Saturday, July 9, 2016

Fast-food “swamps” linked to greater diabetes risk | University of Toronto

Canadians under the age of 65 have a greater risk of developing diabetes if they live near a high number of fast-food restaurants and few healthier dining options, known as fast-food swamps, according to researchers at the Dalla Lana School of Public Health.

The study, Relative and absolute availability of fast-food restaurants in relation to the development of diabetes: A population-based cohort study, published on June 9, 2016 in the Canadian Journal of Public Health, is the first in Canada to examine whether living within walking access to various types of restaurants within urban residential areas influences the risk of developing diabetes among adults.

At the outset of the study, researchers identified individuals without diabetes and followed them forward in time to see who did or did not develop diabetes. After accounting for individual- and neighbourhood-level socio-economic factors and neighbourhood walkability, researchers found that individuals had a 79 per cent higher risk of developing diabetes when their neighbourhoods had a disproportionately high volume of fast-food outlets and few restaurants of another type.

"Our results show that having restaurant options that offer healthier alternatives to fast-food — for example cafes, sit-down restaurants or coffee shops — may be important for mitigating people's risk of developing diabetes," said Jane Polsky, a PhD candidate in the Division of Social and Behavioural Health Sciences. "The double whammy of having high numbers of fast food restaurants with few healthier alternatives was associated with the highest risk of diabetes."

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Friday, July 8, 2016

A Medical Mystery of the Best Kind: Major Diseases Are in Decline - The New York Times

Something strange is going on in medicine. Major diseases, like colon cancer, dementia and heart disease, are waning in wealthy countries, and improved diagnosis and treatment cannot fully explain it.

Scientists marvel at this good news, a medical mystery of the best sort and one that is often overlooked as advocacy groups emphasize the toll of diseases and the need for more funds. Still, many are puzzled.

"It is really easy to come up with interesting, compelling explanations," said Dr. David S. Jones, a Harvard historian of medicine. "The challenge is to figure out which of those interesting and compelling hypotheses might be correct."

Of course, these diseases are far from gone. They still cause enormous suffering and kill millions each year.

But it looks as if people in the United States and some other wealthy countries are, unexpectedly, starting to beat back the diseases of aging. The leading killers are still the leading killers — cancer, heart disease, stroke — but they are occurring later in life, and people in general are living longer in good health.

Colon cancer is the latest conundrum. While the overall cancer death rate has been declining since the early 1990s, the plunge in colon cancer deaths is especially perplexing: The rate has fallen by nearly 50 percent since its peak in the 1980s, noted Dr. H. Gilbert Welch and Dr. Douglas J. Robertson of the Geisel School of Medicine at Dartmouth and the Veterans Affairs Medical Center in White River Junction, Vt., in a recent paper.

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How Scared Should I Be of Hospitals? | VICE

I've always liked hospitals in a way. They're clean, well-lit places, where smart people rush around trying to fix problems with modern technology.

But being in the hospital is hell. You surrender all power and turn into a prop, to be dealt with by people who are at work. They calmly break your skin, and think nothing of looking at your genitals or your shit. The whole experience is mostly just waiting for something interesting to happen, which means bouncing back-and-forth between boredom and creeping menace. And the whole time you're surrounded by the beeps and whirrs of machines that sound unmistakably like a TV character's death.

Fear of hospitals is visceral. It needs no explanation. But there are real risks involved in being at a hospital. Some, like waking up during surgery, can't be prevented by worrying. But steps can be taken to avoid some things, such as bacterial infections. So is there such a thing as a healthy fear of hospitals that we should actively cultivate?

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Thursday, July 7, 2016

A Snooze-Worthy App Collection to Add to the Smartphone - The New York Times

With smartphones, tablets and smart watches glowing and buzzing on our night stands, it's no wonder that low-quality sleep has become a public health problem. Sleep-monitoring apps for smartphones can help.

One app that has given me good results is SleepBot (free on iOS and Android), which has provided insights into my sleeping habits and helped me work out the distractions and habits that seem to mar my sleep.

As with many other sleep apps, you set an alarm time, then slide your phone under your pillow while keeping the phone plugged in to your charger so you don't wake up to a drained battery. As you shift through various stages of sleep during the night, SleepBot logs your body's moves.

When it's time for your alarm to go off, SleepBot waits until your phone's sensors detect that you're moving more, which means you are probably in a period of light sleep. Then it sets off your alarm.

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Tuesday, July 5, 2016

Google's DeepMind to use AI in diagnosing eye disease - USA Today

Google plans to use more than one million anonymized eye scans to teach computers how to diagnose ocular disease.

The Menlo Park, Calif.-based company has signed a deal with a British eye hospital to use artificial intelligence to learn from the medical records of 1.6 million patients in London hospitals.

The goal is to teach a computer program to recognize the signs of two common types of eye disease, diabetic retinopathy and age-related macular degeneration.

That's something humans are surprisingly imperfect at. Physicians diagnose these ailments by analyzing medical charts and interviewing patients, yet still get it wrong 10 to 20% of the time.

Artificial intelligence could enable a machine to scan millions of records and documents, learn from them and then make more accurate diagnoses and save time while doing so.

The partnership, announced Monday, is between DeepMind, an artificial intelligence company owned by Google, and Moorfields Eye Hospital in London.

"With sight loss predicted to double by the year 2050, it is vital we explore the use of cutting-edge technology to prevent eye disease." Peng Tee Khaw, director of the National Institute for Health Research's Biomedical Research Centre in Ophthalmology at Moorfield Eye Hospital, said in a release.

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The Threshold - The New Yorker

Heather Meyerend is a hospice nurse who works in several neighborhoods in South Brooklyn—Sheepshead Bay, Mill Basin, Marine Park, Bensonhurst, Bay Ridge. She usually has between sixteen and twenty patients, and visits each at home once a week, sometimes more. Some patients die within days of her meeting them, but others she gets to know well, over many months. She sees her work as preparing a patient for the voyage he is about to take, and accompanying him partway down the road. She, like most hospice workers, feels that it is a privilege to spend time with the dying, to be allowed into a person's life and a family's life when they are at their rawest and most vulnerable, and when they most need help. Some hospice workers believe that working with the dying is the closest you can get on earth to the presence of God.

Heather is not brisk or efficient, as nurses in hospitals are. She is purposely inefficient, in fact. Most of the time when she visits patients, she doesn't have much to do: she takes vital signs, she checks that there are enough supplies and medications in the house, she asks if old symptoms have gone away or new ones developed. If she were rushing, she could do all that in about five minutes, but her visits usually last an hour or more. Sometimes there is a complicated medical situation to take care of. Sometimes she does something non-medical that needs to be done, which is the hospice way—she might sweep a floor, she might heat up dinner. But, even when there's nothing else to do, the idea is to be around longer, to chat, to sit close by, to put her hands on the patient's skin as she goes about her checkup. Her visit may be the high point of the day for the patient, who may not be able to get out of bed, or for whoever is taking care of the patient, who may not have left the house or seen anybody else for a day or two; either or both of them may be going a little crazy and may badly need interruption or variety of any kind, ideally someone different to talk to. So Heather moves slowly; she sits down; she delays; she lingers.

Dying can be long and bewildering, lonely and painful, frequently undignified, and consumed by pressing and unpredictable and constantly changing and multiplying needs. It's a relief to have someone around who understands what's going on and what may happen next. On the other hand, when dying is long it becomes ordinary, just another kind of living, but one in which your friends may be gone and your children busy, or not busy enough. In that case, it can be a good thing to see someone who is not a member of your family; who comes from the world outside your illness; who has known you long enough to be familiar but not long enough to have heard your stories already; who wants to know where your pain is but doesn't need you to explain everything; and who is there to take your vital signs but who behaves as though she might have come over to borrow a snow shovel or a couple of eggs.

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What’s up, doc? Tell me over my smartphone, please -

This year, a German businesswoman arrived in Washington DC and promptly developed a painful sinus infection. She searched online and found a local doctor, Suzanne Doud Galli. But instead of ordering a taxi to visit Dr Galli's office, the patient arranged a virtual consultation via her smartphone from the comfort of her hotel room, with the help of an app called HealthTap.

The app's algorithm matched the patient's symptoms with Dr Galli's expertise. Dr Galli prescribed medicine and sent the prescription electronically to a pharmacy near the patient's hotel — all in about 10 minutes.

"I think this is the future of medicine," says Dr Galli. "Most primary care physicians are going to have virtual medicine in their office, because patients won't waste their time going to a doctor's office when they can ask a question online."

Companies such as HealthTap, which has signed up 100,000 US doctors to serve its global audience in 100 countries, are seeking to find a niche in the increasingly crowded market known as telemedicine.

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Monday, July 4, 2016

NYTimes: Can You Get Over an Addiction?

I shot heroin and cocaine while attending Columbia in the 1980s, sometimes injecting many times a day and leaving scars that are still visible. I kept using, even after I was suspended from school, after I overdosed and even after I was arrested for dealing, despite knowing that this could reduce my chances of staying out of prison.

My parents were devastated: They couldn't understand what had happened to their "gifted" child who had always excelled academically. They kept hoping I would just somehow stop, even though every time I tried to quit, I relapsed within months.

There are, speaking broadly, two schools of thought on addiction: The first was that my brain had been chemically "hijacked" by drugs, leaving me no control over a chronic, progressive disease. The second was simply that I was a selfish criminal, with little regard for others, as much of the public still seems to believe. (When it's our own loved ones who become addicted, we tend to favor the first explanation; when it's someone else's, we favor the second.)

We are long overdue for a new perspective — both because our understanding of the neuroscience underlying addiction has changed and because so many existing treatments simply don't work.

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