Friday Five: Merck for Mothers, Gates Foundation, mental health, antibiotics, housing

Each Friday, I use five sentences to summarize and comment on five important, interesting, or just plain amusing health stories from the week. Merck for Mothers expands to the US

The US’s high infant mortality rate is often cited as an indicator of our nation’s poor health. However, the maternal mortality rate is often ignored while the number of pregnancy-related deaths has doubled since 1990. Pharmaceutical giant Merck established its Merck for Mothers overseas to help reduce maternal mortality and has just announced it will import those programs to work with expectant mothers in the US. It will provide $6 million in funding for initiatives in ten states and three cities, including Baltimore and Philadelphia. The project will also work to standardize procedures for pregnancy-related emergencies.

Maternal mortality by GDP per capita. I've highlighted a few countries for comparison. While the US does have a comparatively low maternal mortality rate, it is far above other countries with similar GDPs. The size of the circles represent the size of the population, and the color indicates the geographic region. Source: Gapminder

 

The Gates Foundation funds all kinds of new public health ideas

The Bill and Melinda Gates Foundation is dedicated to improving public health around the world, and its Grand Challenges Explorations is a way to promote innovation. This week, the Foundation announced the 81 winners of this year’s $100,000 grants. All of the grants awarded fall into these categories:

  • Increasing the interoperability of good data (ex: improving humanitarian information management in crises)
  • Develop the next generation of condom (ex: condom applicator that can minimize interruption)
  • Labor saving innovations for women smallholder farmers (ex: participatory reality TV show encouraging the use of draught animals)
  • New approaches for the detection and treatment of selected neglected tropical diseases (ex: artificial snail decoy to confuse a parasite)
  • The ‘One Health’ concept: bringing together human and animal health for new solutions (ex: new canine rabies vaccine)

Non-specialist health care workers in developing nations are successful at mental health care

A report published this week shows good news for mental health in low- and mid-income countries. Examining 38 studies, researchers found that non-specialists (such as doctors and nurses rather than psychologists and psychiatrists), who have some mental health training, have been successful in alleviating mental, neurological, and substance abuse issues. Compared to untrained health care workers, patients of trained workers had a positive affect on depression, youth PTSD, and problem drinkers. The researchers caution against making assumptions about what kinds of interventions might work. But the bright side is that training primary care workers to consider mental health needs could help get much-needed care to people who may otherwise go without. You can read the report—and a plain language summary—here.

Tonight’s nightmare is…bacteria that no antibiotic can kill

New Zealander Brian Pool died in July, but the specifics of his death were just reported this week. While in teaching in Vietnam, he underwent surgery and contracted KPC-Oxa 48, a strain of bacteria that is resistant to all antibiotics. That’s right, all of them. New Zealand authorities were strict about quarantine, so there’s little worry that the bug will spread from this particular incident. If you’d like to learn about all the things at risk if we lose the ability to kill bacteria, Maryn McKenna has a terrifying run down.

Why we need public housing

I’ve recently become interested in the importance of safe, stable, and affordable housing as a prerequisite for good health. Ensuring everyone has their basic needs met is perhaps the most important public health issue. How can anyone expect to have a successful smoking cessation intervention if participants don’t know where they’ll sleep tonight? Now that I’m paying attention to the issue, I’m seeing it everywhere. This infographic explains how public housing can be a part of the solution.

public_housing_info

Friday Five: withdrawal, Amanda Bynes, gluten-free labels, vaccine rates, urgentrx

Each Friday, I use five sentences to summarize and comment on five important, interesting, or just plain amusing health stories from the week. Pulling out is surprisingly popular

A study that will be published in the September issue of Obstetrics & Gynecology shows that 31% of women aged 15-24 used withdrawal as the primary form of contraceptive at least once. The study also found that 21% of those women became pregnant, compared to 13% of women who used other methods. I was pretty outraged to learn that so many young women rely on their partners to pull out, so I consulted the Kinsey Institute site Kinsey Confidential to compare different forms of contraceptives:

Method Typical Effectiveness Theoretical Effectiveness
Withdrawal 81% 94%
Male condoms 85% 98%
Oral contraceptives 92% 99.9%
Intrauterine Device (IUD) 99% 99%
Implant 99.01% 99.01%

Whelp, turns out the much-touted condoms don’t fare much better in preventing pregnancy than withdrawal, but IUDs and implants are far better. Advocating for more extensive use of IUDs and implants would help more women learn about their effectiveness and safety, and could play a major role in reducing the number of unplanned pregnancies. (FYI: condoms protect against some STIs, so keep using them, okay?)

Now we know what’s ailing Amanda Bynes

After publicly unraveling, actress Amanda Bynes has been placed on psychiatric hold and reportedly diagnosed with schizophrenia. Schizophrenia is a debilitating yet treatable disease that can lead to delusions, hallucinations (including hearing voices and smelling odors that don’t exist), and cognitive issues, among other symptoms. I sincerely hope that her family and doctors help her find the right treatment so she can find relief from her suffering. This story is playing out all over the gossip mills, and we can learn from this: erratic behavior requires intervention. In an open letter, her former co-star Nick Cannon also taught us an important lesson about how provide compassion:

So I say to my sister Amanda Bynes you’re not alone. I’m here for you. I understand. I care and I appreciate you, because that’s what family does and that’s what family is for. I also extend this to anyone else in my life, past or present that may find themselves in hard times. I’m here! Call me! Because I truly believe, the hand you’re helping up today may be the one you’re reaching for tomorrow.

Side note: take a look at this fantastic Atlantic article with Dr. Christine Montross titled “How well do we really understand mental illness?” for more insight into the hows and whys of treating severe mental illness.

Gluten-free labels, now with accuracy!

People with celiac disease, those with gluten sensitivity/intolerance, and dieters can all rejoice because this week, the FDA standardized the label “gluten-free.” The limit is 20 ppm, the lowest amount of gluten detectable in a food product. Foods such as fresh fruit and eggs can carry the label “gluten free” because they naturally contain no gluten. Regulations like this help consumers make informed choices. Considering more than two million Americans cannot digest gluten, having consistent, effective labels is the right thing to do for their health.

State-by-state vaccine rates tell us about exemptions

Each year, the CDC analyzes vaccine rates among the 50 states, Washington DC, five cities, and eight other US jurisdictions that receive federal funding for immunizations. This year, Mississippi topped the list, with 99.9% of kindergarteners receiving full doses of MMR, DTaP, and varicella (chicken pox). Overall, median exemption rate for the country was 1.8%; Oregon had the highest, with 6.5% of kindergarteners not meeting the vaccine standards. Interestingly, Mississippi does not allow religious or philosophical exemptions for immunizations. Removing religious and philosophical exemptions altogether wouldn’t be appropriate, but perhaps the success Mississippi has with getting children vaccinated will spark a conversation about strengthening the requirements for getting an exemption.

UrgentRx: alleviating upset stomachs, potentially saving lives

Forbes just published its list of what it deems the 25 most innovative consumer and retail brands of the year. An over-the-counter medication company, UrgentRx, made the cut. The company produces powders of common treatments for headaches, allergies, and digestive issues, along with plain aspirin intended for use during a heart attack. UrgentRx powders can be taken without water, meaning that you can give yourself a hit of heartburn medicines whenever you need it. The implication for potentially life-saving doses of aspirin are immense: a study in the American Journal of Cardiology, as reported by Harvard Medical School, showed that chewed aspirin worked faster against heart attacks than swallowing it whole or taking a liquid version. For a person with heart disease, carrying around a powdered dose eliminates the need to chew and provides the benefits of aspirin as quickly as possible.

Friday Five: sterilization, pain robot, brains, surgeons, Sharknado

Each Friday, I use five sentences to summarize and comment on five important, interesting, or just plain amusing health stories from the week. Rural women are more likely to be sterilized

Tubal ligation, also known as sterilization or “getting your tubes tied,” is far more common among rural women as compared to urban women. Of rural women, 23% said they had been sterilized; urban women, 13%. There is only speculation about why this difference exists. Some of the theories floating around are: less access to other forms of birth control; piggybacking tubal ligation onto post-partum Medicaid coverage; lower educational level. Importantly, 39% of those rural women regret their decision. We should be asking why they didn’t choose a long-term, reversible birth control such as an IUD or an implant (like Implanon) instead.

Somewhat cute robot helps reduce kids’ pain and suffering during injections

As a needle phobic myself, I was very excited to learn that there’s an innovation in helping kids’ distress during shots. The robot not only talks to the child in order to distract him or her from the scary needle, but encourages exhalation during the injection to help with muscle relaxation (video here). There are two reasons why reducing pain and anxiety for children receiving immunizations is important: excessive worry can make other parts of the exam difficult, and in the future, an adult who had a bad medical experience as a child may be more likely to avoid care. These both have significant health implications. If this robot can help, I say let’s get one in every pediatrician’s office—and maybe in internist’s offices too, for ‘fraidy cats like me.

Brain pathways involved with learning and changing behavior charted

This week the NIH published a study identifying neural pathways associated with learning and changing behavior in mice. The nerves associated with the switch from moderate to compulsive drinking were found to also have a role in learning and decision making. Researchers hope that their insights will be helpful in understanding alcoholism and addiction. Learning more about why some people can use substances in moderation while others become addicted is crucial to improving mental and physical health. Hopefully, these findings will also apply for humans.

Surgery residents operate less often under new rules

Medical residents (doctors who are done with medical school and are completing their practical training) work notoriously long shifts and even longer workweeks. Restrictions created in 2011 limited shifts to 16 hours for first-year residents and 28 hours for the more advanced doctors and everyone’s week is limited to 80 hours. Surgical residents have in turn participated in fewer hours of surgery because of the limits on working hours. Many doctors are concerned that this will put the budding surgeons at risk for not gaining enough experience. There has to be a balance between allowing doctors to get enough rest while also learning enough to practice on one’s own—the question is, how

Kathleen Sebelius may in fact have a sense of humor

Twitter blew up last night with references to Sharknado, a horribly wonderful movie about a tornado that blew sharks into a city. (I don’t know how that works, I didn’t watch it!) Buzzfeed immediately wrote an article claiming “There is no Obamacare coverage for pre-existing Sharknado injuries.” Kathleen Sebelius replied: https://twitter.com/Sebelius/status/355766513334108160 Hey, an ACA joke!

I leave you this weekend with an excellent infographic explaining pretty much everything you need to know about gender, sexual orientation, and the like…The Genderbread Person!

Genderbread-Person

Friday Five: Oklahoma tornado, MERS, 3D printing, polio, live-tweeting surgery

Each Friday, I use  five sentences to summarize and comment on five important, interesting, or just plain amusing health stories from the week.  

Tornado in Moore, OK is the latest national disaster

On Monday, a mile wide tornado with 200+ mph winds decimated Moore, OK. Approximately 10,000 people were directly affected, 240 injured, and 24 killed, including nine children. Reports of heroism abound, as do shocking photos. Coming just months after the shooting at Sandy Hook and weeks after the Boston Marathon bombing, the Moore tornado victims may find themselves on the losing end of American disaster fatigue. Hopefully Moore will stay in the forefront of American’s minds and not blend in with other communities rebuilding from natural and human-made tragedies.

 

MERS is on the move

After a slow march toward notoriety, MERS is becoming a real threat. This novel coronavirus dubbed Middle East Respiratory Syndrome has been confirmed in 44 people across multiple countries and caused 22 deaths. In this month alone, two new outbreak clusters surfaced—one in Saudi Arabia infected 22 people and killed 10, the other in France infected two, one of whom contracted MERS from a hospital roommate. However, the exact mode of transmission, incubation period, and reservoir (meaning whether or not the virus lives someplace outside of humans) are unknown and research is stymied due to restrictions placed on the virus by Erasmus Medical Center in the Netherlands. For a virus with a 50% mortality rate so far, this is an egregious example of the problems with commercializing organisms needed for public health research. How many others will fall ill and die because of Erasmus’s patent?

 

Child’s life is saved by 3D printed trachea splint

In a groundbreaking and heartwarming use of the new technology of 3D printing, University of Michigan researchers created and implanted a trachea splint in a young child. Kaiba Gionnfrido, who had spent nearly all of his 20-month long life in a hospital on a respirator due to his trachobrochomalacia, or the softening and subsequent collapse of the windpipe. The splint, made to fit Kaiba perfectly, will give structure to his trachea to allow it to grow and is composed of a biopolymer that will be absorbed by his body in about three years. After years of requiring daily resuscitation, the splint allowed Kaiba to come off the respirator three weeks later. We can look forward to the emerging practice of saving lives using 3D printing to create custom-made medical devices.

 

Polio in Kenya and Somalia threatens eradication effort

A four-month old girl developed symptoms of paralysis and two other children tested positive for polio in a Kenyan refugee camp. Just a few weeks ago, Somalia reported its first wild case in five years. Vaccination rates in these areas are low, and nearly 500,000 people travel to and from the Kenyan refugee camp annually, increasing risk for an epidemic. This development complicates the newly adopted six year plan for polio eradication, and mass vaccination campaigns in the area are underway in hopes of containing the virus. Maintaining vaccination in vulnerable areas, even after years pass with no new infections, is crucial to destroying polio forever.

 

Brain surgery documented on Twitter and Vine

In this week’s example of how social media is revolutionizing health care and medicine, UCLA Hospital live tweeted Vine videos of brain surgery. Brad Carter, an actor and musician, underwent awake brain surgery to implant a pacemaker to calm his essential tremors. The Vine videos show distinct improvement in Carter’s guitar playing once the pacemaker was in place. By using Twitter and Vine to document the surgery, UCLA surgeons and Carter do the public a great service—showing exactly how incredible medicine can be. The videos inspire awe while simultaneously taking some of the mystery out of surgery.

 

This week's song to celebrate the end of the week: The Cure's "Friday I'm in Love"

[youtube=http://www.youtube.com/watch?v=b69XWDUtMew]