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Health

The Five Most Promising Uses Of 3D Printing In Medicine

(Credit: Extreme Tech)

On Thursday, the Associated Press reported that doctors had, for the first time, used a 3D printer to create a life-saving artificial airway for a baby boy. The Ohio child was born with a birth defect that cause his airway to collapse, putting him at constant risk of suffocation — until doctors asked the U.S. Food and Drug Administration (FDA) for permission to print him a new one.

The FDA agreed, although it still hasn’t adopted an official policy on bioprinting body parts. But the agency will be forced to make a decision soon enough, as increasingly sophisticated 3D printers take the American field by storm. Here are five ways that 3D printers could be a game changer for U.S. health care:

1. Cutting down the backlogged kidney transplant list. 80 percent of the approximately 113,000 Americans on the organ transplant list need a new kidney — but only 30,000 transplants are performed in the U.S. each year, contributing to 4,000 annual kidney-related deaths. But with the use of “Bio-Ink” and 3D printers, that could all change. Researchers at the University of Iowa have been using a “bioprinter” to simulate living tissue structures. Dr. Ibrahim Ozbolat, who is heading the project predicts that fully formed, transplant-ready organs could be an impending reality. “The long-term goal of this [lab] is to create functioning human organs some five or 10 years from now. This is not far-fetched,” said Ozbolat.

2. Regulating diabetes by creating entirely new organs. As if creating organs from stem cells wasn’t enough, Dr. Ozbolat’s team has an even loftier goal in mind: the creation of entirely new organ structures to treat Americans’ medical problems. “One of the most promising research activities is bioprinting a glucose-sensitive pancreatic organ that can be grown in a lab and transplanted anywhere inside the body to regulate the glucose level of blood,” said Ozbolat of his goal. Considering the epidemic-level of diabetes in the United States — and the associated health care costs of the disease — that would be a true medical revolution, essentially nullifying the disease. And if Ozbolat’s team could create that kind of technology, it could potentially be modified to treat cancers and other chronic conditions.

3. Grafting skin onto burn victims. The current process of skin grafting requires the painful removal of skin from an unaffected area of the patient’s body. But researchers at the University of Toronto have developed a method of loading skin cells and various other polymers into a 3D printer to artificially create thick layers of skin. Strikingly, the team used a simplified 3D printer that costs far less than the average $200,000, and claim that their printer can produce tissue for 1/1000th of that cost “even by the most conservative estimates.”

4. Making prostheses resemble the original missing limb. This is a field in which there has already been significant progress with 3D printers — and garners major potential for patient satisfaction and quality of life. The trouble with many prostheses is that they wear down, don’t perfectly conform to patients’ limbs, and can present a stigma for patients who need them. But scientists at Bespoke Innovations have created prosthetic coverings “that perfectly mirror the sculptural symmetry and function of the wearer’s remaining limb,” and can even be customized to conform to the patient’s fashion style. Actually creating an entirely new limb would be ambitious — but considering that doctors recently replaced 75 percent of a man’s skull with a 3D-printed implant, that might not be out of the question, either.

5. Addressing poor Americans’ dental health needs. One aspect of U.S. health care that gets overlooked is the meager availability of dental coverage, especially for the poor. But the use of 3D printing in orthodontics could help change that by making dental procedures cheaper and more efficient — or at the very least could help rectify some the medical consequences of paltry dental coverage. A digital scan of the inside of a patient’s mouth and a 3D printer is all that’s needed to create crowns, bridges, and dentures. It also makes the process less invasive and more accurate by making it unnecessary to create physical molds of patients’ mouths.

Health

Students Allege Four Major Universities Violated Federal Sexual Assault Policy

(Credit: Where Is Your Line)

On Wednesday, students and alumni of Swarthmore College, the University of Southern California, the University of California, Berkeley, and Dartmouth College filed federal complaints against their respective schools for failing to adequately address sexual assault and harassment on campus. If found guilty by the Department of Education, the campuses could be subject to disciplinary actions, including fines and the loss of federal funding for student aid.

The complainants allege that the colleges have violated either the Clery Act, Title IX of the Education Amendments of 1972, or both. The Clery Act requires all campuses to report crime statistics, including for sexual assault, and Title IX prohibits sex-based discrimination at educational institutions.

“We are asking the Department of Education to open an investigation into these complaints and take appropriate actions to force these colleges to comply with the law or risk losing their federal funding,” said Gloria Allred, a civil rights attorney representing many of the plaintiffs.

A growing number of students at major colleges and universities have been stepping up their efforts to combat rape and sexual assault in schools. Last month, Los Angeles’ Occidental College was served with similar federal complaints. The University of North Carolina, Chapel Hill is undergoing a federal investigation for allegedly threatening to expel a student who spoke out publicly about her own rape.

Other elite institutions such as the University of Notre Dame, Harvard University, and Amherst College have also been in the news over complaints that administrators have failed to foster a safe campus environment and contributed to victim-blaming and rape culture. Just last week, Yale University was forced to pay a $165,000 fine after federal investigators determined that it had violated the Clery Act by failing to report instances of rape.

While some colleges have taken small steps towards improving their policies on sexual assault and campus safety, the latest round of federal complaints underscores how entrenched rape culture is in many American campuses.

Health

As Drug-Resistant Superbugs Continue To Spread, U.S. Taps Pharma Giant To Develop New Antibiotics

(Credit: How Stuff Works)

The U.S. government has tapped pharmaceutical giant GlaxoSmithKline to create new antibiotics meant to fight the rise of drug-resistant bacteria and safeguard against bioterrorism. The first-of-its kind public-private partnership could be worth up to $200 million when all is said and done.

The deal may raise some eyebrows considering GSK’s massive corporate resources and recent controversies surrounding the company’s marketing practices and safety procedures. Last year, GSK plead guilty to criminal charges for promoting off-label drug use and not reporting safety data for a popular diabetes medication. The British drug maker also paid $3 billion to the Justice Department in a fraud settlement.

But officials consider the unusual arrangement between GSK and the U.S. Biomedical Advanced Research and Development Authority (BARDA) necessary because pharmaceutical companies have few financial incentives to invest in antibiotic production:

The problem of antibiotic resistance and the rise of so-called “superbugs” that cannot be treated with traditional medicines has been growing for years, but drug companies have been reluctant to invest in new medicines because of poor returns.

Patients tend to take antibiotics for only a short period, prices are traditionally low and any new antibiotics are likely to be reserved for serious infections – once again minimizing the sales opportunity.

David Payne, head of GSK’s antibacterial discovery unit, said public-private partnerships, like the one with BARDA, were a key part to solving the problem.

The government’s decision reflects just how concerned public health officials are about the rise of so-called “superbugs” such as carbapenem-resistant Enterobacteriaceae (CRE). Some scientists predict that CRE alone could kill half of all people who contract it since it can withstand even the toughest antibiotics.

Professor Dame Sally Davies, England’s chief medical officer, has recently warned that without the production of effective new drugs to fight these types of bacteria, the human species could be looking at a world in which seven percent of all hospital admissions stem from a drug-resistant infection — a problem that she has compared to global warming in its scope and potential to undermine worldwide health. “It’s a ticking time bomb,” she told England’s The Independent.

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Health

STUDY: People Eat Bigger Portion Sizes When The Food Is Labeled ‘Healthy’

(Credit: FoodMag)

People assume they can eat larger portion sizes of foods labeled “healthy,” even when those foods actually have the same amount of calories as the “non-healthy” versions, according to the results from a new study. The research project was an attempt to assess whether food companies’ marketing efforts to brand their products as healthier have an impact on consumer choices.

Researchers asked 186 adults to determine the appropriate portion sizes of both “healthy” and regular brands of different foods. The participants tended to serve themselves larger portions of the “healthy” food, and they also tended to underestimate the amount of calories that were actually in it. The study’s researchers attribute these behaviors to the effective marketing strategies that the food industry uses to convince people that even processed foods aren’t so bad if they’re being touted as healthier options:

“People think (healthier food) is lower in calories,” said Pierre Chandon, a marketing professor at the INSEAD Social Science Research Center in France, and they “tend to consume more of it.”

That misconception can lead to people eating larger portion sizes of so-called healthy foods, and therefore more calories.

“Foods are marketed as being healthier for a reason, because food producers believe, and they correctly believe, that those labels will influence us to eat their products and perhaps eat more of their products,” said Dr. Cliodhna Foley Nolan, the director of Human Health and Nutrition at Safefood, a government agency in Ireland.

The new study builds upon previous research that found that green labeling is “coded” as healthier — so when a product is marketed in green packaging, Americans tend to assume it has fewer calories, even if it’s a product like a candy bar.

As Americans continue to grapple with an ongoing obesity epidemic, fast food companies in the United States have attempted to use these type of marketing tactics in order to rebrand themselves as healthier choices Popular chains like McDonald’s, Panda Express, Taco Bell, and Coca-Cola have all attempted to improve their national image by offering up “healthy” options — even though they haven’t actually changed much about the actual nutritional content of their products.

Health

How Sexual Stigma Is Undermining HIV Treatment On American Indian Reservations

(Credit: Navajo AIDS Network)

A Navajo reservation on the Arizona-New Mexico border has seen its HIV diagnoses go up by 20 percent since 2011. Despite a concerted push by the federal Indian Health Service (IHS) and public health advocates to expand tribal HIV education programs, doctors have found treatment and prevention efforts to be stymied by cultural stigma surrounding the disease and homosexuality.

Since the Navajo tribe is a comparatively isolated population, the topline numbers of HIV infections among tribe members are relatively low, and at least part of the rise is attributable to enhanced screening efforts. However, that same seclusion allows stigma and the fear of community repercussion to prevent infected Navajo men from seeking care once they are diagnosed. “Our communities are very small, and that can lead to people avoiding stigma, rather than getting the care they need,” IHS chief medical officer Dr. Susan V. Karol told the New York Times.

In turn, that stigma can prevent tribe members from even discussing the disease and their various treatment and prevention options:

Melvin Harrison, the executive director of the Navajo AIDS Network, which provides services for tribal members with H.I.V., said that of the 65 people his group treats, a majority have not told family or friends.

“That’s how big the stigma is here,” he said. “They are afraid of rejection.” [...]

One Navajo man, who contracted H.I.V. from his partner in 2001, recalled how his mother refused to hug him and served him food on plastic plates when she found out he was infected. [...]

[The] man has not told his three brothers that he has H.I.V. because he fears they will shun him. “I don’t think I’ll ever tell them,” he said. “I don’t want to be pushed out of their lives.”

This dynamic devolves further due to the added stigma regarding homosexuality in the tribe. The IHS estimates that men who have sex with men (MSM) accounted for accounted for nearly half of the new cases since 2011, and 75 percent of the Navajo AIDS Network’s clients are closeted homosexual men.

But this tendency to sweep HIV infection under the rug presents a major barrier to an effective treatment regimen. Family and community awareness of the disease is an important tool for making sure that HIV-positive men are following through on their medications and checkups. Conversely, the desire to keep a diagnosis secret can create tensions in tribal doctor-patient relationships and contribute to treatment noncompliance. Teen mothers and mentally ill Americans have faced similar stigma, and have either forgone care or been denied access to adequate medical and social resources as a consequence.

For the Navajo community in particular, overcoming these archaic cultural mores is literally a matter of life and death. Although the medical reason for it remains ambiguous, researchers note that Native Indians diagnosed with HIV and AIDS have a lower chance of survival compared to other racial groups.

Health

Thanks To Debunked Anti-Vaccine Study, U.K. Sees Dramatic Surge In Measles Cases

(Credit: Pak Med)

U.K. public health officials are racing to contain a rash of measles outbreaks among older British children that threatens to spread the highly contagious disease throughout the country. The budding epidemic has been linked to a debunked 1998 anti-vaccine study that caused U.K. vaccination rates against measles to plummet.

In 1998, a team of British scientists led by Dr. Andrew Wakefield published a widely rebuked paper that incorrectly linked the measles, mumps, and rubella (MMR) vaccine with autism. The study, which received widespread attention at the time, led many British parents to forgo their children’s MMR shots — something that is possible in the U.K. since schoolchildren aren’t subject to mandatory vaccination laws as they are in the United States.

The vaccine exodus led to a sharp decline in MMR immunization — from 90 percent of all children to just 54 percent in a year — and its consequences are now coming into full view, as unvaccinated British teenagers spread measles by the thousands:

This year, the U.K. has had more than 1,200 cases of measles, after a record number of nearly 2,000 cases last year. The country once recorded only several dozen cases every year. It now ranks second in Europe, behind only Romania.

The majority of those getting sick in the U.K. — including a significant number of older children and teens — had never been vaccinated. [...]

Across the U.K., about 90 percent of children under 5 are vaccinated against measles and have received the necessary two doses of the vaccine. But among children now aged 10 to 16, the vaccination rate is slightly below 50 percent in some regions.

To stop measles outbreaks, more than 95 percent of children need to be fully immunized. In some parts of the U.K., the rate is still below 80 percent.

By contrast, the U.S. — where measles immunization rates are above 90 percent — reported just 55 cases of measles last year.

Still, Americans tend not to get their vaccinations if they can help it. While U.S. school attendance is generally contingent on a variety of shots for highly contagious diseases, others such as the yearly influenza shot and HPV vaccine aren’t, leading the Centers for Disease Control (CDC) to call American immunization numbers “unacceptably low.” Politicians and public officials who parrot discredited conspiracy theories similar to the Wakefield study contribute to that trend.

Health

Too Often, Teen Mothers Receive Shame Instead Of Support

(Credit: Pacific Standard Magazine)

This week, news broke that a Michigan school district is barring two teens from displaying their pregnant bellies in their school yearbook. The school district’s superintendent explained that depicting images of teen pregnancy in the yearbook goes against the school’s mission of “promoting abstinence.” One of the pregnant teens said she “went to the bathroom and cried” upon hearing the news.

Aside from the ironic fact that teens who receive abstinence-only education are actually more likely to become pregnant than the students who receive accurate sexual health information about prevention methods, the situation in Michigan also illustrates the pervasive negativity that Americans associate with teenage pregnancies. That attitude ultimately creates a environment that punishes, stigmatizes, and shames young mothers — many of whom are subject to much larger structural issues that are out of their control, like the type of sex education they received in school or the level of poverty they were born into.

Unfortunately, the situation in Michigan is hardly the only example of this dynamic in play. Here are five other instances of teen moms being shamed instead of supported:

1. A North Carolina high schooler’s photo won’t appear in her yearbook because she posed with her newborn son. One teen mom in North Carolina can relate all too well to the pregnant students in Michigan. After posing for a photo with her baby son, she was told that the picture wouldn’t be allowed to appear in the yearbook this year. The school claimed that the image would “promote teen pregnancy” and told the student she had two days to submit a different photo without her son. She declined, saying, “If he wasn’t going to be in it with me, I didn’t want be in it at all.”

2. One Louisiana high school banned pregnant teens from attending classes on campus altogether. Last year, a charter school in Louisiana received significant backlash for its policy forbidding pregnant students from remaining on campus. According to the school handbook, pregnant students were required to either switch to another school or begin a home school program — and if the school “suspected” a girl of being pregnant, administrators could force her to take a pregnancy test to find out for sure. After the ACLU stepped in to file a formal discrimination complaint, the Louisiana Department of Education ordered the school to drop its policy.

3. A celebrity-studded national campaign tells teens that being a mother is incompatible with being successful. Public service campaigns that stigmatize young parents are all too common. Teens are often bombarded with negative messages intended to dissuade them from having a baby at a young age — but instead of focusing on effective information about tools to prevent pregnancy, like information about where to access affordable birth control or other family planning support, these ads simply focus on how teen mothers’ lives are ruined. Many of them also have the added effect of dismissing parenthood altogether. A recent campaign from the Candie’s Foundation depicts celebrity’s faces alongside these messages, including Carly Rae Jepson proclaiming that being a mother prevents women from achieving great things:

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Health

Obama Administration Sets Strict New Safety Rules To Prevent Child Care Deaths

(Credit: Morrow County Child Care)

The Obama Administration took a big step on Thursday to ensure that kids in child care are safe. Speaking before a D.C.-area day care, Health and Human Services (HHS) Secretary Kathleen Sebelius announced strict new regulatory rules — the first in 15 years — for child care facilities across the nation.

The newly announced regulations will apply to any child care center or family home that receives federal funding through HHS’s Child Care and Development Fund. Among the expanded rules are universal background checks and fingerprinting for child care workers, mandatory CPR and first aid training for such employees, and “safe sleeping practices” to prevent accidental suffocation deaths. “We frankly can’t wait any longer,” said Sebelius of the regulations.

Administration officials and child safety advocates hope that the requirements will put a dent in the depressingly high number of young children who die as a consequence of negligent care and unsafe practices. For instance, three-month-old baby boy Dane died after a child care worker “put him face-down on a blanket and left him for an hour” — just one example of a child death that the new rules’ safe sleeping component might have prevented.

Federal rules governing these care facilities are currently limited to preventing infectious epidemics and making sure that buildings meet fire safety codes. For the most part, states are left to their own discretion in coming up with more expansive regulations — making the new federal standards particularly significant.

However, the new requirements only apply to the 513,000 child care centers that receive federal money. That means that thousands of other facilities that care for children will still answer to watered-down rules that are left up to the states — and considering how lax some states’ standards are, that’s a big problem.

In a 2010 report, the child safety organization Child Care Aware of America found that nine states scored zero points on their child care safety score sheet. Some of these states, including Iowa, Idaho, and Virginia, require a child care facility to serve seven or more children before requiring state licensing or inspections; eight other states, including Texas, West Virginia, Pennsylvania, Michigan, and South Carolina, do not require a facility inspection or even an on-site visit before issuing a child care license; and Louisiana and New Jersey don’t require any child care facilities to receive a state license at all. “Unfortunately, in too many cases, it takes well-publicized deaths in child-care settings to prompt state action to strengthen their licensing standards to better address children’s safety,” an HHS official told the Washington Post.

While child care advocates are encouraged by the new federal rules, many still acknowledge that real reform requires congressional action, as well as more funding for the federal Child Care and Development Fund. The Fund was last reauthorized by Congress in 1996.

Health

Americans Who Battle Cancer Are Twice As Likely To Go Bankrupt, Even If They Have Health Insurance

Cancer patients are much more likely to go bankrupt than Americans who aren’t faced with a cancer diagnosis, a new study finds. Even the Americans who have access to health insurance aren’t necessarily safe from bankruptcy, since the high cost of treating cancer can still put an untenable strain their finances.

A team of researchers in Washington state collected data from nearly 400,000 adults, evenly split between those who had been treated for cancer and those who were cancer-free. After checking to see which of those adults had filed for bankruptcy between 1995 and 2009, the researchers found that cancer patients were 2.5 times as likely to go bankrupt in that period.

Although the study didn’t specifically look at insurance coverage, previous research has demonstrated that the Americans who cite major health issues as the reason they filed for bankruptcy are actually often insured. One 2006 study found that more than 60 percent of bankruptcies in the United States are due to high medical bills, and in those cases, three-quarters of those Americans had insurance when they got sick. NBC News interviewed one cancer patient who found herself in this situation, even though she was employed and insured when she first got her diagnosis:

That rings true for Janet Literski, 57, who had purchased health insurance as an independent contractor working in sales. When she was diagnosed with non-Hodgkin’s lymphoma in 2008 Literski discovered her insurance covered only part of her surgical costs and none of her diagnostic tests. Then there were co-payments and deductibles. By the time she was diagnosed with pancreatic cancer two years later, she was about $150,000 in medical debt.

In 2011, no longer able to work, Literski and her disabled husband filed for bankruptcy. “It was a gut wrenching decision because you feel like a personal failure, and that makes me angry because I had tried to do everything right,” Literski says. “I had health insurance, I was working.”

Literski is now covered by Medicaid and receives disability payments and though she hasn’t been told she’s in remission, she says she is “healthy enough.”

[The study's lead author, Dr. Scott Ramsey,] says cancer centers need to do a better job of assessing each patient’s financial status, offering credit counseling, and managing patient care.

Even bigger disparities emerged when the researchers broke down the cancer patients in their study by different demographics. The younger groups were up to 10 times more likely to go broke than the older patients, and non-white women were the most likely to run out of money.The cancer that is associated with the highest risk of bankruptcy is thyroid cancer — likely because that disease mostly affects younger women. On the other hand, older men with prostate cancer are the least likely to reach financial rock bottom.

Ramsey and his researchers first presented their research in 2011, and their final findings were published in the Health Affairs journal this week. The timing of the study’s release coincides with some recent pressure to help lower the cost of cancer drugs. Last month, a group of over 100 doctors criticized Big Pharma companies for making “life-saving” cancer drugs too expensive for Americans to afford. The doctors asserted that the “unsustainable drug prices” were “causing harm to patients,” and urged reforms in this area to ensure that cancer patients don’t have to go without the treatment they need.

Cancer patients have also been recently caught up in the budget battles resulting from sequestration. At the end of April, cancer clinics blasted Congress for taking legislative action to restore the sequester cuts that were causing airport delays rather than working to address the cuts that are undermining Americans’ chemotherapy treatment. As a result of the automatic budget cuts, some Americans are being forced to delay their chemotherapy, and some cancer clinics may even be forced to close their doors.

Health

Why Doctors Are Wrong To Oppose More Authority For Nurses

(Credit: The Telegraph)

Doctors are reluctant to give nurses more authority to treat patients, according to findings in a New England Journal of Medicine study released on Wednesday. But doctors’ skepticism about nurses having expanded roles isn’t based on the facts — and it ignores the reality that nurse practitioners must take on such responsibilities if health care reform is to succeed.

The new study finds that many doctors don’t trust nurses to lead patient-centered “medical homes,” with only 17 percent of surveyed primary care physicians viewing it positively. “Medical homes” are arrangements encouraged by Obamacare in which nurses, doctors, pharmacists, and specialists work together to provide patients with better and more efficient care in a unified setting.

There is also a striking chasm between doctors and nurses on the issue of nurse practitioners’ ability to provide safe, quality patient care:

When researchers asked whether they felt the quality of care provided by physicians in exams and consultations was higher than that provided by nurse practitioners, more than 66 percent of doctors agreed, while 75 percent of nurses disagreed.

Doctors also overwhelmingly disagreed with many nurses’ position that they should receive the same level of pay as doctors for performing similar services.

But this position is an untenable one in the era of Obamacare, with more than 25 million Americans expected to gain health coverage in the coming decade. Since the bulk of these Americans are expected to consume primary care — rather than specialty — services, it’s important that the U.S. medical system have enough medical workers to serve them. And there simply aren’t enough primary care doctors to tackle that burden on their own.

Instead, nurse practitioners will have to take on additional responsibilities. There’s no reason to suspect that this will compromise patient care quality — in fact, multiple studies have shown that the quality of care that nurse practitioners provide for acute primary care is on par with doctors. One randomized trial comparing nurses’ versus doctors’ ability to manage complex care regimens for HIV-positive patients receiving antiretroviral therapy also found no evidence of professional inferiority. As David Hebert, CEO of the American Association of Nurse Practitioners, told Kaiser Health News, “[N]urse practitioners have been practicing safely and providing great outcomes for decades.”

Doctors — and patients — would be well served by an expanded role for nurse practitioners. Primary care doctors tend to be concentrated in urban areas, creating a major barrier to rural and isolated communities’ access to basic medical services. But nurses are more numerous and could have greater access to such populations, making them ideal candidates for heading medical homes and seeing to the day-to-day aspects of patient care.

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