Discussion Topic Week 7

The discussion topic this week is “Should people who willingly engage in behavior that can cause self-infliction of disease or conditions be required to take health promotion or disease prevention classes?

I do not believe that requiring these people to take a class will change their behavior. In the example of cigarette smokers, I’m confident they are aware that it is not healthy for them to smoke. There are scientific studies, warning labels on the packages, proactive campaigns to spread awareness of the health issues, and even laws prohibiting smoking in certain areas. This has been going on for long enough in this country for it to be considered common knowledge that smoking cigarettes is bad for your health, and yet there are still many people who smoke. I have never met a person who wasn't aware of the possible consequences of smoking, and yet they are able to rationalize a reason for not quitting. This is actually a common theme in people who are addicted, whether it is to smoking, alcohol, or other drugs. There is actually an entire scientific journal dedicated to studying this type of behavior “AddictiveBehavior”. People who are addicted to something cannot be convinced by educational materials or disease prevention classes. It takes psychological help to determine the root cause of the problem causing them to self-harm, and then a plan to bring them back to positive behavior. This goes beyond anything provided in a health promotion class.

There are times when providing more information to someone is no longer beneficial. We see this a lot in public health, and it is the reason why we resort to implementing policy rather than relying on outreach programs. In the case of addictive drugs it is more effective to make them illegal than to implement an educational outreach program and require users to take a health promotion class. In that context it is easy to see how restricting access is the right choice. When we are talking about the context of over-eating, it becomes more difficult since we all have to eat to live. Finding a balance between educational outreach and restricting particularly unhealthy foods seems to be the current way of thinking, and it remains to be seen how effective it is. Again, most people understand that a cheeseburger, large fries, and a large soda is not a healthy meal, but that doesn't stop millions of people from eating them every day. With the current education programs most people should be aware that eating these unhealthy foods can lead to diabetes, heart disease, and many other deadly conditions, but that still doesn't stop them. It’s going to take a radical change in policy to truly address this issue, because people will never make the choice for themselves.

Discussion Topic Week 6

This week’s discussion topic is about whether mandatory full body scans are a good idea for the population of Fort Worth. From the context of the original question I am assuming a full body scan refers to a CT scan.

First of all, what is a CT scan? According to the Envison Radiology website it is process that uses a series of X-ray images taken from various angles around the body. Computers then combine the images to make a 3D image of ones bones and soft tissues (Envision Radiology). How do doctors use this information? It is possible for doctors to view bone disorders, tumors, and internal injuries without having to do any invasive procedures. The ability to detect tumors and other disorders makes it a valuable tool for early cancer diagnosis.

That all sounds great, so it’s no wonder that physicians order them so frequently. There’s no harm in an early cancer diagnosis, right? Well, there is some conflicting information out there. A study found that childhood leukemia rates nearly tripled with exposure to CT scans (Pearce, Salotti, Little, McHugh, Lee, 2012). A review of the risks by Dr. Rita Redberg estimates there could be approximately 15,000 deaths resulting unnecessary CT scans that were performed in 2007 alone (Redberg, 2009). On the other hand, two doctors from the Mayo clinic believe that because the increase in radiation exposure is so low the the benefits outweigh the risks (Hara & McCollough, 2013). The one thing that became clear is that not everyone agrees on the dangers of scanning.

After conducting more research a trend emerged. The articles that promoted CT scans by saying they had minimal risk did not cite any specific scientific research to support their claims. Most were written by the medical community, but that could mean they have an agenda to profit from extra scans. All of the research that suggested increased exposure to radiation from CT scans resulted in an increased risk of cancer came from peer reviewed scientific journals. Finally I found a study that showed a clear correlation between CT scans and cancer rates (Smith-Bindman, Lipson, Marcus, Kim, Mahesh & Gould, 2009), and I made up my mind. I do not believe that full body scans should be mandatory. The increased radiation amounts do not provide enough benefit to the general population to be beneficial. I completely support their use in emergency situations, to support a diagnosis, and even if there is a strong medical history of cancer, but they should not be mandatory for healthy individuals, especially children.

 
References:
CT Scans at Envision Radiology. (n.d.). CT Scans at Envision Radiology. Retrieved April 14, 2014, from http://www.envrad.com/services-ct-scans.html

Pearce, M., Salotti, J., Little, M., McHugh, K., & Lee, C. (2012, June 6). Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: a retrospective cohort study. The Lancet, 380, 499-505.

Redberg RF. Cancer Risks and Radiation Exposure From Computed Tomographic Scans: How Can We Be Sure That the Benefits Outweigh the Risks?. Arch Intern Med. 2009;169(22):2049-2050. doi:10.1001/archinternmed.2009.453.

Hara, A., & McCollough, C. (2013, May 31). Interview by Mayo Clinic. Mayo clinic experts provide some insight about radiation dose from ct imaging. Retrieved from http://www.news-medical.net/news/20130531/Mayo-Clinic-experts-provide-some-insight-about-radiation-dose-from-CT-imaging.aspx

Smith-Bindman, R., Lipson, J., Marcus, R., Kim, K., Mahesh, M., & Gould, R. (2009). Radiation dose associated with common computed tomography examinations and the associated lifetime attributable risk of cancer . Internal Medicine, 169(22), 2078-2086. doi: 10.1001/archinternmed.2009.427

Discussion Topic Week 5

For this post I am taking the role of a well-educated scientist at a biotech firm defending the use of genetically modified food (or GMO’s). 

First of all, it is important to understand what we mean by genetically modified food. In a strictly literal sense nearly all of our modern crops have been genetically modified over the centuries of farming to become what we now consider food. Through the basic technique of planting selected seeds from the best crops, we forever altered the natural progression of plant evolution. What we are discussing today, however, is selectively altering genes that would not happen naturally. We have come a long way from Mendel and his peas, and are now capable of inserting genes from other organisms that give us desired characteristics such as disease resistance, pest resistance, drought resistance, and increased nutritional value (James, 2012).

There are a few studies out there that show potential negative health effects of eating genetically modified foods. One study shows pigs that ate a diet of only GM food had a greater chance of stomach inflammation than pigs that ate a non GM food diet (Carman, Vlieger, Ver Steeg, Sneller, Robinson, Clinch-Jones, Haynes & Edwards, 2013). Another study looked at GM crops with genes that create toxins that make them resistant to insects and whether these toxins can be found in pregnant and non-pregnant women. The results showed that some of the women did show traces of the toxins (Aris & Leblanc, 2011). Even though these studies were done with relatively small sample sizes, their results should not be ignored. Globally, 75% of soybeans, 32% of corn, and 26% of canola is genetically modified (James, 2012). What this tells me as a scientist is that we need to have a more rigorous safety testing regiment for the foods we create. 

It also tells me that maybe we should be more creative with the genes we use. Instead of developing a corn that excretes pesticide, maybe we could develop a corn with a hard outer shell that insects cannot penetrate. Rather than have a soybean that excretes an herbicide, we could have it grow taller and with large flat leaves to block out the sun and prevent weeds from growing. There is a lot of room for innovation, and I believe the benefits will vastly outweigh any potential negatives that may exist. The population is growing and we need to be able to feed everyone in a cheap, sustainable way. At this point genetically modified foods show the most promise for being able to accomplish this goal.

References:

Carman, J., Vlieger, H., Ver Steeg, L., Sneller, V., Robinson, G., Clinch-Jones, C., Haynes, J., & Edwards, J. (2013). A long-term toxicology study on pigs fed a combined genetically modified (gm) soy and gm maize diet. Journal of Organic Systems, 8(1), 38-54. Retrieved from http://www.organic-systems.org/journal/81/8106.pdf

Aris, A., & Leblanc, S. (2011). Maternal and fetal exposure to pesticides associated to genetically modified foods in eastern townships of quebec, canada. Reproductive Toxicology, 31(4), 528-533. doi: 10.1016/j.reprotox.2011.02.004

James, C. (2012, 02 07). Isaaa brief 43-2011: Executive summary. Retrieved from http://www.isaaa.org/resources/publications/briefs/43/executivesummary/default.asp

Discussion Topic Week 4

The task for this assignment is to research the effects of disturbing or graphic images on cigarette boxes, and whether or not they are effective at reducing smoking. Currently in the U.S. smoking manufacturers are only required to put a small text based warning on the packages. Attempts by the FDA to require graphic images on cigarette boxes have been opposed by the cigarette companies, perhaps because they have seen the effects it has had in other countries. 

A study comparing Australia and Canada (countries that require graphic images) to the United States and the United Kingdom (which do not require graphic images) showed that the graphic warnings had greater impact on awareness and avoidance of cigarettes than the text only warnings (Borland, Wilson, Fong, Hammond, Cummings, Yong, Hosking & Hosking, 2009). Another study assessed the perceived value of a pack of cigarettes and found that the ones with graphic images were consistently valued less (Thrasher, Rousu, Anaya-Ocampo, Reynales-Shigametsu, Arillo-Santillan & Hernandez-Avila, 2007). The reasons these measures are significant are because they are indicators for quitting smoking in populations. So why hasn’t smoking cessation increased drastically in the countries that have graphic images on the boxes?

Some argue that the studies are flawed or that there is a psychological response that encourages people to continue smoking when faced with the disturbing images (Ruiter & Kok, 2005). I believe that the images do not go far enough, and that improvements could be made. I propose making changes to the texture of the box to affect more than just an emotional sense. If the box was very sticky, or slimy, people would be much less likely to carry them around. Some people enjoy the smell of tobacco so I propose making the boxes smell like rancid or rotting flesh, which would elicit a powerful sense of revulsion. Changing the color and shape of cigarettes could also have an effect, perhaps in the shape of a slug or some other repulsive creature. I hypothesize these changes would have a drastic impact on reducing the number of smokers, and more importantly reducing the number of new smokers. 

 

References:

Borland, R., Wilson, N., Fong, G., Hammond, D., Cummings, K., Yong, H., Hosking, W., & Hosking, W. (2009). Impact of graphic and text warnings on cigarette packs: findings from four countries over five years. Tobacco Control, 18(5), 358-364. doi: 10.1136/tc.2008.028043

Thrasher, J., Rousu, M., Anaya-Ocampo, R., Reynales-Shigametsu, L., Arillo-Santillan, E., & Hernandez-Avila, M. (2007). Estimating the impact of different cigarette package warning label policies: The auction method. Addictive Behaviors, 32(12), 2916-2925. Retrieved from http://www.sciencedirect.com/science/article/pii/S0306460307001682

Ruiter, R., & Kok, G. (2005). Saying is not (always) doing: cigarette warning labels are useless. European Journal of Public Health, 15(3), 329. doi: 10.1093/eurpub/cki095