January 27, 2012
In case you missed the comment on yesterday’s post, here is a link to a shared video:
January 26, 2012
Here is an image shared on my daughter, Joy’s, Christmas card of my beautiful little granddaughter, Gabrielle, who’s expected to make her entrance into the world in another couple of months.
I was talking with one of my former graduate students yesterday, catching him up on Joy’s pregnancy and the excitement we all feel as we look ahead to Gabrielle’s birth. He in turn shared with me that his sister is pregnant.
I asked if they knew whether it would be a boy or a girl, and he told me that in India, there is a law that forbids doctors from telling the mother the sex of the baby. It was passed in an effort to help prevent the killing of an unborn female fetus. Apparently, boys are preferred over girls. I was shocked to learn that a country would have to adopt a law to try to prevent such acts. Are there other countries with such laws?
January 25, 2012
Yes, I have been traveling. And you may remember my story in my book, ‘Talking about health…’ where I was on spring break at the beach and got such a pain in my neck that I thought I would die. Well, this is what I know. First, physical therapy and exercises brought me back from that episode and keep me in shape for the most part. But I need a good pillow as well. For me, that turns out to be a memory foam pillow. No, I am not being paid to advertise this pillow. But it is worth telling you about it anyway. Just based on my personal experience. During my travels this past week, I started to feel that familiar neck twinge. I quickly decided to purchase a memory foam pillow to sleep on and — wallah! — no more neck pain. Here is a bit of info about how these pillows work:
January 18, 2012
I have been meaning to look up the research linked to ads about high fructose corn syrup for awhile. You know the ones. They says that the two are the same and that your body doesn’t know the difference. What they don’t every explicitly say in any of the ads I have seen is: they are both high calorie carbohydrates that should be eaten in moderation, err on the side of less rather than more.
Turns out that the Corn Refiners Association started the ad campaign to clear up misconceptions about corn syrup versus cane sugar. You can see the original ad here:
http://www.youtube.com/watch?v=scHpZ10ok0c&feature=related
I cannot embed it because the Corn Refiners have disabled embedding. After a bit of surfing, I did find one of the ads from the campaign because someone else is using it along with their personal conclusions about why corn syrup is bad. I thought it would be worth checking to see if I could find any research.
A review of the science [found here: http://ajl.sagepub.com/content/4/6/515.full.pdf+html] supports several conclusions. Of course, the broadest conclusion is that more research is needed. But that being said, here goes. On p. 519, the authors conclude,
“From a compositional standpoint, high-fructose corn syrup, sucrose, invert sugar, honey, and concentrated fruit juices are all virtually interchangeable. All of these nutritive sweeteners are composed of approximately 50% glucose and 50% fructose. All are absorbed similarly, have similar sweetness, and have the same number of calories per gram.”
Jauary 17, 2012
Sometimes, life really is a race…
Here is my daughter pictured in a skull at the Head of the Charles rowing competition. Looking at it, I am thinking about how our discussion about conscience clauses ignores the other side of the story.
I was reminded of our right to refuse treatment based on our values and morals when I once more searched to find published research about how doctors, especially pharmacists, talk about these issues with patients when it means that a doctor/pharmacist is not going to provide medication or treatment.
Orr and Jensen conclude in the Journal of Medical Ethics,
“How should the clinician respond when a patient or family requests “inappropriate” treatment based on religious beliefs? As in all situations where there is disagreement about treatment options, good communication is the most important step towards resolution. The patient or family must clearly understand the medical situation. This may require repeated discussion, conversations with consultants,viewing of x-rays or other clinical data, or other efforts familiar to most clinicians. A management conference, which includes the patient/family, primary physician, consultants, bedside nurses and others from the care-team, is often the best way to ensure that such communication happens.” (1993, p. 145; http://jme.bmj.com/content/23/3/142.full.pdf+html)
The article’s title? ”Requests for “inappropriate” treatment based on religious beliefs.”
I think the suggested course of communication in the decision-making scenario is a great model for how to talk about decisions when the shoe is on the other foot, so to speak…and the focus is conscience clauses and the provider’s religious beliefs.
January 16, 2012
A conscience clause — when might a pharmacist feel conflicted about filling a prescription? The most commonly discussed event is birth control. Birth control pills, the morning after pill… these medications cause feelings of conflict between values related to pro-life and anti-abortion, and dispensing the medications.
The store, Target, supports a pharmacist’s rights not to fill these prescriptions. However, a pharmacist must direct a consumer to another Target store where the prescription can be filled. I can find no research that has been done to see how such conversations might take place or what happens when — as in the town where I live — there is one Target store. I don’t know if there is more than one pharmacist there. I don’t know if any of them object to filling these prescriptions. But if they do, what happens? How would I know? Who would tell me?
January 14, 2012
Do you remember the first time that you heard the word ‘conscience’? I grew up in a household where my parents used the word and shaped my ‘conscience’ — my sense of right and wrong. And as an adult, I feel the twangs of my conscience guiding my decisions. I would hate to have a job where someone told me that I could not follow my conscience. It is hard enough to work in a job where and live in a world where not everyone shares my ‘conscience’. But at least I am able to behave based on my moral code, even if it doesn’t always reward me to do so.
Health care providers face challenges to their ability to act based on their conscience in some situations. Efforts have been made to adopt policies to allow health care providers to act based on their conscience. These ‘conscience clauses’ aim to allow doctors and pharmacists and other health care providers to choose not to provide some services because to provide the service would go against their conscience. Watch this video and we’ll talk more about this issue in the coming week.
January 12, 2012
Shortly before the holidays, I heard Dr. Oz talking about coffee. He played a game with audience members and emphasized that coarsely ground, light roast coffee made with cold water and NEVER microwaved is best when aiming for the benefits of coffee. Benefits? I thought. Isn’t it interesting how different stories emphasize different results?
On the hunt for the science I went. In 2009, a study reported that 3-5 cups of coffee a day related to a reduced risk –65% less — for dementia and Alzheimer’s disease [http://iospress.metapress.com/content/d885346618q57103/].
I was reminded of my discussion in my book, Talking about health, about old science, new science, conflicting science, and no science. I went online in search of some more science to discuss the coffee and caffeine health benefits. I found the Dr. Oz story: http://www.drozfans.com/dr-ozs-advice/dr-oz-american-roast-coffee-prevents-colon-cancer-coffee-trivia/
An article in 1990 reports findings that the participants who reported drinking more coffee had a higher incidence of colon cancer [http://www.jstor.org/pss/20065645].
A study reported in 1993 found no relationship between more than 34,000 women’s reports of caffeine consumption and breast cancer [http://aje.oxfordjournals.org/content/138/6/380.short].
In 2007, a study found that 2 cups of black tea or decaf. coffee each day related to reduced risk for ovarian cancer, but regular coffee did not show this relationship. Again, women self-reported their behaviors [ http://onlinelibrary.wiley.com/doi/10.1111/j.1525-1438.2006.00773.x/full].
Also in 2007, a study found that drinking 2 cups a day of regular coffee greatly reduced — 43% — risk for liver cancer [http://www.gastrojournal.org/article/S0016-5085(07)00568-9/abstract].
What does it all mean? Talking about health means thinking about when a study was conducted, who particpated, and how the research was done. Self-reports are different from clinical studies. I don’t know of any clinical trials where participants are given coffee over time and compared to participants who do not consume coffee. So the research depends on individuals reporting how much coffee they drink. And then clinical reports about their health status provide a picture of what might be making a difference in the health of some compared to others. So when talking about health, don’t lose sight of the meaning of shorthand expressions like, ‘drinking 2 cups of coffee a day reduces your risk for cancer’…
January 11, 2012
OK. Running on the networks is this annoying commercial. The key message is, “You wouldn’t want your doctor doing your job.”
I suppose it is intended to somehow make us feel guilty because we are somehow offending our doctor in our personal efforts to read product labels and make informed decisions about over the counter drug purchases.
I don’t think my doctor would be offended. Instead, I think both my doctor and I are annoyed by an ad that suggests only a doctor knows best.
