2011

New evidence on yoga

October 20, 2011 By sh648 2 Comments

Here on EBL, we’ve written plenty about alternative treatments like T’ai Chi and meditation. They’re always popular topics, maybe because many of us are looking for ways to improve our health.

So I was excited to see a New York Times blog post about the evidence surrounding yoga and pain relief. For one, it’s great news that major media outlets like the New York Times are touting the importance of systematic reviews. And it’s also good to hear that an alternative treatment practiced by so many people – myself included – actually works.

The actual analysis, conducted by researchers in the United Kingdom and published in the Journal of Alternative and Complementary Medicine, reviewed ten randomized clinical trials that measured whether yoga helped reduce pain among patients with a variety of ailments. Nine of the trials found yoga led to significantly greater pain reduction than other therapies such as standard care, therapeutic exercises, touch and manipulation, or no intervention at all.

While the analysis gave preliminary indications that yoga works for pain relief, it concluded that more research is needed. The yoga practices in each of the studies varied widely, as did the type and intensity of pain experienced by patients.

Dr. M. Cary Reid is a geriatrician at Weill Cornell Medical Center and director the Translational Research Institute for Pain in Later Life, an evidence-based center in New York City to help older adults prevent and manage pain. He recently completed his own systematic review of alternative therapies including yoga for the treatment of osteoarthritis, which is submitted for publication.

Dr. Reid shared his thoughts on yoga for pain relief: “The good news is there appear to be few downsides to doing yoga, so my thinking is that we should be offering it routinely to patients, particularly those who are reluctant to try pain medications.” He echoed the need for larger, more definitive studies.

Until then, I’ll still be frequently my local yoga studio.

Filed Under: Evidence-Based Living, Health and Wellness, In The Media Tagged With: alternative treatments, evidence-based practice, Health and Wellness, science in the media

Got mold? Follow the evidence

October 17, 2011 By sh648 2 Comments

Storms, floods and hurricanes are an unfortunate reality in our world – one that often leads to damp buildings, mold and potential health problems.

Here on EBL, we’ve discussed some of the evidence-based tactics for dealing with flooding. Now a new systematic review by the Cochrane Collaboration reviews the data available on preventing respiratory illnesses due to environmental mold.

The review included eight studies with 6,538 participants. In each study, researchers tracked incidence of asthma and respiratory illnesses after the removal of mold and dampness from family houses, schools and an office building.

The review found some improvements in health. For example, the number of emergency and inpatient visits decreased and students visited the doctor less frequently due to colds. On the whole, mold remediation decreased the severity and amount of symptoms in patients with asthma and respiratory infections.

But because each study measured different outcomes and designs varied widely, the authors found it “difficult to draw hard conclusions” and recommended better research.

Filed Under: Evidence-Based Living, Health and Wellness Tagged With: environment, evidence-based practice, Health and Wellness, research translation

Is junk food cheaper?

October 11, 2011 By sh648 1 Comment

It’s a major misconception in our modern society: processed foods like chips, frozen dinners and Happy Meals are not cheaper, but actually more expensive than whole foods like whole grains, fruits and vegetables. While this topic graces our TV screens in shows like Jamie Oliver’s Food Revoluion and our shelves in books like Michael Pollan’s In Defense of Food, the misconception remains among many Americans.

A few weeks ago, Mark Bittman wrote a column in the New York Times making the case that cost is not what keeps American families from eating healthy meals. Bittman argues that advertising and marketing of snacks and fast food, the addictive nature of unhealthy foods and a lack of cooking skills are to blame for America’s nutrition problems.

It’s a problem that is documented by plenty of evidence, says Christine Olson, a professor of community nutrition at Cornell.

“His article lends some visibility to a fact that is well-known by nutritionists and family economists and amply-substantiated by research,” she said. “A home-prepared family meal is generally more nutritious and cheaper than a family meal purchased at a restaurant, even a fast food restaurant. But the frenetic pace of family life and the relentless advertising by the fast food industry contribute to the widely-held opposite perception. “

Cornell Cooperative Extension has been educating families about this very issue for decades. Its Food and Nutrition Education in Communities program has been helping families gain the knowledge, skills, attitudes they need to eat healthily since the 1970s. Another program called Cooking Up Fun teaches young people about cooking with healthy ingredients.

It’s one of the many ways that Cornell Cooperative Extension is using evidence to help improve the lives of families in New York.

Filed Under: Evidence-Based Living, Health and Wellness, In The Media Tagged With: behavior change, Cooperative Extension programs, food and nutrition, nutrition, science in the media

Eating fish lowers your stroke risk

October 5, 2011 By sh648 Leave a Comment

We’ve all heard that seafood should be part of a healthy diet. It provides lean protein and healthy fats that reduce your risk of heart disease, depression, joint pain and other problems. A new international meta-analysis has found that people who eat fish a few times each week are less likely to suffer a stroke than those who only eat a little or none at all.

The study, published in the journal Stroke, found the omega-3 fatty acids in fish may lower stroke risk through their positive effects on blood pressure and cholesterol. The analysis is based on 15 studies, which followed a total of 400,000 people ages 30 to 103. Each study asked participants how frequently they ate fish, then followed them for between 4 and 30 years to see who suffered a stroke.

The analysis found that eating three extra servings of fish each week led to a 6 percent drop in stroke risk. That translates to one fewer stroke among a hundred people eating extra fish over a lifetime.

While the research provides an interesting link, it does not prove that adding fish to your diet will keep you from having a stroke. People “could have healthier diets in other ways, people could exercise more, people could have better education that could lead them to see their doctors more,” Dariush Mozaffarian, a Harvard School of Public Health epidemiologist whose research was included in the analysis, told Reuters this week. But it’s likely that people who start out eating no fish or very little probably have the most to gain by putting it on their plate more often, he said.

Filed Under: Evidence-Based Living, Health and Wellness Tagged With: evidence-based practice, food and nutrition, nutrition, research translation

When should kids start kindergarten?

September 30, 2011 By sh648 Leave a Comment

It’s a question I’m already pondering two full years before I need to make the decision: When will my son be ready for kindergarten? Aaron turned three last week. Having a fall birthday means he will always be one of the youngest kids in his class. In two years, he will qualify to start kindergarten as a four-year-old – for a few weeks, at least. That is, unless I decide to hold him back.

Educational literature and the media are abuzz about this trend of redshirting kindergarteners. Many parents want to make sure their kids are emotionally ready to start school. Others don’t want their children to the smallest in the classroom, or the least advanced.

So when I read an opinion article in the New York Times arguing that most kids should start kindergarten on time, even when their birthdays are close to the cut-off dates, I was intrigued.

It turns out the research consistently shows that, on average, children who are held back a year do no better than those who start kindergarten with their designated class. One study found differences in test scores between younger and older classmates declines over the elementary school years, and that children benefit from having older classmates to learn from. Another longitudinal study found that delaying kindergarten does not result in any long-term advantages, and that younger students may have a small advantage in human capital later in life.

Clearly, each child needs to be evaluated individually to determine when he or she is ready to start school. But the evidence clearly shows that many four-year-olds will do just fine in kindergarten and may end up ahead of their peers in the long run thanks to their early school experiences.

Personally, I will be carefully considering our choices for Aaron over the next several years, with lots of input from his preschool teachers. In the meantime, it’s nice to know that he can be successful – whatever decision we make.

Filed Under: Evidence-Based Living, In The Media, Youth Development

The evidence on pain: A new blog

September 29, 2011 By sh648 1 Comment

Millions of older adults throughout our country live with chronic pain – a disabling and costly disorder. Two years ago, Cornell helped establish an evidence-based center in New York City called the Translational Research Institute for Pain in Later Life, or TRIPLL, to help older adults prevent and manage their pain.

TRIPLL is a collaboration between six institutions: Weill Cornell Medical College, Cornell-Ithaca, Columbia University’s Mailman School of Public Health, Hospital for Special Surgery, Memorial Sloan Kettering Cancer Center and Visiting Nurse Service of New York and Council of Senior Centers & Service of NYC, Inc.

The center aims to build evidence-based practices for pain prevention and treatment, and then disseminate that information to older adults in New York City.

Now the center has launched a blog — http://tripll.org/blog/ — to share research-based information to help those dealing with chronic pain. The blog covers the latest pain research, and also share stories of people living and coping with chronic pain.

“Poorly treated pain has profound consequences for older adults,” said TRIPLL director M. Cary Reid, a geriatrician at Weill Cornell Medical Center. He estimates that as many as 40 percent of seniors living independently in the U.S. suffer from chronic pain.

“Unfortunately, older adults and their doctors often dismiss chronic pain as part of aging, causing it to be neglected,” he said. “We want to raise this overlooked issue and improve how we treat pain in older adults.”

If you or someone who love copes with chronic pain, the TRIPLL blog is a must-read to find out what the evidence says about pain management and hear stories from others coping with chronic pain.

Filed Under: Evidence-Based Living, Health and Wellness Tagged With: evidence-based programs, Health and Wellness, research translation

“You can’t say, ‘You can’t play.’”

September 21, 2011 By sh648 Leave a Comment

Over dozens of years in the classroom, author and veteran kindergarten teacher Vivian Paley noticed a disturbing trend among her students: Each year, some children developed the power to create the games, make the rules, and decide who was allowed to play and who would be left out.

So Paley decided to make a new rule in her classroom: “You can’t say, ‘You can’t play.” Paley documented the children’s reaction to the new rule with audio recordings. (You can hear some of them in an episode of the NPR show This American Life.)

The following year, Paley’s rule was expanded to her entire school. She’s written a book on the experiment. And, since then, educators across the country have adopted the rule and studied its implications. My own son’s preschool subscribes to the rule, so I thought I’d do a little digging to find out what the research says about it.

While there is no meta-analysis available to date on “You can’t say, ‘You can’t play,” studies have shown the rule improves social acceptance among kindergarteners. The non-profit research center Child Trends implemented an intervention program among 144 kindergarteners that involved storytelling and group discussion to help children become more aware the different ways they may exclude their peers and learn ways to act in more accepting ways. Their study found that children in the program felt more accepted by their peers compared to the control group.

Another study investigated teacher’s perceptions about inclusive play for young children. The found programs to implement the rule must involve training and on-going support to help teachers communicate the rule to students and deal with problems that emerge as students struggle with inclusive play.

On the whole, I’m impressed with the data available on “You can’t say, ‘You can’t play.’” It seems to be a positive way to teach young children about social acceptance and diversity. This is one area, though, where I’d love to see some more comprehensive research or a literature review to clarify all of the benefits to our children.

Filed Under: Evidence-Based Living, In The Media, Youth Development Tagged With: behavior change, children and youth, evidence-based programs, intervention research

How to cope with trauma

September 13, 2011 By sh648 1 Comment

Sadly, disasters are a part of our life today. Both natural disasters like hurricanes or tragedies like the September 11 terrorist attacks take a devastating toll on the people involved in them. Many people who live through these kinds of dangerous events develop an anxiety disorder called post-traumatic stress disorder, or PTSD.

Given the recent flooding on the east coast from Hurricane Irene and Tropical Storm Lee, as well as the anniversary of Sept. 11, 2001, we thought it’d be helpful to see what the evidence says about PTSD.

The best resource we could find is from the National Institute of Mental Health. Researchers there created an online guide that describes PTSD and summarizes the best treatments based on current research.

Not everyone who lives through a dangerous event will develop PTSD. There are some factors that can help people avoid this debilitating condition. They include finding a support group, developing a way to get through the bad event and learn from it, and the ability to act and respond despite being in fear.

According to the research, people who have a history of mental illness, who saw other people get hurt or killed or who have little or no social support after a tragedy are more likely to develop PTSD.

The take-home message is, if you or a loved one have experienced a traumatic event, there are evidence-based steps you can take to avoid or cope with PTSD.

You can help a relative or friend by:

Offering emotional support, understanding, patience, and encouragement.
Inviting your friend or relative out for positive distractions.
Paying attention comments about your friend or relative harming him or herself, and reporting this behavior to a medical professional.

If you’ve experienced a traumatic event, you should:

Talk to your doctor about how you’re feeling.
Engage in mild activity or exercise to help reduce stress.
Try to spend time with other people and tell others about things that may trigger symptoms.

We’d all like to live in a world where disasters don’t happen. But given the realities of our society and environment, it’s important to understand the evidence about living through trauma.

Filed Under: Evidence-Based Living, Health and Wellness, In The Media Tagged With: evidence-based practice, Health and Wellness

Flooded? Follow the evidence

September 9, 2011 By sh648 1 Comment

A double whammy from Hurricane Irene and Tropical Storm Lee drenched the east coast over the past two weeks leading to swollen rivers, flooded valleys and the destruction of roadways, bridges and buildings from Vermont to Maryland.

As communities in eastern and central New York, from the southern Adirondacks to the Pennsylvania border, continue to struggle under the deluge, Cornell Cooperative Extension has information that can help.

The New York Extension Disaster Education Network, or NY EDEN, is a collaborative network based at Cornell dedicated to educating New York residents about preparing for and recovering from natural disasters.

The network offers dozens of evidence-based tips on how to protect your property, remain safe, and clean-up after serious flooding. Among their recommendations:

Over half of all flood-related drownings occur when a vehicle is driven into hazardous flood water, according to the Centers for Disease Control. That’s because most people underestimate the force of flood water. It takes only two fee of rushing floodwater to carry away most vehicles. So if you come across an area covered with water, turn around.
Check for cracks in the foundation, shifted walls and a roofline out of position before re-entering a building that is flooded.
Turn off the electricity in a flooded building before touching any electrical devices or walking through a flooded basement.
Furniture that has been flooded and has porous materials such as leather, fabric should be discarded because it will likely produce dangerous molds in your home. For other furniture, take it outside and remove as many parts as possible. Use a solution of one part water and one part ammonia to wipe down the furniture, then move it to a well-ventilated, shady spot to dry. (Wood furniture dried in the sun will warp.)

Stay safe and don’t forget to refer to the evidence when cleaning up after a flood!

Filed Under: Evidence-Based Living, Health and Wellness Tagged With: Cooperative Extension programs, environment, evidence-based practice, Health and Wellness, research translation

Evidence-based energy: What we really know about hydraulic fracturing

September 1, 2011 By sh648 Leave a Comment

A newer method for extracting natural gas from layers of shale deep below the earth’s surface – called hydraulic fracturing or hydrofracking – has ignited debates across the nation. Proponents say that natural gas key to the country’s energy future. (Burning natural gas produces fewer greenhouse gases emissions than coal and oil.) But opponents say this method for extracting it poses risks to ground water supplies.

Over the past several years, Cornell researchers have mounted an unprecedented response to the issue. They’ve stepped up research efforts to collect and develop as much evidence as possible about hydrofracking. And they are reaching out to help individuals and communities across New York to help them make decisions about the benefits and dangers of drilling.

They have created the Cornell Cooperative Extension Natural Gas Resource Center, which is made of a 12 faculty members from a wide array of disciplines—including sociology, environmental sciences, and geology—and 20 extension educators. The group has compiled information for people impacted by hydraulic fracturing including individuals considering leasing their land, community groups, and local governments.

The Resource Center’s web site is a treasure trove of information on the topic including how geologists use seismic data to determine if natural gas is accessible, how to negotiate a lease for gas drilling and the economic impacts of drilling.

If you live in an area where natural gas drilling is a possibility, you’ll definitely want to dig into this resource.

Filed Under: Cornell Cooperative Extension, Evidence-Based Living, In The Media Tagged With: Cooperative Extension programs, economics, energy, environment, policy, science and public opinion, science in the media

A new federal report: Vaccines and serious side effects

August 29, 2011 By sh648 Leave a Comment

It’s a debate that has raged for decades – whether vaccines lead to serious side effects – and specifically whether the combination vaccine to prevent measles, mumps and rubella causes autism in children.

The federal government has investigated the risk of vaccines a dozen times in the past 25 years to determine what the evidence says on the issue. Their latest report, written by a committee at the Institute of Medicine and released last week, found no evidence that the MMR vaccine causes autism.

The report reviewed eight vaccines in total that are recommended by the U.S. Centers for Disease Control. For each vaccine, a committee of medical experts reviewed adverse events associated with vaccines to evaluate the scientific evidence about whether the event was related to the vaccine.

The committee did find evidence for some adverse events related to vaccines. For example, people who have had the chickenpox vaccine can develop pneumonia, meningitis or hepatitis late in life if they suffer an unrelated illness, such as cancer, that compromises their immune systems. And the HPV vaccine rarely causes a life-threatening allergic reaction.

The committee also found the evidence rejected five adverse relationships related to vaccines, including the link between the MMR vaccine and autism.

But for the majority of adverse events, the committee could not find enough evidence to determine whether vaccines contributed to the problems or not. Often times, this was because the event was extremely rare, making it difficult to study.

You can read a summary of the report, with information about all of the vaccines studied, by clicking here. The bottom line is, it’s important to understand the vaccines that you and your children are receiving, and be prepared for potential side effects that could occur based on the evidence.

Filed Under: Evidence-Based Living, Health and Wellness, In The Media Tagged With: children and youth, evidence-based practice, Health and Wellness, research translation, science in the media