May 2009

Friday, May 29

The Green Monkey sounds like a bar on the edge of the jungle somewhere in Malaysia. But it’s actually the Frankensteinish creation of disease researchers.

Japanese scientists have created a monkey that glows green, and the gene that makes it glow green is passed on to offspring. They accomplished it by incorporating a jellyfish gene into the DNA of a marmoset.

When viewed under an ultraviolet light, the animals are fluorescent. The idea is that the researchers can more easily identify problem genes, such as those that cause Alzheimer’s disease. It is also proof that scientists can pass on genes that they want to study in future generations.

The research was published in this week’s journal, Nature.

The BBC has some rather ghoulish photos of how these animals look under the lights.

I’m not opposed to using animals for research. But at a certain point, you have to ask where the scientific community is going, and how far they are willing to push the envelope.

One of the biggest concerns among ethicists is that human genetic modifications will be next. The term, “designer babies” is loaded with negative implications.

“Some in the future might want to put a gene into humans to give them the running speed of a cheetah, for example, or maybe create the potential for night vision,” Lori Andrews, who studies reproductive technologies at the Illinois Institute of Technology’s Chicago-Kent College of Law, told The Washington Post yesterday.

Mark Rothstein, a bioethicist at the University of Louisville, nailed it when he added: “It’s hard to put your finger on what is it about this research that is likely to stimulate ethical debate besides the sort of gut feeling that this is not the right thing to do.

“But I think we’d better contemplate where this research is going and develop policies to deal with it before it slaps us in the face.”

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Thursday, May 28

Each insured family pays $1,017 in higher health premiums for uninsured care, a report issued today says.

The additional expenditure covers health care for the uninsured, largely at emergency rooms where they are legally entitled to receive basic care regardless of their status, according to a report by Families USA. The health care reform advocacy group calls it a “hidden tax” that hits individual policy owners with about $368 in additional annual costs.

The uninsured received about $116 billion in health care in 2008 and paid for 37 percent of it out of pocket. Charities picked up another 26 percent. That left $42.7 billion to be passed on to the insured to support delinquent costs.

What kind of health care reform does Families USA envision? The organization likes the idea of a government alternative to private health care coverage. You can see their plan spelled out in detail here.

The idea, which President Obama brought up during the campaign, is controversial. If it is introduced, it will be heatedly opposed by many groups, in particular the health insurance industry. Insurers worry that a public alternative will drive down prices and slice into their profits.

This is not government health care. It has nothing to do with free choice, since anyone who has coverage through Aetna, UnitedHealth or any other insurer wouldn’t have to do anything. They could keep their plan as is. But if you’re uninsured and shopping for a plan, the private insurers will have to remain competitive in order to have a shot at your business.

It’s not an ideal solution but it warrants serious discussion. My sincerest hope is that we do not see a return of the Harry and Louise TV commercials that helped jettison the Clinton plan in 1993 before it even had a chance to be rationally debated.

This is why Obama publicly huddled with insurers earlier this month, extracting a promise to slash 1.5 percent from annual health care cost increases over the next decade. According to New York Times columnist Paul Krugman, industry officials are already backing away from this promise.

Blue Cross Blue Shield is busy developing a series of ads to whip up public sentiment against the public option plan. I wonder who will play Harry and Louise this time?

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Wednesday, May 27

You may find the violent doodlings of your school-age son to be, well, disturbing. No need to worry, a popular author says.

Boys in particular are notorious for sketching people getting machine gunned, or having their arms severed. Their parents often reel in horror when they see this kind of “art,” and it never makes it on to the family refrigerator display area.

But the artists actually have a good handle on separating cartoon violence from the real thing, says Ted Dewan, who wrote One True Bear about a gruff teddy bear who wins the heart of a violent boy.

The debate over cartoon violence has raged for years. Cartoons, particularly post-World War II, contained an act of violence every 10 seconds or so. Critics complained loudly, leading to a new menu of milder fare starting in the 1970s and 1980s. The issue was satirized very effectively on The Simpson’s via the Itchy and Sratchy Show.

U.S. psychologist Michael Thompson, author of Raising Cain: Protecting the Emotional Life of Boys, says fantasy violence should be accommodated at the same time family and school violence must be stopped. Otherwise, he says, the risk is that they conclude school is not for them.

“Children, boys in particular, have been play acting at hunting, chasing, killing and dying since the beginning of human history,” Thompson told the BBC.

“There is no connection between writing violent stories and committing violence. If you write violent stories, you are not going to end up in jail, you are going to end up in Hollywood writing action movies.”

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Tuesday, May 26

It was my first trip to Sonic Drive-in. A hot day, a cold Strawberry Fruit Smoothie, and a lesson in American fast food cuisine.

The people I was with directed me into the parking slot and familiarized me with the rules of the road. You pull an item off the menu, punch the red button and speak to the gods of burgers, fries and shakes. One of their angels appears within minutes, gliding toward your car with a tray full of cold, creamy high-cal goodness.

Getting out of your car is discouraged. There are a few picnic tables outside the store but really, who wouldn’t rather eat in the car with your favorite radio station and friends with whom you can crack jokes about other patrons inside their own vehicles?

Payment is cash only, although there is a place to slide a Sonic prepaid card if you decide to make this a regular haunt.

I ordered a regular sized Strawberry Fruit Smoothie. My car mates had a Cherry Limeade, a Small Vanilla Cone and a Lime Real Fruit Slush.

My smoothie arrived promptly, a study in perfect mass-produced precision. Ideal consistency, cold but not solid, and a well-engineered straw that was wide enough to funnel it all in without getting clogged up. There were enough strawberry seeds in the drink for my taste buds to verify that this was a real food product.

But as I worked my way through it, it occurred to me that the smoothie was unnaturally sweet. They could have backed off on the sugar, maybe added a shot of fresh lime and some mint, and it would have had the sort of challenging tartness that Anthony Bourdain might admire.

Yes I know. I watch too much Food Channel. And the Travel Channel has trained me to turn up my nose and smirk when I pass the Golden Arches.

Anyway. When I got home, I went online and checked the Sonic nutrition menu. The regular strawberry smoothie, it says, has 98 grams of sugar. That makes it one of the most sugary concoctions on the menu, packing approximately the same punch as a peanut butter and jelly sandwich. (Lime Real Fruit Slush, 50; Cherry Limeade, 57; Vanilla Cone, 22.)

Now, this is not a post to say, stay away from fast food, or the Sonic drive-in. But it is a suggestion that you check selections more carefully and keep your eyes open, especially when it comes to eating out.

I actually had a positive experience at Sonic and I’d go back again. And, to the company’s credit, all the information is there online for you to see and absorb.

But think about what you’re absorbing, analyzing foods not only with your taste buds, but your eyes and mind as well.

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Thursday, May 21

Police are always on the lookout for people who are DUI, and rightfully so. But soon they may also be watching for DWT—driving while texting.

It’s bad enough that people behind the wheel have a cell phone plastered to their ear. But although your mind is engaged elsewhere, at least drivers are keeping their eyes on the road. Not so with texting.

Even if the driver is so skilled he can punch the keys without looking at them, reading a reply necessitates a long glance or two at his cell phone.

Boston is banning cell phones for all of its transportation workers after 49 people were injured in a trolley accident. The driver had been texting his girlfriend. In California, a woman slammed into line of cars, causing an explosion and killing a driver at the front of the line. She’d been texting.

In a study presented to the Pediatric Academic Societies on May 2, teens involved in a simulated test drive wove in and out of traffic, and mowed down pedestrians while fiddling with their MP3 players and texting on their cell phones.

Dr. Phil weighs in on the topic in this video. Note the melodramatic music, by the way. His guest seems to take it quite lightly, but Dr. Phil rips her a new one.

A story in US News claims 20 percent of drivers at any given time are engaged in sending or reading a text message. If you narrow it down to drivers 18 to 24, it’s 66 percent.

Look for legislatures to begin generating legislation on this. It can’t happen too soon.

Wednesday, May 6

How do you promote good health habits without the government or your company breathing down your neck? Try an on-the-job farmer’s market.

That’s what’s happening at several Kaiser Permanente hospitals around the country. The idea was launched six years ago at the Kaiser Medical Center in Oakland, CA. It’s the brain child of Dr. Preston Maring, who believes that it encourages good eating habits.

In an article in Good Magazine, Maring cites one case of an employee who weighed 300 pounds, began buying fresh fruits and vegetables at the hospital market and cooking at home more often. He lost 60 pounds.

There are now markets at 30 different Kaiser locations around the country. “We put the market out front—on the main sidewalk, right in the middle of the foot traffic—where we could highlight fresh fruits and vegetables,” he says. “It’s great for the surrounding community, great for the people that work there, and great for the patients.”

The logistics of an operation like this can be complicated–there are parking issues to contend with, among other things–but Kaiser found that they were not insurmountable. Find out exactly how they set it up in this article about hospital-based farmers’ markets.

There’s no reason why this idea can’t be carried further to small markets at other kinds of offices and private companies. It can benefit employees while representing a good public relations gesture for the surrounding community.

Using fresh locally grown produce is not only the healthiest way to eat, it’s also the best way to cook. I make at least one trip a week to an outdoor market in my area, picking up what’s fresh and plentiful. And here’s another benefit: It’s cheap. When an item comes into the market in quantity, you can pick it up for a fraction of what you’d pay at a supermarket. And the quality is superior.

It is, as they say, a win-win. I hope the idea catches on.

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Tuesday, May 19

Life expectancy in Afghanistan is only 44 years. The reasons may seem obvious, but they’re spelled out in grisly detail in this story published yesterday on To people in the West, 44 is an astonishing figure. But countries ravaged by years of war accumulate health problems, not just because of military attacks, but deteriorating infrastructure.

As the author of the story points out, for example, even the lucky ones in Kabul get only a few hours of electricity per day. There’s very little clean drinking water and lawlessness rules.

But there are worse places than Afghanistan in terms of early death, according to the CIA World Factbook. Some African countries suffer from soaring AIDS rates, plummeting their life expectancy into the 30s. Swaziland ranks last, with an average rate of 32.2 years.

The United States ranks 45th, by the way, with a rate of 78.06 years. European countries tend to do better, including France (80.87), Switzerland (80.62), and Italy (79.94).

But some Asian countries blow them all away.

Macau, a special administrative region of China, similar to Hong Kong, is ranked at the top of the CIA chart with a rate of 84.3. Women tend to live well into their late 80s. The territory is an unusual cultural mix of Chinese and Portuguese. Both languages are spoken there, along with English.

It’s a small area with a subtropical climate and a tourist-based economy. Jobs are concentrated in the service industry, with a lot of residents working in restaurants and the gambling industry. And in addition to having the longest living people, Macau has the world’s greatest population density, at 18,428 people per square kilometer.

All of those people, crammed in together, a lot of them working service jobs, but still the healthiest on the planet. The autonomous Macau government spends 9.25 percent of its budget on health care. By comparison, the U.S. spends 16 percent of GDP on health care.

So yes, Americans are lucky. But we should still be asking the decision makers in Washington: Why can’t we get more bang for our buck?

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Monday, May 18

“How are you feeling today, Dave? You look a little down.” HAL wasn’t a psychologist in the movie, 2001: A Space Odyssey. But maybe he could have been.

Britain’s National Health Service is offering a computer version of cognitive behavioral therapy (CBT) that officials hope will fill some of the cracks in the country’s mental health system. See this story in the UK Guardian by a writer who took the online program and pronounced it “not as useless as I had imagined.”

Tim Lott explains that he doesn’t believe he’s actually clinically depressed. He has simply been experiencing “a depressing amount of depression.”

“This course is unusual because I didn’t have to leave my desk or even talk to another human being. The therapy is administered entirely by a computer program. Beating the Blues is an attempt by the NHS to meet the growing demand for mental health treatment without spending a fortune on face-to-face therapy.”

Mental health help via the computer isn’t exactly new. Some studies have pointed to benefits, although no one has suggested that it’s capable of replacing face-to-face therapy.

One American program, called Good Days Ahead, bills itself as an interactive approach to treating depression and anxiety. It’s published by a company called Mind Street based in Louisville, Kentucky. It was developed by a trio of physicians from Kentucky, Wisconsin and Pennsylvania. (There’s a demo of it on the company’s Web site.)

A December article in the Psychiatric Times contended that using the online CBT program allowed users to cut face-to-face time in half, while reducing symptoms as effectively as a full course of face-to-face treatment.

There are caveats to some of the studies, though. British researchers point out that results are based on self-reported data. And dropout rates are high.

But high-tech therapy seems to be finding a niche. Woody Allen is a classic example of someone who appreciates psychoanalysis. But he even he saw computer therapy coming. “Anything I can’t reason with or kiss or fondle I get into trouble with,” he said. “I have a tape recorder–I paid a hundred and fifty dollars for it–and as I talk into it, it goes, `I know, I know.'”

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Friday, May 15

Dr. Thomas Frieden reportedly keeps a bowl of free condoms in his office reception area. What does that say about the country’s new CDC director?

It’s no big deal, I know. But it does reveal that Frieden, the current New York City health commissioner, is a bit of a show-boater when it comes to public health issues.

He’s the guy, after all, responsible for the elimination of trans-fats in the city’s restaurants. He also launched a program to help New York’s 500,000 diabetics better manage their disease by tracking their blood sugar and then reporting the results to treating physicians.

President Obama named Frieden to head the Centers for Disease Control (CDC) today. It’s further evidence that activism and disease prevention will be front and center with this administration’s evolving health policy.

There’s no doubt that Americans need to adopt better health habits. Obesity, diabetes, and other chronic illnesses can certainly be the result of bad lifestyle choices. The question is, where do we draw the line when it comes to government intervention to make sure those better lifestyle choices are made? (See my May 11 post on health care reform.)

Frieden makes some social libertarians a little nervous. And his war on trans-fats was not universally hailed, even by the scientific community.

“I call it the panic du jour,” David Kritchevsky told The New York Times in August, 2005. Kritchevsky, a dietary fat and cholesterol researcher at the Wistar Institute in Philadelphia, added that trans fat “is an easy whipping boy.”

What’s more, Frieden has been described as a cheerleader for the Center for Science in the Public Interest. This is an organization some have dubbed, “America’s food police.” The group has harshly criticized fat, sugar, salt, alcohol and, in particular, caffeine.

Founder Michael Jacobson is on the advisory board of The Great American Meatout. He has advocated diets with 60-80 percent of normal caloric intake based on studies that show animals live longer on near-starvation diets. This may be true, but in a country where eating disorders are another fast-growing problem, even among the middle aged, I wonder if this is the kind of message we need to promote.

In commenting on Frieden’s appointment, New York Mayor Michael Bloomberg said today: “We have 350,000 fewer smokers among our friends, neighbors and loved ones. We now boast the nation’s most extensive community-based electronic health record system. We’ve taken steps against trans-fats and have more information about the calorie content in our foods. New Yorkers get far more cancer screenings. At least as importantly, we also have a data system that will hold us all accountable for continued progress.”

Progress, yes. But at what cost?

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Thursday, May 14

Virginia officials are still hunting for a hacker who swiped medical records for 8.3 million people in a state prescription database.

As of Tuesday, the FBI admitted that finding the hacker was like looking for a needle in a haystack. But they seemed confident that they’d eventually solve the puzzle.

The breach occurred on April 30, after which the hacker posted a ransom note demanding $10 million for the records.

A growing number of states are using systems like the one in Virginia to track the sale and use of pharmaceuticals. It’s one way to eliminate doctor shopping. It also allows police investigating drug fraud and narcotics abuse to access the data, which contains names, addresses, birth dates, and the types of meds people are on.

But this case demonstrates the flipside. Think of it this way: Here’s a database pinpointing where these drugs are located within the state—information that is now in the hands of criminals.

In the latest incident, Virginia officials insist that a sophisticated firewall was in place and operational.

Nevertheless, electronic medical records seem to fall into the wrong hands a lot. In February, 2008 a government laptop computer was stolen from the National Institutes of Health (NIH) containing records for 2,500 individuals enrolled in clinical trials. The information wasn’t even encrypted.

It’s so common that the Government Accountability Office (GAO) reported last year that 19 of 24 agencies reviewed had at least one data breach that could expose people to identity theft.

Sure, electronic storage of medical information is still a good idea. Its time has come and it can’t be stopped anyway. But it’s obvious that governments, hospitals and other health care providers will have to put a lot more resources into keeping these records secure.

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