sh648

Citizen scientists: The new research corps

November 28, 2012 By sh648 1 Comment

More often than ever before, people from all walks of life – from retired senior citizens to young families – are helping scientists collect data that support research projects. This movement of “citizen science” has flourished over the past decade as technology has advanced, allowing volunteers to share information with researchers quickly and accurately.

In fact, there are several interesting examples of “citizen science” here at Cornell University, including a survey of backyard birds and a project called Yardmap that encourages homeowners to map their yards so that researchers can better understand the habitat available to birds.

This month, a group of researchers from the United Kingdom has published a review that details exactly how “citizen science” is working, including summaries of projects across the globe, interviews with scientists who use this data and , and a guide of the best practices for conducting these types of projects. The review found some interesting conclusions. Among them:

The motivation for citizen scientists varies greatly. Successful projects tend to take into account the interests and skill-sets of participants, and their expectations.
Getting feedback from volunteers is an important component of a sucessful project and is acheived through a wide variety of mediums, including social media and face-to-face interactions.
Technologies such as GPS and smart phones have made it easier for citizens to share accurate data, but relying on these devices excludes those who don’t have access to them.

Cornell gerontologist Karl Pillemer is a proponent of “citizen science” for people in their 60s, 70s and 80s. He has conducted research that found that older adults who get involved in creating a sustainable society and conserving natural resources are not only helping the environment, they are also helping themselves.

“Research shows that citizen science activities provide a wonderful opportunity to achieve two goals at once: Adding to our knowledge about areas important to quality of life for people, while also providing opportunities for rewarding and meaningful activity,” he said. “And citizen science activities can be adapted for any life course stage, from elementary school students to retirees.”

In short, projects that use citizen volunteers to collect data are an important part of environmental research today, and understanding the best practices for this type of research is important.

Filed Under: Evidence-Based Living, The Learning Center Tagged With: research methods, social trends, volunteers

Evidence-based Thanksgiving: Is giving thanks good for you?

November 21, 2012 By sh648 Leave a Comment

I have talked to a lot of people who identify Thanksgiving as their favorite holiday. As reasons for this they note that it has the benefits of family, friends, and food without the consumerist insanity that surrounds Christmas. The symbolic importance of Thanksgiving is indicated by the fact that it creates the busiest travel time, with 42.2 million people taking a trip of at least 50 miles.

But how often do we do what the name of the holiday implies: That is, actually give thanks for things? The emotion that encompasses that act is gratitude, which the dictionary defines as “a feeling of thankfulness or appreciation.” Science can’t tell us whether Thanksgiving is good for you, but we at Evidence-Based Living wondered: What about giving thanks? Is there evidence that gratitude itself has benefits?

It turns out that there is a significant scientific literature on gratitude. A comprehensive review of the research was recently conducted by Alex Wood, Jeffrey Froh, and Adam Geraghty that helps answer the question: Is gratitude good for you? They look at how gratitude promotes well-being and then move beyond that question, examining intervention programs that attempt to achieve positive outcomes by promoting gratitude.

The authors note that although we may feel grateful for specific events, gratitude can also be seen as “part of a wider life orientation towards noticing and appreciating the positive in the world.” (I’ve heard the expression an “attitude of gratitude.”) Some people are more likely to notice and appreciate the positive in life than others are. And this orientation seems to protect people from psychological distress.

Wood and colleagues’ review shows that gratitude is negatively related to depression. In one study, an attitude of “thankfulness” reduced the risk of such disorders as major depression, generalized anxiety disorder, and drug abuse. Gratitude has also been found to help people adjust to traumatic life events and their aftermath. On the positive side, a dozen studies have found a positive relationship between gratitude and feelings of well-being.

An important question is causality: It could be that less depressed people are more likely to be grateful,rather than the opposite. To answer this question, scientists have developed intervention programs to promote feelings of gratitude and then looked at the effects in experiments. The authors review 12 studies that examined the effects of interventions such as daily listing of reasons to be grateful, grateful contemplation (thinking or writing more generally about gratitude), and behavioral expressions of gratitude (actually thanking another person).

The findings are very encouraging, with programs that promote gratefulness resulting in statistically significant increases in positive emotion, decreases in negative emotion, and reduced worry. A study of adolescents even found an increase in satisfaction with school after a gratitude intervention. More research of course needs to be done, but based on this review promoting gratitude seems to make sense to improve well-being.

An appealing part of the gratitude list idea is its simplicity. Anyone can do it – interventions are as straightforward as listing 3-5 things for which one is grateful before going to bed. Why not try it? Or get the turkey-sated crew around the Thanksgiving table to make a list before dozing off in front of the football game!

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

The facts on mold for hurricane victims

November 16, 2012 By sh648 Leave a Comment

Nearly a month after hurricane Sandy battered the east coast, homeowners in New York and New Jersey are still trying to dry out their homes and assess all of the damage. For those whose homes were flooded, a major problem they will face is mold.

Mold spores thrive in flooded homes, where everything is damp and there is plenty of organic material as a base for them to grow and thrive. They often cause respiratory problems, irritate the skin and eyes, and can lead to lung infections.

Here at EBL, the topic of mold in homes is not a new one. Just last year, we wrote about a systematic review by the Cochrane Collaboration that details the best ways to prevent respiratory problems caused by mold.

Luckily, there is plenty of solid evidence on effective ways to cope with mold in your home. Joe Laquatra, a professor of design and environmental analysis at Cornell, is an expert in coping with mold in homes and a member of the New York State Center for Indoor Environmental Quality. He has developed a comprehensive, evidence-based information sheet that details the health effects of mold in homes and the best methods for removing it.

Among his recommendations are:

Homes that are wet for more than 48 hours are at risk of developing mold.
It’s best to discard wet ceiling tiles, cellulose insulation, and often drywall as well.
If mold is detected over more than ten square feet of a home, the best course of action is to hire a mold remediation contractor. Another fact sheet offers tips about selecting a contractor.

The take-home message: Mold is a serious issue in homes that have experienced flooding. It’s important to understand all of the facts to avoid health problems caused by mold.

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

What we know about autism therapies

November 13, 2012 By sh648 1 Comment

According to the U.S. Centers for Disease Control and Prevention, one in 88 American children have an autism spectrum disorder – developmental disabilities characterized by delays in social interaction and communication, cognitive difficulties and repetitive behaviors.

Autism appears in children by three years of age and typical treatments include medicine and therapy. Now there’s a new meta-analysis investigating behavioral interventions to treat autistic children.

The analysis looks at 33 systematic reviews and 68 intervention studies of autistic children. The review – published earlier this month in the journal Pediatrics – found that some intervention programs did help improve behavioral symptoms.

Intensive behavior programs – which include therapy for at least 25 hours a week – were found to be moderately effective at improving core deficits such as adapting to change, decision-making and memory. The evidence showed these programs were particularly effective when they began shortly after diagnosis, and when they address the concerns of the family and offer opportunities for them to participate.

The authors agreed that there is plenty of room for improvement. They suggested that comprehensive therapy programs need to address even more deficits including social communication, language, play skills, aggression and preoccupation with rituals.

They also identified gaps in our knowledge about autism therapies. Researchers need to

– Develop uniform outcome measures so that future systematic reviews can more easily pool data.

– Conduct more studies on pre-verbal or non-verbal children to determine the interventions that help them best.

– Assess how individual, specific therapies impact core deficits such as IQ and communication skills.

– Collect more evidence to determine the most effective dose and duration of therapies.

All in all, the take home message is that behavioral therapy does help children diagnosed with autism, but that researchers have a long way to go to ensure that interventions are doing all that they can to help autistic children develop and thrive.

Filed Under: Evidence-Based Living, Health and Wellness, Youth Development Tagged With: behavior change, children and youth, Health and Wellness, intervention research

New evidence on smoking and pregnancy

November 8, 2012 By sh648 2 Comments

It’s no secret that smoking is bad for your health – and, for pregnant women, has serious impacts on the health of their unborn babies. Smoking during pregnancy not only increases the chance for early labor and miscarriage , but also lowers the unborn baby’s heart rate, limits the oxygen he receives, , and increases his risk of lung disease later in life.

Now there is new evidence that provides pregnant mothers with one more reason to avoid smoking: A new systematic review published in the British Medical Journal found that children whose mothers smoked during pregnancy were more likely to be overweight.

The analysis reviewed a total of 30 prospective studies to identify factors during pregnancy and infancy that led to obesity in childhood. Children whose mothers smoked during pregnancy were 47% more likely to be obese.

The review also found that children were significantly more likely to be overweight if their mothers were overweight before giving birth, or if they were fed solids before they were 4 months old.

There were also some factors that seemed to protect against childhood obesity. Breastfed babies were 15 percent less likely to be overweight in childhood. Babies who gained weight more slowly during infancy were also significantly less likely to become overweight as children.

The review offers some solid guidelines for mothers during pregnancy and while caring for young infants. The authors also noted medical professionals could use the findings to develop screening guidelines for pregnant mothers and young babies.

The bottom line: Nutrition and health during pregnancy and infancy has an important impact on a child’s health and well-being.

Filed Under: Evidence-Based Living, Health and Wellness Tagged With: children and youth, food and nutrition, Health and Wellness, nutrition, parenting, research translation

New evidence: Do well-visits really work?

November 5, 2012 By sh648 Leave a Comment

Over the past three decades, the U.S. health care system has put an emphasis on well-visits – annual appointments with a primary care physician to help detect any medical problems early. The idea makes perfect sense: If a doctor can identify a medical condition in the early stages, the patient can begin treatment sooner and prevent the disease from progressing.

But this turns out to be a great example of how new evidence can contradict a widely-accepted practice.

A systematic review published this month by the Cochrane Collaboration – one of our favorite data libraries – found that regular health checks-ups have no effect on a patient’s risk of developing cardiovascular disease, cancer or of dying. In other words, well visits do not decrease your risk of dying, heart disease or cancer.

The review included 14 longitudinal, randomized controlled trials. Each study included a group of adults who were offered regular health checks and a control group of adults who were not. A total of 182,880 people participated in the studies.

The health checks did have some effects. Two of the trials identified greater numbers of patients with high blood pressure, high cholesterol and chronic diseases, but these trials still did not show an increased incidence of heart disease or death in the control group.

The authors did offer several caveats: Most of the trials were conducted decades ago, when the risk factors and treatments for chronic medical conditions were different than they are today. The authors also noted that primary care physicians are likely to identify chronic problems when a patient comes in for another issue, or complains of a symptom.

What’s the take-home message here? As policy makers continue to debate the best ways to reform the U.S. health care system, they need to take into account all of the evidence on our current medical practices.

Filed Under: Evidence-Based Living, Health and Wellness

Dads influence teen sexual behavior

October 30, 2012 By sh648 1 Comment

Here at EBL, we’ve written before about why teenagers are more likely to make risky decisions compared to adults – including engaging in risky sexual activity. But we also know that parents can influence their teens’ decisions about sex—and we’re not just talking about a mom sitting down with a teen for “the talk.”

A new systematic review in the journal Pediatrics found evidence that dads have a unique influence on the sexual behavior of their adolescent children, independent of the mother’s impact.

For their analysis, researchers found 13 studies published between 1980 and 2011 that investigated fathers’ influence on sexual risk-taking for youth ages 11 to 18. They used a sweeping definition of fathers that included stepfathers, adoptive fathers and other men who acted as the primary male caregiver to teens.

What did they find? Fathers (and father figures) matter. The emotional quality of the father-child relationship makes a difference: teens who considered themselves close to their fathers tended to begin having sex later. When fathers are communicative about sex, their children are more likely to make healthy decisions. Fathers’ attitudes matter too: when dads approved of adolescent sexual activity, teens tended to start having sex earlier compared with teens whose dads did not approve.

Maybe the most interesting findings dealt with parenting style: teens with either overly restrictive or overly lenient fathers tended to have sex earlier than teens with dads who found a more balanced approach.

The take home message? Dads and male adults who act as father figures should communicate with teens about their expectations and rules surrounding sexual behavior. And though it may be hard as teens become more independent, keeping a close, positive relationship helps keep adolescent children healthy.

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

The evidence on super-sized soft drinks

October 26, 2012 By sh648 1 Comment

Next year, New York City residents must say good-bye to their super-sized sodas and Double Big Gulps. Beginning in March, the city will limit to 16 ounces the size of soft drinks sold at restaurants, street carts, movie theaters and sporting venues. The New York City Board of Health passed the proposal last month in an effort to reduce the consumption of sugary drinks thought to contribute to the nation’s obesity epidemic.

But what evidence do we have about sugary soft drinks and weight gain and harm our health? We know that sugar-sweetened drinks account for nearly half of the total added sugars Americans consume and 7 percent of our total calories. But what impact does that have on our health?

New York Times writer Jane Brody also provides an overview of some of the evidence on this topic in her column this week. There are also several systematic reviews that tell the story:

A 2007 meta analysis in the American Journal of Public Health reviewed 88 studies that examined the association between soft drink consumption and nutrition and health outcomes. The analysis found consuming soft drinks led to increased energy intake and body weight, and was associated with lower intakes of milk, calcium, and other nutrients. It also found an association between soda intake and diabetes.
Another systematic review, published in the American Journal of Clinical Nutrition in 2006 – which included 30 cross-sectional, prospective and experimental studies looking at the relationship between sugary soft drink consumption and weight gain – concluded that sugary soft drinks are associated with weight gain and obesity.
A third review published in Cambridge University’s Nutrition Research Reviews in 2008 came up with inconclusive results. The review examined 44 epidemiological studies and interventions and six meta-analyses – all looking at the relationship between sugary soda consumption and obesity. The author concluded that while sugary soft drinks are a source of calories, there is little evidence that they cause more weight gain than other sources of calories. He said the impact of sugary sodas on weight gains depends on variables including how much soda is consumed each day and the formulation of the specific drink. His review also concluded that consuming large amounts of sugary soft drinks on a daily basis is most directly associated with weight gain.

So, did the New York City Board of Health make an evidence-based decision in limiting sugary soft drink sizes? I think the answer is yes. While there is some mixed data on the association of soft drink consumption and weight gain, the evidence makes it abundantly clear that consuming large amounts of soda is the major problem. By limiting soft drinks sizes, the City is essential legislating the old adage, “Moderation in all things.”

Filed Under: Evidence-Based Living, Health and Wellness, In The Media Tagged With: behavior change, evidence-based practice, food and nutrition, Health and Wellness, nutrition, policy

Do alternative medicine treatments help us save money?

October 24, 2012 By sh648 2 Comments

As our society continues to debate how to improve the U.S. health care system, some researchers and policy makers are asking whether alternative therapies such as massage, acupuncture and aromatherapy are effective, and whether they help save money by resolving medical problems.

On a personal note, I’ve always been intrigued by medical treatments that fall outside of western medicine. I received acupuncture when I was pregnant with my son. He was breech, and there is some evidence that acupuncture can help babies to turn into the right position. (After trying several other treatment options including chiropractic adjustments and yoga, he did turn around, although it’s difficult to determine exactly what helped.)

A new systematic review published in British Medical Journal Open analyzes cost studies on complementary and integrative medicine from 2001-2010. For the analysis, the researchers found 204 cost analysis studies of alternative medicine treatments. But only 22 of the studies met quality standards to be included in the review.

In an analysis that reviews broad array of medical conditions, it’s difficult to come up with a single conclusion. But the review did find that some alternative treatments yielded the same or better results as traditional medical treatments. In total, ten treatments showed cost savings. Among them are acupuncture for breech delivery, acupuncture for low back pain, tai chi for avoiding hip fractures and nutritional supplements to prevent cataracts.

The review concludes that there is some real potential in saving money in our health care system and helping people heal faster through alternative medicine treatments. But more high-quality studies are needed that measure economic as well as health outcomes, and combine alternative treatments with typical care methods to measure how they work together.

Filed Under: Evidence-Based Living Tagged With: alternative treatments, economics, evidence-based practice, Health and Wellness

Do exercise programs for kids really work?

October 17, 2012 By sh648 1 Comment

Nearly 12.5 million children – or 17 percent of the U.S. population ages 2-19 – are obese. As a response to this growing problem, schools and community groups have launched intervention programs designed to get kids moving. But do they work?

A new meta analysis published last month in the British Medical Journal was designed to answer just that question. It included 30 studies on exercise programs for children published worldwide between January 1990 and March 2012.

Studies in the review measured the effects of intervention programs that targeted children under 16 years old and lasted for at least four weeks. To be included, studies had to definitively measure levels of physical activity in children throughout the day – not just during the intervention class period – with devices like motion sensors.

In each case, the investigators expected that the programs would increase the children’s overall daily physical activity.

The review uncovered some surprising evidence: programs designed to encourage increased physical activity among kids didn’t work. On the whole, the programs increased children’s overall physical activity levels by about 4 minutes a day – even though the programs themselves ranged from 30 to 90 minutes in length.

One explanation is that children unconsciously compensate for the energy they use during structured activity programs by being doing sedentary activities aftewards, Brad Metcalf, a research fellow and medical statistician at Peninsula College who led the review, told the New York Times. Another explanation is that many of the programs took place after school, replacing a time period when children are typically most active anyway.

This analysis did yield some clear results: that we need to come up with additional strategies for encouraging physical activity among children.

Filed Under: Evidence-Based Living, Health and Wellness, Youth Development Tagged With: behavior change, children and youth, Health and Wellness, intervention research

Gender bias in the field of medicine?

October 11, 2012 By sh648 Leave a Comment

In the early- and mid-1900s, women were forbidden to attend medical school or practice medicine across the United States. While our society has made great strides in encouraging women to join and even become leaders in professions like medicine, it is important to understand how these efforts are playing out in real life.

For a new review published in the Journal of General Internal Medicine, researchers conducted a survey of 4,578 full-time faculty at 26 U.S. medical colleges. They found that women made up only 19 percent of full professors and only 12 percent of department chiefs. Their survey also found that while men and women were engaged in their work to a similar degree and both groups had similar aspirations for leadership roles, women did not feel the same sense on inclusion in their profession and were not as confident about their ability to be promoted.

The study confirms research by Cornell Professors Wendy Williams and Steve Ceci, who have dedicated their careers to understanding why women are more likely to pursue advancement in science and technology fields like physics, chemistry, mathematics and engineering.

The husband-and-wife team has published a major systematic review that concludes women tend to drop out of math and science related fields because they shoulder more responsibility of caring for young children – and this duty often coincides with the most demanding years of their careers.

What’s the answer? It’s clear that more research is needed to find out the support systems and environments needed to help women fulfill their career goals. From my perspective, more flexible schedules, accessible and quality childcare and longer maternity leaves would go a long way in helping women to achieve career advancement and raise their families at the same time.

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

The evidence on arsenic and rice

October 9, 2012 By sh648 2 Comments

The magazine Consumer Reports released a study last month that revealed low levels of arsenic – a chemical element that is toxic when consumed in higher doses – in rice and rice products grown across the world.

The study tested 223 types of rice and rice products – such as rice-based cereals and rice milk – purchased in the United States in April, May and August of this year. It found arsenic in every product it tested, and dangerous levels of inorganic arsenic in dozens of products. Consumer Reports the story points out that their study is “a spot check of the market and “too limited to offer general conclusions about arsenic levels in specific brands within/across rice product categories.” Nevertheless, their article raises some surprising questions about toxins in our food supply.

Following the Consumer Reports study, the U.S. Food and Drug Administration released some preliminary results of a long-term study on arsenic levels in our food supply. Their study found levels of arsenic in rice similar to the Consumer Reports study.

So, what’s a rice-lover to do? Consumer Reports recommends limiting consumption of rice and rice products, while the FDA is not recommending any limits on rice consumption.

Since the FDA and Consumers Reports found the same level of arsenic in food, the question in my mind is: Exactly how dangerous is low-level exposure to arsenic? A search of systematic reviews yielded some interesting results.

One meta-analysis found consuming arsenic in drinking water is associated with a higher risk of lung cancer.
Another analysis found chronic arsenic exposure can lead to mental retardation and developmental disabilities such as physical, cognitive, psychological, sensory and speech impairments – although in higher levels that measured in the rice products tested by Consumer Reports and the FDA.
Other analyses found inconclusive results on the relationship between arsenic exposure and diabetes and arsenic exposure and cardiovascular disease – although both of these reviews identified limitations in the study methodology and called for additional research.

My plan is to think more carefully about the rice products my family consumes. I’m not going to throw out the brown rice in my pantry, and we will still enjoy stir fry and sushi on a regular basis. But I certainly plan to steer way from rice cereals and other rice products at the grocery store.

Filed Under: Evidence-Based Living, Health and Wellness, policy Tagged With: agriculture, evidence-based practice, food and nutrition, Health and Wellness, nutrition, policy, research translation, science in the media