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Clear evidence: Breastfeeding is good for babies

March 22, 2011 By 4 Comments

With my second child due any day now, I admit I’ve got babies on the brain at the moment.  If there’s one thing the evidence clearly shows, it’s that breastfeeding is good for both moms and babies.

Review after review shows that breastfeeding protects against asthma, childhood obesity, ear infections, respiratory illness and more.  It helps mothers avoid breast and ovarian cancer, and leads to quicker weight-loss after having a baby.  (You can find a good review of that evidence and more from the U.S. Surgeon General’s office.)

In addition, there are economic benefits to families.  Formula is expensive!

But across the U.S., less than half of women continue breastfeeding after six months. And among some populations, such as African-American women, those rates are much lower.

Luckily, there is also good evidence that educational programs are effective in promoting breastfeeding among new mothers.  The best method seems to be in-person training –whether with a nurse at the hospital, at pediatrician’s offices or in a support group for new mothers all proved effective in increasing the number of infants who are breastfed at three months of age.

There are other interventions that help as well. In fact, the U.S. government has deemed this is such an important issue that the Centers for Disease Control has published a list of evidence-based guidelines to breastfeeding interventions.  Among the recommendations are providing support in the workplace for breastfeeding women and creating media campaigns to improve attitudes toward breastfeeding. 

I feel extremely lucky that the hospital where I plan to deliver and our pediatrician’s office have lactation consultants – people trained to teach women how to breast feed and address problems that come up in the process.  I used their help when my son was born two years ago, and I certainly plan to take advantage of them again this time.

Update: Hannah May was born on Saturday afternoon and is currently enjoying the benefits of breastfeeding.

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

A move toward evidence-based criminal justice

March 17, 2011 By Leave a Comment

Earlier this month, the state of Illinois abolished its death penalty, the fourth state in the U.S. to remove the sentence in the past decade.  Among public leaders, consensus has grown slowly to support the decision not due to questions of morality, but of accuracy. Since 1973, nearly 140 death row inmates across the nation have been found innocent and released from prison before they were executed. 

Case reviews have found some common reasons why inmates are wrongfully-convicted such as eyewitness error, police and prosecutor misconduct, mishandled evidence, faculty testimony by another inmate in exchange for a reduced sentence and false confessions.

The increasing awareness that our criminal justice system doesn’t always get it right has spurred universities and non-profits across the country to reopen investigations for inmates who claim their innocent.  Cornell’s own Death Penalty Project is among the groups that work on such cases.

Maybe more importantly, publicity about wrongful conviction cases has created a movement toward evidence-based crime policy – using research on criminal justice issues to put policies into place that help to ensure our criminal justice system gets it right the first time around. For example, one systematic review of eyewitness testimony procedures found that high levels of stress negatively impact the accuracy of eye-witness testimony.

Researchers at the College of Human Ecology have partnered with Cornell faculty members in psychology and law to conduct basic research on some of these topics relevant to these issues including false memory, child testimony and jury decision-making and offer classes to students interested in this type of research.

The Campbell Collaboration – a clearinghouse for systematic reviews on social policy issues – has a crime and justice group that is working to broaden the information available on criminal justice issues. And other institutions, such as George Mason University, have created centers aimed at translating this research into policies and practices that local law enforcement officials are use in the field.

It’s a good start on a topic that should be pursued vigorously until changes are made.  In many cases our police officers, judges and juries are making life-or-death decisions about people’s lives.  If there’s ever a time to rely on evidence-based practices, this is it.

Filed Under: Evidence-Based Living, In The Media, policy Tagged With: , ,

Professor Dan Lichter: Census drives evidence-based decisions

March 14, 2011 By 1 Comment

As the U.S. Census bureau continues to release data on state demographics, researchers, public officials and program managers across the country are digging into the new information to make decisions about everything from construction projects to quality-of-life issues and emergency services.

EBL sat down this week with Professor Daniel  Lichter, an expert in population studies and public policy at the College of Human Ecology, to talk about the 2010 census and its implications for using data to drive real-life decisions. 

Lichter called the decennial  census “the most important statistical gathering exercise in the entire United States.”  Here are some of this other thoughts about the event.

EBL: Can you describe the historical significance of the census?

Lichter:  We’ve had census every year since 1790. It’s required by U.S. Constitution.  It is conducted to insure the one person, one vote idea – to determine the number of seats each state would receive in the U.S. House of Representatives and to realignvoting districts in each state every ten years.

EBL: How has our use of the information changed over the years?

Lichter: The census is also vital for program planning and public policy. It’s always been used in some sense for those sorts of things, but it’s used now more than ever before. How do we know where to build new highways or schools or whether we need a new waste water treatment plant?

“Today, increasingly, we use census data for identifying particular populations and areas with specific needs so we can more effectively target resources to those areas.  The census is vital for earmarking public funds. It also has a huge constituency in the private sector in terms of marketing. It helps companies decide, for example, where to build new stores.

EBL: How did the 2010 census pan out?

Lichter: It’s probably the most successful census ever in terms of coverage. The census bureau has become very good at identifying hard-to-reach populations and reaching out them.

People should always fill out their census schedules when they get them because it reflects whether they’re accurately represented in Congress and whether they receive their fair share of revenues.  By law, these data are strictly confidential to insure completeness and accuracy.

(The U.S. Census Director recently spoke at Cornell about how his organization was able to collect accurate information. You can read about his talk by clicking here.)

EBL: How do you use census data in your research?

Lichter:  I’m very much interested in the changing racial and demographic composition of the U.S. population. We are almost to the point now where half of the births in the United States are to populations other than non-Hispanic whites.  We are rapidly moving toward a  majority-minority society.

I’m interested in what that means, not only in terms of educating children now, but what it means for the labor force 20 years out.  What we do or don’t do for minority populations today is going to have a major effect on our country 20 years from now.

I’m also interested in racial segregation, and to what extent racial and ethnic groups live near each other. Our population is becoming more diverse, but many communities and neighborhoods are also becoming more segregated. Some of my work tries to understand how race relations are reflected in the geographic distribution of people.

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

New York continues PROSPER Partnership to prevent substance abuse

March 8, 2011 By 1 Comment

We heard some exciting news at EBL this week!  New York families will soon have more access to evidence-based programs that prevent substance abuse among middle school students and their families.

You might remember that we wrote about PROSPER Partnerships – which stands for PROmoting School-community-university Partnerships to Enhance Resilience – as an ideal model for implementing substance abuse prevention programming based on real evidence. The program links Cooperative Extension, public schools, and local communities to choose proven programs that serve the needs of individual communities.

Last month, New York was chosen as one of five states in that will continue the process of forming a PROSPER Partnership, with Cornell serving as the university partner.

The goal is for New York to become a full PROSPER State Partnership by August of this year.

Kim Kopko, Extension Associate in the Department of Policy Analysis and Management and New York State Liaison for PROSPER, is excited to continue with the program.

“This is indeed a very positive development and an exciting opportunity to utilize the Cornell Cooperative Extension System to bring evidence-based programming to families and communities in New York,” she said.
As you might expect, PROSPER uses plenty of evidence to determine if a state is ready to enter a full partnership. PROSPER staff collected and analyzed data from a state survey, in-depth interviews with Cooperative Extension staff and partnering agencies, and information garnered from various activities in New York.

PROSPER has also plenty of evidence to prove that their system yields results. PROSPER Programs typically recruit 17 percent of eligible families in their communities, compared to less than six percent for other community programs.

Students who participate in the program are better at problem solving, more likely to refuse offers of alcohol and other drugs, less likely to believe that substance use has positive effects and more likely to delay initiation of substance use. And each $1 invested in the program yield about $9.60 of savings.

All of that is great news for New York families, who will soon have even greater access to evidence-based programming.

Filed Under: Cornell Cooperative Extension, Evidence-Based Living, Youth Development Tagged With: , , , ,

The King’s Speech: What stuttering treatment works?

March 5, 2011 By Leave a Comment

Many people loved the movie The King’s Speech. But few were more riveted to the screen than current or former stutterers – like myself. At some point in early childhood, I began to stutter when I said certain words. Unlike the King, I was pretty fortunate. For some reason, my playmates were generally supportive rather than tormenting and I don’t recall being teased about my fluency problems.

And I will be forever grateful to Dr. Wolfe, the speech therapist in the college town in which I grew up. I remember Dr. Wolfe as jolly fellow, who reassured us kids that we’d be fine, we’d probably outgrow it, but would we mind just trying this or that technique? He spiced up the lessons with trips into real-world settings, such as ordering in our local candy shop. The best part: I got out of school for the therapy sessions. Dr. Wolfe would have to be well into his 80s by now, so if you’re still around: Thanks!

Like many children who stutter, my speech became more fluent as I got older (possibly because of therapy, but a large proportion of children who stutter get better on their own). But having had an inspirational speech therapist myself, my Evidence-Based Living antennae began to hum, leading to the question:

What is the research evidence on the effectiveness of speech therapy?

In particular, what’s the evidence on behavioral therapy such as that practied by Lionel Logue, who actually was King George VI’s speech therapist? Of course, at EBL we know where to turn: To systematic reviews of the literature. Fortunately, a great review of stuttering treatment research exists – in fact, I suggest you look at it just because it is such a terrific example of systematic review.

Dr. Anne Bothe and colleagues looked at all published studies from 1970 – 2005. Articles had to be original research, they had to have measurable outcomes, and they had to meet a set of critera for good science (described in the article).

One interesting finding right from the start: Only 31 articles met the criteria for sound methods. So even in an area with so much interest as stuttering, very few studies exist that use randomized-controlled designs, have adequate controls for reliability and validity, and look at both short-term and long-term outcomes.  Another review by Nan Bernstein Ratner looks at various forms of treatment from a clinical perspective (2010).

There is so much that’s interesting in these reviews, I suggest you take a look. Scientists are continually finding out new things about why stuttering occurs, from the genetic component to the influence of brain structure and function. But in honor of The King’s Speech, what do the reviews say seems to work best for adults?

For adults, Rhode’s systematic review most strongly endorses what’s called fluency shaping. This treatment works to replace stuttering with more fluent speech (hence the name). And the extensive review Bothe et al. conducted shows that one particular type of fluency shaping really seems to work: prolonged speech. This therapy involves such techniques as managing the stream of breath, creating a more deliberate flow between words, and generally slowing the speech down. One problem with these programs is that speech sometimes doesn’t seem totally natural; the most effective programs use prolonged speech therapy combined with other techniques.

Now, that seems does seem somewhat like what King George VI got from Lionel Logue, after all.

If you have some time to kill, the Stuttering Foundation has some very reassuring information for the approximately 1% of adults who stutter: Lists of famous people who struggled with the problem. Did you know that stutterers include: James Earl Jones, Nicole Kidman, Marilyn Monroe, baseball player Johnny Damon, and writer John Updike?

(And here’s a disclaimer to prevent riled-up comments from the speech therapy world: I know there is a huge debate over what kind of therapy works best for stuttering. For those of you who are interested, the two reviews are a good place to start. Some places to go for descriptions of therapies are the National Institute on Deafness and other Communication Disorders (NIDCD) and the Stuttering Foundation.

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

Video feature: Teaching design that follows the evidence

March 2, 2011 By 1 Comment

We often think of using evidence in making medical decisions or evaluating social programs.  But is there a way to use data in a more subjective field like design?  The answer is yes!

Several decades ago, a new field called Evidence-Based Design linked the principles of evidence-based medicine with architectural and interior design to create health care facilities proven to help patients heal.  (Since then, the field has expanded to corporate environments as well.)

To date, there have been more than 1,000 academic studies that investigate design elements to make patients feel more comfortable, improve the quality and safety of health care, and create a positive working environment for health care professionals.  

One comprehensive review on the best practices is published here and includes recommendations like creating single-bed hospital rooms, using noise-deadening materials in construction, and maximizing natural light in health care facilities.

 At Cornell, faculty members in the College of Human Ecology are working on the cutting edge of this field.  They’ve investigated how the design of an intensive care unit impacts the communication among the nursing staff. And they’ve examined ways to improve the experience of people with Alzheimer’s disease living in residential facilities.

 Professor Frank Becker in the Department of Design and Environmental Analysis teaches a course that brings together students majoring in business, health care administration and design to learn about and create evidence-based health care facilities.  You can watch a video about the class below.

Here at EBL, we love it when experts in all fields discover and use evidence to improve people’s lives!

Filed Under: Evidence-Based Living, Health and Wellness, The Learning Center Tagged With: , , , ,
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