcommittee on Science and Technology lays the blame squarely on inadequate funding, which it says has not kept pace with increasing demands on the agency.
"This imbalance is imposing a significant risk to the integrity of the food, drug, cosmetic and device regulatory system, and hence the safety of the public," the report states.
And things could get worse, the report stresses: "...the Agency suffers from serious scientific deficiencies and is not positioned to meet current or emerging regulatory responsibilities."
William Hubbard, a former FDA associate commissioner and an advisor to the Coalition for a Stronger FDA, a group that lobbies on behalf of the agency, called the report "one of the most remarkable reports I've ever seen. They are basically saying the FDA can't protect the public, and they are saying that our future competitiveness in new technology, emerging science and pharmaceuticals and devices is seriously threatened."
Hubbard also thinks that more money is needed for the FDA to do its job. "The number doesn't matter -- it just needs to be a lot," he said. "You would need a steady increase over five years to fix the FDA."
The report started as a review of the science at the FDA, Hubbard said, and mushroomed into something more.
"The committee was horrified that the science wasn't there, then they were horrified that the capabilities weren't there -- and the only way to fix that is funding," he said.
The FDA budget request for 2008 is $1.74 billion, plus another $444 million in user fees. These fees are paid by drug makers and medical device makers to underwrite the approval process of their products.
Another expert thinks that the FDA needs more money, but to really protect the public the agency's culture also needs changing.
"You need not only an overhaul of resources but an overhaul of philosophy on what safety and efficacy really means," said Dr. A. Mark Fendrick, a professor of internal medicine and professor of health management and policy at the University of Michigan.
"While a substantial increase in resources will enhance the scientific capabilities and capacity of the FDA, funding alone will not address the inherent tension between America's insatiable demand for immediate access for innovative products and an unwillingness to tolerate products that are anything but perfectly safe," Fendrick explained.
Another FDA supporter also thinks that improving the FDA starts with money.
"There are a lot of problems in the FDA that can't be solved without more resources," said Steven Grossman, a spokesman for the FDA Alliance, which lobbies on behalf of the agency. "All the problems don't go away if you have more money, but there are a whole lot of problems you can't confront without money."
Grossman thinks there is need for another $450 million in unrestricted spending to start bringing the agency up to snuff. That request is currently winding its way through Congress. "We hope to get at least a third of that," he said. It's going to take several years of increased funding to get the FDA to where it should be, he added.
According to the report, the FDA's "inability to keep up with scientific advances means that American lives are at risk." The committee noted that while science had undergone radical changes, the agency' evaluation methods haven't hanged in more than 50 years.
In addition, the food supply is at risk, the report said: "Crisis management in [the] FDA's two food safety centers, [the] Center for Food Safety and Applied Nutrition (CFSAN) and [the] Center for Veterinary Medicine (CVM), has drawn attention and resources away from FDA's ability to develop the science base and infrastructure needed to efficiently support innovation in the food industry, provide effective routine surveillance, and conduct emergency outbreak investigation activities to protect the food supply."
The report also calls for better-trained FDA scientists and improvements in the agency's computer technology. The full report will be presented at a meeting of the FDA's Science Board on Monday.
In recent years, numerous food recalls and the withdrawal from the market of popular medications -- the removal of the painkiller Vioxx in 2004 was one of the most high-profile examples -- have eroded public confidence in the FDA. A recent survey found that 47 percent of Americans rated its performance as fair or poor.
And a study published in September found the number of serious adverse drug events more than doubled between 1998 and 2005 in the United States, as did the number of related deaths. From 1998 to 2005, the number of reported serious adverse drug events increased from 34,966 to 89,842. The number of fatal adverse drug events almost tripled during the same time period, from 5,519 in 1998 to 15,107 in 2005.
The number of adverse events increased four times faster than the total number of outpatient prescriptions, which rose from 2.7 billion to 3.8 billion during that time frame, according to the study, which was published in the Archives of Internal Medicine.
Dr. Sidney M. Wolfe, director of Public Citizen's Health Research Group, called the new FDA report a "partial and simplistic view of what is wrong with the FDA."
"There seems to be more importance placed on satisfying industry [at the FDA]. It's not an atmosphere where people are free to express their differing opinions," he said.
Wolfe thinks the agency needs to be changed substantially, including new legislation that would strengthen its ability to regulate food additives, drugs and dietary supplements. He also thinks user fees should be abolished, because the fees make the relationship between the agency and drug companies too close.
More information
For more on what the FDA is doing about drug safety, visit the Food and Drug Administration.
more discussion: Forum
· Addiction Forum · Ask the Doctors Forum · Ayurveda Forum · Ayurvedic & Thai Herbs Forum · Colon Cleansing Forum · Dental Forum · Diabetes Forum · Diet Forum · General Cleansing Forum · Hepatitis A, B. C Forum · Integrated Medicine Forum · Live Blood Analysis Forum · Ozone-Oxygen-Forum · pH - Alkaline - Acidity Forum · Weight Loss Forum
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