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| CENTER
FOR THE ADVANCEMENT OF HEALTH |
DECEMBER
2005
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Reframing
the Suboptimal
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The
Center for the Advancement of Health translates
to the public the latest research on prevention,
chronic disease management and health care, with
an emphasis on how social, behavioral and economic
factors affect illness and well-being. The Center
is an independent nonprofit corporation that
receives core funding from the John D. and Catherine
T. MacArthur Foundation and The Annenberg Foundation.
D
I S C O N N E C T
Despite
its widespread use since
ancient times traction
to help treat low back pain has no benefit, according
to a new systematic evidence review. Study author Judy M.A. Clarke, M.D., says
traction was introduced before it was properly evaluated in high-quality randomized
trials and that it is hard to persuade health care providers not to use it. Clarke
analyzed 24 studies involving 2,177 patients and found, “Neither continuous
nor intermittent traction by itself is more effective in improving pain, disability
or work absence than placebo, sham or other treatments.” Clarke JA,
et
al. Traction for low-back pain with or without sciatica (review). The Cochrane
Database of Systematic Reviews 2005, Issue 4.
T
O P_M E D I A_H
I T S
Center
President Jessie Gruman had an op-ed piece published
in the Chicago Sun-Times on Oct. 29 about how
to
best prepare for avian influenza and a letter to the editor of the Washington
Post Nov. 1 on the same topic.
A
Health Behavior News Service story about a Cochrane
Library review finding
no link between MMR vaccines and autism was used by the
Washington Post, Boston
Globe, Newsday, U.S. News & World Report and Reuters, among others.
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As
Donald Rumsfeld once famously noted, “There are
known knowns; there are things we know we know. We
also know there are known unknowns; that is to say
we know there are some things we do not know. But there
are also unknown unknowns - the ones we don’t
know we don’t know.”
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Jessie
Gruman
President
and Executive Director
Center for the
Advancement of Health
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Welcome to the world of health research!
As
someone devoted to translating evidence about health
into healthy behavior, I am constantly concerned about
how much we don’t know and perplexed at why we,
as a society, we still cannot put into practice all the
things we do know.
For instance:
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An
article in the journal Psycho-Oncology reflects the
reality that while cancer treatment is almost entirely
biomedical, most cancer patients are in dire need
of emotional care physicians don’t usually provide.
The
National Institutes of Health advises that cognitive
behavioral therapy is as effective as sleeping
pills for insomnia but the pharmaceutical industry
sold $2.1
billion worth of them last year, getting doctors
to write 35 million prescriptions.
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Evidence
beyond any doubt led pediatricians to plead with
parents to put their infants to sleep on their
backs.
Now, the New York Times reports a growing
trend for parents to put babies on their stomachs – so
they will sleep quieter.
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A
government survey reveals that 43 percent of
Americans with emphysema continue to smoke
after they are diagnosed.
The survey also found that 22 percent of
people with asthma, 21 percent of stroke victims
and
20 percent of
people with cardiovascular problems say
they continue to smoke.
Why
are these dangerous disconnects so numerous?
Science columnist Sharon Begley of the Wall
Street Journal suggests that “brains have a remarkable talent
for reframing suboptimal outcomes to see setbacks in
the best possible light.” She was reporting on
an article in Science supposing that “the relationship
between intentions and outcomes may sometimes be far
looser than what current theorizing has suggested.”
This
inherent human capacity to reframe bad news is more obvious
in politics and war
than in health.
But
at the
same time, seemingly unwarranted
optimism may be useful in certain areas of behavior,
especially
around New
Year’s
Day. People do seem willing to try again and again to
quit smoking or to lose weight despite repeated failures
in the past – and often they
finally do succeed.
It
is true that “we don’t know what we don’t
know,” but we do know one thing: We can use solid
scientific support to better understand risk, to shape
public policy, to guide personal resolutions and to protect
and improve our health and that of our nation.
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APPOINTMENT: The
Center has named Douglas
Kamerow, M.D., Ph.D.,
and Dean Robinson, Ph.D., to its board
of trustees. Dr. Kamerow is chief scientist, health
social, and
economics research at Research Triangle Institute and
is U.S. editor of the British Medical Journal. Dr.
Robinson is associate professor of political science
at the University of Massachusetts at Amherst. His
research focuses on African-American politics, social
movements and political thought.
GRANT: The Center for the Advancement of Health was awarded
a $3.5 million grant from the W. K. Kellogg Foundation to work
to eliminate racial and ethnic health disparities by linking
Kellogg Health Scholars, communities, public health practice,
research, academic institutions and policy development. This
new program is the successor to the two successful postdoctoral
programs supported by the W.K. Kellogg Foundation over the
past decade -- the Scholars in Health Disparities Program and
the Community Health Scholars Program. Building on the achievements
of these two programs, the Kellogg Health Scholars Program
will have two tracks -- a multidisciplinary-disparities track
and a community-disparities track -- and will have the objective
of linking research, policy and community. The Center's Barbara
Krimgold is co-director of the Kellogg Health Scholars Program
and director of the multidisciplinary-disparities track. The
University of Michigan's Toby Citrin is co-drector of the Kellogg
Health Scholars Program and drector of the community-disparities
track. For more information, go to http://www.kellogghealthscholars.org.
AWARD:
Research!America, the alliance that advocates a higher
national priority
for medical and health research, has
named the Center for the Advancement of Health the winner
of its award as the “Organization that has Distinguished
Itself by Its Advocacy.” The award will be presented
at Research!America’s 10th anniversary gala March
21, 2006. “The Center has made an outstanding contribution,
through advocacy on a national level, toward demystifying
health care and medical research and successfully translating
health behavior research into effective policy and practice," said
Mary Woolley, president and CEO of Research!America.
NEW
OUTLET: Publisher McGraw-Hill’s
AccessMedicine online clinical library for doctors now
features daily feeds from the Center’s Health Behavior
News Service and the Health Behavior News Digest.
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HEALTH AND BEHAVIOR INFORMATION TRANSFER
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The National Institutes of
Health has
selected David Mechanic as the first recipient of the Annual
Matilda White Riley Lecture in the Behavioral Sciences. The
lecture will take place 3 p.m. May 22, 2006, at Building
1 of the NIH in Bethesda, Md. Dr. Mechanic is director of
the NIMH Center at Rutgers for Research on the Organization
and Financing of Care for the Severely Mentally Ill. ---
The
deadline for nominations for the Community-Campus
Partnerships for Health Annual Award is Jan.
20, 2006. The award recognizes exemplary partnerships
between communities and higher educational
institutions that build on each other’s
strengths to improve health professional education,
civic engagement and the overall health of
communities. For more information go to http://depts.washington.edu/ccph/awardsfaq.html
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Applications
are due Jan. 31, 2006, for the Sixth Annual Summer
Institute
on Randomized Clinical Trials Involving Behavioral
Interventions to be held July 9-21, 2006, at
the Airlie Conference Center in Virginia. Go
to http://obssr.od.nih.gov/Conf_Wkshp/rct/RCT_Info.htm.
for more information.
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