Basketball Head Injuries

Traumatic brain injuries from basketball increasing among adolescents, study suggests.
ABC World News (9/13, story 8, 2:20, Sawyer) reported, "Some sobering news tonight about the most popular sport for American children and teens, basketball." When "you think of the hazards of basketball, you think of sprained ankles or sprained fingers, but a journal called Pediatrics has a new study which says the number of teenagers and adolescents suffering traumatic brain injuries from basketball is soaring." ABC's Sharyn Alfonsi explained, "Researchers say traumatic brain injuries associated with playing basketball, mostly concussions, spiked 70 percent over 10 years." More "kids now play basketball than any other sport," and emergency departments "report basketball now accounts for more head injuries than even football."
The New York Times (9/13, Parker-Pope) "Well" blog reported that "about 375,000 children and teenagers are treated in hospital emergency rooms each year for basketball-related injuries." Notably, "the proportion related to head trauma is on the rise." In 2007, "the last year of the study, about four percent of youth basketball injuries were to the head, about double the number of such injuries reported by emergency rooms in 1997." Boys "were most likely to experience cuts, fractures, and dislocations; girls were more likely to suffer head or knee injuries." Among boys, "the percentage of head injuries doubled over the period, but among girls, it tripled," the blog added.
The CNN (9/13, Henry) "The Chart" blog reported that the number of basketball-related injuries, however, "decreased over the course of the study and totaled more than four million during the 11 year period." According to senior study author Dr. Laura B. McKenzie, "the study did not include patients who were treated outside of emergency rooms, so it's likely the overall number of basketball related injuries is greater."

PSA Screening Update

Study suggests men with lowest initial PSA levels benefit least from additional screening.
Bloomberg News (9/13, Ostrow) reports that research published in the journal Cancer found that men ages 55 and older who have the lowest baseline levels of prostate-specific antigen "benefit the least from repeating the test." While "the study adds fresh evidence to a debate about how to screen for prostate cancer to catch tumors early while avoiding false positives that trigger unnecessary tests and treatment," some argue that the study needed to follow its subjects for longer to demonstrate benefits.
The CNN (9/13, Hagan) "The Chart" blog reported that Dr. J. Brantley Thrasher, spokesman for the American Urology Association, and the William L. Balk, chair of the Department of Urology at the University of Kansas, said, "This can't be done in a vacuum," adding, "We're getting data that may help us in the future."

Website to Help Pill Identification

NIH web tool aims to help identify pills.
CNN (9/10) reported in The Chart blog, "Poison control centers get more than 1 million calls a year about medicines that need to be identified. And maybe you've been in situations when pills seem to wander away from their labeled bottles, and you don't know what they are." Now, however, "the National Institutes of Health is developing a way to quickly identify medications based on appearance. Pillbox, in its beta testing phase, gives possibilities for your mystery pill based on its shape, color, size, imprint, and 'scoring.'" In addition, there is "an advanced search so you can go the other way: Search for a drug and see what it's supposed to look like." Notably, "the National Library of Medicine and the Food and Drug Administration are working on photographing more pills."

Hispanic Women and Breast Cancer

Study: Hispanic women diagnosed with breast cancer at younger age than Caucasian women.
The Houston Chronicle (9/13, Ackerman) reports "Mexican-American women are diagnosed with breast cancer at a significantly younger age than Caucasian women, a surprising finding from a new study that raises more questions about the recent push to delay routine screening." University of Texas MD Anderson Cancer Center researchers surveyed 22,000 "women in Hispanic neighborhoods in Harris County and found nearly half of those with the potentially deadly disease were diagnosed before they turned 50, about 10 years earlier than the national average for all women." The study "suggests a huge number of breast cancer cases wouldn't be caught at early stages" under new screening guidelines "issued last year by the US Preventive Services Task Force."
Disparate cancer rates among US, foreign citizens attributed to lifestyle differences. The Indianapolis Star (9/13, Berggoetz) reports, "The latest global cancer statistics show that 76 women per every 100,000 in the US were diagnosed with breast cancer in 2008, compared to 44 women per 100,000 in South America," disparate figures that are being attributed to lifestyle differences. Indeed, "some of this is due to US advancements in screening, diagnosis and record keeping," but experts at the American Institute for Cancer Research also believe that "differences in diet, weight and physical activity are key reasons."

Massage and Immunity Link

Study: Single massage may help boost immune, endocrine system.
The Los Angeles Times (9/9, Roan) "Booster Shots" blog, citing a study published in the Journal of Alternative and Complementary Medicine, reported that "a single massage produced measurable changes in the immune system and endocrine system of healthy adults." The researchers "studied 29 healthy adults who received a 45-minute Swedish massage" and "24 healthy adults who had a 45-minute session of light touch massage." Researchers found several changes in the blood tests of the Swedish massage group "that indicated a benefit to the immune system." For example, "Swedish massage caused sizeable decreases in arginine vasopressin, a hormone that contributes to aggressive behavior, and small decreases in the stress hormone cortisol."

CVS Flu Vouchers

CVS announces $5 million in vouchers for free flu vaccinations.
The AP (9/9) reports, "CVS Caremark Corp. said Wednesday it will give away up to $5 million in seasonal flu vaccinations to people without health insurance." They "will be available at clinics or community health centers starting Sept. 20. Consumers will be able to redeem the vouchers at any of CVS' 7,100 locations and its retail MinuteClinics." The AP adds, "CVS said it is working with Direct Relief USA, a nonprofit organization, to give out the shots." Normally, the vaccine would cost $29.95 at CVS and will be supplied by Novartis AG and Sanofi-Aventis. Meanwhile, "Walgreen also plans to give away vouchers for up to $1 million in free flu shots this year."

Social Isolation and Psychosis

Isolation, social fragmentation common to urban life may add to people's risk of developing psychotic disorders.
The Time (9/7, Park) "Wellness" blog reported that "life in the big city can...even promote a greater risk of developing a mental disorder, such as depression." To explain why, researchers examined data from "study of Swedish citizens born in 1972 and 1977, and found that the isolation and social fragmentation common to urban life added to people's risk of developing psychotic disorders, such as schizophrenia." The investigators found that "while the development of psychoses is driven primarily by individual risk factors -- such as genetics or personal circumstances -- the disconnectedness of urban living could help explain why rates of psychotic disorders were higher in the city than in rural areas."
HealthDay (9/7, Preidt) quoted the study authors as saying, "Our findings highlight the concern that physical integration alone is not sufficient, but that some of the positive characteristics traditionally conferred by segregation, such as a localized sense of safety, cohesion, and community spirit, must also be maintained to enhance the mental health of individuals within the population." The study is published in the September issue of the journal Archives of General Psychiatry, HealthDay noted.

Protein Sources Matter

Replacing carbs with proteins from plants may be better than doing so with meat proteins.
USA Today (9/7, Hellmich) reports, "If you're trying to cut carbs, it may be better for your health to eat more protein and fat from plant sources than animal sources," according to research published in the Annals of Internal Medicine. Investigators "followed 85,168 women and 44,548 men for several decades." The researchers found that "participants who replaced carbs with protein and fat from animal sources were more likely to die from all causes, including cancer and heart disease." The Los Angeles Times (9/6, Stein) "Booster Shots" blog, the CNN (9/6) "The Chart" blog, and HealthDay (9/6, Gardner) also covered the story.

Cockroach Brain Therapy

New treatment for bacterial infections may come from cockroach, locust brains.
The Los Angeles Times (9/4, Khan) "Booster Shots" blog reported that "the next cures for bacterial infections may come from an unlikely place: cockroach brains." Tissues "from cockroach and locust brains and nervous systems killed off 90% of E. coli and MRSA bacteria without harming the human cells they were attacking," according to researchers from the University of Nottingham. The "researchers suspect it's the proteins in the insect brains that so effectively kill the bacteria." Scientists are "currently studying the properties of as many as nine antimicrobial molecules, trying to figure out how they work and why." The findings, released Saturday, "are being presented this week at the autumn meeting of the Society for General Microbiology."

Bloomberg News (9/7, Bennett) reports that "insects, such as cockroaches, have a defense mechanism against bacteria, a 'logical' development from living in unhygienic conditions." Research "has shown cockroaches to spread germs linked to allergic reactions and asthma in the home and drug-resistant bacteria in hospitals." Invasive MRSA "is a hospital-acquired infection that sickens about 90,000 people and kills 15,000 in the US every year," according to the CDC. The researchers are testing the potency of the molecules "against emerging superbugs such as Acinetobacter," Bloomberg adds.

Childhood Obesity and Sleep

Childhood obesity associated with lack of adequate night-time sleep.
The CBS Evening News (9/6, story 11, 0:20, Mitchell) reported, "A study out today shows how important an early bedtime can be to a child's waistline. Researchers followed a group of youngsters ages five and under, a quarter of whom slept ten or less hours a night. After five years, four out of five of those kids who slept less had either turned overweight or obese. By the way, napping made no difference either way."
HealthDay (9/6, Preidt) reported that the study included "1,930 US children, ages one month to 13 years, who were divided into two groups -- younger (ages one month to 59 months) and older (ages five to 13 years)." Data on the children "was collected at the start of the study (baseline) in 1997 and again in 2002 (follow-up)."
MedPage Today (9/6, Phend) noted that "for kids four and under, low sleep levels appeared to have a lasting effect," with a "correlation between baseline sleep and overweight or obesity five years later (odds ratio 1.80, P<0.01)." For "kids five to 13, sleep levels had only a current effect" in which "low follow-up sleep levels predicted higher odds of overweight or obesity at follow-up (OR 1.80, P<0.01), although this effect lost significance once baseline BMI was included." The researchers said: "These findings suggest that there is a critical window prior to age five years when nighttime sleep may be important for subsequent obesity status."
The CNN (9/6, Falco) "The Chart" blog reported that "if children are getting less than 10 hours of sleep at night, they are well below the CDC sleep recommendations," which suggest, for example, "that a one-year old baby should sleep 13-15 hours at night," while three- to five- year-olds should sleep "11-13 hours" per night.
Studies link weight gain during pregnancy, overweight kids. The New York Times (9/7, Brody) reports, "Increasing evidence indicates that the trouble often starts in the womb, when women gain more weight than is needed to produce a healthy, full-size baby." Excessive weight gain "in pregnancy, recent findings show, can result in bigger-than-average babies who are prenatally programmed to become overweight children - who, in turn, are more likely to develop diabetes, heart disease and cancer later in life." While genes "play a role in weight issues for some people, recent studies indicate that genetics is not the main reason babies are born too fat. Rather, the new evidence suggests that in addition to gaining significantly more weight than is recommended during pregnancy, more women now start out fatter before they become pregnant."

New Fibromyalgia Drug News

FDA panel does not back potential fibromyalgia drug.
Bloomberg News (8/21, Peterson) reported that an FDA panel failed to back a potential "fibromyalgia drug" Rekinla (sodium oxybate), which "includes a chemical linked to date rape," because the drug "doesn't provide enough benefits to outweigh risks of abuse and accidental overdose." The panel voted 20-2 against approval of the drug, which is also currently prescribed under the name brand name Xyrem to treat narcolepsy. Yasmin Choudry, a medical officer in the FDA's division of risk management, said the FDA is concerned "the expanded population and increased availability of the drug in patients' homes may lead to an increase in cases of abuse and misuse, including malicious use."
The Wall Street Journal (8/21, Dooren) notes that many of the FDA panelists also called for long-term data on the safety and effectiveness of sodium oxybate.

Low Level Smoke Exposure Risk

Low levels of smoke exposure could cause genetic abnormalities in airway cells.
The Los Angeles Times (8/20, Kaplan) "Booster Shots" blog reported, "Smoking a pack (or two) of cigarettes each day is obviously not good for your lungs. But for those who enjoy an occasional smoke, an obvious question is, 'How many cigarettes can I smoke before I start to do some damage?'" New research from Cornell indicates there's a "sobering answer: Zero."
Even "secondhand smoke" does harm, reports CNN (8/23). "Sometimes it's hard to avoid being around family members who smoke at home or friends who light up at bars. But it's worth it," because "just a small amount of smoke can be detrimental to your health."
Indeed, "public-health bans on smoking have been fueled by strong population-based data that links exposure to secondhand cigarette smoke and a higher incidence of lung diseases, such as emphysema and even lung cancer, but [they] do not establish a biological cause for the correlation," Time (8/20, Park) reported. "Now, for the first time, researchers can point to one possible cause: the passive recipient's genes are actually being affected." Before reaching that conclusion, investigators "devised a study in which 121 volunteers -- some of whom smoked and some of whom had never smoked -- agreed to have samples of their airway cells studied for genetic activity."
The team eventually discovered that "when exposed to smoke, the genes get turned on and off abnormally," WebMD (8/20, Doheny) reported. "The cell is crying out at a biological level, saying, 'Something's wrong. I'm being stressed here.'" Altogether, "about 370 different genes sense the smoke...and turn off and on in the area."
And, "there was no level of nicotine or cotinine, no matter how small, that did not produce genetic abnormalities," HealthDay (8/20, Reinberg) noted. Yet, "knowing which genes are damaged could provide targets for new drugs that could protect the lungs," the authors wrote in the American Journal of Respiratory and Critical Care Medicine. Dr. Norman H. Edelman, of the American Lung Association, "applauded the study," saying, "I like this one, because it cleverly uses molecular biology to answer a very important question, one that I get asked very often."

Pain Therapy with Virtual Reality

Scientists devise virtual reality treatment for excruciating pain.
NBC Nightly News (9/2, story 9, 2:35, Williams) reported on "a novel way to control pain that involves mental distraction so effective, so real it actually eases a patient's physical suffering." Chief science correspondent Robert Bazell explained that "Hunter Hoffman, of the University of Washington, devised the virtual reality as a treatment for excruciating pain, especially pain caused by burns." In "Snow World," there are no reds or oranges or even suggestions of warmth and heat. Patients don earphones and goggles and immerse themselves in the virtual world where they are soothed by familiar music. After speaking with a burn patient and using Snow World himself during an experiment, Bazell concluded, "The success is a demonstration of what doctors have long known -- that pain is perceived in the brain and even distraction can bring amazing relief."
Study explores why some people are more likely to become addicted to opioid painkillers. HealthDay (9/2, Preidt) reported that, according to a study published in the September issue of the journal Addiction, "the mystery of why some people are more likely to become addicted to opioid painkillers has been partially unraveled by the Geisinger Health System." In a study of 705 back pain patients prescribed opioid painkillers for more than three months, researchers "found that the group most vulnerable to addiction has four main risk factors in common: age (being younger than 65); a history of depression; prior drug abuse; and using psychiatric medications." In fact, "painkiller addiction rates among patients with these factors are as high as 26 percent," the study found.

Osteoporosis Treatment and Esophagus Cancer

Drugs to treat osteoporosis may increase esophageal cancer risk.
Bloomberg News (9/3, von Schaper) reports, "A group of drugs used to prevent bone loss in osteoporosis patients may increase the risk of contracting cancer of the esophagus." In fact, "patients who took the medicines, known as bisphosphonates, for five years or filled at least 10 prescriptions were twice as likely to be diagnosed with the cancer as those who didn't."
The "findings are in contrast to another recent study that used the same database of 80,000 patients and concluded that there was no link between the drugs and esophageal cancer," the AP (9/3, Cheng) reports. "That study was published last month in the Journal of the American Medical Association." But, the authors of the current BMJ paper "say they tracked patients for nearly twice as long -- nearly eight years."
Specifically, Oxford researchers "used the UK General Practice Research Database to collect data on almost 3,000 men and women with esophageal cancer, more than 2,000 with stomach cancer and over 10,000 with colorectal cancer diagnosed between 1995 and 2005," HealthDay (9/2, Reinberg) reported. "They compared these patients with age- and sex-matched people without these conditions."
Investigators eventually discovered that "individuals diagnosed with esophageal cancer of were 1.93 times as likely (95% CI 1.37 to 2.70) to have received at least 10 prescriptions for oral bisphosphonates, compared with controls not having cancer," MedPage Today (9/2, Gever) reported. The "likelihood of receiving at least one bisphosphonate prescription among esophageal cancer patients was 1.30 (95% CI 1.02 to 1.66) relative to controls, the researchers found." Meanwhile, an "accompanying editorial by an FDA epidemiologist, Diane Wysowski, PhD, noted that links between bisphosphonates and esophageal cancer have been proposed for more than 15 years," and the agency "has collected a total of 68 case reports of esophageal cancer in patients taking bisphosphonates, half in the US and the rest in Europe and Japan, but has not ordered label warnings."
Still, the Medicines and Healthcare products Regulatory Agency (MHRA) recently "said there was 'no need' for patients to stop taking the medication on the basis of the study alone," the UK's Telegraph (9/3, Adams) reports. "Dr. Des Spence, a Glasgow GP who has also written on the subject in the BMJ, said doctors should focus less on the drugs and more on how to avoid falls, as well as on improving diet and increasing targeted exercise."

Research on Lunch Cancer Prevention

Metformin may help prevent tobacco-induced lung cancer.
The Los Angeles Times (9/2, Maugh) reports, "A growing body of evidence suggests that the widely used diabetes drug metformin can reduce the risk of cancer." Indeed, "there is not yet enough evidence to recommend using the drug routinely for cancer prevention, but the evidence is strong enough that physicians and patients considering drug therapy for type 2 diabetes might want to lean toward metformin because of its ancillary effects," researchers at the National Cancer Institute maintained. The latest study bolstering that recommendation involves "tobacco carcinogens" and lung tumors.
Through their work with mice, investigators noted that "metformin was associated with a substantial reduction (up to 73 percent) in the number of tumors" the rodents "developed when they were given a common carcinogen found in tobacco," HealthDay (9/1, Gardner) reported. "Despite the fact that there have been no randomized controlled trials on whether metformin really can prevent cancer, researchers expressed excitement both over this animal study," which is detailed in Cancer Prevention Research.

Antipsychotics and Teens

Over half a million US children, teens now taking antipsychotics, FDA report says.
On its front page, the New York Times (9/2, A1, Wilson) reports, "More than 500,000 children and adolescents in America are now taking" antipsychotics, "according to a September 2009 report by the Food and Drug Administration." Recently, another study "found a doubling of the rate of prescribing antipsychotic drugs for privately insured two- to five-year-olds from 2000 to 2007. Only 40 percent of them had received a proper mental health assessment, violating practice standards from the American Academy of Child and Adolescent Psychiatry." Many experts now believe that prescribing antipsychotics for young children may be risky for the development of both their bodies and their brains.
Mental health leads list of top 5 concerns at colleges. Under the headline "5 Big Health Issues On Campus," NPR (9/1, Wyckoff) reported on "what health concerns are topping the agenda now," according to college health officials and Dr. Al Glass, president of the American College Health Association. The issues, in order, are mental health, because "stress is a biggie," followed by sleep issues; the "perennial concern" of infectious diseases such as flu; exercise needs to prevent obesity, and alcohol abuse.

Teens and Substance Abuse

Teens from different ethnic groups may abuse substances for different reasons.
The CNN (8/30, Hellerman) "The Chart" blog reported that "teens of different ethnic groups use alcohol, marijuana, and cigarettes for different reasons and educators should use different strategies to keep them clean," according to a new study funded by the National Institute on Alcohol Abuse and Alcoholism. The study, published in the Journal of Studies on Alcohol and Drugs, "analyzed roughly 5,500 responses from seventh- and eighth-graders in Southern California to surveys that were distributed by researchers from the RAND Corporation." Hispanic "students were the most likely to report having tried alcohol, cigarettes, or marijuana," followed by "African-American students" and then Caucasians. The blog entry also noted that Asian-American students "were substantially less likely" to have tried any substance.

Embryonic Stem Cell News

NIH orders halt to its human embryonic stem cell research.
The Washington Post (8/31, Stein) reports at "The Checkup" blog, "The National Institutes of Health Monday ordered all of its researchers conducting research on human embryonic stem cells to immediately halt their experiments." Also noted is that "NIH Director Francis Collins announced last week that the ruling was forcing the agency to shelve any requests for new funding for the research from scientists at universities, colleges, research institutes and elsewhere around the country." At present, "the NIH has eight research projects that use human embryonic stem cells, as well as a unit that characterizes lines added to the NIH registry of approved cells." The decision is in response to "the recent preliminary injunction ordered by the United States District Court for the District of Columbia in the matter of Sherley v. Sebelius."

Zoning Out

Zoning out, daydreaming may play key role in mental well-being.
The Los Angeles Times (8/30) reports, "Some scientists wonder whether unstructured mental time -- time to zone out and daydream -- might also play a key role in our mental well-being." Researchers now studying the brain's "default mode network" say that understanding it "may do more than lend respectability to the universal practice of zoning out: It may one day help diagnose and treat psychiatric conditions as diverse as Alzheimer's disease, autism, depression, and schizophrenia." Notably, brain scan studies have revealed that "the brain parts constituting the default mode network are uniquely vulnerable to the tangles, plaques and metabolic disturbances of Alzheimer's disease," indicating that default mode network is integral to people's sense of self.
Brain's default mode network may work differently in people with psychiatric disorders. In a related story, the Los Angeles Times (8/30, Healy) reports, "A series of studies published in recent years suggests that in people with depression, autism, schizophrenia, and post-traumatic stress disorder, the default mode network, that curious pattern of brain activity that ramps up when we daydream, works differently than it does in healthy control subjects." Interestingly, "in each condition, the malfunctions look slightly different, holding out the prospect of better psychiatric diagnoses down the line." For example, in people who are depressed, fMRI studies have "found the default mode network to be 'hot-wired' to brain regions that process emotions or help focus attention on demanding mental tasks and that connections over-fire or fire unreliably."

Breastfeeding and Type II Diabetes

Breastfeeding may lower a woman's lifetime risk of developing type 2 diabetes.
The Los Angeles Times (8/27, Roan) "Booster Shots" blog reported that, according to a study published in the Sept. issue of the American Journal of Medicine, "breastfeeding a newborn for even one month will lower a woman's lifetime risk of developing type 2 diabetes." After examining "data from 2,233 women in California's Kaiser Permanente healthcare system," researchers discovered that "27% of the mothers who did not breastfeed developed type 2 diabetes." What's more, "these women were almost twice as likely to develop the disease, compared with women who had breastfed or who had never given birth."
The study authors speculated that "breastfeeding helps moms lose the abdominal fat they gain during pregnancy more efficiently," Time (8/27, Park) reported. "While abdominal -- or visceral -- fat is important for the gestating baby's development, it can be detrimental to a mother's health if it continues to build after delivery, since it's been linked to greater risk of metabolic disorders such as insulin resistance and heart disease as well as diabetes."
According to MedPage Today (8/27, Fiore), lactation also "suppresses gonadotropin levels and has been associated with lower and slower responses to growth hormone."
WebMD (8/27, Doheny), and the Orlando Sentinel (827, Shrieves) "Vital Signs" blog also covered the story.
America's 2009 birth rate hits historical low. The Washington Post /AP (8/28, Marchione) reported that data from the CDC's National Center for Health Statistics reveal that the "birth rate dropped for the second year in a row since the recession began in 2007." Specifically, the rate "fell to 13.5 births for every 1,000 people last year," which is "down from 14.3 in 2007 and way down from 30 in 1909." The "situation is a striking turnabout from 2007, when more babies were born in the United States than any other year in the nation's history."
According to Bloomberg News (8/27, Randall), "detailed data on mothers' ages in 2009 won't be available until next year and will give a greater indication of the link between the recession and the declining births in America, according to the CDC." The Washington Post (8/27, Stein) "The Checkup" blog also covered the story.
Testicular cancer may be linked with abnormal fetal development. Bloomberg News (8/30, Gale) reports, "Testicular cancer may be linked with abnormal fetal development," according to a paper in Human Reproduction. "Until now, it has been impossible to study testicular development during pregnancy in humans" but after developing a viable "model," UK scientists hope to eventually "understand the processes that can lead to the onset of testicular germ cell cancer in young adult life.

Emergency Room Expectations

Survey indicates 80% of patients expect to be attended to by physicians in EDs.
American Medical News (8/30, O'Reilly) reports, "Nurse practitioners and physician assistants account for at least 10% of outpatient visits and increasingly are being used to handle patient care in emergency departments." However, a new paper appearing in the American Journal of Bioethics reveals that "80% of patients expect to see a physician when they come to the ED." In addition, the "survey of 507 ED patients at three teaching hospitals in Pittsburgh and Dallas found that, even for a minor complaint such as a cold symptom, only 57% would agree to see a nurse practitioner and 53% would see a physician assistant." Respondents also "preferred to see a fully trained physician compared with a medical resident, but not by as wide a margin as their desire to avoid nonphysicians."

Medial Home and Family Practice

"Medical home" concept recasts primary-care practices.
NPR (8/26, Rovner) profiled the concept of the "medical home," an idea it says is "spreading around the nation" and involves changes in medical practice that range from where healthcare professionals are located in an office to the use of EMRs to profile patient populations' treatment and compliance on charts and graphs. NPR focused on Martin's Point, Maine, to describe how the "medical home" works. A key concept within the home "is to have everyone 'practicing at the top of their license' or doing what they are most trained to do," says physician Lisa Letourneau, who says another fundamental is "to hand off some of the less specialized -- and often time-consuming -- tasks to others."

Concierge Medicine

Columnist questions ethics of "concierge doctoring."
In the New York Times (8/27) Doctor and Patient column, Pauline W. Chen, MD, discusses concierge medical practices in which patients pay a monthly or yearly retainer to guarantee "around-the-clock access to [a] doctor, appointments within 24 hours of calling, longer office visits, and...personalized attention and care coordination." Over time, "the debate about the ethics of concierge doctoring has grown more heated, with more and more physicians unabashedly lining up to take sides." For example, "an editorial in the Annals of Internal Medicine this spring...questioned not only the ethics, but also the quality of care delivered in such practices." Chen wonders "whether it is possible to practice in a way that reconciles concierge medicine with all the ethical concerns."
Tufts Medical Center uses concierge retainer fees to provide free care to impoverished patients. The New York Times (8/26, Tara Parker-Pope) "Well" blog pointed out, "Although patients often sing the praises of concierge medicine, the medical community is grappling with the ethical concerns of creating two different levels of medical care for the haves and the have-nots." But, physicians at Tufts Medical Center in Boston have come up with a practice model that benefits both wealthy and poor patients alike. Since 2004, primary-care physicians there "have offered patients the option of being part of either a traditional general medical practice or a retainer practice." The $1,800 yearly retainer fee paid by the concierge patients "is used to support the traditional general medical practice, the teaching of medical students and trainees, and free care to impoverished patients."

Healthy Alternative with Antioxidants

Asian black "forbidden rice" may offer more health benefits than others.
A handful of stories focus on the health benefits of black rice, which is the subject of a new study presented at the American Chemical Society in Boston, by Zhimin Xu, associate professor at Louisiana State University Agricultural Center in Baton Rouge, and colleagues.
CNN /Health.com (8/26, Storrs) pointed out that black rice "is still relatively rare," although "researchers are trying to bring its distinctive flavor and mix of antioxidants to the masses," because the rice "is full of antioxidant-rich bran, which is found in the outer layer that gets removed during the milling process to make white rice." The bran of black rice also "contains the antioxidants known as anthocyanins, purple and reddish pigments -- also found in blueberries, grapes, and acai -- that have been linked to a decreased risk of heart disease and cancer, improvements in memory, and other health benefits."

Depressed Mothers and Impoverished Children

More than half of babies in poverty are being raised by mothers showing symptoms of depression.
The Washington Post (8/26, St. George) reported that, according to a study conducted by researchers at the District of Columbia-based Urban Institute and based on government data on more than 14,000 children born in 2001, "more than half of babies in poverty are being raised by mothers who show symptoms of mild to severe depression, potentially creating problems in parenting and in child development." What's more, investigators found that "one in nine infants in poverty had a mother with severe depression." Unfortunately, the study also found that "even severe depression goes largely untreated among low-income mothers of infants, with just 30 percent speaking to a professional about a mental health problem."

Depression in Children

Some research suggests depression may begin in preschool children.
The New York Times (8/29, MM48, Paul) examines a range of opinions on the topic of depression in preschoolers. After an anecdotal opening about the symptoms exhibited by a preschool child from St. Louis, the Times reports, "Preschool depression may be a legitimate ailment, one that could gain traction with parents in the way that attention-deficit/hyperactivity disorder (AD/HD) and oppositional defiant disorder (ODD)...have entered the what-to-worry-about lexicon." This is partly because, "according to recent research," the onset of depression "seems to be earlier than expected. Today a number of child psychiatrists and developmental psychologists say depression can surface in children as young as two or three."

Overeating and Body Changes

Overeating for just four weeks may cause lasting changes in body fat composition.
The Los Angeles Times (8/24, Roan) "Booster Shots" blog reported that, according to a study published in the journal Nutrition & Metabolism, "overeating for just four weeks can cause changes in body fat composition that last for years." In a two-year study of 18 young and healthy adults of normal body weight who were told to be sedentary and to raise their intake of calories by 70% for one month and a control group who changed neither their diet nor their exercise habits, researchers found that "at the one-year mark, the gluttony group was an average of 3.3 pounds heavier than before their four-week binge while there was no change in the body weight of the control group."
BBC News (8/24) reported, "The study suggests that even a short period of excessive eating and a lack of exercise can potentially change a person's physiology -- making it harder to lose and keep off weight." The UK's Telegraph (8/25, Alleyne) also covers the story.

Flu Shot Update

CDC officials urging public to get flu shot sooner this year.
The Wall Street Journal (8/25, Mckay) reports that this year, CDC and other health officials are urging Americans to get the flu shot, which contains protection against three strains, most notably, H1N1, early. CDC Director Thomas Frieden stated, "I think last year will be a plus rather than a minus in terms of vaccine coverage," and added that the agency is working on new technology that will allow vaccines to be produced faster. Nevertheless, CDC officials are aware that some people are still hesitant to get the vaccine because of concerns that it was not adequately tested, or because they believe H1N1 is not a major health threat.