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Researchers Use Twitter To Track Diseases And Public Health Issues

A researcher has used social media to track attitudes about vaccination and how they correlate with vaccination rates, in the process creating a novel model to track a variety of disease states.

The study adds to a growing body of evidence that social networking can be used to track diseases and other natural disasters that affect public health. Earlier this year, researchers used Twitter to track rapidly-evolving public sentiment about H1N1 influenza, and found that tweets correlated with actual disease activity. Before that, researchers analyzed how Twitter was used to disseminate information (and misinformation) about flu trends.

In the latest study, Read more »

*This blog post was originally published at ACP Internist*

Vaccination Rates For Health Care Workers At A Dismal Level

A 3D graphical representation of a generic influenza virion’s ultrastructure, by CDC/ Doug Jordan, M.A. Health care workers’ fear of flu shots has risen as an issue again.

Refusing flu vaccination has risen among health professionals again and again. And again. And again and again.

Vaccination rates for health care workers stands at 35%, which is “a dismal rate,” according to Margaret C. Fisher, MD, a pediatric disease subspecialist and the medical director of The Children’s Hospital at Monmouth Medical Center. She spoke about vaccinating adults and health care workers at Internal Medicine 2011.

The issue is as annual as the flu itself, and this time, a physician at London’s Imperial College NHS Trust has jumped into the debate, tackling misinformation given within his country’s own health service. He said: “A very interesting question for me is Read more »

*This blog post was originally published at ACP Internist*

More Evidence Of The Safety And Effectiveness Of Vaccines

One of the basic human “needs” is the desire for simplicity. We have limited cognitive resources, and when we feel overwhelmed by complexity one adaptive strategy is to simplify things in our mind. This can be useful as long as we know we are oversimplifying. Problems arise when we mistake our schematic version with reality.

In this same vein we also like our narratives to be morally simple, so there is a tendency to replace the complex shades of gray with black and white. This is perhaps related to cognitive dissonance theory. We have a hard time reconciling how someone can be both good and bad, or how a good person can do bad things. So there is also a tendency to see people as all good or all bad. We can transcend these tendencies with maturity and wisdom, but that takes work.

A good example of the desire for simple moral clarity is the anti-vaccine movement. Their world is comprised of white hats and black hats (guess which one they perceive themselves as wearing), as evidenced by the blog posts and comments over at Age of Autism. There is a certain demand for purity of thought and message that seems to be getting worse over time in a self-reinforcing subculture. Many now see their struggle in apocalyptic terms.

The desire for simplicity even extends to factual claims. Read more »

*This blog post was originally published at Science-Based Medicine*

New Study Supports Previous Evidence That Autism Is Triggered In Utero

Science has found no evidence that vaccines cause autism; but the true cause(s) of autism have not yet been determined. So far the available evidence has pointed towards a largely genetic cause with possible interaction with environmental factors. A new study supports that interpretation. It also supports previous evidence that autism is triggered prior to birth, rather than at the time of vaccinations.

Schmidt et al. published a study in Epidemiology on May 23, 2011, entitled “Prenatal Vitamins, One-carbon Metabolism Gene Variants, and Risk for Autism.” It was a population-based case control study of 566 subjects comparing a group of autistic children to a matched control group of children with normal development. They looked at maternal intake of prenatal vitamins in the 3 months before conception and the first month of pregnancy, and they looked for genotypes associated with autism. They found that mothers who didn’t take prenatal vitamins were at greater risk of having an autistic child, and certain genetic markers markedly increased the risk. There was a dose/response relationship: the more prenatal vitamins a woman took, the less likely she would have an autistic child. There was no association with other types of multivitamins, and no association with prenatal vitamin intake during months 2-9 of pregnancy.

They had a large sample size, and they tried to eliminate confounders. They looked for these potential confounders of the association between prenatal vitamin intake and autism: child’s sex, birth year, parent-reported race/ethnicity, family history of mental health conditions, paternal age at child’s birth, maternal age at child’s birth, education, prepregnancy body mass index (BMI) category, cereal intake from 3 months before through the first month of pregnancy, cigarette smoking, alcohol consumption, and residence with a smoker during the period 3 months before pregnancy to delivery. Only maternal education and the child’s year of birth proved to be confounders. They adjusted for these two factors in their analyses. A weakness of their study is that it depends on patient recall long after the fact. Also, it did not attempt to gather any diet information.

Mothers of children with autism were less likely to report taking prenatal vitamins (odds ratio 0.62). Having certain genotypes increased the odds that a vitamin-omitting woman would have an autistic child. Children with the COMT 472 AA gene were at increased risk of autism. If their mothers took prenatal vitamins, the odds ratio for the risk of autism was 1.8; if their mothers didn’t, the odds ratio jumped to 7.2.  This suggests that the maternal-fetal environment can magnify the effects of a child susceptibility gene. There was an association with certain maternal genes as well: those odds ratios went as high as 4.5.

The association was robust. The authors think Read more »

*This blog post was originally published at Science-Based Medicine*

Many Parents Still Lack Confidence In Vaccines

Some parents remain unpersuaded that all childhood vaccines are safe or even necessary, a new survey published in Health Affairs shows.

Photo by James Gathany via the CDCWhile most parents vaccinate their children, they lack confidence in them, researchers pointed out. Parental education should include thorough explanations why infants should be fully immunized before age two.

Vaccination levels for most recommended vaccines were above 90% of national immunization goals in 2009, reported the CDC’s National Immunization Survey. But, researchers wrote, high immunization rates aren’t the same as high confidence in the vaccines.

Using data from the 2010 HealthStyles survey of 6,253 households (response rate 67%), researchers identified Read more »

*This blog post was originally published at ACP Internist*

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Latest Book Reviews

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

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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