Collective Imagination

Your daily healthy imagination question: How do you expect the new health care reform law to change your experience with health care?

Tue, 30 Mar 2010 10:44:03 -0500

This is the nineteenth (semi) daily question on the Collective Imagination blog.

Every day, respond to the question (or another commenter's answer) and you will be eligible to win a custom ScienceBlogs USB drive. We'll announce the previous day's winner in each daily question post.

Yesterday, we asked what you think is the most overlooked issue in health communication.

A few of you returned to the issue of mental health, saying that both mental diseases and the stigma around them ought to be discussed more openly. Other things you think are overlooked are the effects of mixing prescription medications, the relationship of doctors to drug companies that offer financial rewards for prescribing certain medications, and the general misunderstanding of patients of the basics of biology and anatomy.

S.C. Kavassalis is our randomly selected winner of the day from yesterday's question. S.C., email us at editorial@scienceblogs.com to claim your prize.

We'll be giving out USB drives daily through the end of March. To get your own, answer today's question in the comments below. This one is pretty much for you Americans...but everyone else feel free to chip in, too!

How do you expect the new health care reform law to change your experience with health care?

For more information about health care and technology, check out GE's healthymagination.

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Sharing your workouts online

Mon, 29 Mar 2010 15:24:30 -0500

One of the oft-recommended ways to improve exercise discipline is to work out with a buddy - someone who will call you on it if you don't show up for the gym, and will make you feel guilty if you slack off early. Workout buddies provide inspiration, friendly competition, and make exercising social. Unfortunately, for many of us it's incredibly hard to mesh our schedules with our friends' schedules, especially when we live far apart, belong to different gyms, and have different work hours. We end up workout-buddy-less and willpower-less. (At least I do.)

I think one of the easiest ways Web 2.0 can contribute to individuals' health is to help us maintain those buddy relationships, even when we can't see our buddies in person. It may not be quite as good as the real thing, but you can share your daily workouts using networking tools and mobile apps, some of which have really snazzy real-time or GPS functionalities. Check out RunKeeper:

(skip ahead to 45 seconds or so for the demo).

RunKeeper seems to be for pretty hardcore runners, rather than casual workout buddies; I'm not sure I want everyone knowing how long it takes me to run a mile even when I'm in good condition! (How about a WalkKeeper, guys? Or a StrollKeeper?) But RunKeeper shows what mobile apps can do: give you new ways to share your workouts with--and be accountable to--your remote friend network.

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Your daily healthy imagination question: What do you think is the most overlooked issue in health communication? Explain

Mon, 29 Mar 2010 12:05:51 -0500

This is the eighteenth (semi) daily question on the Collective Imagination blog.

Last week we asked whether you are as conscientious about your mental health as you are about your physical health.

You are all very conscious of your mental health and how important it is! It sounds like having personally struggled with mental health problems, or having a family member who has, has done a lot to make you value the importance of paying attention to and getting treatment for depression, anxiety and other problems. In fact, many of you said that mental health is more of a concern for you than physical health. Most of you acknowledged that the two are too closely related to be separated—a healthy mind contributes to a healthy body and vice versa.

k8 is our randomly selected winner of the day from yesterday's question. k8, email us at editorial@scienceblogs.com to claim your prize.

We'll be giving out USB drives daily through the end of March. To get your own, answer today's question in the comments below.

What do you think is the most overlooked issue in health communication? Explain.

For more information about health care and technology, check out GE's healthymagination.

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A "Virtual Autopsy" made possible by touch-screen technology

Sun, 28 Mar 2010 11:18:14 -0500

Over at my blog, bioephemera, I just posted a video of a new touch-screen tabletop device, the "Virtual Autopsy," that lets you slice into, rotate, and magnify an MRI-based digital representation of the human body. It's pretty amazing. I wish I had one on my iPhone. (And if someone makes an app that does this for the iPad, I'm going to start thinking every biology lab needs an iPad.) Check out the video, or see the Virtual Autopsy in person at the Swedish Embassy in DC!

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What if smoking were safe[r]?

Fri, 26 Mar 2010 09:56:44 -0500

Recently, I saw an interesting health research post at iO9. Briefly, some Australian researchers decided to block GM-CSF, a protein involved in lung inflammation, to see if it would reduce the lung damage caused by smoking. It did:

Cigarette smoke-exposed mice that were treated with [a GM-CSF blocking molecule] had significantly less lung inflammation in comparison to untreated mice. This indicates that GM-CSF is a key mediator in smoke-induced lung inflammation and its neutralization may have therapeutic implications in diseases such as COPD [chronic obstructive pulmonary disease/disorder]. (source)

Clinical research like this helps us understand the molecular process of inflammation, and might eventually lead to treatments to alleviate symptoms in people with COPD. But it doesn't mean (contrary to what some of the commenters on the iO9 post seem to think!) they're trying to make smoking "safe." The researchers didn't even look at lung cancer, or the myriad of other health problems correlated with smoking (cardiovascular diseases, higher risk of miscarriage, cataracts, etc.). It's highly unlikely that blocking GM-CSF would solve all those problems, and it wouldn't change the underlying nicotine addiction that forces many smokers to light up. The only way to be completely safe is not to smoke at all.

But let's imagine a sci-fi scenario: what if technology could make smoking safe? Suppose you could take a pill to ensure that the only health consequence you'd experience would be nicotine addiction. Or that cigarettes could be altered so second-hand smoke wouldn't injure bystanders. It's not that far-fetched: last year, an article in the New Scientist noted that "Many tobacco companies across the world are already pinning their hopes of future growth on the development of so-called 'potentially reduced exposure products'."

In a world where smoking no longer damaged the lungs or heart or eyes or liver, where the only organ affected would be the nicotine-addicted brain, would smoking still be socially unacceptable? Would ashtrays return to doctors' offices and restaurants, or would we be unwilling to give up our smoke-free airplanes and hotel rooms for another Mad Men-esque era of smoky interiors? More to the point, does society have a problem with nicotine addiction - aside from the smoke? And if not, why not?

What do you think - how much have things really changed?

Cigarette ad from the Stanford School of Medicine Collection.

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Your daily healthy imagination question: Are you as conscientious about your mental health as you are your physical health? Why or why not?

Thu, 25 Mar 2010 11:01:15 -0500

This is the seventeenth (semi) daily question on the Collective Imagination blog.

Yesterday we asked whether you trust that your doctor or other medical caregiver always has your best interests at heart when dispensing medical advice.

Most of you have had very positive experiences with your doctors, and have no reason to believe that they might not be anything but honest with you. But some readers report experiences with doctors who overprescribe medications, refer them unnecessarily to specialists, or recommend procedures they may not need. Others said that they have had doctors who do not take time to fully investigate a patient due to scheduling demands, or because their insurance is not premium.

Becca is our randomly selected winner of the day from yesterday's question. Becca, email us at editorial@scienceblogs.com to claim your prize.

We'll be giving out USB drives daily through the end of March. To get your own, answer today's question in the comments below.

Are you as conscientious about your mental health as you are your physical health? Why or why not?

For more information about health care and technology, check out GE's healthymagination.

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Dataviz: mapping tobacco policies, state by state

Thu, 25 Mar 2010 08:48:19 -0500

Many health policy experts believe that when it comes to smoking, increased tobacco taxes and restrictive smoke-free laws can save lives by forcing smokers to quit. As a result, most states have implemented tobacco taxes and/or laws - with confusing effect, since they're all different!

About a week ago, Robert Wood Johnson released an interactive map that helps to clear things up, showing tobacco taxes and laws state-by-state. The map makes it very easy to see what cigarette taxes are in each state; it turns out the average cigarette tax is $1.34 per pack, with only two states (RI and CT) above $3.00 per pack. It also makes it easy to identify the states that have smoke-free bars, restaurants, and workplaces.

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Your daily healthy imagination question: Do you trust that your doctor always has your best interests at heart? Why or why not?

Wed, 24 Mar 2010 10:54:56 -0500

This is the sixteenth daily question on the Collective Imagination blog.

On Monday, in recognition of World Water Day, we asked you about the availability of clean drinking water where you live, and whether you worry about the quality of your water.

Taste not withstanding, it sounds like access to clean drinking water is not an active concern for most of you. Whether it comes from a well or a filtration plant, your water is relatively contaminant-free and in abundant supply—Vancouverites have it particularly good, as R says, "our water is so clean that the bathwater looks blue!" But Mike Charlton in Las Vegas brought a different perspective, telling us the desert city's water conditions are "a disaster in the making." And Lampang in Thailand has his water delivered in bottles by a local man. "What's in it and how pure is it?" He asks. "I'd rather not know thanks very much."

Art is our randomly selected winner of the day from yesterday's question. Art, email us at editorial@scienceblogs.com to claim your prize.

We'll be giving out USB drives daily through the end of March. To get your own, answer today's question in the comments below.

Do you trust that your doctor or other medical caregiver always has your best interests at heart when giving medical advice? Why or why not?

For more information about health care and technology, check out GE's healthymagination.

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Work with Care: OSHA brings worker fatalities to its homepage

Wed, 24 Mar 2010 09:00:48 -0500

Late last fall, the Department of Labor's Occupational Safety and Health Administration added a sobering news feed to its homepage: a rotating list of updates on recent worker fatalities. It was accompanied by a quote from Hilda Solis, Secretary of Labor: "With every one of these fatalities, the lives of a worker's family members were shattered and forever changed. We can't forget that fact."

The feed, meant to call attention to preventable workplace accidents, includes snippets like "2/16/2010 WA - Worker was bitten by a customer's dog at a gated storage facility while on duty. Worker passed away two days later at the hospital from blood poisoning related to the dog bite" and "2/2/2010 TX - Worker was inflating a tire that exploded, striking him." OSHA also provides weekly reports of fatalities reported by employers to OSHA (these reports include employers' names). According to OSHA, "The fatalities listed include only those that initially appear to be work-related. . . OSHA investigates all work-related fatalities and catastrophes. After OSHA's investigation is complete, these reports will be updated with inspection results and citation information."

In a recent talk I attended at Harvard, Office of Information and Regulatory Affairs Head Cass Sunstein emphasized that the idea behind the feed was transparency. It calls attention to industries and employers with unacceptable accident rates, putting them on the hot seat. It also reminds any visitor that despite all of our industrial and medical innovations, preventable workplace fatalities still happen every week - often in routine situations we'd never think of as dangerous.

What do you think: is the workplace fatality feed on OSHA's homepage a positive innovation? What if there were a similar feed on the Health and Human Services site describing recent deaths from preventable diseases? Are such web feeds educational, transparent, or just kind of morbid?

Update: in a coincidence worthy of Scienceblogs, Frank Swain of Sciencepunk just posted about the Twitter feed he created from OSHA's worker fatality feed. Read his perspective!

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Retrofitting shipping containers to treat combat brain injuries

Wed, 24 Mar 2010 08:54:44 -0500

From NextGov.com:

The portion of Iraq war soldiers suffering from PTSD is estimated to be as high as 35 percent. As a result, Lt. Gen. Eric Schoomaker, the Army surgeon general, has pushed the service to consider using technology to provide much-needed treatment.

The telehealth unit is actually a standard 8-by-20 foot shipping container that houses most of what can be found in a brick-and-mortar clinic, including three treatment rooms. The difference, however, is there is no doctor on staff. Patients see physicians via the unit's computer network, which is equipped with video teleconferencing (VTC) systems.

VTCs allow a clinician to view a remote patient, an essential part of treating PTSD and traumatic brain injury, said Gregory Gahm, director of the National Center for Telehealth and Technology and a retired Army psychologist with 20 years of active-duty service.

The new units are currently being tested on military bases.

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New FCC Broadband Plan Advocates e-Health Technologies

Tue, 23 Mar 2010 08:01:06 -0500

In response to a 2009 mandate from Congress, the FCC has released a new National Broadband Plan - including an entire chapter on e-health in its various manifestations. The plan puts forth a suite of recommendations to improve health care through technology: reducing barriers to electronic health record usage, incentivizing health IT adoption, promoting the creation of "converged communications and health care devices" (like health apps for smartphones), establishing data-sharing protocols for medical researchers, ensuring sufficient broadband connectivity to support all that electronic traffic, and passing legislation to ensure that patients have access to their own medical data and test results (in many cases, they're not "authorized" to get it).

Some of these recommendations are addressed to Congress, some to administrative agencies (HHS, FDA, CMS, FCC), and some to state governments (for example, the report suggests modernizing state regulations that pose barriers to health technology adoption). Cooperation between various government actors, the FCC argues, is necessary to help the US catch up to other nations, who are making more effective use of health technologies:

The United States ranks in the bottom half (out of 11 countries) on every metric used to measure adoption, including use of electronic medical records (10th), electronic prescribing (10th), electronic clinical note entry (10th), electronic ordering of laboratory tests (8th), electronic alerts/prompts about potential drug dose/interaction problems (8th) and electronic access to patient test results (7th).
Adoption rates for e-care are similarly low. A Joint Advisory Committee to Congress found that less than 1% of total U.S. provider locations use e-care. Approximately 200 e-care networks connect only 3,000 providers across the country; typically, the networks are used on a limited basis.37 A 2008 American Hospital Association survey found that for each of six conditions, only 2-12% of hospitals use Internet-enabled monitoring devices (fixed and mobile), covering 4-8% of relevant patient populations for each condition. Only 17% of home-care agencies use remote monitoring solutions in their practices. (source)

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Your daily healthy imagination question: How's your drinking water?

Mon, 22 Mar 2010 11:42:12 -0500

This is the fifteenth daily question on the Collective Imagination blog.

Last week, we asked you when you thought individuals should have access to their family members' medical records. Most of you agreed that the legal standards in place now sufficiently cover the range of circumstances under which access should be allowed. But there are some gray areas: Should children between the ages of 13 and 17 be allowed to choose whether their parents can see their records? If individuals want to know whether a deceased relative was a carrier of breast cancer genes, do they have a right to find out?

Jim Ernst is our randomly selected winner of the day from yesterday's question. Jim, email us at editorial@scienceblogs.com to claim your prize.

We'll be giving out USB drives daily through the end of March. To get your own, answer today's question in the comments below. In honor of World Water Day, we want to know about your water:

How available is clean drinking water where you live? Is the quality of your water a concern?

For more information about health care and technology, check out GE's healthymagination.

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Access to peer-reviewed health research: who needs it?

Mon, 22 Mar 2010 07:21:21 -0500

Abel Pharmboy over at Terra Sigillata recently posted about the frustration of trying to get online access to articles from medical/scientific journals (in Abel's case, Nature). Basically, if you don't have a very expensive subscription (personally or through a university/employer), you have to pay a hefty sum (I saw a $55, 15-page article just last week!) to read about research originally funded by your taxpayer dollars. It's just how the business of peer-reviewed journals works.

While some journals (PloS, for example) are freely available to the public, and Congress has made moves to require access to the publications derived from publicly funded research, paywalls are still a problem. I know they're a problem for scientists at small startup companies, students and professors at smaller colleges, or high school teachers trying to create advanced biology lesson plans. But I'd like to hear from you: is it also a problem for patients? How many of you have personally gone online to research a disease or medication, only to end up at a journal paywall asking you to fork over $12 or $24 or $32 just to see if the article answers your question? Of those of you who do read medical research literature outside your personal fields of expertise, how many of you find it helpful?

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The Language of Life

Sun, 21 Mar 2010 11:32:22 -0500

The Guardian has a review of NIH Director Francis Collins' book,The Language of Life: DNA and the Revolution in Personalized Medicine, in which he argues in favor of personalized medicine, better health technology, and universal access to genomic data:

Collins makes it clear where all this is leading. Piecemeal medicine is inefficient and brings a huge human cost in failures through inappropriate treatment and adverse reactions. Nothing less than complete genome sequences for all is his goal - having sequenced one platonic human genome, he now wants 7 billion individual ones. It seems very likely that one day the two most universal possessions will be a mobile phone and a personal genome record.

Read the rest here.

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Wonderful dataviz shows which dietary supplements are "worth it"

Sat, 20 Mar 2010 19:40:42 -0500

Health supplements can be incredibly confusing - not to mention misleading. Many have no proven efficacy, yet they're touted as miracle cures for everything from weight loss to hot flashes to insomnia. So what's the scientific consensus - what should you believe, and which supplements should you buy? Who would you even ask?

Enter David McCandless and Andy Perkins of Informationisbeautiful.net: they've created a simply wonderful interactive graphic that shows you which dietary supplements have the clinical data to back them up.

The creators explain,

"The higher a bubble, the greater the evidence for its effectiveness. But the supplements are only effective for the conditions listed inside the bubble.

You might also see multiple bubbles for certain supps. These is because some supps affect a range of conditions, but the evidence quality varies from condition to condition. For example, there's strong evidence that Green Tea is good for cholesterol levels. But evidence for its anti-cancer effects is conflicting. In these cases, we give a supp another bubble."

While supplements at the top are pretty safe bets, those below the dotted "worth it line" - the majority - simply aren't backed by enough objective evidence to justify taking them (at least in the creators' opinion). The size of the bubble indicates the supplement's popularity as measured by Google hits. The tab at the right lets you filter the supplements by medical condition - for example, you can view only those supplements that help with arthritis (Devil's claw is the only one to make the "worth it" cutoff) and hide the rest. (The snapshot above only shows the name of the supplement; on the interactive version at their website, when you mouse over a bubble, it tells you what medical conditions it's good for).

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