The toll of Type 2 diabetes, in poems

In this video screen grab, Erica Sheppard McMath recites her poem "Death Recipe" for Youth Speaks. Courtesy Youth Speaks

In this video screen grab, Erica Sheppard McMath recites her poem “Death Recipe” for Youth Speaks. Courtesy Youth Speaks

Public health educators in California are using poetry to engage young people about diabetes.

Dr. Dean Schillinger, a professor at the University of California San Francisco School of Medicine, started the partnership between UCSF and Youth Speaks as a way to spark conversations about the disease.

The partnership, called The Bigger Picture, holds workshops to educate teens and young adults about diabetes. After the workshops, the teens take the information and express their reactions through poetry.

Schillinger told NPR Type 2 diabetes needs to be talked about as a social disease, rather than focusing on people’s personal decisions.

Type 2 diabetes is worse in poor, urban neighborhoods and communities of color. NPR reports that half of African-American youths and a third of Latino youths born in 2000 are expected to develop Type 2 diabetes at some point in their lives.

Here is an excerpt of a poem written by 22-year-old Erica Sheppard McMath, followed by its full video rendition. In the poem, she expresses trying to stay healthy while watching her family struggle with obesity and disease:

It’s like knowing most of your family has diabetes
but your still smacking on sour patches
as you’re walking your aunt to her dialysis appointment
It’s like Auntie Marlow being blind at 32
It’s like Grandma Susie dying from a heart attack at 51
It’s like cousin Kieara shooting insulin in her nine year old arm

Geneticist: All women should get tested for mutations that cause breast cancer

Balloons fly over the Yemeni capital Sanaa to increase awareness and promote treatment of breast cancer.  MOHAMMED HUWAIS/AFP/Getty Images

Balloons fly over the Yemeni capital Sanaa to increase awareness and promote treatment of breast cancer. MOHAMMED HUWAIS/AFP/Getty Images

A prominent geneticist is urging all women to get tested for genetic mutations that cause breast cancer.

Mary-Claire King, a professor of genome science at the University of Washington, identified the first breast cancer gene. The genes are called BRCA1 and BRCA2. NPR reports that women who have mutations in these genes are much more likely to get breast cancer and ovarian cancer.

Doctors usually only recommend women get tested for the BRCA gene if breast cancer or ovarian cancer runs in their family.

recent article by King published in The Journal of the American Medical Association asserts that the current approach misses identifying genetic mutations in some women. About half the women who carry BRCA1 and BRCA2 don’t have a family history of breast or ovarian cancer, according to the JAMA article.

But King’s recommendation concerns breast cancer advocates.

Fran Visco, president of the National Breast Cancer Coalition, told NPR the tests are unnecessary and can lead to serious and expensive surgeries. Screening tests can cost hundreds to thousands of dollars depending on insurance coverage.

“We are far, far from being ready to recommend that all women be screened for genetic predisposition to breast cancer,” Visco said.

Testing for the mutations has spiked since the activist and actress Angelina Jolie announced that she had been tested and decided to undergo prophylactic mastectomies after discovering she carried the gene mutation. A recent study by The Journal of the American Medical Association found no survival benefit to getting a double mastectomy, a procedure many women who test positive for BRCA1 and 2 often choose.

The science of diet and headlines: Does low-carb really win?

Several fruits and vegetables: grapefruit, strawberry, red cabbage, kiwi and pepper.  Jose R. Aguirre/Cover/Getty Images

Several fruits and vegetables: grapefruit, strawberry, red cabbage, kiwi and pepper. Jose R. Aguirre/Cover/Getty Images

A new study in the Annals of Internal Medicine shows diets low in carbohydrates like bagels and pasta lead to more weight loss than diets low in fat. The study is one of many contradictory studies about diet that can lead to misleading headlines about what to eat or not to eat.

Cardiologist Harlan Krumholz directs the Yale-New Haven Hospital Center for Outcomes Research and Evaluation and is a director of the Robert Wood Johnson Clinical Scholars Program at Yale. Krumholz says more comprehensive studies are needed to make results like these meaningful. In an op-ed for NPR he details his concerns about the state of diet studies:

The JAMA survey of studies went back as far as 1966 and found fewer than 50 blinded trials. All told, they included fewer than 8,000 people. The studies were generally small (most had fewer than 100 people), and they typically lasted for only 24 weeks. Finally, these trials weren’t able to determine whether a particular diet actually lowered the risk of disease.

Doctors have built recommendations based off observational studies that Krumholz says are limited. That’s because people who eat different diets often live different lifestyles that aren’t taken into account in observational studies. The most recent study that’s creating buzz in the low-carb debate enrolled 148 people, a very small sample. “The diet industry generates billions of dollars annually, but it is built on razor-thin evidence about what is best for any individual,” he said.

Krumholz called for personalized diet recommendations for people based on more than weight loss findings. But in order for that to happen we need larger studies with longer follow-up, he says.

For more on this topic:

  • Listen to The Daily Circuit’s interview with Dr. Lawrence Cheskin,  director of Johns Hopkins Weight Management Center and Dr. Marion Nestle, professor of nutrition, food studies and public health at New York University, Steinhardt.
  • Read about it in The New York Times
  • Watch Duke University’s Dr. Eric Westman answer questions about low-carb diets

Apple event and health

Apple CEO Tim Cook announces the new Apple Watch.  Justin Sullivan/Getty Images

Apple CEO Tim Cook announces the new Apple Watch. Justin Sullivan/Getty Images

Apple unveiled its new iPhone and Apple Watch Tuesday, and some industry observers say the event fell short of big expectations about the role of health technology in the announcement. A new “Health” app and “HealthKit” software developed with Mayo Clinic were announced earlier this summer, and fueled feverish anticipation of a breakthrough in technology and personal health data. Bloomberg calls all this new technology “Dr. Apple’s” first steps into “a giant market that affects everyone personally and is at the core of America’s fiscal problems.”

But Forbes’ Dan Diamond reports that the tech company’s health plans got cut from yesterday’s program. He suggests among the reasons was Apple’s recent implication in the iCloud data breech that led to the hacking of celebrity nude photographs may have caused the company to hold back on promoting the idea of an app that holds consumers’ health data.

And other reports ask whether the Apple event was a game changer for health technology or a bitter disappointment. Industry watchers report that the vision of wearable technology to manage personal medical care remains the major promise of technology like the Apple Watch.

High school athletes and concussions

People take a concussion screening at the Science Museum of Minnesota Friday, Feb. 24, 2012. Health Fair 11, in association with North Memorial Medical Center, is offering the free screenings during the state high school sports tournaments to encourage awareness of brain injuries in Minnesota. The tests are used as a baseline for possible future brain injuries. Alex Kolyer for MPR News

People take a concussion screening at the Science Museum of Minnesota Friday, Feb. 24, 2012.  Alex Kolyer for MPR News

Will you let your teen-ager play contact sports?  Last week, state health officials in Minnesota released data showing that nearly 3,000 high school athletes in the state suffered concussions.

That number — which amounts to 22 concussions per high school — is dramatically higher than previous estimates, according to MPR News.

Most states have passed concussion laws that require a health provider’s clearance before a student athlete can return to play following a concussion injury and that has helped track the occurrences.

A study from the Institute of Medicine showed that football players in high school are nearly twice as likely to suffer a concussion than college players, but it’s still unclear whether repetitive injuries lead to long-term brain disease.

Researchers at Cleveland Clinic developed an app that works with the gyroscope and accelerator within the iPad 2 to measure motion and acceleration. The app can also assess cognitive skills through a series of tests taken on the iPad. It’s been used to test high school athletes for concussions for more than two years, but is being expanded for use in emergency settings.

Lori Glover with the Institute for Athletic Medicine at Fairview Health Services, which collaborated on the report in Minnesota, told MPR News that concussions are easily hidden or overlooked.

“What I would say to parents, coaches, kids, the important thing is be attentive to this. Don’t take it lightly,” she added. “Most resolve typically, so don’t be afraid, but you need to get it managed appropriately.”

List of resources below video

Resources

Study: Double mastectomies don’t save lives

Dr. Edward Sickles MD (R) and Larisa Gurilnik RT look at films of breast x-rays at the UCSF Comprehensive Cancer Center August 18, 2005 in San Francisco, California.  Justin Sullivan/Getty Images

Dr. Edward Sickles MD (R) and Larisa Gurilnik RT look at films of breast x-rays at the UCSF Comprehensive Cancer Center August 18, 2005 in San Francisco, California. Justin Sullivan/Getty Images

Double mastectomies following diagnosis of cancer in one breast have become more common in the United States in the last 10 years. NPR reported recently that most women with cancer in one breast are not at risk for developing cancer in the other breast and that doctors consider the trend worrisome.

Now, a study by the Journal of the American Medical Association finds no survival benefit with bilateral mastectomy compared with less drastic surgery accompanied by radiation.

The results confirm what many doctors have suspected, said Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society.

The study looked at records of 189,734 women in California who were diagnosed with early-stage breast cancer from 1998 to 2011. It found that the survival rate was higher for women who chose to get a lumpectomy rather than women who chose a double mastectomy. Those women also avoided risks of major surgery and loss of a healthy breast.

By 2011, the last year of the study, 33 percent of the women under 40 were choosing bilateral mastectomy, even though most of them had stage zero or 1 cancer, a very early, very treatable form, NPR reports.

The senior author of the study hopes the numbers will help educate women and doctors.

Another recent JAMA study showed the biggest reason women were making the choice to get a double mastectomy was worry about their cancer coming back. More than two-thirds of the women who had the double mastectomy — 69 percent — had no genetic or family risk factors that would make it more likely that they would get breast cancer again, according to NPR.

You can find more context and information about mastectomies — why they’re done, the risks and results — on the Mayo Clinic site.

ICYMI: Alive Inside

Our networks are buzzing with word-of-mouth accolades for the independent film Alive Inside, a documentary that explores the use of music with elderly patients with Alzheimer’s or dementia. It won the 2014 Sundance Film Festival Audience Award and is now playing in select venues around the country. Watch this segment of the film, and see if it’s at a theater near you.

Five tips from ‘Mayo Clinic’s Guide to Stress-Free Living’

Stressed out? You’re not alone. Polling by NPR, Harvard University and the Robert Wood Johnson Foundation concluded almost half of Americans report significant stress.

Dr. Amit Sood with Chris Farrell

Dr. Amit Sood with Chris Farrell / Eamon Coyne for Healthy States

In “Mayo Clinic’s Guide to Stress-Free Living,” Dr. Amit Sood offers a clinically tested program for reducing stress. Dr. Sood recently spoke to a live Healthy States audience. His full remarks can be heard at MPR News here. As part of his approach, Dr. Sood offers a five-point daily framework for minimizing anxiety and stress:

Monday/Gratitude: Reframe your challenges using gratitude as an anchor. Focus on what went right instead of what went wrong in a situation.

Tuesday/Compassion: If someone is upset, you can view it as they are insulting you, or you can see that they are hurting and need help. Finding more commonality with the other person is the key to compassion.

Wednesday/Acceptance: You can’t always change the undesirable. A good line to ask yourself is “will it matter five years from now?” This question will help you not overreact. Your brain is premium real estate and you can’t waste valuable space worrying about certain things.

Thursday/Meaning in Life: Try to become a “happiness officer” for a little corner of the world. Focus on something larger than yourself or try to commit random acts of kindness.

Friday/Forgiveness: It’s not always an easy choice. You don’t have to justify, condone or deny, just forgive.

Dr. Sood also talks briefly about stress and resiliency in this Mayo Clinic video.

Scientists track the origins of Ebola outbreak

 

Women walk past a slogan painted on a wall reading "Stop Ebola" in Monrovia on August 31, 2014. Dominique Faget/AFP/Getty Images

Women walk past a slogan painted on a wall reading “Stop Ebola” in Monrovia on August 31, 2014. Dominique Faget/AFP/Getty Images

Researchers are starting to get a handle on how the worst Ebola outbreak in history began — and they’re doing it by tracking mutations in the virus.

According to Vox, scientists can use these mutations as markers to piece together how the Ebola virus has traveled from person to person. Because they know the general mutation rate of the virus, they can also pin down the dates of when the disease spread.

The good news is, these discoveries are laying a foundation for future research. But mutations in any virus can be scary — they can make the disease better or worse.

Randomly mutating is common behavior for viruses. But the more a virus mutates, the more chance it has to be detrimental to human health, said Pardis Sabeti, a biologist at MIT and Harvard who co-authored the study.

“You never want to give a virus that kind of opportunity,” Sabeti told Vox. “We hope that this work opens up new doors for more people to work together to stop this virus now.”

Health officials are concerned now that the virus has spread to cities like Sierra Leone’s Freetown that host 1.2 million people.

“We have never had this kind of experience with Ebola before,” David Nabarro, coordinator of the new U.N. Ebola effort, told the Washington Post. “When it gets into the cities, then it takes on another dimension.”

Last week, the World Health Organization warned that the number of cases could hit 20,000 in West Africa.

You can keep up with the latest in the Ebola outbreak on the Centers for Disease Control and Prevention’s website.

Managing the Spike in Mental Health Services

Marleen Cross, Amanda Goettl and Melinda Hennies, left to right, who are part of a 13-person ACT Team managing 95 patients with mental health issues, get ready for their daily meeting Thursday, May 23, 2013 at Mental Health Resources in St. Paul. Jennifer Simonson/MPR News

Marleen Cross, Amanda Goettl and Melinda Hennies, left to right, who are part of a 13-person ACT Team managing 95 patients with mental health issues, get ready for their daily meeting Thursday, May 23, 2013 at Mental Health Resources in St. Paul. Jennifer Simonson / MPR News

The Affordable Care Act of 2014 brought with it a major expansion in the coverage of mental illness and addiction, addressing issues of access and parity for people with mental health diagnoses. As a result of this policy change, millions of people have access for the first time to health services for mental illness.

But The New York Times reports that the increased access to services is creating pressure on systems that are not able to handle the load, citing instances where patients have to wait 7 weeks between appointments with their therapists.

Meanwhile, Vox and other media report this week that a new study shows the federal health policy is having an impact on teenagers’ access to mental health care. The report found mental health treatment climbed 5.4 percentage points for 18-25 year olds when compared to a similar group of young adults aged 26-35, who were too old to benefit from the expansion of dependent coverage.