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Changing One’s Behavior Is Harder Than It Looks

Glenn Laffel, M.D., Ph.D., of Pizaazz hypothesizes about why we often don’t make changes that would benefit our health. He says:

“Somewhere in the course of our daily lives, though, most of us do exhibit behavior that suggests at least some disregard for our health. We don’t change our diet, though we know we should. We don’t floss, take medications as prescribed, or get the screening tests we’re supposed to.”

He knows multiple complex causes exist for this and questions whether being diagnosed with a chronic condition motivates people to improve health behaviors exploring whether the delay between health behaviors and health outcomes contributes to unhealthy behavior. After looking at attrition rates in a diabetes self-management program, he concludes:

“It calls attention to a key distinction behavioral psychologists like to make in explaining human motivation: there’s a difference between awareness of the need to act, and the volition to act.”

Family doctor Kenny Lin, M.D., previously recommended that people “tackle one behavior at a time.” He says: Read more »

*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*

Red-Light Cameras Save Lives

Most people don’t like them. Privacy advocates abhor them. But, really– how many things can you name that save lives AND generate revenues for cash-strapped local and state governments? Red-light cameras are one such item.

A recent study by the Insurance Institute for Highway Safety has shown that red-light cameras saved 159 lives over a four-year period in the 14 large U.S. cities where the study took place. The scientists claimed that more than 800 traffic fatalities would have been prevented during the course of the study if the cameras had been deployed in all large U.S. cities.

The scientists compared fatal car crash rates in U.S. cities with populations of at least 200,000 for two four-year periods: 1992 to 1996 and 2004 to 2008. They excluded cities that had already deployed red-light cameras in the earlier period, and cities that instituted cameras during the later period.

In the 14 cities that used red-light cameras during 2004 to 2008, the rate of fatal red-light running crashes was 35 percent lower than in 1992 to 1996. The crash rate did drop in cities that never deployed camera programs, but only by 14 percent.

Based on these data, the scientists determined that the rate of fatal red-light running crashes was 24 percent lower in cities with cameras in 2004 to 2008 than it would have been had they not deployed the cameras. In fact, the benefits of red-light cameras were actually larger than this. The rate of all fatal crashes at intersections with signals (not just red light running crashes) dropped by 14 percent in cities that deployed red-light cameras, whereas it increased by 2 percent in other cities. Read more »

*This blog post was originally published at Pizaazz*

Drunk Fans At Sporting Events

Among fans who attend live sporting events, drinking alcohol is nearly as commonplace as root-root-rooting for the home team. And while virtually no one has a problem with a fan who pushes back a beer or two during the game, flat-out drunk fans can ruin the experience for those sitting nearby. Worse yet, these people frequently get behind the wheel of a car after the game is over.

Recently, Darin Erickson and colleagues at the University of Minnesota decided to find out just how many fans go overboard at games, and their findings are worrisome, indeed. Using standard blood alcohol testing on 362 adult volunteers who were leaving 13 professional baseball and three professional football games, the scientists found that 40 percent had measurable levels of alcohol in their blood and a stunning eight percent were legally drunk (as defined by a blood alcohol level of .08 or greater). The highest alcohol level recorded by the scientists was .22.

Erickson’s group also observed that Monday Night Football attendees were more likely than other fans to have been drinking. In addition, fans who were 35 years old or younger were eight times more likely to leave the game drunk, and those who attended tailgating parties before the game were 14 times more likely to leave the game drunk.

The latter finding is consistent with a study from the University of Toledo, in which scientists gave breathalyzer tests to tailgaters at a college football game. The scientists found that an astounding 90 percent of the participants consumed alcohol during tailgate festivities, and among them, the average blood alcohol concentration was 0.06, well on the way to being legally drunk.

Maybe these people should save the money they spent on tickets and go to a bar. Erickson’s study was published in Alcoholism: Clinical & Experimental Research.

*This blog post was originally published at Pizaazz*

Weight-Loss Counseling: Is Race A Factor?

Most people know that the U.S. is struggling to contain a surging epidemic of obesity, and that the problem is most acute among African-Americans. Whereas about 27 percent of all adult Americans are obese (defined as having a body mass index of 30 or more), fully 37 percent of African-American adults are obese, and that number jumps to an appalling 42 percent among African-American women.

Over the years, public health officials have provided evidence that socioeconomic and cultural factors drive this racial disparity. Now, a new study suggests there is another reason as well: Obese African-Americans receive less obesity-related counseling than their white counterparts, and it matters not whether the physicians they see are African-American or white.

To reach these conclusions, Sara Bleich and colleagues from the Johns Hopkins School of Public Health used clinical encounter data from the 2005–2007 National Ambulatory Medical Care Surveys (NAMCS). The sample included 2,231 visits involving African-American and white obese people who were at least 20 years old and who visited family practitioners and internists that were either African-American or white. Asian and Hispanic patients and physicians were excluded from the study because their numbers were too small to permit hypothesis testing.

For each encounter in the study, the scientists determined whether the patient received guidance on weight reduction, diet and nutrition, or exercise from his or her physician. Read more »

*This blog post was originally published at Pizaazz*

Nutrition Labels For Alcoholic Beverages?

Virtually all bottled beverages you can buy have handy-dandy nutrition labels from which you can access information about calories, carbs, and so forth. All beverages except the ones containing alcohol, that is. Why is that?

Maybe it’s because alcoholic beverages contain little to no protein, sodium, cholesterol, Vitamin A, Vitamin C, calcium and iron (remember that alcohol is metabolized as a fat, not a carbohydrate) — so why bother? Then again, alcohol does contain calories — a lot of them. Would people drink less if they knew how many calories they were consuming? Would they drink less if they knew how many “servings” of alcohol were contained in the bottle they just purchased?

Maybe it’s because of the cost of performing nutritional analyses on each vintage of wine, each and every year, would turn profitable vineyards into money losers? Then again, plenty of niche beverage producers who run reasonably narrow margin businesses have never complained about the requirement to provide nutritional information.

The Tax and Trade Bureau is the federal agency that decides what information must appear on the labels of alcoholic beverages. Currently, it does not require manufacturers of wine, beer and the hard stuff to list ingredients. It does require them to list chemicals that folks might have an adverse reaction to things like sulfites, aspartame, and dyes.

The Tax and Trade Bureau also mandates that wines containing 14 percent or more alcohol by volume must state this fact on a label. Wines containing less than 14 percent can either specify the alcohol content or affix the words “light wine” or “table wine” to their labels. In addition, “light” beer bottlers must state calorie and carbohydrate content, and distilled liquor bottlers must specify the alcohol content by volume. Read more »

*This blog post was originally published at Pizaazz*

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When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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