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Evidence-based health reform: Sometimes research really does matter!

December 31, 2010 By Leave a Comment

Sometimes, people committed to evidence-based approaches and to the translation of research findings into practice can feel a bit down. Research findings seem to move into real-world settings at a glacial pace, and policy makers and the general public can seem dismissive of the empirical evidence.

So it’s very encouraging to note that the Health Reform bill was explicitly based on scientific findings from health services research. The Academy Health website features a special session from the 2010 AcademyHealth Annual Research Meeting that looked at how health services research helped inform Congressional health reform discussions. Experts report on how such research influenced design decisions about health insurance, payment and delivery systems.

Despite controversy about the health reform bill, you have to hand it to those who crafted it for taking research evidence seriously.

Filed Under: Evidence-Based Living, Health and Wellness, policy

Happy Evidence-Based New Year!

December 31, 2010 By Leave a Comment

Happy New Year from all of us at Evidence-Based Living! Thanks to the nearly 15,000 readers who have visited the site this year and provided positive feedback and advice. In 2010, we’ve covered topical issues, ranging from evidence about sports performance, to parenting, to nutrition, to child development, to aging, and much more. We’ve also looked at the broader issues of how science gets translated into practice and policy, providing information on topics like  systematic reviews of research,  evidence-based programs, and translational research. We’re looking forward to another year of what we hope is a lively and interesting take on how research evidence can be applied in the real world.

We’d like to take this opportunity to thank:

  • The College of Human Ecology at Cornell for supporting the Evidence-Based Living Blog
  • Cornell Cooperative Extension educators for their frequent visits and comments
  • Sheri Hall, our guest blogger, who has kept those interesting posts coming
  • And of course all of our readers, who provide the reason to keep blogging!

Our New Year’s Resolution: More involvement from you! We’d like to increase comments and dialogue about posts, and also get your suggestions for topics you would like covered. So get in touch – and keep looking at the evidence!

Karl and Rhoda

Filed Under: Evidence-Based Living

Does reading aloud to young children make a difference?

December 23, 2010 By 2 Comments

One of my earliest memories as a child was sitting on a wooden porch swing reading books with my mom.  My mom tells me that she started reading to me from day one, and even read to her belly while she was pregnant. Needless to say, books have always held an important place in our home.

When my son Aaron was born, my husband and I started reading to him right away too.  In the beginning we had some children’s books, but we would also read aloud whatever each of us happened to be reading at the time.  Aaron heard a little Harry Potter and some Bicycling magazine, and even a few academic studies that I had to read for work. Now that he’s two years old, we read at least three or four children’s books together each day. Currently, his favorite stall tactic is, “Mama, how about we read a book?”

A few weeks ago, when a friend passed along a book to me about the benefits of reading to children, I was eager to learn about the tangible benefits. The book, called Reading Magic, makes the case that reading aloud to children helps them develop an interest in books, encourages those first words, inspires them to learn to read themselves, and creates a special bond between child and parent.

While I found the book interesting, it doesn’t offer any systematic, concrete evidence about reading aloud to children. So, of course, I had to do some digging.  It turns out my mom knew what she was doing all those years ago!

Three separate systematic reviews of what educators call dialogic reading – essentially engaging in a conversation with young children as you read to them – found positive effects for language skills, improved literacy and school readiness.

The study that piqued by interest the most was a review of 10 studies published by the Puckett Institute’s Research and Training Center on Early Childhood Development, an organization dedicated to identifying and implementing evidence-based practices that improve the development of at-risk infants, toddlers, and preschoolers.

The study identified several specific benefits for children who regularly participated in dialogic reading, including: positive gains in expressive language development, increases in the length of spoken phrases, and greater expressive vocabulary scores.

All of this raises the question, what the heck makes dialogic reading so special?  Essentially, the adult helps the child become the teller of the story by asking questions and prompting the child to participate. The Reading Rockets project, sponsored by the U.S. Department of Education, provides some practical tips on how to engage in dialogic reading with kids.

If there are any small children in your life, sit down with them for a regular story time. The evidence shows it’s great for kids.

Filed Under: Evidence-Based Living, The Learning Center, Youth Development Tagged With: , , ,

Portable space heaters: Money-savers or energy-wasters?

December 16, 2010 By 6 Comments

In Ithaca, it seems that the weather took a sudden dip a few weeks ago.  Temperatures fell below freezing within a few hours, and it doesn’t look like they’ll warm much until spring. That was our cue to turn on the heat for the season.

As much of the northern hemisphere launches into winter, millions of people across the country are firing up their home heating systems – an act that will cost most households hundreds if not thousands of dollars this year. 

With those costs comes the natural inclination to save a little money.  That’s when many – myself included, occasionally – turn to portable electric space heaters. When there’s a chill in the room, it seems so logical to flip a switch to warm a smaller space, instead of cranking up the heating system for the entire house.  But are electric space heaters a good way to reduce your heating costs?  The evidence says no.

Mark Pierce, extension associate at Cornell’s College of Human Ecology, is an expert in energy efficiency issues in residential buildings.  He conducted a detailed analysis of heating costs in a 1,200-square-foot, three-bedroom house to determine if there is a benefit to using portable electric heaters.

Pierce asked the question, which is more expensive: heating the entire house to 70 degrees for three hours, or heating the house to 60 degrees for three hours and using a space heater to raise the temperature of one room to 70 degrees? 

His analysis factored in all sorts of details like the levels of insulation in the floors, walls and ceiling, heat loss through windows and doors, and they type of heating fuel used. He assumed an outside air temperature of 10 degrees.

Using average costs for heating fuels in New York, he found turning down the thermostat from 70 to 60 degrees would reduce heating costs by about 50 to 80 cents, depending on the heating fuel used.  Meanwhile, using a portable heater to heat one room from 60 to 70 degrees over the same time period would cost 52 cents – a meager savings, even when using the most expensive heating fuels.

But why is the cost of heating just one room with a space heater so high?  Because electricity is about twice as expensive as fossil fuels, Pierce explains.

“Electricity is more expensive because it is a secondary form of energy, meaning that a primary form of energy – burning fossil fuels to power a generator for example – must first be consumed to make electricity,” he writes. “By the time electricity gets to your home from a power plant, about 70 percent of the energy consumed to create it has been lost due to generation and distribution system inefficiencies.”

Instead, Pierce recommends other ways to reduce your heating bills, such as adding insulation to your floors, walls and ceilings, installing a more efficient heating system and sealing holes and cracks around doors, windows and electrical outlets.

You can read more evidence-based tips about reducing your home heating bills by clicking here.  Wishing you a warm and cozy winter!

Filed Under: Cornell Cooperative Extension, Evidence-Based Living, The Learning Center Tagged With: , , , ,

Drinking in college? Yep, it hurts your GPA

December 13, 2010 By Leave a Comment

When those in authority try to get college students to drink less, they typically go for scare tactics. They remind students about the dangers of alcohol poisoning, arrest, or accidents. Because binge drinking can be so hazardous, over 100 college presidents have signed on to a movement called the Amethyst Initiative that seeks to reduce bouts of heavy drinking. (And believe it or not, the main policy recommendation of this group is to lower the drinking age!)

So students have heard about the most extreme (and low-frequency) negative effects of alcohol consumption on campus. But what about more frequent outcomes? There’s one concern common to all college students: academic performance. There aren’t many people like the Delta frat brothers in the movie Animal House, who are proud when Dean Wormer tells them: “Here are your grade point averages. Mr. Kroger: two C’s, two D’s and an F. That’s a 1.2. Congratulations, Kroger. You’re at the top of the Delta pledge class.”

But it’s tricky to test the effects of alcohol consumption on academic performance. One big problem is that there may be another variable explaining both poor student performance and drinking (for example, mental health issues) so the connection could be what scientists call “spurious” (seemingly correlated, but there’s something in the background that promotes both behaviors).

I love to report on a truly clever research design, and that’s what we have from economists Scott Carrell of UC-Davis and his colleagues Mark Hoekstra and James West. Their article published by the National Bureau of Economic Research takes advantage of a unique data set, allowing them to test the effects of starting to drink more heavily.

Their data come from the 2000-2006 classes of the United States Air Force Academy (USAFA). Unlike most college campuses, the ban on underage drinking is strictly enforced and can lead to expulsion. Surveys show that drinking before age 21 is much lower at the USAFA than at most college campuses. Another advantage: The USAFA has a highly standardized curriculum where students don’t choose their subjects or professors in core courses and everyone takes the same exams.

So hand it to the researchers for finding an ideal research setting to answer their question (there ought to be a prize for this)!

Now if you’ve followed me this far, using these data, what would be the ideal test of the effects of alcohol? You’ve got it: Each cadet’s 21st birthday. Prior research clearly shows a sudden increase in drinking immediately following turning 21. So they were able to look at students who turned 21 shortly before final exams versus those who turned 21 afterwards.

The results: Drinking definitely affects academic performance. In an interview, Scott Carrell notes that the reduction is approximately half a letter grade. And the effect is strongest for high-performing students. The trend doesn’t just last for the week of the birthday party, but continues for around eight months afterward.

So college binge drinking doesn’t just lead to low-frequency, high-impact outcomes like fatalities. It can also lower GPA and, the authors’ suggest, future life chances as a result.

Filed Under: Evidence-Based Living, Health and Wellness, Youth Development Tagged With: , ,

Science in the courtroom: A Cornell professor uncovers the facts behind child testimony

December 2, 2010 By 1 Comment

I received a postcard in the mail last week notifying me I was called for jury duty.  The prospect seemed an inconvenience. (Where would I find care for my two-year-old son while serving?). But it was also exciting!

I’ve always been interested in the law, and the idea of serving on a jury conjured up a feeling of civic responsibility that felt good.  It was a job I wanted to take seriously, and I immediately began wondering if there was any research I should consider before embarking on this important task.

Unfortunately, there were no trials in my town this week, so I didn’t even have to report to the court. But the notice did bring to mind the work of Cornell Professor Stephen Ceci, an expert in developmental psychology who has conducted ground-breaking research on the testimony of children.

Ceci’s work bridges the gap between research and real-life in a very tangible way: findings from his studies have influenced the way thousands of law enforcement officers, social workers, lawyers, and judges deal with the testimony of children. This is research that makes a tangible difference in the lives of people who often find themselves in difficult situations.

 (An interesting side note: Ceci refuses to be an expert witness for either prosecutors or defenders – a decision that has lent him credibility among judges throughout North America, who often cite his work in their decisions.)

A main topic of Ceci’s work is how children respond when they are questions about sexual abuse. The conventional wisdom says that children delay reporting abuse for years and will initially deny any abuse occurred when asked directly. But after repeated questioning, they gradually begin to tell little bits and pieces about how they were abused. Next, they recant altogether. Only later, when they are in what is perceived to be a psychologically safe situation, do they give a full and elaborate disclosure.

In analyses of dozens of published studies, Ceci and his colleagues separated out the methodologically-sound studies on children’s disclosure from poorly conducted ones. They found in high-quality studies, children did report abuse in full detail when explicitly asked. They also found that when a child is questioned repeatedly, he is likely to relent and say what he thinks the interviewer wants to hear to get out of an uncomfortable situation.

“It’s important for judges to know what science shows, because this set of invalid beliefs animates the whole investigatory process,” Ceci explained. “It motivates investigators and interviewers to pursue reluctant children, who may be reluctant because nothing actually happened.”

In the case U.S. v. Desmond Rouse, the United States Court of Appeals for the Eighth Circuit (the court directly beneath the U.S. Supreme Court) established new law on vetting child testimony based almost exclusively on the work of Ceci and his colleagues.

For anyone who works with children involved in the court system, Ceci’s work provides a whole new way to think about their testimony.

Filed Under: Evidence-Based Living, In The Media, policy, The Learning Center, Youth Development Tagged With: , , , ,
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